Medication herbal

H, MATSUURA D, MIYAKE M, UENO M, TAKAI I, YAMAMOTO T, KUBO M, MOSS J, NODA M (2002) Identification in traditional herbal medications and confirmation by synthesis of factors that inhibit cholera toxin-induced fluid accumulation. Proc Natl Acad Sci U S A. 99 3042-6. 

Obtain a thorough history of prescription, nonprescription, and herbal medication use. Is the patient taking any medications that can exacerbate HF ... 

Review patient history to determine treatment regimens that have been used in the past, including nonprescription, prescription, and herbal medications. 

Take a thorough medication history with particular attention to over-the-counter and herbal medications. 

Bradley P, ed. British Herbal Compendium. London British Herbal Medical Association, 1992. 

The potent carcinogen aflatoxin B1 is activated by generation of an epoxide on a dihydrofuran moiety [43]. The potent MBIs contained in grapefruit juice and in the herbal medication St J ohn s Wort are furanocoumarin compounds [44—46]. A similar moiety is also incorporated in the HIV protease inhibitor L-754,394, a potent CYP3A4 MBI [47]. 

Herbal medications are drugs in every sense of the word. They chemically modify bodily processes and can have therapeutic or harmful effects, depending on how they are used. However, there are a few general differences between herbal and pharmaceutical drugs (Tyler 1994). Herbal drugs tend to be more dilute than pharmaceutical drugs (table 1.1). For example, caffeine is available in 200 mg tablets to produce stimulation. Coffee contains 1-2% caffeine, so in order to get the same amount of caffeine one must use 20 g of coffee bean. Similarly, aspirin is... 

Another possible reason for public interest in herbal medications is that they provide some autonomy from medical professionals. Multiple factors contribute to a person s satisfaction with medical care (Siahpush et al. 1999 Sixma et al. 1998 Kaptchuk and Eisenberg 1998). One cause of dissatisfaction results from the traditionally passive role of the patient. Independent of its efficacy, alternative medicine provides an individual with a greater range of explanations and treatment options for their illnesses. The psychological appeal of more options is sufficient to draw individuals to consult alternative medicine, especially in cases where modern medicine has not been effective. 

A significant fact was revealed by Eisenberg and colleagues regarding disclosure and the use of herbal medicines (1993, 1998). Of the proportion of respondents who utilized alternative medicine, only about 40% had disclosed this fact to their physician. The use of herbal medications was among the most common alternative treatments, and also one of the treatments with the greatest increase in use. Further, it was estimated that during the year of the survey 15 million adults took prescription... 

The reiuctance of many physicians to prescribe herbai medications is in many ways understandabie. Much research needs to be done to ensure the efficacy and safety of many herbs. Few authoritative texts are avaiiabie that summarize the avaiiabie ciinicai research (see Tyier 1994). Because physicians naturaiiy want to provide their patients with the best avaiiabie care, herbal medications do not always present an attractive option due to the uncertainty that surrounds them. 

In 1994, the Dietary Supplement Health and Education Act was passed by the U.S. Congress. This allowed herbal medications to be advertised and sold without oversight from the FDA. Specifically, it states that a substance will not legally be classified as a "drug" if it is not represented as treatment for a disease (Heiligenstein and Guenther. 1998 Dietary Supplement Health and Education Act of 1994). Thus, many herbal medicines are now sold and regulated as dietary supplements. 

The purpose of this discussion of science, clearly, is to apply it to herbal medicine. The reputed uses of drugs may not always be accurate or effective. Applying the scientific method to herbal medicine therefore allows us to test the traditional uses and to know with greater certainty what an herbal medication does and how reliably it does it. Although far from infallible, the process as a whole gives us greater confidence in our conclusions. 

Although the latter classes of evidence provide useful information. Class I evidence is the goal of research in herbal medication. Case studies and anecdotal evidence should be treated seriously, but they should also be followed up with empirical research. 

Two neurodegenerative diseases will be considered in greater detail here, Alzheimer s disease and Parkinson s disease, due to the pertinence of herbal medications to their treatment. Also discussed in some detail are vascular dementia and normal aging. Other degenerative conditions may benefit from herbal medications, but have not received the amount of attention in research that the above conditions have. Of particular interest to many degenerative conditions are herbal medications with demonstrated antioxidant and neuroprotective effects. 

It is unlikely that any herbal medications will replace the pharmaceutical drugs for dementia at present. However, ginkgo makes a compelling case because it is similar in efficacy to the available cholinesterase inhibitors, has additional antioxidant effects, and is relatively inexpensive. 

Long before the advent of modern pharmaceutical drugs, several herbal medications were employed for the alleviation of mental disorders. Some of these are considered impractical by today s standards for treatment of psychopathology. For a short time, Freud advocated the use of cocaine to alleviate depression. Cannabis and opium were used to treat agitation. Other herbal medications are being supported by scientific research and seriously considered by the medical community. Some are offered here more for historical interest, and yet others have only recently added psychotherapeutic value to their list of potential benefits. 

The discovery of pharmaceutical medications for the treatment of mental illnesses has revolutionized treatment and our understanding of the brain. Several herbal medications have been employed historically for the... 

In many developing countries of the world, there is still a major reliance on crude drug preparation of plants used in traditional medicines for their primary health care. Pharmacognosists employed in the different institutions are aware of the changing trends of herbal medications and a number of useful texts on the analysis, uses, and potential toxicities of herbal remedies have appeared recently, which serves as useful guides in pharmacy practice. The history of medicine includes many ludicrous therapies. Nevertheless, ancient wisdom has been the basis of modem medicine and will remain as one important source of future medicine and therapeutics. The future of natural products drug discovery will be more holistic, personahzed and involve the wise use of ancient and modem therapeutic skills in a complementary manner so that maximum benefits can be accmed to the patients and the community. 

Gordon, D. W., G. Rosental, ]. Hart, R. Sirota, and A. L. Baker. The broadening spectrum of liver injury caused by herbal medication. JAMA 1995 273(5) 489-501. 

Smith, B. G., and P. V. Desmond. Acute hepatitis induced by ingestion of the herbal medication Chaparral. Aust N Z J Med 1993 23(5) 526. Gnabre, J. N., Y. Ito, Y. Ma, and R. C. Huang. Isolation of anti-HIV-1 lignans from Larrea tridentata by counter-current chromatography. J Chromatogr A... 

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