Pharm Herbals

Front 1

Echinacea
(Echinacea purpura, pallida,
angustifolia)• Uses:

Back 1

Immunostimulant for
colds, flu, etc.

Front 2

Echinacea
(Echinacea purpura, pallida,
angustifolia)• Mechanism:

Back 2

Increased
WBC and spleen cells

Front 3

Echinacea
(Echinacea purpura, pallida,
angustifolia)• Side effects:

Back 3

nausea,
hypersensitivity, headache

Front 4

Echinacea
(Echinacea purpura, pallida,
angustifolia)• Caution:

Back 4

Autoimmune
states, progressive
systemic diseases;
immunosuppressant drug
use, pregnancy

Front 5

Ginseng (Panax quinquefolius)
• Uses:

Back 5

Increases
stamina, staying power,
virilence, memory,
Antiaging [caps, tea,
extract, root powder: < 2
g/day]

Front 6

Ginseng (Panax quinquefolius)
• Side Effects:

Back 6

elevated
BP, nervousness, insomnia

Front 7

Ginseng (Panax quinquefolius)
• Caution:

Back 7

Hypertension,
cardiovascular disease,
diabetes (hypoglycemia),
avoid in pregnancy or with
steroids; possible “ginseng
abuse syndrome”,
adulteration problems

Front 8

Ginko Biloba• Uses:

Back 8

Cognitive problems
in elderly; circulatory
problems (e.g. cerebral
vascular disease, claudication);
vertigo; tinnitus

Front 9

Ginko Biloba
• Active ingredient:

Back 9

flavone
and terpene lactones

Front 10

Ginko Biloba• Mechanism:

Back 10

Promotes vasodilation and inhibits
PAF (Plt aggr factor)

Front 11

Ginko Biloba• Caution:

Back 11

aspirin, avoid use
with anticoagulants

Front 12

Garlic (Allium sativum)
• Uses:

Back 12

Lipid reduction,
Blood pressure
control, Antibacterial,
Antifungal [600-900 mg
tabs/day fresh/dried cloves;
tabs, powder, oil]

Front 13

Garlic (Allium sativum)
• Side effects:

Back 13

odor,
dermatitis, nausea

Front 14

Garlic (Allium sativum)
• Caution:

Back 14

Anticoagulants,
ulcer/reflux, pregnancy

Front 15

St. John’s Wort (Hypericum perforatum)• Uses:

Back 15

Antianxiety,
antidepressant (Hypericin®)

Front 16

St. John’s Wort (Hypericum perforatum)• Mechanism:

Back 16

May inhibit
5-HT uptake. May be
antiinflammatory due to
flavinoid content (300-500
mg caps of standard = 0.3%
hypericin tid or 2-3 gm in tea)

Front 17

St. John’s Wort (Hypericum perforatum)• Side effects:

Back 17

photosensitivity, nausea,
dry mouth, restlessness

Front 18

St. John’s Wort (Hypericum perforatum)• Caution:

Back 18

SSRI, MAO
interactions, pregnancy,
alcohol CYP's dec oral contra's

Front 19

Ginger (Zingiber officinale)
• Uses:

Back 19

Ginger (Zingiber officinale)
Antiemetic,
antispasmodic,
carminative [root,
extract, caps, tabs, tea
(1 g fresh root or powder
for nausea)]

Front 20

Ginger (Zingiber officinale)• Side effects:

Back 20

heartburn

Front 21

Ginger (Zingiber officinale)
• Caution:

Back 21

Anticoagulants; use
during pregnancy
Controversial

Front 22

Black Cohosh (Cimicifuga racemosa)• Uses:

Back 22

Phytoestrogen
for symptoms of
menopause (caps, root,
fluid and solid extracts
with doses of 40 mg/day
crude extract)

Front 23

Black Cohosh (Cimicifuga racemosa)• • Mechanism:

Back 23

Suppresses
LH release

Front 24

Black Cohosh (Cimicifuga racemosa)• • Side effects:

Back 24

nausea,
hypotension, abortion

Front 25

Black Cohosh (Cimicifuga racemosa)• • Caution:

Back 25

contraindicated
in pregnancy, follow BP

Front 26

Saw Palmetto (Serenoa repens)
• Uses:

Back 26

Prostatic
Obstructive Symptoms
(Stage I and II)
[lipidosterolic extract 160 mg
bid or 1 g dried berries tid with
food]

Front 27

Saw Palmetto (Serenoa repens)• Side effects:

Back 27

nausea,
diarrhea, headache

Front 28

Saw Palmetto (Serenoa repens)• Caution:

Back 28

Take with
meals, avoid other
hormone therapy, rule
out prostatic CA!!!
(will shrink prost but may delay tx if CA)
• May be of some benefit
in BPH

Front 29

Ephedra Ma Huang
(E. sinica, E. nevadensis)• Uses:

Back 29

Asthma, hay fever,
bronchitis, edema, arthritis, fever,
hypotension, urticaria, weight loss
(Herbal Phen-Fen), kidney problems,
venereal disease, allergy relief,
narcolepsy, rheumatism
Amphetaminelike
Dependence

Front 30

Ephedra Ma Huang
(E. sinica, E. nevadensis)•
• Active principle:

Back 30

ephedrine,
pseudoephedrine (only of sufficient
quantities in Chinese species)

Front 31

Ephedra Ma Huang
(E. sinica, E. nevadensis)• • Side Effects:

Back 31

insomnia, irritability,
headaches, nausea, vomiting,
tachycardia, heart failure,
arrhythmias

Front 32

Ephedra Ma Huang
(E. sinica, E. nevadensis)•
• ABUSE POTENTIAL

Back 32

Used by
athletes as stimulant;

Front 33

Aloe Vera
• Uses:

Back 33

Treatment of
burns, superficial
wounds: antiinflammatory;
soothing; antipruritic;
antiseptic?

Front 34

Aloe Vera• Side Effects:

Back 34

rare
dermatitis; severe
diarrhea when used
internally

Front 35

Aloe Vera• Caution:

Back 35

Avoid
Injection will cause death

Front 36

Bearberry (Arctostaphylos uva-ursi)• Uses:

Back 36

Urinary tract
antiseptic/mild diuretic [<
10g/day drops, tabs, tea]

Front 37

Bearberry (Arctostaphylos uva-ursi)• • Mechanism:

Back 37

Arbutin
(5-15%) transformed to
hydroquinone, a urinary
antiseptic

Front 38

Bearberry (Arctostaphylos uva-ursi)•• Side effects:

Back 38

greenish urine, nausea

Front 39

Hawthorn (Crataegus douglas)• Uses:

Back 39

Heart failure
(stage I & II), coronary
vasodilator [160-900 mg
extract p.o. in 2-3
doses/day]

Front 40

Hawthorn (Crataegus douglas)• Side effects:

Back 40

fatigue,
hypotension, nausea,
sweating, sedation

Front 41

Hawthorn (Crataegus douglas)• Caution:

Back 41

follow BP esp.
if on antihypertensives,
use with nitrates may
also increase digoxin
effect; avoid use with
sedatives

Front 42

Valerian (Valeriana officinalis)
• Uses:

Back 42

Sedation, Anxiety
reduction, Improved sleep
patterns [tabs, caps, tinctures,
tea (400 mg extract before bed)]

Front 43

Valerian (Valeriana officinalis)• Side effects:

Back 43

nausea (bad
taste), hypersensitivity,
rare paradoxical reaction
(excitability)

Front 44

Valerian (Valeriana officinalis)• Caution:

Back 44

avoid with alcohol
and CNS depressants, avoid
in liver disease; unstudied in Pregnancy

Front 45

Psychoactive Herbs

Back 45

• Kava (Piper
methysticum)
• Marijuana
(Cannabis)
• Peyote
• Datura or Jimson
• Morning Glory
• Opium Poppy
Kava

Front 46

Kava (Piper methysticum)
• Uses:

Back 46

Anxiety; stress
reduction

Front 47

Kava (Piper methysticum)
• Active principle:

Back 47

kavapyrones in form of
extract, root, tabs or caps
[70 - 240 mg/day]

Front 48

Kava (Piper methysticum)• Side Effects:

Back 48

decreased reflexes and
judgement, kava dermatitis

Front 49

Kava (Piper methysticum)
• Caution:

Back 49

ABUSE
POTENTIAL Psychological
dependence – avoid use with
alcohol, benzodiazepines,
Levodopa

Front 50

Herbal Antioxidants

Back 50

• Green Tea (antiox prop)
• Grapeseed Extract (proanthocyanidins
= pacs)
• Pine Bark (pacs--pycnogenol)
• Turmeric (curcumin)
• Milk Thistle (silymarin)
• Cabbage Family
• Miscellaneous plant pigments:
carotenoids, flavenoids

Front 51

Nutritional Supplements:
5-HTP (Griffonia Seeds)• Uses:

Back 51

Weight loss;
depression; addiction; PMS;
insomnia; migraine;

Front 52

Nutritional Supplements:
5-HTP (Griffonia Seeds)• Mechanism:

Back 52

Precursor for
Serotonin (inc serotonin levels) a chemical
neurotransmitter that
modulates: mood; emotion;
sleep; appetite

Front 53

Nutritional Supplements:
5-HTP (Griffonia Seeds)

Back 53

• Side Effects: Parkinson’s
disease; nausea; vomiting; GI
cramping, diarrhea, variations in blood pressure

Front 54

• Melatonin:

Back 54

Hormone produced by pineal gland via
synthesis from serotonin. Involved in maintenance
of circadian rhythms

Front 55

• Melatonin:• Uses:

Back 55

Jet-lag and other sleep disturbances;
depression (especially Seasonal Affective
Disorder); potential adjuvant therapy with IL-2 in
advanced cancers; endocrine disorders (e.g.
menopause); antioxidant properties (anti-aging and
anticancer); increased sexual performance;
potential oral contraceptive.

Front 56

• Melatonin:• Side Effects:

Back 56

Relatively low with rare
development of arthralgias, myalgias and
leukopenia. Modest elevation in hepatic enzymes.

Front 57

Phytoestrogens:

Back 57

Plant-derived compounds that act like
estrogens. Most well studied are the isoflavones in soy or
red clover.

Front 58

Phytoestrogens:• Mechanism:

Back 58

Believed to act like endogenous estrogens to
significantly reduce menopausal symptoms (e.g. “hot
flashes”). Also reduces total cholesterol and LDL while
elevating HDL. The effect on lipids has not been observed
with isoflavones administered alone!! May increase bone
density and possess antioxidant properties that may provide
utility in treating breast and prostate cancer.

Front 59

Phytoestrogens:• Uses:

Back 59

Cancer treatment or prevention; cardiovascular
disease (esp. lipid involved); osteoporosis. Clear efficacy in
reducing menopausal symptoms.
• Concerns: May not be safe in women with ER+ breast
cancer or pregnant or nursing women.

Front 60

DHEA
• Dehydroepiandrosterone

Back 60

(DHEA): An adrenal
hormone produced in high quantities in youth that declines with age. Peak concentrations are produced around age 25.
• Concerns: May lead to suppression of natural production
of DHEA and could increase liver damage. Use
supplemental antioxidants to prevent oxidative damage to
liver.

Front 61

DHEA
• Dehydroepiandrosterone
• Mechanism:

Back 61

Generates sex hormones (i.e. estrogen and testosterone); increases percentage of muscle mass;
decreases percentage body fat; stimulates bone deposition
and possesses antioxidant properties.

Front 62

DHEA
• Dehydroepiandrosterone
• Uses:

Back 62

Reduce cardiovascular disease; improve mood;
increase lean body weight; treat lupus and osteoporosis;
enhance immune system, treat multiple sclerosis and
Alzheimer’s disease. Used by athlete’s to promote muscle
mass and strength.

Front 63

Glucosamine/Chondroitin
• Glucosamine:

Back 63

A natural amino sugar that
promotes formation and repair of cartilage by
stimulating cartilage-building proteins.

Front 64

Glucosamine/Chondroitin
• Chondroitin Sulfate:

Back 64

A carbohydrate
component of cartilage that promotes water
retention and elasticity, inhibits enzymes that
break cartilage down and may stimulate immune
system.

Front 65

Glucosamine/Chondroitin
• Uses:

Back 65

Osteoarthritis if used long enough.
Response can vary greatly among individuals.

Front 66

Glucosamine/Chondroitin
• Concerns:

Back 66

Generally well tolerated. Care
required in patients with bleeding disorders or
taking anticoagulants. Shell-fish allergies.

Front 67

Fish Oil/Omega-3 Fatty Acids
• Omega-3 Fatty Acids:

Back 67

Polyunsaturated fatty
acids found in high concentrations in fish oil.
Identified as “essential” fatty acids. Play an
important role in the production of arachidonic acid
products.

Front 68

Fish Oil/Omega-3 Fatty Acids
• Omega-3 Fatty Acids:
• Uses:

Back 68

FDA provided a qualified health statement
that supportive but not conclusive research shows
that consumption of EPA and DHA omega-3 fatty
acids may reduce the risk of coronary heart
disease.

Front 69

Fish Oil/Omega-3 Fatty Acids
• Omega-3 Fatty Acids:
• Concerns:

Back 69

Increased bleeding and difficulty
regulating glycemic control in diabetics.

Front 70

Herbal-Drug Interactions

Back 70

Sedatives, sleeping pills,
antipsychotics, alcohol
Kava
Ginseng Warfarin
Caffeine, decongestants,
stimulants
Ephedra (Ma Huang)
Antidepressants, cardiac
glycosides

Front 71

Herbal Product Drug Interaction

Back 71

St. John’s wort
Aspirin, warfarin,
ticlopidine, clopidogrel,
dipyridamole
Ginkgo Biloba

Front 72

Herbal Products Best Avoided

Back 72

Yohimbe CNS stimulant
Ephedra (Ma Huang) Arrythmias, BP
Comfrey Liver toxicity
Chaparral Liver toxicity

Front 73

Herbal Product Toxicity
The Dangers with Herbals
Natural is not always safe

Back 73

Toxins in herbs contain other active agents
- specific indications
Proper dosing is essential
Delay in seeking care
Abuse potential

Front 74

History of Medicine

Back 74

2000 B.C. - “Here eat this root”
600 A.D. - Eat that Nigella
1000 A.D. - “That root is heathen.
Here, say this prayer.”
1850 A.D. - “That prayer is
superstition. Here drink this potion.”
1920 A.D. - “That potion is snake oil.
Here, swallow this pill.”
History of Medicine (2)
1945 A.D. - “That pill is ineffective.
Here, take this antiseptic penicillin.”
1955 A.D. - “Oops… germ mutated.
Here take this tetracycline.”

Front 75

History of Medicine (3)

Back 75

1960 - 2000 A.D. - “39 more ‘oops,
more germs mutated’….Here, take this
more powerful antibiotic, if you can
afford it. 20% of North Americans
cannot, 80% of the world cannot.”
2004 A.D. - “The bugs have won!
Cipro, Z-Pac and Vanco have failed and
besides we can’t afford it. Here eat this
garlic!!”