10: Musc-Skel and Low Dose Herbs

Question 1

Salix spp

[Willow bark]

Answer 1

salicin! converted to salicylic acid in GI by microbes
cooling and drying
salicyl glycosides–> salicylic acid in GI (distal ileum)
anti-inflamm, analgesic, febrifuge
IND: M and jt pain, HA, fever
C/I: salicylate allergy, G6PD def

Question 2

Filipendula ulmaria

[Meadowsweet]

Answer 2

salicin!
cooling and drying
salicylaldehyde, methyl salicylate, phenolic glycosides
anti-inflamm, diaphoretic, diuretic, antibacterial
IND: burning pain, gastritis, PUD
C/I: salicylate allergy

Question 3

Actaea racemosa

[Black cohosh Cimicifuga]

Answer 3

salicin!
triterpene glycosides, comifugine
antispasmodic, anti-inflamm, antirheumatic, alterative, nervine, “estrogenic”

Question 4

Tanacetum parthenium
[Feverfew]

glucosamine chondrotin + tanacetum 150mg tid encapsulated

Answer 4

drying and warming
antimicrobial, anti-inflamm, febrifuge, reduces secretion of inflammatory mediators from WBCs/histamine from mast
IND: migraine HAs, RA, inflammatory OA, fever

Question 5

Curcuma longa

[Turmeric]

Answer 5

cooling, warming, stimulating
curcumin, zingiberone
alterative, anti-inflamm, antiox, anti-CA, cholagogue
specificity=liver, circ sys
IND: inflamm, jaundice, liver d/o, chronic skin. CVD
C/I: large doses in pregnancy, bile duct obstxn

NOT very bioavail–eat with fat or pepper to increase

Question 6

Zingiber officinale

[Ginger]

Answer 6

specificity= circ, digestive
zingiberene, zingiberole
antiemetic, carminative, stomachic, anti-inflamm, analgesic, expectorant
IND: weak digestion, colic, gas, cramping, N, V, morning/motion sickness

Question 7

Rosmarinus officinalis

[Rosemary]

Answer 7

rosmarinic aicd, volatile oils
circ stim, stimulant nervine, rubefacient, anti-inflamm
IND: hypotension following stress, poor memory, inflamm
C/I: preg

Question 8

Boswelia serrata

Answer 8

resin: boswelic acid, volatile oils, polysaccharide
anti-inflamm, circ stim, analgesic
IND: GI and jt inflammation, IBD
C/I: large doses GI irritation

Question 9

Corydalis yanhusuo

Answer 9

bitter, warm, acrid
corydaline, DHCB
anodyne, invigorates blood
IND: neuralgic pain, dysmenorrhea, traumatic injury, abdominal pain
**DHCB: no antinociceptive tolerance

Question 10

Piscidia erythrina

[Jamaican dogwood]

Answer 10

relaxing
isoflavonoids (rotenone=toxic), glycosides, calcium oxalate, resin, fats
*TOXIC
sedative, antispasmodic, anodyne
IND: dysmenorrhea, insomnia, M tension/pain, neuralgia
C/I: pregnancy, may cause N, overdose=bradycardia, convulsions, death

Question 11

Valeriana officinalis

Answer 11

warming, lax
volatile oils: isovalianic aicd, borneol
sedative, relaxant, antispasmodic, hypotensive, diuretic
C/I: potentiate other sleep-inducers, long term use may cause benzo type withdrawal

Question 12

Viburnum opulus

[Cramp bark]

Answer 12

drying
viopudial, hydroquinones (arbutin)
antispasmodic, nervine, hypotensive, beta2 receptor agonist, anti-inflamm
IND: dysmenorrhea, menorrhagia, bronchoconstiction, skel m spasms, pelvic congestion, bladder spasms, asthma

Question 13

Capsicum annuum

[Cayenne]

Answer 13

oleoresin capsaicin
circ stim, anti-inflamm, mucolytic, diaphoretic, cholesterol reducing, gastric stim, depletes sub P, anodyne
IND: neuralgia, myalgia, jt pain, psoriasis, toothache
capsaicin creams for shingles, postherpetic neuralgia, arthritis
C/I: avoid in eyes/mucous membranes!
TOPICAL for pain

Question 14

Gaultheria procumbens

[Wintergreen]

Answer 14

volatile oil: methyl salicylate, oenanthic alcohol
NEPHROTOXIC
TOPICAL

Question 15

Arnica

Answer 15

stimulating
volatile oils, resins, flavonoids
stimulates circ and macrophage activity, helps resolve edema and ecchymosis
IND: tissue trauma, arthritic jts
CAUTION: Low dose both internally and externally (acts as topical immunostimulant to clean up tissue destruction waste)

Question 16

Carica papaya

[Papaya]

Answer 16

papain: proteolytic enzymes with anti-inflammatory action
increase serum firinolytic, reduce plasma fibrinogen, decrease bradykinin, reduce edema/pain, decrease PGE2 and thromboxane A2
modulate immune cell surface adhesion

need large dose for anti-inflamm effect

Question 17

Ananas cosmosus

[Pineapple]

Answer 17

bromelain: proteolytic enzymes with anti-inflammatory action
increase serum firinolytic, reduce plasma fibrinogen, decrease bradykinin, reduce edema/pain, decrease PGE2 and thromboxane A2
modulate immune cell surface adhesion

500-2000mg daily in divided doses

Question 18

Highest class of medicine

Answer 18

deep curative and tonifying action.
Taken over mos-years. Action is slow, target many processes. Correspond with spring and early summer
Ex: nettles, dandelion greens

Question 19

Middle class of medicine

Answer 19

herbs taken for tx of specific ailment

taken in small amounts over extended period or large amounts over short period

Question 20

Lower class of medicine

Answer 20

herbs that are very forceful in their action in a particular direction. Can easily upset harmony of organism. Only used SHORT term

Question 21

Aconitum napellus

[Monkshood, Wolfsbane, Aconite]

Answer 21

LOW DOSE
terpene alkaloids, aconitine
sedative, anodyne, febrifuge
IND: pain, small/freq pulse, shock, fear, anxiety, fever, sudden/violent fever esp early stages
dosing: 1-10 drops in 4oz water. dispense from that 1 tsp every 2 hrs. MAX=1 drop
NEVER dispense in an undiluted bottle

Question 22

Datura stromonium

Answer 22

LOW DOSE: Deadly Nightshade
tropane alkaloids-atropine. parasympathoLYTIC (anticholingergic)
large doses- effect CNS: dilates pupils, dries, increase HR, increase CO, decrease peristalsis
Overdose= mad as a hatter, hot as hell, dry as a bone, blind as a bat
IND: resp tract spasms, m spasms of Parkinson’s

Question 23

Hyoscyamus niger

Answer 23

LOW DOSE: Deadly Nightshade
tropane alkaloids-atropine. parasympathoLYTIC (anticholingergic)
large doses- effect CNS: dilates pupils, dries, increase HR, increase CO, decrease peristalsis
Overdose= mad as a hatter, hot as hell, dry as a bone, blind as a bat
IND: urinary tract spasms, N/D assoc with motion sickness and Meniere’s GI spasms,

Question 24

Gelsemium

Answer 24

LOW DOSE
oxindole alkaloids-gelsemine, gelsemicine
febrifuge, sedative, anodyne
IND: bright eyes, flushed face
CI: cardiac weakness, with sedative drugs, preg

Question 25

Bryonia

Answer 25

LOW DOSE
curcurbitacin glycosides-bryonin, bryonidin
febrifuge, anodyne, sedative
IND: inflammation of serous membranes
sxs of toxicity= colic, V, D, gastroenteritis, cardiac dep, mydriasis, death

Question 26

Pulsatilla

Answer 26

LOW DOSE
alkaloid – anemonine, saponins.
Actions: nervine, sedative, emmenagogue
Indications: nervous anxiety

Question 27

Atropa belladona

Answer 27

LOW DOSE: Deadly Nightshade
tropane alkaloids-atropine. parasympathoLYTIC (anticholingergic)
large doses- effect CNS: dilates pupils, dries, increase HR, increase CO, decrease peristalsis
Overdose= mad as a hatter, hot as hell, dry as a bone, blind as a bat
IND: GI spasms, SLUD

Question 28

Emergency procedure for overdose

Answer 28

Call Poison control
1. CPR
2. Minimize absorption of toxic (vomit if non corrosives in hour or less)
Emesis-not appropriate in many situations. Could do Ipecac syrup but has a LOT of problems. not standard of care
3. Gastric lavage in hospital
4. Activated charcoal**
5. Saline cathartics
6. Precipitations of alkaloids with tannins (black tea, uva ursi, oak bark)
STABILIZE the pt

Question 29

Eschscholszia californica

Answer 29

for pain

Question 30

OTHER LOW DOSE herbs

Answer 30

Piscidia, Arnica