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 […]

Taxol (Paclitaxel) and Cancer Chemotherapy

Taxol is an antineoplastic agent. This compound, first isolated from the bark of the Western yew tree in 1971, exhibits unique pharmacological actions as an inhibitor of mitosis, differing from the vinca alkaloids and colchicine derivatives in that it promotes rather than inhibits microtubule formation. Following its introduction into clinical trial, the drug was approved for treatment of cisplatin-refractory ovarian cancer in 1992 and has promising activity against cancers of the breast, lung, esophagus, and head and neck. Malignant neoplastic diseases may be treated by various approaches: surgery, radiation therapy, immunotherapy, or chemotherapy, or a combination of these. The extent of a malignant disease (staging) should be ascertained in order to plan an effective therapeutic intervention. Plants have antineoplastic activities. A significant portion of the product derived from plants serve either as protective agents against various pathogens (e.g., insects, fungi, or bacteria) or growth regulatory molecules (e.g., hormonelike substances that stimulate or inhibit cell division and morphogenesis). Chemical Groups Of Natural Products With Anticancer Properties Cancer Chemotherapy Before discussing the specific Read more […]

Ginger (Zingiber Officinale)

Medical Uses Ginger is used for nausea and vomiting, motion sickness, and inflammation. It may help to prevent cancer. Historical Uses Greek bakers imported ginger from the Orient to make gingerbread. Spanish mariners brought ginger to the New World. Growth Ginger is cultivated in tropical climates. Ginger: Part Used • The knotted and branched rhizome (an underground stem) called the root. Major Chemical Compounds • Volatile oils, particularly zingiberene, bisabolene, gingerols, and shogaols • Niacin • Vitamin A Ginger: Clinical Uses Ginger is used for nausea and vomiting, motion sickness, and inflammation. It also has anticancer effects. Ginger has been shown to relieve nausea and vomiting during pregnancy without adverse effects. It is approved by the German Commission E and the World Health Organization (WHO) for “prevention of motion sickness.” WHO also has approved ginger for postoperative nausea, pernicious vomiting in pregnancy, and seasickness, whereas the German Commission E approved ginger only for dyspepsia and does not recommend its use during pregnancy. Mechanism of Action Ginger does not influence the inner ear or the oculomotor system; apparently it exerts its antiemetic effect Read more […]

Chaste Tree Berry (Vitex Agnus-Castus)

Medical Uses Chaste tree berries are used for premenstrual syndrome and for menopausal and menstrual symptoms. Historical Uses Long associated with chastity and virtue, this herb is also known as “monk’s pepper” and chasteberry In folklore, chaste tree berry was used for menstrual problems and to increase milk flow Growth Chaste trees grow in the southern United States. The berries look and smell like peppercorns. Chaste Tree Berry: Part Used • Fruit Major Active Compounds • Flavonoids • Agnuside Chaste Tree Berry: Clinical Uses Chaste tree berry is used for premenstrual syndrome and for menopausal and menstrual symptoms. It is approved by the German Commission E for “menstrual irregularities, PMS, and mastodynia” (breast tenderness). Mechanism of Action Chaste tree berries work to balance progesterone and estrogen and decrease prolactin levels. They have shown significant competitive binding to estrogen receptors alpha and beta and have stimulated a progesterone receptor. Chaste Tree Berry: Dosage Tea: Pour 1 cup of boiling water onto 1 teaspoon (0.5 to 1 g) of ripe berries and let sit for 10 to 15 minutes. The tea may be taken up to three times a day. Standardized vitex extract: 40 drops Read more […]

DOPAMINE RECEPTOR AGONISTS

DOPAMINE RECEPTOR AGONISTS act to stimulate dopamine receptors, and these have a major neurotransmitter role in the CNS. Dopamine is also a precursor in the formation of the catecholamine monoamine neurotransmitter noradrenaline and the hormone adrenaline. The distribution of dopamine in the brain is very non-uniform. There is some in the limbic system, and a large proportion is found in the corpus striatum — a part of the extrapyramidal motor system which is concerned with the coordination of movement. Dopamine-containing nerves are found in three main pathways in the brain. The nigrostriatal pathway contains about 75% Of the dopamine in the brain, and the cell bodies lie in the substantia nigra and the nerves terminate in the corpus striatum. The second important pathway is the mesolimbic pathway, the cell bodies of which lie in the mid-brain and project to parts of the limbic system, particularly the nucleus accumbens. The third, the tubero-infundibular system, consists of short neurons that run from the arcuate nucleus of the hypothalamus to the median eminence and the pituitary gland, the secretions of which they regulate. With respect to disturbances of dopamine neurotransmitter function, the first-mentioned Read more […]

Nausea And Vomiting Of Pregnancy

Nausea And Vomiting Of Pregnancy And Hyperemesis Gravidarum Nausea and vomiting of pregnancy (NVP), generally referred to as “morning sickness,” is a common pregnancy discomfort. Its association with pregnancy was documented on papyrus dating as far back as 2000 bce. The earliest reference is in Soranus’ Gynecology from the 2nd century ce.s9 Some degree of nausea, with or without vomiting, occurs in 50% to 90% of all pregnancies. It generally begins at about five to six weeks of gestation and usually abates by 16 to 18 weeks gestation. As many as 15% to 20% of pregnant women will continue to experience some degree of nausea and vomiting of pregnancy into the third trimester, and approximately 5% will continue to experience it until birth. The socioeconomic impact of nausea and vomiting of pregnancy on time lost from either paid employment or household work is substantial, with one study reporting as many as 8.6 million hours of paid employment and 5.8 million hours of household work lost each year because of nausea and vomiting of pregnancy. Additionally, women experiencing more extreme versions of nausea and vomiting of pregnancy or hyperemesis gravidarum are vulnerable to social isolation, and possibly depression, Read more […]

Herb-Drug Interactions: Shatavari

Asparagus racemosus Willd. (Asparagaceae) Synonym(s) and related species Wild asparagus. Not to be confused with asparagus, which is Asparagus officinalis, the species used as a food. Constituents The root and rhizome of shatavari contain a series of steroidal saponins, the shatavarins and others, based on sarsapogenin, diosgenin and arasapogenin. The polycyclic alkaloid asparagamine A, benzofurans such as racemofuran and racemosol, and the isoflavone 8-methoxy-5,6,4′-trihydroxyisoflavone 7-O-beta-D-glucopyranoside are also present. Use and indications Shatavari is widely used in Ayurvedic medicine for dealing with problems related to women’s fertility, loss of libido, threatened miscarriage and menopausal problems, and to increase the flow of breast milk. It is also reported to be antispasmodic, aphrodisiac, demulcent, diuretic, anti-diar-rhoeal, antirheumatic and antidiabetic. Some of these indications are supported by pharmacological (but little clinical) evidence. Pharmacokinetics No relevant pharmacokinetic data found. Interactions overview Shatavari may have additive effects with conventional antidiabetic drugs, and may alter the absorption of a number of drugs by delaying gastric emptying. Shatavari Read more […]

Herb-Drug Interactions: Senna

Cassia senna L, Cassia angustifolia Vahl. (Fabaceae) Synonym(s) and related species Indian senna. Cassia acutifolia Delile, Senna alexandrina Mill. Senna obtained from Cassia senna is also known as Alexandrian senna or Khartoum senna, and senna obtained from Cassia angustifolia is also known as Tinnevelly senna. Pharmacopoeias Alexandrian Senna Fruit (British Ph 2009); Senna Fluid Extract (US Ph 32); Senna Leaf (British Ph 2009, European Ph 2008, US Ph 32); Senna Liquid Extract (British Ph 2009); Senna Oral Solution (US Ph 32); Senna Pods (US Ph 32); Senna Pods, Alexandrian (European Ph 2008); Senna Pods, Tinnevelly (European Ph 2008); Senna Tablets (British Ph 2009); Sennosides (US Ph 32); Standardised Senna Granules (British Ph 2009); Standardised Senna Leaf Dry Extract (British Ph 2009, European Ph 2008); Tinnevelly Senna Fruit (British Pharmacopoeia 2009). Constituents Anthraquinone glycosides are major components of senna. In the leaf the anthraquinones include sennosides A, B, C and D, and palmidin A, rhein anthrone and aloe-emodin glycosides. The fruit contains sennosides A and B and a closely related glycoside, sennoside Al. Senna is usually standardised to the content of sennosides, generally Read more […]

Ginger: Uses

Clinical Use Although ginger is used in many forms, including fresh ginger used in cooking or chai (Indian spicy tea), pickled or glazed ginger, ethanol extracts and concentrated powdered extracts, preparations made with the root are used medicinally. Depending on the specific solvent used, the resultant preparation will contain different concentrations of the active constituents and may differ markedly from crude ginger. Although the great majority of research refers specifically to the species Zingiber officinale, there is the potential for confusion with other species or even with other genera. Furthermore, there are reported to be wide variations in the quality of commercial ginger supplements with concentrations of gingerols ranging from 0.0 to 9.43 mg/g. As such, the results of specific research can not necessarily be extrapolated to different preparations. PREVENTION OF NAUSEA AND VOMITING Many clinical studies have investigated the effects of ginger in the prevention and treatment of nausea and vomiting associated with different circumstances, including pregnancy, the postoperative period, motion sickness and chemotherapy. A recent systematic review of 24 RCTs covering 1073 patients suggest that results Read more […]

ANTIEMETICS

ANTIEMETICS are used to prevent vomiting. They are thus related to antinauseant drugs which are used to reduce or prevent the feeling of nausea that very often precedes the physical process of vomiting (emesis). Commonly, the terms are used synonymously, though it is usually an antinauseant action that is being sought. The type of antinauseant drugs used, and the likelihood of success, depends on the mechanism and origin of the nauseous sensation, and there are a number of ways it can be triggered. Motion sickness (travel sickness) can often be prevented by taking antinauseant drugs before travelling, e.g. the antihistamines meclozine and dimenhydrinate, and the anticholinergic hyoscine. Probably all these drugs act as central MUSCARINIC CHOLINOCEPTOR ANTAGONISTS. Similar drugs may be used to treat nausea and some other symptoms of labyrinthine disease (where the vestibular balance mechanisms of the inner ear are disturbed, e.g. in Meniere’s disease), though other antinauseant drugs may also be necessary, e.g. cinnarizine or phenothiazine derivatives such as chlorpromazine and prochlorperazine. Steroids, such as dexamethasone and methylprednisolone, are effective antiemetics that work by an undefined mechanism. In view Read more […]