Malva sp. (Mallow)

Distribution and Importance of the Plant Although about 1000 species are designated with the common name of mallow, approximately 30 species belonging to the genus Malva (of the Malvaceae family) are known for their medicinal value, mostly in a traditional sense. The common (blue or high) mallow (Malva sylvestris L.) is a biennial to short-lived perennial with prostrate to semi-erect stems (10-80 cm long) and long-stalked rounded leaves with a heart-shaped base and five to seven broad shallow-toothed lobes. The leaves of M. sylvestris var. incanescens Gris are hairy. The flowers (appearing from May to September) are pale lilac to bright mauve-purple and the seeds are flat button-like nutlets. The plant is found naturally in marginal or waste lands, hedgerows and roadsides and is approximately 1 m high, with stalked, roundish, five- to seven-lobed leaves. Plant parts abound with a mild mucilage. Malva aegyptia (Egyptian mallow) is an annual species, endemic in the Mediterranean countries, 20-50 cm high with purple-blue flowers. Malva cretica (Crecian mallow) is another Mediterranean species, which is an annual, 10-30 cm high with rose-coloured leaves. Malva ambigua Guss (M. sylvestris var. ambigua) is a Read more […]

Specific Medicinal Uses of Cannabis: Use as an Antiemetic

Many agents used in cancer chemotherapy produce severe nausea and vomiting in most patients. Symptoms can last for hours or days and have a major impact on patient nutrition and electrolyte status, body weight and physical and mental resilience to both the disease and its treatment. The current choice of available anti-emetics is limited and most are only partially effective, which may lead patients to refuse therapy all together, or for clinicians to use chemotherapeutic regimens which are less than optimum. For these reasons, the search for more effective antiemetics continues. Cannabis In the late 1960s and early 1970s, patients receiving various cancer chemotherapy regimes (including mustine, vincristine, prednisone and procarbazine) noted that smoking cannabis from illicit sources, before and during chemotherapy, reduced the incidence of nausea and vomiting to a variable degree. Only since the isolation of THC have formal clinical trials on the safety and efficacy of cannabis derivatives been conducted. As far as crude cannabis is concerned, we have only anecdotal evidence that inhaling its smoke is effective in a variable percentage of patients who vomit, despite supposedly adequate doses of standard antiemetics. There Read more […]

Healing Powers of Aloes: Pharmacology and Therapeutic Applications

Constipation Aloe latex possesses laxative properties and has been used traditionally to treat constipation. The old practice of using aloe as a laxative drug is based on its content of anthraquinones like barbaloin, which is metabolised to the laxative aloe-emodin, isobarbaloin and chrysophanic acid. The term ‘aloe’ (or ‘aloin’) refers to a crystalline, concentrated form of the dried aloe latex. In addition, aloe latex contains large amounts of a resinous material. Following oral administration the stomach is quickly reached and the time required for passage into the intestine is determined by stomach content and gastric emptying rate. Glycosides are probably chemically stable in the stomach (pH 1–3) and the sugar moiety prevents their absorption into the upper part of the gastrointestinal tract and subsequent detoxification in the liver, which protects them from breakdown in the intestine before they reach their site of action in the colon and rectum. Once they have reached the large intestine the glycosides behave like pro-drugs, liberating the aglycones (aloe-emodin, rhein-emodin, chyrosophanol, etc.) that act as the laxatives. The metabolism takes place in the colon, where bacterial glycosidases are Read more […]

Asteraceae: Drug Interactions, Contraindications, And Precautions

Patient survey data from Canada, the U.S., and Australia show that one in five patients use prescription drugs concurrently with CAM. The inherent polypharmaceutical nature of complementary and alternative medicine increases the risk of adverse events if these complementary and alternative medicine either have pharmacological activity or interfere with drug metabolism. Since confirmed interactions are sporadic and based largely on case reports, advice to avoid certain drug-CAM combinations is based on known pharmacological and in vitro properties. Known Hypersensitivity to Asteraceae Cross-reactive sesquiterpene lactones are present in many, if not all, Asteraceae. Patients with known CAD from one plant may develop similar type IV reactions following contact with others. Affected patients are often advised to avoid contact with all Asteraceae, yet this advice is based on limited knowledge of cross-reactivity between relatively few members of this large family. Some authorities recommend avoiding Asteraceae-derived complementary and alternative medicine if, for example, the patient is known to have IgE-mediated inhalant allergy to ragweed. While a reasonable approach, this ignores a number of important facts: (1) Read more […]

Alkylating Agents

The alkylating agents exert their antineoplastic actions by generating highly reactive carbonium ion intermediates that form a covalent linkage with various nucleophilic components on both proteins and DNA. The 7 position of the purine base guanine is particularly susceptible to alkylation, resulting in miscoding, depurination, or ring cleavage. Bifunctional alkylating agents are able to cross-link either two nucleic acid molecules or one protein and one nucleic acid molecule. Although these agents are very active from a therapeutic perspective, they are also notorious for their tendency to cause carcinogenesis and mutagenesis. Alkylating agents that have a nonspecific effect on the cell-cycle phase are the most cytotoxic to rapidly proliferating tissues. Nitrogen Mustards The activity of nitrogen mustards depends on the presence of a bis-(2-chloroethyl) grouping: CH2—CH2C1 | N | CH2—CH2C1 This is present in mechlorethamine (Mustargen), which is used in patients with Hodgkin’s disease and other lymphomas, usually in combination with other drugs, such as in MOPP therapy (mechlorethamine, Oncovin [vincristine], procarbazine, andprednisone). It may cause bone marrow depression. Chlorambucil Chlorambucil Read more […]

Antimetabolites

Antimetabolites are structural analogues of naturally occurring compounds and function as fraudulent substances for vital biochemical reactions. Folic Acid Analogues Methotrexate (Amethopterin) is a folic acid antagonist that binds to dihydrofolate reductase, thus interfering with the synthesis of the active cofactor tetrahydrofolic acid, which is necessary for the synthesis of thymidylate, purine nucleotides, and the amino acids serine and methionine. Methotrexate is used for the following types of cancer: • Acute lymphoid leukemia: During the initial phase, vincristine and prednisone are used. Methotrexate and mercaptopurine are used for maintenance therapy. In addition, methotrexate is given intrathecally, with or without radiotherapy, to prevent meningeal leukemia. • Diffuse histiocytic lymphoma: Cyclophosphamide, vincristine, methotrexate, and cytarabine (COMA). • Mycosis fungoides: Methotrexate. • Squamous cell, large-cell anaplastic, and adenocarcinoma: Doxorubicin and cyclophosphamide, or methotrexate. • Head and neck squamous cell: Qi-platinum and bleomycin, or methotrexate. • Choriocarcinoma: Methotrexate. Tumor cells acquire resistance to methotrexate as the result of several Read more […]

Taxol and Cancer Chemotherapy: Natural Products

Vinca Alkaloids The vinca alkaloids (vinblastine, vincristine, and vindesine), which bind to tubulin, block mitosis with metaphase arrest. Vinca alkaloids are used for the following types of cancer: • Acute lymphoid leukemia: In the induction phase, vincristine is used with prednisone. • Acute myelomonocytic or monocytic leukemia: Cytarabine, vineristine, and prednisone. • Hodgkin’s disease: Mechlorethamine, Oncovin (vincristine), procarbazine, and prednisone (MOPP). • Nodular lymphoma: Cyclophosphamide, Oncovin (vincristine), and prednisone (CVP). • Diffuse histiocytic lymphoma: Cyclophosphamide, Adriamycin (doxorubicin), vincristine, and prednisone (CHOP); bleomycin, Adriamycin (doxorubicin), cyclophosphamide, Oncovin (vincristine), and prednisone (BACOP); or cyclophosphamide, Oncovin (vincristine), methotrexate, and cytarabine (COMA). • Wilms’ tumor: Dactinomycin and vincristine. • Ewing’s sarcoma: Cyclophosphamide, dactinomycin, or vincristine. • Embryonal rhabdomyosarcoma: Cyclophosphamide, dactinomycin, or vincristine. • Bronchogenic carcinoma: Doxorubicin, cyclophosphamide, and vincristine. The chief toxicity associated with vinblastine use is bone marrow depression. Read more […]

IMMUNOSUPPRESSANT

IMMUNOSUPPRESSANTS are agents that inhibit the body’s reaction to infection or foreign bodies. In this capacity, drugs with this property may be used to prevent tissue rejection following donor grafting or transplant surgery (though there is then the risk of unopposed infection). Also, immunosuppressants are used to treat autoimmune diseases (where the immune system is triggered into acting against systems in the body), including disorders such as rheumatoid arthritis or lupus erythematosus, and also to treat collagen disorders. These agents include cyclosporin, rapamycin and tacrolimus, cytotoxic agents such as azathioprine and cyclophosphamide. and the glucocorticoids. These will be discussed in turn. Cyclosporin is technically an antibiotic, which was discovered serendipitously during a search for antifungal agents and is unique in having a selective action on lymphocytes. It is a cyclic peptide of 11 residues – some previously unknown. It is particularly important as an immunosuppressant in limiting tissue rejection during and following organ transplant surgery. It can also be used to treat severe active rheumatoid arthritis and some skin conditions, such as severe resistant atopic dermatitis and (under supervision) Read more […]

Stress: Ashwagandha

The roots of ashwagandha have long been used as “rasayana” drugs in Ayurvedic medicine to prevent or treat disease through the restoration of a healthy balance of life. Ashwagandha is used in Ayurvedic medicine as a general restorative medicine, and to improve general health, longevity, and prevent disease. Ashwagandha is much less stimulating than ginseng, making it preferable for patients with irritability, anxiety, and insomnia, and as a gentle tonic herb for the nervous system. The species name, somnifera, indicates the plant’s traditional use for sleep induction. Ashwagandha is immunomodu-latory and improves energy in patients experiencing stress-induced illness or exhaustion. It is indicated in inflammatory conditions, such as arthritis or other musculoskeletal disorders, and it is combined with other herbs in the treatment of cancer. Ashwagandha is used in Ayurveda and Unani systems of medicine for the treatment of pain, skin diseases, infection, inflammation, gastrointestinal disorders, rheumatism, and epilepsy. It is also used as a general tonic for the improvement of libido, liver health, mental state, cancer, heart disease, and the immune system. In vivo studies support its use for anti-inflammatory, immunomodulatory, Read more […]

Stress: Rhodiola

Rhodiola rosea, also called golden root, Arctic root, and rose root, grows in arctic and mountain regions throughout Europe, Asia, and America. Its use was first recorded by the Greek physician Dioscorides in 77 ce in De Materia Medica. It has been used for centuries as a traditional medicine in Russia, Scandinavia, and other countries for the treatment of fatigue, depression, anemia, impotence, GI ailments, infections, and nervous system disorders, and to promote physical endurance, longevity, and work productivity. Rhodiola appeared in the scientific literature of Sweden, Norway, France, Germany, the Soviet Union, and Iceland as early as 1725. Because most of the identified literature on this herb is from foreign language sources, I have relied largely upon secondary sources for this review. Rhodiola rosea has been an accepted medicine in Russia since 1969 for the treatment of fatigue, somatic and infectious illness, psychiatric and neurologic conditions, and as a psychostimulant to increase memory, attention span, and productivity in healthy individuals. It is also officially registered in Sweden and Denmark and is widely used in Scandinavia as a general tonic and to increase mental work ability under stress. Rhodiola Read more […]