RH Herb Safety & Contraindications 4

Question 1

Which herbs are most commonly implicated in herb-induced liver injury (HILI) and require monitoring in patients with hepatic disease?

Accepted Answer

Kava and comfrey

Answer

Kava (Piper methysticum) and comfrey (Symphytum spp.) are among the most well-documented hepatotoxic herbs, and their use is contraindicated in patients with pre-existing liver disease.

Question 2

Aristolochic acid-containing herbs are contraindicated primarily due to their risk of causing:

Accepted Answer

Nephropathy and urothelial carcinoma

Answer

Aristolochic acids found in Aristolochia species cause aristolochic acid nephropathy (AAN), progressive renal failure, and significantly increase risk of urothelial cancer.

Question 3

A patient with gallstones asks about using turmeric in medicinal doses. The key contraindication concern is:

Accepted Answer

It may trigger biliary colic by stimulating bile flow

Answer

Turmeric and curcumin are cholagogues that stimulate bile flow, which may trigger biliary colic or obstruction in patients with gallstones.

Question 4

Which herb is contraindicated in patients with kidney disease because it contains oxalates and can exacerbate oxalate kidney stones?

Accepted Answer

Wood sorrel / high-oxalate herbs

Answer

High-oxalate herbs such as wood sorrel (Oxalis spp.) and large amounts of spinach-family plants can contribute to calcium oxalate kidney stone formation and are avoided in at-risk patients.

Question 5

Ephedra (Ma Huang) is contraindicated in patients with cardiovascular disease primarily because it:

Accepted Answer

Stimulates adrenergic receptors raising heart rate and blood pressure

Answer

Ephedrine in Ephedra acts on alpha and beta adrenergic receptors, causing vasoconstriction, tachycardia, and hypertension, which are dangerous in cardiovascular patients.

(RH) Registered Herbalist Practice Test

(RH) Registered Herbalist Practice Test

RH Herb Safety & Contraindications 4