Добавил:

Sekretar kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.

Вуз:

Ростовский Государственный Медицинский Университет

Предмет:

Медицина общая

Файл:

Книга_35_библиотеки_им_акад_М_И_Перельмана

.pdf

Скачиваний:

Добавлен:

02.09.2026

Размер:

19 Мб

Скачать

☆

<<< < Предыдущая 1 2 3 4 5 6 7 8 9 1011 / 4711 12 13 14 15 16 17 18 19 20 21 22 23 24 25 > Следующая >>>

10 Herbal Substances that Aect Hemostasis

https://t.me/medicina_free

Herbs andHerbal Extracts

most commonly utilized herbs do not appear to result in a bleeding diathesis and are excluded from this discussion.

Due to the global diversity of plants and the propensity of humans in different cultures to explore the possible uses of these plants, there are a very large number of herbs utilized

The following selected herbal preparations were chosen for discussion based on both their propensity to cause bleeding and their popular use (Table10.2).

for a variety of medicinal purposes. At present, many of the

Table 10.2 Herbal supplements, multivitamin and non-herbal vitamin supplements

Herbal supplements

Supplement Marketed uses/Effects Andrographis

Andrographis paniculata

Ashwagandha

Withania somnifera

Boswellia

Boswellia serrata

Bromelain Bromeliaceae spp.

Cannabinoids Cannabis spp.

Cranberry

Vaccinium macrocarpon

Danshen

Salvia miltiorrhiza

Devil’s Claw

Harpagophytum procumbens

Dong Quai

Angelicae sinensis

Evening Primrose Oil

Oenothera biennis

Fenugreek

Trigonella foenum-graecum

Feverfew

Tanacetum parthenium

Garlic

Allium sativum

Ginger

Zingiber ofcinale

Ginkgo

Ginkgo biloba

Ginseng Panax spp.

Immunostimulatory, antiviral, antibacterial, anti-inammatory, antitumor, antidiabetic, antimalarial, hepatoprotective, cardiovascular disease, infertility Anti-arthritic, antirheumatic, anti-inammatory Inhibition of platelet

Osteoarthritis, rheumatoid arthritis, inammatory bowel disease, asthma Anti-edema, anti-inammatory, antithrombotic, brinolytic

Multiple sclerosis, chronic pain, nausea/vomiting, others

Improve urinary tract infection, metabolic prole, antioxidant

Atherosclerosis, hypercholesterolemia, arthritis, insomnia, menstrual disorders

Analgesic, antipyretic COX-1 and COX-2 inhibition –

Menstrual cramping, menstrual regulation, migraine, antispasmodic Anti-inammatory, women’s health conditions Antiplatelet effects, coumarin

Increase milk production, antidiabetes, anticancer, anticholesterol, antioxidant, anti-inammatory, antimicrobial, hepato- and neuro-protective Fever, migraine, rheumatoid arthritis, menstrual problems

Atherosclerosis, hypertension, thrombus formation, and lower serum lipid and cholesterol levels

Arthritis, rheumatism, muscular aches, pains, sore throats, cramps, constipation, indigestion, nausea, vomiting, motion sickness, hypertension, dementia, fever, infectious diseases, helminthiasis Cognitive disorders, peripheral vascular disease, erectile dysfunction Improve energy and alertness, aphrodisiac, diabetic blood sugar control

Anticoagulant/Antiplatelet effect

Inhibits PAF-induced platelet aggregation

aggregation Prolongs PT and aPTT, inhibition of Factor Xa and XIa Inhibition of ADP-induced platelet aggregation, reduced platelet endothelial adhesion, prolongs PT and PTT CBN and THC inhibit thrombin-induced clot formation, prolong clotting times Component compounds inhibit platelets, no data supporting cranberry juice itself inhibiting platelets Inhibits ADP-induced platelet aggregation, thrombosis formation

Inhibits platelet aggregation May potentiate warfarin

constituents Contains Vitamin K antagonist coumarins

Reduced ADP-induced platelet aggregation, decreased COX production Inhibit platelet aggregation invivo in dose-dependent fashion

Inhibit AA-induced human platelet serotonin release and aggregation

Inhibition of PAF-induced platelet aggregation Inhibits invitro thromboxane synthesis, increased blood clotting time, PAF inhibition

Drug interactions (if known)/ Miscellaneous

–

Chemical burn debridement agent

CBD may increase warfarin concentrations

Increased INR in those taking warfarin

Signicantly increases concentrations of warfarin

effect May potentiate warfarin effect Should be avoided in those taking warfarin

–

Warfarin use increases bleeding risk, rich in sulfur-containing compounds allicin and alliin –

–

Increased warfarin clearance

(continued)

C. Lilie et al.

https://t.me/medicina_free

Table 10.2 (continued)

Herbal supplements

Supplement Marketed uses/Effects Green Tea

Camelia sinensis

Hawthorn Crataegus spp.

Horse Chestnut

Aesculus hippocastanum

Kava

Piper methysticum

Motherwort

Leonurus japonicus

Oregano

Origanum vulgare

Policosanol Cardiovascular benets, claudication pain relief Reduces AA, collagen and

Resveratrol Anti-inammatory, anticancer, anti-Alzheimer’s,

Saw Palmetto

Serenoa repens

Skullcap

Scutellaria baicalensis

St. John’s Wort

Hypericum perforatum

Turmeric

Curcuma longa

Willow Bark

Salix alba

Wintergreen Oil (methyl salicylate) Multivitamins and non-herbal vitamin supplements Coenzyme Q10 Cardiovascular benet, possibly improve liver,

Fish Oil (omega-3 long chain fatty acids) Glucosamine/ Chondroitin Sulfate Vitamin E Antioxidant, anti-atherosclerosis, cancer prevention Antagonizes Vitamin K effect

Others: Magnesium, Lycopene, Selenium, Taurine

Cardiovascular benets, antioxidant, antiinammatory, antidiabetic, antiviral

Digestive disorders, gall bladder disease, asthma Inhibition of ADP-induced

Chronic venous insufciency, hemorrhoids, anti-inammatory, antioxidant, anti-edema

Anxiolytic, sedative Inhibits COX, Dose-dependent

Menstrual disorders, blood stasis, analgesia Inhibition of ADP-induced

Respiratory and gastrointestinal disorders, others Prolongs aPTT –

antidiabetes

Benign prostatic hypertrophy, anti-inammatory Inhibits COX –

Antioxidant, antibacterial, antiviral, antitumor, others Prolongs aPTT, PT, inhibits

Depression, anxiety, sleep disturbances CYP3A4 isoenzyme induction Decreased warfarin efcacy,

Skin conditions, respiratory illness, analgesic, liver dysfunction Anti-inammatory, analgesic, antirheumatic, antipyretic Arthralgia, skin irritation Structurally similar to aspirin Elevated INR when

muscle, and brain health Cardiovascular benets May decrease ADP-induced

Cartilage health in osteoarthritis Glucosamine inhibits ADP-

Various May inhibit platelet function Selenium may increase

Anticoagulant/Antiplatelet effect

Inhibits AA, collagen, and ADP-induced platelet aggregation

platelet aggregation, reduction in thromboxane A2 biosynthesis Inhibits ADP-induced platelet aggregation, arterial and venous contraction mediated by 5HT(2A) receptor

decrease in platelet aggregation

platelet aggregation

ADP-induced platelet aggregation

Increases platelet NO, inhibits PAI-1

brin polymerization and platelet aggregation

Inhibition of ADP and GPVIinduced platelet aggregation Inhibits AA-induced platelet aggregation

– Possible elevated bleeding

platelet aggregation and prolong bleeding time

induced platelet activation

and inhibit thrombin-induced platelet aggregation

Drug interactions (if known)/ Miscellaneous

Contains Vitamin K, may decrease warfarin effect

–

Plant contains esculin, a poison that can cause death if eaten raw

May result in liver toxicity

–

Increases effect of omega-3 fatty acids and aspirin, extracted from sugar cane and beeswax plants May partially explain cardiovascular effects of wine consumption

Healing effects are described in the oldest Chinese medicinal book in existence

enhances clopidogrel efcacy

–

Contains precursor to salicylic acid

combined with warfarin

risk if taking warfarin Bleeding risk elevated in those also taking warfarin or aspirin/NSAIDS May increase INR in those taking warfarin Bleeding risk may be elevated if dose is high or taking anticoagulants

warfarin activity

Andrographis

The herbaceous plant Andrographis paniculata has many pharmacological effects which could be used for a number of disease states including protection from cardiovascular disease, infertility, and potentially many others. It contains

the herbal compound andrographolide which is shown to inhibit platelet-activating factor (PAF)-induced human platelet aggregation in a dose-dependent manner and exhibits antiplatelet activity through other molecular mechanisms [28].

10 Herbal Substances that Aect Hemostasis

https://t.me/medicina_free

Ashwagandha

Ashwagandha is an important Indian medicinal plant which may have anti-arthritic, antirheumatic, anti-inammatory, and other properties. Extracts are shown to have some inhibitory effects on platelet aggregation [29].

Boswellia

Boswellia serrata, or Indian frankincense, is classically used as an anti-inammatory agent for the treatment of arthritis. There is evidence of substantial antithrombotic properties from the extract causing prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) that appears linked directly to Factor Xa and XIa inhibition [30].

Bromelain

Bromelain extract is produced from pineapples and confers anti-edema, anti-inammatory, antithrombotic, and brinolytic activities. It contains a number of proteases which may prevent adenosine diphosphate (ADP)-induced platelet aggregation and adhesion of platelets to blood vessel endothelial cells. In high doses, it may also prolong the PT and partial thromboplastin time (PTT). It may be utilized clinically as a chemical burn debridement or anti-edema agent and has not yet had a reported occurrence of the adverse effect of bleeding in humans [31].

Cannabinoids

Cannabis extract is used as a therapy for multiple sclerosis, chronic pain, nausea/vomiting, and others. Cannabinol (CBN) and tetrahydrocannabinol (THC) appear to inhibit thrombin-induced clot formation invitro and prolong clotting times invivo in a rat model [32]. Another component, cannabidiol (CBD), inhibits P450 (CYP) 3A enzymes (and other isoenzymes), and it may decrease the metabolism of warfarin as a result [33].

Cranberry

Cranberry juice or supplements are taken to improve urinary tract infections, improve metabolic prole, and as an antioxidant. Clinical data do not currently report cranberry having an effect on platelet aggregation, despite several of its components having been shown to do so [34]. Case reports demonstrate an interaction between cranberry and warfarin resulting in an elevated international normalized ratio (INR) [35, 36].

Danshen

Danshen is an herb used for centuries to improve cardiovascular health. An extract contacting several constituents has been shown to inhibit thrombosis formation and platelet aggregation [37]. At least one active component of Danshen inhibits platelet aggregation induced by ADP [38]. Danshen

enhances anticoagulation in patients taking warfarin by directly increasing plasma concentrations of warfarin [

39].

Devil’s Claw

Devil’s Claw is a plant of the sesame family used as an analgesic and anti-pyretic. The active ingredient harpagoside has been implicated in previous invitro studies that show altered platelet function [40]. Further studies have conrmed that cyclooxygenase (COX)-1 and COX-2 inhibition by this active ingredient are likely responsible [41]. The clinical implication of this remains questionable.

Dong Quai

Dong quai is an ancient Chinese herbal medication which is taken largely for its benets with menstrual cramping, menstrual regulation, and migraine headache. It has also been used as an antispasmodic [42]. It possesses several constituents which are known to decrease platelet aggregation by inhibiting thromboxane A study supports this action in select patients [43, 44]. A case report suggests dong quai may potentiate the effect of warfarin [42].

synthesis and a clinical

Evening Primrose Oil

Evening primrose oil originates from the evening primrose plant and is used as an anti-inammatory and in women’s health conditions. It is postulated to have antiplatelet effects and contains coumarin constituents which could lead to an interaction with warfarin [45, 46].

Fenugreek

Fenugreek is an ancient herbal which possesses many vitamins and active compounds which have been used for the treatment of increasing milk production, diabetes, cancer, and hypercholesterolemia. It possesses antioxidant, antiinammatory, antimicrobial, and hepato- and neuroprotective properties [47]. Fenugreek contains a high content of coumarin-like compounds which can lead to increased risk of bleeding. Excessive intake of fenugreek has been shown to cause a Vitamin K reversible prolongation of INR with coagulation failure in a susceptible patient. It may be advisable to avoid this medication in patients taking warfarin [48].

Feverfew

Feverfew has classically been used as an antipyretic and in the treatment of migraines. Feverfew’s active constituent of sesquiterpene lactones is suspected to be responsible for its effect on platelets. The primary effect is a reduction in ADPmediated platelet aggregation [49]. It has also been shown to decrease COX production leading to reduction in thromboxane synthesis [50].

https://t.me/medicina_free

C. Lilie et al.

Garlic

Garlic is a plant bulb and species of the onion family that is well known for its culinary applications, but it has also been used medicinally for several millenia. Today, it is used principally for the treatment of atherosclerosis, hypertension, thrombus formation, and to lower serum lipid and cholesterol levels [51]. Primary chemical components of garlic, ajoene and volatile oil, have been implicated in irreversibly potentiating platelet inhibitors, including prostacyclin, indomethacin, and dipyridamole [52]. Garlic reportedly inhibits platelet aggregation invivo in a dose-dependent fashion [53,

54], mainly through the effects of sulfur-containing com-

pounds alliin and allicin which inhibit the production and release of thromboxane and adenosine [55]. However, these antiplatelet results have not been reproducible in all clinical trials [56–58]. Some studies report that aged garlic extract has been found to signicantly reduce adrenaline-induced platelet aggregation and to a lesser extent collagen-induced platelet aggregation, with no effect on ADP-induced platelet aggregation [59, 60]. There are several cases in the literature of excessive dietary garlic intake or use of garlic as a medicine associated with coagulation alterations [61]. One case report describes an elevated INR, reportedly due to an interaction between garlic and warfarin [62]. At recommended doses, it appears that garlic supplements do not have anticoagulant properties in individuals not taking concomitant anticoagulant medications. However, when consumed in higher than recommended doses or when used in combination with anticoagulants, garlic may be a factor for increased risk of bleeding.

Ginger

Ginger is the rhizome of the Zingiber ofcinale plant with widespread uses ranging from the treatment of arthritis and inammatory conditions to hypertension and dementia. It is commonly utilized in the treatment of nausea and gastrointestinal discomfort [63, 64]. Gingerols are the key active component of ginger and have been shown to inhibit arachidonic acid (AA)-induced human platelet serotonin release and aggregation [65]. In vitro studies have also shown COX-1 inhibition leading to antiplatelet activity more potent than aspirin alone [66]. Despite these ndings, further experiments have failed to demonstrate signicant changes in clotting status or coagulation in individuals taking warfarin [67].

Ginkgo

Ginkgo biloba is marketed for improvement in peripheral vascular disease, erectile dysfunction, and has gained traction for Alzheimer’s disease and multi-infarct dementia treatment. Ginkgolides are one of the more widely studied active ingredients and have been shown to have dose-

dependent, rapid onset, potent inhibition of PAF-induced platelet aggregation [68]. Several case reports exist implicating gingko as the cause of unexpected hemorrhage in the perioperative period including unprovoked intracranial hemorrhage [69, 70].

Ginseng

Ginseng (Panax ginseng) has a long history of use in eastern Asian culture to boost the immune system. Today, it is a prominent additive to energy drinks for increased alertness and focus [71]. One of ginseng’s bioactive component, gensinosides, seems to be responsible for anticoagulation effects and may reduce platelet volume through PAF inhibition. Ginseng has also been shown to inhibit invitro thromboxane synthesis and lead to increased blood clotting time [72]. Despite the effective inhibition of the coagulation cascade, a clinical trial showed that warfarin clearance was increased with concomitant use of ginseng, leading to less effective anticoagulation as shown by a corresponding difculty in achieving the desired therapeutic INR [73].

Green Tea

Green Tea, the second most consumed beverage in the world, has many purported benets including improved cardiovascular health, antioxidant, anti-inammatory, antidiabetic, and antiviral effects [27, 42]. Components of green tea, including polyphenols and catechins, have been shown to inhibit AA, collagen, and ADP-induced platelet aggregation [74]. In vivo studies have supported this with signicantly prolonged bleeding time in conscious mice after green tea and catechin administration [75]. Additionally, Vitamin K is present in green tea in a signicant quantity and may decrease the anticoagulant effect of warfarin [34].

Hawthorn

Hawthorn is classically used for gastrointestinal disorder treatment. There are many active ingredients in hawthorn and some interact with platelet function. In vitro studies have shown that hawthorn extract and inhibits ADP-induced platelet aggregation and causes a signicant reduction in biosynthesis of thromboxane A2 [76].

Horse Chestnut

Horse chestnut is an herbal medication historically taken for chronic venous insufciency and is purported to have antiinammatory, antioxidant, and anti-edema properties. Extracts have been shown to inhibit ADP-induced human platelet aggregation and cause contraction of both veins and arteries [77]. One clinical study has shown it is as effective as compression stockings in chronic venous insufciency. The potential for drug interactions with other antiplatelet drugs needs further study [74].

10 Herbal Substances that Aect Hemostasis

https://t.me/medicina_free

Kava

Kava is a substance with predominantly psychomotor activities and is used as an anxiolytic and sedative. It inhibits COX with a similar potency to nonsteroidal anti-inammatory drugs (NSAIDS), causes a dose-dependent decrease in platelet aggregation and may also cause hepatotoxicity [78].

Motherwort

Motherwort is classically used to treat menstrual disorders such as amenorrhea and dysmenorrhea but applications extend to other conditions of blood stasis and analgesia. Studies have shown decreased platelet aggregation after intravenous administration [79]. Further invitro studies have isolated an active ingredient bis-spirolabdane diterpenoid that has the ability to signicantly reduce ADP-induced platelet aggregation [80].

Oregano

Oregano is an herbal supplement purportedly utilized for respiratory disorders, gastrointestinal disorders, and many others and has been shown to prolong aPTT in an invitro study [81].

Policosanol

Policosanol is taken for its purported ability to improve lipid prole and for its cardiovascular health benets, policosanol is shown to inhibit platelet aggregation response to AA, collagen, and ADP [82]. It seems to have an additive antiplatelet effect when taken along with aspirin and omega-3 fatty acids, though no reports have identied policosanol as a contributor to clinical bleeding [83, 84].

Resveratrol

Resveratrol is a phenolic antioxidant present in grape skin, which may explain part of the benecial cardiovascular effects of wine consumption. The compound increases the production of nitric oxide (NO) by stimulated platelets and, thus, blunts platelet function through inhibition of the proinammatory pathway [85]. It also decreases plasminogen activator inhibitor-1 (PAI-1) which may increase a patient’s brinolytic state [86]. Case reports of clinically signicant bleeding due to resveratrol are lacking.

Saw Palmetto

Saw palmetto is a commonly used herbal supplement which improves symptoms of benign prostatic hypertrophy [87]. Presumably through its ability to inhibit COX, it has been implicated in a case report of reported severe bleeding during craniotomy, as well as a cause of hematuria and coagulopathy [27]. The true clinical impact on coagulation remains unclear.

Skullcap

Skullcap is a traditional Chinese herbal medicine with many purported medicinal benets, perhaps most notably as an antioxidant, antibacterial, antiviral, and antitumor agent. It is a component of dozens of Chinese medicinal preparations and its constituents are being widely researched to dene medicinal benets [88]. One of its major components, oroxylin A, is shown to prolong the aPTT and PT, inhibit brin polymerization, and platelet aggregation [89].

St. John’s Wort

St. John’s wort is a widely used supplement, particularly in the treatment of depression, anxiety, and sleep disturbances. Most of the effects on coagulation come through potent cytochrome isoenzyme modulation. St. John’s wort reduces plasma warfarin concentrations through induction of CYP3A4 and possibly other CYP isoforms because warfarin, which exists as a racemic mixture of R- and S-enantiomers, is metabolized by CYP1A1 and CYP3A4 (R-warfarin) and CYP2C9 (S-warfarin). Such interactions have been conrmed in clinical trials showing decreased plasma concentrations of warfarin and phenprocoumon [90]. In contrast, the efcacy of clopidogrel is enhanced with coadministration of St. John’s wort. The induction of CYP3A4 enhances conversion of the prodrug clopidogrel to its active form resulting in demonstrable decreases in ADP-induced platelet aggregation [91].

Turmeric

Turmeric is a commonly used spice in cooking on the Indian subcontinent and particularly in curry dishes, but it is also marketed as a treatment for aches, respiratory conditions, skin conditions, and liver dysfunction [92]. Curcumin has been identied as the active ingredient with anti- inammatory properties and data are limited on its effect on platelet function. In vitro studies have found evidence of ADP and glycoprotein VI inhibition leading to reduced platelet aggregation [93, 94]. Despite the demonstrated invitro platelet inhibitory effects, clinical data to investigate and substantiate this effect invivo are lacking [34].

Willow Bark

Willow tree bark extract is an ancient supplement historically utilized for the treatment of inammation and additionally is an analgesic, antirheumatic, and antipyretic substance. The primary pharmacologically active compound is salicin, which once oxidized becomes salicylic acid [34]. In a doubleblinded, randomized controlled trial of 35 patients receiving willow bark extract or placebo and 16 patients receiving acetylsalicylate, willow bark extract was shown to have a statistically signicant inhibition of AA-induced platelet aggregation compared to placebo. However, this inhibition was not as great as those who had received acetylsalicylate [95].

https://t.me/medicina_free

C. Lilie et al.

Wintergreen Oil

Wintergreen oil, or methyl salicyclate, is most commonly used as a topical ointment for the treatment of arthritis and other skin irritation. The active compound methyl salicyclate is structurally very similar to aspirin and even topical absorption can lead to substantial blood concentrations. Several cases of increased INR have been reported when wintergreen is used by patients on a stable warfarin regimen [96, 97].

Numerous other herbal compounds may have some effect on blood coagulation. Berberine has been shown in an invitro study to inhibit thrombin-induced platelet aggregation as a direct thrombin inhibitor [98]. Boldo may have interactions with warfarin causing increased INR [99]. Chinese Peony has been reported to have anticoagulant properties. Analysis of extracts reveal chemical structural similarities to animal heparin [100]. Corydalis yanhusuo has been shown to inhibit platelet aggregation [101]. Cyanidin-3-Glucoside is a plant-based anthocyanin that is shown to inhibit platelet function at multiple points including platelet activation, aggregation, secretion, and thrombus formation [102]. Persimmon leaf ethanol extract is shown to prolong aPTT and inhibit platelet activation, while ethanol extract of persimmon leaf and Citrus junos (Yuzu) prolongs aPTT and PT in mice [103, 104]. Poncitrin is often taken for gastrointestinal problems, contains coumarin compounds, and has been shown to inhibit the aggregation of rabbit platelets induced by ADP, PAF, AA, and collagen [105]. Piper wallichii possesses compounds which inhibit platelet aggregation induced by PAF [106]. Rhus verniciua stokes is a traditional herbal supplement which decreases platelet aggregation to collagen in vivo [107]. Safower extract and some of its components have signicant antiplatelet and anticoagulation activity [108]. Of note, a number of herbals contain a large amount of vitamin K and may decrease the effectiveness of warfarin, including stinging nettle (Urtica dioica), noni fruit (Morinda

citrifolia), dandelion (Taraxacum ofcinale), and horsetail (Equisetum arvense) [109].

When multiple supplements that have been identied as inhibiting coagulation or platelet function are taken together, this will likely further increase the risk of perioperative bleeding [110]. Traditional herbal preparations are often prepared as combination herbal supplements which are shown to possess antithrombotic and antiplatelet effects [111]. For instance, treatment of rats with reduction of Sheng-Nao- Kang decoction, comprised of six herbal components, prolongs aPTT, PT, thrombin time, and decreases brinogen [112].

Multivitamins andVitamin Supplements

Multivitamins/minerals, calcium, and individual vitamins (B, D, C, E) are among the most common nutritional supple-

ments people take [ potential bleeding concerns in the perioperative setting (Table10.2).

21]. Clinicians should be aware of their

Coenzyme Q10

Coenzyme Q10 supplementation may have cardiovascular benets and may provide some benet to liver, muscle, and brain health. It does not appear to increase bleeding when taken in isolation [71]. Coenzyme Q10 has a complex interaction with warfarin. It appears to increase the clearance of both R- and S-enantiomers of warfarin without decreasing the therapeutic effects of warfarin. Coadministration of warfarin and coenzyme Q10 may lead to a mild increased risk of bleeding in patients taking warfarin, though this interaction is poorly understood and lacks denitive support [27].

Fish Oil

Omega-3 fatty acids are found naturally in certain sh and these supplements are typically taken for their purported cardiovascular benets. Ingestion of supplemental omega 3 long-chain polyunsaturated fatty acid reduces risk for myocardial infarction and coronary artery disease at 1g/day, perhaps even more importantly for those with low sh intake [3]. Standard dosage of sh oil has recently been shown to decrease platelet aggregation and clot formation when assessed by multiplate aggregometry and viscoelastic rotational thromboelastometry [113]. Other studies reporting a decrease in platelet aggregation and a prolonged bleeding time are reported, though, sh oil alone did not appreciably cause abnormal surgical bleeding or abnormal bleeding time or platelet aggregation [71]. Bleeding time appears to be increased when this supplement is taken concurrently with warfarin or aspirin/NSAIDS [27].

Glucosamine/Chondroitin Sulfate

Often taken concurrently, glucosamine and chondroitin sulfate supplements are utilized for the improvement of cartilage health for those with osteoarthritis. Interestingly, chondroitin shares a similar glycosaminoglycan structural makeup with heparin [114]. Glucosamine is shown to reduce platelet function via inhibition of ADP-induced platelet activation in humans [115]. In isolation, these supplements have not been convincingly shown to increase clinical bleeding. The use of glucosamine or glucosamine-chondroitin sulfate with warfarin may result in increased INR and bruising [116].

Vitamin E

Vitamin E supplements are purported to provide antioxidant and anti-atherosclerosis benet as well as cancer prevention [114]. Vitamin E may antagonize the effect of Vitamin K and inhibit the production of Vitamin K-dependent factors, although this typically occurs only at high doses [117]. Vitamin E has been shown to inhibit the intrinsic coagulation

10 Herbal Substances that Aect Hemostasis

https://t.me/medicina_free

pathway and may inhibit platelet aggregation and adhesion in patients with thrombocytopenia or diabetes [118]. In vitro reports and several clinical studies suggest a signicant increase in bleeding risk due to Vitamin E-induced inhibition of platelet aggregation or interaction with aspirin or warfarin, though subsequent clinical studies have been unable to consistently replicate these results. Thus, any anticoagulant effects of Vitamin E may be dose-dependent and there may be elevated bleeding risk if they are co-administered with anticoagulants [27, 114].

Others

Magnesium, lycopene, selenium, and taurine may inhibit platelet function [71, 118]. Selenium may increase warfarin activity as shown in an animal model, possibly by displacing warfarin from albumin [119].

Supplement Interaction withPrescription Medication

One mechanism of nutritional supplement-associated hemorrhage is related to interaction with prescription medications. Perhaps the best studied prescription medication with such a risk is warfarin [34]. In general, the use of any previously mentioned nutritional supplement which independently exhibits an antiplatelet or anticoagulant effect, along with a pharmaceutical with antiplatelet or anticoagulant effects, should be expected to increase the risk of perioperative hemorrhage.

Perioperative Considerations

Routine questioning of patients about nutritional supplement usage is both reasonable and practical. Recommendations by several societies and care groups have been reported regarding the suggested time to avoid taking nutritional supplements in anticipation of surgery. These recommendations are limited by the clinical data available and should not replace clinical judgment in different patient care scenarios. The American Society of Anesthesiologists has previously recommended discontinuation of all herbal medications 2–3weeks before an elective surgical procedure [120]. The Swedish Medical Products Agency recommends the discontinuation of some of the most commonly taken naturopathic medicines 2weeks prior to surgery [113]. Dental professionals suggest discontinuation of herbal supplements 14 days prior to receiving invasive surgical procedures, though supplements may not need to be held prior to routine dental and dental hygiene procedures [121]. Others suggest discontinuation of any supplement around 15days before an elective urologic extracorporeal shockwave lithotripsy procedure

[122]. This seems prudent given ongoing effects of some herbals even at 14 days after administration [123]. The American Society of Regional Anesthesia and Pain Medicine has published updated guidelines addressing the risks of bleeding-related complications associated with regional anesthesia in patients receiving any antithrombotic or thrombolytic therapy. The authors recommend against required discontinuation of herbal supplements prior to neuraxial procedures and that regional anesthesia should not be withheld in those patients using these therapies. There is not a need to cancel a surgery or procedure if patients have not already discontinued these supplements [124].

Until more rigorous scientic studies related to bleeding risks associated with herbal medications and supplements exists, 2weeks seems to be both a reasonable and consensus time period for discontinuing herbal medications prior to elective surgery. In isolated circumstances, such as prior to urgent or emergent surgery where bleeding poses a risk, it may be prudent to investigate the effects of a patient’s nutritional supplements with standard coagulation tests in order to guide treatment for hemorrhage.

References

1. Craig WJ.Health-promoting properties of common herbs. Am J

Clin Nutr. 1999;70(3,Suppl):491S–9S.

2. Petrovska BB. Historical review of medicinal plants’ usage.

Pharmacogn Rev. 2012;6:1–5.

3. Khan SU, Khan MU, Riaz H, Valavoor S, Zhao D, Vaughan L,

etal. Effects of nutritional supplements and dietary interventions on cardiovascular outcomes: an umbrella review and evidence map. Ann Intern Med. 2019;9. Epub ahead of print

4. Mohan A, Lahiri A.Herbal medications and plastic surgery: a hid-

den danger. Aesthet Plast Surg. 2014;38(2):479–81.

5. Miller FG, Emanuel EJ, Rosenstein DL, Straus SE.Ethical issues

concerning research in complementary and alternative medicine. JAMA. 2004;291(5):599–604.

6. Smith T, Kawa K, Eckle V, Morton C, Stredney R.Herbal supple-

ment sales in US increased 8.5% in 2017, Topping $8 Billion. Herbal Gram. 2018;119:62–71.

7. Kirk J, Dunker KS. Dietary counseling: the ingredient for suc-

cessfully addressing the use of herbal supplements and probiotics in chronic kidney disease. Adv Chronic Kidney Dis. 2014;21(4):377–84.

8. Kennedy J, Wang CC, Wu CH.Patient disclosure about herb and

supplement use among adults in the US.Evid Based Complement Alternat Med. 2008;5(4):451–6.

9. Wang L, Lanka L, Chen D, Pruthi RK.Severe postoperative hem-

orrhage in a patient on dietary and herbal supplements. J Perioper Pract. 2018;28(10):263–6.

10. Zwiebel SJ, Lee M, Alleyne B, Guyuron B.The incidence of vita-

min, mineral, herbal, and other supplement use in facial cosmetic patients. Plast Reconstr Surg. 2013;132(1):78–82.

11. Corey RL, Rakela J. Complementary and alternative medicine:

risks and special considerations in pretransplant and posttransplant patients. Nutr Clin Pract. 2014;29(3):322–31.

12. Cohen MH. Complementary and integrative medical therapies,

the FDA, and the NIH: denitions and regulation. Dermatol Ther. 2003;16(2):77–84.

https://t.me/medicina_free

C. Lilie et al.

13. Abe A, Kaye AD, Gritsenko K, Urman RD, Kaye AM. Perioperative analgesia and the effects of dietary supplements. Best Pract Res Clin Anaesthesiol. 2014;28(2): 183–9.

14. Little DP.Authentication of Ginkgo biloba herbal dietary supplements using DNA barcoding. Genome. 2014;57(9):513–6.

15. Amster E, Tiwary A, Schenker MB.Case report: potential arsenic toxicosis secondary to herbal kelp supplement. Environ Health Perspect. 2007;115(4):606–8.

16. Buettner C, Mukamal KJ, Gardiner P, Davis RB, Phillips RS, Mittleman MA.Herbal supplement use and blood lead levels of Unites States adults. J Gen Intern Med. 2009;24(11):1175–82.

17. Yan G, Zhu Z, Jin L, Chen J, Xie H, Miozzi J, etal. Study on the quality evaluation of compound Danshen preparations based on the xCELLigence real-time cell-based assay and Pharmacodynamic authentication. Molecules. 2018;23(9):2090.

18. Vaclavik L, Krynitsky AJ, Rader JI.Mass spectrometric analysis of pharmaceutical adulterants in products labeled as botanical dietary supplements or herbal remedies: a review. Anal Bioanal Chem. 2014;406(27):6767–90.

19. Aykan DA, Aykan AC. Factors associated with the concomitant use of cardiovascular drugs and dietary herbal products: a cross-sectional study. J Cardiovasc Pharmacol Ther. 2018;27:1074248418794938. Epub ahead of print

20. Kaye AD, Clarke R, Sabar R, Vig S, Dhawan KP, Hofbauer R, Kaye AM.Herbal medicines: current trends in anesthesiology practice– a hospital survey. J Clin Anesth. 2000;12(6):468–71.

21. Qato DM, Wilder J, Schumm LP, Gillet V, Alexander GC.Changes in prescription and over-the-counter medication and dietary supplement use among older adults in the United States, 2005 vs

2011. JAMA Intern Med. 2016;176:473–82.

22. Rosenberg EI, Genao I, Chen I, Mechaber AJ, Wood JA, Faselis CJ, et al. Complementary and alternative medicine use by primary care patients with chronic pain. Pain Med. 2008;9(8):1065–72.

23. Navo MA, Phan J, Vaughan C, Palmer JL, Michaud L, Jones KL, etal. An assessment of the utilization of complementary and alternative medication in women with gynecologic or breast malignancies. J Clin Oncol. 2004;22(4):671–7.

24. Lewanda AF, Gallegos MF, Summar M. Patterns of dietary supplement use in children with down syndrome. J Pediatr. 2018;201:100–5.

25. Shaikh SA, Tischer S, Choi EK, Fontana RJ.Good for the lung but bad for the liver? Garlic-induced hepatotoxicity following liver transplantation. J Clin Pharm Ther. 2017;42(5):646–8.

26. Medina-Caliz I, Garcia-Cortes M, Gonzalez-Jimenez A, Cabello MR, Robles-Diaz M, Sanabria-Cabrera J. et al; Spanish DILI registry. Herbal and dietary supplement-induced liver injuries in the Spanish DILI registry. Clin Gastroenterol Hepatol. 2018;16(9):1495–502.

27. Wang CZ, Moss J, Yuan CS. Commonly used dietary supplements on coagulation function during surgery. Medicines. 2015;2(3):157–85.

28. Jayakumar T, Hsieh CY, Lee JJ, Sheu JR.Experimental and clinical pharmacology of Andrographis paniculata and its major bioactive Phytoconstituent Andrographolide. Evid Based Complement Alternat Med. 2013;2013:846740.

29. Madhusudan M, Zameer F, Naidu A. M N Nagendra Prasad, Dhananjaya BL, Hegdekatte R.Evaluating the inhibitory potential of Withania somnifera on platelet aggregation and inammation enzymes: an in vitro and in silico study. Pharm Biol. 2016;54(9):1936–41.

30. Kokkiripati PK, Bhakshu LM, Marri S, Padmasree K, Row AT, Raghavendra AS, etal. Gum resin of Boswellia serrata inhibited human monocytic (THP-1) cell activation and platelet aggregation. J Ethnopharmacol. 2011;137(1):893–901.

31. Maurer HR.Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci. 2001;58(9):1234–45.

32. Coetzee C, Levendal RA, van de Venter M, Frost CL.Anticoagulant effects of a Cannabis extract in an obese rat model. Phytomedicine. 2007;14(5):333–7.

33. Yamaori S, Ebisawa J, Okushima Y, Yamamoto I, Watanabe K.Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Life Sci. 2011;88(15–16):730–6.

34. McEwen BJ.The inuence of herbal medicine on platelet function and coagulation: a narrative review. Semin Thromb Hemost. 2015;41(3):300–14.

35. Paeng CH, Sprague M, Jackevicius CA.Interaction between warfarin and cranberry juice. Clin Ther. 2007;29(8):1730–5.

36. Hamann GL, Campbell JD, George CM.Warfarin-cranberry juice interaction. Ann Pharmacother. 2011;45(3):e17.

37. Fei YX, Wang SQ, Yang LJ, Qiu YY, Li YZ, Liu WY, etal. Salvia miltiorrhiza Bunge (Danshen) extract attenuates permanent cerebral ischemia through inhibiting platelet activation in rats. J Ethnopharmacol. 2017;207:57–66.

38. Maione F, De Feo V, Caiazzo E, De Martino L, Cicala C, Mascolo N. Tanshinone IIA, a major component of Salvia mlthorriza Bunge, inhibits platelet activation via Erk-2 signaling pathway. J Ethnopharmacol. 2014;155(2):1236–42.

39. Chan TY.Interaction between warfarin and danshen (Salvia miltiorrhiza). Ann Pharmacother. 2001;35(4):501–4.

40. Bermejo Benito P, Diaz Lanza AM, Silvan Sen AM, De Santos GJ, Fernandez Matellano L, Sanz Gomez A, etal. Effects of some iridoids from plant origin on arachidonic acid metabolism in cellular systems. Planta Med. 2000;66(4):324–8.

41. Anauate MC, Torres LM, de Mello SB.Effect of isolated fractions of Harpagophytum procumbens D.C. (devil’s claw) on COX-1, COX-2 activity and nitric oxide production on whole-blood assay. Phytother Res. 2010;24(9):1365–9.

42. Page RL 2nd, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy. 1999;19(7):870–6.

43. Dong WG, Liu SP, Zhu HH, Luo HS, Yu JP.Abnormal function of platelets and role of angelica sinensis in patients with ulcerative colitis. World J Gastroenterol. 2004;10(4):606–9.

44. Norred CL, Brinker F.Potential coagulation effects of preoperative complementary and alternative medicines. Altern Ther Health Med. 2001;7:58–67.

45. Bayles B, Usatine R. Evening primrose oil. Am Fam Physician. 2009;80(12):1405–8.

46. Werneke U, Earl J, Seydel C, Horn O, Crichton P, Fannon D.Potential health risks of complementary alternative medicines in cancer patients. Br J Cancer. 2004;90(2):408–13.

47. Ahmad A, Alghamdi SS, Mahmood K, Afzal M.Fenugreek a multipurpose crop: potentialities and improvements. Saudi J Biol Sci. 2016;23(2):300–10.

48. Philips CA, Augustine P.Rare cause of isolated severe coagulation failure in cirrhosis: traditional healing with fenugreek. BMJ Case Rep. 2018;12:2018.

49. Groenewegen WA, Heptinstall S.A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. J Pharm Pharmacol. 1990;42(8):553–7.

50. Heptinstall S, White A, Williamson L, Mitchell JR.Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet. 1985;1(8437):1071–4.

51. Stevinson C, Pittler MH, Ernst E.Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials. Ann Intern Med. 2000;133(6):420–9.

52. Apitz-Castro R, Escalante J, Vargas R, Jain MK. Ajoene, the antiplatelet principle of garlic, synergistically potentiates the antiaggregatory action of prostacyclin, forskolin, indo-

10 Herbal Substances that Aect Hemostasis

https://t.me/medicina_free

methacin and dypiridamole on human platelets. Thromb Res. 1986;42(3):303–11.

53. Chan KC, Yin MC, Chao WJ.Effect of diallyl trisulde-rich garlic oil on blood coagulation and plasma activity of anticoagulation factors in rats. Food Chem Toxicol. 2007;45(3):502–7.

54. Fukao H, Yoshida H, Tazawa Y, Hada T.Antithrombotic effects of odorless garlic powder both invitro and invivo. Biosci Biotechnol Biochem. 2007;71(1):84–90.

55. Makheia AN, Vanderhoek JY, Bailey JM. Inhibition of platelet aggregation and thromboxane synthesis by onion and garlic. Lancet. 1979;1(8119):781.

56. Scharbert G, Kalb ML, Duris M, Marschalek C, KozekLangenecker SA.Garlic at dietary doses does not impair platelet function. Anesth Analg. 2007;105(5):1214–8.

57. Macan H, Uykimpang R, Alconcel M, Takasu J, Razon R, Amagase H, etal. Aged garlic extract may be safe for patients on warfarin therapy. J Nutr. 2006;136(3 Suppl):793S–5S.

58. Mohammed Abdul MI, Jiang X, Williams KM, Day RO, Roufogalis BD, Liauw WS, etal. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol. 2008;154(8):1691–700.

59. Steiner M, Lin RS.Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract. J Cardiovasc Pharmacol. 1998;31(6):904–8.

60. Beckert BW, Concannon MJ, Henry SL, Smith DS, Puckett CL.The effect of herbal medicines on platelet function: an invivo experiment and review of the literature. Plast Reconstr Surg. 2007;120(7):2044–50.

61. Borrelli F, Capasso R, Izzo AA. Garlic (Allium sativum L.): adverse effects and drug interactions in humans. Mol Nutr Food Res. 2007;51(11):1386–97.

62. Sunter W.Warfarin and garlic. Pharm J. 1991;246:722.

63. Al-Suhaimi EA, Al-Riziza NA, Al-Essa RA. Physiological and therapeutical roles of ginger and turmeric on endocrine functions. Am J Chin Med. 2011;39:215–31.

64. Saenghong N, Wattanathorn J, Muchimapura S, Tongun T, Piyavhatkul N, Banchonglikitkul C, et al. Zingiber ofcinale improves cognitive function of the middle-aged healthy women. Evid Based Complement Alternat Med. 2012;2012:383062.

65. Koo KL, Ammit AJ, Tran VH, Duke CC, Roufogalis BD.Gingerols and related analogues inhibit arachidonic acid-induced human platelet serotonin release and aggregation. Thromb Res. 2001;103(5):387–97.

66. Nurtjahja-tjendraputra E, Ammit AJ, Roufogalis BD, Tran VH, Duke CC. Effective anti-platelet and COX-1 enzyme inhibitors from pungent constituents of ginger. Thromb Res. 2003;111(4–5):259–65.

67. Jiang X, Williams KM, Liauw WS, Ammit AJ, Roufogalis BD, Duke CC, etal. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol. 2005;59(4):425–32.

68. Koch E.Inhibition of platelet activating factor (PAF) - induced aggregation of human thrombocytes by ginkgolides: considerations on possible bleeding complications after oral intake of Ginkgo biloba extracts. Phytomedicine. 2005;12(1–2):10–6.

69. Rowin J, Lewis SL.Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology. 1996;46(6):1775–6.

70. Vale S. Subarachnoid haemorrhage associated with Ginkgo biloba. Lancet. 1998;352(9121):36.

71. Stanger MJ, Thompson LA, Young AJ, Lieberman HR. Anticoagulant activity of select dietary supplements. Nutr Rev. 2012;70(2):107–17.

72. Teng CM, Kuo SC, Ko FN, Lee JC, Lee LG, Chen SC, et al. Antiplatelet actions of panaxynol and ginsenosides isolated from ginseng. Biochim Biophys Acta. 1989;990(3):315–20.

73. Janetzky K, Morreale AP.Probable interaction between warfarin and ginseng. Am J Health Syst Pharm. 1997;54(6):692–3.

74. Jagroop IA.Plant extracts inhibit ADP-induced platelet activation in humans: their potential therapeutic role as ADP antagonists. Purinergic Signal. 2014;10(2):233–9.

75. Kang WS, Lim IH, Yuk DY, Chung KH, Park JB, Yoo HS, etal. Antithrombotic activities of green tea catechins and (−)-epigal- locatechin gallate. Thromb Res. 1999;96(3):229–37.

76. Vibes J, Lasserre B, Gleye J, Declume C.Inhibition of thromboxane A2 biosynthesis invitro by the main components of Crataegus oxyacantha (hawthorn) ower heads. Prostaglandins Leukot Essent Fatty Acids. 1994;50(4):173–5.

77. Felixsson E, Persson IA, Eriksson AC, Persson K.Horse chestnut extract contracts bovine vessels and affects human platelet aggregation through 5-HT(2A) receptors: an invitro study. Phytother Res. 2010;24(9):1297–301.

78. Raduege KM, Kleshinski JF, Ryckman JV, Tetzlaff JE.Anesthetic considerations of the herbal, kava. J Clin Anesth. 2004;16(4):305–11.

79. Zou QZ, Bi RG, Li JM, Feng JB, Yu AM, Chan HP, et al. Effect of motherwort on blood hyperviscosity. Am J Chin Med. 1989;17(1–2):65–70.

80. Xiong L, Zhou QM, Peng C, Xie XF, Guo L, Li XH, et al. Sesquiterpenoids from the herb of Leonurus japonicus. Molecules. 2013;18(5):5051–8.

81. Alikhani Pour M, Sardari S, Eslamifar A, Azhar A, Rezvani M, Nazari M.Cheminformatics-based anticoagulant study of traditionally used medicinal plants. Iran Biomed J. 2017;21(6):400–5.

82. Arruzazabala ML, Molina V, Mas R, Fernandez L, Carbajal D, Valdes S, etal. Antiplatelet effects of policosanol (20 and 40 mg/ day) in healthy volunteers and dyslipidaemic patients. Clin Exp Pharmacol Physiol. 2002;29(10):891–7.

83. Arruzazabala ML, Valdes S, Mas R, Carbajal D, Fernandez L.Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res. 1997;36(4):293–7.

84. Castaño G, Arruzazabala ML, Fernández L, Mas R, Carbajal D, Molina V, et al. Effects of combination treatment with policosanol and omega-3 fatty acids on platelet aggregation: a randomized, double-blind clinical study. Curr Ther Res Clin Exp. 2006;67(3):174–92.

85. Gresele P, Pignatelli P, Guglielmini G, Carnevale R, Mezzasomoa AM, Ghiselli A, etal. Resveratrol, at concentrations attainable with moderate wine consumption, stimulates human platelet nitric oxide production. J Nutr. 2008;138(9):1602–8.

86. Tomé-Carneiro J, Gonzálvez M, Larrosa M, Yáñez-Gascón MJ, García-Almagro FJ, Ruiz-Ros JA, etal. One-year consumption of a grape nutraceutical containing resveratrol improves the inammatory and brinolytic status of patients in primary prevention of cardiovascular disease. Am J Cardiol. 2012;110(3):356–63.

87. Oki T, Suzuki M, Nishioka Y, Yasuda A, Umegaki K, Yamada S. Effects of saw palmetto extract on micturition reex of rats and its autonomic receptor binding activity. J Urol. 2005 Apr;173(4):1395–9.

88. Zhao T, Tang H, Xie L, Zheng Y, Ma Z, Sun Q, etal. Scutellaria baicalensis Georgi. (Lamiaceae): a review of its traditional uses, botany, phytochemistry, pharmacology and toxicology. J Pharm Pharmacol. 2019;71(9):1353–69.

89. Ku SK, Lee IC, Bae JS. Antithrombotic activities of oroxylin a invitro and invivo. Arch Pharm Res. 2014;37(5):679–86.

90. Borrelli F, Izzo AA.Herb-drug interactions with St John’s wort (Hypericum perforatum): an update on clinical observations. AAPS J. 2009;11(4):710.

91. Lau WC, Welch TD, Shields T, Rubenre M, Tantry US, Gurbel PA. The effect of St John’s wort on the pharmacodynamic response of clopidogrel in hyporesponsive volunteers and

100

https://t.me/medicina_free

C. Lilie et al.

patients: increased platelet inhibition by enhancement of CYP3A4 metabolic activity. J Cardiovasc Pharmacol. 2011;57(1):86–93.

92. Aggarwal BB, Sundaram C, Malani N, Ichikawa H.Curcumin: the Indian solid gold. Adv Exp Med Biol. 2007;595:1–75.

93. Shah BH, Nawaz Z, Pertani SA, Roomi A, Maymood H, Saeed SA, et al. Inhibitory effect of curcumin, a food spice from turmeric, on platelet-activating factor- and arachidonic acid-mediated platelet aggregation through inhibition of thromboxane formation and Ca2+ signaling. Biochem Pharmacol. 1999;58(7):1167–72.

94. Mayanglambam A, Dangelmaier CA, Thomas D, Damodar Reddy C, Daniel JL, Kunapuli SP. Curcumin inhibits GPVImediated platelet activation by interfering with the kinase activity of Syk and the subsequent activation of PLCgamma2. Platelets. 2010;21(3):211–20.

95. Krivoy N, Pavlotzky E, Chrubasik S, Eisenber E, Brook G.Effect of salicis cortex extract on human platelet aggregation. Planta Med. 2001;67(3):209–12.

96. Yip AS, Chow WH, Tai YT, Cheung KL.Adverse effect of topical methylsalicylate ointment on warfarin anticoagulation: an unrecognized potential hazard. Postgrad Med J. 1990;66(775):367–9.

97. Joss JD, Leblond RF. Potentiation of warfarin anticoagulation associated with topical methyl salicylate. Ann Pharmacother. 2000;34(6):729–33.

98. Wang X, Zhang Y, Yang Y, Wu X, Fan H, Qiao Y.Identication of berberine as a direct thrombin inhibitor from traditional Chinese medicine through structural, functional and binding studies. Sci Rep. 2017;7:44040.

99. Lambert JP, Cormier J.Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy. 2001;21(4):509–12.

100. Liapina LA, Novikov VS, Pastorova VE, Uspenskaia MS, Smolina TI, Liapin GI.An anticoagulant from extracts of peony roots: its isolation and properties. Izv Akad Nauk Ser Biol. 1995;2:249–51.

101. Li CH, Chen C, Zhang Q, Tan CN, Hu YJ, Li P, etal. Differential proteomic analysis of platelets suggested target-related proteins in rabbit platelets treated with Rhizoma Corydalis. Pharm Biol. 2017;55(1):76–87.

102. Yao Y, Chen Y, Adili R, McKeown T, Chen P, Zhu G, et al. Plant-based food Cyanidin-3-glucoside modulates human platelet glycoprotein VI signaling and inhibits platelet activation and thrombus formation. J Nutr. 2017;147(10):1917–25.

103. Kim AH, Kim HJ, Ryu R, Han HJ, Han YJ, Lee MK, et al. A mixture of ethanol extracts of persimmon leaf and citrus junos sieb improves blood coagulation parameters and ameliorates lipid metabolism disturbances caused by diet-induced obesity in C57BL/6J mice. J Microbiol Biotechnol. 2016;26(2):295–308.

104. Ryu R, Kim HJ, Moon B, Jung UJ, Lee MK, Lee DG, et al. Ethanol extract of persimmon tree leaves improves blood circulation and lipid metabolism in rats fed a high-fat diet. J Med Food. 2015;18(7):715–23.

105. Teng CM, Li HL, Wu TS, Huang SC, Huang TF. Antiplatelet actions of some coumarin compounds isolated from plant sources. Thromb Res. 1992;66(5):549–57.

106. Shi YN, Shi YM, Yang L, Li XC, Zhao JH, Qu Y, etal. Lignans and aromatic glycosides from Piper wallichi and their antithrombotic activities. J Ethnopharmacol. 2015;162:87–96.

107. Lee JH, Kim M, Chang KH, Hong CY, Na CS, Dong MS, etal. Antiplatelet effects of Rhus verniciua stokes heartwood and its

active constituents-setin, butein, and sulfuretin-in rats. J Med Food. 2015;18(1):21–30.

108. Yao D, Wang Z, Miao L, Wang L.Effects of extracts and isolated compounds from safower on some index of promoting blood circulation and regulating menstruation. J Ethnopharmacol. 2016;191:264–72.

109. Fasinu PS, Bouic PJ, Rosenkranz B.An overview of the evidence and mechanisms of herb-drug interactions. Front Pharmacol. 2012;3:69.

110. Bedi HS, Tewarson V, Negi K.Bleeding risk of dietary supplements: a hidden nightmare for cardiac surgeons. Indian Heart J. 2016;68(Suppl 2):S249–50.

111. Kim TH, Lee KM, Hong ND, Jung YS.Anti-platelet and antithrombotic effect of a traditional herbal medicine Kyung-ok-Ko. J Ethnopharmacol. 2016;178:172–9.

112. Dang X, Miao JJ, Chen AQ, Li P, Chen L, Liang JR, etal. The antithrombotic effect of RSNK in blood-stasis model rats. J Ethnopharmacol. 2015;173:266–72.

113. Bagge A, Schott U, Kander T. Effects of naturopathic medicines on Multiplate and ROTEM: a prospective experimental pilot study in healthy volunteers. BMC Complement Altern Med. 2016;16:64.

114. Wong WW, Gabriel A, Maxwell GP, Gupta SC. Bleeding risks of herbal, homeopathic, and dietary supplements: a hidden nightmare for plastic surgeons? Aesthet Surg J. 2012;32(3):332–46.

115. Hua J, Suguro S, Iwabuchi K, Tsutsumi-Ishii Y, Sakamoto K, Nagaoka I. Glucosamine, a naturally occurring amino monosaccharide, suppresses the ADP-mediated platelet activation in humans. Inamm Res. 2004;53(12):680–8.

116. Knudsen JF, Sokol GH.Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: case report and review of the literature and MedWatch database. Pharmacotherapy. 2008;28(4):540–8.

117. Booth SL, Golly I, Sacheck JM, Roubenoff R, Dallal GE, Hamada K, etal. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. Am J Clin Nutr. 2004;80(1):143–8.

118. Grisa A, Florio S, Bellia E, Cho SC, Froum SJ.The role of dietary supplements in postsurgical bleeding: an update for the practitioner. Compend Contin Educ Dent. 2016;37(10):690–5.

119. Davila JC, Edds GT, Osuna O, Simpson CF.Modication of the effects of aatoxin B1 and warfarin in young pigs given selenium. Am J Vet Res. 1983;44(10):1877–83.

120. Frost EA. Herbal medicines and interactions with anesthetic agents. Middle East J Anaesthesiol. 2006;18(5):851–78.

121. Spolarich AE, Andrews L.An examination of the bleeding complications associated with herbal supplements, antiplatelet and anticoagulant medications. J Dent Hyg. 2007;81(3):67.

122. Gravas S, Tzortzis V, Rountas C, Melekos MD.Extracorporeal shock-wave lithotripsy and garlic consumption: a lesson to learn. Urol Res. 2010;38(1):61–3.

123. Morihara N, Hino A. Aged garlic extract suppresses platelet aggregation by changing the functional property of platelets. J Nat Med. 2017;71(1):249–56.

124. Horlocker TT, Vandermeuelen E, Kopp SL, Gogarten W, Leffert LR, Benzon HT. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. Reg Anesth Pain Med. 2018;43:263–309.

<<< < Предыдущая 1 2 3 4 5 6 7 8 9 1011 / 4711 12 13 14 15 16 17 18 19 20 21 22 23 24 25 > Следующая >>>

Соседние файлы в папке Библиотека им академика М.И. Перельмана

#
31.08.202625 Мб0Книга_30_библиотеки_им_акад_М_И_Перельмана.pdf
#
31.08.202624 Мб0Книга_31_библиотеки_им_акад_М_И_Перельмана.pdf
#
31.08.202622 Мб0Книга_32_библиотеки_им_акад_М_И_Перельмана.pdf
#
02.09.202620 Мб0Книга_33_библиотеки_им_акад_М_И_Перельмана.pdf
#
02.09.202619 Мб0Книга_34_библиотеки_им_акад_М_И_Перельмана.pdf
#
02.09.202619 Мб0Книга_35_библиотеки_им_акад_М_И_Перельмана.pdf
#
29.08.2026102 Мб0Книга_3585_Библиотеки_им_академика_М_И_Перельмана.pdf
#
29.08.2026101 Мб0Книга_3586_Библиотеки_им_академика_М_И_Перельмана.pdf
#
29.08.202692 Мб0Книга_3587_Библиотеки_им_академика_М_И_Перельмана.pdf
#
29.08.202691 Мб0Книга_3589_Библиотеки_им_академика_М_И_Перельмана.pdf
#
29.08.202690 Мб0Книга_3590_Библиотеки_им_академика_М_И_Перельмана.pdf