Page 1147 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 64 Dietary Supplements & Herbal Medications 1133

TABLE 64–1 Various supplements and some associated risks.

Commercial Name,
Scientific Name,
Plant Parts Intended Use Toxic Agents, Effects Comments
Aconite Analgesic Alkaloid, cardiac and central nervous system Avoid
effects
Aconitum species
Aristolochic acid Traditional Chinese medicine; Carcinogen, nephrotoxicity Avoid
various uses
Aristolochia species
Black cohosh Menopausal symptoms Hepatotoxicity Avoid 1
Cimicifuga racemosa
Borage Anti-inflammatory; diuretic Pyrrolizidine alkaloids, hepatotoxicity Avoid
Borago officinalis
Tops, leaves
Chaparral Anti-infective; antioxidant; Hepatotoxicity Avoid
anticancer
Larrea tridentata
Twigs, leaves
Coltsfoot Upper respiratory tract Pyrrolizidine alkaloids, hepatotoxicity Avoid ingestion of any parts of
infections plant; leaves may be used topi-
Tussilago farfara cally for anti-inflammatory effects
Leaves, flower for up to 4–6 weeks
Comfrey Internal digestive aid; topical Pyrrolizidine alkaloids, hepatotoxicity Avoid ingestion; topical use
for wound healing should be limited to 4–6 weeks
Symphytum species
Leaves and roots
Ephedra, Ma-huang Diet aid; stimulant; Central nervous system toxicity, cardiac Avoid in patients at risk for stroke,
bronchodilator toxicity myocardial infarction, arrhythmia,
Ephedra species hypertension, seizures, general
anxiety disorder
Germander Diet aid Hepatotoxicity Avoid
Teucrium chamaedrys
Leaves, tops
Gland-derived extracts Hormone replacement Risk of bacterial, viral, or prion transmission; Avoid
(thymus, adrenal, thyroid) variable hormone content
Human placenta derivatives Antirheumatic; Risk of bacterial, viral, or prion transmission Avoid
anti-inflammatory
Jin Bu Huan Analgesic; sedative Hepatotoxicity Avoid
Kava-kava Anxiety Hepatotoxicity Avoid
Pennyroyal Digestive aid; induction of Pulegone and pulegone metabolite, liver Avoid
menstrual flow; abortifacient failure, renal failure
Extract of Mentha pulegium
or Hedeoma pulegioides
Poke root Antirheumatic Hemorrhagic gastritis Avoid
Phytolacca americana
Royal jelly of Apis mellifera Tonic Bronchospasm, anaphylaxis Avoid in patients with chronic
(honeybee) allergies or respiratory diseases;
asthma, chronic obstructive
pulmonary disease, emphysema,
atopy
Sassafras Blood thinner Safrole oil, hepatocarcinogen in animals Avoid
Sassafras albidum root, bark
1 Cases of hepatotoxicity have occurred; these cases are rare given the widespread use of black cohosh.