• Structure attached to sugar
• Polar, soluble in water

• Nitrogenous bases
• Bitter taste
• Insoluble in water, but the salt forms are soluble
• Examples: atropine, cocaine, morphine, quinine, caffeine, nicotine

• Two 6-carbon rings, joined by 3 carbon atoms or related structures
• Lots of --OH groups
• Polyphenols
• Often in flowers, fruits, and berries

• 5-carbon units (Monoterpene = 2 5-carbon units, Sesquiterpenes = 3 5-carbon units)
• Volatile; not soluble in water, but soluble in alcohol
• Examples: Gingko, ginseng, lycopene

• Polyphenolic, complex structures
• Astringent
• Bitter taste, make you pucker
• Very water soluble
• Examples: tea, witch hazel, oak, wines

Indications

Grade A: Constipation (Dried latex from the inner lining)

Grade B: Dandruff, genital herpes, and psoriasis

Side effects

Topical: delayed wound healing, redness, burning

Oral: Diarrhea, lowered blood sugar, colorectal cancer, appendicitis, bowel paralysis, low potassium, hives, rash, irregular heartbeat, stomach cramping, dehydration, muscle weakness, uterine contractions

Contraindications

Irregular heart beat, diabetes, heart disease, kidney disease

Indications

Grade B: High cholesterol

Side effects

Stomach upset, rash, eye irritation, asthmatic interaction, lowered blood sugar, increased HR

Contraindications

Allergy, diabetes, asthma, heart disease

Interactions

Diabetes meds, cholesterol meds, caffeine

Indications

No A or B indications, but found in some Rx products (B & O suppositories)

Blocks acetylcholine

Side effects

Anticholinergic (dry mouth, constipation)

Contraindications

Hx of heart disease, HTN, MI, arrhythmia, CHF, ulcers, GERD, BPH, narrow angle glaucoma, myasthenia gravis, Down syndrome

Indications

Grade B: menopausal symptoms

Dose: TID for 2 weeks, max effect in 8 weeks, don't use more than 6 months

Side effects

GI, rash, weight gain, headache

Contraindications

Breast or uterine cancer (really any kind of cancer), aspirin allergy, history of blood clots, stroke, or seizure

Interactions

Warfarin and aspirin

Indications

Grade B: asthma (inhibits leukotriene biosynthesis)

Side effects

GI (acid reflex), abnormal cholesterol, increased menstrual discharge

Contraindications

Hx of ulcers or GERD

Interactions

Asthma and CA meds, cholesterol meds, NSAIDs, antifungals

Indications

Grade B: inflammation and sinusitis

Contains anti-inflammatory enzyme; derived from pineapples!

Side effects

GI, difficulty breathing, uterine bleeding, increased HR and BP

Interactions

Anticoagulants, BP meds

Indication

Grade B: UTI prevention (inhibits bacterial adhesion)

Side effects

GI, increased blood sugar (cranberry juice), kidney stones

Contraindications

Allergy to cranberries or blueberries; history of diabetes

Interactions

ANTICOAGULANTS!!!, vitamin B12, antacids, PPI, medications excreted in urine

Indications

Shortens duration and severity of cold symptoms (stimulates immune system)

Use at first sign of cold, then continue for 2 weeks (no more than 8 weeks)

Standardized by ecinacoside or cichonic acid

Side effects

GI, rash, chronic decreased wound healing

Contraindications

History of liver disease

Interactions

Medications that affect the liver or immune system

Indications

Grade A: weight loss

Grade B: asthma

Side effects

Increased BP and HR, irritability, seizures, stroke, death

Contraindications

CV disease, seizures, prostate disorders

Interactions

Caffeine, alcohol, BP meds, thyroid meds, MAOI

Indications

No A or B grade--used for aromatherapy or inhalation only!

Side effects

GI, constrict pupils, drowsiness

Contraindications

Hx seizures

Interactions

Medications that cause drowsiness

Indications

Grade B: eczema, skin irritation

High content omega-6 essential fatty acids (GLA)

Side effects

Headache, nausea, vomiting, diarrhea

Contraindications

Seizures!

Interactions

Anesthesia (must DC 2 weeks before surgery), seizure meds, ginger, black cohosh, oleander, phenthiazines

Indications

Grade B: Migraine headache prevention

Side effects

Mouth inflammatiob/swelling of lips, loss of taste, withdrawal symptoms

Interactions

Meds that increase bleeding risk

Indications

Grade B: Constipation

Side effects

Skin rash, congestion/SOB, diarrhea, other GI problems

Contraindications

Esophageal strictures, IBD, and bowel obstruction

Interactions

Meds for cholesterol, constipation, BP, and glucose

Indications

Grade B: High cholesterol

Side effects

Bad breath, BO, sweating, bleeding, asthma, gas

Contraindications

Allergy to tulips, onions, lillies, etc.; bleeding disorder, asthma, thyroid problems

Interactions

Anticoagulants, BP/cholesterol meds, thyroid meds

Indications

Grade B: Chemotherapy-induced nausea and pregnancy-induced nausea

Side effects

Bleeding, rash, bad taste

Contraindications

Bleeding disorder, hx irregular heartbeat, 3rd trimester of pregnancy

Interactions

Anticoagulants, meds to control stomach acid, BP meds

Indications

Grade A: Claudication and Alzheimers/dementia

Grade B: Cerebral insufficiency

Must use minimum 6-8 weeks to see results

Side effects

Bleeding, headache, GI/constipation, dizziness

Contraindications

Bleeding disorders

Interactions

Anticoagulants and herbs that increase bleeding (garlic, ginger, ginseng), anticonvulsants

Indications

Grade B: Type II diabetes and Mental Performance

Side effects

Rose spots, GI, headache, water retention, blood thinning, decreased sugars

Interactions

Anticoagulants, diabetes meds

Indications

Grade A: Knee osteoarthritis

Grade B: Osteoarthritis

Need minimum of 4 weeks to see benefit; NOT PRN!

Side effects

Drowsiness, increased nail growth, sun sensitivity, increased water retention

Contraindications

Diabetes, shellfish allergy, cataracts, PUD

Interactions

Diabetes meds, diuretics

Indications

Grade B: Chronic venous insufficiency/varicose veins

Enhances tensile strength, collagen content, and epithelialization

Side effects

Skin rash (contact dermatitis), nausea, sedation, increased cholesterol, fatigue, increased blood sugar, decreased fertility, cancer, allergic reactions

Contraindications

Pregnant/breastfeeding, high cholesterol, cancer, diabetes

Interactions

CNS depressants, cholesterol meds, diabetes meds, steroids

Indications

Grade A: Congestive Heart Failure

Acts as ACE-I, BB, dilator of coronary arteries, negative and positive inotrope, and antioxidant

Side effects

stomach discomfort, palpitations, sleeplessness, agitation, difficulty breathing, headache, dizziness, fatigue, sweating, mild skin eruptions

Contraindications

Low BP, irregular heartbeat, asthma, insomnia

Interactions

CV meds (BP meds), cholesterol meds, ephedrine-based meds

Indications

Grade A: Chronic venous insufficiency

Standardized to contain 16-20% escin (triterpene glycoside)

Side effects

Anaphylaxis, poor coordination, paralysis, coma, n/v/d, confusion, weakness, lowered blood sugar, bleeding

Contraindications

Diabetes, kidney disorders, clotting/bleeding disorders

Interactions

NSAIDs, diabetes meds, phenytoin, theophylline

Indications

Grade B: Increased urination (diuresis)

Do not use in children

Side effects

Confusion, difficulty speaking, bulging eyes, memory problems, nicotine overdose symptoms, cold hands and feet, abnormal heart rate, weight loss

Contraindications

Allergy to nicotine, smoker, or NRT;  hx alcoholsim, malnutrition, kidney disorders, abnormal heart rhythm

Interactions

Nicotine, vitamin B1 (thiamine), stimulants, diuretics, steroids, digoxin, stimulant laxatives

Indications

Grade A: anxiety

Also has COX-1 and COX-2 activity

Side effects

Live damage/failure, pulmonary HTN, kidney damage, sedation, GI, abnormal muscle movement, apathy, tachycardia, SOB, bleeding

Contraindications

Liver disease, Parkinson's, heart disease, lung diseaes, pregnant/breastfeeding

Interactions

Meds that affect liver (amiodarone, methotrexate, antifungals), MAO-Is, meds with increased bleeding risk

Indications

Grade B: anxiety (aromatherapy)

Side effects

GI, dermatitis, photosensitivity, fatigue, bleeding, anemia

Contraindications

Hx seizures, bleeding disorder, eating disorder, pregnant/breastfeeding

Interactions

Narcotics, benzodiazepines, anticoagulants, cholesterol meds

Indications

Grade B: Cirrhosis

Side effects

GI, HA, itching, loss of appetite, heartburn, joint pain, impotence, decreased blood glucose, anaphylaxis

Contraindications

Diabetes, pregnant, breastfeeding

Interactions

Meds that use P-450 enzyme system

Indications

Grade A: High cholesterol and pellagra

Grade B: Atherosclerosis and prevention of heart attack recurrence

Side effects

Skin flushing (prevent with baby aspirin), rash, change in insulin levels, myopathy

Contraindications

Liver disease/dysfunction, abnormal heart rhythm, heart disease, blood clotting/bleeding disorders, asthma, anxiety, thyroid disorders, stomach ulcer, gout diabetes, pregnant/breastfeeding

Interactions

Diazepam, thyroid meds, cholesterol meds, nicotine, diabetes meds, meds that increase bleeding risk

Indications

Grade A: High blood pressure, high triglycerides, secondary cardiovascular disease prevention

Grade B: protection from cyclosporine toxicity in organ transplant patients

Dose standarized to EPA and DHA

Side effects

GI, acid reflux, fishy taste, changes in vitamin E, vitamin D, or vitamin A, increased LDL, mania (in bipolar pts), restlessness

Contraindications

Diabetics, increased bleeding risk pts, high LDL

Interactions

Meds that increase bleeding risk!!!, BP meds, cholesterol meds

Indications

Grade A: Mild to moderate depressive disorder

Standardized to 0.3% hypericin extract

Side effects

Sun sensitivity, GI, fatigue, sedation, restlessness, anxiety, sexual dysfunction, dizziness, HA, dry mouth, weight loss

Contraindications

Hx thyroid disorder; pregnant/breastfeeding

Interactions

P450 enzyme system, OC, HIV meds, tyramine foods (serotonin syndrome)

Indications

Grade A: Enlarged prostate (BPH)

Side effects

Bleeding, stomach pain, bad breath, constipation/diarrhea, ulcers, jaundice, breast tenderness/enlargement, sexual side effects

Contraindications

Anticoagulants, BPH meds

Interactions

Anticoagulants, hormone therapy

Indications

Grade B: High cholesterol

Side effects

Anaphylaxis, hair loss, weight gain, inflammation of leg joints

Contraindications

Nut allergy; hx chronic inflammatory disorders, asthma, hair loss, diabetes

Interactions

Diabetes meds, cholesterol meds

Indications

Grade B: insomnia

Side effects

HA, GI, drowsiness, hypothermia, insomnia, withdrawal if abruptly d/c'd

Contraindications

Driving/heavy machinery; liver disease, pregnant/breastfeeding

Interactions

CNS depressants, alcohol, beta blockers

Indications

Grade B: Genital warts

Also a source of caffeine

Side effects

Caffeine-related

Contraindications

>500 mg caffeine/day (16 cups of green tea)

Interactions

Stimulant meds

Indications

Grade A: Hyperlipidemia

Same structure as lovastatin and mevinolin

Should be taken with food

Side effects

Mild headache and GI

Interactions

Alcohol (inc. risk hepatotoxicity); abx and ranitidine (inc. risk muscle breakdown); digoxin, thyroid meds