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Herbal medicine summary +

*many drugs available in market are derived from plants, include: Aspirin, atropine, belladonna, capsaicin, cascara, colchicines, digoxin, ephedrine, resperine, scopolamine, senna, taxol, tubocurarine, vinblastine & vincristine *Herbs are considered dietary supplement, dietry supplement are not drugs or food (not considered drugs by the FDA). *this statement is required on the product label: this product has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent. *Unsafe herbs: Carcinogenic herbs: Borage, Calamus, Coltsfoot, Life root, & Sassafras. Hepatotoxic herbs: Chaparral, Germander, Kava, & Life root. Causing Peudoaldosteronism: high doses of Licorice. Causing myocardial infarction, strokes & seizures: Ma huang. Fatal in children: Pokeroot. *commonly used herbs:

1.Black Cohosh
*uses: for the premenstrual symptoms. *action: has Estrogen like effects, but with different mechanism. *contraindications: pregnancy. *S.E.: liver toxicity may occur.

2.Chaste tree berry

*Uses: 1.dirosrders of M.C. 2.breast swelling 3.PMS. *Action: inhibits prolactin secretion & inhibits FSH. *C.I.: 1.pregnancy 2.when using Hormone replacement therapy.

*S.E.: 1.Gastrointestinal upset 2.skin rash 3.inc. menstrual flow.

3.Cranberry
*Uses: UTI *Mechanism: urinary acidification. (Cranberry juice has high amount of Salicylic acid) *C.I.: 1.BPH 2.urinary obstruction. 3.nephrolethiasis. *D.I.: 1.inc Vit B12 abs. 2.inc. drug excretion from kidney. *S.E.: 1.N&V 2.Nephrolethiasis.

4.Dong quai
*Uses: 1.Menstrual disorders. 2.Anemia 3.Insomnia 4.Constipation 5.Rheumaism 6.neuralgia 7.Hypertension. *Mechanism: only 1/400 as active as Estrogen. *C.I.: 1.Pregnancy 2.Diarrhea 3.Hemorrhagic Ds 4.Hypermenorrhea 5.Hypotension 6.Colds&Flus 7.Allergy to Parsely. *D.I.: Anticoagulants (Warfarin) *S.E.: 1.Photodermatitis. 2.flatulance&Headache. 3.it contains Safrole(Carcinogenic)

5.Echinecea
*Uses: Internal use:upper&lower RTI. External use: ttt of superficial wounds& ulcers. *Mechanism: it increases body resistance to bacteria. *C.I.: 1.Immunosuppressants. (autoimmune Dz) 2.pregnancy& Lactation 3.Allergy to family. *S.E.: 1.N&V. 2.Allergy. 3.anaphylaxis 4.male infertility.

6.Feverfew
*Uses: Prophylaxis in Migraine. *Mechanism: inhibits Serotonin realease.

*C.I.: 1.pregnancy &lactation 2.children<2years. *D.I.: anticoagulants. *S.E.: 1.irritation of tongue& swelling of lips (i.e. Angioedema) 2.contact dermatitis.

7.Garlic
*Uses: 1.Hyperlipoproteinemia. 2.Arteriosclerosis. 3.immunostimulant (3lemona kedda fi sydala) *Mechanism: interfere in thromboxane synthesis. *C.I.: 1.Diabetes(inc insulin) 2.pregnancy &lactation. 3.peptic ulcer. 4.gastroesophageal reflux. *N.B.: discontinue 2 weeks b4 surgery. *D.I.: 1.Anticougulant(inc) 2.amphotericin(inc) 3.protease inhibitors(dec) 4.antihypertensives. 5.antidiabetics. *S.E.: 1.Heart burn. 2.Flatulance. 3.Sweating. 4.Menorrhagia.

8.Ginger
*Uses: 1.dyspepsia. 2.prophylaxis in travel sickness symptoms. *Mechanism: promotes saliva & gastric juice secretion. *C.I.: 1.Diabetics. 2.heart conditions. 3.gallstone pain. *D.I.: 1.antiplatelets &anticoagulants. 2.diabetic agents. 3.CCBs. *S.E.: 1.Heart burn. 2.Diarrhea. 3.Dermatitis.

9.Ginkgo
*Uses: 1.cerebral circulatory disorders. 2.vertigo,Tinnitus,weak memory & mood swing. *Mechanism: contain Flavonoids(antioxidant), Terpenoids, Ginkgolides(dec platelet aggregations) & Bilobalide(protect nerves) *C.I.: 1.Epilepsy. 2.Bleeding disorders. 3.Diabetes. 4.Infertility. *D.I.: 1.Antiplatelets. 2.Thiazides(inc BP) 3.anticonvulsants. 4.Antidiabetics.

5.Aminoglycosides(OTOTOXIC) 6.Trazodone(coma) *S.E.: 1.gastric disturbances. 2.toxic ingestion: Tonic-clonic Seizures & loss of consciousness.

10.Asian Gensing
*Uses: 1.inc Energy. 2.inc Concentraition. 3.during convulsions. *Mechanism: each Ginsenoside produces different effect on CNS. *C.I.: 1.Pregnancy& Lactation. 2.Children. 3.hypertension,emotional/psychological imbalances. 4.history of bleeding. 5.breast cancer. 6.diabetes. 7.schizophenia. *D.I.: 1.wz Phenelzine(MAO) hallucination & Psychosis. 2.wz Warfarin dec INR. 3.wz Stimulants(caffeine) 4.hypoglycemics(inc) *S.E.: 1.Excitation 1st 4 days. 2.inability 2 concentrate 4 long time. 3.vaginal bleeding(has Estrogen-like effect) 4.hypertension, Diarrhea, Insomnia, euphoria, nervousness & skin eruptions.

11.Siberian Ginseng
*Uses: 1.Fatigue. 2.inc energy. 3.inc concentration. 4. Convalscence. *Mechanism: may stimulate animal-pituitary-adrenal cortex. *C.I.: 1.Hypertension, MI& hypertonic crisis. 2.Diabetes. 3.bleeding. 4.schizophrenia& mania. *D.I.: 1.Digoxin(inc) 2.hexabarbital(inc sleep latency& duration) 3.diabetic agents(inc hypoglycemic risk) 4.anticoagulants. *S.E.: 1.Insomnia 2.Diarrhea. 3.dec. blood glucose. 4.tachycardia& hypertension.

12.Milk Thristle
*Uses: chronic inflammatory Liver disease & cirrhosis. *Mechanism: 1.produces antioxidants. 2.activate RNA Polymerase. *C.I.: 1.pregnancy. 2.allergy to Chrysanthemums. *S.E.: 1.Dirrhea. 2.allergic reactions.

13.Saw Palmetto
*Uses: micturition difficulties with BPH. *Mechanism: inhibits Dihydrotestosterone. *C.I.: 1.Pregnancy. 2.Children. 3.stomach upset. *S.E.: 1.Hemorrhage. 2.Headache. 3.Stomach upset.

14.St. Johns Wort

*Uses: supportive ttt for anxiety & depression. *Mechanism: may inhibit serotonin reuptake. *C.I.: 1.4 fair skin persons when exposed 2 bright sunlight. 2.hypothyrodism. *D.I.: 1.antidepressants(SSRIserotonin syndrome) 2.drugs metabolized by CYP450 3.dec efficacy of: Warfarin,Cyclosporin,Digoxin,O.C.,Antiretrovial,Theophylline&Irinotecan. *S.E.:1.photodermatitis. 2.GI irritations. 3.Allergic reactions 4.restlessness 5.inc TSH 6.inc BP.

15.Valerian
*Uses: restlessness & nervous disturbance of sleep. *Mechanism: believed that its sedative activity secondary to valepotriates. *C.I.: 1.In driving 2.other tasks requiring alertness. *D.I.: 1.Barbiturates 2.BZD 3.Opiates 4.Alcohol 5.other sedatives. *S.E.: 1.Headache 2.Hangover 3.excitability 4.Insomnia 5.Cardiac disorders. *Toxicity: 1.Hallucination 2.Hypothermia 3.Ataxia 4.inc muscle relaxation. *N.B.: dose should b tapered down slowly or else Benzodiazepine-like withdrawal symptoms.

*POTENTIALLY SAFE* 16.Chondroitin

*Nonapproved indication: 1.Viscoelastic agent in ophthalmic procedures 2.ttt of Osteoarthritis

*Mechanism: used in synthesis of new cartilaginous matrix on concentrating in cartilages. *C.I.: 1.previous hypersensitivity 2 Chondroitin Sulfate. 2.Bleeding disorders. 3.possible transmission of mad cow disease(produced from Bovine cartilage) so used wz Caution. *D.I.: may interact wz Heparin, theoretically may interact wz warfarin. *S.E.: 1.Nausea 2.headache 3.Epigastric pain.

17.Coenzyme Q10 (Ubiquinone)

*Nonapproved indication: 1.CHF 2.HT 3.Stable Angina 4.Cancer 5.Heart burn 6.Ventricular arrhythmias 7.Periodontal disease. *Mechanism:naturally accuring coenzyme wz a role in oxidative phophorylation&ATP synthesis *C.I.: 1.Biliary obstruction 2.Diabetes mellitus 3.Hepatic &renal insufficiency. *D.I.: 1.dec by Hypolipidemic agent. 2.inhibited by oral hypoglycemic 3.inc Doxorubicin toxicity *S.E.: 1.Rash&GI S.E.(nausea&diarrhea) 2.inc Aminotransferase(wz high doses)

18.Glucosamine
*Nonapproved indication: Osteoarthritis. *Mechanism: enhances cartilage proteoglycan synthesis &inhibits its deterioration. *C.I.: 1.hypersensitivity to glucosamine or shellfish 2.Diabetes (may impair insulin secretion) *D.I.: 1.inc Fluoxetine. 2.interacts wz diabetic agents. *S.E.: 1.GI,Heart burn &Diarrhea. 2.Headache,Drowsiness& Insomnia.

19.Melatonin
*Orphan drug status: ttt of Circadian rhythm sleep disorders in blind ppl. *Nonapproved indication: 1.Insomnia 2.Cancer 3.Depression 4.Jet leg. *C.I.: 1.Avoid in pregnancy 2.may inc sezures & depression symptoms. *D.I.: 1.Vit B12 influence melatonin secretion (low VitB12low melatonin) 2.MAOIs& SSRIinc Melatonin level. 3.BBsdec Melatonin. 4.Immunosuppresants may interact .

*S.E.: 1.Headache 2.Drowsiness& Fatigue in day time 3.transient depression.

KAVA(piper methysticum)
*Indication: Insomnia & Nervousness. *Mechanism: has centeral depressant action similar 2 Pentobarbital. *C.I.: 1.Depression. 2.pregnancy,lactation&Children. 3.when alertness needed. *D.I.: 1.it inc sedative effect of Barbiturates,BZP,Opiates&Alcohol. 2.inc MAOI. 3.inc antiplatelets effectinc bleeding. 4.dec Levodopa dec dopamine. *S.E.: 1.Hepatotoxicity 2.allergic skin reactions. 3.KAVA DERMOPATHY(swollen face&bloodshot eyes) 3.visiual disturbances 4.Neurological(Dystonic rxs & Dyskinesia) 5.yellow skin,nails&hair. 6.Toxicity(Ataxia,muscle weakness& ascending paralysis without loss of consciousness).

Thats it 4 the Herbsthe important things are the USES & S.E. (last June exam the Herbal part was very easy the questions were all about the USES). RABENA M3AKY. GBU.