Botanical Medications And Supplements

BOTANICAL MEDICATIONS AND SUPPLEMENTS ARLENE MACEREN –DIAZ M.D

•

ECHINACEA (ECHINACEA purpurea ) Leaves contain flavanoids, poly-acetylenes & caffeoyl conjugates.

•

Mechanism of action -activate cytokine ( increased interleukins and tumor necrosis factor) - anti- inflammatory properties Effect uses -reduction in the duration of cold symptoms, alleviate influenza Toxicities - dizziness / headache

•

diseases caused by chronic inflammation, such as arthritis more effective than other non-steroidal anti-inflammatories (NSAIDS), like aspirin relieves inflammation and pain

Respiratory Tract Conditions • asthma • colds (given as a warm infusion) • coughs • influenza • shortness of breath Other • • • • •

antidote in opium over use dermatitis , relieves insect bites has a tonic effect (Feverfew extract, taken cold) relieves skin perspiration associated with migraines (Feverfew extract, taken cold) tinnitus

Toxities and drug interaction: -mouth ulcers and git effects -may react with nticoagulants - should not be use in pregnant women Echinacea purpurea ( Cone flower) FEVERFEW ( TANACEUM parthenium) -leaves ,flowers ,roots - contains flavanoids glycosides, monoterpines, & parthenolides ( a lactone that forms covalent bond with thiol grps protein ) Mechanism of action :

1. 2. 3.

decrease histamine release from mast cells inhibition of prostaglandin, 5ht and leukotriene decrease formation of tumor necrosis

Effects :

• •

• • •

• • •

purgative [an agent that produces a vigorous emptying of the bowels, more drastic than a laxative or aperient] anti-arthritic [eases symptoms of arthritis] aperient[a mild stimulant producing a natural movement of the bowels; a gentle purgative] bitter [applied to bitter tasting drugs which act on the mucous membranes of the mouth and stomach to increase appetite and promote digestion] carminative [an agent for easing griping pains, colic and expelling gas from the intestines] emmenagogue [an agent that promotes menstrual flow] laxative [an agent promoting evacuation of the bowels; a mild purgative] tonic [an agent that tones, strengthens and invigorates organs or the entire organism giving a feeling of wellbeing]

Feverfew is used fo: Brain and Nervous System Conditions

• • • • • • •

delerium tremens (DT's) in alcoholics (given as a warm infusion) dizziness gives a sense of well-being alleviates melancholy and weariness low spirits, 'down in the dumps' reduces frequency and severity of migraine headaches [by controlling inflammation that constricts the blood vessels in the head] reduces nervousness, hysterical complaints promotes a restful sleep

Cardiovascular Conditions • lowers blood pressure Gastrointestinal Conditions • colic (given as a warm infusion) • eases nausea and vomiting • expels worms • flatulence (gas/wind) (given as a warm infusion) • improves digestion • indigestion • stimulates appetite • stomach irritation (Feverfew extract, taken cold) Genitourinary Conditions • promotes adequate kidney function Female Conditions • expels afterbirth • induces menstruation • strengthens the womb Inflammatory Conditions

Chrysanthemum parthenium (Fever few bachelor’s button) GARLIC ( Allium sativum) -contains organic thiosulfinates ,that can form allicin via the enzymes that are disrupted of the garlic bulb. Mechanism of action - inhibits hmg-coa reductase and ace - blocks platelet aggregation - increase nitric oxide - has antimicrobial and antifungal activity - reduces carcinogen activity Uses: - decrease atheroclerosis - decrease incidence of stomach cancer - adjuctdrug to lower serum cholesterol and b.p Toxicities and drug interaction - nausea, hypotension ,allergic reactions - interact with anticoagulant and anti-platelet agent GINKGO biloba ( maidenhair tree ) - leavescontains flavone glycoside and terpenoids Mechanism of action : -has anti-oxidant and radical scavenging effects -increase formation of nitric oxide - reduces blood viscosity - reduces changes in neurotransmitters Uses

•

•

Studies have shown it to be effective in increasing peripheral blood flow. This makes it especially useful in treating age-related brain disorders, cerebral and vascular insufficiency, Raynaud's disease, chronic bronchitis, emphysema and to prevent strokes. Ginkgo has demonstrated remarkable ability to improve memory. PREVENTS EARLY ONSET OF ALZHIEMER AND DEMENTIA. increased energy, antioxidant effects, decreased blood clotting, better concentration, improved hearing and others.

Toxicity 1. g.i. t effects 2. anxiety 3. insomnia 4. headache Drug interactions: – React with anticoagulant, anti-platelet agent GINSENG (PANAX GINSENG) - contain multiple triterpenoid saponin glycosides ( ginsenosides). siberian or brazilian ginseng does not contain this chemicals Mechanism of action - an adaptogen, improve mental and physical performance Toxicity and drug interactions - has estrogenic effects ( mastalgia ,vaginal bleeding ) - insomnia , nervousness and hypertension

- use with caution in patient receiving anti-hypertensive hypoglycemic or psychiatric medications

Ginseng ( panax ginseng) KAVA ( Piper methysticum) - roots contains kawain, mysthyticin, yangonin Mechanism of action: - facilitates the actions of gaba in the cns ( effect is comparable to oxazepam ) Uses : - useful as anti-anxiety , and sedative

ST. JOHN’S WORT ( HYPERICUM PERFORATUM)

Toxicity: - g.i.t efects -ataxia, paresthesia - “drunken feeling” - muscle weakness - tingling sensation of the mouth

Mechanism of action: -decrease activity of serotonergic re-uptake

–

dried flowers contain hypericin , hyperforin

Drug interaction: potentiate effect of cns depressant should be avoided in patient taking dopamine

Uses: -treatment of mild depression ( anti-depressant) - antiviral , anti- cancer

MA-HUANG ( EPHEDRA) Mechanism of action : - releases norepinephrine from sympathetic nerve endings

Toxicities: g.i t disturbances, photosensitization - synergistic effect with ssris & maoi

Uses : 1. nasaldecongestant 2. pressor agent

3. antiasthmatic

Toxicities : -dizziness - insomnia -tachycardia -anorexia - flushing - arrythmia - palpitations - marked increase in b.p - toxic psychosis Contraindications:

1. 2. 3.

4. 5. 6.

Anxiety Glaucoma hyperthyroidism diabetes heart failure hypertension

st. john’s wort SAW PALMETTO ( SERENOA REPENS or SABAL SERRULATA) - berries contain phytosterols, aliphatic alcohol, polyprenes and flavonoids Mechanism of action : -inhibits 5 alpha reductase - has antagonistic effects on androgen receptor Uses: benign prostatic hyperplasia Toxicity : abdominalpain, g.i distress decrease libido, headache and hypertension Saw palmetto ( serenoa repens or sabal serrulata)

Ma- huang (ephedra) MILK THISTLE ( SILYBUM MARIANUM)

–

fruit and seeds contain flavonolignans (silymarin)

Mechanism action: - reduces lipid peroxidation, scavenges free radicals -enchances superoxide dismutase -inhibits formation of leukotrienes -increases hepatocyte rna polymerase activity Uses - protect liver injury caused by alcohol, acetaminophen, amanita mushrooms, viral hepatitis Toxicities: none, no significant drug interaction