Bot Med II Study Guide for Final

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STUDY GUIDE FOR FINAL EXAM – BOT MED II SPRING 2008
(To be reviewed in class, week 11, 8 am)

Be able to define the words/concepts of:

Alteratives – when are they indicated, when are they contraindicated. Herbal examples.
indic: slow peristalsis, constip, toxic, poor absorb, low vitality
CI: active Crohn's, D, acute gallbladder attack, GI bleeds
herbs: taraxicum, rumex spp, silibum marianum, arctium lappa = burdock, trifolium, gallium aparine = cleaver's

Adaptogens – When are they indicated. Herbal examples.
hormonal or homeostatic modulator, most biphasic in action, allows body to cope w/ stress
indic: CFS, hormonal imbalance, HTN, depression
CI: none unless hx says otherwise
ex: eleutherococcus senticosus = siberian, panax ginseng = chinese, lipidium meyenii (macca), withania somnifera = ashwaghanda, rhodiola rosea = rhodiola (vikings used it), glycyrrhiza glabra

Counter Irritant – When are they indicated. Herbal examples
def: aka rubefacient, applied to skin, application relieves deep pain applied topically also strong laxatives, topicals activate substance P esp capsicum
indic: arthritis, strains sprains gout raynauds, chronic constip dt low peristalsis
CI: none but CI laxative use with Crohn's or contact dermatitis with topical
ex: topicals capsicum frutescens or annuum, alium sativum, brassica juncea = mustard, mentha species, cinamommun ceylonicum and comfora
gi ex: cascara sagrada, rhamnus pershiana = buckthorne, aloe vera peels

Demulcent – When are they indicated. Herbal examples
def: mucilagious soothing and protecting
indic: irritated tissue, burns, abrasions, erosions, URI, UTI
CI: too much mucus
ex: althea officinalis (malvaeae) = marshmallow, aloe vera gel, abelmoschus esculentus = okra (cotton family: malvaceae), smilax regelii = sasparilla, salvia hispanica has omega 3's = chia, linum ussitatissimum = flax, glycyrrhiza glabra, ulmus rubra, tussilago farfara = colt's foot, thapsus verbascum

Bitters – What is the physiologic effect? Herbal examples.
def: tastes bitter and stims bile, gastric acid and pancreatic enzymes
indic: sluggishdigest, hypochlorhydria
CI: GV spasm, biliary obstrx, pancreatitis, gastric ulcer
ex: gentiana lutea, ruta graveolens = garden rue (classic, ci: citrus allergy, rutaceae), taraxicum, artemisia = wormwood, mugwort, etc, achillea (in my stuffing next Thanksgiving), many culinary herbs (sage, rosemary, etc), oregon grape

Intestinal Antispasmodics – Herbal Examples
def: relaxes smooth muscle
indic: gerd, gallbladder attack
CI: lack of peristalsis
ex: dioscorrhea villosa = wild yam (esp for gall attack or kidney stone on way to ER), mentha spp (gerd sometimes ci), foeniculum vulgare, anithum graveolens = dill (seed is stronger), Zinziber officionale, many carminatives work as mild antispasmodics

Respiratory Antispasmodics – Herbal Examples
def: relaxes smooth muscle
indic: cough, asthma, esp when sleep problem
CI: none except when expectorating
ex: cinnanomum camphora = camphor, *lobelia inflata = pukeweed, prunus cerrasus = cherry bark, angelica arcangelica = european in Umbelliferae (angelica sinensis is chinese and dong quai, different indications)

Uterine Antispasmodics – Herbal Examples
def: relax smooth muscle
indic: cramps, limit premature birth
CI: none but hx personal
ex: vitex agnus castus = chaste tree bark/monk's pepper, dioscorrea villosa esp w/ concommittant hyperestrogen, *viburnum opulus = viburnum use first

GI Astringents – When are they indicated? Herbal Examples
def: cools and dries inflam
indic: ulcer, crohns, anal fissue, hemorrhoid
CI: hypochlorhydria
ex: hamamelus verginiana = witch hazel, achilea millefolium, esculus hippocostanum = horse chestnut (the nut), persimmon

Respiratory Antimicrobials - Herbal Examples
def: antibact, viral, fungal action
indic: infx
CI: none but pt hx
ex: origanum vulgare = organo oil esp for sinus infx, olea europea = olive leaf, thymus vulgaris, ligusticum porteri = osha esp for bronchi on west coast it's native and Apiaceae family has toxic member so be careful with harvesting, sambucus nigra = elderberry esp antiviral, there is a european elderberry naturalized in the east, allium sativa, thuja plicata, grindelia spp = gumweed looks like hockweed, populus spp

GI Antimicrobials – Herbal Examples
def: anti everything incl parasites
indic: infx
CI: none but hx
ex: mahonia = oregon grape, artemesia absinthum = wormwood esp for parasites, larrea tridentata = creosote bush, allium sativa, juglans nigra, oregonum vulgare

Nervines – Herbal Examples
def: alleviates hyperactive sympathetic nervous system activity or promotes parasymp
indic: stress, insomnia, indigestion, panic, hyperactivity, muscle tension/tic
CI: some have narcotic or overstimulating action in large doses
ex: piper methisticum (CI: liver probs), melissa officinalis (good thyroid med, amphoteric), matricaria, scutellaria, valerian, humulus, passiflora incarnata, escholzia californicus

HPA Axis – Herbs that act via HPA axis
ex: glycyrrhiza glabra modulates adrenal output, increases half life of cortisol
ashwagandha = withania somnifera, adrenal support
panax ginseng = chinese
eleutherococcus senticosus = siberian
oplopanax = devil's club
mushrooms: reishi, cordyceps, shitake, all chinese mushrooms

Estrogen agonists and amphotericism – Examples of herbs known to be estrogen agonists
ex: punica granatum = pomegranate contains estrone
humulus lupulus
cannabis sativa
soy = glycine max (coumestans, isoflavones)
trifolium praetens (coumestans)
linum usitatissiumu (lignans)
black cohosh = cimicifuga = actea

Hemostatics/Stypics – Herbal Examples
achillea
plantago spp, incl lanceolata ovata
cassia oxidentalis = closely related to senna

Alteratives for Hormonal Metabolism – why would alteratives be appropriate for hyperestrogenism?
liver: taraxicum, silibum, marianum, cynara = artichoke, arctium lappa, schizandra
use phytoestrogens to block receptors with weak acting est
avoid plastic
increase fiber in diet: flax
loose weight
incr prog: dioscorrhea, vitex, viburnum,

Monoamines – What are monoamines and by what mechanisms might herbs affect them?
aromatic ring with amino group attached by 2c chain
dopa, epi, nor epi all are monamines
any dopa affector: melissa, sage are dopaminergic
stigmasterol in soy, licorice, alfalfa, sage (dopaminergic), fennel
diosgenin in dioscorrea, smilax, daucus carrota, aletris farinosa, chamelerium luteum

Know the common and latin names of: (Be able to Match the latin to the common name)
Be able to recognize a 1 sentence summary of the primary actions of these herbs.

Taraxicum = dandelion
main liver alterative and diuretic leaves

Arctium lappa = burdock = gobo
hepatic alterative
alterative
skin complaints

Trifolium = clover
blood purifier, general alterative
anti-cancer

Rumex = dock
hepatic alterative, bitter
jaundice

Mahonia = Oregon grape
antimicrobial, hepatic alterative, bitter

Chelidonium = greater celandine
bitter, liver & gallbladder
NOT FOR ACUTES
classic cholegogue
(Raphanus = black radish lets bile flow, incr liquidity)

Chionanthus = chionanthus
classic liver alterative

Smilax = sasparilla
anti-poison per Stansbury: toxin protective herb
demulcent
gi tonic, alterative, for aphrodisiac, anti-syphillis, diuretic, anti-rheumatic
possible liver toxicity in high doses, LD50 in rats is 240mg/kg
protect gut from toxins
steroidal saponins

Ceanothus velutinus = red root
lymphogogue, alterative
for HTN
ovarian cysts, fibroid tumors
tonsillitis
alkaloids for HTN and lymph blockage
natives drank tea, pioneers used as sub for black tea
C. velutinus effective in relieving inflam/irrit from infections of mouth and throat
C. integerrimus used by North American tribes to ease childbirth

Silybum = milk thistle
liver detox herb
supports regen of liver tissue
beware if pt on many pharmaceuticals: changes detox speed

Eleutherococcus = Siberian ginseng
adaptogen
adrenal tonic

Larrea tridentata = creosote bush = chaparral
anti-carcinogen, anti-infx, detox??, anti-allergy
resp infx, antihistamine
cox inhibitor
for OM

Angelica = arcangelica
blood mover
dong quai used for menopause
researched for circ benefits
incr circ in pelvis
incr metabolism in female reprod organs
for vascular congestion
UMBEL family: Apiacaea
for resp and carminative per Craig

Cimicifuga = black cohosh = bug bane
Actea racemosa
female probs: menopause, dysmenorrhea,
estrogen agonist
for deep dark depression
dopaminergic
phytoest and triterpene glycosides
used widely for menopause many forms
does not stim excessive endometrial prolif
nervine

Foeniculum = fennel
carminative, mild dopaminergic--galactogogue
relaxes hollow tubes
antispasmodic
mom drink lots of tea for colicky baby

Glycyrrhiza = licorice
adaptogen
doubles the half life of cortisol
demulcent
expectorant
anti-spasmodic
CI: HTN
for gastric & duodenal ulcers

Leonurus cardiaca = motherwort
cardiac tonic
nervine* GABA up and beta blocker, for stress response too high
pos affect on platelets
for palpitations
for hyperthyroidism, reduce elevated TSH
for all sx of hyperthyroid: high BP spike, irrit, nervous, fast heart, etc
uterine tonic
vascular tonic
protects endothelium from oxidative damage
amennogogue
panic attacks
female herb
cardiovascular herb, affects platelet agg and good for atherosclerosis
blood mover
hormonal balancer

Melissa = lemon balm
for hyperthyroid probs
nervine
gladdening herb
may have dopamine effect
may affect pit release of prolactin
may have calming mood effect via limbic system
extremely lemony
upper
also antiviral, colds, herpes, EO as topical
thyroxine production decrease if excessive, regulates TSH release mb via dopa
colic tea
herpes

Panax = Chinese ginseng
adaptogen
antiaging, energy, sexual fx in older years, viagra of ancient times
panax ginseng: vital tonic, improve energy and sexual function, keep adrenals toned to respond well to stress
immune polysaccharides incl large mols not known how they trigger immune response, body may regard as foreign and mount a response, mechanism of action stim WBC numbers, incr phagocytosis, NK cells more ative, TNF and IFN more output by WBC's, makes more sense for systemic infx or cancer, chronic viruses, more for serious chronic immunodef states, AIDS. Ganoderma = reishi mushroom grows in China and PNW, panax ginseng = classic best when root looks like person, rhodiola = native to Siberia, oplopanax = devil's club for chronic infx/fatigue, cordyceps = fungus that grows on dead insects, maitake, shitake, glycyrrhiza (does it all), astragalus = colds flus viruses allergies, echinacea (also lymph herb), wilthania = Indian "ginseng" = ashwagandha is stinky like a horse, eleutherococcus = Siberian ginseng. Lower dose for longer time period. For those who are ill all the time. Chronic fatigue syndrome, hep C. Chi tonics, for exhaustion, loss of vital force, mb mental or physical, low stamina.

Vitex = chasteberry, monk's pepper
endocrine regulator, prolactinergic
monk's pepper or chaste tree berry
used to decrease male libido
also for adolescent acne in males, skin complaints
may stim LH release from pit
***progesteronic effect "enhances prog"
ace in the hole all purpose female herb
breast probs, fibroids, etc all high est
foundation in many of her herbal formulas
she gets vitex fresh ground and encapsulated for her practice
dose: fairly low, a dropperful 60 drops or 1/2-1 tsp 1-2x daily

Viburnum = cramp bark
uterine antispasmodic, tonic, anti-inflammatory
***if it doesn't work for uterine cramps, consider other etio for pain
may be engorgement, vascular congestion-->back ache for 3 days before period
may be ovarian irrit
may be bowels or sacral nerve roots
ACE IN THE HOLE for menstrual cramps
if predictable cycle, start the afternoon or night before to prevent discomfort
if irreg cycle take when sx arrive, dose every 30 mins-1 hour for acutes
mabye 3-4 doses/day to prevent
if DUB or fibroids also good
if cycle gets long in peri, this may be esp helpful
PRUNIFOLIUM is another sp, AMERICANUM
good ornamental shrub in herb garden

Dioscorrea = wild yam
smooth muscle relaxant, antispasmodic, esp for gall colic, stim prog
DHEA can get shunted into stress hormones with none leftover to make sex hormones
tx stress and sex hormones increase
diosgenin and saponins
synthesize steroids from this
for colic, IBS, intest cramps, relax bile duct for biliary colic
for bronchial and other hollow tube spasm
esp for twisting boring pain around umbilicus

Mentha = mint
carminative, antispasmodic
CI w/ gerd
anti-nausea

Matricaria = chamomile
nervine, antispasm, carminative
anti-emetic (so is mahonia)
ASTERACEAE

Achillea = yarrow
alterative, styptic, febrifuge, diaphoretic
bitter, diuretic, anodyne = sooths pain
inhibits prostaglandins = anti-inflam
antiseptic = all purpose antimicrobial
good for BP
used to tone uterus, control bleed
ACE IN HOLE TO STOP BLEEDS anywhere
ASTERACEAE

Cinamomum = cinnamon
with kasha and camphor same family
blood sugar regulation, carminative, counter irritant
germicidal, laxative, gastric stim, demulcent,
astringent
hemostatic for uterus passive hemorrhage

Hydrastis = goldenseal
topic antimicrobial, liver alterative
oxyquinoline alkaloids incl hydrastine
(also in oregon grape berberine)
expensive here, overharvested so people are using oregon grape more now
grows in forest, need shade cloth or forest cover
drying, good for allergies

Phytolacca = poke root
lymphogogue
particularly lymphatic
stim bile flow but also enhance general body circ Y lymph
phytolacca for enlarged lymph nodes, tonsils, sore throat, URI, sore nodes
underarm infx
activator for formulas
for dampness, colds always go mucousy
irritating/caustic when fresh handled
berries are not medicinal

Ulmus fulva = slippery elm
demulcent esp for resp
singer
demulcent, emollient, nutritive, astringent, anti-tussive and vulnerary

Symphytum = comfrey
bone knit, wound healing
root is mucilaginous
alantoin
cell proliferant
classic for fractures
wound closing, reduce infx and scarring

Allium = garlic, chives, onion
anti-microbial, hypotensive, diaphoretic, expectorating
LILIACEAE
expectorant: isothionate glycosides
immune polysaccharides
hot
for BP, circ, high lipids, high sugar
cough syrup: chopped onion soaked in honey
antimicrobial best with physical contact
for ear infx: eat garlic or take tincture
stimulates mucus, flow unstops eustacian tubes
some systemic effect
for lung infx: sulfur in isothiocyanate like to volatilize from inner tissues & inhaled
make mucus thinner, planes out into sheets that slide, better expectoration
for GI infx, bact, dysbiosis, yeast
topicals for athlete's foot blended with water and vinegar

Thymus = thyme
anti-microb, esp fungal, carminative, esp resp
spasmolytic, antihelminthic, antithyrotropic in animals
expectorant, kills mosquito larvae
awesome for common cold
drying
for damp heat
for acute wheezing
asthma, bronchitis, candidiasis

Lobelia = pukeweed
antispasmodic
binds nicotinic receptors, for smoking cessation
small doses or sick
for acute wheezing, tx for asthma
beta agonists: lobelia, leon usu, viburnum, tilia, (works on BV's and uterus)
lobelia relaxes bronchi
used for tachycardia, coronary vasospasm, angina
lobelia oil on cervix during delivery to help dilation
nervine AFTER it makes you puke, also for anxiety
beta blocker, calms the heart, controls rate
pink flower
stimulant/irritant but also bronchodilator

Calendula = calendula
anti-viral, anti-genotoxic and anti-inflammatory
salves for dermatitis, acne
mucuous memb sooth
adaptogen, demulcent, vulnerary, lymphatic
controlling bleeding and soothing irritated tissue
for abdominal cramps and constipation
both spasmolytic and spasmogenic effects
triterpene saponins
anti-tumor (cytotoxic) activity
immunomodulatory (lymphocyte activation)
weak antimicrobial
demulcent
wound healing
topical for infx
lymphogogue too
improves circ just below dermis
esp for skin infx
preventative
sucus = extract w low alc content
epsom salt soaks for infected wound, then calendula salve
for any mucus membrane it could contact
for sore throat, for ulcer
whole flowers in tea for bladder infx
easy to grow (very)
best to gather flowers just before they open & before pollenation
related to marigold, Asteraceae

Commiphora = guggul sim to myhrr
atheroscelorisis
mukul resin from bush in desert
from India
high chol, TG's
decreases plt stickiness: lowers clotting
affects TSH, incr iodine effect, stim thyroid
for high blood sugar and sluggish metab, trouble loosing weight
for DMII
SEs: D, GI upset with longterm use
one small trial compares well to tetracycline for cystic acne
good smell, good for athlete's foot and preserving mummies

Curcuma = tumeric
anti-inflammatory, hepatic tonic, topical for skin
anti-oxidants
curcuma for liver and antiinflam, in her allergy/hayfever formula
ZINGIBERACEAE
yellow color
atherosclerosis, bursitis, RA
anti-histamine
increases cortisone
prevents platelet clumping
prevents cancer
CI: gallstones, it's choleretic
anti-fertility??? can cause uterine stimulation (abortifacient?)

Centella asiatica = gotu kola
nutritive, anxiolytic, cerebral tonic, anti-oxidant
juiced in Asia
little round leaves
mix juice with sugar can, serve in plastic bag with straw
also canned
heals body tissues, bones, intestine ulcers, bladder ulcers, osteoporosis,
like equisetum
circ effects in brain, neuroprotectant: prevent age related demise to neuroreceptors
Misty says for adrenals, mix with guarana for good upper with no let down
it's in her nervine adrenal support formula

Passiflora = passion fruit
sedative, muscle relaxer
Passiflora binds gaba receptors
calming
contains trytophan-->melatonin, sedating
don't use with MAO inhibitors: antidepressants
(monoamine oxidase inhibitors are a class of antidepressants, formerly used only after SSRIs and tricyclic antidepressants have failed, but now sometimes used as first med chosen, selegiline and moclobemide are current drug names, particularly effective for "atypical" depression and smoking cessation)
modern uses: nervous sedative, anxiolytic, antispasmodic, nervine, hypotensive, analgesic
for insomnia, restlessness, high blood pressure
for excessive motor activity: tension, tremors, twitching, tics, convulsions incl epilepsy
(doesn't affect resp rate and mental fx)
anxiolytic and sedative effects verified in animal studies
tranquilizing effect dt alkaloid and flavonoid constituents
often included in pain formulas when discomfort is due to muscle tension and emotional turmoil
energetically cooling, moves energy lower in body, grounding, affects heart &liver meridians
sold as medicine in Germany, Switzerland and France

Scutellaria lateriflora = skullcap, mad dog
nervine, antispasmodic, reduces BP, anti-histamine
inhibits arachidonic acid-->anti-inflam
not showy, is diminutive, small flower
similar chem to valerian but milder
"mad dog" for shaking of rabies
LABIACEAE
overdose may stimulate

Valerian = valerian
nervine, sedative
GABA AGONIST
mellowing out, may cause weird dreams, hangover
like valium
for panic attacks, body tension, etc
dysmenorrhea
toxicity --> visual disturbance?

Hypericum perforatum = St John's wort
antidepressant, tissue healing topical
detox increases liver fx
upregs phase II detox
a weak SSRI: serotonin stays in synapse prolonging firing of happy nerve
antianxiety effect, mood lifter
dopaminergic-->prolactin
may bind gaba receptors

EST AGONISTS
humulus
cannabis
pomegranate
cimicifuga = actea = black cohosh
glycine max
trifolium
glycyrrhiza
virburnum = crampbark
nightshades

Piper methysticum = kava kava
happy muscle relax, nervine
antispasmodic, narcotic in high doses
big gun
slur speech, loss of coordination
may be overly stimulating in some people

Withania somnierfera = ashwaganda
adaptogen, sedative (for sleep)
nervine
anti-inflam
SOLANACEAE, only member that is anti-inflam
wilthania somniferum = indian ginseng, not really a ginseng but has similar activity
aka ashwaganha, not sedating but helps cortisol elevation and helps sleep
Stansbury has them take it 3x/day, I've been told take it morning and noon
ashwaghanda means like a horse
smell? not pleasant, animal like
makes you strong
anti-inflam activity direct on wounds sim to hydrocortisone
contains withaferin A anti-inflam
improve cardiac fx
increase heart wt and glycogen content in myocardium and liver
withanolides are anxiolytic and antidepress, may act on GABA system
stops stress induced memory disruption

Panax = chinese ginseng
adaptogen
HOT, yang
anti-aging
brain circ
sex
energy
tastes good

Ephedra = mormon tea = ma huang
upper, asthma or bronchial antispasmodic
neurostimulatory
antihistamine, mast cell stabilizer
for cough

Tussilago = coltsfoot
demulcent esp for URI's
better longterm
mucilaginous
for acute wheezing
CV stim
saponins, expectorating
don't take when preg: abortifacient
comes up early in gardens, too easy to grow, mucilaginous, antispasmodic, decreases excessive bronchoirritant by blocking calcium channels of bronchioles, long reputation as cough dispeller, leaves are fuzzy, holds mucilage, flowers precede leaves in Feb/Mar, leaves later, funky stems have little mini-leaves, put flowers in honey and bake low temperature, decant watery honey for cough syrup or mix with lomatium

SERMS
selective estrogen response modifier
weak estrogen binds receptor
prevents strong estrogen action
cimicifuga = actea = black cohosh