Botanical Medications Nutritional Supplements

Appreciate that these substances are marketed without governmental review of efficacy and safety. Recognize that in many cases the medical value of these substances has not been demonstrated in controlled clinical studies. 

Identify the most widely used botanical products and describe their purported medical uses, adverse effects, and potential for drug interactions. 

Describe the proposed medical uses and adverse effects of dehydroepiandrosterone and melatonin. 

The use of botanical or herbal medications has increased markedly in the past decade. Popular botanical products in the USA include echinacea, garlic, ginseng, gingko, Ma-huang, psyllium, St. John s wort, and saw palmetto. These natural medicinals are available without prescription and, unlike over-the-counter medications, are considered to be nutritional supplements rather than drugs. As such, these substances are marketed without FDA review of efficacy or safety and there are no mandated require- 

In the case of many herbal products and nutritional supplements, evidence for their medical effectiveness based on controlled clinical studies is incomplete or nonexistent. CUnical trials of herbal products have been characterized by multiple variables, including their formulation, their chemical constitution, the dosages used, and the duration of treatment. Thus it has often been difficult to make recommendations regarding possible therapeutic benefits. 

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Ephedrine occurs in various plants and has been used in China for over 2000 years it was introduced into Western medicine in 1924 as the first orally active sympathomimetic drug. It is found in Ma-huang, a popular herbal medication (see Chapter 65 Botanicals ("Herbal Medications") Nutritional Supplements). Ma-huang contains multiple ephedrine-like alkaloids in... 

Serotonin is present in a variety of sites in the brain. Its role as a neurotransmitter and its relation to the actions of drugs acting in the central nervous system are discussed in Chapters 21 and 30. Serotonin is also a precursor of melatonin (see Chapter 65 Botanicals ("Herbal Medications") Nutritional Supplements). 

Chapter 65. Botanicals ("Herbal Medications") Nutritional Supplements... 

Katzung PHARMACOLOGY, 9e > Section X. Special Topics > Chapter 65. Botanicals ("Herbal Medications") Nutritional Supplements > ... 

New chapter on botanicals (herbal medications) and nutritional supplements, with questions and answers... 

By definition, a nutraceutical (derived from the term nutritional pharmaceutical ) is a foodstuff (fortified food or dietary supplement) that is held to provide health or medical benefits in addition to its basic nutritional value [1], Nutraceuticals derived from botanicals deliver a concentrated form of presumed bioactive agents from plants that are not generally part of the food supply. The term nutraceutical has no regulatory definition. Similarly, functional foods, as defined by the International Life Sciences Institute (ILSI), are foods that by virtue of physiologically active food components, provide health benefits beyond basic nutrition [2], For the purposes of this review, these two terms will be differentiated by the form in which they are consumed. Nutraceuticals refers to dietary supplements most often found in pill or capsule form functional foods are ingested as part of a normal food pattern. Both are intended to provide beneficial effects beyond their nutritional value, and contribute to an improved state of health and/or reduction of risk of disease. 

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