Chamomile: Traditional Use and Therapeutic Indications

Traditional Use Chamomile has been known for centuries and is well established in therapy. In traditional folk medicine it is found in the form of chamomile tea, which is drunk internally in cases of painful gastric and intestinal complaints connected with convulsions such as diarrhea and flatulence, but also with inflammatory gastric and intestinal diseases such as gastritis and enteritis. Externally chamomile is applied in the form of hot compresses to badly healing wounds, such as for a hip bath with abscesses, furuncles, hemorrhoids, and female diseases; as a rinse of the mouth with inflammations of the oral cavity and the cavity of the pharynx; as chamomile steam inhalation for the treatment of acne vulgaris and for the inhalation with nasal catarrhs and bronchitis; and as an additive to baby baths. In Roman countries it is quite common to use chamomile tea even in restaurants or bars and finally even in the form of a concentrated espresso. This is also a good way of fighting against an upset stomach due to a sumptuous meal, plenty of alcohol, or nicotine. In this case it is not easy to draw a line and find out where the limit to luxury is. Clinic and practice Preliminary remark The suitability of the empirical Read more […]

GASTRIC SECRETION INHIBITORS

GASTRIC SECRETION INHIBITORS act at some stage in the control process to inhibit the enzymic or gastric acid secretions of the stomach, with the latter being a major therapeutic target. The neuronal, hormonal and paracrine control of gastric acid secretion from the parietal cells of the gastric mucosa is complex. The pathways involved include acetylcholine via the parasympathetic innervation of the stomach, the hormone gastrin. the paracrine agent histamine and possibly the paracrine hormone gastrin-releasing peptide. Anticholinergic agents have not proved very valuable in the long-run, having a limited ability to reduce acid secretion at doses that can be tolerated in view of widespread side-effects. Some more recently developed agents show gastric-selectivity (they are Mrcholinoceptor-preferring ligands, which may be the reason for their selectivity), e.g. pirenzepine and telenzepine: see muscarinic cholinoceptor antagonists. Gastrin receptor antagonists and gastrin-releasing peptide antagonists have now been developed for experimental use, but it is not yet clear if either will be useful clinically. See BOMBESIN RECEPTOR ANTAGONISTS; CHOLECYSTOKININ RECEPTOR ANTAGONISTS. Histamine H2-receptor antagonists Read more […]

Heartburn

Heartburn (Gastroesophageal Reflux) In Pregnancy Heartburn is caused by a reflux of gastric acids into the lower esophagus, usually occurring after meals or when lying down. The gastric acids irritate the esophagus, causing a burning sensation behind the sternum that may extend into the neck and face, and may be accompanied by regurgitation, nausea, and hypersalivation. Inflammation and ulceration of the esophagus may result. Up to two-thirds of women experience heartburn during pregnancy. Only rarely it is an exacerbation of preexisting disease. Symptoms may begin as early as the first trimester and cease soon after birth. Most women first experience reflux symptoms after 5 months of gestation; however, many women report the onset of symptoms only when they become very bothersome, long after the symptoms actually began. The prevalence and severity of heartburn progressively increases during pregnancy. The exact causes(s) of reflux during pregnancy include relaxed lower esophageal tone, secondary to hormonal changes during pregnancy, particularly the influence of progesterone, and mechanical pressure of the growing uterus on the stomach which contributes to reflux of gastric acids into the esophagus. However, some Read more […]

ANTIULCEROGENIC AGENTS

ANTIULCEROGENIC AGENTS (or ulcer-healing drugs) are used to promote healing of ulceration of gastric and duodenal peptic ulcers. A number of classes of drugs may be used. See also gastric secretion inhibitors. First, the HISTAMINE H2-ANTAGONISTS are very effective and have considerable usage, e.g. cimetidine. famotidine, nizatidine and ranitidine. These agents decrease gastric acid secretion and promote healing and may be used to treat dyspepsia and oesophagitis of a number of etiologies. Acid production is also very effectively reduced by the newer agents, the proton pump inhibitors, e.g. omeprazole (see GASTRIC PROTON PUMP INHIBITORS). Anticholinergic drugs are only really suitable in the case of agents that show some gastric-selectivity, e.g. pirenzepine and telenzepine (see muscarinic cholinoceptor ANTAGONISTS). They work by reducing the secretion of peptic acid by the stomach mucosa. Some prostaglandin analogues are effective in protecting the mucosa, and are incorporated into some preparations of NSAIDs to offer concurrent protection (though they may cause unacceptable stimulation of the ileum), e.g. misoprostol. (see prostanoid receptor agonists) . Bismuth-containing antacid preparations have been Read more […]

Herb-Drug Interactions: Milk thistle

Silybum mahanum (L.) Gaertn. (Asteraceae) Synonym(s) and related species Lady’s thistle, Marian thistle, Mediterranean milk thistle, St Mary’s thistle. Carduus marianus, Mariana lactea Hill. Pharmacopoeias Milk Thistle (US Ph 32); Milk Thistle Capsules (US Ph 32); Milk Thistle Fruit (British Ph 2009, European Ph 2008); Milk Thistle Tablets (US Ph 32); Powdered Milk Thistle (US Ph 32); Powdered Milk Thistle Extract (US Ph 32); Refined and Standardised Milk Thistle Dry Extract (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The mature fruit (seed) of milk thistle contains silymarin, which is a mixture of the flavonolignans silibinin (silybin), silicristin (silychristin), silidianin (silydianin), isosilibinin and others. It may be standardised to contain not less than 1.5% (European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4), or not less than 2% (The United States Ph 32) of silymarin, expressed as silibinin (dried drug). Standardised extracts, containing high levels of silymarin, are often used. Milk thistle fruit also contains various other flavonoids, such as quercetin, and various sterols. Note that milk thistle leaves do not contain silymarin, Read more […]

Herb-Drug Interactions: Garlic

Allium sativum L. (Alliaceae) Synonym(s) and related species Ajo, Allium. Pharmacopoeias Garlic (US Ph 32); Garlic Delayed Release Tablets (US Ph 32); Garlic Fluid Extract (US Ph 32); Garlic for Homeopathic Preparations (British Ph 2009, European Ph 2008); Garlic Powder (European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4, British Pharmacopoeia 2009); Powdered Garlic (US Ph 32); Powdered Garlic Extract (The United States Ph 32). Constituents Garlic products are produced from the bulbs (cloves) of garlic and are usually standardised according to the content of the sulphur-containing compounds, alliin, allicin (produced by the action of the enzyme alliinase on alliin) and/or γ-glutamyl-(S)-allyl-L-cysteine. Other sulphur compounds such as allylmethyltrisulfide. allylpropyldisulfide, diallyldisulfide, diallyltrisulfide, ajoene and vinyldithiines, and mercaptan are also present. Garlic also contains various glycosides, monoterpenoids, enzymes, vitamins, minerals and flavonoids based on kaempferol and quercetin. Use and indications Garlic has been used to treat respiratory infections (such as colds, flu, chronic bronchitis, and nasal and throat catarrh) and cardiovascular disorders. It is believed Read more […]