Pharmacology Final

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Pharmacology Final
2011-05-02 00:11:38
Dietary Herbal III

Dietary and Herbal III
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  1. active ingredient in st. john's wort
    • hypericin
    • hyperforin
  2. Pharmacologic effects of hypericin
    monoamine oxidase a and b inhibitor
  3. MAO-A deaminates
    • serotonin
    • melatonin
    • epinephrine
    • norepinephrine
    • dopamine
  4. MAO-B deaminates
    • phenylethylamine
    • dopamine
  5. invitro studies of hydroalcoholic extract have shown
    inhibition of serotonin, NE and DA reuptake
  6. Chronic administration of st. john's wort has shown ____ in mice
    • down regulation of cortical adrenoreceptors
    • up regulation of 5ht2 receptors
    • reduction of interleukin 6 production
  7. a randomized trial comparing citalopram 20mg to st. john's wort 900mg showed
    equivalence in reducing symptoms of moderate to severe depression over 6 weeks.
  8. Antiviral and anti-carcinogenic effects of SJW
    hypericin is photolabile, when activated it inhibits enveloped and non-enveloped viruses as well as growth of some neoplastic tissues
  9. ADEs with st. johns wort
  10. Drug interactions with SJW
    • antidepressants = additive effects
    • may induce cyp450 => numerous interactions
    • induction of p-glycoprotein drug transporter
  11. most common formulation of SJW
    dried hydroaclcoholic extract
  12. onset of action with SJW
    2-4 weeks
  13. Coenzyme Q10
    potent antioxidant used for hypertension and prevention of statin-induced myopathy
  14. effects of coenzyme q10 on coronary artery disease and chronic stable angina
    modest but appear promising
  15. ADEs with coenzyme q10
    • rarely has any ADEs even at high doses
    • GI upset/diarrhea/nausea/heartburn and anorexia in <1%.
    • maculopapular rash and thrombocytopenia are rare
    • irritability, dizziness, headache
  16. Drug interactions with CoQ10
    structural similarity to vitamin K which decreases effectiveness of warfarin
  17. Glucosamine uses
    pain associated with knee osteoarthritis
  18. Available forms of glucosamine
    • sulfate and hydrochloride
    • hydrochloride is ineffective
  19. Endogenous glucosamine is used for
    production of glycosaminoglycans and other proteoglycans in cartilage
  20. Studies with glucosamine
    have shown improvements in pt with osteoarthritis
  21. ADEs with glucosamine
    • very well tolerated
    • mild diarrhea and nausea
    • may cause allergy in people with shellfish allergies
  22. Drug interactions with glucosamine
    may increase the INR in patients taking warfarin resulting in increased risk of bruising or bleeding
  23. Results when taking glucosamine
    • may take 1-2 months
    • no direct analgesic effects
  24. Melatonin
    • serotonin derivative produced by the pineal gland
    • regulation of sleep wake cycle
    • release coincides with darkness (9pm-4am)
    • release is suppressed by daylight
  25. Other uses studied for melatonin
    • contraception
    • protection against oxidants
    • prevention of aging
    • treatment of depression
    • HIV
    • cancer
  26. Current uses of melatonin
    prevention of jet lag and induction of sleep
  27. sleep maintenance insomnia
    • pt older than 65 who have low melatonin levels
    • treatable with melatonin sustained release
  28. Melatonin receptors have been identified in
    • granulosa cell membranes in the female reproductive tract
    • associated with midcycle suppression of LH
    • may result in partial inhibition of ovulation
  29. melatonin may be used with _____ days 1-21 of the menstrual cycle to lower LH levels
  30. melatonin in men
    • decreased sperm quality
    • possibly due to aromatase inhibition
  31. ADEs with melatonin
    • next day drowsiness
    • changes in BP
  32. Drug interactions with melatonin
    • concentrations of melatonin are altered with NSAIDs, antidepressants, adrenoreceptor agonists/antagonists, scopolamine and sodium valproate
    • increases effects of nifedipine
  33. Melatonin is metabolized by ____ and may interact with ____.
    • CYP 1A2
    • fluvoxamine
  34. Melatonin for jet lag
    • take on the evening of departure and for 1-3 nights after arrival in new time zone
    • exposure to daylight is also important