Lecture 3 - Herbal Medications

Where is Creatine stored in the body?

95% stored in skeletal muscle, rest is stored in brain and cardiac muscle

Melatonin

A hormone that your brain produces in response to darkness It helps with the timing of your circadian rhythms and sleep

St. Johns Wort

A plant with yellow flowers that has been used in traditional european medicine

Butterbur

A shrub that grows in europe and parts of asia and north america

Tea Tree Oil Uses

Acne Ocular demodicosis Onychomycosis Tinea Pedis

Coenzyme Q10 Side effects

Additive effects with antihypertensives, structurally similar to Vitamin K --> can interfere with Warfarin

Garlic Standardization

Allicin component

Other Dietary Symptoms

American ginseng Asian ginseng Butterbur Tea Tree Oil

Creatine

An amine that plays a role in skeletal muscle energy metabolism

Garlic Drug Interactions

Anti-platelet, anticoagulant, thrombotic agents Increases risk of bleeding May have additive effects on antihypertensive or antidiabetic

St. Johns Wort research

Appears to be more effective than placebo and as effective as standard antidepressant medications for mild and moderate depression

Turmeric Uses

Arthritis, digestive disorders,. respiratory infections, allergies

Garlic Adverse effects

Body odor and malodorous breath Mild GI effects

Butterbur drug interactions

CYP3A4 inducer Avoid in patients with ragweed allergy and avoid in pregnancy

Coenzyme Q10 MOA

Cofactor in the electron transport chain for ATP

Elderberry uses

Commonly used for cold, flu, and COVID-19

Osco Uses

Commonly used for seasonal colds, influenza, and respiratory tract infections

Red Rice Yeast Components

Contains a substance called Monacolin K which is identical to the active ingredient in Lovastatin

Genitourinary Supplements

Cranberry Saw Palmetto

Elderberry

Dark purple berry of the european or black elder tree

St. Johns Wort Uses

Depression, menopausal symptoms, ADHD, OCD

Zicam Lozenges

Do NOT exceed 7 lozenges in 24 hours

When do doctors consider melatonin especially effective

Eastward travel and for travel that lasts longer than 3 days

Saw Palmetto Uses

For urinary symptoms associated with an enlarged prostate gland --> BPH

GI Supplements

Ginger Probiotics

Which supplement potentially helps with pain from OA?

Glucosamine

Musculoskeletal System Dietary Supplements

Glucosamine Chondroitin Turmeric Creatine

Components of Glucosamine

Hydrochloride and sulfate salt forms

Uses of Garlic

Hyperlipidedmia: may reduce total cholesterol and LDL HTN: effects on BP are limited

American Ginseng drug reactions

Insomnia, agitation, tachycardia and high doses May decrease the effects of Warfarin

Osco MOA

Isopathy, a principle suggesting that a medicine derived from an agent that causes the disease is used to cure the disease Heart and lungs of ducks are thought to be reservoirs of the influenza virus

Probiotic most commonly used bacterial strains

Lactobacillus and Bifidobacterium Yeast: Saccharomyces boulardii

How are Turmeric supplements made?

Made from the dried rhizome (underground stem) and typically contain a mixture of curcuminoids

Asian Ginseng drug interactions

May have additive effects on HTN medications, glucose lowering meds May decrease effectiveness of Warfarin

Glucosamine & Chondroitin Side effects

May interact with blood thinning medications

Tea Tree Oil (TTO)

Melaleuca alternifolia

Where is Coenzyme Q10 found?

Naturally found in the body with higher concentrations in the heart, liver, kidneys, and pancreas

Where is Creatine found?

Naturally produced in the body from amino acids in the kidney and liver Mostly found in red meat and seafood

Research on Turmeric

No clear conclusions have been reached about whether turmeric and its components have benefits for health conditions

Melatonin research

Not enough strong evidence on the effectiveness or safety of melatonin supplementation for chronic insomnia

Asian Ginseng

Panax ginseng Native to china, Korea, and far eastern siberia Important substance is called Ginsenosides

American Ginseng

Panax quinquefolius Mostly produced in ontario canada

St. Johns Wort Drug interactions

Potent CYP3A4/ P-glycoprotein Inducer Decrease in digoxin, anticonvulsants, antiretrovirals Increased metabolism of warfarin increased risk of serotonin syndrome

Research of Coenzyme Q10

Research does not suggest the use or against since results are inconclusive or limited

What kind of exercise is Creatine best for?

Shown to be effective for anaerobic short duration high intensity exercise since it helps product ATP

Red Rice Yeast Side effects

Similar to Lovastatin Myopathy, rhabdomyolysis, and liver toxicity Not recommended in those pregnant or lactating

Central Nervous System Supplements

St. Johns Wort Ginko Melatonin

Glucosamine & Chondroitin

Structural components of cartilage Produced naturally in the body

Tea Tree Oil MOA

Terpinen-4-ol has antibacterial and antifungal properties Acts by disrupting the permeability barrier of microbial cell membrane structures Suppresses inflammatory mediators including TNF-alpha, ILs 1, 8, 10, and prostaglandin E2

Adaptogen

Theorized to help the body resist physiological stress

Probiotics and IBD

There is no recommendation on the use of probiotics in adults and children with IBD due to knowledge gaps

What is Coenzyme Q10 used for?

Treat conditions relating to the heart such as HTN, HF, cancer, myopathy

Glucosamine & Chondroitin Uses

Treatment for osteoarthritis

Butterbur does not help with

UTI, asthma, other conditions

Tea Tree oil Safety

Unsafe when used orally Possibly safe when used topically Use in caution with children No Known Major Drug interactions

American Ginseng Uses

Used as a diuretic or stimulant to boost the immune system, and as an "adaptogen"

How is Red Rice Yeast used?

Used to help lower cholesterol and related lipids

Creatine Uses

Used to improve strength, increase lean muscle mass, and help the muscle recover more quickly during exercise

Zicam

an array of products containing zinc as its active ingredient For cold and allergy relief

Gingko uses

anxiety, cognitive impairment and memory aid

Butterbar cautions

contain chemicals called pyrrolizidine alkaloids (PAs) which can damage the liver, lungs, and blood circulation

Cranberry: UTI risk

decreases risk by 1/3

Probiotic in antibiotic associated diarrhea

evidence suggests that starting a probiotic treatment with Lactobacillus or Saccharomyces within 2 days of 1st ABX diagnosis Doesn't help in the elderly

Probiotic atopic derm evidence

evidence suggests that the use of probiotics might reduce the risk of developing atopic dermatitis, but may only provide limited relief

Cardiovascular Dietary Supplements

garlic red yeast rice coenzyme fish oil niacin

Elderberry safety

generally safe and well tolerated Unripe, green elderberries contain a cyanide producing chemical that can cause nausea, vomiting, and diarrhea

Ginger research

ginger may be helpful for mild nausea and vomiting associated with pregnancy Not for hyperemesis gravidarum Using for motion sickness has shown subjective improvements up to 4 hours prior to travel

Where is elderberry found?

grows in warmer parts of europe, north america, northern africa

Saw Palmetto research

has not been conclusively shown to be effective fro BPH

Gingko side effects

headache, stomach upset, dizziness, palpitations, constipation Increased risk of bleeding in patients on blood thinners

Asian Ginseng Uses

improve physical stamina, concentration, and memory May help improve glucose metabolism and lower blood sugar

St. Johns Wort adverse effects

increased sensitivity to sunlight in large doses Insomnia, anxiety, dry mouth, dizziness, GI, fatigue

Gingko drug interactions

inhibitor of CYP450 enzymes May reduce effects of anti-epileptics increasing seizure risk

Asian Ginseng adverse effects

insomnia, agitation, tachycardia at high doses Avoid in mental health patients due to agitation

Ginger drug interactions

interacts with anticoagulants and antiplatelets May induce bleeding risk in large doses May effect glycemic alternating drug --> monitor in patients with DM

Zicam cautions

intranasal zinc has been linked to a severe and permanent loss of smell and should not be used

Melatonin uses

jet lag, delayed sleep wake phase disorder, some sleep disorders in children, and anxiety before and after surgery

Osco

made from the heart and liver of a wild duck

Probiotics help to

modify endogenous microflora

Butterbur uses

mostly seen in treating urinary tract symptoms, stomach upset, headaches, allergic rhinitis Reduces frequency of migraines in adults and children 500 mg per day is as effective as Zyrtec

Gingko research

no conclusive evidence that it helps with memory loss

Probiotics contain

one or more culture of living organism, usually bacteria or yeast

Turmeric

plant in the ginger family Found in china, japan, india

Cranberry

promoted for UTIs Has NOT shown to be effective in treating an existing UTI

Osco side effects

rare headaches and angioedema Not enough evidence for proven efficacy

Saw Palmetto

shrublike palm native to southeastern US

Red Rice Yeast

traditional Chinese medicine Made by culturing rice with various strains of yeast Monascus purpureus

Gingko

traditional chinese medicine

Ginger uses

treatments for several types of nausea and vomiting