Sunday 3/ 4 / 2015
©Ali Kareem 2014-2015
Name
:
______________________________
Class
:
_______________________________
مكتب اشور لالستنساخ
BOTANICAL “ HERBAL ”
MEDICATIONS
Lecture 8
Total lectures NO. 59
Dr. Najeeb
Botanical or ``herbal`` medications
--------------------------------------------------------------------------
Botanical or ``herbal`` medications are available without prescription
and unlike over- the-counter medications are considered to be
nutritional supplements rather than drugs. As such these substances
are marketed without govermental review of safety & efficacy.They
are markated with few mandated reqirements.
1-Echinacea
------------------
Nature
Derived from Echinacea purpurea.
Actions
-Echinacea can reduce the duration of cold symptoms.
-Adverse effects
Unpleasant taste &GIT effects
Dizziness & headache.
2- Ephedra (Ma huang
)
---------------------------------------
Nature
Derived from various plants of the genus Ephedra.
Epedrine & Pseudoephedrine are two major constituents.
Actions
Ephedrine & pseudoephedrine release noradrenaline from
sympathetic nerve endings
Uses
-Asthma
-CNS stimulants
-Flu
-Athletic perfomance
-Weight loss
Adverse effects
-Insomnia,
-Anorexia
-Tachycardia
-Arrhythmia
-Toxic psychosis
Contraindications
Anxiety,bulimia,arrhythmia,hypertension ,heart
failure,hyperthyroidism,glaucoma & pregnancy.
3-Feverfew
---------------
Nature
Feverfew =Tanacetum parathenium, contains among others a lactone
that forms covalent bonds with thiol groups on proteins.
Actions
Inhibition of prostaglandin & leukotriene formation.
Uses
Migraine
Adverse effects
-Mouth ulcers
-GIT effects
-Possible antiplatelet action
4-Garlic
-----------
Nature
Garlic is Allium sativum.
Actions
In vitro studies show that garlic blocks platelet
aggregation,increases nitric oxide, is fibrinolytic , inhibits
hydroxymethylglutaryl coenzyme A reductase & angiotensin
converting enzyme .
Controlled studies have shown small reductions in blood pressure &
in cholestrol and reducion in plaque volume.
Adverse effects & interactions
Hypotention , nausea & allergic reactions.
used with caution in patients using antiplatelet drugs.
5-Ginkgo
------------
Nature
Prepared from Ginkgo biloba.
Contains glycosides & terpenoids
Actions
In vitro:antioxidents & increased formation of NO.
Animal studies: revealed reduced blood viscosity & changes in CNS
neurotransmitters .
Clinical uses
Intermittent claudication, coronary bypass surgey & in Alzheimer`s
dementia.
Adverse effects
GIT effects, headache & may be epileptogenic.
6-kava
----------
Nature
Prepared from Piper methisticum.
Actions
In vitro:Kava facilitates the action of GABA in CNS.
Clinical studies
In anxiety states ( needs several weeks of use)
Adverse effects
Skin exfoliatin , paresthesia, dystonia, hepatitis & hepatic necrosis.
7-Ginseng
--------------
Nature
Derived from plants of the genus Panax.
Actions
A smal clinical trial suggested some value in type 2 diabetes.
Ginseng is purported to improve mental & physical performance but
the clinical support for such effects is limited.
Adverse effects
Vaginal bleeding & mastalgia due to estrogenic effects. insomia ,
hypertension.
Caution: with hypoglycemic, antihypertensive, anticoagulant or
psychiatric medications.
8-Milk thistle
----------------
Nature
Milk thistle is derived from Silybum maryanum which contains
silymarin.
Actions
In vitro studies show that milk thistle scavengers free
radicals,increases hepatocyte RNA polymerase activity.
In human:in viral hepatitis & in liver injury caused by Amanita
mushrooms the results of clinical trials have been mainly
favourable.A commercial preparation is available in some countries
as an antidote to mushroom poisoning.
Adverse effects
Loose stools.
9-St John`s wort
---------------------
Nature
Derived from Hypericum perforatum.
Actions
In vitro studies: reduced serotonergic reuptake
In patients some but not all clinical trials have shown efficacy with
depression .
Adverse effects
Git effects,photosensitization.
Drug interactions
-SSRI
-MAOI.
-Warfarin ,becauase St John`s wort is a cytochome P450 enzyme
inducer
-Contracepive pills,for the same reason.
10-Saw palmetto
---------------------
Nature
Derived from Serena repens or sabal serrulata.
Actions
In vitro:inhibition of 5 apha reductase.
Clinical trials:in BPH saw palmetto have shown improvement in
urinary flow but didnot lower prostate specific antigene when
compared with finasteride.
Adverse effects
GIT effects,headache & decreased libido.
Done by
Ali Kareem