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Platelet and global haemostatic effects of common traditional Chinese herbal medicines: implications for anaesthesia. KFJ Ng May 2011. 5. 22 (2000) 13 (2003). 7. 8 (2006) 13 (2005). 7 (2007) 14 (2004). Ann Pharmacother 2004;38:1651. The “Big 3”. Ginkgo biloba (7/29) Garlic (3/29)
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Platelet and global haemostatic effects of common traditional Chinese herbal medicines: implications for anaesthesia KFJ Ng May 2011
5 22 (2000) 13 (2003) 7 8 (2006) 13 (2005) 7 (2007) 14 (2004)
The “Big 3” • Ginkgo biloba (7/29) • Garlic (3/29) • Saw palmetto (2/29)
Ginkgo biloba Am J Hematol 2005; 79: 343
Ginkgo biloba (EGb 761) Thromb Res 2003; 108: 151
Garlic A&A 2007; 105: 1214
Garlic Prostaglandins Leukot Essent Fatty Acids 1998;58:257
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Danshen (丹參, salvia root) Platelets 2008;19:24
Danshen (丹參, salvia root) Thromb Res 2008;123:298
Ligusticum wallichii (chuanxiong, Szechuan lovage, “川芎”) Thromb Res 2001;104:15
Curcuma zedoaria (zedoary, ezhu, “莪朮”) Thromb Res 2011;127:111
Curcuma zedoaria (zedoary, ezhu, “莪朮”) Thromb Res 2011;127:111
Dang-Gui-Shao-Yao-San (當歸芍藥散)(dong guai, chuanxiong, and others) Am J Chin Med 2005;33:747
Radix et Rhizoma Notoginseng(sanqi, “三七”) J Clin Pharmacol 2000;40:1150
Radix et Rhizoma Notoginseng (sanqi, “三七”) Pharmacotherapy 2001;21:773
Radix et Rhizoma Notoginseng(sanqi, “三七”) J Ethnopharmacol 2009;125:380
Radix et Rhizoma Notoginseng(sanqi, “三七”) J Ethnopharmacol 2009;125:380
Radix et Rhizoma Notoginseng(sanqi, “三七”) J Ethnopharmacol 2009;125:380
Get to know the “bad guys” • Know the common ones used in your locality • Back to the basics • Haemostasis testing
Can you tell me… • Indication for treatment? • Drug interactions? • Precautions e.g. menstruation? • Bleeding symptoms
Printer LCD screen Soft keys Trigger solution Test cartridge Cassette Carousel
EPICT = 188 sec Sensitivity = 88% Specificity = 52%