Chapter 8 Herbal Therapies Flashcards
Any plant part or plant used for its therapeutic value
Herb
The art and science of using herbs for promoting health and preventing and treating illness
Herbal medicine
The branch of pharmacology that uses the chemicals from plants, molds, fungi, insects, and marine animals for their medicinal value
Pharmacognosy
In ___________ herbology, herbs are primarily classified according to their therapeutic properties and constituents of the plant.
Western
In Western herbal theory, the recommendation to use _______ is based on a statistically significant reduction in the levels of fasting glucose, total cholesterol, and LDL-C levels
Cinnamon
_____ is often referred to as “true cinnamon” or Ceylon cinnamon.
Cinnamon (C. zeylanicum)
Name other commercially labeled cinnamon
Saigon cinnamon (C. loureiroi) and C. burmannii
___ is generally based on the concept that man is a microcosm of a larger macrocosm.
The Dao
Distinction between Western and Traditional Chinese Medicine
Instead of relying on science to identify the sources of disease and health, the Chinese looked to nature from a Daoist perspective.
TCM places much value on ___
Power of food in healing; person consuming herb.
Other aspects of TCM include acupuncture, energy movements (tai chi), massage (tui na), and balance, are always considered in developing a treatment regimen.
____ is defined as the study of life; ayur means “life” and veda means “to study.”
Ayurvedic Medicine
Ayurvedic medicine encompasses a myriad of therapies based on the constitution of the individual and nature of his or her particular disease.
In Ayurvedic herbology, herbal therapy is interchangeable with food and spices, Their use depends on a person’s constitution, classified according to the tridosha theory and the nature of the diseases. Name the 3 doshas
1) vata (air/ether), which corresponds to the nervous system and movement
2) pitta (fire/water), representing transformation, circulation, warmth, and digestion
3) kapha (water/earth), representing nourishment, solidity, and the formative aspects of tissue, fluid, and bone
Ayurvedic treatment of imbalances within the tridoshic theory is not limited to herbal therapy alone, there are 5 additional therapies. What are they?
(panchakarma), diet, aromatherapy, massage (abyanga), meditation, daily routine (dinacarya), and the practice of yoga.
The ____ Act of 1994 also requires dietary supplements (including herbs) to carry on the label this statement: “This product has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”
Dietary Supplement Health and Education (DSHEA)
___ is a complementary medicine grading system founded by clinicians and researchers from more than 100 academic institutions.
Natural Standard; Graded A-F
It is designed to provide clinicians with the latest scientific data and expert opinion on complementary medicine including herbal therapies.
Grade of A = strong scientific evidence
Grade B = good scientific evidence
Grade C = unclear
Grade D = fair negative
Grade F = statistically significant negative evidence
___ was designed as a reference for both practitioners and consumers. It evaluates the current evidence regarding herbs and nutritional supplements and is compiled from of 25,000 research articles and more than 600 peer-reviewed journals.
Healthnotes The Natural Pharmacy
____ scale uses the Strength of Recommendation Taxonomy to rate the scientific evidence of a variety of integrated medicine treatments
The Rakel Evidence Versus Harm; Graded A-C
A grade based on consistent, good quality, patient-oriented evidence
B grade based on inconsistent or limited-quality patient-oriented evidence
C grade based on consensus, usual practice, opinion, disease-oriented evidence, or case series for studies of diagnosis, treatment, prevention, or screening
__ is considered one of the best sources of reliable evidence for and against specific treatments for specific conditions.
Cochrane
The Cochrane Collaboration produces reviews of evidence and creates a database of health-care interventions
___ nonprofit educational and research organization dedicated to the science of herbal medicine
American Botanical Council (ABC)
Comprises an advisory council of experts and is affiliated with several natural medicine health science institutions and organizations. Provides commentary, additions, and in some cases, editor’s notes for correction on all Commission E monographs.
What is the gold standard of care for practice
Evidence-based medicine (EBM)
Plant is a succulent. Contains numerous active constituents: vitamins, enzymes, minerals, sugars, lignin, saponins, salicylic acids, and amino acids
MOA: Derived from either the juice (gel) expressed from the leaf, latex (the layer between the gel and skin), or preparations that combine both the gel and skin.
Route: oral and topical
Uses: digestive ailments, constipation. Stimulant type of laxative similar to Senna. Acne, abrasions, cuts, irritation, minor burns, frostbite, sunburns, minor wounds, and psoriasis.
ADR: Gastric irritation, possible skin reaction
Contraindications: Avoid in patients who take any anticoagulant or long-term aspirin therapy. Avoid latex and plant skin.
Aloe
This herb is commonly referred to as Chinese or Mexican parsley and is known in Asian cultures as leaf-coriander. High in vitamin A and has high levels of vitamin K, folic acid, niacin, beta-carotene, vitamin C, vitamin B6, iron, and manganese
MOA: Result of its flavonoids, which have high antioxidant effect. Phytonutrients and fiber aid in control of lipid levels
Route: Oral
Uses: Digestive aid, carminative, antispasmodic, diuretic and antibacterial effects. Rheumatism and joint pain, help maintain good cholesterol levels
ADR: With the exception of individual sensitivity to the herb, considered to be safe
Contraindications: Avoided in high doses in pregnant women
Cilantro
One of the oldest, most common spices worldwide.
MOA: active component cinnamaldehyde, responsible for promoting insulin release, enhancing insulin sensitivity, increasing insulin disposal, and exerting activity in the regulation of proteintyrosine phosphatase 1B and insulin receptor kinase.
Uses: treatment of diabetes, gastrointestinal complaints, inflammatory issues, boosting cognitive function, and even as an antimicrobial.
Route: Oral
ADR: none listed
Contraindications: none listed
Cinnamon
There are many species of cinnamon; however, the four principal Cinnamomum species are C. zeylanicum from Sri Lanka, C. Loureiroi from Vietnam, C. burmannii from Indonesia, and C. aromaticum from China.
Of these four species, C. zeylanicum and C. aromaticum are the most widely exported and utilized.
Cinnamon would not be considered a primary therapy; however, regular use in the diet may improve patient response to medical therapy and influence clinical outcomes.
One of the oldest medicinal annual plants in the family Leguminosae used in Ayurvedic medicine and TCM.
MOA: none listed
Uses: may increase milk production in lactating women (similar to estrogen) and may help lower blood sugar in diabetes. Considered a “softening herb” and has been used to treat constipation.
Route: Oral
ADR: none listed
Contraindications: Avoided by patients who have legume allergies, and it should be used with caution in women with estrogen-related risk.
Fenugreek
Scientifically known as Trigonella foenum-graecum, other common names for fenugreek include bird’s foot, chilbe, Greek hay, methi, and trigonella
The rhizome (or underground stem) of the plant is the usable part of the plant.
MOA: anti-serotonergic and 5-HT3 receptor antagonism, although this is not fully understood
Uses: nausea and vomiting
Route: Oral
ADR: none listed
Contraindication: none listed
Ginger
(Zingiber officinale), also known as amomum zingiber or gingerroot
perennial sub-shrub belonging to the Lamiaceae family
MOA: phenols and carvacrol. Flavonoids appear to relax tracheal and ill smooth muscle via inhibition of ACh and histamine receptors
Uses: relieve coughs, bronchitis
Route: Oral
ADR: none listed
Contraindications: none listed
Thyme
MOA: none listed
Uses: indigestion, flatulence, constipation, and menstrual cramps. In infants for colic
Route: oral
ADR: diarrhea and mucous membrane irritation
Contraindication: None listed
Caraway
Comes from the locust bean tree (Ceratonia siliqua). High fiber content and tannins (found in wine, nuts, and cheeses).
MOA: none listed
Uses: In combination with a hydrating solution such as Pedialyte to treat diarrhea.
Route: Oral
ADR: none listed
Contraindication: none listed
Carob Powder
non-digestible carbohydrates (e.g., foods high in fiber or those that promote a healthy microbiota)
serve to induce the growth of helpful bacteria and fungi, particularly in the gastrointestinal tract.
Prebiotics
usually lactobacillus or bifidobacteria
have a beneficial effect on the digestive system.
Sources include dairy products, yogurt containing live active cultures, tempeh, Japanese miso, and other fermented foods.
Probiotics
Beneficial in the treatment of several conditions including diarrhea, constipation, and irritable bowel syndrome, regulating blood sugar levels in diabetes. Helps create firmer stool.
It is a soluble fiber that comes from the husk of the seeds of Plantago ovata. Bulk-forming agent
Potential role in tremens of metabolic syndrome
Psyllium
Comes from the leaves and pods of the cassia shrub. Can be overused and create a laxative dependency.
MOA: When it enters the intestinal tract, bacteria convert it into a biologically active agent.
Uses: Increases peristaltic action in the lower bowel
Route: Oral
ADR: abdominal cramping, diarrhea, hypokalemia, and clubbing of the fingers with chronic use
Contraindications: Excreted in breast milk and should not be taken by breastfeeding women. Patients with irritable bowel syndrome, hemorrhoids, GI inflammatory conditions, or prolapsed rectum should not use.
Senna (Senokot)
Foods that act as both prebiotics and probiotics
Synbiotics
The fruit is dried, powdered, and mixed together and given daily as a general tonic and detoxify.
Traditionally used to treat gastrointestinal disorders and restore bowel health.
Blend of 3 fruits
Triphala
Blend of three fruits: amla (Emblica officinalis), bibhitaki (Terminalia bellirica), and haritaki (Terminalia chebula).
Each fruit balances one of the three doshas—amla controls pitta, bibhitaki controls kapha, and haritaki controls vata
Used for hundreds of years by Native American tribes for cold symptoms, not specifically as a preventive herb or immune booster. Also provides protection against infection, and reduces the need for pain management
Echinacea
From the Panax quinquefolius plant. Usually dried or cured and is highly valued.
MOA: not listed
Uses: tonic and adaptogen to improve one’s resistance to adverse conditions, enhancing internal induction, phagocytosis, and natural killer, B, and T cells. It has shown either in vivo or in vitro to potentiate nerve growth factors, provide an antioxidative and anti-apoptotic effect and influence ATP levels. Found to increase plasma insulin levels and increase insulin receptors and sensitivity
ADR: dizziness, drowsiness, headache, and insomnia, although chest pain, diarrhea, HTN, impotence, nervousness, agitation, palpitations, nausea, and vomiting
Contraindication: not listed
Ginseng
Also known as dong chong xia cao in TCM, genus of ascomycete fungi that are endoparasitoids,
Uses: boost immunity and improve energy, stamina, and endurance by facilitating mitochondrial function, and influence cortisol and other stress hormones
Cordyceps (Cordyceps sinensis) a type of Mushroom
Used to support the immune system, is also used to improve brain function and memory.
Found to induce the synthesis of nerve growth factor, which is essential for the growth and differentiation of neurons, particularly those in the forebrain, which houses memory
Lion’s Mane (a type of mushroom)
Considered to work similarly to a flu shot. This mushroom is high in beta-glucans which stimulate the immune system and activate the immune response
Maitake (Grifola frondosa)
Mushroom of immortality known for ability to boost immunity, and used in cancer prevention/treatment.
In China, it is known as ling zhi and is prepared alone or in several herbal formulas for its ability to boost immunity and as a tonic to impart strength, vigor, slow aging, and promote longevity.
Reishi
Nicknamed the romantic mushroom
Affinity to grow clustered with other mushrooms, stimulated by music. High in beta-glucans, rich in B vitamins and minerals. Effective against oxidative stress and inflammation. May help fight cancer cells and facilitate healing of chromosome damage caused by anticancer treatments. Found to improve the overall survival of gastric cancer patients
Shiitake
Adaptogen used in Ayurvedic medicine. Used to strengthen the immune system, enhance stamina, and improve libido.
Referred to as Indian ginseng or winter cherry for its rejuvenating properties. used as an aphrodisiac.
Found to have a GABA-mimetic effect and promote formation of dendrites. Demonstrated an anxiolytic effect, improved energy and mitochondrial health
Ashwagandha
Ayurvedic herb. Increases stamina, libido, and sexual function in men. Improves muscle tone and endurance. Improves symptoms of menopause in women and found to increase serum testosterone. Improves fertility and psychosexual aspect
Gokshura
Referred to as the yin yang huo in TCM. Improves fertility and increases sexual drive.
Suggested to be Icarian, a flavonoid glycoside that has been suggested o increase nitric oxide synthesis in the penis and inhibit PDE5 in cavernosal smooth muscle
ADR: tachyarrhythmias, aggressive behavior, and irritability have been noted in older patients.
Horny Goat Weed (Epimedium)
Peruvian herb used to improve sexual behavior.
MOA: unknown
Significant positive effect on sexual dysfunction and sexual desire
ADR: altered menstrual cycle, moodiness, cramps, gastritis, and insomnia
Maca (Lepidium meyenii)
Decreases symptoms of an enlarged prostate due to BPH.
ADR: dizziness, headaches, nausea, vomiting, constipation, diarrhea, and slow clotting response have been reported.
discontinued or used with caution in patients who are taking anticoagulation
Saw Palmetto (fruit of the Serenoa repens plant)
Aphrodisiac.
Enhances the central sexual impulse by blocking the alpha-2 adrenoceptors in the locus coeruleus in the brain
ADR: HTN and increased heart rate, but the most common side effects are anxiety and agitation.
Yohimbine
MOA: phenolic constituents and the role of oligosaccharides.
Uses: wounds, urinary disorders, diarrhea, diabetes, stomach ailments, and liver problems, urinary tract infections.
ADR: due to high levels of salicylic can cause gastric side effects often associated with excessive use.
Important to remind patients to hydrate with water and avoid if contains refined sugar
Cranberry
Referred to as Chinese angelica root or female ginseng in TCM. Member of the parsley family.
Uses: menstrual pain, premenstrual syndrome (PMS), infrequent periods, recovery from childbirth, menopause, and fatigue/low vitality.
nourishes blood and invigorates circulation. Consumed by men for premature ejaculation
ADR: allergic reactions of topical. Taking along with anticoags increases risk of bruising and bleeding
Dong Quai (Angelica sinensis)
Uses: morning sickness in pregnant women, uterine relaxant. Shortens labor and decreases likelihood of pre and post-term gestation, artificial rupture of their membranes, or require a caesarean section, forceps, or vacuum birth.
Targets the genitourinary system and can help with menstrual cramps and reduce severity of bleeding
Raspberry Leaf (Rubus idaeus)
Ayurvedic herb of the asparagus family. meaning of name is “she who possesses a hundred husbands”
Uses: supports fertility and vitality, regulates hormone level, used in menopause. Supports production of breast milk. Improves libido
Shatavari (Asparagus racemosus)
There are two varieties: shatavari (red shatavari) and mahashatavari (white shatavari) and both are estrogenic
Is a steroid precursor found in plants
from yam family and secreted by primate adrenal glands. hormone-like
It is converted into androgens and estrogens (depending on the person’s gender) and may raise the blood level of a precursor of human growth hormone.
May cause negative feedback to the adrenal glands, thereby reducing production of endogenous hormones.
Uses: adrenal insufficiency and depression
ADR: aggressiveness, hirsutism, insomnia, and irritability.
Contraindications: Patients with hormone- sensitive cancers should be discouraged from using it, as should pregnant and breastfeeding women. Likely to interact with other hormone therapy
Dehydroepiandrosterone (DHEA)
Extract from leaves that stimulated prostaglandin synthesis and thereby cause vasodilation, increasing tissue perfusion and cerebral blood flow.
Uses: improve mental alertness, treatment of cerebrovascular disease and peripheral vascular disease. Improve cognitive ability, concentration, and memory. Dementia symptoms
ADR: diarrhea, headache, nausea, vomiting, bruising, excessive bleeding, and seizures in overdose.
Contraindication: Because it reduces platelet-activating factor and erythrocyte aggregation, it should not be taken with anticoagulants or antiplatelet medications.
Ginkgo (Ginkgo biloba, ginkogink)
Shrub that comes from the dried root of a member of the black pepper family
MOA: seems to act on the gamma- aminobutyric acid (GABA) receptor, similar to benzodiazepines
Uses: treat anxiety disorders, fatigue, and insomnia, seizure activity, sedation
ADR: decreased motor reflexes, diminished judgment, and visual disturbances. Long-term use may decrease platelet count and cause dry, flaky skin; reddened eyes; shortness of breath; pulmonary hypertension; and weight loss.
Contraindications: Interacts with other antiphyschotic drugs. Should not be used in pregnancy or when breastfeeding because its safety is uncertain during pregnancy
Kava (Piper methysticum), also called ava, awa, kava-kava, kawa, kew, or tonga
Hormone produced by the pineal gland.
Because it is a hormone, exogenous consumption over extended periods of time may act as negative feedback and suppress normally secreted amounts.
MOA: Produced when serotonin is broken down in the pineal gland with the help of two enzymes; arylalkylamine N-acetyl transferase (AA- NAT) and hydroxyindole-O-methyl transferase
Uses: induce sleep, prevent jet lag
ADR: altered sleep patterns, confusion, headache, tachycardia, and hypothermia.
Potentiates benzodiazepines and succinylcholine
Melatonin
Chemical found naturally in the body produced from methionine, an amino acid found in foods
faster onset of action than conventional antidepressants.
Uses: depression
ADR: mania
S-adenosyl-L-methionine (SAM-e)
Known as Tipton’s weed, rosin rose, goat-weed, chase-devil, or Klamath weed. Its flowers and leaves
Uses: Depression, regulates mood and can be deactivated by light
ADR: trouble sleeping, vivid dreams, restlessness, anxiety, irritability, stomach upset, fatigue, dry mouth, dizziness, headache, skin rash, diarrhea, and tingling.
numerous drug interactions; especially SSRIs and can also weaken the effect of other medications including cyclosporin, birth control pills, antidepressants, some cancer and HIV medications, warfarin, oxycodone, and digoxin
St. John’s Wort (SJW)
(all-heal, amantilla, setewale capon’s tail, herba benedicta) that seems to inhibit uptake and increase presynaptic release of GABA. Not readily absorbed, highly unstable, quickly decomposes
Uses: anxiety, restlessness, and difficulty getting to sleep. Relaxant
ADR: Dosage at 2.5 g or more can cause cardiac disturbance, excitability, headache, insomnia, and nausea. It can potentiate alcohol and other CNS depressants
Contraindications: Should not be used by pregnant or breastfeeding women, children, or patients with impaired liver
Valerian
Extracted from the cartilage of cow trachea.
Uses: stimulate chondrocyte metabolism and synthesis of collagen, improving the formation of cartilage and is often combined with glucosamine for the treatment of pain.
ADR: dyspepsia, headache, motor restlessness, euphoria, nausea, and risk of internal bleeding. May potentiate anticoagulants.
Chondroitin
herb used to treat headaches and migraines. Other uses include toothache, joint pain, asthma, stomachache, menstrual problems, and threatening miscarriage.
MOA: mechanism of action is the inhibition of serotonin release from platelets.
ADR: mouth ulcerations, hypersensitivity, and a withdrawal syndrome characterized by moderate to severe pain and joint and muscle stiffness
Feverfew (bachelors’ button, featherfoil, Santa Maria, midsummer daisy)
Amino acid found in mucopolysaccharides and chitin.
Uses: treatment of OA, stimulate cartilage production and enhance rebuilding of damaged cartilage.
comparable efficacy over celecoxib in osteoarthritic pain relief and function improvement
Glucosamine
Active component of which is called curcumin
Uses: arthritis, proctitis, Crohn’s disease, ulcerative colitis, irritable bowel disease, peptic ulcer, gastric ulcer, lupus nephritis, and chronic pain, and has shown the ability to modulate multiple cell signaling pathways. pro-inflammatory disesases
Tumeric
Uses: anti-inflammatory, antipyretic, and analgesic
Can potentially cause allergic responses and gastritis
White willow bark (Salix alba)
Oil extracted from the leaves and bark of Gaultheria procumbens and methyl salicylate.
Effective in relieving pain from muscle strains, inflamed muscles, ligaments, and joints.
Overgenerous application can result in salicylate poisoning from absorption into the bloodstream.
Patients who are allergic to aspirin or who are taking oral anticoagulants should not use it.
Wintergreen Oil
