Botanical Toxicity & Safety High-Yield Flashcards

Clinical Sciences

Which herbs are considered the most toxic and should never be used?

Sanguinaria canadensis, Digitalis purpurea, Rauvolfia serpentina, Veratrum album, Vinca spp, Viscum album, Aconitum napellus, Atropa belladonna, Datura stramonium, Gelsemium sempervirens, Hyoscyamus niger, Papaver somniferum.

What is the mnemonic for recognizing highly toxic herbs?

'Some Deadly Reapers Visit Villages Violently, Attacking All Defenseless Groups. Hide Properly!'

Which chemical constituent group is most associated with hepatotoxicity?

Unsaturated Pyrrolizidine Alkaloids (PA) found in Cineraria maritima and Symphytum officinale.

What are common symptoms of tropane alkaloid toxicity?

Dry mouth, tachycardia, confusion, hallucinations, convulsions, respiratory depression, and death.

What herbs contain thujone and are contraindicated in pregnancy?

Juniperus communis, Tanacetum vulgare, Artemisia absinthium, Thuja occidentalis, Achillea millefolium, Salvia officinalis.

What is the mechanism of action of thujone toxicity?

GABA receptor antagonist that may cause convulsions, muscle spasms, anxiety.

What are the dosing categories for tinctures?

Weak: >12 mL/day, Standard: 6-12 mL/day, Strong: 3-6 mL/day, Very Strong: <3 mL/day, Drop dosing: <1 mL/day.

What herbs should never be used internally due to PA toxicity?

Cineraria maritima, Symphytum officinale.

What are the safe herbs for pregnancy?

Echinacea, Garlic (Allium sativum), Turmeric (Curcuma longa), Chamomile (Matricaria recutita), Red Raspberry Leaf, Ginger, Cranberry, Goldenrod, Cornsilk, Eupatorium purpureum, Equisetum arvense.

Which herb induces CYP3A4 and reduces drug availability?

Hypericum perforatum (St. John's Wort).

What are the drug interaction risks of Glycyrrhiza glabra (Licorice)?

May worsen potassium depletion, interact with cardiac glycosides, and potentiate corticosteroids.

What herb component can cause serotonin syndrome when combined with SSRIs?

Hypericum perforatum (St. Johns Wort).

What are the risks of combining herbs with similar actions?

Additive toxicity, e.g., combining sedatives or hypoglycemics can increase risk of side effects or toxicity.

Which herbs reduce drug absorption due to high mucilage content?

Althea officinalis (Marshmallow), Plantago spp (Plantain), Ulmus spp (Slippery Elm), Tussilago farfara (Coltsfoot).

Which mushroom can cause 'Shiitake dermatitis'?

Lentinus edodes (Shiitake) - caused by raw consumption, self-resolving rash.

What is the mnemonic for thujone-containing herbs?

'J TATAS': Juniperus, Tanacetum, Artemisia, Thuja, Achillea, Salvia.

What is the risk of combining herbal blood thinners with anticoagulant drugs?

Serious bleeding risk - herbs like garlic, turmeric, and ginkgo may potentiate warfarin and others.

Name one herb that reduces sugar cravings and supports glucose regulation.

Gymnema sylvestre.

What is a potential consequence of long-term use of berberine-containing herbs in children?

Risk of kernicterus due to displacement of bilirubin from albumin.

Which alkaloid-rich herbs are commonly associated with CNS and cardiovascular toxicity?

Atropa belladonna, Datura stramonium, Hyoscyamus niger, Aconitum napellus, Gelsemium sempervirens, Rauvolfia serpentina.