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Pharmacology Final
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Placebo effect with herbal supplements can contribute up to ____ % of the observed response
30-50%
All statements reguarding positive benefits of herbal supplements should be reguarded as ___ and safety should be considered ___.
preliminary
tenative
In charge of proving supplements to be un-safe
FDA
dietary supplements
plant based substances and synthetic purified chemicals
3 most widely used species of echinacea
purpurea
pallida
angustifolia
chemical constituents of echinacea
flavonoids
lipophilic constituents
water soluble polysaccharides
water soluble caffeoyl conjugates
Most widely studied echinecia species
purpurea
chicoric acid, alkamides and polysaccharides are most often noted as having
immune modulating properties
Human studies using E purpurea have shown
increased phagocytosis
increased WBC
increased monocytes & neutrophils
increased NK cells
in vitro e purpurea increased production of
interleukins 1, 6 & 10
tumor necrosis factor alpha
Isolated purified polysaccharides from E purpurea have shown
cytokin activation
E purpura extract shows _____ in all cell lines
enhanced natural killer cell activitity
Certain echinacea constituents have demonstrated anti-inflammatory properties invitro via inhibition of
cyclooxygenase
5-lipoxygenase
hyaluronidase
Randomized controlled clinical trials involving echinacea for wound healing
have not been performed in humans
echinacea is most often used in individuals who have
colds and other respiratory tract infections
Meta analysis of 14 randomized trials for echinacea for cold treatment or prevention
decreased odds of developing clear signs and symptoms of a cold by 58%
decreased symptom duration by 1.25 days
Echinacea has been used investigationally to enhance
hematologic recovery following chemo
echinacea also used as an ajunct treatment of
UTI and vaginal fungal infections
E. purpurea is ineffective in treating
recurrent genital herpes
ADEs with echinacea
Flu like sympotms with IV use
GI upset or rash(5%) with oral use
Echinacea should be avoided in these pts
immune deficiency
autoimmune disorders (MS, RA)
tuberculosis
Echinacea should not be used with
medications known to cause a disulfiram like reaction
echinacea has a high alcohol content
pt. taking immunosuppresant drugs
Echinacea should not be used as a preventative agent longer than
10-14 days
Vipers/pit vipers
rattlesnakes
copperhead
water moccasin
Elapids
coral snake
arizona coral snake
Pit viper venom (crotalid)
hemovenom
marked tissue destruction
hemolysis
coral snake venom (micrurus)
neurotoxic
non-depolarizing muscle blockade
onset may be delayed up to 12 hours
Signs of crotalid bite
swelling
pain
perioral numbness
dizziness
ecchymosis
decreased platelet activity
hypotension/shock
Micrurus symptoms
sialorrhea
ptosis
dysphagia
local paresthesias
tremor
respiratory distress
Snakebite treatment
relax to reduce venom flow
ice (do not freeze tissue)
NPO for 24 hours after bite
crotalid polyvalent immune Fab - no skin test
maintain airway
sedation
anti-infectives
Micrurus treatment
anivenin micrurus fulvius
requires skin test
Maintain airways with
beta agonists
sedation and pain releif with pit vipers
no non-steroidals, meperidine or morphine
use APAP
sedation with Coral snake bites
no sedation because of neurotoxicity
APAP for pain
Other drugs to avoid with snake bites
steroids - dampens immune response
heparin
Venomous insect treatment
Ice or cold compress
remove stinger
monitor for anaphylaxis
local anesthetic
watch for 2' infection
poisonous spiders
latrodectus mactans - black widow
loxosceles reclusa - brown recluse
Black widow symptoms
no local reaction
cramping in large muscle groups
fasciculations/sweating
ptosis
seizures in children
HTN in elderly
Black widow toxin
alpha latrotoxin
opens Ca2+ channels allowing calcium movement into cells
Black widow treatment
clean site/tetanus
ice
latrodectus antivenin
calcium gluconate IV for muscle contractions
methocarbamol/diazepam
Brown recluse toxins
sphingomyelinase D
Dermanecrosis factors 33 and 37
phospholipase
protease
esterase
collagenase/hyaluronidase
DNAase/RNAase
Extensive tissue damage at site of brown recluse bite usually due to
sphingomyelinase D
demanecrosis factor 33 and 37
Brown recluse symptoms
burning/pruritis
bull's eye lesion
fever
vesicle formation
necrosis
brown recluse treatment
ice
corticosteroids
dapsone
anti-infectives prn
scorpion bite symptoms
pain at sting site
nystagmus
tachycardia/HTN
fasciculations/ataxia
respiratory distress
seizures
scorpion sting therapy
ice for 2 hours only
topical anesthetic/antibiotic
establish airway
betablockers
benzodiazepines
centruroides antivenin
Author
Rx2013
ID
82334
Card Set
Pharmacology Final
Description
Dietary and Herbal 1
Updated
2011-04-28T00:35:50Z
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