Fundamentals of Pharmacology for Veterinary Technicians Chapter 23 Herbal Therapeutics © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Basic Terminology • Alternative medicine refers to treatments or therapies that are outside accepted conventional medicine • Complementary medicine refers to the use of alternative therapies with or in addition to conventional treatment © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Types of Alternative and Complementary Medicine • Veterinary acupuncture and acutherapy – Examination and stimulation of body points by use of acupuncture needles, injections, and other techniques for the diagnosis and treatment of conditions • Veterinary chiropractic – Examination, diagnosis, and treatment of animals through manipulation and adjustments • Veterinary physical therapy – Use of noninvasive techniques for rehabilitation • Veterinary homeopathy – Treatment by administration of substances that are capable of producing clinical signs in healthy animals © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Types of Alternative and Complementary Medicine • Veterinary botanical medicine – Uses plants and plant derivatives as therapeutic agents • Nutraceutical medicine – Uses micronutrients, macronutrients, and other nutritional supplements as therapeutic agents • Holistic veterinary medicine – Comprehensive approach to health care using both alternative and conventional diagnostic techniques and therapeutic approaches © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Western vs. Chinese Herbal Medicine • Western herbal medicine – Holds that individuals have an inner force that works to maintain physical, emotional, and mental health – Teaches that many diseases occur because an individual’s inner force or natural immune system is out of balance • Chinese traditional herbal medicine – Based on a holistic philosophy of life that emphasizes the relationship among the mental, emotional, and physical components of each individual; also stresses the importance of harmony among individuals, their social groups, and the greater population – Attempts to restore health through correction of imbalances within a patient’s body or between the patient and natural order © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Herbal Supplements • Herbal supplements are one of the fastest growing segments of the dietary supplement market in the United States – One reason may be the desire for a more holistic approach to health care – Another reason may be that people believe conventional treatments have real or perceived limitations – Another reason may be that people believe natural products do not have side effects – Herbs have been used for a long time – Advertising methods have influenced people’s buying behavior © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Quality Control • Herbal supplements do not require FDA approval because they are considered food supplements • Herbal supplements may have active ingredients that vary among dose forms • The FDA is working with several trade organizations to develop guidelines for herbal supplements • Table 23-1 covers other factors affecting herb quality • See Table 23-2 for information on herbal forms © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Ginkgo Ginkgo biloba • Active ingredients are ginkgo flavone glycosides and terpene lactones • Used to reduce aging effects of the nervous system, to reduce hypertension, and as a general tonic in animals • May inhibit cytochrome P450 and induce hypoglycemia © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. St. John’s Wort Hypericum perforatum • Active component, hyperforin, regulates the effects of serotonin • Used to treat behavior disorders such as lick granulomas, aggression, separation anxiety, and obsessive-compulsive disorders • May inhibit cytochrome P450, affect blood pressure, and cause photosensitivity © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Ginseng Panax ginseng • Active component, ginsenosides, are responsible for increasing energy, countering stress, and enhancing physical performance • Also seems to stimulate natural killer cell activity • Used to treat weight loss, anorexia, and systemic infections • May affect blood glucose levels, increase blood pressure and heart rate, increase GI motility, and induce seizures at high levels © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Garlic Allium sativum • • • • Active component, allicin, causes reduction of cholesterol, triglyceride levels, and hypertension Believed to have anticarcinogenic properties Used to treat parasitic infections, fungal infections, and respiratory problems, and to acidify urine (some with limited success) May cause inhibition of platelet aggregation, prolonged bleeding times, GI upset, and Heinz body anemia © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Echinacea Echinacea purpurea • Active components, fructofuranosides, contribute to tissue regeneration, regulation of the inflammatory response, and a mild cortisone-like effect • Stimulates phagocytosis and natural killer cell activity • Used to shorten the severity and duration of infections • Side effects are minimal © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Saw palmetto Serenoa repens • Fatty acids from the berries produce an enzyme to prevent the conversion of testosterone to dihydrotestosterone • Used to treat benign prostatic hyperplasia, to stimulate appetite, and as a mild diuretic • Side effects are minimal other than gastrointestinal problems © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Evening primrose Oenothera biennis • Contains gamma-linolenic acid, an acid in the omega-6 family • Used to treat premenstrual syndrome, rheumatoid arthritis, diabetic neuropathy, and eczema in humans • Side effects include loose stools and abdominal cramps • May lower the seizure threshold in some on phenothiazine medication; use caution in animals © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Goldenseal Hydrastis canadensis • Active ingredient, berberine, gives goldenseal its antibacterial and antiparasitic properties • Used to treat bacterial and parasitic infections • Side effects include cardiac problems, and stimulation of the CNS and uterine contractions © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Cranberry Vaccinium macrocarpon • Interferes with the attachment of urinary pathogens to the urinary bladder wall • Used to treat urinary tract infections • Side effects include diarrhea, stomach problems, and the development of kidney stones © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Valerian Valeriana officinalis • Volatile oils in valerian break down the inhibitory substance GABA • Used to treat hyperactivity in dogs, for mild tranquilization, and as a sleep aid • Side effects include hepatotoxicity with long-term use and interaction with other depressant drugs © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Advice Regarding Herbs • The National Animal Supplement Council has developed a “Compliance Plus” program to develop standards for the herbal supplement and product industry – Provides reliable information to clients about possible side effects or interactions • Follow general guidelines listed © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. General Guidelines for Herbs • Ask all clients whether they give herbs or other supplements to their animals • Inform clients that herb-drug interactions exist • Encourage the use of standardized products from respected manufacturers • Use herbal therapies in recommended doses • Avoid herbs with known toxicities • Do not use herbs in pregnant or nursing animals, the very young, or the very old • Accurate diagnosis of the animal’s condition is essential to evaluate all therapeutic options • Document all herb or supplement use in the animal’s medical record © 2004 by Thomson Delmar Learning, a part of the Thomson Corporation.