SKILLS LAB 2 HERBALS

SJW

Hypericum perforatum, clusiaceae

clinical uses: treatment of mild to moderate depressive disorders

MOA- delayed onset of action, synthetic antidepressants, inhibition of NT degradation and reuptake, interruption of HPA axis through inhibition of CRH receptor binding

active ingredients- hypericin, hyperforin (hyper four in… induces CYP3A4), quercetin glycosides

drug interactions: hyperforin (hyper four in) induces CYP 3A4 & P-gp, serotonin syndrome avoid wine and cheese

pregnancy and lactation = CONTRAINDICATED

ginko

ginko biloba, ginkogoaceae

clinical uses: cerebral insufficiency, central hypoxemia, dementia, tinnitus, vertigo, Alzheimers disease, arteriosclerotic conditions

moa- antioxidant effects ROS scavenging, antagonism at peripheral benzodiazepine GABA receptor, inhibition of PAF, MAO inihibition

active ingredients- ginkogolides, bilobalides, biflavones, quercetin derivatives

drug interactions: antiplatelet, anticoags, NSAIDS, benzos, SSRIs, MAO inhibitors

pregnancy and lactation = CONTRAINDICATED

kava

piper methysticum, piperaceae

clinical uses: social anxiety disorders, phobias, postmenopausal, and generalized anxiety disorders

moa- kavalactones bind to GABAa receptor different from benzodiazepine binding site to enhance GABA binding to the ion channel, binding & blocking of Ca & Na ion channels and NMDA receptors

active ingredients: kavalactones, kavain

drug interactions: avoid alcohol or CNS depressants as additive effects may occur, potential hepatotoxicity, high chronic use can lead to dermopathy, benzos, barbiturates

pregnancy & lactation: contraindicated

valerian

valeriana officinalis

clinical uses: used as a sleeping aid & mild anxiolytic

moa- valerenic acid binds to GABAa receptor & enhances GABA binding, pinoresinol is a partial agonist @ adenosine receptors

active ingredients: valerenic acid, valerenal & valtrate, pinoresinol; valtrate degrades to baldrinal

drug interactions: chronic high doses may lead to muscle weakness & hypothermia, alcohol, benzos, CNS depressants

pregnancy & lactation: contraindicated

red yeast rice

monascus purpureus, monascaea

clinical uses: effective in lowering cholesterol & LDL, suppression of plaque

moa- inhibition of HmG-CoA reductase, nephrotoxic effects, mediated through polyketide monascidin A

active ingredients- monocolin K, ankaflavin, monascin

drug interactions- STATIN drugs, hepatotoxicity, myopathy

pregnancy & lactation: contraindicated

cinnamon

cinnamomum zeylanicum, lauraceae

clinical uses: decrease blood glucose lvls, decrease platelet count,

moa- COX and NO production, inhibition of Na/K ATPase transporter

active ingredient- essential oil, oligomeric polyphenols

drug interactions- generally recognized as safe if taken in dietary doses, increase in heart & respiratory rate & GI motility

pregnancy & lactation: GOOD TO USE

fish oil

clinical uses: hypertriglyceridemia, cardiovascular disease, hypertension, psoriasis

active ingredients- poly-unsaturated fatty acids, eicosapentaenoic acid, docosahexanenoic acid

drug interactions- anticoags

pregnancy & lactaction- potential for toxic metal exposure due to source of fish oil

saw palmetto

serenoa repens, arecaceae

clinical uses- benign prostate hyperplasia (BPH)

moa- inhibition of enzyme 5a-reductase

active ingredients- fatty acids, triterpene sterol

interactions- should not be taken together with hormone replacement or oral contraceptivesm

pregnancy & lactation- contraindicated

chastetree berry

vitex agnus-castus, verbenaceae

clinical uses- menstrual irregularities, premenstraul syndrome, secondary amneorrhea, postmenopausal symptoms, hyperprolactinemia

moa- agonist at D2, receptors leading to inhibition of prolactin secretion, inhibition of proliferation of malignant cells, ROS scavenging, estrogen receptor modulator

active ingredients- agnuside, aucubin, casticin

drug interactions- may increase effects of dopamine agonists, interfere with contraceptive

pregnancy & lactation- contraindicated

black cohosh

cimicifuga racemosa, ranunculaceae

clinical uses- potentially for hot flashes, perimenopausal symptoms

moa- selective estrogen receptor modulators (SERMS), reduced release of catecholamines through antagonism of nicotinic acetycholine receptors

active ingredients- cimifugoside, actein, formononetin

drug interactions- antihypertensive drugs

pregnancy & lactation- contraindicated