Herbal Actions for URTI and Common Cold

Herbal Actions Used to Treat Colds

• Immunostimulant: activates the immune system to help fight off infection
• Diaphoretic: induces sweating
• Antitussive: soothes and relieves coughs
• Antispasmodic: relaxes smooth muscles
• Expectorant: liquifies respiratory secretions to facilitate the expulsion of phlegm and mucous
• Mucolytic: helps to break down mucous and loosen thick bronchial secretions
• Demulcent: soothes irritated mucous membranes
• Antimicrobial: destroys or inhibits the growth of microorganisms
• Antiadherance: prevents microorganisms from attaching and thus infecting the cells of the mucous membranes
• Antipyretic (syn. Febrifuge): reduces a fever
• Lymphatic: promotes the proper functioning of the lymphatic system

Herbs Used to Treat Colds

• Echinacea
  • Latin: Echinacea purpurea/angustifolia/pallida
  • Plant part: Root and herb
  • Indications: prevent and treat common cold, flu, URTIs, vaginal candidiasis, UTIs
  • Actions: Immunostimulant, antimicrobial
• Barberry
  • Latin: Berberis vulgaris
  • Plant part: Root
  • Indications: general infections, GI infections, hepatic/gallbladder conditions, constipation, type 2 diabetes, PCOS, inflammatory skin conditions
  • Actions: Hepatic, cholagogue, antimicrobial, bitter, antiinflammatory, alterative, endocrine modulator
• Coptis / Goldenthread
  • Latin: Coptis sinensis
  • Plant part: Root
  • Indications: chronic or acute skin characterized by inflammation, acute GI infections, chronic sinusitis, hepatitis
  • Actions: antimicrobial, anti-inflammatory, hepatic, bitter
• Yellow Dock
  • Latin: Rumex crispus
  • Plant part: Root
  • Indications: Chronic skin conditions, constipation, convalescence
  • Actions: Alterative, laxative, hepatic, astringent, mild adaptogen, blood purifier and builder
• Red Clover
  • Latin: Trifolium pratense
  • Plant part: Flowers, aerial parts
  • Indications: skin conditions, PCOS, irregular menses, menopausal hot flashes
  • Actions: Alterative, lymphatic, mild female endocrine modulator
• Withania
  • Latin: Withania somnifera
  • Plant part: Root
  • Indications: Fatigue, nervous exhaustion, chronic inflammatory disease, anemia, lowered libido, convalescence, hypothyroid presentations
  • Actions: Adaptogen, hypotensive, immune modulator, anti-inflammatory, nootropic

Nutrition and Colds

• Dietary Sugar
  • Impacts immune function
  • Decreases phagocytic capacity of neutrophils
• Enough Dietary Protein
  • Deficiency impairs immune function and increases infections
  • Amino Acids are important for immune function
• Honey for Healing
  • Natural antimicrobial properties
  • Decreases inflammation
• Probiotics
  • Supports healthy microbiome
  • Important for immune function

Depression and Mood Regulation

• Diet and Mood Regulation
  • Blood sugar balance
  • Weight management
  • Stimulants
  • Food sensitivities
• Antioxidants
  • Intake is associated with improved depression and anxiety
• Spices
  • Saffron: effective in reducing depressive symptoms
  • Turmeric: curcumin lowers anxiety scores
• Omega-3 Fatty Acids
  • Beneficial effects on depression
• 5-HTP
  • Tryptophan is important for brain function
• B Vitamins
  • Important for anabolic and catabolic cellular processes
  • Supplementation may reduce anxiety and depression
• Magnesium
  • Deficiency is common among people with depression
  • Supplementation may reduce depressive symptoms
• Vitamin D
  • Could reduce risk of depression by reducing inflammation and regulating mood
  • Serum vitamin D levels correlate with clinical depression

Pharmacology and Bioavailability

• Bioavailability
  • Amount of the administered dose of a drug that reaches the systemic circulation in an active (unchanged) form
  • Influenced by several factors
• Distribution
  • Tissue targets are influenced by size of the organ, blood flow, drug solubility, and protein binding
• Metabolism
  • Enzyme-catalyzed conversion of drugs to their metabolites
  • Primary goal is to inactive or detoxify foreign substances and prepare them for excretion
• First Pass Effect
  • Drugs absorbed via the gut reach the liver via the portal vein before entering the systemic circulation
  • The degree to which the drug is inactivated by liver enzymes prior to entering the systemic circulation substantially alters the drug's bioavailability
• Phase 1 Metabolism
  • Primary goal is to introduce or open up a binding site for hydrophilic compounds to be added later by phase II mechanisms
  • Oxidative reactions are the most common
  • Microsomal cytochrome P450 (CYP450) system is involved
• Phase 2 Metabolism
  • Not all drugs require phase I metabolism prior to phase II
  • These reactions essentially conjugate a water-soluble molecule to the spot opened up by phase 1 reactions
  • In many instances, this means conjugating something to an available hydroxyl group
• Enterohepatic Circulation
  • Glucuronide conjugates are excreted in bile
  • Some commensal gut bacteria have glucuronidase enzymes that can cleave the glucuronide off the metabolite, resulting in the parent drug being able to be reabsorbed
• Elimination
  • Most water-soluble drug metabolites are excreted by the kidneys
  • Various mechanisms exist throughout the sections of the nephron
  • Lipid-soluble drugs are excreted in the distal tubule if they're small enough
  • Lipid-soluble drug metabolites and glucuronide-conjugates are excreted by the liver into bile and excreted in feces

Antibiotic Stewardship

• Antibiotic stewardship is essential to prevent antibiotic resistance.

Mechanisms of Antibiotic Resistance

• Bacteria may develop resistance to antibiotics through various mechanisms.
• Antibiotic resistance can lead to urgent threats, concerning threats, and watch list threats.

Classification of Antibiotics

• Antibiotics can be classified into three main categories based on their antimicrobial spectrum:
  • Narrow: Active against a single species or limited group of pathogens.
  • Broad: Active against a wide range of pathogens.
  • Extended: In between narrow and broad spectrum.

Antibiotic Examples

• Penicillin V:
  • Narrow spectrum antibiotic.
  • Oral suspension.
  • Adverse effects: GI upset, nausea, vomiting, diarrhea, and rash.
  • Rare cases: can cause anaphylaxis.
  • Target: Group A streptococcus pharyngitis.
  • Dosage: > 27 kg: 300 mg TID or 600 mg BID for 10 days.

Antibiotic Resistance Threats

• Urgent threats:
  • Carbapenem-resistant Acinetobacter.
  • C.auris.
  • C.difficile.
  • CRE.
  • N.gonorrhoeae.
• Concerning threats:
  • Erythromycin-resistant group A Streptococcus.
  • Clindamycin-resistant group B Streptococcus.
• Watch list:
  • Azole-resistant A. fumigatus.
  • Drug-resistant M. genitalium.
  • Drug-resistant B. pertussis.