SAIF ALGHAMDI
‫توكلت على اهلل‬
Herbal Medicine
Black cohosh: Contain high concentration of estrogen
- To treat Panful of menstruation
- To treat Hot flashes caused by menopause
Q- Cranberry:
- To treat Recurrent UTI
Q- Saw palmetto:
- To treat urinary symptoms of Benign Prostatic Hyperplasia BPH
Echinacea: Immunostimulants
- Supportive therapy for Respiratory tract infection
- To treat Common cold and flu
- To treat Ulcer
- In case of hard to treat superficial wounds
Feverfew:
- To treat Migraine headache
Ginkgo biloba:
- Increase cerebral blood flow
- SE: Bleeding in overdose
- Monitor: INR – PT
Milk thistle: Active of ( Silymarin )
- To treat Chronic inflammatory liver disease
- To treat Cirrhosis
Q- St. John's Wort:
- To treat Anxiety and Depressant
- SE: Liver microsomal enzyme inducer
- SE: Decrease the effect of any drug take it with it
Kava Kava:
- To treat Anxiety and Depressant
Hepatotoxic Plant: Kava Kava – Liferoot
Herbal Medicine + Dietary Supplement NEED monitoring INR and PT:
- Ginkgo biloba
- Garlic
- Co-enzyme Q10
Dietary Supplement
-
Its not approved by FDA
BUT its undergo Good Manufacturing Practice (GMP)
Fish oil: Omega 3 – EPA – DHA:
-
Prevent Cardiovascular disease
To treat ADHD
Garlic:
-
To teat High cholesterol and HTN
SE: Bleeding in overdose
Monitor: INR – PT
Chondroitin + Glucosamine:
-
To treat Osteoarthritis
Co-enzyme Q10:
-
Antioxidant
SE: Bleeding in overdose
Monitor: INR – PT
Melatonin:
-
To treat Sleep regulation in people work in different shifts.
Green tea: Contain Vitamin K
-
Antioxidant
You have to decrease concentration of warfarin
Folic acid: Pregnant
-
To Prevent Neural tube defect
Vitamin C-E + Beta carotene:
-
Antioxidant
Protect from free radical
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
Herbal products + Vitamins &Minerals
HERBAL PRODUCTS
DEFINITIONS
COMPLEMENTARY
MEDICINE
ALTERNATIVE
MEDICINE
NATURAL
MEDICINE
refers to health practices (e.g., dietary supplements and acupuncture) that are
used with conventional medicine (e.g., physician visits and prescription
medications).
This term is used when conventional medicine is not used.
general umbrella term that includes herbals
(plant products), vitamins, minerals and many substances that are not
plant-derived but exist in nature, such as glucosamine from shellfish.
** Be careful with folic acid supplement labeling from manufacture bc sometimes they would write the unit in DFE mcg
not which are not exactly the same as the usual micrograms →
E.g. Folic acid 600 mcg DFE = 400 mcg of folic acid daily, which is the approved recommended dose for women in childbearing years and pregnancy
INTERACTIONS WITH PRESCRIPTION DRUGS
“St. John’s Wort plant ” → St.John's wort (SJW) has several important drug interactions to be aware of.
Because this plant
It leads to …
So we should avoid…
…
Induces CYP450
lowers levels of other drugs which
Do not use with many drugs, including
3A4,
leads to treatment failure
oral contraceptives, transplant drugs
2C19,2C9,1A2and pand warfarin.
glycoprotein
(P-gp),
Seratogenic in
High risk of serotonin syndrome esp Avoid concomitant use with SNRI,
nature
if combined with drugs that
SSRI, MAO, linezolid
↑serotonin
Causes
Can lead to sun burns, so always
Avoid concomitant use with
photosensitivity
counsel the patient to put sunscreen
photosensitizing drugs, including
diuretics, retinoids,
quinolones, sulfamethoxazole,
tetracyclines & transplant drugs (e.g.,
tacrolimus
may lower the
Can lead to fitting (seizures)
Caution is required
seizure threshold
when taking multiple drugs that lower
the seizure threshold
(e.g., bupropion, quinolones, tramadol,
penicillin and
carbapenems) or in anyone with a
history of seizures
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
VITAMIN SUPPLEMENTATION
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Most popular deficiencies in vitamins is in:
o Vitamin D & Calcium
o + Folic acid deficiency in child bearing women .
lack of thiamine (vitamin B1) is common in alcoholism.
Thiamine deficiency can cause Wernicke's encephalopathy. Symptoms of
Wernicke's include mental confusion, ataxia, tremor and vision changes.
As the symptoms of Wernicke's fade, Korsakoff syndrome/psychosis tends to
develop which causes permanent neurologic (mental) damage.
Anticonvulsants can contribute to calcium deficiency; supplementation with
calcium and vitamin D is required for most patients
For all prescription medications for low bone density
(osteopenia or osteoporosis) adequate calcium and vitamin D
supplementation should be recommended.
All women of childbearing age should obtain 400 mcg/day of
folic acid.
During pregnancy, folate requirements increase to 600 mcg/day.
Folate should be taken at least one month before pregnancy
and continued for the first 2 - 3 months of pregnancy.
Prescription prenatal vitamins usually contain 1,000 meg, or
1 mg, of folate
patients should not exceed 400 IU of vitamin E daily bc it
could possess cardiovascular risk .
Preterm (< 37weeks) breastfed infants should receive 2 mg/
kg/day of elemental iron supplementation from age 1 – 12
months
Adolescent girls are at risk of anemia once menstruation
begins→ give iron-rich diet or oral iron supplement.
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
‫ – اللهم ارشح يل صدري ويرس يل أمري‬Ph. Noora Mh. Noureldin – MOH preperations
Vitamin: Major Function + Deficiency Effect
• Vitamin A: Retinol ( Vision + Immunity reproductive + Growth )
DF: Blindness – Infections – Stunted growth – Dry skin
• Vitamin B1: Thiamine ( Energy metabolism )
SAIF ALGHAMDI
‫توكلت على اهلل‬
DF: Beriberi – Neurologic problem
• Vitamin B2: Riboflavin ( Energy metabolism )
DF: Inflammation of the mouth and skin
• Vitamin B3: Niacin ( Energy metabolism )
DF: Pellagra
• Vitamin B5: Pantothenic acid ( Protein Fat Carb metabolism )
DF: Extremely rare
• Vitamin B6: Pyridoxine ( Protein Fat metabolism )
DF: Scale dermatitis – Anemia – Convulsion • Vitamin B7: Biotin ( Protein Fat Carb metabolism + Benefit for Skin Hair Nails )
DF: Extremely rare
• Vitamin B9: Folic acid ( Help make DNA for new cell + Activates B12 )
DF: Anemia – Birth defect
• Vitamin B12: Cobalamine ( Make DNA for new cell + Activate Folate + Protect Nerve cell )
DF: Anemia – Irreversible nerve damage - Paralysis
• Vitamin C: Ascorbic acid ( Antioxidant + Synthesis Collagen + Immune function )
DF: Scurvy – Gingivitis – Impaired wound healing
• Vitamin D: Cholecalciferol ( Bone growth + Maintain absorption of Calcium )
DF: Rickets – Osteomalacia
• Vitamin E: Tocopherol ( Antioxidant + Protect cell membrane )
DF: RBC breakage – Nerve damage – Inability to concentrate
Vitamin + Major Function
SAIF ALGHAMDI
‫توكلت على اهلل‬
• Vitamin A: Retinol ( Vision + Immunity reproductive + Growth )
• Vitamin B1: Thiamin ( Energy metabolism )
• Vitamin B2: Riboflavin ( Energy metabolism )
• Vitamin B3: Niacin ( Energy metabolism )
• Vitamin B5: Pantothenic acid ( Protein Fat Carb metabolism )
• Vitamin B6: Pyridoxine ( Protein Fat metabolism )
• Vitamin B7: Biotin ( Protein Fat Carb metabolism + Benefit for Skin Hair Nails )
• Vitamin B9: Folic acid ( Help make DNA for new cell + Activates B12 )
• Vitamin B12: Cobalamine ( Make DNA for new cell + Activate Folate + Protect Nerve cell )
• Vitamin C: Ascorbic acid ( Antioxidant + Synthesis Collagen + Immune function )
• Vitamin D: Cholecalciferol ( Bone growth + Maintain absorption of Calcium )
• Vitamin E: Tocopherol ( Antioxidant + Protect cell membrane )
• Vitamin K: Phylloquinone - Phytonadione ( Helping the blood clot + Bone health )
B-1
Thiamin
B1
Riboflavin
Co-enzyme (FAD)
B-2
B2
B3
Niacinamide & Niacin
B-3
important
Co-enzyme in reaction:
Producing energy from
carbohydrates
proper nerve function
stabilizing the appetite
promoting growth and good
muscle tone
Sources
Fish
Liver
Legumes
Nuts
Whole grain or
enriched breads and
cereals
RDA
Men 14+
1.2 g/day
Women 1418
1.0 g/day
Women 19+
1.1 g/day
energy production
carbohydrate, fat, and protein
metabolism
formation of antibodies and red
blood cells
cell respiration
maintenance of good vision,
skin, nails, and hair
Large amounts in
dairy
eggs
meats
Small amounts in
leafy green vegetables
enriched grains
Men 14-70
1.3 mg/day
Women 1470
1.0 mg/day
71+
Larger doses
energy production
maintenance of skin and tongue
improves circulation
maintenance of nervous system
health of the digestive track
Men 14+
16 mg/day
Women 14+
14 mg/day
Two Types
Niacinamide (Nicotinamide)
does not regulate cholesterol
Niacin (Nicotinic Acid)
highly toxic in large doses
Inosital Hexaniacinate is a
supplement that gives the
cholesterol regulation without
high toxicity
Wafa Shamlan
Warnings
nontoxic even
at high dosages
Deficiency
Beri-Beri (wet &
dry)
Loss of appetite
Weakness &
Feeling tired
Insomnia
Loss of weight
Depression
Heart &
Gastrointestinal
Who a Ri k
Homeless &
Malnourished
Alcoholics
People with
malabsorption
conditions
Itching and
People with
burning eyes
cataracts
Cracks and sores in People with Sickle
mouth and lips
Cell Anemia
Bloodshot eyes
Alcoholics
Dermatitis
Oily skin
Digestive
disturbances
In doses of only 50-100
Pellegra
Most people
mg nicotinic acid can
disease caused by B- get plenty of
cause dilation of blood
3 deficiency
B-3 from their
vessels and potentially
rare in Western
diet because it
painful ingling niacin
societies
is added to
fl h diarrhea
gastrointestinal
white flour.
nausea, vomiting, and
disturbance, loss of
long term liver damage. appetite
Nicotinamide is almost
headache, insomnia,
always safe to take,
mental depression
although a few cases of
fatigue, aches, and
liver damage have been pains
reported in doses of
nervousness,
over 1000 mg/day.
irritability
B-6
Pyridoxine
B6
B12
Cobalamin
B-12
C
Ascorbic acid
C
important
RDA
Warnings
Deficiency
Who a Ri k
Production of red blood cells
conversion of tryptophan to
niacin (B-3)
immunity
nervous system functions
reducing muscle spasms,
cramps, and numbness
maintaining proper balance of
sodium and phosphorous in the
body
Men 14-50
1.3 mg/day
Men 50+
1.7 mg/day
Women 14-18
1.2 mg/day
Women 19-50
1.3 mg/day
Women 50+
1.5 mg/day
High doses of B-6 may be
recommended to treat
PMS, carpal tunnel
syndrome, and sleep
disorders, but continued
use of high doses may
result in permanent nerve
damage.
Pregnant women should
always consult their doctor
before taking this
supplement and all others.
nervousness, insomnia
loss of muscle control,
muscle weakness
arm and leg cramps
water retention
skin lesions
very rare
alcoholics
patients with kidney
failure
women using oral
contraceptives
proper nerve function
production of red blood cells
metabolizing fats and proteins
prevention of anemia
DNA reproduction
energy production?
Men and Women14+
2-3 mcg/day
pernicious anemia
B-12 injections often
taken regularly
HIV
Chronic Fatigue
Syndrome
Protects you body from free
radicals
helps form connective tissue
that hold your bones, muscles,
and tissues together (collagen)
aids in the healing of wounds
aids the body in absorbing iron
from plant sources
helps to keep your gums healthy
helps your body to fight
infections
aids in the prevention of heart
disease
helps prevent some forms of
cancer
Men: 60mg/day
Women: 60mg/day
Pregnant women:
95mg/day
Children: 45mg/day
Anemia ( pernicious)
nerve damage
hypersensitive skin
Rarely inadequate
intake,but due to
malabsorption*,
autoimmune diseases
destroy parietal cells of
stomach
(Scurvy)
fatigue, depression,
and connective tissue
defects (eg, gingivitis,
petechiae, rash,
internal bleeding,
impaired wound
healing).
Toxicity
Diarrhea
gastrointestinal discomfort
rebound Scurvy
Avoid chewable tablets
(may cause damage to
teeth)
Wafa Shamlan
Weight loss
fatigue and joint
pain
scurvy (bruising
easily, bleeding
gums, and tendency
for bones to
fracture)
reduced resistance
to colds and
infections
slow healing of
wounds and
fractured bones
important
A
Retinol
A
E
Tocopherol
E
Vision
Generates pigments for the retina
Maintains surface lining of eyes
Bone growth
Reproduction
Cell division and differentiation
Healthy Skin
Regulate Immune System
Protects cell membranes and other fatsoluble parts of the body (LDL
cholesterol) from oxidation
May reduce the risk of heart disease
May also discourage development of
some types of cancer
Promotes normal growth and
development
Promotes normal red blood cell
formation
Acts as anti-blood clotting agent
Pla ome role in he bod abili o
process glucose
Also been known to aid the process of
wound healing
RDA
Children
2000 3500
I.U.
Men
5000 I.U.
Women
4000 I.U.
Warnings
Hypervitaminosis
A leads to toxic
symptoms:
Dry, itchy skin
Headaches and
fatigue
Hair loss
Liver damage
Blurred vision
Loss of appetite
Skin coloration
Children
0-12 months
3-4 mg
Males18+
10 mg
30 IU
Females18+
8 mg
24 IU
pregnant
12 mg
lactating
11 mg
Wafa Shamlan
Deficiency
Night blindness
Decreased resistance to
infections
Extremely dry skin, hair
or nails
Severe vitamin E
deficiencies are rare
Lack of vitality
Lethargy
Apathy
Inability to concentrate
Muscle weakness
Who a Ri k
Young children
Children with inadequate
health care
Adults in countries with
high incidences of vitamin A
deficiency or measles
Adults or children with
diseases of the pancreas,
liver, intestines, or
inadequate fat
digestion/absorption
People over the age of 55
Smokers
People who abuse alcohol
Anyone with inadequate
caloric or nutritional dietary
intake or increased
nutritional requirements