Lesson E3 - Herbal Remedies Flashcards
It should be recognized that the practise of medicine prior to the 1940’s depended on a large number of ___________.
- natural products
Name 2 reasons why there has been an increase in the availability of herbal preparations in the last decade?
- General public wants to use more natural products (believe they are safer)
- Manufacturers who promote these products for financial gains
Herbal medicines are used more widely in _______ than _________
- Europe
- North America
It is estimated that more than ____ of the practising physicians in Europe prescribe plant-derived pharmaceuticals or herbal medicines.
- 40%
True or false? In Europe, the regulations controlling the manufacture and testing of herbal products are more stringent than in Canada.
- True
True or false? In 2004 Canada introduced new regulations that should begin the process of better regulations to ensure the _______ and ______ of these products.
- True
- Efficacy
- Safety
____ of the world’s population is reported to rely on herbal products
2/3
Define Allopathic medicines
- Drugs used by mainstream medicine.
- These drugs have a drug identification number (DIN) from Health Canada and have undergone full testing for safety and efficacy.
Define Herbal medicines (homeopathic)
- Plant products sold as medicine (no DIN); often crude mixtures and evaluation is lacking.
Define Allopathic phytopharmaceuticals
- They have a DIN.
- Full status as a drug and meet all requirements of a drug, i.e. full safety and efficacy evaluation.
Define Phytopharmaceuticals
- Drug obtained from plants, purified, and used at therapeutic doses and with scientific evidence of efficacy and documented toxicity, e.g. digitalis (digoxin), quinine, cocaine, atropine, tubocurarine.
Define Food supplement
- This is a herbal product used at one-quarter of the proposed therapeutic dose
Food supplement are herbal product used at ____ of the proposed dose
- 1/4
Name 5 reasons why people are moving towards herbal products
- The public has expressed concern over the side effects of allopathic medicines.
- The cost of the allopathic medicines, especially newer agents, are high.
- There is a lack of faith in allopathic drugs
- There is often hope that somehow a herbal or natural product will cure a chronic or terminal disease. (Patient will do anything)
- There is a general belief that herbals are not toxic
True or false? Herbal products cannot be toxic?
False
There is a lack of faith in allopathic drugs which lead to what statement?
- “What is natural is best”
True or False? Plants have a value in the preparation of both herbal and allopathic drugs.
- True
Name a few values of plants in pharmaceuticals?
- Used in both herbal and allopathic drugs
- They are a source of direct therapeutic agents, e.g. digoxin or taxol.
- They provide a source of raw material for the manufacture of more complex semisynthetic compounds, e.g. taxol, estrogens.
- The structure of plant substances can be used as a model for new compounds.
True or False? A plant estrogen is used as the starting material in the preparation of ethinyl estradiol, the estrogen in the oral contraceptives.
True
Name 9 problems associated with herbal medicine
- Lack of efficacy data
- Lack of data on safety
- Lack of standardization
- Undeclared ingredients
- Intentional adulteration
- Source is questionable
- Confusing literature
- Toxicities
- Drug interactions with allopathic medicines
When referring to problems of herbal medicines what does intentional adulteration mean?
- The addition of substances other than herbal
True or false? Prescription meds (allopathic) can interact with herbal medecine
- True
- Some serious ones have been reported
___ of patients who use herbals do not tell there physician
- 2/3
Drugs can be classified as mild or potent. Where are potent drugs only available
- From a physician on a prescription
Valerian is used as a ______ and ______
- Sedative
- Hypnotic
__________ It is often termed the Valium of the 19th century
- Valerian
Give some characteristics of Valerian
- Sedative + Hypnotic
- Called the valium of the 19th century
- The active ingredients are a group of compounds known as Valepotriates
- The active ingredients are a group of compounds known as Valepotriates
- Can be useful for mild insomnia
- Less effective than benzodiazepines
- Hepatotoxicity may be a significant problem
What is Feverfew used for? Name some characteritics
- Modern use = Migraines
- May be used for mild migraines (Study concluded)
- Toxicities occurred in 20% of users (11% had mouth ulcerations)
- Dermatitis is a problem
Some studies reported a ___ reduction in migraines when you use feverfew
- 24%
What is Comfrey used for?
- Wound healing (allatoin active ingredient)
- Comfrey was once used internally for ulcers, ulcerative colitis, bronchitis and digestive disorders, but due to its hepatotoxic and carcinogenic potential, it should not be used internally. Comfrey would be one herbal product to avoid
What is devil’s claw used for?
- Treatment of inflammatory conditions, including rheumatoid arthritis
- Devil’s Claw lacked the biochemical effects expected of anti inflammatory drugs of the non-steroidal type (e.g. ibuprofen).
- Doses 100 times greater than the recommended dose were found ineffective for surpressing inflammation
What is Echinacea used for?
- Recommended for the prevention and treatment of the common cold.
- It is also recommended for wound healing and as an anti-inflammatory.
What is the mechanism of action of Echinacea?
- Stimulating the immune system
What is aloe vera used for?
- Used topically as an aid for healing wounds and burns
True or false? It has also been used to treat fungal infections. There is evidence of antifungal activity.
- False
- It has been used to treat fungal infections
- There is NO evidence of antifungal activity
True or false? Results in terms of wound healing are conflicting; not all studies show a benefit.
- True
What happens if you take aloe internally?
- Causes severe diarrhea
What do people use Ginseng for?
- To increase their endurance and stamina
Herbalists consider Ginseng an _________
adaptogen
Define what is an adaptogen
- An adaptogen is a herb that restores normal balance.
- In other words, if the blood pressure is low, the herb raises it, and if the blood pressure is high, it lowers it.
What do advocates of Ginseng claim?
Advocates of Ginseng claim that it is an aphrodisiac; that it enhances memory, learning, productivity, and physical stamina, as well as enhancing the immune system
- It is purported to improve health overall, reduce cholesterol, heart attacks, and blood sugar in diabetes.
True or False? The efficacy of Ginseng in humans has not been established
- True
What are the adverse effects observed with Ginseng?
- Headache, high blood pressure and bleeding
- Ginseng may affect platelet aggregation (sticking together to form a clot), and will increase the effect of oral anticoagulants (blood thinners).
True or false? Ginseng increases the effects of anticoagulants (blood thinners)
- True
True or False? Ginseng can contribute to the formation of a clot?
- True
- Ginseng may affect platelet aggregation (sticking together to form a clot), and will increase the effect of oral anticoagulants (blood thinners).
Why should diabetics who use insulin not take ginseng?
- Increase plasma insulin levels
What is St. John’s Wort used for? What does it contain?
- Hypericin
- Treat mild to moderate depression and to heal wounds
St. John’s Wort which contains hypericin modifies an number of central nervous system pathways. What are the pathways that are modified.
- Dopamine, serotonin, norepinephrine
- Enhance the activity of these pathways like other antidepressants
True or False? Hypericin (St. John’s Wort) have been show to not have true antidepressant activity
- False
- It has been shown to have true antidepressant activity
True or false? St. John’s wort is less effective than other antidepressants such as tricyclic antidepressants or SSRI’s
- True
True or false?/ Why? Some studies have shown that St. John’s Wort increases the rate of healing in burns. T
- True
- The beneficial effect may be due to stimulation of growth of skin cells.
True or False? St. John’s Wort should not be taken with other antidepressants
- True
- It can be addictive
What are the adverse effects of St. John’s Wort?
- Syndrome has been associated with the herb
- The syndrome was manifested as confusion, agitation, shivering, fever, sweating, diarrhea, muscle spasms, and tremor.
- The herbal can also cause phototoxicity (the drug is deposited in the skin, and sunlight breaks down the drug causing a skin reaction or rash).
Define photoxicity? Can this occur with St. John’s wort?
- Yes it can occur
- The drug is deposited in the skin, and sunlight breaks down the drug causing a skin reaction or rash)
What are the solution to herbal product use?
- There is a need for appropriate regulations and standards. Products should be standardized.
- There is a need to determine the efficacy of these products in controlled trials.
- There is a need for valid toxicity testing.
