RH Herb Safety & Contraindications 2

Question 1

Which herb is most known for inducing CYP3A4 enzymes and reducing blood levels of many pharmaceutical drugs?

Accepted Answer

St. John's Wort

Answer

St. John's Wort (Hypericum perforatum) is a potent inducer of CYP3A4 and P-glycoprotein, significantly reducing plasma levels of drugs like cyclosporine, antiretrovirals, and oral contraceptives.

Question 2

A patient taking warfarin asks about using Ginkgo biloba. The primary safety concern is:

Accepted Answer

Increased bleeding risk

Answer

Ginkgo biloba has antiplatelet and mild anticoagulant properties that can potentiate warfarin, significantly increasing bleeding risk.

Question 3

Which herb is contraindicated in patients with autoimmune diseases such as lupus or multiple sclerosis?

Accepted Answer

Echinacea

Answer

Echinacea stimulates immune function and is contraindicated in autoimmune conditions where immune upregulation could worsen symptoms.

Question 4

Licorice root (Glycyrrhiza glabra) is contraindicated in patients with which condition due to pseudohyperaldosteronism?

Accepted Answer

Hypertension

Answer

Glycyrrhizin in licorice inhibits 11-beta-HSD, causing sodium retention and potassium loss, which raises blood pressure and is dangerous in hypertensive patients.

Question 5

Which herb's volatile oils can cause liver toxicity and are contraindicated in patients with hepatic disease?

Accepted Answer

Peppermint oil (high dose)

Answer

High doses of peppermint oil can cause hepatotoxicity due to pulegone metabolites, and it is used with caution in patients with existing liver conditions.

(RH) Registered Herbalist Practice Test

(RH) Registered Herbalist Practice Test

RH Herb Safety & Contraindications 2