Herbal Remedies and Homeopathy Flashcards
Dilutions–BONUS
15X= remedy that has been diluted 1015 times
12C= remedy that has been diluted 10012 times
50 MC: and
Homeopathic potencies are designated by the roman numerals “X” or “C” according to whether each dilution is 10-fold or 100-fold, and by a coefficient that represents the number of steps
X= 1:10
C= 1:100
Homeopathy
Homeopathy is the practice of stimulating the body’s ability to heal itself by giving small doses of highly diluted substances (called remedies) derived from a plant, mineral, or animal substance
Homeopaths believe in threating the individual vs. treating the disease
Homeopathy
Homoios (similar)
Pathos (suffering or disease
Red Yeast Rice: Monacolin K
Naturally occurring analogue of lovastatin inhibits cholesterol synthesis
Red Yeast Rice: Adverse Effects
Increased liver function enzymes
Rhabdomyolysis
Red Yeast Rice:
Monitoring
Monitor LFTs
Should NOT drink more than 2 drinks/ day due to increased risk of hepatotoxicity
Pregnancy Category X
Melatonin : MOA
Regulates sleep and circadian rhythms
Light inhibits melatonin secretion and darkness stimulates secretion
Melatonin: Proposed benefits
Insomnia
Prevention of “jet lag”
Kava: Proposed benefits
Mild anxiety
Sleep disturbances
Kava: MOA
Dopamine, monoamine oxidase-B, and GABAB receptors.
May have antithrombotic activity.
Kava: Drug Interactions
Levodopa- Reduced efficacy of levodopa
Concomitant use is not recommended with medications that cause hepatotoxicity
Evening Primrose Oil:
Proposed benefits
Menopause
PMS (studies inconclusive)
Evening Primrose Oil:
Caution
Thought to possess antiplatelet effects and patients taking warfarin and platelet active medications or herbs should use with caution.
Should avoid use in patients with seizures (lowers seizure threshold).
Ginseng: Proposed benefits
Immunomodulatory/ Antiviral- reduce severity of cold and upper respiratory infection symptoms
Antineoplastic/ Anti-tumor
Ginseng: Asian
Panax ginseng (Asian ginseng
Ginseng: American
Panax quinquefolius
(American ginseng-better);
Ginkgo biloba:
Proposed Benefits
Peripheral Vascular Disease
Dementia
Memory impairment
Ginkgo biloba:
Adverse Effects
Allergic skin reaction
-Ginkgo pollen can be allergenic; contact with fleshy fruit pulp can cause contact dermatitis
Spontaneous bleeding (rare)
Seizures (seed consumption) –ONLY GET LEAF or you will have a seizure.
Ginkgo biloba: Drug interactions
Increased bleeding (3G’s) risk with anticoagulants (i.e. warfarin), anti-platelets.
Advise patients using anticoagulants to be cautious and talk to healthcare provider prior to starting
Only leaves should be used- seeds and pulp are toxic
Garlic: Active ingredients
Allicin
Garlic: Proposed benefits
Hyperlipidemia
Hypertension –increases 20mgHH
Inhibition of platelet aggregation
What are the herbals Anti-platelet effects?
AVOID 3G’s Ginger/Garlic/Gingo
Garlic: Adverse Effects
Potential increased risk in bleeding
Black Cohosh:
Proposed benefits
Menopause
Premenstrual Syndrome (PMS)
Black Cohosh:
Adverse Effects
*GI upset – Occurs in 50% patients
Acute hepatitis (increase case reports of acute hepatitis)
Black Cohosh:
Drug Interactions
Possible additive estrogenic activity with estrogen therapy or oral contraceptives
Black Cohosh:
Dietary Supplement Information Expert Committee
cautionary statement regarding potential hepatotoxicity
Consider getting LFTs periodically*****
Extraction Ratio
5:1 ratio
5 parts of herb were used to prepare 1 part of the extract
Ginkgo biloba is prepared as a dried extract in tablet form and is typically standardized to a
50: 1 extract ratio
- 50 parts of the ginkgo leaf were used to prepare 1 part of the extract
Plant Based Dietary Supplements
Plant based DS should indicated the scientific name of the plant containing the Latin binomial, as well as the specific plant part
The common name Latin binomial (genus and species)
The only Echinacea that works?
Echinacea purpurea
Counseling Points
Purchase products with a seal of quality on the label:
United States Pharmacopeia’s Dietary Supplement Verification Program or NSF International’s Certification Program
Continue to use the same brand and formulation for a continued use product
-Variability between batches; Consistent product and dose
Act passed with only test Dietary supplements for SAFETY, not efficacy?
Dietary Supplement Health and Education Act (DSHEA) of 1994
Efficacy claims cannot be made, only claims of effects on body structure or function
USP Verified Mark:
Mandatory disclaimer?
allowed on label only if manufacturer meets certain standards
This product is not intended to diagnose, treat, cure or prevent any disease”
Dietary Supplement (DS) Synonyms –Synonymously
Nutraceuticals Natural products Supplements Herbs Botanicals Phytochemicals
meaning Nutritional Supplement?
Substance added to diet to improve health. Usually contains dietary ingredients such as vitamins
Meaning Herbal Medication?
Plants or plant extracts used to improve health
Meaning Complimentary Therapy?
Used in ADDITION to conventional treatment
Meaning Alternative Medicine?
Treatments that are NOT generally recognized by the medical community as standard and are used instead of conventional treatments
What is DSHEA identified GMPs for dietary supplements in 2007?
To ensure supplements “are produced in a quality manner, do not contain contaminants or impurities, and are accurately labeled”
Covers manufacturing, packaging, labeling, storing of supplements, quality control, testing of ingredients, and record keeping
Medications vs. Dietary Supplements
Medication:
Active ingredient identified
Safety and efficacy proven by manufacturer
Purity and contents regulated
Claims to treat/cure/ prevent disease
Dietary Supplement
May not identify active ingredient
No proof of efficacy required; FDA must provide proof if unsafe
Standards for quality and purity not as strictly regulated
No claims to treat/cure/prevent disease
