Herbal Agents

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Herbal Agents

• Pharmacology 49.222
• Bill Diehl-Jones RN, PhD
• Faculty of Nursing and Department of Zoology

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Agenda

• Zen Review
• How are herbs classified?
• Specific herbs
• Bilberry,Black cohosh, Echinacea, Garlic, Ginger,
  Gongko, Ginseng, Hawthorn, Milk thistle, St.
  Johns Wort
• Efficacy
• Precautions

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Classification of Herbal Remedies

• The U.S. Food and Drug Administration classifies
  phytomedicines as dietary supplements
• They are NOT recommended as substitutes for
  conventional medicine
• Only Germany has standardized doses of herbs

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Bilberry(Vaccinium myrtilus)

• Relative of cranberry
• Active ingredient(s)
• Anthocyanoside (antioxidant)
• Pectin (soluble fibre)
• Physiologic effect(s)
• Relaxes smooth muscle, inhibits platelet
  aggregation
• Most common use
• Treatment of diarrhea

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Black Cohosh(Cimifuga racemosa)

• Active ingredient(s)
• Glycosides
• Isoflavones
• Aglycones
• Physiologic effect(s)
• Binds estrogen receptor, inhibits LH
• Most common use
• Treatment of PMS, postmenopausal syndromes

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Echinacea(Echinacea purpurea)

• Member of daisy family
• Active ingredient(s)
• Polysaccharides, alkylamides, flavinoids, caffeic
  acid
• Physiologic effect(s)
• Activates T lymphocytes, stimulates IFN, TNF-?,
  ILs
• Most common use
• Prevention/reduction of cold and flu symptoms

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Garlic(Allium sativum)

• Active ingredient(s)
• Allicin
• Ajoene
• Physiologic effect(s)
• Inhibits platelet aggregation
• Inhibits cholesterol metabolism
• Most common use
• Reduces cholesterol (decreases triglycerides,
  LDLs, increases HDLs)

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Ginger(Zingiber officinal)

• Active ingredient(s)
• Sesquiterpenes, aromatic ketones
• Physiologic effect(s)
• Inhibits arachidonic acid metabolism
• Most common uses
• Antiemetic, diuretic, digestion aid

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Gingko(Gingko biloba)

• Active ingredient(s)
• Flavone glycosides
• Flavonoids
• Terpene lactones
• Physiologic effect(s)
• Antioxidant, prevent platelet aggregation,
  antagonize PAF, increases cerebral perfusion
• Most common use(s)
• Tmt of cerebral vascular insufficiency,
  peripheral vascular disease (eg Raynauds
  disease)

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Ginseng(Panax ginseng)

• Active ingredient(s)
• Tritepenoid saponin glycosides
• Physiologic effect(s)
• May have effect on pituitary similar to
  corticosteroids, improves HbA1c
• Hypertensive at low dose hypotensive at high
  dose
• Most common use
• Couteracts physical/mental fatigue
• Improvement of bodys ability to fight stress and
  disease

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Herbal Medicines to Avoid

• Clients with Hx of hemorrhagic stroke
• Bilberry
• Feverfew
• Garlic

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Herbal Medicines to Avoid

• Clients on Digoxin
• St. Johns Wort

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Herbal Medicines to Avoid

• Pregnant and lactating patients
• MOST herbal remedies

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Herbal Medicines to Avoid

• Patients with autoimmune disease, severe allergy
  to sunflowers/daisies
• Ginseng