Bot Med III Review

[liveonearth]

CONSTIUENTS

CARDENOLIDES
steroidal mol w/ extra ring
and 5C lactone sugar moiety bound to 17 carbon
occur in plants
digoxin in Digitalis

convallarin in Convallaria

apocynamarin, apocynum in Apocynum, dogbane

bufodienolides are similar, in toadskins
positive inotropic action: incr force of contraction while decr rate
for CHF, cardiomyopathy, weak heart action
for dyspnea
incr K influx at cell membrane, allows repeat contraction
toxic, can slow or stop the heart if dose too high
monarch butterflies store these toxins as defense mech

TROPANE ALKALOIDS
tropane = nitrogenous bicyclic organic compound
found in solanaceae plants: nightshades
(mandrake, henbane, deadly nightshade, datura, potato, tomato)
also found in Erythroxylaceae (coca), cocaine from coca

all are anticholinergic
hot as a hare, red as a beet, dry as a bone, blind as a bat, mad as a hatter
atropine = racemic hyoscyamine (from Atropa belladonna)
for dilate bronchi and for pain
atropine in eyes to dilate pupils for exam
scopalamine for motion sickness, patches/pills
from henbane and Datura species (Jimson weed)
hyoscyamine = levo-isomer of atropine
from henbane (Hyoscamus niger), mandrake (Mandragora officinalis)
all 3 chems present in leaves, stems, flowers of Datura, (Brugmansiae)


PILOCARPINE
muscarinic alkaloid, nonselective muscarinic receptor agonist-->parasympathetic stim
in leaves of Pilocarpus jaborandi

stims secretions incl saliva, tears, sweat
for Sjogrens and other AI with dryness
for constitutional dryness, dry mouth, eyes, bowel mvts (then use in tincture systemically)
prescription only
usu used in small amounts in tincture blend, incl circulatory herbs
drawback of oral use: makes you sweat or give diarrhea
fine line in dosage
more used in eyedrops, pilocarpine hydrochloride
wiki: topical for glaucoma (contracts ciliary mm-->miosis), xerostomia
is ANTIDOTE for tropane alkaloid toxicity
used to dx CF (sweat test)

ERGOTAMINE
fungal rust on cereal grains, esp rye
fungus = Claviceps purpurea makes it from L-tryptophan
active on many different neurotransmitter receptors incl: dopa, seratonin, epi
LSD precursor
powerful vasoconstrictor
for bleeding esp postpartum hemorrhage
for migraines
tiny little pills, dissolve in mouth immediately postpartum
purified alkaloids are druglike
danger, high doses-->vascular stasis, thrombosis and gangrene

RESERPINE
an indole alkaloid in Rauwolfia

for hypotensive via CNS, antipsychotic too
for dyskinesia of Parkinson's
invokes parasympathetic to dominate over sympathetic
SE: depression, impotence, lethargy, Parkinsonism dt dopamine effects
these SEs more present in pts with this disposition to start with
to use: pt should be type A, high powered pt to use this, full bounding HTN, hyperemic
dropped as pharmaceutical 30 years ago when beta blockers developed
modern allo docs may raise eyebrows at use
mech: blocks vesicular monoamine transporter VMAT-->free norepi, sero, dopa not able to get out of presynaptic nerve cytoplasm-->metabolized by MAO and never reach synapse
no catecholamines at peripheral sympathetic nerve endings
reserpine depletion of monoamine neurotransmitters in synapses is
oft cited supporting theory that depletion of neurotransmitters causes depression ???

COLCHICINE
from autumn crocus, Colchicum autumnale = meadow saffron

inhibits cell division, botanists use to induce mutations in plants
inhibits microtubule formation: "spindle poison", used for CA
inhibits deposition of uric acid-->used for gout, FDA approved for this use in 2009
cools redness, swelling, pain, halts inflam process, inhibits WBC activity
cathartic and emetic effects
tends to be on board exams, naturopaths can prescribe
Stansbury never uses it
also used for other inflam, causes neutropenia
toxicity potentiated by statins
toxicity sx: burning in mouth/throat, fever, V/D, abdominal pain, kidney failure
organ failure, hypovolemic shock dt vascular damage & fluid loss thru GI-->death
CI: renal failure

PODOPHYLLUM
from may apple, Podophyllum peltatum
cytostatic, use root
for warts, anti-mitotic, for virus, condylomata
(main use is topical for warts)
for cancers related to virus lots of research in animals
also caustic: limited internal use, more topical
if internal: cathartic or laxative effect: biliary
resinous, mixed into other sticky stuff
applied once, wash off in 24-48 hours and wait a month
if wart still present after a month, reapply
common escarotic for cx ca is sanguinaria, milder then podophylum

BERBERINE
= a quaternary ammonium salt from the group of isoquinoline alkaloids
found in roots, rhizomes, stems, and bark
strongly yellow colored, used as dye
yellow fluorescence-->used in histology for staining heparin in mast cells
in Mahonia aquafolia (Oregon Grape) formerly known as Berberis
also in Hydrastis (Goldenseal)

many applications
hepatotonic, cholegogue, gentle and physiologically appropriate
anti-microbial vs virus, bact, parasites
need to get it directly on body part affected
on purulent mucus membranes, tonsilitis
sitz bath for purulent vaginitis
skin soak for pus, abscesses
excellent eyewash
for ingrown toenail: foot soak
ear lavage for swimmer's ear
more

BULK FIBER
cellulose, pectin, indigestible fibers
no caloric value but imp to ecosystem health
helps probiotic gut species, more aerobic sp
for diabetes, metabolic syndrome, to slow uptake of glucose
for high cholesterol, helps with elimination of bile
for endocrine imbalance
for GI malfx, hemorrhoids, constip, etc
some pts need supplements even with good raw foods in diet

KAVAPYRONES (not same as kavalactones??)
in Piper methysticum
kavain and dihydromethysticin
nervine, antispasmodic, anticonvulsant, analgesic and anxiolytic properties
relax ureteral spasm, for kidney stone acutes
for spastic bladder, urinary retention, urinary reflux
antimicrobial for STD pathogens
for epilepsy: http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=20005172
kava pyrones have a weak Na+ antagonistic effect that may contribute to their antiepileptic properties (ii) that they have pronounced L- type Ca2+ channel antagonistic properties and act as an positive modulator of the early K+ outward current. These two actions may be of importance for mood stabilization. (iii) Furthermore, kava pyrones have additive effects with the serotonin-1A agonist ipsapirone probably contributing to their anxiolytic and sleep- inducing effects. (iv) Finally, they show a distinct pattern of action on glutamatergic and GABAergic transmission without affecting LTP. The latter, however, seems not to be true for the spissum extract of Kava where suppression of LTP was observed. 7. In summary, kava pyrones exhibit a profile of cellular actions that shows a large overlap with several mood stabilizers, especially lamotrigine.

SILYBIN AND SILYMARIN
in milk thistle, Silybum marianum
silybin = major active constituent of silymarin
silymarin = mixture of flavonolignans extracted from blessed milk thistle
THE liver herb, helps liver process fats & sugars
hepatoprotective, anti-CA
part of diabetic formula, syndrome x
helps with recycling of glutathoine, detox
for amanitas poisoning, cerebral edema, hepatitis tx
for jaundice, fatty stool, early cirrhosis, alcoholics
I recently read that supplements that say they have extract with 80% silymarin usu have 40-60%
injectable form now kept on hand in ERs for acute Amanita phalloides (mushroom) poisoning

ALLIUM DISULFIDES
from garlic
allicin = antibacterial and antifungal, pungent smell, garlic's defense vs pests
for MRSA tx
thiosulfinate functional group, R-S(O)-S-R formed when garlic is crushed
deactivated below pH of 3, unstable at room temperature
diallyl disulfide (4,5-dithia-1,7-octadiene) and allicin = organosulfur compounds in garlic
decreases platelet aggregation, "blood mover"
for pts with poor circ, elderly diabetics, renal failure, retinopathy, distal paresthesias
lowers insulin, insulin is a disulfide, garlic mb insulinomimetic
lowers cholesterol, improves HDL/LDL ratio, less impressive for triglycerides
thins mucus in lungs
supports heavy metal detox
for all pts with DM, metabolic syndrome
can use in dietary way, no need to put it in tea, just eat a lot of it
30-60 grams of onion/day, about half that dose/day of garlic
some pts don't tolerate it raw, some disufides survive cooking
student comment: let onion or garlic sit for a few minutes before cooking to improve assimilation
garlic powder?: ok, not as good as fresh but still has some of the good stuff

Study: http://www.ncbi.nlm.nih.gov/pubmed/19093848
From Allium stipitatum, three pyridine-N-oxide alkaloids (1-3) possessing disulfide functional groups were isolated. The structures of these natural products were elucidated by spectroscopic means as 2-(methyldithio)pyridine-N-oxide (1), 2-[(methylthiomethyl)dithio]pyridine-N-oxide (2), and 2,2'-dithio-bis-pyridine-N-oxide (3). The proposed structure of 1 was confirmed by synthetic S-methylthiolation of commercial 2-thiopyridine-N-oxide. Compounds 1 and 2 are new natural products, and 3 is reported for the first time from an Allium species. All compounds were evaluated for activity against fast-growing species of Mycobacterium, methicillin-resistant Staphylococcus aureus, and a multidrug-resistant (MDR) variants of S. aureus. Compounds 1 and 2 exhibited minimum inhibitory concentrations (MICs) of 0.5-8 mug/mL against these strains. A small series of analogues of 1 were synthesized in an attempt to optimize antibacterial activity, although the natural product had the most potent in vitro activity. In a whole-cell assay at 30 mug/mL, 1 was shown to give complete inhibition of the incorporation of (14)C-labeled acetate into soluble fatty acids, indicating that it is potentially an inhibitor of fatty acid biosynthesis. In a human cancer cell line antiproliferative assay, 1 and 2 displayed IC(50) values ranging from 0.3 to 1.8 muM with a selectivity index of 2.3 when compared to a human somatic cell line. Compound 1 was evaluated in a microarray analysis that indicated a similar mode of action to menadione and 8-quinolinol by interfering with the thioredoxin system and up-regulating the production of various heat shock proteins. This compound was also assessed in a mouse model for in vivo toxicity.

ADAPTOGEN
term coined from soviet research
to reduce sick leave and increase factory output
CHI TONIC term from Chinese med, for vital force
both are same
how is this different from alterative?
helps with adrenal fx, HPA axis, improves stress tolerance

ALTERATIVE
open emunctories
helps with metab, assimilate, excretion

INSULOMIMETICS
gymnema
possibly allium, momordica
http://www.kppub.com/articles/july2009/d-pinitol-insulomimetic.html
vanadate = (chemistry) compound containing oxoanion of vanadium in highest oxidation state (+5)
H2O2
D-pinitol from the leaves of Bougainvillea spectabilis

mustard???

EICOSANOIDS
= signaling molecules made by oxidation of twenty-carbon essential fatty acids
eico = 20
families: PG, LK, TX, prostaglandins, leukotrienes, thromboxanes (also prostacyclins)
for each family there are 2-3 series, derived either from an ω-3 or ω-6 EFA
aka cytokines, inflam mediators
made from fatty acids
she says she didn't ask specifics about chart distributed
altered genetic ratios of enzymes in this system influence base level inflam
asthma, eczema, all immune/inflammatory rxns influenced by this


SALICYLATES
willow, salicylaceae, poplars
queen of the meadow, filipendula
black cohosh
cox inhibitors

SOME SPECIFIC HERBS

MENTHA PIPERITA
peppermint, spearmint, other minds
relaxes smooth muscle
good for colic, cramps, gi upset, nausea, gas, bloat, also corrigent
corrigent: corrects upset from irrit by other sources, use in formula to tame irritant
no mint for gerd dt it relaxes hiatal sphincter

ARMORACIA
horseradish
for mucus moving in sinuses
use acutely for head colds, sinus infx

COMMIPHORA MYRRHA
niche: oral cavity
for gum infx, dental work, trench mouth, thrush, tonsilitis, pharyngitis, herpangina
(clove oil for tooth pain)
she uses tincture not EO because EO is so strong
made from bark gum resin

PHYTOLACCA
lymphatic
in hemp formula
for CFS with enlarged LNs
for breast infx, mastitis, internal and topical
for inguinal LN enlargement, ovaritis, PID

CLOVE
to relieve dental pain
in anbesol for teething babies

EUPHRASIA
eyebright
for itchy watery allergic phenomena of eyes, styes, conjuncitivis
for ear congestion dt allergies

HYPERICUM PERFORATUM
St John's wort
for nerve inflam, neuropathy, nerve injury
for bruising (topical), black and blue
for virus, herpes, aids
hypericine promotes photophobia
used with lasers to tx throat cancers, google "hypericine cancer"
efficaceous on skin cancers, BCC, 6 week trial showed decrease in skin lesions but ca cells still present
increases P450 liver processing rate: lowers drug levels

SANGUINARIA
caustic
escharotic, diluted for ca of cx
in black salve

CIMICIFUGA/ACTEA
for depression, anxiety
for fibromyalgia, for rheumatic crampy pains, headache, backache, esp when assoc w/ hormonal disturbance

ANEMOME PULSATILLA
indic: gonadal pain
for orchitis, ovaritis, testicular pain, acutes
nervine for fickle/changeable emotions
small bit orally in formula with other herbs

TANACETUM
feverfew
for allergy, stabilizes mast cells, antihistamine
for migraines, hives

VIBURNUM
cramp bark
for menstrual cramps, and other cramps
for fibro, muscle cramps, chronic backache
for pts who can't tolerate valerian, kava

VACCINIUM
berries incl blue, cran
antiox, antiinflam
for general vascular integrity, retinopathies
for UTI
reduces atherosclerosis, regs NO
helps circ, lowers PLT agg

MOMORDICA
balsam pear, bitter melon
food in some cultures
lowers blood sugar, may mimic insulin: insulomimetic
may regenerate beta cells

TRIGONELLA
fenugreek
maple syrup aroma,
pleasant in tea, powder, tastes good in tincture
for high blood sugar, lipids, chol
for diabetic complaints
hormonal activity: galactogogue, affects dopamine and prolactin
increases breast size??

GYMNEMA
insulinomimetic
incr panc output of insulin
renders sweet things tasteless: management tool for sweet tooth, take every 1-3 hours
use late in series of herbs for DM that doesn't respond to other management

GINKGO BILOBA
vascular enhancer, blood mover
inhibits PLT agg, vasodilator via NO
enhances coronary perfusion, cerebral perfusion, peripheral circ
like tanacetum it decreases allergic phenomena, much used for this purpose in Asia
for allergies, hayfever, asthma
may stabilize mast cells, lower histamine response??

GINSENG
adaptogen
for weak muscles, easy strains, vague muscle complaints that aren't AI or fibro
for elders
for ED, hormonal support, premature ov failure, for those who feel old

ZINGIBER OFFICINALE
circulatory, decr plt agg, blood mover, warming
anti-inflam
affects eicosanoid pathways, all the enzymes in it, multiple anti-inflam mechanisms
widely used as synergist in formulas esp in Asia
for arthritis, cold hands/feet
anti-nausea

PIPER METHYSTICUM
antispasmodic
for spasm and anxiety
for ureters, urinary spasm
big gun for acute body pain, spasm, fibro, tense, crampy, restless, anxious

BOSWELIA
vets use for race horse arthritis, hip degeneration
ayurveda
for arthritis, musculoskel
resiny, turns transparent tincture opaque
relative of frankincense

FORMULA MATCHING ON TEST
dry eyes
dental
fibro
diabetic neuropathy
etc

TEST NOTES
toxic herbs on test have already been mentioned, pilocarpine

BMM III Final Study Guide

The Test will cover HEENT, Toxic Botanicals, Pain and Inflammation, Musculoskeletal and Diabetes

Be Familiar with the following specific molecular constituents:
What plant do they occur in?
What is their therapeutic and physiologic significance?
Cardienolides – digoxin, apocynamarin
Tropane Alkaloids – Atropine, Hyoscyamine, Scopalamine
Pilocarpine
Ergotamine
Reserpine
Colchicine
Podophyllin
Berberine
Bulk Fiber
Kava Pyrones
Silibin,Silymarin
Allium disulfides

Philosophical/Therapeutic Concepts of:
Alteratives
Adaptogens
Chi Tonics
Insulomimetics

Biochemical/Molecular Concepts:
What are “Eicosanoids”? What plant substances are needed to synthesize them?
What herbs affect enzymatic transformation of the Eicosanoids?
What plants contain salicylates?
How do flavinoids affect inflammation? (What mechanisms?)

Specifics:
Mentha – relaxes GI smooth muscle, may need to avoid with GERD\
Armoracia – stimulating hot “mucous mover”, especially for sinuses
Commiphora myrrha – resinous disinfectant especially for oral cavity
Phytolacca – especially for lymphatic swelling
Cloves – especially for topical use to allay oral and dental pain
Euphrasia – specific to decongest UR mucous membranes
Hypericum – antiviral, anti-inflammatory, specific for bruising and nerve inflammation
Sanguinaria – caustic herb used to stimulate or even irritate and ablate tissues
Cimicifuga – specific for fibromyalgia-like presentations, anxiety states with crampy muscle pain
Anemone pulsatilla – gonadal pain , and volatile emotions
Tanacetum – blood reactivity, vascular inflammation, hives, migraines
Viburnum – uterine cramps
Vaccinium – improves vascular integrity and reduces vascular inflammation
Momordica – insulomimetic
Trigonella – improves blood sugar and lipids, hormonally active
Gymnema – Increases pancreatic production of insulin via Beta cells
Ginkgo – Vascular anti-inflammatory, reduces allergic responses, enhances perfusion
Panax – weakness, poor circulation, erectile dysfunction, hormonal insufficiency
Zingiber – PAF inhibitor, anti-inflammatory, antimicrobial, warming blood mover
Piper methysticum – anxiolytic anodyne
Boswellia – musculoskeletal inflammation

Be able to match specific formulas to their best use for :
Strept throat, an Eyewash, Thrush, Dry eyes, UR allergies, Dental Procedures, cold sores, Fibromyalgia, Arthritis – osteo vs RA, Neuralgia, Diabetes (to manage blood sugar itself vs to prevent sequalae), Headaches (muscle tension HA vs Migraine HA)