پاورپوینت کامل Chiefs Conference Herbal Supplements 37 اسلاید در PowerPoint

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پاورپوینت کامل Chiefs Conference Herbal Supplements 37 اسلاید در PowerPoint

اسلاید ۴: Aloe VeraUsesConstipation– strong laxative properties: aloin, aloe-emodin and barbaloinGenital Herpes– hydrophyllic cream prepPsoriasis VulgarisSeborrheic DermatitisAphthous stomatitis “canker sores”DM type IILichen PlanusSkin burnsWound healingUlcerative Colitis– ۲۰۰۴ randomized, placebo controlled trial. 44 patients, 100mL BID x 4wks. 30% vs 7% had clinical remission and 37% vs 7% had clinical improvement.

اسلاید ۵: Aloe VeraAdverse EventsDiarrhea, GI upsetHypoglycemia in combination with oral diabetes medscase report of aloe vera induced hepatitis in Des Moines, Iowa VAMC (Annals of Pharm, 2007)In 2002, FDA required that all OTC aloe laxative products be removed from the U.S. market or reformulated because the companies that manufactured them did not provide the necessary safety data

اسلاید ۶: Black Cohosh actaea racemosa or Cimifuga racemosaCommon Names: black snakeroot, bugbane, bugwort, rattleroot, rattletop, rattleweed, and macrotys– Insects avoid itHistory: Native American medicine – malaise, Gyn d/o, kidney d/o, malaria, rheumatism and sore throat. 19th century home remedy, diuretic, and to cause menstruationMember of buttercup family, perennial plant in N. AmericaOral preparation are from the roots and rhizomes (underground stem)– Remifemin most well studied prep

اسلاید ۷: Black Cohosh Use: primarily hot flashes, post-menopausal sxs Estrogenic propertiesEvidence: None consistentKupperman Index– measures of hot flashes, depression and insomnia (not vaginal dryness)German study: 60 women s/p hysterectomy. Compare 8 mg/d of a black cohosh extract version of Remifemin with three estrogen regimens: estriol (1 mg/day), conjugated estrogens (1.25 mg/day), and estrogen-progestin (2 mg estradiol / 1 mg norethisterone acetate) for 6mo. In all groups modified Kupperman index was significantly lower at 4, 8, 12, and 24 wks post Tx. Black cohosh decreased symptoms similarly to the other treatments.NCCAM (Natl Center on Complimentary and Alternative Medicine)–currently funding 12-month, RPCT on whether black cohosh is effective in reducing the frequency /intensity of menopausal sxs , improve QOL

اسلاید ۸: Black Cohosh Not regulated by FDA, compositions vary greatlyCommon adverse effects: headaches, gastric complaints, heaviness in legs, weight gainCase reports of acute hepatitis (one requiring liver transplant 3 wks after starting the herb)U.S. Pharmacopeia (the standards-setting organization for foods and drugs) advises black cohosh products be labeled with : Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice Relative contraindication if liver dz, breast cancer, pregnantNo published studies beyond 6 mos of useIf estrogenic– long term effects on uterine tissue and CV risk

اسلاید ۹: Carnitine Generic term for compounds that include L-carnitine, acetyl-L-carnitine, and propionyl-L-carnitineFound in most cells in body… Main Role: transport long-chain FAs into mitochondria for oxidization.Concentrated in skeletal and cardiac muscle that utilize FAs for energyHealthy children and adults DO NOT need to consume carnitine from food/ supplements, as the liver and kidneys produce sufficient amounts from the AAs lysine and methionine to meet daily needsAnimal products like meat, fish, poultry, and milk are the best sources. Adult diet– ۶۰-۱۸۰mg/dFoodMilligrams (mg)Beef steak, cooked, 4 ounces 56-162Ground beef, cooked, 4 ounces 87-99Milk, whole, 1 cup 8Codfish, cooked, 4 ounces 4-7Chicken breast, cooked, 4 ounces 3-5Ice cream, ½ cup 3Cheese, cheddar, 2 ounces 2Whole-wheat bread, 2 slices 0.2Asparagus, cooked, ½ cup 0.1Kidneys efficiently conserve carnitine, so even carnitine-poor diets have little impact on the bodys total carnitine content

اسلاید ۱۰: Carnitine FDA approved to treat carnitine deficiencies onlyPrimary– genetic d/o manifests w/ cardiomyopathy, Skeletal muscle weakness, hypoglycemiaSecondary– renal dz or drugs (chemotx, antiseizure, pivampicillin) that reduce absorption/increase excretionOther UsesAthletic performance– no evidence it improves exercise/physical performanceAging– decline in mitochondrial function thought to contribute to aging, carnitine decreases with age. Meta-analysis of PCT- DB suggests acetyl-L-carnitine may reduce deterioration in older adults with mild cognitive impairment from Alzheimers disease . Subjects took 1.5-3.0 grams/day of acetyl-L-carnitine for 3-12 months.CV D and PVDDM type II– recent analysis of two multicenter clinical trials of subjects with either type 1 or type 2 diabetes found Tx with acetyl-L-carnitine (3 g/day orally) for one year provided significant relief of nerve pain and improved vibration perception in those with diabetic neuropathy. The treatment was most effective in subjects with type 2 diabetes of short duration. Diabetes Care 2005;28:96-101Male infertilityESRD and HD patients (studies small, not PCT or blinded)

اسلاید ۱۱: Carnitine At doses of 3g/day or more… adverse eventsNausea/vomitingAbdominal crampsDiarrhea“fishy” body odorMuscle weakness in uremic pts Lower seizure threshold

اسلاید ۱۲: Dandelion Taraxacum officinale Common Names— dandelion, lions tooth, blowballDandelion greens are great source of Vitamin AHistorically– used in Native American and traditional Arabic medicine to treat liver, spleen, kidney diseaseLeaves are dried to make teas, capsule, extractsToday, used as diuretic and for minor digestive problemsNo evidence for use to treat any conditionSide Effects: generally safe, rare reports of GI upset, diarrhea

اسلاید ۱۳: Echinacea Echinacea purpurea, Echinacea angustifolia Common Names— echinacea, purple coneflower, coneflower, American coneflowerBelieved to stimulate the immune systemTraditionally used to treat/prevent URI or viral syndromes. Less commonly for boils/acnePlant and roots are dried to make teas, squeezed juice, extracts or preps for topical useNo evidence for use to treat any conditionSide Effects: if taken orally– allergic rxns (rash, anaphylaxis), asthma flare.