Schedule 20 Flashcards
What herbs are schedule 20?
Convallaria majalis
Conium maculatum
Ephedra sinica
Aconitum napellus
Hyoscyamus niger
Datura stramonium
Gelsemium sempervirens
Atropa bella-donna
Cinchona officinales
Lobelia inflate
What herbs are restricted?
Arnica montana
Phytolacca americana
Piscidia piscipula
Sympytum officinale
Bryonia alba
Chelidonium majus
Lily of the valley
Latin name
Family
Parts used
Convallaria majalis
Asparagaceae
Radix & Herba
Hemlock
Latin name
Family
Parts used
Conium maculatum
Apiaceae
Folia
Ephedra
Latin name
Family
Parts used
Ephedra sinica
Ephedraceae
Stems & Branches
Monkshood
Latin name
Family
Parts used
Aconitum napellus
Ranunculaceae
Radix
Henbane
Latin name
Family
Parts used
Hyoscyamus niger
Solanaceae
Semen & Folia
Thornapple
Latin name
Family
Parts used
Datura stramonium
Solanaceae
Semen & Herba
Yellow jasmine
Latin name
Family
Parts used
Gelsemium sempervirens
Gelsemiaceae
Radix
Deadly nightshade
Latin name
Family
Parts used
Atropa bella-donna
Solanaceae
Radix & Herba
Cinchona
Latin name
Family
Parts used
Cinchona officinales
Rubiaceae
Cortex
Puke weed
Latin name
Family
Parts used
Lobelia inflate
Campanulaceae
Herba & Semen
Arnica
Latin name
Family
Parts used
Arnica montana
Asteraceae
Flos
Poke root
Latin name
Family
Parts used
Phytolacca americana
Phytolaccaceae
Radix
Jamaican dogwood
Latin name
Family
Parts used
Piscidia piscipula
Fabaceae
Cortex
Comfrey
Latin name
Family
Parts used
Sympytum officinale
Boraginaceae
Folia & Radix
White bryony
Latin name
Family
Parts used
Bryonia alba
Cucurbitaceae
Radix
Greater celandine
Latin name
Family
Parts used
Chelidonium majus
Papaveraceae
Herba
Convallaria majalis:
Common form of prescription and max weekly dose
Tincture
Max weekly 1 : 8 at 25 ml
Conium maculatum:
Common form of prescription and max weekly dose
Tincture
EXTERNAL USE ONLY - 7 %
Ephedra sinica
Common form of prescription and max weekly dose
Tincture
Max weekly dosage 1 : 4 at 50 ml
Aconitum napellus
Common form of prescription and max weekly dose
Tincture for a cream
EXTERNAL USE ONLY
1.3% in creams
13% of a 1 : 10 ratio
Hyoscyamus niger
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 10 at 21 ml
Datura stramonium
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 10 at 10.5 ml
Gelsemium sempervirens
Common form of prescription and max weekly dose
Tincture
Max weely dosage: 1 : 10 at 5 ml
Atropa bella-donna
Common form of prescription and max weekly dose
Tincture
Max weekly dosage:
Herba 1 : 10 at 10 ml
Radix 1 : 10 at 6 ml
Cinchona officinales
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 10 (45%) at 52.5 ml
Lobelia inflate
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 8 at 33.5 ml
Arnica montana
Common form of prescription and max weekly dose
Infused oil & Tinctures
EXTERNAL USE ONLY - not for prolonged application
1 : 10 Tincture
Phytolacca americana
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 5 at 8 ml
Piscidia piscipula
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 3 at 50 ml
Sympytum officinale
Common form of prescription and max weekly dose
Tincture & infused oil, poultice and compress
Max weekly dose:
Folia: 1 : 5 at 100 ml for a max of 6 weeks
Radix: External use only 1 : 10 100 % of product
Bryonia alba
Common form of prescription and max weekly dose
Tincture
Max weekly dosage: 1 : 10 at 10 ml
Chelidonium majus
Common form of prescription and max weekly dose
Tincture & Sap
Max weekly dosage: 50 ml - short term use only
Convallaria majalis actions & indications
Actions: Negatively chronotropic, Positively inotropic, Cardiotonic
Indications: Heart failure, Angina, Endocarditis, Cardiac insufficiency
Convallaria majalis clinical discussion
A specific for cardiac insufficiencies.
An effective remedy for heart conditions that step from weak cardiac output and cardiac irregularities.
It’s also used in indications related to the emotional heart, in the form of drop doses.
Convallaria majalis use in children
Use in extreme cases with caution.
Convallaria majalis cautions / contraindications
Avoid in use with digitalis/digoxin due to additive effect.
Avoid use in quinine, diuretics, irritant laxatives and some antibiotics.
Avoid in pregnancy and lactation.
Convallaria majalis signs of toxicity
Similar to digitalis overdose: arrhythmias, GIT disturbance, headache & vision disturbance
Convallaria majalis key chemistry
Cardiac glycosides including convallatoxin.
Conium maculatum actions & indications
Actions: Analgesic & Antispasmodic
Indications: External haemorroids (only on protruding parts)
Conium maculatum clinical discussion
Extremely toxic, used externally only for painful, itching haemorrhoids.
Conium maculatum use in children
N/A
Conium maculatum cautions / contraindications
Not for internal use. Avoid in pregnancy and lactation.
Conium maculatum signs of toxicity
Conium means ‘to whirl’ - a sign of toxicity is dizziness. CNS stimulation followed by depression, including paralysis of motor nerve endings, starting at feet and moving upwards, preventing breathing.
Caffiene may help work as an antidote.
Conium maculatum key chemistry
Piperidine alkaloids including coniine.
Ephedra sinica actions & indications
Actions: Bronchodilator, Diaphoretic, CNS stimulant, Decongestant, Anticattarhal, Sympathomimetic
Indications: Emphysema, Bronchial asthma, Hayfever, Rhinitis, Acute allergic reactions
Ephedra sinica clinical discussion
Its used to support respiratory issues, particularly asthma and ephedrine is used as a conventional treatment. It has an anti-allergic action due to the constituent ephedrine which prevents vasodilation, and a bronchodilatory effect due to pseudoephedrine which relieves spasm in the bronchial tubes.
Ephedra sinica use in children
Should not be used except in older children in exceptional circumstances.
Ephedra sinica cautions / contraindications
Caution in those with anxiety, eating disorders, benign prostatic hyperplasia, hypertension and those on anti depressants.
Pregnancy and lactation.
Ephedra sinica signs of toxicity
Arrhythmias, tachycardia, hypertension, insomnia, anxiety, psychosis
Ephedra sinica key chemistry
Indole alkaloids including L-Ephedrine, and pseudoephedrine
Aconitum napellus actions & indications
Actions: Analgesic
Indications: Facial neuralgia, sciatica, arthritic pain, gout, tingly numbing sensation, rheumatism
Aconitum napellus clinical discussion
Used topically in minimal doses for pain, especially associated with a tingling sensation. eg. neuralgia.
It’s analgesic effect is due to its high content of aconitine and other alkaloids which reduce the conduction of pain signals via reducing the permeability of nerve cells to sodium channels and have an anti-inflammatory effect.
Aconitum napellus use in children
Avoid.
Aconitum napellus cautions / contraindications
Avoid in pregnancy and lactation. Do not use on broken skin.
Aconitum napellus signs of toxicity
Tingling and numbness of tongue/mouth, which then extends to the entire body’s surface (like crawling ants) and a strangling sensation.
Aconitum napellus key chemistry
Aconitins, a diterpenoid alkaloid - one of the most deadly substances known.
Hyoscyamus niger actions & indications
Actions: Anticholinergic, antispasmodic, mild diuretic. bronchodilator, antidiarrheal
Indications: Whooping cough, vertigo, IBS, GI spasms, travel sickness (sedative), urinary spasms
Hyoscyamus niger clinical discussion
Milder and less sedating than Datura and Atropa, less likely to cause delierum than Atropa.
It’s a specific for pain in the head and the urinary system.
Hyoscyamus niger use in children
Avoid
Hyoscyamus niger caution / contraindications
Avoid in pregnancy and lactation. Can increase the anticholinergic activity of other drugs such as antihistamines, some cardiac drugs and antidepressants.
Hyoscyamus niger signs of toxicty
Feverish, thirst/dry mouth, flushing, delirium, visual disturbance leading to blindness.
Hyoscyamus niger key chemistry
Tropane alkaloids including hyoscyamine, atropine and scopolamine.
Datura stramonium actions & indications
Actions: Narcotic, analgesic, antispasmodic, anticholinergic, respiratory spasmolytic
Indications: Parkinsons disease, asthma, bronchitis, coughs, bronchial constriction
Datura stramonium clinical discussion
The anticholinergic activity works in a similar way to Atropa, but has a specific affinity with the bronchial smooth muscles and less tendency to lead to constipation. A key remedy for treating asthma and parkinsons.
Datura stramonium use in children
Unsafe, except in older children in extreme cases.
Datura stramonium cautions / contraindications
Avoid in pregnancy and lactation. Can increase anticholinergic activity of other drugs such as antihistamines. some cardiac drugs and antidepressants.
Datura stramonium signs of toxicity
Causes more delerium than other tropane alkaloid herbs.
Feverish, thirst/dry mouth, flushing, visual disturbance leading to blindness.
Datura stramonium key chemistry
Tropane alkaloids such as atropine & hyoscyamine.
Gelsemium sempervirens actions & indications
Actions: Anxiolytic, analgesic, sedative, nervous system depressant, diaphoretic
Indications: Chronic pain - tooth decay, trigeminal neuralgia, nerve pain, trauma pain, migraine
Gelsemium sempervirens clinical discussion
It is a powerful painkiller and a sedative used for acute situations. It has a specific action on the fifth cranial nerve (trigeminal) and therefore useful in neuralgia and dental pain.
Gelsemium sempervirens use in children
Avoid.
Gelsemium sempervirens cautions / contraindications
Avoid in pregnancy and lactation, heart disease, hypotension, myasthenia gravis.
Gelsemium sempervirens signs of toxicity
Double vision, drooping eyelids, dyspnea, hypotension, bradycardia, muscle weakness, paralysis.
Suppression of respiration can lead to death.
Gelsemium sempervirens key chemistry
Indole alkaloids including gelsemine.
Atropa bella-donna actions & indications
Actions: Narcotic, Anticholinergic, antispasmodic, analgesic, hypohidrotic, antisialagogue
Indications: GIT colic, Gastritis, Severe IBS, Muscular pain, parkinsons, urinary incontinence, menstrual pain, sciatica, neuralgia, bronchitis
Atropa bella-donna clinical discussion
Used for spasmodic disorders, especially in the digestive system for conditions such as IBS.
Atropa bella-donna use in children
Unsafe, except in older children in extreme cases.
Atropa bella-donna cautions / contraindications
Avoid in pregnancy and lactation. Can increase anticholinergic activity of other drugs such as antihistamines. some cardiac drugs and antidepressants.
Atropa bella-donna signs of toxicity
Feverish, third/dry mouth, flushing, delerium, visual disturbance leading to blindness, feeble pulse. ‘hot as a hare, dry as a bone, red as a beet, mad as a hatter, blind as a bat’.
Atropa bella-donna key chemistry
Tropane alkaloids, atropine & hyoscyamine.
Cinchona officinales actions & indications
Actions: Bitter, antimalarial, antiparasitic, febrifugal, tonic, emmenagogue
Indications: Malaria, autoimmune diseases (especially lupus).
Cinchona officinales clinical discussion
Predominantly used to treat malaria, especially drug-resistant types. Can be used in the treatment of autoimmune conditions with caution.
Cinchona officinales cautions / contraindications
Not in pregnancy, CVS issues or patients with hypertension
Cinchona officinales signs of toxicity
Cinchonism (nausea, vomiting or tinnitus), gradually reversible. Chronic toxicity can lead to blindness, heart arrhythmia and cardiotoxicity.
Cinchona officinales key chemistry
Quinoline alkaloids - quinine and cinchonine
Lobelia inflate actions & indications
Actions: Respiratory antispasmodic, antiasthmatic, stimulating expectorant, muscle relaxant
Indications: spadmodic asthma, bronchitis, emphysema, muscle spasm, whiplash, nicotine addiction
Lobelia inflata clinical discussion
A key herb used for acute asthma and as an expectorant in bronchial congestion with thick, stuck mucus. Small doses stimulate breathing but very low doses suppress.
Lobelia inflata use in children
Avoid
Lobelia inflata cautions / contraindications
Nausea, heart disease. Avoid in pregnancy and lactation. Caution with lithium.
Lobelia inflata signs of toxicity
Nausea & vomiting, dizziness, dyspnoea, raised heart beat, tremors
Lobelia inflata key chemistry
Piperidine alkaloids, mainly lobeline.
Arnica montana actions & indications
Actions: Anti-inflammatory, circulatory, analgesic, haemolytic, anticoagulant
Indications: Topically for bruising, sprains, aches & pains
Arnica montana clinical discussion
Used most commonly for its circulatory, anti-inflammatory and haemolytic action for bruising, sprains and strains. These are due to the sesquiterpene lactones, especially helenalin.
Arnica montana use in children
Safe but avoid in very young children.
Arnica montana cautions / contraindications
Not on broken skin. Can cause dermatitis in sensitive individuals. Not for prolonged application.
Arnica montana signs of toxicity
If taken internally, arnica is a GIT irritant, may even cause gastroenteritis, muscle paralysis, arrhythmia and even death.
Arnica montana key chemistry
Sesquiterpene lactones (helenalin)
Phytolacca americana actions & indications
Actions: Lymphatic, depurative, emetic, purgative, narcotic, anticatarrhal antineoplastic, antifungal, antimicrobial, antiviral.
Indications: Chronic infections, congestions such as sinusitis. Lymphatic inflammations (mumps, cysts, tonsillitis, hydroceles & mastitis), rheumatism. Topically for skin infections such as tinea and scabies.
Phytolacca americana clinical discussion
Pokeroot is a powerful lymphatic, particularly in chronic infections with swollen lymph nodes such as mastitis, tonsillitis. Can be used in a poultice for acute mastitis. It is also a powerful antimicrobial for topical applications, particularly for fungal or microbial conditions.
Phytolacca americana use in children
Not advised, only in extreme exceptional circumstances
Phytolacca americana cautions / contraindications
Pregnancy and lactation, avoid with leukaemias and GI irritation.
Phytolacca americana signs of toxicity
Abdominal cramps, water and bloody diarrhoea. Transient blindness and hypotension. Poisening can occur from topical absorption.
Phytolacca americana key chemistry
Triterpene saponins: phytolaccoside. Alkaloids including phytolaccine.
Piscidia piscipula actions & indications
Actions: Analgesic, spasmolytic, sedative.
Indications: Toothache, neuralgia, migraine, dysmenorrhoea, insomnia, nervous debility, intestinal colic.
Piscidia piscipula clinical discussion
One of the herbal dispensary’s key painkillers, although it is also strongly sedative. This sedating action makes it useful for treating insomnia, especially if related to toothache, neuralgia and nervous tension.
Piscidia piscipula use in children
Only in exceptional circumstances in older children.
Piscidia piscipula cautions / contraindications
Avoid use in pregnancy, lactation and with persons attempting to conceive. Avoid use with early morning restless insomnia. Long-term usage should be avoided with cases of depression. Prescribe with caution in neurological, liver and kidney diseases, or if there is a history of allergic or anaphylactic reactions.
Piscidia piscipula signs of toxicity
May cause nausea & headache in susceptible patients
Piscidia piscipula key chemistry
Complex isoflavones
Symphytum officinale actions & indications
Actions: Haemostatic, vulnerary
Indications: Broken bones, sprains, strains, ulcers (external and internal), bleeding GIT tract, bladder & lungs.
Symphytum officinale clinical discussion
The root is no longer used internally, only externally, and the leaves only internally in limited dosage for a maximum of 6 weeks. The key use for comfrey is in healing broken bones, ligament and tendon repair in strains and sprains. Allantoin content increases cell proliferation resulting in quicker, stronger repair.
Symphytum officinale use in children
Avoid internal use, developing livers are more susceptible to liver damage.
Symphytum officinale cautions / contraindications
Not to be used on deep wounds, as the rapid cell proliferative effects can cause skin to heal over the top and cause an abscess. Avoid use in pregnancy and lactation. PA content can lead to hepatotoxicity:
Symphytum officinale signs of toxicity
Slow progress means there are no noticeable immediate signs, but prolonged use may cause hepatotoxicity which can result in signs of poor liver function: hepatomegaly and jaundice.
Symphytum officinale key chemistry
PA’s - highested in roots and older leaves. If taken internally, the N-oxides are metabolised by commensal gut bacteria to free PAs which are then absorbed and cause toxicity issues.
Allantoin, mucilage.
Bryonia alba actions & indications
Actions: Laxative, emetic, diuretic, analgesic (topical)
Indications: Myalgia, rheumatic disease and arthritis, Severe respiratory conditions such as pneumonia, bronchitis, pleurisy, whooping cough and Bornholm disease.
Bryonia alba clinical discussion
Primarily indicated in muscular pain and severe respiratory disorders.
Bryonia alba use in children
Avoid.
Bryonia alba cautions / contraindications
Avoid in pregnancy and lactation.
Bryonia alba signs of toxicity
Vomiting, dizziness, cramps, diarrhea, convulsions, anuria, neurosis, rash/blisters, colic, hematochezia, collapse, leading to kidney damage, abortion, paralysis as well as death.
Bryonia alba key chemistry
Bryonin (alkaloid), cucurbitacins, glycosides
Chelidonium majus actions & indications
Actions:Choleretic, cholagogue, hepatoprotective, bitter, antiemetic, antispasmodic, antimitotic, anthelmintic.
Indications: GIT disorders including colic and minor gallbladder complaints, IBS, intestinal polyps, liver conditions, endometriosis & fibroids.
Chelidonium majus clinical discussion
The powerful isoquinoline alkaloids including chelidonine help stimulate bile flow so is carefully used in some cases of liver disorder.Helps control uterine lining overgrowth such as in endo and fibroids.
Chelidonium majus use in children
Avoid
Chelidonium majus cautions / contraindications
Avoid in pregnancy and lactation.
Avoid in blocked bile duct, pre-existing serious liver disease or damage. Excessive or prolonged intake may cause liver damage in sensitive individuals.
Chelidonium majus signs of toxity
Nausea, vomiting, GIT disturbance. Chronic overdosing can lead to liver damage/failure.
Chelidonium majus key chemistry
Isoquinoline alkaloids, inc. chelidonine and sanguinarine.
