Hepatic tonic

Iran. Flour is used as a food. A decoction of the dried seed is used externally as an emollient and applied on hemorrhoids and infected ulcers. A decoction of the dried seed is taken orally as a diuretic and antipyretic and used for hepatitis, diarrhea, scorbutism, nephritis, bladder inflammation, gout, enema, and its tonic effect. Decoction of the dried seed is applied to the nose to reduce internasal inflammation " ". 

Many congeners of phenytoin have been synthesized, but only three have been marketed in the USA, and one of these (phenacemide) has been withdrawn. The other two congeners, mephenytoin and ethotoin, like phenytoin, appear to be most effective against generalized tonic-clonic seizures and partial seizures. No well-controlled clinical trials have documented their effectiveness. The incidence of severe reactions such as dermatitis, agranulocytosis, or hepatitis is higher for mephenytoin than for phenytoin. 

Schisandra chinensis (Turcz.) Baill. Wu Wei Zi (Chinese magnolia vine) (fruit, kernel) Schizandrin, deoxyschizandrin, schizandrol, schizandrer.8-33 Antitussive, a tonic. A tendency to lower SGPT caused by hepatitis. 

A full-term neonate was accidentally given carboprost 250 pg intramuscularly in an error for hepatitis vaccine. Within 15 minutes, he became tachypneic and hypertensive and then developed bronchospasm and dys-tonic movements and/or seizure activity in the arms. He was hyperthermic and had diarrhea. He recovered within 18 hours. 

In all cases where a tonic is indicated. With suitable hepatics and laxatives, sometimes forms part of prescriptions for liver complaints, dyspepsia and constipation. 

The bark of C. cassia is a tonic, stomachic and carminative. The bark is useful in inflammation, headache and piles. C. cassia bark and its essential oil are used in various medicinal preparations. The essential oil from the stem bark and cinnamaldehyde regulates the triggering of hepatic drug-metabolizing enzymes by the formation of a glutathione-conjugate (Choi et al., 2001). The bark exhibits promising anticancerous and antitumour activities. 

A 20-year-old woman was found unresponsive at a rave. She was hot to the touch and on the way to hospital had a tonic-clonic seizure and became pulseless and apneic. Aggressive resuscitation was unsuccessful. An autopsy showed gross pulmonary congestion and edema. She had acute neuronal ischemia and mild hepatic steatosis, without any evidence of myocardial damage. Her blood ecstasy concentration was 1.21 mg/1. Death was reported to have been secondary to ecstasy toxicity. 

Although generalized tonic-clonic seizures have occasionally been described during trials of high doses of interferon alfa, they have also been reported after the use of intermediate or even low doses (67-69). There was a 1.3% incidence of generalized seizures in a retrospective study of 311 patients treated with low doses for chronic viral hepatitis (70). In another study, tonic-clonic seizures were identified in 4% of children treated for chronic hepatitis B (71). As seizures occurred only in children under 5 years of age with fever or potential perinatal nervous system injury, immaturity of the nervous system was suggested to be an additional factor for interferon alfa-induced neurotoxicity in children. 

Ginseng is promoted as a tonic capable of invigorating the user physically, mentally, and sexually. It is also said to possess antistress activity, or to serve as an adaptogen, improve glycemic control and stimulate immune function. Claims that ginseng can improve athletic performance, enhance longevity, or treat toxic hepatitis are not supported by human trials. 

Bupleurum falcatum (Chai hu plants) is an important tonic herb for the liver and circulatory system of humans and can alleviate hepatitis. Chang et al. (2004) reported aster yellows phytoplasma associated with Bupleurum falcatum plant in Canada. Diseased plants showed resetting, proliferation of auxiliary shoots at the nodes of the stem, witches - broom, virescence and phyllody symptoms. 

The root of the plant Cryptolepis sanguinolenta (Lindl.) Schlt (Periplocaceae) is used in traditional African medicine to treat a variety of diseases including malaria, jaundice, hepatitis, urinary tract infections, hypertension, inflammatory conditions and stomach ache. Extracts of the roots are also used as a tonic often taken daily for years without evidence of toxicity. Various studies indicate that the crude extracts as well as the isolated alkaloidal constituents of the plant possess a number of interesting pharmacological properties. The focus of this overview is to highlight the potential of Cryptolepis sanguinolenta in modem health care. 

H. styphelioides has been employed in traditional Cuban herbal medicine as a depurative, diaphoretic, diuretic, and tonic against blennorrhea, cold, cough, and dysmenorrhea and for the treatment of arthritis, rheumatism, hepatitis, herpes, and syphihs [124]. 

Sidransky, H., Vemey, E., and Orenstein, J., Effects of altered tonicity by sodium chloride on L-tryptophan binding to hepatic nuclei, Am.. Physiol. Cell Physiol., 278, Cl237, 2000. 

The well known toxic effects of alcohol appear to be ameliorated by the administration of vitamin C which plays a role in hepatic detoxification mechanisms by contributing to the oxidising cytochrome P450 system. Perhaps the gin and tonic imbibers should be advised to resume the now outmoded gin and orange in order that the latter may help to counter the after effects of the former The vitamin has also been used in treating lead poisoning but carefully controlled trials showed no effect of ascorbate in reducing heavy metals in hair. 

THERAPEUTIC USES Carbamazepine is useful in patients with generalized tonic-clonic and both simple and complex partial seizures. Renal and hepatic function and hematological parameters should be monitored. The therapeutic use of carbamazepine is discussed below. 

Anticonvulsant used for tonic-clonic and partial seizures blocks Na" channels in neuronal membranes. Serum levels variable due to first-pass metabolism and nonlinear elimination kinetics. Tox sedation, diplopia, gingival hyperplasia, hirsutism, teratogenic potential. Drug interactions via effects on plasma protein binding or induction of hepatic metabolism. 

Anticonvulsant primary drug in absence, clonic-tonic, and myoclonic seizure states. Tox GI distress, hepatic necrosis (rare), teratogenic (spina bifida) inhibits drug metabolism. 

Ethotoin differs from phenytoin in that one phenyl substituent at position 5 has been replaced by hydrogen, and the N-H at position 3 is replaced by an ethyl group (Fig. 20.5). It may be indicated for treatment of tonic-clonic and complex partial (psychomotor) seizures. Because it is considered to be less toxic but also less effective and more sedating than phenytoin, ethotoin usually is reserved for use as an add-on drug (39). Ethotoin does not share phenytoln s profile of antlarrhythmic action. The metabolism of ethotoin, like phenytoin, is saturable and nonlinear. Its administration Is contraindicated in patients with hepatic abnormalities and hematologic disorders. 

Because diazepam clearance is decreased in the elderly and in patients with hepatic insufficiency, a dosage reduction may be warranted. Intravenous diazepam should be used cautiously in patients who are elderly, very III, or have limited pulmonary reserve, because respiratory depression has occurred. Rarely, IV diazepam is given to patients for absence status (typical and atypical), because It will precipitate tonic status epileptic. 

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