Botanical Medicine Practice Flashcards

Practice flashcards covering safety, dosing, herb categories, and specific herb monographs for Botanical Medicine Board Exam review.

Common Side Effects of Safe Herbs

Allergies, contact dermatitis, Gastrointestinal upset, abdominal pain, loose stools, and headache.

Coumarins

A constituent group primarily associated with blood thinners.

Thujone

An active constituent group primarily known for causing kidney toxicity and CNS effects like convulsions.

Emmenagogues

Herbs that stimulate menstruation; contraindicated in pregnancy due to the risk of uterine contractions.

Zombie Apocalypse Category

A classification for toxic or poisonous herbs that are equally harmful to a mother and a fetus.

Estrogenic Herbs

Hormone-modulatory herbs that should be avoided in pregnancy to prevent interference with fetal development.

Salvia officinalis (Sage) Lactation CI

Avoided during breastfeeding because it can reduce milk production.

GI Stimulant Contraindications

Peptic ulcers, gallstones, kidney stones, and intestinal obstruction.

Cholagogue Risk Assessment

If the stone size is unknown, these herbs should not be used until the risk is assessed.

Hypericum perforatum + SSRIs Interaction

Combining these can lead to additive toxicity known as serotonin syndrome.

Bitter Herbs + PPIs Interaction

An example of opposing actions where the herb reduces the effectiveness of the proton pump inhibitor medication.

Digitalis (Cardiac Glycosides) Potassium Rule

Interacts dangerously with drugs affecting potassium balance, leading to potential lethality.

Hypericum perforatum Metabolic Effect

An inducer of the enzyme CYP 3A4, which potentially decreases drug availability.

Narrow Therapeutic Window Examples

Lithium and Warfarin; require extreme caution when combined with metabolic-affecting herbs.

Mucilaginous Herbs Group

Includes Althea officinalis, Plantago spp, Tussilago, and Ulmus spp; these reduce the absorption of other medications.

Law of Similars (Homeopathy)

A principle where the toxicity profile of a substance matches the homeopathic picture it is meant to treat.

Sanguinaria canadensis

Bloodroot; a highly toxic herb in the 'Zombie Apocalypse' list.

Digitalis purpurea

Foxglove; a 'Zombie Apocalypse' herb containing toxic cardiac glycosides.

Veratrum album

White Hellebore; a highly toxic herb noted for causing severe GI and respiratory issues.

Aconitum napellus

Monkshood; a toxic herb causing numbness and cardiac/respiratory paralysis.

Atropa belladonna

Deadly Nightshade; contains tropane alkaloids that block acetylcholine, causing sympathetic overdrive.

Datura stramonium

Jimsonweed; similar to Belladonna but often associated with nausea and anuria.

Gelsemium sempervirens

Carolina Jessamine; toxic herb causing flaccid paralysis and visual disturbances.

Pilocarpus microphyllus

Jaborandi; contains pilocarpine and is unsafe for general internal use.

Arnica montana Safety Rule

Unsafe for internal use; generally used topically for bruises and inflammation.

Tanacetum vulgare

Tansy; a toxic herb used to expel worms but carries risk of convulsions and death.

Podophyllum peltatum

Mayapple; an extremely toxic cytotoxic purgative herb.

Asteraceae Family Allergic Potential

Known for causing seasonal allergies and cross-reactivity if a patient is allergic to ragweed.

Solanaceae Family

The nightshade family; includes Withania somnifera, Capsicum, and Atropa belladonna.

Berberine-Containing Herbs Contraindications

Pregnancy, lactation, and children due to the risk of kernicterus.

Thujone Mechanism of Action

Acts as a GABA receptor antagonist, leading to a loss of inhibition and potential convulsions.

Thujone ACCE Toxicity Mnemonic

Abortifacient, Convulsions, Carcinogenic, Emmenagogue.

Unsaturated Pyrrolizidine Alkaloids (PAs)

Highly liver-toxic and tumorigenic; can cause Hepatic Veno-Occlusive Disease (HVOD).

Cineraria maritima PA Safety

Contains unsaturated PAs; restricted to topical use only.

Cardiac Glycoside Herbs List

Convallaria majalis, Digitalis purpurea, and Leonurus cardiaca.

Herbs Safe in Pregnancy (Examples)

Echinacea, Allium sativum, Curcuma longa, Matricaria recutita, and Rubus idaeus.

Carvacrol

Source is Origanum vulgare (Oregano); potent broad-spectrum antimicrobial.

Allicin

Active compound in Allium sativum (Garlic); lipid-lowering and hypotensive.

Cinnamaldehyde

Found in Cinnamomum verum; lowers blood glucose and acts as an antifungal.

Eugenol

Main component of Clove (Syzygium aromaticum); liver toxic if ingested but used topically for toothaches.

Thymol

Source is Thymus vulgaris (Thyme); potent antiseptic and antifungal used in dentistry.

Weak Tincture Dosing Range

$$>12\,mL\,qd$$

Standard Tincture Dosing Range

$$6-12\,mL\,qd$$

Strong Tincture Dosing Range

$$3-6\,mL\,qd$$

Very Strong Tincture Dosing Range

$$<3\,mL\,qd$$

Drop Dosing Range

$$<1\,mL\,qd$$

Clark’s Rule (Weight-Based)

$$\text{Adult Dose} \times \frac{\text{Child’s Weight (lbs)}}{150}$$

Young’s Rule (Age-Based)

$$\text{Adult Dose} \times \frac{\text{Child’s Age}}{\text{Age} + 12}$$

Pickrell’s Easy Rule

Cut the adult dose in half if the child is half the size (works for safe herbs only).

$1\,tsp$ Conversion

$$5\,mL$$

$1\,tbsp$ Conversion

$$15\,mL$$

$12\,gtt$ Conversion

$$1\,mL$$

bid

Twice daily

tid

Three times daily

qid

Four times daily

gtt

Drops

po

By mouth

qs

Enough to make

Fucus vesiculosus (Bladderwrack)

Supports hypothyroidism from iodine deficiency; acts as a nutritive iodine source.

Melissa officinalis (Lemon Balm)

A limbic sedative and hyperthyroidism support; mellows overactivity.

Lycopus virginicus (Bugleweed)

Reduces thyroid hormone levels by inhibiting peripheral T4 to T3 conversion.

Gymnema sylvestre

Alters the taste of sweets to reduce cravings; used for metabolic syndrome and diabetes.

Momordica charantia (Bitter Melon)

Used for Type 2 diabetes and psoriasis; emmenagogue effects make it CI in pregnancy.

Smilax spp (Sarsaparilla)

Contains steroid saponins; used for male low testosterone, andropause, and chronic dermatitis.

Tribulus terrestris (Puncture Vine)

Androgenic in males, estrogenic in females; used as a libido booster and for CAD.

Vaccinium myrtillus (Bilberry)

Antioxidant used for retinal conditions, varicose veins, and short-term kidney antiseptic.

Actaea racemosa (Black Cohosh)

Estrogen mimetic used for dysmenorrhea, PCOS, and menopause; CI in 1st trimester.

Angelica sinensis (Dong Quai)

Female adaptogen and uterine tonic; increases bleeding risk and is CI in pregnancy.

Caulophyllum thalictroides (Blue Cohosh)

Uterine stimulant used for labor facilitation; potentially teratogenic and CI in early pregnancy.

Chamaelirium luteum (False Unicorn Root)

Ovary and uterus tonic; used for threatened miscarriage but CI in early pregnancy.

Dioscorea villosa (Wild Yam)

Spasmolytic used for 'Die Spasms!' (dysmenorrhea, intestinal colic, and pain).

Medicago sativa (Alfalfa)

Nutritive phytoestrogen used for hyper/hypoestrogenism; CI in Gout and SLE.

Capsella bursa-pastoris (Shepherd’s Purse)

Styptic used specifically for postpartum hemorrhage and menorrhagia.

Geranium maculatum (Cranesbill)

Astringent containing tannins; used for diarrhea, blood in stools, and menorrhagia.

Mitchella repens (Partridge Berry)

Helps 'Ripen the Uterus' for labor; used in formulas for childbirth preparation.

Rubus idaeus (Red Raspberry Leaf)

Gentle uterine tonic considered very safe throughout pregnancy to strengthen uterine tone.

Vitex agnus-castus (Chasteberry)

Increases progesterone and pituitary function; used to rebalance hormones post-birth control.

Paeonia alba (White Peony)

Female endocrine modulator used for hormonal imbalances; CI in pregnancy.

Pausinystalia yohimbe (Yohimbe)

Aphrodisiac and $\\alpha_2$-adrenergic blocker used for impotence; CI in schizophrenia.

Prunus africana (Pygeum)

Prostatic tonic and 5-alpha-reductase inhibitor best for Benign Prostatic Hyperplasia (BPH).

Serenoa repens (Saw Palmetto)

Blocks DHT binding in the prostate; used for BPH, nocturnal enuresis, and urinary tract inflammation.

Artemisia annua (Sweet Wormwood)

Potent antimicrobial and bitter used for malaria and parasitic infections.

Baptisia tinctoria (Wild Indigo)

Immune stimulant used for acute URTI, tonsillitis, and pharyngitis; short-term use only.

Commiphora myrrha (Myrrh)

Potent antimicrobial used topically for strep throat and internally as an expectorant; caution in hyperthyroidism.

Cordyceps sinensis (Caterpillar Fungus)

Adaptogen for chronic infections, asthma/COPD, and protects bone marrow.

Melaleuca alternifolia (Tea Tree)

Toxic internally; used topically for acne, thrush, and fungal infections.

Hypericum perforatum (St. John’s Wort) Antiviral

Specific for EBV and CMV; also used for depression and wound healing.

Lomatium dissectum

Strong antiviral for respiratory infections; associated with a self-limiting whole-body rash.

Ligusticum porteri (Osha Root)

Antiviral adaptogen and diaphoretic used for cold/flu symptoms and chronic fatigue.

Olea europaea (Olive Leaf)

Cardiovascular protective leaves used for viral infections with fever and chills.

Usnea barbata (Old Man’s Beard)

Effective against gram-positive bacteria like M. tuberculosis; contains usnic acid.

Verbena officinalis (Vervain)

Alterative nervine used for menopause and respiratory inflammation; diaphoretic for fevers.

Dipsacus sylvestris (Teasel Root)

Indicated for Lyme disease, syphilis, and immune-mediated joint pain.

Juglans nigra (Black Walnut)

Potent antihelminthic used for intestinal worms like roundworm; toxic in long-term use.

Tabebuia impetiginosa (Pau d’Arco)

Powerful antifungal and antimicrobial used for Candida, chronicles sinusitis, and HSV.

Astragalus membranaceus

Deep immune adaptogen used for cancer and chronic infection; CI in autoimmune diseases.

Echinacea Actions

Vulnerary, immune stimulant, and antimicrobial; safe in pregnancy.

Eleutherococcus senticosus (Siberian Ginseng)

Middle adaptogen used for adrenal support and lack of stamina.

Ganoderma lucidum (Reishi)

Deep immune activation and adaptogen; contraindicated in organ transplants.

Glycyrrhiza glabra (Licorice) SE

Pseudohyperaldosteronism (edema, high blood pressure, and hypokalemia) due to glycyrrhizin.