Herbal Medicine Materia Medica 2

Transcription

1 Herbal Medicine Materia Medica 2 WHMF212 Session 6: Nervous System Part I Endeavour College of Natural Health endeavour.edu.au

2 Session 6 Nervous System Part I Materia Medica (from Traditional literature & research): Avena sativa Bacopa monniera Lavandula angustifolia Hypericum perforatum Passiflora incarnata Endeavour College of Natural Health endeavour.edu.au 2

3 Nervous System Peripheral nervous system (Nucleus Medical Media, 2012) Endeavour College of Natural Health endeavour.edu.au 3

4 Nervous System The Nervous System is divided into: Central Nervous system (CNS) (Brain and spinal cord) Peripheral Nervous system (PNS) (Somatic & Autonomic Nervous system) The Autonomic Nervous system is further broken down into: Sympathetic division (Fight or flight) Parasympathetic (Rest and digest) (Bone & Mills, 2013) Endeavour College of Natural Health endeavour.edu.au 4

5 Nervous System Herbal medicine is useful in supporting: Stress, anxiety, panic, minor depressive conditions Psychosomatic conditions Neuralgia, visceral spasms Nervous debility / exhaustion Insomnia Dose reduction of orthodox prescriptive hypnotics & sedatives (Bone & Mills, 2013) Endeavour College of Natural Health endeavour.edu.au 5

6 Nervous System Herbal Actions & Contra-indications: Analgesics Cautions: Concurrent orthodox prescription analgesics Pain in children Neurological disease Depression and mental disease (psychosis) Liver and kidney disease History of allergy or anaphylactic reactions Long term therapy with herbal analgesics is not advisable (Bone & Mills, 2013) Endeavour College of Natural Health endeavour.edu.au 6

7 Nervous System Herbal Actions & Contra-indications: Sedatives and Hypnotics Cautions: Herbal sedatives and hypnotics don t have the equivalent short-term efficacy so gradual weaning needs to occur with GP driven step-down approaches to withdrawal from drugs. Depression Insomnia marked by increasing restlessness during the early hours of the morning. (Bone & Mills, 2013) Endeavour College of Natural Health endeavour.edu.au 7

8 Nervous System Herbal Actions & Contra-indications: Antispasmodics and Relaxants Cautions: Relaxant or antispasmodic herbs that have a more sedative activity, as these should be reduced over time and are not appropriate for medium to long term therapy. Less sedating herbs are generally well tolerated long-term. Are generally safe and well tolerated. (Bone & Mills, 2013) Endeavour College of Natural Health endeavour.edu.au 8

9 Nervous System Herbal Actions & Contra-indications: Nervine Tonics Cautions: As a group, nervine tonics are almost nutritional in their activity and pose few risks of adverse effects except in those patients with extremely debilitated constitutions. Long term therapy with nervine tonics and trophorestoratives is appropriate in most presentations, and is considered safe. (Bone & Mills, 2013) Endeavour College of Natural Health endeavour.edu.au 9

10 Avena sativa Plant family: Poaceae Part used: mature seed Constituents: Polyphenols, saponins, mono & oligosaccharides, vit. A, B-complex, C, E, K. silicon, calcium, iron, potassium, manganese, zinc Actions: Antidepressant, thymoleptic, nervine tonic, anxiolytic, cardiac tonic (BHP, 1983; Blumenthal et al., 2000; Bone, 2003; Fisher, 2009) Avena sativa (Trepte, 2006) Endeavour College of Natural Health endeavour.edu.au 10

11 Avena sativa Historical & Traditional Prescribing: Oats were used by humans around 2000BC and ancient texts describe the herbs medicinal uses - depression, general debility, nervous prostration, insomnia, for improving energy of the heart. Used to treat conditions like leprosy, the itch and fistulas. (Bone, 2003; Fisher, 2009) Avena sativa (Zell, 2009a) Endeavour College of Natural Health endeavour.edu.au 11

12 Avena sativa Cautions / Contraindications / Warnings: Grain contains gluten and is contraindicated in Coeliac disease, however the alcohol extract should not cause a reaction. Herb/Drug Interactions: None known Pregnancy and Lactation: No adverse effects expected (Bone, 2003; Fisher, 2009) Endeavour College of Natural Health endeavour.edu.au 12

13 Avena sativa Preparation Adult ml/g Dosage directions & considerations Oral Oat seed 1:1 (25%) Oats green 1:2 (25%) 20-40mL/week 20-40mL/week Oatmeal or straw 1-4gm/ dose Take up to three times per day (Bone, 2003; Fisher, 2009) Taste: sweet and warm (Thomsen & Gennat, 2009) Endeavour College of Natural Health endeavour.edu.au 13

14 Bacopa monniera Plant family: Scrophulariaceae Part used: Aerial parts Active Constituents: Saponins, alkaloids, flavonoids Action: Cognition enhancing, nervine tonic, mild sedative, anxiolytic, mild anticonvulsant, adaptogenic, antioxidant (Bone, 2003; Thomsen & Gennat, 2009) Bacopa monniera (Quod, 2014a) Endeavour College of Natural Health endeavour.edu.au 14

15 Bacopa monniera Historical & Traditional Prescribing: Nervine tonic for nervous breakdown, epilepsy, insanity, aphoria. Cardiac tonic, urinary incontinence, constipation As a tonic for diseases of the skin, nervous system, blood (Bone, 2003) Bacopa monniera (Quod, 2014b) Endeavour College of Natural Health endeavour.edu.au 15

16 Bacopa monniera Cautions / Contraindications / Warnings: None known Herb/Drug Interactions: None known Pregnancy and Lactation: No adverse effects expected (Bone, 2003) Bacopa monnieri (Garg, 1990) Endeavour College of Natural Health endeavour.edu.au 16

17 Bacopa monniera Preparation Adult ml/g Dosage directions & considerations Oral Fluid extract 1:2 (25%) 35-90mL/week Saponin herb: oral use may cause of irritation of the gastric mucous membranes and reflux (Bone, 2003) Requires 12 week continual use before cognitive benefits are seen (Thomsen & Gennat, 2009) Dry herb 1-2gm/ dose Take up to three times per day (Bone, 2003; Thomsen & Gennat, 2009) Taste: Astringent, cold, turning sweet (Thomsen & Gennat, 2009) Endeavour College of Natural Health endeavour.edu.au 17

18 Lavandula angustifolia Plant family: Lamiaceae Part used: Flower Active Constituents: Volatile oil; tannins; coumarins; flavonoids; phytosterols; triterpenes (Blumenthal et al., 2000) Action: Carminative, spasmolytic, antidepressant, anxiolytic (BHP, 1983; Bone, 2003) Lavandula angustifolia (Zell, 2009b) Endeavour College of Natural Health endeavour.edu.au 18

19 Lavandula angustifolia Historical & Traditional Prescribing: Historically: Digestive dysfunction, spleen congestion. A diuretic. A gargle for toothache. To restore a lost voice. Passions of the heart and its trembling's, fainting's and swooning's. Externally and internally for bites of mad dogs, serpents and other venomous creatures. (Fisher, 2009) Lavandula angustifolia (Sanja565658, 2009) Endeavour College of Natural Health endeavour.edu.au 19

20 Lavandula angustifolia Cautions / Contraindications / Warnings: None known Herb/Drug Interactions: None known Pregnancy and Lactation: No adverse effects expected (Bone, 2003) Lavandula dentata (Nanosanchez, 2009) Endeavour College of Natural Health endeavour.edu.au 20

21 Lavandula angustifolia Preparation Adult ml/g Dosage directions & considerations Oral Fluid extract 1:2 (60%) 15-30mL/week High doses are said to cause abdominal pain and colic (Bone, 2003) Infusion of dried herb 1-2gm/ dose Take up to three times per day (Bone, 2003; Fisher, 2009) Taste: Dry 3 rd degree, hot 3 rd degree (Thomsen & Gennat, 2009) Odour: aromatic, intense and pleasant: taste: bitter and pungent (Fisher, 2009) Endeavour College of Natural Health endeavour.edu.au 21

22 Hypericum perforatum Plant family: Guttiferae Part used: Aerial parts Active Constituents: Naphthodianthrones (Hypericin), Phloroglucinols (hyperforin), flavonoids, volatile oil, tannins Action: Sedative, astringent, anti-depressant, anti-inflammatory, anti-viral, vulnerary Topically: analgesic, antiseptic (BHP, 1983; Fisher, 2009) Hypericum perforatum (Schmidt, 2012) Endeavour College of Natural Health endeavour.edu.au 22

23 Hypericum perforatum Historical & Traditional Prescribing: Excitability, hysteria, nervous conditions, depression. Neuralgia, fibrositis, sciatica, spinal injuries or irritations, shock, concussion, throbbing of the body without fever Haemorrhage, menorrhagia, diarrhoea, jaundice, chronic urinary conditions (Bone, 2003) Hypericum perforatum (Johansson, 2012) Endeavour College of Natural Health endeavour.edu.au 23

24 Hypericum perforatum Cautions / Contraindications / Warnings: Not recommended for severe depression, psychotic symptoms or suicidal risk Pregnancy & Lactation: No adverse effects expected Herb/Drug Interactions: Induces cytochrome P-450 (enhances) reducing drug levels of immune suppressants, cardiac glycosides, HIV anti-retrovirals, chemotherapy drugs, anticoagulants, oral contraceptive pill Additive effect with SSRI anti-depressants (Bone & Mills, 2013; ESCOP, 2003) Endeavour College of Natural Health endeavour.edu.au 24

25 Hypericum perforatum Preparation Adult ml/g Dosage directions & considerations Oral Liquid Extract 1:1 (60%) standardized hypericin 42-84mL/ week Mild SE: nausea, rash, itch, fatigue, restlessness, photosensitivity, acute neuropathy, dizziness & constipation (1-3% clients) (Fisher 2009) Infusion of dried herb 2-4gm/ dose Take up to three times per day (Fisher, 2009) Taste: Cold, Pungent (Thomsen & Gennat, 2009) Endeavour College of Natural Health endeavour.edu.au 25

26 Passiflora incarnata Plant family: Passifloraceae Part used: Aerial parts Active Constituents: Apigenin and luteolin glycosides; alkaloids; fatty acids; phytosterols; sugars; volatile oils (Blumenthal et al., 2000) Actions: Spasmolytic, sedative, hypnotic, anodyne, anxiolytic (BHP, 1983; Bone, 2003) Passiflora incarnata (Zell, 2009c) Endeavour College of Natural Health endeavour.edu.au 26

27 Passiflora incarnata Historical & Traditional Prescribing: Restlessness, wakefulness, nervous irritability especially from exhaustion, prolonged illness, hysteria, insomnia (all ages) Spasmodic conditions, generalised seizures, epilepsy, nervous headache Spasmodic asthma, neuralgic pain Topically for burns, scalds, haemorrhoids, painful ulcer and toothache (Bone, 2003) Passiflora incarnata (Zell, 2009d) Endeavour College of Natural Health endeavour.edu.au 27

28 Passiflora incarnata Cautions / Contraindications / Warnings: None known Herb/Drug Interactions: None known Pregnancy and Lactation: No adverse effects expected (Bone, 2003) Passiflora incarnata (passion flower) (Audrey, 2008) Endeavour College of Natural Health endeavour.edu.au 28

29 Passiflora incarnata Preparation Adult ml/g Dosage directions & considerations Oral Fluid Extract 1:2 (45%) 15-40mL/ week May be more effective as a hydroalcohol extract than an infusion Infusion of dried herb gm/ dose Take up to three times per day Taste: Cool & dry (Thomsen & Gennat, 2009) (Fisher, 2009) Endeavour College of Natural Health endeavour.edu.au 29

30 Recommended Readings Braun, L., & Cohen, M. (2015). Herbs & natural supplements. An evidence-based guide (4 th ed.). Chatswood, NSW, Australia: Churchill Livingston. Avena sativa (p ), Bacopa monniera (p ), Lavandula angustifolia (p ), Hypericum perforatum (p ), Passiflora incarnata (p ) Fisher, C. (2009). Materia medica of Western herbs. Nelson, New Zealand: C. Fisher. Avena sativa (p ), Lavandula angustifolia (p ), Hypericum perforatum (p ), Passiflora incarnata (p ) Endeavour College of Natural Health endeavour.edu.au 30

31 References Audrey (2008). Passiflora incarnata (passion flower) cropped [Image]. Retrieved from Blumenthal, M. (2000). Herbal medicine: Expanded commission E monographs. Newton, Massachusetts, USA: Integrative Medicine Communications. Bone, K., & Mills, S. (2015). Principles and practice of phytotherapy (2 nd ed.). London UK: Churchill Livingstone. Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. St Louis, Missouri, USA: Churchill Livingston. British Herbal Medicine Association (1995). British herbal pharmacopoeia Bournemouth UK: British Herbal Medicine Association. European Scientific Cooperative on Phytotherapy (2003). ESCOP Monographs (2 nd ed.). Exeter, UK: European Scientific Cooperative on Phytotherapy. Fisher, C. (2009). Materia medica of Western herbs. Nelson, New Zealand: C. Fisher. Garg, J.M. (1990). Acopa monnieri [Image]. Retrieved from eri_w_img_1612.jpg Johansson, C.T. (2012) Hypericum perforatum [Image]. Retrieved from IMG_4353.jpg Endeavour College of Natural Health endeavour.edu.au 31

32 References Nanosanchez (2009). Lavandula dentata 2 [Image]. Retrieved from Nucleus Medical Media (2010a). Autonomic nervous system [Video]. Retrieved from cription/smart/1189/downloads/cache_mdjpg/ap00108autonomicnervoussy s.jpg Nucleus Medical Media (2010b). Effects of anxiety [Video]. Retrieved from cription/smart/1189/downloads/cache_mdjpg/bn00073.jpg Nucleus Medical Media (2012). Peripheral nervous system [Video]. Retrieved from -nervous-system/view-item?itemid=73695 Quod, T. (2014). Bacopa monnieri [Image]. Quod, T. (2014b). Bacopa [Image]. Sanja (2009). Lavandula angustifolia 01 [Image]. Retrieved from tifolia_01.jpg/800px-lavandula_angustifolia_01.jpg Schmidt, U. (2012). Hypericum perforatum L [Image]. Retrieved from atum_l._% %29.jpg/582px- Hypericum_perforatum_L._% %29.jpg Thomsen, M., & Gennat, H. (2009). Phytotherapy desk reference. Global. Natural Medicine Pty Ltd Endeavour College of Natural Health endeavour.edu.au 32

33 References Trepte, A. (2006). Avena sativa II [Image]. Retrieved from Zell, H. (2009a). Avena sativa 02 [Image]. Retrieved from _002.JPG/360px-Avena_sativa_002.JPG Zell, H. (2009b). Lavandula angustifolia 002 [Image]. Retrieved from ngustifolia_002.jpg/450px-lavandula_angustifolia_002.jpg Zell, H. (2009c). Passiflora incarnata [Image]. Retrieved from carnata_001.jpg/450px-passiflora_incarnata_001.jpg Zell, H. (2009d). Passiflora incarnata 004 [Image]. Retrieved from carnata_004.jpg/640px-passiflora_incarnata_004.jpg Endeavour College of Natural Health endeavour.edu.au 33

34 Tutorial Session 6

35 Autonomic nervous system (Nucleus Medical Media, 2010a) Endeavour College of Natural Health endeavour.edu.au 35

36 Effects of anxiety (Nucleus Medical Media, 2010b) Endeavour College of Natural Health endeavour.edu.au 36

37 Tutorial Case Study Rachel: 40 yo female, BP 150/95 (you suspect white coat syndrome), HR 90 BPM Presenting Symptoms: Anxiety/panic attacks Location: NS, Cardio-vascular system. Onset: Following motor vehicle accident 1 year ago Provocation/Palliation: Accident was not Rachel s fault, she was hit by a drunk driver. She currently cannot drive in cars, either as driver or passenger, or in crowded spaces without getting anxious, sweaty, heart palpitations, nausea. Radiations: Also off work for 2 months with broken bones to upper arm, ribs and jaw. Endeavour College of Natural Health endeavour.edu.au 37

38 History: Tutorial Has 4 teenage children at home that wear her out. Works as a librarian in a busy city library Was overlooked for a recent promotion due to her time off work due to panic attacks. GIT Nausea with anxiety. Lasts until Rachel calms down. Loss of appetite since accident. Prior to this healthy appetite. Stools formed, brown, some undigested food. Once every two days. Endeavour College of Natural Health endeavour.edu.au 38

39 Tutorial Client Requirements: Herbal formula/s to aid the symptoms of anxiety and panic attacks, and any other symptoms that the client presents with. Based on this information: Fill out the following tables Groups discuss their findings to the class Endeavour College of Natural Health endeavour.edu.au 39

40 Tutorial Treatment Goals prioritize into short term & long-term. Systems and/ or symptoms supported with these goals. Herbal actions for these goals & the herb with these actions (Latin binomials only). Endeavour College of Natural Health endeavour.edu.au 40

41 Tutorial Herb (Latin Binomial) Weekly dose/ml (range) Chosen Herb dosage in ml Client Directions Endeavour College of Natural Health endeavour.edu.au 41

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