P

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PASQUE FLOWER

















Other Common Name: Pulsatilla
Botanical Names: Anemone pulsatilla,Pulsatilla vulgaris#
Family: Ranunculaceae
Plant Part Used: Dried* aerial parts

# Alternative name.


* The fresh plant should not be used because it contains a constituent (protoanemonin) that causes irritant side effects.1



PRESCRIBING INFORMATION


































Actions Spasmolytic, analgesic
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing pasque flower in formulations in the context of:

• Painful or inflammatory conditions of the male or female reproductive tract, including dysmenorrhea, ovarian pain, orchitis, and epididymitis (5)

• Hyperactivity, insomnia, tension headache (5)
Contraindications Pregnancy and lactation.1
Warnings and Precautions The recommended dose range must not be exceeded.
Interactions None known.
Use in Pregnancy and Lactation Contraindicated in pregnancy and lactation.
Side Effects None expected if taken within the recommended dose range. Excessive (undefined) doses can cause violent gastritis. 1
Dosage Dose per day** Dose per week**
  0.4-1.5 ml of 1:2 liquid extract 3-10 ml of 1:2 liquid extract

** This dose range is extrapolated from the British Herbal Pharmacopoeia 1983, the British Herbal Compendium 1992, and the experience.



SUPPORTING INFORMATION

















Traditional Prescribing
Traditional Western herbal medicine uses include:

• Painful or inflammatory conditions of the male or female reproductive system, such as dysmenorrhea, orchitis, ovarian pain, and epididymitis2

• Hyperactivity, insomnia, tension headache, asthma2

• Skin eruptions and boils2
  Eclectic physicians used only fresh plant preparations but at lower doses3 to those that British herbalists advocated, who were mainly advocating dried plant preparations.2
Pharmacologic Research No pharmacologic information relevant to the current use of pasque flower has been found.
Clinical Studies No clinical studies have been conducted using liquid extract of pasque flower.


REFERENCES



1 British Herbal Medicine Association. British herbal compendium. Bournemouth: BHMA, 1992.


2 British Herbal Medicine Association’s Scientific Committee. British herbal pharmacopoeia. Bournemouth: BHMA, 1983.


3 Ellingwood F, Lloyd JU. American materia medica, therapeutics and pharmacognosy, ed 11. Portland: Eclectic Medical Publications, 1983.





PASSION FLOWER

















Other Common Name: Passiflora
Botanical Name: Passiflora incarnata
Family: Passifloraceae
Plant Part Used: Aerial parts


PRESCRIBING INFORMATION


































Actions Anxiolytic, spasmolytic, mild sedative, hypnotic
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing passion flower in formulations in the context of:

• Anxiety (2,4,5)

• Achieving mild sedation in healthy individuals (2)

• Adjuvant therapy for opiate withdrawal (2)

• Insomnia, in combination with valerian (3)

• Restlessness and irritability with difficulty in falling asleep (4,5)

• Cardiac insufficiency (NHYA functional class II) for anxiolytic effects, in combination with hawthorn leaf and flower (2)

• Nervous tachycardia, nervous headache (5)

• Nervous symptoms resulting from menstrual disturbances (5)

• Spasmodic conditions, including dysmenorrhea, asthma, whooping cough, and epilepsy (5)

• Neuralgic pain, including facial, rectal, and cardiac pain (5)
Contraindications None known.
Warnings and Precautions None required.
Interactions None known.
Use in Pregnancy and Lactation No adverse effects expected.
Side Effects None expected if taken within the recommended dose range.
Dosage Dose per day* Dose per week*
  3-6 ml of 1:2 liquid extract 20-40 ml of 1:2 liquid extract

* This dose range is extrapolated from King’s American Dispensatory 1983 and the author’s education and experience.



SUPPORTING INFORMATION























Traditional Prescribing
Traditional Western herbal medicine uses include:

• Restlessness, wakefulness, nervous irritability, especially when resulting from exhaustion or prolonged illness1

• Hysteria, nervous tachycardia1,2

• Insomnia in infants and older adults or resulting from mental worry or overwork1,2
 
• Spasmodic conditions, including tetanus, chorea, and whooping cough1

• Generalized seizures,2 epilepsy1

• Spasmodic asthma,2 oppressed breathing1

• Neuralgic pain,2 including facial, rectal, and cardiac pain1

• Nervous headache1

• Nervous symptoms resulting from menstrual disturbances, spasmodic dysmenorrhea1

• Topically for burns, scalds, hemorrhoids, painful ulcers, and toothache1
  Native Americans used passion flower topically for ringworm, swellings, and sore eyes. Passion flower was official in the NF from 1916 to 1936 and was recommended as an antispasmodic and sedative.3
  Passion flower has also been used traditionally in Brazil for treating insomnia.4
Pharmacologic Research
The main documented constituents of dried aerial parts of Passiflora incarnata are flavonoids (up to 1.2%), especially flavone-C-glycosides, including isovitexin.5 The presence of trace amounts of the harmane alkaloids appears to depend on the stage of development of the plant, and in many samples, they are absent.6 The German Commission E recommends that passion flower not contain more than 0.01% of harmane alkaloids.

• Experimental studies have investigated the sedative and anxiolytic activity of passion flower constituents in an attempt to find the active components. An experimental study conducted in 1976 found sedative activity for maltol after high doses by injection.7 Maltol is an artifact and is present only in passion flower preparations at low concentrations.8 A recent study, which found sedative and anxiolytic activity for an aqueous extract and aqueous alcohol extract, respectively, found no activity for several combinations of constituents (maltol + harmane alkaloids, maltol + flavonoids, or maltol alone) at low or high concentrations.9 (All preparations were administered by injection.) This finding suggests that as yet unidentified compounds are responsible for the activity of passion flower.

• Aqueous and ethanolic extracts of passion flower demonstrated sedative activity after oral and intraperitoneal administration in experimental models.9–14 The sedation index was comparable to meprobamate (250 mg/kg) and higher than that of diazepam (10 mg/kg) and chlordiazepoxide (10 mg/kg).12

• Oral administration of a passion flower extract exhibited anxiolytic activity in vivo,15 and analgesic activity was demonstrated in vivo after oral administration of an aqueous extract of passion flower. 10 After oral administration, passion flower extract demonstrated antiinflammatory activity in three experimental models.16

• Passion flower extract did not interact with benzodiazepine, dopaminergic, or histaminergic receptors in vitro.17

• Inhaling the essential oil of passion flower, or of its volatile constituents (maltol,2-phenylethanol), did not decrease the motility of mice under normal conditions. Motility was decreased after caffeine-induced overagitation.18
Clinical Studies
• A randomized, double-blind, controlled,14-day trial compared clonidine (an alpha-2 adrenergic agonist, maximum dose 0.8 mg/day) plus passion flower extract against clonidine plus placebo in the outpatient detoxification of opiate addicts. Both treatments were equally efficacious in treating the physical symptoms of withdrawal, but the group receiving passion flower showed superiority over clonidine alone in terms of managing mental symptoms. The dosage of the undefined passion flower extract was 60 drops per day. 19

• In a pilot, randomized, double-blind, controlled trial, passion flower extract was as efficacious as oxazepam (a benzodiazepine drug) for managing generalized anxiety disorder. However, passion flower treatment resulted in a lower incidence of impairment of job performance. The daily dose of the undefined passion flower extract was 45 drops.20

• A passion flower and valerian combination improved symptoms of insomnia in uncontrolled trials.21,22 Side effects characteristic of benzodiazepine tranquilizers were not observed.22 In a controlled trial with comparison against chlorpromazine (an antipsychotic drug), EEG recordings showed sedative activity after 6 with the herbal combination.21 The dosage administered in one of these trials was 1.0 to 2.5 dessert-spoonfuls per day of syrup (100 g of which contained 25 g of passion flower extract 1:1 and 12.5 g of valerian extract 1:1).22

• In a randomized, double-blind, placebo-controlled study, a single dose of passion flower extract (equivalent to 7 g of dried herb) demonstrated a sedative effect when compared with baseline values in healthy female volunteers as assessed by a self-rating scale for alertness.23

• In a randomized, double-blind trial, hawthorn (leaf and flower) combined with passion flower reduced heart rate at rest, diastolic blood pressure during exercise, plasma cholesterol and increased exercise capacity compared with placebo in NHYA stage II heart failure patients.24

• In Germany, the Commission E supports using passion flower to treat nervous restlessness.25

• ESCOP recommends passion flower for treating nervous tension, restlessness, and irritability with difficulty in falling asleep. 26


REFERENCES



1 Felter HW, Lloyd JU. King’s American dispensatory, ed 18. Portland: Eclectic Medical Publications, 1905. rev 3, reprinted 1983


2 British Herbal Medicine Association’s Scientific Committee. British herbal pharmacopoeia. Bournemouth: BHMA, 1983.


3 Vogel VJ. American Indian medicine. Norman, Okla: University of Oklahoma Press, 1970.


4 Bernardes A. A pocket book of Brazilian herbs: forklore, history, uses. Rio de Janeiro, Brazil: Shogun Arte, 1983.


5 Wagner H, Bladt S. Plant drug analysis: a thin layer chromatography atlas, ed 2. Berlin: Springer-Verlag, 1996.


6 British Herbal Medicine Association. British herbal compendium. Bournemouth: BHMA, 1992.


7 Aoyagi N, Kimura R, Murata T. Chem Pharm Bull. 1974;22(5):1008-1013.


8 Meier B. Z Phytother. 1995;16(2):115-126.


9 Soulimani R, et al. J Ethnopharmacol. 1997;57(1):11-20.


10 Speroni E, Minghetti A. Planta Med. 1988;54(6):488-491.


11 Sopranzi N, et al. Clin Ter. 1990;132(5):329-333.


12 Galliano G, Foussard-Blanpin O, Bretaudeau J. Phytotherapy. 1994;(40/41):18-22.


13 Capasso A, Pinto A. Acta Ther. 1995;21(2):127-140.


14 Speroni E, et al. Phytother Res. 1996;10(suppl 1):S92-S94.


15 Della Loggia R, Tubaro A, Redaelli C. Riv Neurol. 1981;51(5):297-310.


16 Borrelli F, et al. Phytother Res. 1996;10(suppl 1):S104-S106.


17 Burkard W, et al. Pharm Pharmacol Lett. 1997;7(1):25-26.


18 Buchbauer G, Jirovetz L, Jager W. Arch Pharm. 1992;325(4):247-248.


19 Akhondzadeh S, et al. J Clin Pharm Ther. 2001;26(5):369-373.


20 Akhondzadeh S, et al. J Clin Pharm Ther. 2001;26(5):363-367.


21 Kammerer E, Wegener T. Natura Med. 1995;10(2):1-8.


22 Mollenhauer C. Z Phytother Abstractband. 1995:22.


23 Schulz H, Jobert M, Hubner WD. Phytomed. 1998;5(6):449-458.


24 von Eiff M, et al. Acta Ther. 1994;20:47-66.


25 Blumenthal M, et al, editors. The complete German Commission E monographs: therapeutic guide to herbal medicines. Austin: American Botanical Council, 1998.


26 Scientific Committee of the European Scientific Cooperative on Phytotherapy [ESCOP]. ESCOP monographs: Passiflorae herba. Argyle House, Gandy Street, Exeter, Devon, EX4 3LS, United Kingdom: European Scientific Cooperative on Phytotherapy, ESCOP Secretariat, July 1997.





PAU D’ARCO

















Other Common Name: Lapacho
Botanical Names: Tabebuia avellanedae, Tabebuia impetiginosa,#Tabebuia ipe+
Family: Bignoniaceae
Plant Part Used: Bark

# Alternative name.


+ Medicinally interchangeable species.



PRESCRIBING INFORMATION


































Actions Immune-enhancing, antitumor, antibacterial, antifungal, antiparasitic, depurative
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing pau d’arco in formulations in the context of:

• Adjuvant therapy for cancer (4a,6)

• Adjuvant therapy for protozoal infections (7)

• Topical treatment for skin diseases, fungal infections, skin cancer, varicose ulcers (6)
Contraindications Patients on anticoagulant therapy should not be prescribed pau d’arco because of the potential warfarinlike action of naphthoquinones at high doses.
Warnings and Precautions Although pau d’arco can generate free radicals and interfere with mitochondrial respiration and blood coagulation, no evidence has been found that the long-term use of pau d’arco the dose should not be too high, and patients on anticoagulant therapy should not take pau d’arco likely to be mild, and it should not be trusted as a sole treatment for cancer or infections.
Interactions Prescribing pau d’arco
Use in Pregnancy and Lactation Caution in pregnancy resulting from possible abortive and teratogenic actions.
Side Effects Adverse effects have been recorded during clinical trials using lapachol, but no evidence has been found to suggest that pau d’arco would cause similar effects. No adverse effects are expected when consumed within the recommended dosage.
Dosage Dose per day* Dose per week*
  3-7 ml of 1:2 liquid extract 20-50 ml of 1:2 liquid extract

* This dose range is adapted from dried plant dosages administered by decoction in traditional South American medicine.1 The ence and the fact that ethanol-water is a more effective solvent than water for many phytochemicals are taken into account.

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Dec 4, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on P

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