Gastrointestinal Tract, Urinary Tract and Liver Disorders PDF

10/26/24 Gastrointestinal tract, Urinary tract and Liver disorders 114 114 1  10/26/24 Saw Palmetto ( Serenoa repens ) Therapeutic effects A....

10/26/24 Gastrointestinal tract, Urinary tract and Liver disorders 114 114 1  10/26/24 Saw Palmetto ( Serenoa repens ) Therapeutic effects A. Anti -Androgenic Effects B. Anti -Inflammatory Effects 115 115 Saw Palmetto (Serenoa repens) Therapeutic effects 1. Anti-Androgenic Effects (Tea bag ??) The lipophilic extract of the herb inhibits binding of dihydrotestosterone (DHT) to the cytosolic androgenic receptor and alpha-1-adrenoceptor in the prostate. (thus preventing prostate hyperplasia). Age 80 years male Anti-androgenic effects of the lipophilic extract also consist of 5-alpha-reductase inhibition. (same mechanism of finasterid) drug 116 2  10/26/24 116 Saw Palmetto (Serenoa repens) Therapeutic effects 2. Anti-Inflammatory Effects The hexane extracts of the herb have demonstrated anti- inflammatory activity. Inhibition of the synthesis of arachidonic acid inflammatory metabolites, ( blocking of cyclo-oxygenas and 5-lipoxygenase pathways ) The drug also posses anti-spasmodic properties by inhibiting calcium influx and activation of the sodium/calcium ion exchanger. Extracts of the drug may also antagonize the contracting effect of acetylcholine on urinary bladders. 117 117 3  10/26/24 Saw Palmetto (Serenoa repens) Indications Approved by Commission E: Prostate complaints Irritable bladder 118 Saw Palmetto (Serenoa repens) Drug Interactions: Saw Palmetto is believed to exert estrogen, androgen and alpha-adrenergic blocking effects. * The use of hormones, hormone-like drugs or adrenergic drugs concomitantly may need to be adjusted. (Endocrine related cancers, e.g. breast, ovary, testes, pituitary) 119 119 4  10/26/24 Saw Palmetto (Serenoa repens) Saw Palmetto anticoagulant effects: Saw palmetto has been attributed to excessive bleeding in a 53year-old man undergoing a surgical procedure to remove a brain tumour. An estimated 2 litres of blood were lost during surgery and bleeding time did not return to normal for 5 days. The patient denied taking NSAIDs pre-operatively but admitted to taking saw palmetto for benign prostate hypertrophy. 120 120 Pumpkin (Cucurbita pepo) Therapeutic effects: As well as amaroids (cucurbitacin), the drug contains delta7-sterols, which are similar in conformation to the Dihydrotestosterone Cucurbitacin has anthelmintic properties. The empirical evidence indicates efficacy for prostate hyperplasia. Pumpkin is also antiphlogistic and antioxidative. 121 121 5  10/26/24 Pumpkin (Cucurbita pepo) Indications Approved by Commission E: Irritable bladder Prostate complaints 122 Pumpkin (Cucurbita pepo) Pumpkin anticoagulant effects: Elderly man who was not taking any anticoagulants and was taking 3 tablets of Curbicin daily (a herbal remedy used for urination problems, and contains extracts from the fruit of saw palmetto and the seed of Cucurbita pepo). His INR was 2.1 (normal 0.9 to 1.2). It did not normalise until a week after the Curbicin was stopped. 123 123 6  10/26/24 Turmeric (Curcuma domestica) Therapeutic effects Turmeric has antihepatotoxic, antihyperlipidemic and anti- inflammatory effects. It is also antioxidative (inhibits lipid peroxide formation in the liver), antitumoral and antimicrobial effects. It also inhibits prostaglandin formation, in vitro. 124 124 Turmeric (Curcuma domestica) Indications Approved by Commission E: Dyspeptic complaints Loss of appetite 125 7  10/26/24 Turmeric (Curcuma domestica) Contraindicaton The drug should not be used by patients with obstructed biliary ducts; those with gallstones should take it only under the supervision of a physician. 126 126 Devil's Claw (Harpagophytum procumbens) Therapeutic Effect Devil's Claw stimulates gastric juice secretion and is choleretic. (increase bile secretion) 127 127 8  10/26/24 Devil's Claw (Harpagophytum procumbens) INDICATIONS Approved by Commission E: Dyspeptic complaints Loss of appetite Rheumatism 128 Devil's Claw (Harpagophytum procumbens) CONTRAINDICATIONS The drug should not be used in the presence of stomach or duodenal ulcers, due to the drug's stimulation of gastric juice secretion. 129 129 9  10/26/24 Dandelion (Taraxacum officinale) Therapeutic Effects secreation of bile Dandelion has cholagogic and secretolytic effects in the upper intestinal tract. Approved by Commission E: Dyspeptic complaints Infections of the urinary tract Liver and gall bladder complaints Loss of appetite 130 130 10  10/26/24 Alpine Cranberry (Vaccinium vitis-ideae) Therapeutic Effects The drug is antiviral and a urine disinfectant due to the tannin fraction. INDICATIONS AND USAGE Unproven Uses: Alpine Cranberry is used to treat urinary tract irritation, gout, rheumatism, and calculus (stone com- plaints). For lower urinary tract symptoms (LUTS), one gelatin capsule containing 500 milligrams of cranberry fruit powder three times daily for six months. 250 ml is equivalent to 400 milligrams 132 132 Alpine Cranberry (Vaccinium vitis-ideae) PRECAUTIONS The urine-disinfecting effect of the hydroquinones are released in the urinary tract only occurs in an alkali environment. The simultaneous administration of medication and food that increases uric acid concentration in the bladder should be avoided. (Purine containing food: meat, kidney, heart, mussels, crab, sardines, herring, yeast) 133 133 11  10/26/24 Celandine (Chelidonium majus) Therapeutic Effects: Celandine has mild analgesic, cholagogic, antimicrobial, and central-sedative effects. It also acts as a spasmolytic on smooth muscles. It also has a nonspecific immune-stimulating effect. 134 134 Celandine (Chelidonium majus) INDICATIONS Approved by Commission E: Liver and gallbladder complaints Unproven Uses: Celandine is used for spasmodic pain of the bile ducts and the gastrointestinal tract. 135 135 12  10/26/24 Milk Thistle (Silybum marianum) Therapeutic Effects Hepatoprotective Effects Silymarin (silychristin and silydianin) seem to inhibit the entrance of toxins and block toxin-binding sites through alteration of the liver cell's outer membrane. Silibinin decreases production of superoxide radicals, it also inhibits leukotriene formation by the Kupffer cells. Silymarin increases glutathione production by the liver, intestines and stomach. Glutathione is used for detoxification in the liver cells. 136 136 Milk Thistle (Silybum marianum) Therapeutic Effects Liver Regenerative Effects Silymarin stimulates RNA polymerase I in the cell nucleus of the hepatocytes, resulting in an increase of ribosomal protein synthesis and the regenerative ability of the liver. The drug also has a cholagogic effect. 137 137 13  10/26/24 Milk Thistle (Silybum marianum) INDICATIONS AND USAGE Approved by Commission E: Dyspeptic complaints Liver and gallbladder complaints The drug is used for toxic liver damage, adjunctive treatment in chronic inflammatory liver disease and hepatic cirrhosis. 138 138 Milk Thistle (Silybum marianum) Drug Interactions: 1.The concomitant use of silymarin and butyrophenones# or phenothiazines results in a reduction of lipid peroxidation??? 2. Silymarin has an antagonistic effect with yohimbine and * phentolamine when given simultaneously. # Haloperidol, the most widely used classical antipsychotic drug in this class *control of hypertensive emergencies. Intracavernosal injection, it increases blood flow which help in erectile dysfunction 139 14 10/26/24 15