Botanical Medicine for URTI

URTI (Bacterial)

• BotMed Prescription/Method Description: "H.E.M.P" formula, which stands for Hydrastis, Echinacea, Myrrh, and Phytolacca.
  • Hydrastis (Goldenseal): "King of mucus membranes", used for respiratory and gastrointestinal tract issues, with antichathartic state.
    • Actions: Antimicrobial, antifungal, antiviral, antiparasite, digestive, and bitter.
    • Chemicals: Isoquinoline alkaloids (berberine, hydrastine).
    • Safety: Avoid use with gastric/stomach ulcers, may cause GI irritation, nausea, vomiting, and diarrhea.
  • Echinacea (Purple Cone Flower): Immunostimulant, used for strep throat, colds, vaginal candidiasis, and UTI.
    • Actions: Immunostimulant.
    • Chemicals: Phytochemical (alkylamide, phenolics, and polysaccharides).
    • Safety: Caution with autoimmunity, safe with pregnancy.
  • Myrrh (Commiphora myrrha): Antimicrobial, antifungal, antiviral, antiparasitic, analgesic, expectorant, and astringent.
    • Actions: Antimicrobial, antifungal, antiviral, antiparasitic, analgesic, expectorant, and astringent.
    • Chemicals: Oleoresin, sesquiterpenes.
    • Safety: Do not use with pregnancy.
  • Phytolacca (Poke Weed): Lymphatic, emetic, and purgative.
    • Actions: Lymphatic, emetic, and purgative.
    • Chemicals: Triterpenoid glycosides, lectins, and pokeweed antiviral protein (PEP).
    • Safety: Toxic, may cause violent emesis, catharsis, or death, do not use with pregnancy.

Nutrition

• Objectives: Reduce sugar intake, increase protein intake, and consume honey, probiotics, and vitamins D.
• Treatment Goals: Reduce uncomfortable symptomatic experience, reduce severity and duration of illness, support full recovery, prevent sequela, and prevent re-occurrence following resolution.
• Sugar: Too much sugar inhibits the immune system, increases pro-inflammatory proteins, and changes the microbiome.
• Vitamin C: Consider bowel tolerance with dosing, potential for osmotic diarrhea and GI upset, and precipitate kidney stones in susceptible individuals.
• Zinc: 30-50 mg/day for adults, take with food to avoid GI upset, and caution with copper deficiency.
• Probiotics: Oral probiotics help with respiratory function, prevention of respiratory symptoms/infections, otitis media, and potential GI upset.

Topical Drug Vehicles

• Type of Vehicle Needed: Depends on the prescription, including creams, gels, lotions, ointments, and foams.
• Potency: TCS potency divided into 7 classes, with Class 1 being the highest potency and Class 7 being the lowest potency.

Homeopathy

• Urtica Urens (Dwarf Nettle): Used for skin issues, itching, burning, and stinging, with swelling and edema.
• Rhus Toxicodendron (Poison Ivy): Used for skin issues, itchy skin, redness, and affinity for skin, mucous membranes, and fibrous tissue.
• Sulphur: Used for skin issues, itchy skin, redness, and burning, with a tendency toward being opinionated, critical, and independent.
• Graphites: Used for skin issues, rough skin, scars, eruptions, cracks, and infections, with a tendency toward being dull, slow, timid, and reserved.

Joint Pain

• Bot Med: Used to treat joint pain, with a focus on hepatic and anti-inflammatory actions.
• Bupleureum Chinensis (Chai Hu): Used for joint pain, with a focus on hepatic, alterative, anti-inflammatory, and hepatoprotective actions.
• Boswellia Serrata (Frankincense): Used for joint pain, with a focus on antimicrobial, anti-inflammatory, and astringent actions.
• Capsicum Frutescens (Cayenne): Used for joint pain, with a focus on stimulant, circulatory tonic, rubefacient, sialagogue, and libido tonic actions.

<|end_header_id|> of to the sample and difference in of long<|end_header_id|><|start_header_id|>assistant### Iron Sources

• Heme iron is derived from hemoglobin and myoglobin, found only in animal products such as meat, fish, poultry, oysters, and clams
• 50-60% of the iron in animal products occurs in the heme form
• Non-heme iron is found in meats, beans, dark greens, leafy veggies, dried fruits, blackstrap molasses, and enriched foods like flour, breads, pastas, and cereals

NSAIDs

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are commonly prescribed medications for pain and inflammation
• They make up 5-10% of all medications prescribed each year
• Up to 96% of patients over 65 use NSAIDs in family practice settings
• Types of NSAIDs:
  • Non-specific COX inhibitors (e.g., acetylsalicylic acid (ASA), ibuprofen)
  • COX-2 specific inhibitors (e.g., celecoxib)
  • Non-specific COX inhibitors without anti-inflammatory effect (e.g., acetaminophen)

Acetylsalicylic Acid (ASA)

• Causes irreversible inhibition of COX by covalent bond of acetyl group
• Dosing: adults, 325-650mg Q4H (every 4 hours), max 4g/day
• Lasts 6 hours, hits in 1 hour
• Contraindicated in children with viral infections
• Adverse effects:
  • GI irritation, ulcers, bleeding
  • Tinnitus, an early sign of salicylate toxicity
  • Hyperventilation, fever, dehydration, metabolic acidosis, impairment of hemostasis
  • Hypersensitivity reactions are uncommon but potentially fatal
  • 5% cross-reactivity with other NSAIDs

Ibuprofen

• Dosing: adults, 200-400mg Q6-8 hours, max 1200mg/day
• Onset of action: 30-60 minutes, duration of action: 4-6 hours
• Adverse effects:
  • GI irritation, nausea, dyspepsia, bleeding
  • Hepatic toxicity
  • Renal toxicity, including acute renal failure if dehydration occurs

Acetaminophen

• Little effect on COX-1 or COX-2
• Dosing: adults, 325-650mg Q4H, max 4g/day
• Onset of action: under 1 hour, duration of action: 4-6 hours
• Risks:
  • Rapidly absorbed from the gut
  • Minimal plasma protein binding
  • Widely distributed to peripheral tissue and CNS
  • Toxic intermediate formed with CYP1A2, 2E1, 3A isoenzymes
  • Glutathione depletion can lead to hepatic necrosis

Celecoxib

• Selective COX-2 inhibitor
• Dosing: 100mg BID PO or 200mg daily PO for osteoarthritis
• Risks:
  • Increased risk of cardiovascular disease and mortality
  • Does not inhibit platelet aggregation

Gastroprotection Strategies

• Using COX-2 selective NSAIDs
• Using prostaglandin analogues (misoprostol)
• Using proton pump inhibitors (omeprazole)
• Risk factors for major GI bleeding:
  • Increased age
  • Concomitant use of systemic corticosteroids or warfarin
  • History of GI bleeding or peptic ulcer disease

Homeopathy

• Bryonia alba (white bryony):
  • Affinities: tendons, ligaments, or connective tissue
  • Causes inflammation and dryness
  • Worse with motion, better with rest and strong pressure
• Rhus tox (Poison ivy):
  • Affinities: joint/tendon/muscle ailment with stiffness
  • Skin: face, scalp, genitals, glands, nerves, mucus membranes, red skin, itchy, herpes
  • Worse with wet, cold air, motion
  • Better from continued motion, change in position, hot drinks
• Ledum (Marsh tea):
  • Acute gouty pain of ankle and knee
  • Worse with heat, in bed at night, motion
  • Better with cold, soaking in cold water

Botanical Medicine (Low Back Pain)

• Same botanicals as joint pain, with exceptions of Corydalis yanhusuo
• Corydalis yanhusuo (yan hou so):
  • Actions: analgesic, hepatic, warming, calminative
  • Constituents: alkaloids, volatile oils
  • Indications: any pain
  • Safety: do not use in pregnancy, drowsiness with high dose

Nutrition

• Focus on:
  • Vitamin C
  • Magnesium
  • Proteolytic enzymes
  • Vitamin D
• Vitamin C:
  • Increases calcium absorption = strong bones/healing
  • Risk of deficiency:
    • Children < 1 year
    • The elderly, especially those in nursing homes
    • Low fruit and vegetable intake
    • Cigarette smokers
    • People with gastro-esophageal reflux disease
  • Sources: fruits (kiwi, papaya, strawberry, citrus), etc.

Foundational Health Management Plan

• Vitamin C can be found in fruits and vegetables, such as citrus fruits (e.g., lemon, which contains ~45 mg of vitamin C per lemon)
• Zinc can be found in meats, poultry, seafood, legumes, and seeds (e.g., 6 medium oysters contain 33 mg of zinc)
• Probiotics can be found in fermented foods, such as sauerkraut, kimchi, yogurt, and tempeh
• A diet with enough nutrients is essential for immune function
• Deficiencies in zinc, selenium, iron, copper, folic acid, and vitamins A, B6, C, D, and E can alter immune responses

Pneumonia Treatment

• The combination of amoxicillin and clavulanate is typically used for treatment failure or recurrence of pneumonia
• Diarrhea is a common adverse effect of combination therapy

Homeopathy

Drosera (Common Sundew)

• Used to treat respiratory illnesses such as whooping cough, laryngitis, bronchitis, and tuberculosis
• Characterized by tormenting cough, paroxysms, and a ringing cough
• Patients may hold their chest to cough due to pain
• Mental state: suspicious of others, easily angered
• Symptoms worsen in the evening, after midnight, and after drinking, exertion, singing, or smoking

Urtica Urens (Dwarf Nettle)

• Used to treat skin conditions such as itching, burning, and stinging
• Characterized by swelling, edema, and heat
• Patients may experience sudden, rapidly developing complaints
• Mental state: passionate, intense emotions not easily expressed

Rhus Toxicodendron

• Used to treat skin conditions such as itchy skin, redness, and urticaria
• Characterized by restlessness, stiffness, and improvement with continuous motion
• Patients may experience cold dampness and prefer heat and hot baths
• Mental state: busy, restless, and superstitious

Sulphur

• Used to treat skin conditions such as itchy skin, red orifices, and back pain
• Characterized by opinionated, critical, and independent mental states
• Patients may experience burning discharges, quick motions, and plethoric skin

Graphites

• Used to treat skin conditions such as rough, scarred, and infected skin
• Characterized by digestive issues, obesity, and chilliness
• Patients may experience constipation, timidness, and insecurity

Botanical Medicine (Week 4)

Joint Pain

• Treat RA as an immune-mediated inflammatory condition
• Treat OA or degenerative conditions by promoting circulation
• More inflammation: favor hepatics
• More swelling: favor diuretics
• Feeling of cold in the joints: use cayenne internally and topically

Bupleureum Chinensis (Chai Hu)

• Primary actions: hepatic, alterative, anti-inflammatory, and hepatoprotective
• Constituents: triterpene saponins, sterols, volatile oils, and polysaccharides
• Daily therapeutic dose: 6-12 mL (1:5 in 40%) tincture or 3-12 g infusion/decoction
• Safety: avoided in cold conditions or constitutions, not established during pregnancy and lactation

Boswellia Serrata (Frankincense)

• Primary actions: antimicrobial, anti-inflammatory, and astringent
• Constituents: resins, boswellic acid, and volatile oils
• Daily therapeutic dose: 2-4 mL (1:5 in 90%) tincture
• Cautions/Contraindications: considered safe, though not generally taken internally in large amounts

Capsicum Frutescens (Cayenne)

• Primary actions: stimulant, circulatory tonic, rubefacient, sialagogue, and libido tonic
• Daily therapeutic dose: 300-3000 mg (as powder or encapsulated supplement)

Diet and Nutrition

Omega-3 Fatty Acids

• Prevent or improve experimental arthritis
• Supplements can reduce joint pain and morning stiffness in RA patients

Folate

• A common RA medication, methotrexate, destroys folate
• Food sources: green vegetables, mushrooms, legumes, strawberries, and oranges
• Folate supplements may be prescribed to those on methotrexate

Iron

• Anemia is common in patients with chronic inflammatory joint conditions such as RA
• Two types of iron exist: ferrous and ferric iron