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Herbal Medicine

Transcript: Ginger to treat a sore throat: Recipe for Ginger Lozenges Method: resemble lollies; suitable for children sweet tasting therefore palatable portable, convenient, easy to administer in direct contact with affected area, local affect do not contain alcohol Actions: carminative, anti-emetic, diaphoretic, peripheral circulatory stimulant, digestive stimulant, anti-inflammatory, anti-microbial, antioxidant,anti-bacterial, anti-fungal, cholagogue, anti-tussive... Ginger (Zingiber Officinale) Belongs to the Zingiberaceae family • sore throat, colds and flu • stomach aches • diarrohea • arthritis • fever • asthmatic & respiratory disorders • gingivitis • nausea & vomiting • indigestion • wind and bloating Chosen preparation: Lozenges 30g fresh grated ginger (1:10) 300ml water double quantity of sugar (e.g. 250ml liquid:500g sugar) 1tsp of cream tartar Recipe for Ginger Lozenges (continued) • Name of product: ginger lozenges • dosage and directions: as required • total contents: no. of lozenges • ingredients list: sugar, ginger • date dispensed: 18/03/14 • expiry date: 01/04/14 • Fill tray with icing sugar or corn starch • make holes using round flat implement (chapstick) • pour mixture quickly into moulds • dust of excess icing sugar Dosage: anti-inflammatory, anti-microbial, diaphoretic, anti-tussive, antibacterial, expectorant qualities relieve swelling, alleviate pain, inflammation, reduce cough warming, stimulating and decongestant qualities effective to soothe and treat a sore throat Disadvantages: Active constituents: • volatile oil • phenolic compounds including gingerols (contribute to pungent taste) and shogaols • acrid soft resin. Preparation of moulds: • recommended dose of ginger ranges from 500mg-9g per day • Make a decoction of ginger in water • Simmer to make a concentrated decoction • Strain and press out liquid • Measure volume of liquid obtained, add double quantity of sugar & 1tsp of cream tartar • Dissolve over low heat whilst stirring • Bring to gentle boil, keep below 150º • Pour into moulds • Allow to set approx. 2hrs close resemblance to lollies contain high percentage of sugar heat affected constituents may be damaged in the process Ginger has long been used across various cultures as both a food and medicine since ancient times. It can be used to treat a wide array of ailments: Part of the plant used is the root or rhizome (stores active constituents). Can be used fresh or dried. Advantages: Labelling: Ingredients: Recipe for Ginger Lozenges (continued)

Herbal Medicine:

Transcript: Herbs and Supplements Uses: CNS sedation without loss of mental acuity Proven risks: Increases sedation, especially of benzodiazepines. In large doses it can cause liver toxicity. Possibly increases effects of antiepileptic meds. Valerian is another sedative, with the same risks, but not to be used with barbiturates. (Kee et al., 2009) Important Echinacea By Kalika, Stacy, Jeremy and Amanda Questions to Ask Patients Green Tea Collaborator Advocate Self Health promotion Clotting Cellular Regulation Inflammation Anxiety Sleep Coping Stress Found to inhibit prostate cancer development in men.(Henning et al., 2012) Proven risk: It decreases the effects of warfarin because it is a source of vitamin K. A patient may drink green tea if it is the same amount everyday and they notify their doctor. (Kee et al., 2009) Interactions Nurses Need to Know References Vitamins C and E Bent, S. (2008). Herbal medicine in the United States: Review of efficacy, safety, and regulation. Journal of General Internal Medicine, 23(6), 854-859. doi:10.1007/s11606-008-0632-y Deglin, J. H., & Vallerand, A. H. (2009). Davis's drug guide for nurses (11th ed.). Philadelphia, Penn.: F.A. Davis. Henning, S., Wang, P., Said, J., Magyar, C., Castor, B., Doan, N., Tosity, C., Moro, A., Gao, K., Li, L., & Heber, D. (2012). Polyphenols in brewed green tea inhibit prostate tumor xenograft growth by localizing to the tumor and decreasing oxidative stress and angiogenesis. Journal of Nutritional Biochemistry, 1-6. doi:10.1016/j.jnutbio.2011.10.007 Kee, J., Hayes, E., & McCuistion, L. (2009). Herbal therapy with nursing implications. Pharmacology: A nursing process approach (pp. 169-186). St. Louis, MO: Saunders-Elsevier. Murray, M., Birdsall, T., Pizzorno, J., & Reilly, P. (2002). How to prevent and treat cancer with natural medicine. New York, NY: Penguin Group. Skinner, C. M., & Rangasami J. (2002). Preoperative use of herbal medicines: a patient survey. British journal of anasthesia. 89 (5) 792-795 WHO guidelines for governments and consumers regarding the use of alternative therapies. (2004). Rev Panam Salud Publica, 16(3):218-21. Wong, W., Gabriel, A., Maxwell, P., & Gupta, S. (2012). Bleeding risks of herbal, homeopathic, and dietary supplements: A hidden nightmare for plastic surgeons? Aesthetic Surgery Journal, 32,332-346. doi:10:1177/1090820X12438913 Facts Garlic (detoxifies and increase immunity) Ginger (digestion) Ginkgo (antioxidant, increase blood flow to CNS) Ginseng (supports adrenals, enhances energy) All proven to increase the effect of anticoagulants and antiplatelet agents. So there is an increased risk of bleeding. (Kee et al., 2009) Concepts Used for Bacterial/viral infections Inflammation of mouth and pharynx. Wounds and burns. UTI/vaginal candiditis Contraindicated with immunosuppressants (Skinner and Rangasami 2002) St John's Wort 1. Are you currently taking any herbal products, supplements, teas, food, natural remedies? 2. Have you taken any herbal supplements in the past? 3. In the past four weeks, what types of tea, vegetable and plant products have you eaten or drank? 4.Are you taking any dietary supplements and for how long? Who recommended these? 5.What other medications are you taking? (Wong et al., 2012) Cancer prevention and aid in treatment The Institute of Medicine state that a dose of 1000 mg of Vitamin E daily is safe. Others recommend that clients resume taking Vitamin E when healing is complete But they inhibit platelet aggregation (Wong et al., 2012) Nursing References The 4 G's Kava-Kava The student will Gain a basic understanding of the 10 most popular herbal remedies Evaluate the scientific evidence for efficacy of these herbs Prioritize safety concerns regarding herb-drug interactions 1 in 5 adults in the U.S. use herbal remedies. (as cited in Bent, 2008) These remedies are not regulated or tested for safety or efficacy by the FDA. “Natural” does not mean safe, harmless, or without risk. (WHO, 2004) Adverse events are due to poor quality and improper use. (WHO, 2004) Pregnant women to need to consult with their primary care provider about all herbal remedies. Discontinue all herbs at least 1 week before surgery, if not 2-3 weeks before surgery, if tapering off is called for. (Murray et al., 2002) Speak with Herbal specialist about dosage to help prevent hepatotoxicity Objectives Davis's Drug Guide for Nurses National Center for Complementary and Alternative Medicine (NCCAM): www.nccam.nih.gov or call 1-888-644-6226 Herb Research Foundation: www.herbs.org FDA: www.fda.gov Office of Dietary Supplements, National Institutes of Health: ods.od.nih.gov Uses: Mild to moderate depression, anxiety, and sleep disorders. Proven to reduce the effect of: -digoxin -SSRIs -Oral contraceptives -warfarin Could cause serotonin syndrome. (Kee et al., 2009)

HERBAL MEDICINE

Transcript: consult with a doctor about effects of herbs and doses Some herbs, such as cannabis and coca, are outright banned in most countries How do herbs work? scientists aren’t sure what specific ingredient in a particular herb works to treat a condition or illness. Whole herbs contain many ingredients, and they may work together to produce a beneficial effect. Many factors determine how effective an herb will be. 80% of the world’s population uses herbal medicine (by WHO) Around 7,000 compounds used in modern medicine originate from plants. herbal medicine is used by animals The first generally accepted use of plants as healing agents were depicted in the cave paintings between 13,000 - 25,000 BCE Make sure you are not allergic to any material Tisanes Infusions Decoctions Maceration Tinctures Liquid extracts Vinegars Syrups Essential oil Salves Dry extracts Inhalation HERBAL MEDICINE Interesting facts Quality control methods for medicinal plant materials, 1998 - by World Heath Organisation (WHO) Chemical, homeophatic drugs and herbs can not be used together. Among individual products should be 1-2 hours difference. Herbal medicine (or "herbalism") is the study and use of medicinal properties of plants • Alkaloids • Polyphenols • Glycosides • Terpenes Rules of using herbal Biological background - Inappropriate for many conditions - Lack of dosage instructions - Poison risk associated with wild herbs - Medication interactions - Lack of regulation Advantages and disadvantages of using herbs + Reduced risk of side effects + Effectives with chronic conditions + Lower cost + Widespread availability Herbal preparations European Directive on Traditional Herbal Medicinal Products (in the European Union (EU))

Herbal Medicine

Transcript: “one of the oldest living tree species” Both the United States and Europe Ginkgo is ranked the number one most bought herbal medication Treat memory and blood disorders History History St. John's Wort depression is the only one that has been looked at the most by scientist and founded to have evidence it works treat mild cases of depression two chemicals being Hypericin and hyperforin scientist argue that is only one of them while other believe it is both Work same way as popular drugs such as Prozac, Celexa and Zoloft Neurotransmitters creating more or dopamine, serotonin, and norepinephrine How it Works Herbal Medicine stomach upset, headaches, skin reactions, and dizziness cause things such as liver and thyroid cancer not been enough studies to prove that is the cause, but the idea alone may scare a lot of consumers Future Future History Not recommended to take this herbal medication with almost any other drug Women who are pregnant or are trying to get pregnant are highly recommended to stay away from this form of medication Someone with schizophrenia should stay away from St. John’s because it increases Dopamine Passionflower St. John’s Wort Ginkgo Ginkgo is made up as of right now what looks to be forty different components flavonoids and terpenoids antioxidants When we age things such as free radicals build up and can lead to the cause of many disease one in particular, Alzheimer's diseases. provide electrons to free radicals that way they are not damaging things such as DNA and other cells Terpenoids, example ginkgolides help to improve blood flow for patients who suffer from peripheral vascular disease by dilating blood vessels and making the blood less sticky By Shannon Custodio April 24, 2014 Ginkgo First founded in Peru during the year 1569. It received its name because the Spanish explorers believed the flower symbolizes Christ's passion for their exploration Above ground part of the plant is the part that is used for medical purposes, including flowers, leaves, and steam Treat insomnia, anxiety, seizures and hysteria's Future Scientist were able to figure out which chemicals were of most use Went on to extract and recreate forms of the compounds Increase in drugs Decrease in herbal medication 19th Century What is it? How it Works commonly used for anxiety and insomnia Liquid extracts, tinctures, tea, and infusions Ability to increase the level of gamma aminobutyric acid (GABA) a chemical in the brain Works in a way that it lowers the activity of brain cells Currently there is a lack of studies that have been done on Passionflower Regulating how much you are taking and how long you are taking the medication is important. Recommended amount is 90 mg pill one per a day or 45 drops of liquid extract daily can help with generalized anxiety disordered Does not have any side effects that you will not find in other prescription drugs for anxiety History Passionflower botanical medicine or phytomedicine plant's seeds, berries, roots, leaves, bark, or flowers for medicinal purposes Before recorded history Recorded information that shows Chinese and Egyptians were using forms of herbal medicine in 3,000 BC all around the world using same plants for same healing Used as a medicine back to as far as the ancient greeks Received the name is because it blooms on Saint John’s birthday, June 24th, and the word “wort” in old English means plant Flowers and leaves is the part of the plant that is used for medical purposes Depression, anxiety, OCD, ADHD, SAD and etc. How it Works

Herbal Medicine

Transcript: Prior experiences with Biomedicine Naturopathy (Prompt: How many clients do you usually see everyday?) "20-30." (Prompt: How long do you spend with each patient?) "5 minutes for minor issues and 15 for larger medical issues. This is all face time. She later spends 20 [minutes] or so documenting what the issue with the patient is." - MD/MPH, Preventative Medicine. HM01WS Herb Companies Lifestyle Acceptable Stress (probably due to low sample size.) Method 1.Freelists "I say [Alternative Medicine] is affordable. But now, eastern medicine is coming to the US trends to become money making system. ... Some people charge patients too much money." - Vietnamese MD/Acupuncturist, 5 years. BW01PL "Most states like Texas, an herbalist or a practicioner require[s] two-year training for herbal medicine." - MD/Acupunturist. 5 years. BW01PL Salves Practicioners Voodoo Health (Not UNO Students) Medicinal Gardening Method2. Sort1, "Use" Ayurvedic Chief Complaint Medical History Drug History Family History Diet Sleep habits Cardiovascular System Nervous System Physical Appearance of hair, skin, nails Tongue Concerns Emotions Energy Exercise Habits Reproductive Health etc Consumers 37 different remedies described unprompted. "I like herbal medicine. I usually take it if it is available. And even if I take western medicine, I will later turn to herbal medicine for its boosting effect." - Herbal Medicine Client, PJ01QS Homeopathy (And we forced all n of them.) Licensing & Training (Prompt: Herbalists reported spending an average of an hour with patients. Is more patient time feasible with western medicine?) "She rolled her eyes at the question and put up quotation marks with her hands when speaking on how herbalists are so "busy" with six patients in a day. ... [T]he only reason herbalists could afford to see that few of patients is because the patients were all paying out of pocket and didn't have to deal with insurance companies." - MD/MPH, Preventative Medicine. HM02WS Alternative Medicine No! Acupuncture in New Orleans? Training (Grungy) (Wealthy) No one could answer this question. Preparations "Initial patient I spend 1 hour and a half and follow up patient is just 1 hour." - MD/Acupuncturist, 5 years. BW01PL Practicioners Chronic (Prompt: How do people find your services?) "Through the Birthing Project and also through Healthy Start. They help low income families who can't afford prenatal care." - Practing Doula, 1 year. CG02GG Allison Ebrahimi Genevieve Gaudet Phuc Le Qian Shi William Schirmer Ted Woods "When patients feel that they weren't listened to they may seek out someone who will listen to them. ... Western doctors may not listen as well as herbalists." - MD/MPH, Preventative Medicine. HM01WS "In September 2007, the Board of Directors of the clinic wanted the herbalist to show credentials...We had to show our resumes, make lists of all the herbs that we used and compile protocols. [points to 3-inch binder of protocols] This was very difficult because we don't do symptomatic medicine...ultimately, its [sic] holistic." - Practicing Herbalist, 11 years. CG01AE Wildcraft "Asian" (Prompt: I indicated that people who use herbal medicine tend to look at it as taking charge of their life and creating a healthy lifestyle.) "She laughed in disapproval and said that you need to look at it among "socio-economic status before commenting on being healthier. ... [I]t is easy for someone to be healthy when they have the money to be healthy, but some use herbal only because it is the cheapest way for them to stay healthy." - MD/MPH, Preventative Medicine. HM02WS "[In Oriental Herbalism,] We have an organzation named NCCAOM that is controlled [sic] both acupuncture and oriental medicine." - MD/Acupuncturist, 5 yeras. BW01PL Traditional Chinese "Walgreens" Personalization 3 consumers interviewed. n=6 Post-Katrina Void Side effects Safety "It's always a challenge working together, though. In modern medicine there is a lot of hierarchy. Herbal medicine doesn't fall into that hierarchy. ... [The informant] likes sharing information with her patients and believes herbal medicine should be as transparent as possible. Patients should feel in charge of their own health." -Practicing Herbalist, 11 years. CG01AE (Hippie) Cost of Healthcare Biomedicine "[T]he issue with herbal medicine is that nothing is proven to help. Herbalists are able to tell patients whatever they want without having any science to back it up." -MD/MPH, Preventative Medicine specialty. HM01WS Grief "Cleansing" I just want to be healthy! "Western medicine approaches symptoms. ... Eastern medicine approaches roots." - MD/Acupuncturist, 5 years. BW01PL Modalities Less popular herbal remedies. New Orleans Used in cooking High Stress Treatment Plans Yoga Herbalists are generous with health, with time, and with the details. ? "Western medicine [is] realizing that 90% of the patient['s] ill health is happening outside of facilities and by understand[ing] the complete person you

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