Natural and herbal agents

Arnica Arnica montana) Astragalus (Astragalus membranaceus) Bilberry Vaccinium myrtillus) 

Butcher s Broom Ruscus aculeatus) Capsicum Capsicum frutescens) 

Cascara Sagrada Rhamnus purshiana) Chamomile Matricaria recutita) 

Ephedra (Ephedra sinica)/Ma Huang Evening Primrose Oil (Oenothera biennis) Feverfew (Tanacetum parthenium) 

Fish Oil Supplements (Omega-3 Polyunsaturated Fatty Acid) Garlic (Allium sativum) Gentian (Gentiana lutea) Ginger (Zingiber officinale) 

Ginkgo biloba Ginseng Panax quinquefolius) Glucosamine Sulfate (chitosamine) 

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Natural and herbal diet pills available in the United States today are considered dietary supplements and are not subject to FDA review prior to being sold. Although these agents may have drug-like activity in the body, they do not need to be proven safe or effective like conventional drugs do. Unlike conventional drugs, natural and herbal diet pills can only be withdrawn from the market when they are proven to be dangerous. As a result, many herbal products reach the market without any scientific evidence that they are safe or effective. These products are discussed in more detail in Chapter 6. 

Some products available on the market contain a combination of Ma Huang and St. John s wort and are referred to as herbal phen-fen. Phen-fen received its name when the combination of phentermine and fenfluramine were used for weight loss. Herbal phen-fen is touted as a natural and effective weight loss agent that does not contain phentermine or fenfluramine. However, herbal phen-fen carries the same warnings that apply to Ma Huang and St. John s wort when each is used alone. Furthermore, there are no clinical studies to support the use of herbal phen-fen. ... 

Although the use of bioactive natural products as herbal drug preparations dates back hundreds, even thousands, of years ago, their application as isolated and characterized compounds to modern drug discovery and development only started in the 19th cenmry, the dawn of the chemotherapy era. It has been well documented that natural products played critical roles in modem dmg development, especially for antibacterial and antitumor agents. More importantly, natural products presented scientists with unique chemical stmctures, which are beyond human imagination most of the time, and inspired scientists to pursue new chemical entities with completely different stmctures from known dmgs. 

Herbal drugs have many unknown and undocumented risks, side effects, and drug interactions. Like contemporary, rigorously tested pharmaceuticals, herbal medicines have some risk associated with their consumption. The fact that a plant is completely natural does not necessarily make that plant entirely risk-free. Several plants, when consumed in their most natural form, can cause grave illness or even death to humans and animals. A partial list of some of these natural herbal agents with the potential to harm is listed in Table 2. Herbalists, scientists, and the general public routinely avoid many of the plants listed in Table 2 because of their impending risks. However, hundreds of additional herbs and alternative medicines... 

Despite its poisonous nature, Conium is included in several herbals as Succus conii, described as a narcotic, sedative, analgesic, spasmolytic, antiaphrodisiac, and anticancer agent. It was even listed at one time (up to 1934) in the British... 

Plants, and natural products, continue to play a vital role in modern society both as the source of conventional therapeutic agents and as herbal preparations in health food stores. In 1994, half of the top 25 drugs on the market in terms of sales were either natural products or based on natural products, now made synthetically or semisynthetically. Examples of active plant compounds with therapeutic uses are shown in Table 1.3. 

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