Platelet and global haemostatic effects of common traditional Chinese herbal medicines: implications for anaesthesia KFJ Ng May 2011 1

22 (2000) 13 (2003) 5 8 (2006) 13 (2005) 7 7 (2007) 14 (2004) 2

Ann Pharmacother 2004;38:1651 3

The “Big 3”    Ginkgo biloba (7/29) Garlic (3/29) Saw palmetto (2/29) 4

Ginkgo biloba Am J Hematol 2005; 79: 343 5

Ginkgo biloba (EGb 761) Thromb Res 2003; 108: 151 6

Garlic A&A 2007; 105: 1214 7

Garlic Prostaglandins Leukot Essent Fatty Acids 1998;58:257 8

Saw palmetto 9

The “Big 3” and more… Plast Reconstr Surg 2007; 120:2044 10

Fufang (compound formula) 11

Danshen ( 丹參 , salvia root) 12

Danshen ( 丹參 , salvia root) Platelets 2008;19:24 13

Danshen ( 丹參 , salvia root) Thromb Res 2008;123:298 14

Ligusticum wallichii (chuanxiong, Szechuan lovage, “ 川芎” ) 15

Ligusticum wallichii (chuanxiong, Szechuan lovage, “ 川芎” ) Thromb Res 2001;104:15 16

Curcuma zedoaria (zedoary, ezhu, “ 莪朮” ) 17

Curcuma zedoaria (zedoary, ezhu, “ 莪朮” ) Thromb Res 2011;127:111 18

Curcuma zedoaria (zedoary, ezhu, “ 莪朮” ) Thromb Res 2011;127:111 19

Angelica Sinensis (dongguai, “ 當歸” ) 20

Dang-Gui-Shao-Yao-San (

當歸芍藥散 ) (dong guai, chuanxiong, and others) Am J Chin Med 2005;33:747 21

Radix et Rhizoma Notoginseng (sanqi, “ 三七” ) 22

Radix et Rhizoma Notoginseng(sanqi, “ 三七” ) J Clin Pharmacol 2000;40:1150 23

Radix et Rhizoma Notoginseng (sanqi, “ 三七” ) Pharmacotherapy 2001;21:773 24

Radix et Rhizoma Notoginseng(sanqi, “ 三七” ) J Ethnopharmacol 2009;125:380 25

Radix et Rhizoma Notoginseng(sanqi, “ 三七” ) J Ethnopharmacol 2009;125:380 26

Radix et Rhizoma Notoginseng(sanqi, “ 三七” ) J Ethnopharmacol 2009;125:380 27

    Get to know the “ bad guys ” Know the common ones used in your locality Back to the basics Haemostasis testing 28

Can you tell me…     Indication for treatment?

Drug interactions?

Precautions e.g. menstruation?

Bleeding symptoms 29

Printer LCD screen Soft keys Trigger solution Test cartridge Cassette Carousel

EPICT = 188 sec Sensitivity = 88% Specificity = 52% 32

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