Botanical medicine

Question 1

Echinacea (E. pupurea and E. pallida)

Answer 1

• Flavonoids, polyacetylenes and caffeonyl conjugates are the active elements from leaves and roots of Echinacea.
• Effects: Known to ↑phagocytosis, activate NK cells, ↓IL6/8 and anti-inflammatory properties via Cox↓.
• Freshly pressed juice ingestion –within 24hr of onset; ↑immune function; ↓duration and intensity of common cold symptoms.
• AE: Unpleasant taste, GI symptoms, headache & dizziness.

Question 2

BPH tx

Effects: ↓ 5 α-reductase and antagonistic effects at androgen receptors. (Finasteride–>↓DHT)

Answer 2

Saw palmeto

Question 3

Depression tx

Answer 3

St. Johns Wort

- SSRI similarity

Question 4

Liver toxicity due to alcohol, acetaminophen and Amanita mushroom poisoning.

Answer 4

Milk thistle
Effects: ↓lipid peroxidation, scavenges free radicals, ↑superoxide dismutase, ↓LT formation, ↑hepatic RNA polymerase activity.

Question 5

Effects: improves mental and physical performance. Possible value in type 2 DM and some immuno-modulating effects.

CNS effects: ↑levels of Ach, 5HT, NE & DA

Answer 5

Ginseng

Question 6

• DEPRESSION
• Rx of intermittent claudication, cerebral insufficiency, dementia / cognitive impairment, and pretreatment in CABG –>↓ oxidative stress.

AE: Epileptogenic
•It is associated with insomnia, headache, anxiety; GI disturbances.
•May produce drug interaction with anticoagulants and antiplatelet drugs (due to its antiplatelet action)

Answer 6

Ginkgho

Question 7

• Contain ephedrine (prescription drug) and pseudoephedrine (OTC as decongestant).
• Effects: Active constituents are indirectly acting sympathomimetics; release NE from nerve endings.
• Used in the Rx of bronchitis, asthma and CNS stimulant. It is promoted for weight loss and ↑ athletic feats (in china used for cold & flu also).

Answer 7

Ephedra (Ma Huang)

Question 8

Parkinsons Disease

• Effects: it is associated with small degree of ↓in BP (systolic & diastolic). Used in Rx CHF, acute MI & CAD; slows progression of early PD and migraine attacks, Myopathy associated with HMG COA ↓.
• AE: GI symptoms. Rarely rash, irritability, ↓warfarin effects, thrombocytopenia, headache and dizziness

Answer 8

Coenzyme Q10

Question 9

Osteoarthritis
It is a nitrogen containing sugar, major component of glycosaminoglycans, which is an important ingredient of connective tissues such as cartilage.
- derived from crustaceans!

Answer 9

Glycosamine

Question 10

serotonin derivative, useful in jet lag because the condition may last for many days. The medicine used in such situation is:

Answer 10

Melatonin

Chronic use should be avoided as this may result in infertility.

Question 11

PMS

Answer 11

Black Cohosh (Actaea racemosa)

Question 12

sedative properties.
consumed to relax without disrupting mental clarity

AE?

Answer 12

KAVA

• Safety concerns have been raised over liver toxicity largely due to the use of stems and leaves.