When people begin their weight loss journey, they are so overwhelmed by their desire to lose weight that they start it enthusiastically. But when they do not see results after a certain time period, their interest weans off. In order to stay focused what they require is a right weight loss supplement that understands their needs. However, the most important hurdle is controlling the ravenous appetite. Amidst a lavish party, if you are asked to control your appetite, it is very difficult to do it. Here where comes the role of weight loss supplements that curb your hunger.

Excess appetite is the culprit that puts barrier in between you and your weight loss regimen. That’s why Hoodithin is the right choice for you as a weight loss supplement. Carrying a natural ingredient Hoodia gordonii, it helps to curb your hunger naturally. The Hoodithin contains pure Hoodia gordonii straight from Kalahari Desert. Because of pre-extracted active ingredients, the supplement is pushed through the system actively and thus works faster and effectively.

Another point why Hoodithin is so popular is that, it does not contain any harmful stimulants like ephedra or even caffeine. So, one can consume Hoodithin even at night to continue the suppression of hunger at night. When you can nullify the biggest enemy in the way of achieving weight loss that is appetite! When you can get lean and healthy muscles along with good supplementary energy for day to day activity, why not try Hoodithin that is soaring in its popularity everywhere? Let’s be devotees of fitness today!

With the advancement in every field, we have gained numerous things that have kept us going in this world. Along with the latest technologies, people take names of vaporizer as one of the best bet. Well, if you want to have healthy herbal atmosphere in your home, vaporizer is the thing you want to possess. After coming home from polluted world outside, you want to have something soothing to inhale and breathe.

This dream of yours is fulfilled effectively by volcano vaporizer. Many people try to find healthier alternatives to smoking. They know that smoking is going to have its hazardous side effects and they have to struggle to quit it. Now with the volcano vaporizer, you can try to quit smoking much easily and at the same time enjoy beneficial herbal therapy as well.

If you put certain herb that you like into the vaporizer chamber, it will be heated at low temperature and emit amazing fragrance to soothe your senses. It will not give rise to unnecessary gases that are harmful to your health. Thus you can enjoy the fragrance and also save yourself of the harm. Isn’t it wonderful!? Get any type of volcano vaporizer you desire through safe online purchase and let your house emit fragrance of your choice always!

Pearls are all time favorite of jewelry lovers. As it is, jewelry comes first in the list when there is some occasion in everyones life. But among all the jewelry, pearls have taken much upper place due to their stunning beauty and affordability as compared to other jewelry. With different types of cultured pearls available freely everywhere, it is no wonder the jewelry market is soaring high.

Also, you get quality designs displayed online, so that you can avail fabulous discounts for online purchase. You also get advice regarding how to maintain your pearls. Well, most people like to preserve their jewelry for lifetime. Even pearls with little care can be cherished throughout your life. After all, if you are purchasing pearl earrings or bracelets for your engagement, you want to remember this jewelry in the memory of your beloved day.

Even many people like to present precious pearls to uplift precious relationships. This allows them to show their love to their spouse or beloved in a better manner. If you feel your relation needs a boost, go for pearls. Lots of varieties are available like Tahitian pearls, freshwater pearls, Akoya pearls, etc. Choose from them the ones you like the most or your spouse likes the most. The elegance, luster and simplicity of these precious pearls make one spellbound. If you want to be among so many people who are purchasing pearls to make their life special, go online today and order your favorite pearl jewelry. You will never be disappointed!

Taxonomic class

Apiaceae

Common Trade Names

Dong Kwai, Dong Quai Capsules, Dong Quai Fluid Extract

Common Forms

Raw root: 4.5 to 30 g (boil or soak in wine)

Tablet (fluidextract): 0.5 g

Also available as capsules, powders, teas and, in some countries, injectable forms.

Source

Active components are obtained from the roots of dong quai (Angelica polymorpha var. sinensis), a fragrant perennial umbelliferous herb that is native to China, Korea, and Japan.

Chemical Components

The volatile oils extracted from the root contain n-butylphthalide, cadinene, carvacrol, dihydrophthalmic anhydride, folinic acid, isosafrole, ligustilide, nicotinic acid, safrole, succinic acid, uracil, and vitamin B12. Coumarin derivatives identified in dong quai include bergapten, imperatorin, osthole, oxypeucedanin, and psoralen. Ferulic acid has also been found.

Actions

Dong quai alters uterine activity in female rabbits. The volatile oil has an inhibitory action on the uterus, whereas the nonvolatile and water-and alcohol-soluble components have stimulatory action.

Studies conducted in rats showed increases in metabolism, oxygen use by the liver, and glutamic acid and cysteine oxidation; these actions may be attributed to vitamin B12 and folinic acid that occur in the herb’s root.

Dong quai extracts, especially alcoholic extracts, were also found to exert quinidine-type effects, prolong the refractory period, and correct atrial fibrillation in animals. Other studies in rats showed that these extracts may prevent atherosclerosis, expand coronary arteries, and increase coronary blood flow. Some coumarins are known to act as vasodilators. Although studies in animals have shown that the volatile oil exerts vasodilatory action to lower blood pressure, the duration of action is short.

Reported Uses

Dong quai is recommended by Western herbalists for many gynecologic disorders, including dysmenorrhea, excessive fetal movement, menstrual irregularities, chronic pelvic infection, and premenstrual syndrome. Most claims are based on data from animal studies or small, uncontrolled human trials, but in a double-blind, placebo-controlled trial of 71 postmenopausal women, dong quai alone was found not to produce estrogen-like responses in endometrial thickness or vaginal maturation and not to be useful in managing postmenopausal symptoms . In traditional Chinese medicine, dong quai is used in combination with other herbs to relieve dysmenorrhea and other disorders. Kotani and colleagues evaluated such an herbal preparation including dong quai in 41 women with dysmenorrhea and found it effective in diminishing symptoms. Because an NSAID was allowed on an as- needed basis, it is difficult to determine the effect of the herbal preparation. Other reported uses include treatment of Buerger’s disease, constipation, headache, hepatitis, hepatocirrhosis, herpes zoster, hypertension, malaria, neuralgia, pyogenic infection, Raynaud’s disease, chronic rhinitis, sepsis, toothache, and ulcerous diseases or abscess. None of these uses has been evaluated clinically.

Dosage

Dosage forms, strengths, and extraction forms vary. In a placebo­controlled study evaluating the estrogenic effects of dong quai on endometrial thickness in postmenopausal women, 500-mg capsules taken P.O. t.i.d. (equivalent to 0.5 mg/kg of ferulic acid), for a total daily dose 4.5 g of root, were used.

Adverse Reactions

GI: diarrhea.

Hematologic: bleeding.

Skin: increased photosensitivity (psoralens in herb may cause severe photodermatitis) .

Other: fever.

Interactions

Anticoagulants, antiplatelets: May enhance effects. Avoid administration with dong quai.

Contraindications And Precautions

Safrole, a component of the volatile oil, is carcinogenic and not recommended for ingestion. Dong quai is contraindicated in pregnant or breast-feeding patients because its chemical components may cause fetal harm. Traditional Chinese texts advise against using dong quai in the presence of an acute infection.

Special Considerations

Monitor the patient for potential bleeding.

Ask why the patient is using dong quai and suggest that he seek a health care provider to address these concerns.

Caution the patient that some of the herb’s components have been shown to increase the risk of some cancers.

Instruct the patient who becomes photosensitive to use sunblock and to wear adequate clothing and sunglasses.

Caution the patient against using dong quai for its yet unproven estrogenic effects.

Advise women to report planned or suspected pregnancy and to avoid using this herb during pregnancy or when breast-feeding.

Commentary

Despite numerous therapeutic claims for dong quai, only a few controlled clinical trials and animal-based studies are available to support its use to treat dysmenorrhea. Most claims regarding dong quai are unsubstantiated and need additional investigation. Dong quai appears to have more than 18 active chemical components, many of which exert widely divergent pharmacologic effects. Some components are carcinogens, and adverse effects of others are unknown. Extensive testing of individual components is needed before dong quai can be regarded as safe or effective.

Taxonomic class

Asteraceae

Common Trade Names

Feverfew, Feverfew Glyc, Feverfew Power, Tanacet

Common Forms

Available as capsules (pure leaf, 380 mg; leaf extract, 250 mg), liquid, and tablets. The leaves are commonly used to make infusions or teas.

Source

Feverfew, a plant from Europe naturalized in the United States and Canada, bears yellow-green leaves and yellow flowers from July to October. The leaves of the plant are usually dried or used fresh in teas and extracts. The most commonly cited botanical name is Chrysanthemum parthenium, synonymous with Tanacetum parthenium. Matricaria parthenium, Leucanthemum parthenium, and Pyrethrum parthenium are also used to refer to the plant.

Chemical Components

The leaves and flowering tops of feverfew contain many monoquiterpenes and sesquiterpenes as well as sesquiterpene lactones (chrysanthemolide, chrysanthemonin, 10-epi-canin, magnoliolide, and parthenolide), reynosin, santamarin, tanaparthins, and other compounds. Parthenolide may be absent or occur in variable amounts, depending on geographic and other variables. Interestingly, melatonin has been found in significant quantities in both the feverfew plant and commercial feverfew products. Fresh green feverfew leaf contains 2.45 mcg/g of melatonin, whereas the freeze-dried leaf contains 1.61 mcg/g of melatonin .

Actions

The main active ingredients are the sesquiterpene lactones, particularly parthenolide, which inhibits serotonin release by human platelets in vitro. This may be the mechanism of action for feverfew’s purported efficacy in treating migraine headaches . Parthenolide also inhibits serotonin release and has demonstrated significant cytostatic activity toward mouse fibrosarcoma (MN-1 1) and human lymphoma . Extracts of feverfew contain several chemicals that inhibit activation of polymorphonuclear leukocytes and the synthesis of prostaglandins and leukotrienes (by way of inhibition of the cyclooxygenase and 5-lipoxygenase pathways). In murine studies, anti-inflammatory and antinociceptive effects have been documented for both feverfew extract and parthenolide.

Reported uses

Although the initial enthusiasm for feverfew has waned, plant preparations are again becoming increasingly popular for use in migraine prophylaxis and as an antipyretic. A detailed and systematic review of all trials of feverfew for migraine prevention published before mid-1998 failed to find sufficient evidence to support the use of feverfew in this regard.

Feverfew is also claimed to be useful for treating asthma, insect bites, menstrual problems, threatened miscarriage, psoriasis, rheumatism, stomachache, and toothache. These uses have not been assessed in human trials.

Dosage

For migraine prophylaxis, 25 mg of freeze-dried leaf extract P.O. daily; 50 mg of leaf P.O. daily with food; or 50 to 200 mg of aerial parts of plant P.O. daily.

For migraine treatment, average dose of 543 mcg P.O. parthenolide daily.

Adverse Reactions

EENT: mouth ulcers (common with teas and whole-herb preparations).

Other: hypersensitivity reactions, post-feverfew syndrome (withdrawal syndrome characterized by moderate to severe pain, joint and muscle stiffness, and anxiety).

Interactions

None reported.

Contraindications And Precautions

Feverfew is contraindicated in pregnant or breast-feeding women.

Special considerations

Monitor for allergic reaction.

Monitor for mouth ulcers. Encourage the patient to exercise proper oral hygiene.

Feverfew potency is often based on the parthenolide content in the preparation, which is variable.

Instruct the patient not to withdraw the herb abruptly but to taper its use gradually because of the risk of post-feverfew syndrome.

Inform the patient that several other strategies for migraine treatment and prophylaxis exist and that they should be attempted before taking products with unknown benefits and risks.

Encourage the patient to promptly report unusual symptoms, such as mouth sores and skin ulcerations.

Commercial feverfew products are likely to contain small amounts of melatonin.

Points of Interest

The concentration of parthenolide in the leaves and flowering tops is highest during the summer, before the seeds are set, and drops rapidly thereafter. This has been offered as an explanation for the difference in parthenolide levels between brands of feverfew capsules and tablets.

The Health Protection Branch of the Canadian government has proposed a standard that formulations contain a minimum of 0.2% parthenolide.

Commentary

Although feverfew has been shown to be effective for migraine prophylaxis in at least two clinical trials, further studies are needed to define better dosage guidelines and specific drug interactions and mechanisms of action. For patients in whom standard drug therapy has failed, feverfew may be an agent that can prevent migraine attacks. Although standardized feverfew preparations with dosages based on free parthenolide content have the best experimental support, no consensus on use exists. The presence of melatonin in feverfew and other botanicals emphasizes the need for complete biochemical characterization of herbal medicinals.

Taxonomic class

Poaceae

Common Trade Names

Aveeno Cleansing Bar, Aveeno Colloidal, Aveeno Dry, Aveeno Lotion, Aveeno Oilated Bath, Aveeno Regular Bath, Oats and Honey, Oat Bran, Oat Straw Tea, Quaker Oat Bran

Common Forms

Tablets: 850 mg, 1,000 mg

Whole grains, cereals, wafers: 750 mg

Also available as bath preparations, gels, lotions, powders, soaps, and teas.

Source

Oat extracts are derived from the grains of Avena sativa. Oats are cultivated mainly in the United States, Russia, Canada, and Germany.

Chemical Components

Oats contain saponins, carotenoids, gluten, polyphenols, monosaccharides, oligo saccharides, various minerals (such as iron, manganese, and zinc), fiber, and cellulose.

Actions

Oat products have emollient properties when applied topically to dry and pruritic skin. Oat bran cereals and oatmeal contain significant quantities of soluble and insoluble fiber. Dietary fiber is believed to lower cholesterol levels by binding bile acids and cholesterol in the intestines, thus preventing their absorption. Although insoluble fiber is less effective, both forms of dietary fiber appear to reduce serum cholesterollevels.

Reported Uses

Oat extracts have long been used as topical treatments for minor skin irritations and pruritus associated with common skin disorders. Oat herb teas are claimed to be valuable as antigout agents and sedatives.

Several trials suggest that regular intake of dietary fiber from oats can lower serum cholesterol levels in patients with elevated or normal serum cholesterol levels. When combined with other fiberrich foods, these reductions are further increased . Four trials have provided additional clinical support for the value of oats or oat-derived products in treating hyperlipidemia. A randomized, controlled, 6-week comparison of rice bran and oat bran demonstrated statistically significant reductions in cholesterol and LDL levels of about 13% and 17%, respectively .

No beneficial effects were noted for triglyceride or HDL levels. Rice bran performed in a manner similar to that of oat bran but to a lesser degree. In a trial of both normal and hypercholesterolemic Mexican Illen an 8-week regimen of oat bran cookies produced a significant reduction in LDL levels of about 26%, as compared with that of a psyllium group (23%) and a control group (8%). Both active treatments were found to lower cholesterol levels in normal and hypercholesterolemic subjects. No effects were noted for HDL levels, but surprisingly, triglyceride levels were reduced about 28% by the oat bran cookies. Trials conducted by Onning and coworkers demonstrate cholesterol-reducing properties of a novel formulation of oat milk. It has been suggested that the beta-glucans present in oat milk are responsible for the beneficial effects on the lipid profile . These trials also failed to document a significant effect of oat products on serum triglyceride or HDL levels.

Epidemiologic evidence supports a relation between oat bran intake and CV risk as measured by body mass index, blood pressure, and HDL levels . Oat extracts and oat bran bread products also appear to lower blood glucose and insulin levels as well as cholesterol levels but the effects on glucose metabolism have not been consistently demonstrated.

Oat derivatives, such as green oat decoction (tea), may be useful in treating chemical addictions and the extract is being evaluated in smoking cessation programs .

Dosages

For lowering cholesterol, studies used 50 to 100 g of dietary fiber from oat bran P.O. daily.

For topical use, apply once or twice daily.

Interactions

None reported.

Adverse Reactions

GI: bloating, increased urgency of defecation flatulence, fullness, perianal irritation.

Skin: contact dermatitis (oat flour).

Contraindications and Precautions

Oats have been considered to be contraindicated in patients with celiac disease, as are wheat, rye, and barley. Some information suggests that this may not necessarily be the case . Certain oat products may be contaminated with wheat and, therefore, would remain contraindicated for patients with this disorder. Use cautiously in patients with bowel obstruction or other bowel dysmotility syndromes or constipation.

Special Considerations

Advise the patient taking oat bran to regulate bowel habits and drink plenty of fluids.

Advise the patient using colloidal oat products for baths to avoid contact with the eyes and acutely inflamed areas. The products should be washed off with water.

Inform the patient that increased bowel movements and flatulence can occur with ingestion of oat products.

Points of Interest

As with other grains, sometimes oats have been contaminated with aflatoxin, a fungal toxin linked with some cancers.

Commentary

Oats provide an important source of soluble dietary fiber and should be consumed (as with other grains and fibers) regularly as part of a healthy diet. Evidence supports the use of oat extracts and oat products as dietary supplement adjuncts to reduce CV risk factors, but long-term studies examining outcomes are needed. Beneficial effects on total cholesterol and LDL levels are small to moderate, and data on positive effects on HDL levels are lacking. Effects on glucose metabolism are inconsistent. Oatmeal baths may be useful for minor skin irritations, but clinical data supporting this therapeutic application are sparse.

Type of Drug:

Anticonvulsants; drugs used to treat epilepsy and seizures.

How the Drug Works:

These agents work in the central nervous system to decrease the frequency of seizures.

Uses:

To control grand mal and psychomotor seizures.

Fosphenytoin, Phenytoin: To prevent and treat seizures during or after neurosurgery.

Mephenytoin: To control focal and Jacksonian seizures.

Unalabeled Uses: Occasionally doctors may use phenytoin to control irregular dystrophic epidermoolysis (arrhythmia), trigeminal neuralgiatic douloureux), recessive dystrophic epidermolysis bullosa and junctional epidermolysis bullosa.

Preccatuions:

Diabetics may experience loss of glucose control. Be prepared to monitor blood sugar more often.

Gum disease occurs frequently with phenytoin. Incidence may be reduced by good oral hygience, including gum massage, frequent brushing and flossing and appropriate dental care.

Pregnancy: Reports suggest an association between use of anticonvulsant drugs by women with epilepsy and an increased number of birth defects in children born to these women. Other factors (eg, genetics or the epileptic condition) may also contribute to the high incidence of birth defects. Most mothers receiving anticonvulsant medication deliver normal infants. Do not discontinue anticonvulsant drugs used to prevent major seizures. This could result in the occurrence of severe seizures and an increased risk to both the mother and the unborn child. In cases where seizures do not pose a serious threat, your doctor may recommend discontinuation of anticonvulsants prior to and during pregnancy. It is not known whether even minor seizures constitute some risk to the developing embryo or fetus. Reports suggest that a mother’s use of anticonvulsant drugs, particularly barbiturates, is associated with a blood clotting defect in the newborn that may cause a bleeding problem within 24 hours of birth. It has been suggested that vitamin K be given to the mother one month prior to and during delivery, and to the infant immediately after birth. An increase in seizure frequency often occurs during pregnancy because of altered phenytoin absoption or metabolism. Periodic lab tests will be required to measure phenytoin levels during pregnancy and doses may need to be adjusted. After birth, the dosage will probably go back to what it was before pregnancy.

Breastfeeding: Hydantoins appear in breast milk. Because of the potential for serious side effects in breastfeed infants, decide whether to discontinue breastfeeding or discontinue the drug. Consult your doctor.

Lab Tests: Lab tests may be required to monitor therapy. Tests may include blood counts, urinalysis, blood sugar levels (especially in diabetics), liver function tests and phonation blood levels.

Drug Interactions:

Toll your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking this medicine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this medicine.

Increased effects of hydantoins may occur when the following drugs are administered with hydantoins:

• Alcohol methylphenidate (eg, Ritalin)
• Cimetidine (eg, Tagamet)
• Disulfiram (eg, Antabuse)
• Fluconazole (Diflucan)
• Isoniazid (eg, Nydrazid)
• Omeprazole (Prilosec)
• Trimethoprim (eg, Proloprim)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; diarrhea; constipation.

Nervous System: Clumsiness; slurred speech; confusion; dizziness; sleeplessness; nervousness; twitchings; tiredness; irritability; sleepiness; depression; numbness; tremors; headache

Respiratory System: Sore throat; sinus inflammation; nasal congestion; asthma; coughing; nosebleed; difficulty breathing; chest pain.

Urinary and Reproductive Tract: Difficult, infrequent, painful or excessive urination; loss of bladder control; vaginal infection; genital swelling; kidney failure.

Skin: Rash; hives; yellowing of skin or eyes; irritation at injection site. Senses: Rapid eye movement; double or impaired vision; light sensitivity; pupil dilation; eye pain or redness; taste changes or loss; distorted sense of smell; tender, bleeding or swollen gums; ear ache; ringing in the ears.

Other: Coarsening of facial features; lip enlargement; hair loss; weight gain; swelling of legs, ankles or hands; joint pain; fever growth in man; swelling of lymph nodes; anemia; high blood sugar levels.

Guidelines for Use:

• Use exactly as prescribed.
• May cause stomach upset. Taking this medicine with or immediately after meals may help prevent stomach discomfort.
• Do not stop taking this medicine suddenly or change the dosage with­out checking with your doctor.
• Brand interchange - Do not change from one brand of this drug to another without consulting your pharmacist or doctor. Products manu­factured by different companies may not be equally effective.
• Phenytoin - Do not take at the same time with antacids that contain calcium.
• May cause drowsiness, dizziness or blurred vision; alcohol may intensify these effects. Use caution while driving or performing hazardous tasks requiring mental alertness, coordination or physical dexterity.
• Do not stop taking this medicine or change the dose without checking with your doctor. Abrupt stopping of hydantoins in epileptic patients may precipitate seizures.
• It is important to brush and floss your teeth and to see your dentist regularly, in order to reduce the risk of gum swelling.
• Diabetics - Monitor blood sugar regularly and report any abnormalities to your doctor.
• Avoid alcohol, antihistamines and other mental depressants (eg, tranquilizers) while taking this medicine.
• Tell your doctor if you are pregnant, become pregnant, are planning to become pregnant or if you are breastfeeding.
• Contact your doctor immediately if rash appears.
• Contact your doctor if any of the following occurs: Drowsiness; slurred speech; clumsiness; rash; severe nausea or vomiting; swollen glands; bleeding, swollen or tender gums; yellowish discoloration of the skin or eyes; joint pain; unexplained fever; sore throat; nosebleed; unusual bleeding or bruising; persistent headache; general body discomfort; bleeding tendencies; pregnancy or any indication of an infection.
• Inform your doctor of any condition in which it is not possible to take this medicine orally (eg, surgery).
• Carry Medic Alert identification indicating that you are have epilepsy and are taking these drugs.
• Lab tests will be required to monitor treatment. Be sure to keep appointments.
• Capsules - Do not use if discolored.
• Dilantin Suspension - Shake well before use.
• Store at room temperature below 86°F in a tight-fitting container. Protect from freezing, moisture and light.

Taxonomic Class

Brassicaceae

Common Trade Names

None known.

Common Forms

Available as juice from the leaves, the whole plant, and tea.

Source

An plant parts of Nasturtium officinale are used for medicinal purposes. A low-growing aquatic that belongs to the mustard family, the plant is native to Europe. It is naturalized in the United States and should not be confused with the garden nasturtium or Indian cress (Tropaeolum majus), a popular annual flower that be

longs to a different plant family.

Chemical Components

Watercress contains gluconasturtiin, the glucosinolate precursor of phenethyl isothiocyanate, benzyl glucosinolate, benzyl isothiocyanate (BITC), vitamins A and C, iron, phosphates, and oils.

Actions

The body converts gluconasturtiin to phenethyl isothiocyanate (PEITC). PEITC is also released when the fresh plant is chewed. The N-acetylcys­teine metabolite of PEITC is detectable in human urine . PEITC and synthetic isothiocyanates acted as inhibitors of the tobacco-specific carcinogen nitrosamine 4-(methylnitrosamino )-1­(3-pyridyl)-1-butanone (NNK) in animal models. PEITC is thought to inhibit the metabolic activation NNK and inhibit lung tumorigenesis . In animals, BITC has demonstrated some ability to inhibit lung tumor formation induced by NNK. Doses of 200 mg/kg in rats did not reduce tumor mass and caused toxic effects .

Other in vitro studies suggest that the chemical components of watercress inhibit histamine release.

Reported Uses

The plant is a popular salad green. It has been used as an anti-inflammatory and antimicrobial, and the juice of the leaves has been used to treat acne, eczema, rashes, and topical infections.

Dosage

A dose of 2 oz of fluidextract (juice) P.O. t.i.d. was used in a human clinical study .

Adverse Reactions

None reported.

Interactions

Acetaminophen: May inhibit acetaminophen’s oxidative metabolism . Avoid administration with watercress.

Contraindications and Precautions

Avoid using watercress in pregnant or breast -feeding patients; effects are not clearly documented in humans.

Special Considerations

• Several cases of fascioliasis of the liver (parasitic fluke infection) have been reported after ingesting wild watercress .
• Advise women to avoid using watercress during pregnancy or when breast-feeding.
• Instruct the patient to carefully wash the fresh herb before use if collecting from the wild to reduce the risk of ingesting waterborne parasites or pathogens.
• Inform the patient using other drugs to use watercress cautiously because interactions with watercress are largely unknown.
• Inform the patient that more safety and efficacy data for watercress are needed.

Points of Interest

• Because it contains vitamin C, watercress was once used to prevent scurvy. The use of watercress in salads has been popular for centuries.

Commentary

Although research has shown watercress compounds to be promising anticancer agents, further research is needed. The role of PEITC as a protective agent in human cancers remains to be established. Watercress has no apparent activity against existing tumors. The fact that few reports of toxicity exist despite the consumption of watercress over a long period indicates that this herb is safe. Recommendations for consumption await additional safety research.

Taxonomic Class

Solanaceae

Common Trade Names

None known.

Common Forms

Available as an extract of the corkwood tree (leaves and stems) in liquid and tablets.

Source

The active ingredients are extracted from the leaves, stems, and root bark of Duboisia myoporoides, which is native to Australia.

Chemical Components

The corkwood tree is a rich source of alkaloids and has been used as a commercial source of scopolamine. The major alkaloids found in young leaves and stems are scopolamine and valtropine; other alkaloids­hyoscyamine, trigloyl tropine, and valeroidine-occur in lesser quantities. Alkaloids extracted from older leaves and stems include acetyl tropine, apohyoscine, butropine, hyoscyamine, isoporoidine, noratropine, poroidine, scopolamine, tropine, valeroidine, and valtropine. The young root and bark of the tree yield apohyoscine, atropine, hyoscyamine, scopolamine, tropine, valeroidine, and valtropine. Similar alkaloids are found in old root and bark samples. Nicotine and nornicotine have also been reported in the leaves .

Actions

Scopolamine and the other alkaloids found in corkwood are antimuscarinics or muscarinic-cholinergic blockers and exhibit a wide range of pharmacologic effects. When taken in therapeutic doses, scopolamine may cause drowsiness and a dreamlike state. Larger doses can result in excitement or restlessness and hallucinations. These antimuscarinics may also affect heart rate, reduce gastric and salivary secretions and GI motility, and cause mydriasis and blurred vision because of cycloplegia.

Reported Uses

The corkwood tree was principally used as a main source of scopolamine and atropine before the availability of other commercial sources.

Scopolamine is commonly used to prevent motion-induced nausea and vomiting, and atropine has limited use in treating GI motility disturbances. It has been reported that corkwood leaves are cured, rolled into a quid, and chewed by native Australians for their stimulant effects and used in hunting to stun animals. Extracts of the leaves have been used medicinally as a substitute for atropine. Quids are chewed to ward off hunger, pain, and tiredness. Alkaloids from the plant are used as a therapeutic substitute for atropine.

Dosage

No consensus exists.

Adverse Reactions

CNS: disorientation, drowsiness, euphoria, excitation (in high doses), fatigue, hallucinations (in high doses).

CV: alterations in heart rate.

EENT: blurred vision, cycloplegia, dry mouth.

GI: constipation.

GU: urine retention.

Skin: dry skin.

Interactions

Amantadine, beta blockers, digoxin, tricyclic antidepressants and other drugs with anticholinergic or anticholinergic-like effects: Increased anticholinergic-like effects. Avoid administration with corkwood.

Contraindications And Precautions

Corkwood and its products are contraindicated in patients who are hypersensitive to antimuscarinics; in those with CY disease, glaucoma, myasthenia gravis, obstructive GI conditions, obstructive uropathy or renal disease, or other conditions that may be exacerbated by antimuscarinics; and in pregnant or breast-feeding patients.

Special Considerations

Adverse reactions from corkwood alkaloids are related to their antimuscarinic action.

Consider exposure to corkwood if the patient manifests pupillary, vision, or behavioral changes.

Advise the patient who is already receiving anticholinergic-like drugs to avoid taking corkwood because of the risk of increased anticholinergic effects.

Caution the patient who may be at risk for disease exacerbation or adverse effects from anticholinergic drugs against using corkwood.

Advise women to avoid using corkwood during pregnancy or when breast -feeding.

Commentary

Although corkwood leaves and stems have been used for medicinal purposes, primarily as an atropine substitute, no clinical studies of the plant have been undertaken. Antimuscarinic toxicity has been reported after occupational or accidental exposure, with absorption through the mucous membranes and upper respiratory tract. Medicinal use of the plant is not recommended.

Type of Drug:

Anticonvulsants; drugs used to treat childhood absence (petit mal) epilepsy.

How the Drug Works:

Succinimides act on the central nervous system to decrease the frequency of seizures.

Uses:

To control absence (petit mal) seizures, particularly when refractory to other drugs.

Precautions:

Do not use in the following situations: Allergy to the drug or any of its ingredients.

Use with caution in the following situations:

Lupus: Cases of systemic lupus eurhythmics have occurred during treatment with succinimides. Symptoms include fever, tiredness, skin lesions, pleurisy, joint pain, headaches, and personality changes.

Pregnancy: Reports suggest an association between use of anticonvulsant drugs by women with epilepsy and an increased number of birth defects in children born to these women. Other factors (eg, genetics, epileptic condition) may also contribute to the higher incidence of birth defects. Most mothers receiving anticonvulsant medication deliver normal infants. Do not discontinue anticonvulsant drugs used to prevent major seizures. This could result in the occurrence of seizures and oxy­gen deficiency in body tissues and an increased risk to both the mother and the unborn child. In cases where seizures do not pose a serious threat, your doctor may recommend discontinuation of anticonvulsants prior to and during pregnancy. It is not known whether even minor seizures constitute some risk to the developing embryo or fetus. Reports suggest that a mother’s use of anticonvulsant drugs, particularly barbiturates, is associated with a blood clotting defect in the newborn that may cause a bleeding problem within 24 hours of birth. It has been suggested that vitamin K be given to the mother one month prior to and during delivery.and the infant immediately after birth.

Breastfeeding: Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 3 years of age have not been established.

Lab Tests: Lab tests may be required during treatment. Tests include blood counts, urinalysis, and liver function.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over the counter or prescription medications or dietary supplements with these drugs. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with these drugs:

• Hydantoins (eg, phenytoin)
• Phenobarbital
• Primidone (eg, Mysoline)
• Valproic acid (eg, Depakene)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; stomach discomfort; appetite loss; diarrhea; constipation; weight loss; cramps.

Nervous System: Drowsiness; dizziness; headache; euphoria; dreamlike feeling; hyperactivity; confusion; sleep disturbances; night terror; hiccup; fatigue; incoordination; depression; irritability; lethargy; sleeplessness; mental slowness; hypochondriacal behavior; aggressiveness; inability to concentrate.

Skin: Rash; unusual bleeding or bruising; hives; increased growth and darkening of fine body hairs; hair loss; itching; skin eruptions.

Other: Joint pain; fever; sore throat; blurred vision; abnormal blood counts; eyes sensitive to light; urinary frequency; blood in urine; muscle weak­ness; swelling of tongue and gums; swelling around eyes; nearsighted­ness; vaginal bleeding.

Guidelines for Use:

• Dosage is individualized. Use exactly as prescribed.
• Do not change the dose or stop taking this medication without consulting your doctor. Abrupt withdrawal may cause seizures.
• If stomach upset occurs, take with food or milk.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• Avoid alcoholic beverages while taking this medicine.
• May cause drowsiness, dizziness, or blurred vision. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Notify your doctor if you experience skin rash, joint pain, unexplained fever, sore throat, unusual bleeding or bruising, drowsiness, dizziness, blurred vision, pregnancy, seizures, depression, aggressiveness, or behavioral changes.
• Succinimides, when used alone in mixed types of epilepsy, may increase the frequency of grand mal seizures.
• Keep scheduled appointments with your doctor and carry Medical Alert identification listing your medical condition and medicine.
• Lab tests may be required during treatment. Be sure to keep appointments.
• Store at room temperature (70° to 86°F). Protect from light, moisture, and excessive heat. Do not use Celontin Kapseals that are not full or in which contents have melted.