Cardio and Digestive Herbs Cont.

1. Cardio and Digestive Herbs Cont. Chamomile, Horse chestnut, Licorice, Spices

2. Chamomile (Matricaria recutita) • Actions: Anti-inflammatory, antiseptic, sedative, antispasmodic. • Medicinal Uses: Gastrointestinal disorders. Calming and sedative effect general relaxation. Children’s cold, eye wash, skin treatment. • Side effects: low • Dose: 1-3 teaspoon decoction tincture 1-4 ml in a cup water oil:1-2 drop (1:50 dilution)

3. Chemistry, Functions, Toxicity • Volatile oils: α-bisabolol, chamazulene, (↓ inflammation, fever) flavonoids: apeginin, luteolin, quercetin (inflammation, sedative, antioxidant) • CNS action is through benzodiazepine receptors • Orally used to treat diarrhea, anxiety, restlessness, flatulence , teas mainly used for sedation or relaxation. • Topically reduce inflammation, induce healing of wounds and burns • Toxicity: contact dermatitis, allergic reactions GI; nausea, vomiting Anaphylaxis in case of extreme sensitivity

4. Herb –Drug Interaction Antiplatelet and anticoagulants (warfarin, aspirin, heparin, NSAIDs, clopidogrel, eptifibatide, tirofiban, ticlopidine, dipyridamole and COX-2 inhibitors

5. Horse Chestnut(Aesculus hippocastanum) • Traditionally used for chronic venous insufficiency (CVI). Other properties: analgesic, anticoagulant, astringent and expectorant. • The medicinal parts of horse chestnut include the dried leaves, the oil extracted from the peeled nuts, and the dried chestnut seeds. • The seeds of horse chestnut contain a saponin mixture: aescin (or escin) and prosapogenin. • Other compounds: rutin and quercitrin and coumarins. • The extract is used as conjunctive treatments for lymphedema, hemorrhoids, BPH. • Dose: 250mg (high dose up to 750mg, tincture: 1-4ml

6. Functions • The 3 types of pharmacodynamic actions that have been attributed to escin include anti-edematous properties, anti-inflammatory activities, and venotonic properties. • Aescin works on the capillary membrane, normalizing vascular permeability. This then may reduce the outflow of fluid into the extracapillary space. • Anti-inflammatory properties suggest that escin can interfere with the cellular phase of the inflammatory process, i.e. with leukocyte activation. The accumulation of leukocytes in CVI-affected limbs with their subsequent activation is considered an important patho-physiological mechanism of CVI.

7. Herb –Drug Interaction • Anticoagulants: may increase anticoagulant effect • Antidiabetic, insulin: Increased hypoglycemic effect • Drugs that are highly protein bound: Aescin binds to plasma proteins and may displace these drugs. • Potential synergetic effect with other anticoagulant and hypoglycemic herbs.

8. Licorice (Glycyrrhiza glabra ) • Traditionally used for peptic ulcer, additionally antiviral, anti-inflammatory, antitussive, and additive in many formulations. • Licorice root contains water-soluble triterpenoid glycoside glycyrrhizin, isoflavans hispaglabrin A and B, glabridin and other phenolic constituents. • Commonly used as a sweetening/flavoring agent to counteract the unpleasant taste of many drugs • Dosage: 200 mg glycyrrhizin daily

9. Functions, Toxicity • Glycyrrhizin is a sweetener, used by the food/drug industry • Glycyrrhetenic acid inhibits 11-beta-hydroxydehydrogenase that prevent cortisol from acting as a mineralcoid. ( leading to sodium and water retention and potassium excretion) • Toxicity: CNS numbness, paralysis CV; hypertension, arrhytmias, heart failure metabolic: hypokalemia, hypernatremia musculoskeletal: myopathy, musclecramps

10. Herb –Drug Interaction • Antiarrhytmics: Hypokalemia, Torsades de Pointes • Antihypertensives:less effective • Corticosteroids: additive effect • Digoxin: increased toxicity • Diuretics: may worsen hypokalemia