Complementary therapy 2: Herbal Medicines Flashcards
What do herbalists believe?
Health is when the natural state of the body is achieved.
Ill health arises when there is an imbalance
What do herbal remedies do?
- Stimulate the body’s defences
- Normalise processes
- Eliminate toxins
What do herbal medicines use?
Whole plants, whole plant parts or whole plant extracts.
- the wide range of compounds act together to produce a single therapeutic effect
In what ways do herbal remedies that make therapeutic claims need to be registered as?
- Medicines
- Or under Traditional Herbal Registration Scheme (THR) (all registered products are given a registration number similar to an MA number)
How long does the product have to have been in use for under the THMP scheme?
30 years
What do products under the THMP scheme have to demonstrate?
- Quality
- Safety
- Does NOT have to demonstrate that it actually works
What information do products under the THMP scheme have to provide?
- contraindications
- side effect
- use in pregnancy, children
What are the restrictions on Pharmacists selling herbal remedies?
Pharmacists can sell from a registered premises any herbal remedies:
- containing substances in parts 1 and 2
- anything sold by a herbal practitioner or shopkeeper
What are the restrictions on Herbal practitioners selling herbal remedies?
Herbal practitioner can sell remedies:
- containing substances in part 2
- GSL herbal medicines
- Any remedy which can be sold by a shopkeeper
What are the restrictions on any shopkeeper selling herbal remedies?
Any shopkeeper or dealer can sell:
- GSL herbal medicines (MA, PL)
- Registered Traditional Herbal Medicinal Products (THR)
What is St John’s Wort used for?
Depression
What is the main ingredient of St John’s Wort?
Hyperforin
What does Hyperforin do?
Inhibit the reuptake of monoamines
- Inhibits the reuptake of serotonin (5-HT)
- Up-regulate serotonin receptors
What is an active hypericin and what can it do?
- Blue-black planar solid
- Can readily form free radicals - linked to photo-sensitivity side effects
What is the extraction solvent for St Johns Wort?
Ethanol 60% (v/v)
How much extract does each St Johns Wort tablet contain?
Each tablet contains 250mg of extract (as a dry extract) from St John’s aerial parts (3.5-6:1) (equivalent to 875-1500mg of St John’s wort (Hypericum perforatum)
What formulations are available for St Johns Wort?
o Tablets
o Capsules
o Teabags
o Tinctures
Are there any Drug interactions for St Johns Wort?
• St John’s wort induces the cytochrome P450 isoenzymes CYP3A4 and CYP2C10.
o Drugs which are metabolised by these isoenzymes will therefore be at a lower concentrations & decreased clinical efficacy.
• St John’s wort induces the P-glycoprotein (P-gp) efflux transporter.
o Drugs which are substrates for this transporter show an increased clearance, leading to lower concentrations & decreased clinical efficacy.
What medications should you not take with St Johns Wort?
- All hormonal contraceptives
- Medicines for depression
- All HRT
- All anticoagulants (blood thinners)
- All immunosuppressants
- Some medicines for high BP (amlodipine, nifedipine, felodipine, verapamil)
- Some medicines for heart disease (digoxin, ivadradine, amiodarone)
- All medicines for epilepsy
- All medicines for HIV infections
- Some medicines for cancer
- Some medicines for migraines
- Lithium (regulates mood)
- Some medicines for cholesterol
- Thyroxine
DO NOT take St Johns wort if:
- You are under 18
- You are pregnant or breastfeeding
- You are allergic to any of the ingredients
- You are lactose intolerant
- Your skin is exceptionally sensitive to sunlight
- You are having light treatment for any condition
- You are suffering from depression
Whilst taking this product:
• Avoid excessive sunbathing or the use of sunbeds/solariums
• Stop using it at least 10 days prior to undergoing any surgery:
• Avoid with anaesthetics/pre-operative medicines:
o Fentanyl, propofol, sevoflurane, midazolam
