Specific Medicinal Uses of Cannabis

The historical and contemporary, medicinal uses of cannabis have been reviewed on several occasions. Perhaps the earliest published report to contain at least some objectivity on the subject was that of O’Shaughnessy (1842), an Irish surgeon, working in India, who described the analgesic, anticonvulsant and muscle relaxant properties of the drug. This report triggered the appearance of over 100 publications on the medicinal use of cannabis in American and European medical journals over the next 60 years. One such use was to treat nausea and vomiting; but it was not until the advent of potent cancer chemotherapeutic drugs that the antiemetic properties of cannabis became more widely investigated and then employed. One can argue that the available clinical evidence of efficacy is stronger here than for any other application and that proponents of its use are most likely to be successful in arguing that cannabis should be re-scheduled (to permit its use as a medicine) because it has a “currently accepted medical use”. Specific Medicinal Uses of Cannabis: Use as an Antiemetic Specific Medicinal Uses of Cannabis: Glaucoma Specific Medicinal Uses of Cannabis: Multiple Sclerosis Spastic Conditions A discussion Read more […]

Herb-Drug Interactions: St John’s wort

Hypericum perforatum L. (Clusiaceae) Synonym(s) and related species Hypericum, Millepertuis. Hypericum noeanum Boiss., Hypericum veronense Schrank. Pharmacopoeias St John’s Wort (British Ph 2009, European Ph 2008, US Ph 32); St John’s Wort Dry Extract, Quantified (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The main groups of active constituents of St John’s wort are thought to be the anthraquinones, including hypericin, isohypericin, pseudohypericin, protohypericin, protopseudohypericin and cyclopseudohypericin, and the prenylated phloroglucinols, including hyperforin and adhyperforin. Flavonoids, which include kaempferol, quercetin, luteolin, hyperoside, isoquercitrin, quercitrin and rutin; biflavonoids, which include biapigenin and amentoflavone, and catechins are also present. Other polyphenolic constituents include caffeic and chlorogenic acids, and a volatile oil containing methyl-2-octane. Most St John’s wort products are standardised at least for their hypericin content (British Pharmacopoeia 2009), even though hyperforin is known to be a more relevant therapeutic constituent, and some preparations are now standardised for both (The United Read more […]

Green tea: Interactions. Contraindications. Pregnancy Use. Practice Points

Adverse Reactions Due to the caffeine content of the herb, CNS stimulation and diuresis is possible when consumed in large amounts. One clinical study found an absence of any severe adverse effects when 15 green tea tablets were taken daily (2.25 g green tea extracts, 337.5 mg EGCG and 135 mg caffeine) for 6 months. Significant Interactions Controlled studies are not available for green tea, so interactions are speculative and based on evidence of pharmacological activity. Therefore, clinical significance is unknown. ANTICOAGULANTS Antagonistic interaction — a case of excessive consumption (2.25-4.5 L of green tea/day) was reported to inhibit warfarin activity and decrease the INR. Intake of large quantities of green tea should be done with caution. HYPOGLYCAEMIC AGENTS Caffeine-containing beverages can increase blood sugar levels when used in sufficient quantity (200 mg of caffeine); however, hypoglycaemic activity has been reported for green tea, which could theoretically negate this effect — the outcome of this combination is uncertain, therefore observe patient. IRON Tannins found in herbs such as Camellia sinensis can bind to iron and reduce its absorption — separate doses by at least 2 hours. Read more […]

β-ADRENOCEPTOR AGONISTS

β-ADRENOCEPTOR AGONISTS (also known as β-adrenergic receptor agonists or β-receptor stimulants) are a class of drugs that act through stimulating β-adrenoceptors, and thus induce some actions of the sympathetic nervous system by mimicking the action of adrenaline and noradrenaline — catecholamine mediators acting predominantly as hormone or neurotransmitter, respectively. The actions of α-adrenoceptor and β-adrenoceptor activation together account for nearly all the very widespread actions of the sympathetic division of the autonomic nervous system, both in normal physiology and in stress. Among other actions, β-adrenoceptors have cardiac stimulant actions, they dilate certain blood vessels, suppress motility within the gastrointestinal tract, bladder and uterus, and stimulate certain aspects of metabolism causing an increase in glucose and free fatty acids in the blood. These actions, in concert with α-adrenoceptors help prepare the body for emergency action. These actions are commonly mimicked for clinical purposes, but effects tend to be widespread. However, it is possible to gain some selectivity of drug action, with consequent minimization of side-effects, by using receptor-subtype-selective β-adrenoceptor Read more […]

ANTIASTHMATIC AGENTS

ANTIASTHMATIC AGENTS relieve the symptoms of bronchial asthma or prevent recurrent attacks. The symptoms of asthma include bronchoconstriction (obstructive airways disease), often with over-secretion of fluid within the bronchioles and other breathing difficulties. Two main types of drugs are used: the first to treat acute attacks; and the second as prophylactics to prevent attacks. BRONCHODILATORS, which are SMOOTH MUSCLE RELAXANTS, work by dilating and relaxing the bronchioles. The most commonly used are the β-receptor stimulant drugs (which are SYMPATHOMIMETICS) , notable examples include salbutamol and terbutaline. See also β-ADRENOCEPTOR AGONISTS. The β-adrenoceptor agonists are most commonly given by inhalation, and are mainly used for treating acute attacks (or immediately before exertion in exercise asthma), and are largely of the β2-adrenoceptor agonist type. Other bronchodilator drugs, which work directly on the bronchioles, include theophylline. The second group of antiasthmatics are ANTHNFLAMMATORY or ANTIALLERGIC AGENTS, such as the CORTICOSTEROIDS and sodium cromoglycate. These drugs prevent the release of local inflammatory mediators, which contribute to attacks, so preventing asthma attacks, Read more […]