The Medical Advisor: The Complete Guide to Alternative and ConventionalTreatments [2 ed.] 0737016221, 9780737016222

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TIME

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TheCompleteGuideto Alternative& ConventionalTreatments Thousands of Ailments & Treatment Options More Than 800 Drugs & Natural Medicines Emergencies & First Aid

THE MEDICAL ADVISOR

TheComplete Guideto Alternative & ConventionalTreatments

BY THE

EDITORS OF TIME-LIFE ALEXANDRIA, VIRGINIA

BOOKS

~ CONSULTANTS NEIL BAUM, MD teaches at Tulane Medical School and serves on the staff of Touro Infirmary and Memori al Medical Center in New Orleans. He is a board-c ertifi ed urolo gist wit h expertise in male sexual dysfunction , urin ary incontinence , and male infertility; he has written ext ensively in these areas. Dr. Baum is the author of Impotence - It's Reversible. HERBERT BENSON, MD teaches at Harvard Medical School and is chief of the Division of Behavioral Medicin e at the De aco ness Hospital. He is also founding president of th e Mind / Body Medi ca l Institute , which specializes in the tr eatment of stress-related illnesses. Dr. Benson has helped draw attention to the field of mind / body medicine through his pioneering work on the relaxat ion response. ZOE BRENNER, LAc, Dipl Ac , Dipl Ch (NCCAOM ), FNAAOM has pract iced acupuncture since 197 7 and Chinese herbal medicin e since 1984. She teaches oriental medicine and the history and philosophy of Chinese medicine at th e Traditional Acupun ct ur e In stitute in Bethesda, Maryland. DWIGHT C. BYERS is a leading authority in reflexology. He began teaching with his late aunt , Eunice Ingham , who pioneered and developed the or iginal Ing ham method of reflexology . Byers tr avels throughout the world to teach ref lexology , and he serves as president of the I nt ernationa l Institute of Reflexology in St. Petersburg , Flor ida. BARRIE R. CASSILETH, PhD is chief of the Inte grative Medicine Servi ce at Memorial Sloan-Ketter ing Cancer Center in New York. She was a member of the founding council of th e Office of Alternativ e Medicine at the National Institutes of Health , and she is now a bo ard member of the American Cancer Society. EFFIE CHOW, PhD, RN, CA is president of th e East West Academy of Healing A rts in San Franc isco. A registered nurse , certified acupuncturist, and qigong master, Dr. Chow has practiced and taught qigong for more than 30 years.

JOHN G . COLLINS, ND , DHANP teaches homeopathy at the National Colleg e of Naturopathic M ed icin e in Portland, Oregon. He also has a private practice in Portland, Oregon. STEPHANIE S. COVINGTON, PhD , LCSW is a psychotherapist and codirector of t he Institute for Relational Development in La Jolla, California. She has taught at the California School of Prof essional Psychology and has written exte nsively on the subject of addiction. Two of Dr. Covington 's rece nt p·ublications include A Woman 's Way Through the Twelve Steps and Helpin g Women Recov er: A Program for Treatment Addiction. She formerly c haired the Women 's Committee of the International Council on Alcoholism and Addiction. KYLE H. CRONIN, ND specializes in women's health care in her medical practice in Phoenix. Dr. Cronin is a cofounder and former academic dean and currently dean of Curricular Development at Southwest College of Naturopathic Medicin e and Health Sciences. TIMOTHY B . DEERING , MD is a board-certified internist and gastroenterologist who practices with Ashevi I le Gastroenterology Associates in North Carolina. PALI C. DELEVITT , PhD consults on alternative therapi es at the cancer cent er of the University of Virginia, where she also t eaches in the School of Medicine . Dr . Delevitt has consulted on curriculum developmen t for the medical schools of Columbia University, Emory University, and Indiana University. JAMES A. DUKE, PhD was an eco nomic botanist w ith the Agriculture Research Service, United States Department of Agriculture, in Beltsville , Maryland, for much of his career. Dr. Duk e advises many organization s, in cluding Nature 's Herb s and allherb.com. KATHLEEN FR Y , MD , MD(H) is a board-certified gynecologist specializing in holistic healthcare for women. She is a licensed classical homeopath and current president of the Am er ica n Holisti c Medical Associ atio n. Dr. Fry has a private medical practice at Alternatives for Women in Scottsdale, Arizona.

CONSULTANTS

ADRIANE FUGH-BERMAN, MD is Assistant Clinical Professor in the Department of Health Care Sciences at George Washington School of Medicine. She is editor of the newsletter Alternative Therapies in Women's Health and the author of Alternative Medicine: What Works. Her articles have appeared in numerous medical and consumer publications. She is on the executive board of the National Women's Health Network. Dr . Fugh-Berman was formerly with the National Institutes of Health, at the Contraception and Reproductive Health Branch and at the Office of Alternative Medicine . ALAN R. GABY, MD is past president of the American Holistic Medical Association. He is professor of therapeutic nutrition at Bastyr University in Kenmore, Washington, and the author of The Patient's Book of Natural Healing. DA V ID E. GOLAN, MD, PhD is an attending physician at Brigham and Women's Hospital in Boston and an associate professor of biological chemistry and molecular pharmacology at Harvard Medical School. A board-certified internist and hematologist, Dr. Golan directs research on blood eel I membranes. He has also created a computer-learning program for pharmacology. CONSTANCE GRAUDS, RPh is founder and president of the Association of Natural Medicine Pharmacists. She is assistant clinical pharmacy professor at the University of California, San Francisco. Grauds is the natural medicine editor for Pharmacy Times and the author of Kava and Anxiety. As a trained specialist in the field of natural medicines, she is also a consultant to the pharmaceutical and natural medicine industries. ELLIOT GREENE, MA is a past president of the American Massage Therapy Association and currently serves on the regulatory Massage Therapy Advisory Committee for the State of Maryland. Nationally certified in massage therapy by the National Certification Board for Therapeutic Massage and Bodywork, he has more than 27 years of experience in the field. Mr. Greene maintains a private practice in Silver Spring, Maryland.

KEITH S. HECHTMAN, MD, FAAOS, FAOSSM is a board-certified orthopedic surgeon who is fellowship-trained in sports medicine. He is an associate professor in the Department of Orthopaedics and Sports Medicine at the University of Miami in Florida. Dr. Hechtman trains medical students , residents, and fellows in the specialty of sports medicine. He is the team physician for Florida International University and the University of Miami. He is also Medical Director of Athletics of Miami-Dade County High Schools. VICTOR HERBERT, MD, JD, MACP teaches medicine at the Mount Sinai-New York University Health System, where he also chairs the Committee to Strengthen Nutrition. A former president of the American Society for Clinical Nutrition, Dr. Herbert consults in the field of nutrition for many organizations, including the World Health Organization. DAVID HOFFMANN, MNIMH is a member of the British National Institute of Medical Herbalists and founding president of the American Herbalist Guild. His writings on therapeutic herbalism were a valuable resource during the preparation of this volume. MAURITA HOLLAND, MALS is an associate professor of information and library science at the University of Michigan in Ann Arbor. Some of her students provided research for this book and are listed individually in the acknowledgments section. TORI HUD SON, ND is a professor at the National College of Naturopathic Medicine and is medical director of A Woman's Time clinic for women in Portland, Oregon. Dr. Hudson specializes in women's healthcare; in 1990, she received a national award for her research and in 1999 she was named Naturopathic Physician of the Year. GRACE BROOKE HUFFMAN, MD serves as a primary care physician at two offices in Maryland and teaches at Georgetown University School of Medicine in Washington, D.C. A boardcertified family practitioner, she has additional certification in geriatrics.

CONSULTANTS

STEVEN IDELL, MD, PhD, FACP, FACCP is chief of the pulmonary division and chairman of the Department of Specialty Care Services at the University of Texas Health Center at Tyler. His research in pulmonary diseases is sponsored by the National Institutes of Health.

ROBERT B. KLEIN, MD, FAAP, FAAAI is chairman of pediatrics at the University of Texas Health Center at Tyler. His other specialties include allergy, pulmonology, and immunology. Dr. Klein also consults on childhood tuberculosis and asthma in Croatia for the U.S. State Department.

JENNIFER JACOBS, MD, MPH specializes in homeopathic medicine and has a private practice in family medicine in Edmonds, Washington. She conducts research in the use of homeopathic medicines in primary care at the University of Washington. Dr. Jacobs is the coauthor of Healing with Homeopathy.

ROBERT KOTLER, MD, FACS practices facial plastic surgery in Beverly Hills, California. Dr. Kotler is a former commissioner and regional consultant to the Medical Board of California. He also teaches at UCLA Center for the Health Sciences.

J OSEP H J. JACOBS, MD, MBA began his medical career as a pediatrician with the Indian Health Service in Gallup, New Mexico, and has continued working with American Indians throughout his career. Dr. Jacobs was director of the Office of Alternative Medicine at the National Institutes of Health from 1992 to 1994 and is a former president of the Association of American Indian Physicians. JONATHAN M. KAGAN, MD is clinical assistant professor of ophthalmology at New York Medical College and a fellow of the American Academy of Ophthalmology. Dr. Kagan maintains a private practice in New York City. He conducts clinical trials of new drugs for ophthalmic use, and he is among the first surgeons to perform laser vision correction. STEVEN W. KAI RYS, MD, MPH, FAAP is associate chair of pediatrics at the DartmouthHitchcock Medical Center, where he directs primary care activities and the Children at Risk Program . He is founder and president of the New Hampshire Alliance for Children and Youth in Concord, New Hampshire . J. DANIEL KANOFSKY, MD, MPH te aches psychiatry, epidemiology, and social medicine at the Albert Einstein College of Medicine and at the Bronx Psychiatric Center, both in New York City. A board-certified psychiatrist , Dr. Kanofsky is also a fellow of the American College of Nutrition . TED KAPTCHUK, OMO, CA is a research associate at Beth Israel Hospital. As a doctor of Oriental Medicine, Dr. Kaptchuk practices both Chinese herbal medicine and acupuncture. He is the author of The Web That Has No Weaver.

J OSEPH J. LAMB, MD is a board-certified internist and a senior clinician with American WholeHealth, Inc. in Alexandria, Virginia, where he practices integrative medicine. Dr. Lamb is the school physician at Episcopal High School in Alexandria. He is on the clinical faculty at George Washington School of Medicine. JESSE M. KRAMER, MD is a dermatologist practicing in Santa Rosa, California . He teaches family medicine physicians through the University of California in San Francisco. DAVID B. LARSON, MD , MSPH is a psychiatrist; his particular interest is the influence of religious commitment on physical and mental health. Currently the president of the National Institute for Healthcare Research, Dr. Larson has worked for the National Institutes of Health and the U.S. Department of Health and Human Services. He serves as an adjunct faculty member for several universities , including Duke and Northwestern University Medical Centers. DANA J. LAWRENCE, DC, FICC is dean of Postgraduate and Continuing Education, director of Publications and Editorial Review, and a professor in the Department of Chiropractic Practice at the National College of Chiropractic in Lombard, Illinois. He is editor of the school's Journal of Manipulative and Physiological Therapeutics. KAREN SUE LEVENTHAL, RPh is a registered pharmacist in Maryland, Pennsylvania, and Washington, D.C. She is currently working for Rite Aid Corporation in Washington, D.C, where she is a pharmacy manager. She received her Bachelor of Science in Pharmacy from the University of Pittsburgh School of Pharmacy.

CONSULTANTS

NORMAN S. LE VY, MD , PhD, FAAO, FACS practices ophthalmology in Gainesville, Florida, specializing in glaucoma. He conducts research at the University of Florida. Dr. Levy is a former professor and chief of ophthalmology at the Veterans Administration hospitals in Gainesville and Lake City, Florida.

JOHN R. MOFFETT, PhD is a former research scientist in the Biology Department at Georgetown University in Washington, D.C. His specific areas of research are neurotransmitters in the visual system and toxins released by immune cells.

PHILIP LEVY, MD, FACE practices at the Phoenix Endocrinology Clinic, Ltd., and is a clinical professor of medicine at the University of Arizona in Tucson. He is an active member of the American Diabetes Association, the Endocrine Society, and the American Association of Clinical Endocrinologists.

ANNE MOORE, MD teaches clinical medicine at Weill Medical College of Cornell University and chairs the New York Hospital breast cancer tumor board. Board certified in internal medicine with subspecialties in hematology and oncology, Dr. Moore is also on the staff of the New York Presbyterian Hospital -Cornell Medical Center.

JOHN E. LONSTEIN, MD is a board -certified orthopedic surgeon and past president of the Scoliosis Research Society. Dr. Lonstein teaches at the University of Minnesota and practices with Twin Cities Spine Surgeons, Ltd. He is also chief of Spine Service and Cerebral Palsy Spine Service at Gillette Children's Hospital in Minnesota.

LEN OCHS, PhD is a social psychologist who has spent 20 years developing computerized biofeedback instrumentation. Dr. Ochs is past president of the Biofeedback Society of New York. He is currently researching energy field neurofeedback systems to treat fibromyalgia and traumatic brain surgery.

DAVE MANNINO, MD, FACCP works at the Centers for Disease Control and Prevention at the National Center for Environmental Health in Atlanta. He teaches at the Emory School of Public Health.

STEPHEN OLMSTEAD, MD practices internal medicine and cardiology in Seattle, where he also teaches at the University of Washington .

ROY J. MATHEW, MD teaches at Duke University Medical Center in Durham, North Carolina. He is also director of the Alcoholism and Addictions program, which provides treatment for people with alcoholism and drug addiction and offers consultation services for other medical specialists regarding addictions. Dr. Mathew's research focuses largely on the effects of alcohol and drugs on the brain and behavior. ALEXANDER MAUSKOP, MD, FAAN is director of the New York Headache Center and the not-for-profit New York Headache Foundation . He also teaches clinical neurology at the State University of New York, where he conducts research on the role of magnesium in headaches. JEFFREY MIGDOW, MD directs prana yoga-teacher training through the Open Center in New York City. He began his yoga training more than 20 years ago at Kripalu Center in Lenox, Massachusetts. In his medical practice, Dr . Migdow counsels patients on lifestyle and recommends a wide variety of homeopathic, nutritional, and other therapies. He is the coauthor of Breathe In, Breathe Out.

ELSA RAMSDEN, EdD, PT is a licensed physical therapist and certified medical psychologist. She is emerita professor at the University of Pennsylvania and an adjunct professor at Widener University. She has taught overseas at the University of Queensland in Brisbane, Australia, and the University of Uppsala, Sweden, and she was a Fulbright senior scholar to Australia. JOHN C. REED, MD, MD(H) is a board-certified family physician who is the National Medical Director for American WholeHealth, Inc. and WholeHealthMD.com. Dr. Reed has integrated acupuncture, homeopathy, and osteopathic medicine into his medical practice. He has consulted for the Office of Alternative Medicine at the National Institutes of Health and was coeditor of that office's report, Alternative Medicine: Expanding Medical Horizons. He currently consults with American WholeHealth's integrative medicine practices in the Washington, D .C., metropolitan area.

CONSULTANTS

NORMAN E. ROSENTHAL, MD is clinical professor of psychiatry at Georgetown University Medical School and a guest researcher at the National Institutes of Health. Dr. Rosenthal is a former president of the Society for Light Therapy and Biological Rhythms. BEVERLY RUBIK, PhD is founding director of the Center for Frontier Sciences at Temple University in Philadelphia. Her particular interests in the field of alternative medicine include spiritual healing , acupuncture, and homeopathy. MILDRED SEELIG, MD , MPH teaches nutrition at the University of North Carolina, Chapel Hill, and preventive medicine at Emory University in Atlanta. Dr . Seelig is editor emeritus of the Journal of the American College of Nutrition. WINIFRED SEWELL, MS, DSc is a fellow of the Medical Library Association. She has taught at the University of Maryland School of Pharmacy as well as the College of Library and Information Services. SCOTT SHANNON, MD practices integrative psychiatry, holistic medicine, and medical acupuncture in Fort Collins, Colorado. Board certified in two specialties, he consults with large hospital systems and major corporations on the integration of alternative therapies with conventional treatments. An officer of the American Holistic Medical Association, Dr. Shannon teaches other physicians nationally about holistic medicine . JILL M. SIEGFRIED, PhD is professor and vicechairman of the Department of Pharmacology at the University of Pittsburgh School of Medicine. She specializes in cancer pharmacology and conducts research in lung cancer. Dr. Siegfried is director of the Lung Cancer Basic Science Program at the University of Pittsburgh Cancer Institute. J. JAMISON STARBUCK, JD, ND practices family medicine in Missoula, Montana. She is a regular feature writer and monthly columnist for two national health magazines, a freelance writer, and an editor. Dr. Starbuck is a past president of the American Association of Naturopathic Physicians.

JAMES P. SWYERS, MA is a science writer and editor who formerly served as managing editor of Alternative Medicine: Expanding Medical Horizons , a report published by the Office of Alternative Medicine at the National Institutes of Health. Before turning to journalism , he worked as a research biochemist and molecular biologist. MICHAEL A. TANSEY, PhD is an EEG neurofeedback clinician and researcher. He is a past president of the Society for the Study of Neuronal Regulation. DICK W. THOM, DDS, ND is an associate professor at the National College of Naturopathic Medicine in Portland , Oregon , where he teaches clinical and physical diagnosis, neurology, endocrinology, and therapeutic drainage. Dr. Thom is also a clinic supervisor at Natural Health Centers. He maintains a private practice at Natural Choices Health Clinic in Beaverton , Oregon. ALEX A. TIBERI, OMO , LAc is chairman of the Department of Oriental Medicine at the Pacific College of Oriental Medicine in San Diego. At his private practice at the Pacific Center of Health, he specializes in acupuncture for sports medicine. Dr. Tiberi has also served as a national examiner for the National Commission for the Certification of Acupuncturists. ANDREW J. VICKERS directs the information service at the Research Council for Complementary Medicine in the United Kingdom. He also teaches research methodology at the University of Westminster and the London School of Acupuncture. ROBERT C. WARD, DO , FAAO teaches biomechanics and family medicine at Michigan State University 's College of Osteopathic Medicine. He was in private family practice for 12 years prior to teaching. CAROLINE WELLBERY, MD, PhD is assistant professor of Family Medicine at Georgetown University in Washington , D.C. She practices medicine at Unity Health Care.

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The textual and visual descriptions of medical conditions and treatment options in this book should be considered as a reference source only; they are not intended to substitute for a healthcare practi tioner's diagnosis, advice, and treatment. Always consult your physician or a qualified practitioner for proper medical care. Before using any drug or natura l medicine mentioned in this book, be sure to check the Index of Conventio nal and Natura l Medicines , beginning on page 882, for any warn ings or cautions. You should keep in mind that herbal remedi es are not as strictly regulated as drugs.

CONTEN1"S

►

CONTENTS

. 12

Introduction ....................... How to Use This Boo k

14

Dictionary of Conventional Medicine and Alternative Therapies ............

. 16

General Guidelines to Health

.30

.........

Children's Health Adult Health Women's Hea lth Men's Health Growing Older

32 37 38 42 44

Emergencies/First Aid

46

Your Medicine Chest

78

Ailments and Options

80

Index of Conventional and Natural Medicines

882

About H erbal and Homeopa t hic Remedies

Eating for Health

1025

. 1028

.................

The Food Guide Pyramid Essential Vitamins and Minerals

1031 1032

A Visual Diagno stic Guide ..........

. 1042

Atlas of the Body .................

. 1052

Append ix ........

. 1068

. ..............

Abbreviations, Professional Titles Health Associations and O rganizatio ns Gallery of Acupressure and Yoga Positions

Glossary 1094

♦

Bibliography 1100

♦

Index 1118

♦

1070 1071 1076

Picture Credits/Acknowledgments

1152

hen you or someone you love is ill or suffering even a minor ailment, i====::::.i

you want to know you are making the best choices about treatment.

On the eve of the 21st century, those choices are more plentiful than ever. Even as healthcare practitioners embrace the technological advances and the research breakthroughs occurring in modern medicine, they are turning with new interest to the alternative, or natural, therapies from medicine's foundations. Venerable healing practices, from acupressure and herbal remedies to yoga and meditation, are increasingly taking their place alongside modern forms of treatment such as immunotherapy and laser surgery. In the context of the many options available, these pages offer clear, concise information on hundreds of health problems, ranging from relatively benign conditions to the most serious diseases. For any given ailment, conventional therapeutic approaches represent the best of modern medical science and mainstream medical practices. Alternative therapies also stand on extensive evidence of their benefitseven if those benefits sometimes defy scientific understanding. In the end, the best decision will be the one you make in conjunction with your healthcare practitioner. The goal of this volume is to provide a solid base of knowledge to help in that process, so you can make informed-and fident-choices

thus more con-

about healthcare.

13

H O W TO

U S E THI S BOOK

he main section of this book consists of some 300 entries and charts covering several hundred ailments. You may want to begin by turning to a symptoms chart (see example below) , which will name several related problems and help you decide which ailment entry to look up based on your symptoms. Ailment entries (example opposite) provide a more complete list of symptoms, plus guidelines to discern whether the condition is potentially serious or requires your doctor 's attention. After explaining what causes the ailment, each entry describes conventional and alternative treatment options; for more information about types of therapies , turn to the Dictionary of Conventional Medicine and Alternative Therapies, beginning on page 18. If specific acupressure techniques or yoga positions are listed as treatment options but not illustrated , check the appendix for the galleries of acupressure points and yoga positions. These are sets of illustrations and capsule descriptions of most of the pressure points and positions described throughout the book. While reading an ailment entry, you may be referred to other entries or to the Emergencies/First Aid section. Bold italic type indicates cross references to other ailment entries or to medicines or herbs described more fully in the Index of Conventional and Na tural Medicines (example opposite) beginning on page 882. Plain bold type is used to emphasize a concept , or to indicate a therapeutic

technique or a subcategory of the main ailment. Other sections are useful as references or to supplement information in the ailment entries. For an overview of health concerns specific to women, men, children, and the elderly , consult the Genera l Guidelines to Health starting on page 30. Your Med icine Ches t on page 78 describes the various herbs , homeopathic remedies, and over-the-counter drugs you should have at hand in your home. Use the Visual Diagnostic Guide to identify problems you can see, such as skin rashes, eye infections , and canker sores. The Atlas of the Body contains detailed i 11ustr at ions of the different bodily systems and the five senses. Technical medical terms and procedures mentioned in the book are defined in the Glossary, beginning on page 1094. If you can't find the ailment or medicine you're looking for, check the general index at the end of the book to see if it's Iisted by an alternate name. For example , "pinkeye" is not in the ailments section, but you will find it in the index with page numbers for the ailment entry II conjunctivitis/' another name for this eye infection. The index makes it easier to find medicines also, by listing the generic names, top brand names, and drug classes of conventional drugs, plus the common and Latin names of herbs. If you want more information about one of the ailments or treatment options presented in the book, contact any of the groups listed in the appendix under Health Associa tions and Orga nizations .

SYMPTOMSCHARTS ABDOMINAL PAINS

NAME OF CONDITION

•··

' , L ~~ --~---•

·"

I I

FIND THE SET OF SYMPTOMS THAT MATCHES YOUR OWN ----

-

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(,a;J>tl]ISHA}yn,rc,,,al:);"M!YUJfl ....

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tl>tt .. )._ ata! l

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nr.t=,.,.~·

liW ~x .dPJJr:'cr'..;al.9...bu::u.,·,1::.>o-,wfa ,q;,.....,,,_...,:,,11µ'(M!\h,o.«rlf.J.a,eth. .,)OJ w::d: .ot,y,:,u,,o1.Remedy Homeop athic eJ

gQS

CONVENTIONAL

AND

NATURAL

♦ Do not abruptly stop taking these

D

drugs. Sudden cessation can provoke withdrawal symptoms, including seizures; irritability; insomnia ; confusion; mental depression; hypersensitivity to pain , noise, or light; and feelings of suspicion and distrust . Slowly reduce the dosage under your doctor 's guidance . + Tolerance may increase with prolonged use; as your body adjusts to the benzodiazepine, the drug becomes less effective. Never increase the dose without consulting your doctor , because the risk of benzodiazepine dependence increases with higher doses. ♦ Do not take benzodiazepines if you are pregnant or breast-feeding. PO S SIBLE

INTER

A CTION

S

Alcohol, anticonvulsants, antihistamines that cause drowsiness (clemastine, diphenhydramine), barbiturates, MAO inhibitors, opioids, tricyclic antidepressants: increased sedative effects, such as excessive mental (central nervous system) depression, sleepiness, and slow or shallow breathing. It is very important that you avoid taking benzodiazepines in combination with any of these drugs.

MEDICINES

BETA-ADRENERGIC BLOCKERS

SPECIALINFORMATION ♦

GENERICNAMES atenolol , metoprolol, nadolol , propranolol , timolol (oral and ophthalmic )

♦

GENERAL DESCRIPTION Also known as beta blockers , these drugs interfere with the action of certain parts of the nervous system, thereby slowing the heart rate and nerve impulses to the heart and other organs. This in turn results in lowered blood pressure and decreased angina. The first of the beta-blocking drugs to be developed (including nadolol , propranolol , and timolol) are called nonselective agents because they work in the wh?le body and can be used to treat a variety of medical conditions. The newer beta blockers , among them atenolol and metoprolol , are called cardioselective because they target beta receptors in the muscles of the heart and blood vessels. These drugs are particularly useful for treating heart disorders such as angina and arrhythmia . For more information, see the individual entries for the generic drugs listed above .

♦

♦

♦

♦

Antacids: may slow the absorption of benzodiaz epines. Separate from benzodiazepine dose by an hour .

Beta blockers, cimetidine, disulfiram, erythromycin, ketoconazole, omeprazole, oral contraceptives, probenecid: may prolong the amount of time ben!odia zepin es remain in your body, leading to increased benzodia zepine effects and possible toxicity.

Cigarette smoking: decreased benzodiazepine eff ects.

Clozapine: risk of profound hypotension (low blood pressure) , slow or shallow breathing , cessation of breathing, and cardiac arrest leading to death .

lsoniazid: increased effect and possible toxicity of diazepam and triazolam. This interaction also may occur with other benzodiazepines. Levodopa: decreased levodopa effect. Rifampin: decreased effect of diazepam and possibly of other benzodiazepines.

Valproic acid: increased benzodiazepine effects, including mental depression; risk of certain types of seizures if taken with clona zepam.

Zidovudine: risk of zidovudine toxicity .

906

TARGETAILMENTS + heart disease, especially angina (pain),

+ •

• ♦ ♦ ♦

heart attack (myocardial infarction) , and abnormal heart rhythms. high blood pressure (hypertension). migraine headaches (propranolol, timolol). tremors (propranolol). schizophrenic and anxiety disorders (propranolol and timolol ). alcohol withdrawal (atenolol and propranolol). glaucoma (timolol) . SIDE

EFFECTS

Not serious: Decreased sexual ability , drowsiness , weakness, trouble sleeping, upset stomach, nervousness, change in bowel habits. Consult your doctor if these effects continue or are both ersome .

Serious: Bronchospasm (trouble in breathing), congestive heart failure (swelling of feet or lower legs, shortness of breath), dizziness, mental depression, prolonged reduced circulation (cold hands and feet), fast or irregular heartbeat, chest pain , sudden shortness of breath , sweating, trembling and weakness. Call your doctor immediately. See Timololfor side effects of an ophthalmic (eye drop) form of a betaadrenergic blocker.

♦

Beta-adrenergic blockers can make you drowsy, dizzy , and lightheaded. Avoid activiti es that require alertness , such as driving , until you know how you react to these drugs. Tell your doctor if you are plannin g surgery or have any of the following conditions , which beta-adrenergic blockers may complicate : allergies , bronchial asthma, or emphysema ; congestiv e heart failure; diabetes mellitus; hyperthyroidism; impaired liver or kidneys; mental depression; myasthenia gravis; poor circulation or circulatory disease. Do not use beta blockers if you have a bronchospastic disease, bronchial asthma, or a severe chronic obstructive pulmonary disease. Beta blockers can both mask the symptoms of low blood sugar and cause a severe rise in blood sugar in patients with diabetes mellitus. Beta-adrenergic blockers can increase the severity of allergic reactions to drugs, food , or insect stings. Contact your doctor immediately if a severe allergic reaction occurs. Suddenly stopping these drugs may cause or increase heart problems. Dosage must be reduced gradually under your doctor's supervision. Before taking these drugs , let your doctor know if you are pregnant or nursing. P OSS I B LE INTER

AC T IO N S

Beta blockers may interact with many over-the-count er and prescription medications, including the following:

Aminophylline, theophylline: decreased clearance of these drugs and possible toxicity.

Antacids (aluminum hydroxide or magnesium): decreased beta-blocker absorption. Take antacid four hours before or two hours after beta blocker.

Antidiabetic drugs, insulin: increased risk of high blood sugar and impaired recovery from hypoglycemia.

Antihypertensive drugs (including calcium channel blockers, clonidine, and guanabenz): increased antihypertensive effect.

Antipsychotic drugs (thioridazine, chlorpromazine): increased effects of both combin ed drugs , producing excessively low blood pressure, slowed heart rate , and difficulty breathing.

Cimetidine: increased beta-block er effect.

Ephedrine, epinephrine, and isoproterenol: decreased effects of these drugs; risk of increased blood pressure.

CONVENTIONAL

I

Estrogens: decreased antihypertensive effect of bet a block ers. MAO inhibitors: combination can cause hypert ension . Do not tak e beta blockers until 14 days after discontinuin g MAO inhibitors .

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen: redu ced beta-blocker effect .

Phenothiazines : increased effec t s of both co mbin ed dru gs.

BETAMETHASONE

AND

also prescribed bilberry leaves to low er blood sugar in diabetics.

DRUG CLASS BRAND NAME Lotrisone (with clotrima zo le)

GENERALDESCRIPTION Lotrisone , a combination of the corticosteroid drug bet amethasone and th e antifungal medication clotrima zo le, is used to destroy fungi and reliev e any accompanying skin inflammation . See Antifungal Drugs, Clotrimazole, and Corticosteroids for more inform ation .

TARGETAILMENTS

Apply powdered form extern ally for: • burns .

Take intern ally for: • eyestrain , cat aracts , glaucoma , macular degeneration , nearsight ed ness, night blindness , constipation , vomiting, diarrhea , dysentery, stomach cramps.

PREPARATIONS Biota leaves are avail ab le in bulk , and th ey can be purchased in dried form in Chinese pharmacies, Asian markets , and some Western health food sto res. A powder ed form is available for tre at ment of burns. It should be app li ed as soon as possible after the burn.

Apply externally fo r: ♦ spider veins, var icose veins, hemorrhoids , burns, skin problems .

PREPARATIONS Over the counter:

Eat fresh or dried berries alon e or mixed with apple powder to tr eat diarrhea. Tea: Boil 2 to 3 tsp leaves in 1 cup water. Drink 1 cup per day for vomiting and sto mach cramps. Use externally as a wash for skin problems and burns. Decoct ion : Use 1 cup wa t er with 1 tsp dried berri es and simmer for 10 to 15 minutes. Drink 1 to 2 cups a day, cold.

SIDE

EFFECTS

Not serious:

• Low concentrations of th e herb in alcohol extractions appeared to inhibit the growth of tuber cu losis and strep tococcus bact eria in a t est-tub e trial. ♦ In hum an te sts, oral preparations co ntaining th e herb slightl y reduced the tim e it took to st op bleed ing from gastri c and duoden al ulc ers, compared wit h a co ntr o l gro up using standard ther apy.

WARNING: If the leaves are consumed over a long period of time, they can be poisonous. Do not exceed the recommend ed dose.

LATIN NAME Vaccinium m yrtillus

BIOTA GENERALDESCRIPTION H erb alists have lon g valued the berries and leaves of the bilb erry , a wild shrub that grows in Europ e and North America. British pilots in World War 11 ate bilberry jam before flying night missions, to enh ance th eir night vision. Small laborato ry studies since th en have indicated that the berries help other eye problems , such as glaucoma , cataracts, and macular degen erat ion (a common cause of blindness in adults). Bilberry 's healing eff ects probably stem fro~ . chemicals known as anthocyanos1des in the berries . Some European herbalists claim that bilberry anthocyanosides may protect the arteries by redu c ing deposits that can lead to heart atta c ks, strokes , and high blood pressure . Dri ed berries work directly on the small intestine_and are used to treat diarrhea . Herbalist s have

LATINNAME Biota orientalis

BISMUTH SUBSALICYLATE

GENERALDESCRIPTION Biot a comes from the leafy twi g of th e arbor v itae shrub. Among its vario us uses, this herb is prescribed to co ntrol ble eding and to heal burns . And in laboratory experim ents with animals , prep aration s of biota seem eff ective as expectorant s. According to th e principles of tr ad ition al Chinese med icine , this herb is astringent, bitter , and slightly cold.

DRUG CLASS Antidiarrheal

Pepto-Bi smol

GENERAL DESCRIPTION Bismuth subsali cy late is used to tr eat di arrhea. Because it appea rs to inhibit intestinal secreti ons, it is also effec tive in pr eventin g symptoms of tr aveler 's diarrhea and can be taken regul arly during the first two weeks of tra vel. This

Take intern ally for: ♦ ble edin g disorders such as vo mitin g and coughing up blood , dry coughing

Prescription D rug

0

Ov er-t heCounter D rug

Dru gs

BRAND NAME

TARGETAILMENTS

0

EFFECTS

SPECIALINFORMATION

SPECIALINFORMATION

BILBERRY

G

Large do ses or prolonged use of th e herb may lead to di zz iness, nausea, and vo mitin g.

The use of fresh bilberries can cause diarrhea in some individuals.

♦

_i

Combinations: Two mi xtures that co nt ain biot a may be pre scribed to pr event bl eeding . In one , the fresh herb is co mbined wit h the leaves of fre sh lotu s and fresh mu gwo rt ; in the ot her, biota is mi xed with mugwo rt leaf and dried gi nger. A blend of biota and cattail pollen is recomm ended for excessive bleed ing from th e ut erus. And a preparation co nt aining biota and jujub e dat es is used for patients with chroni c dry co ughs. Chinese herbali sts can pro v ide information on dosages and add ition al herb al combinations.

Bilberry is ava ilabl e as tinctur es, fluid extra ct , dri ed leaves, and berri es.

SIDE

MEDICINES

th at fa il s to bring up phlegm , blee ding gums, blood in the stool or urine , and uterine bleeding.

At home: Corticosteroids

NATURAL

O

Western Her b

O

Chinese Herb

H omeopathic Remedy

9 Q7

CONVENTIONAL

AND

NATURAL

drug is also used to tr eat symptoms of gastric distress or upset stomac h, including heartburn , acid indi gestion , and nausea. See Antidiarrhea/ Drugs. SPECIAL I NFORMAT ION ♦ Advise you r health care professiona l if yo u have had allergic react ions t o ot her salicy lat es, including aspirin . • If taken in higher doses and for longer periods t o preve nt trave ler's diarrhea, this drug may intensify some of the symptoms of dysentery, gout, kidney disease, stomach ulcers , and hemophilia and oth er bleeding problems. If you have any of these con ditions , consult yo ur doctor first before takin g th e dru g. ♦ Bismuth subsalicylate may have an effect on some labo ratory t ests. Be sure to tell the health care practitioner perfo rming the t est that yo u are taking the medication . POSSIBLE

INTERACTIONS

Antidiabetic drugs (oral) : may reduce b lood sugar leve ls.

MEDICINES

Apply ext ernal ly for: • sciatica, neuralgia , muscl e spasms, rheumatism. PREPARATIONS Over the counter: Black cohosh is availab le as tinctures , syrup, capsu les, fluid ext ract , and also as d ri ed root and rhi zo me.

At home: Decoc tion: Boil ½ tsp powdered roo tstock per cup of water for 30 minutes and let coo l. Take as much as a cup per day, 2 tb sp at a tim e. To take away the bitter taste, add lemon and hon ey.

Combination: Mix the dri ed herb w ith skullcap , wood betony , passionflower, and va lerian to make a mild tr anqu iliz er. SIDE

EFFEC T S

Not serious: Prolonged use may irrit ate the ut erus. Serious: Overdoses or use for long periods can cause dizziness, diarrhe a, nausea, vomiting, abdom inal pain , headaches, joint pains , lowe red heart rat e, hype rten sion , flushing. If any of these symptoms deve lop, st op using black cohosh and ca ll yo ur doctor imm ediat ely.

BLACK COHOSH

LATI N NAM E

Cimicifuga racemosa GENERAL DESCRIPTION The knotty black rhizome and root of black cohos h contain substances that act lik e the female horm one estrogen . A leafy perennial , it is prescribed for severa l menstrua l and menopausal co nditions. In Germany , bl ack co hosh is a key ingredient in the thr ee drugs used most often to t reat menop ausal disorders. Black co hosh also acts as a sedative and is believed to promote urination, dry up disch arges of fluid , aid in expe llin g mucus from th e lung s, and relieve spasmodic co nditions such as the co ughs that accom pany w hoop ing co ugh and tuberculosis. Labor ato ry tests on animals suggest that one of the co mponents of bl ack cohosh, acte in, may help in the treatment of high blood pressure. TARGET AILMENTS Take int ern ally for: • menstrual di scomfort , menopausal disorders , premen str ual stress, headac he, diarrh ea, bleeding gums, spasmodic coughs, high blood pressure.

908

SPECIAL INF ORMA TION • WARN! NG: Because it can potentially cause serious side effects, use black co hosh only und er medical supervis ion . ♦ WARN! NG: Indi v idu als suff erin g from congestive heart fa ilu re or any other type of heart disease shoul d not use black co hosh. ♦ Do not use if you are pregnant, because it can cause premature labo r. ♦ Do not take the herb if you have been adv ised not to take co ntr aceptiv e pills.

fungal and parasitic infections , and mouth sores. Black wa lnut is ri ch in t annin s and conta ins a large amount of iod ine, which makes it a good ant iseptic. Also, the herb is believed to reli eve to xic blood co nditions . And some evi den ce indi cat es th at , if used internal ly over a lo ng period , the herb w ill help elimin ate warts caused by viruses. TARGET AILMENTS Take internally for: • co nstip at ion, inte stinal wo rms and parasites , warts, mouth sores. Apply exte rnally for: • rin gwo rm , scabies, eczema, herpes, psoriasis, sores, pimples , athl ete's foot , jock it ch, cold sores. PREPARATIONS Over the counter: Black wa lnut is available as tinctures , extr act, dried bark , leaves, and fruit rind .

At home: Decoc ti on: Simmer the green husk in boiling water for 10 to 15 minut es. Take 1 tbsp three or four tim es a day.

Gargle: Use th e decoction as a mouth wash o r gargle to tr eat mouth sores. Extract: Rub on the affected area twice a day. Poultice: Make a poultice from the green rind of black walnut and apply to th e sites of ringworm. SIDE

EFFECTS

None expected . SPECIAL INF ORMAT IO N • Do not use if yo u are pregnant. • Fresh green husks may irritate your skin.

BLESSEDTHISTLE BLACK WALNUT LATIN NAME

Cnicus benedictus LATIN NAME

Jug/ans nigra GENERAL DESCRIPTION Native Americans used th e bark of th e black wa lnut , a tr ee th at grows in the eastern U.S., to treat skin problems such as rin gwo rm . They drank a tea made from t he bark as a laxati ve, and t hey chewed on the bark to reli eve headac he pain. Today black walnut's bark, leaves, fruit rind , and liquid extracts are prescr ibed by herbalists for constipation,

GENERAL DESCRIPTION Durin g t he Middle Ages, bl essed thistl e was used t o treat bubonic plague. Modern herbalist s co nsider th e aboveground parts of thi s annual plant a remedy for a range of problems. A component of blessed thistle is th e chemical cnicin , an anti-inflammatory agent that also stops bl eedin g. In add ition extracts from t he plant co ntain mor e than a dozen antibact eri al compounds. Blessed thistl e is also used to induce vomiting in individuals w ho have t aken poison s, and t o regu-

CONVENTIONAL

late menstru al cyc les. This bitt er herb, somet imes known as St. Benedic t 's t histle, is used in the liqueur Benedictine.

Take interna lly for: ♦ poor digestion, feve r, headac he, co li c, gas, d iarrhea.

for respir atory di sord ers such as bro nchitis. Bloodroot is a major ingredient in many mouthwashes and toothpastes because of its abilit y to kill the bacteri a that can lead to gingiv itis (gum disease) and the buildup of plaque. It s key components are the antibacter ial isoquinolin e alka loid s.

Apply exte rn ally for: ♦ cuts and wo unds, fever, shingles.

TARGETAILMENTS

TARGETAILMENTS

PREPARATIONS Over the counter: Blessed t histl e is available as a tin ctu re, extract, and dried herb . At home: Tea: Steep 1 tsp dri ed herb in ½ cup boiling water. Drink 1 cup t o 1½ cups a day, unsweete ned, for problems with di gestion .

Pou lti ce: Mash leaves and other parts, and apply to chilbl ains, wo und s, and sores. Combinations: Used with cramp bark, blue cohos h root, and ginger to tr eat menstrual difficulties. SIDE

EFFECTS

Not serious: Overdoses can cause vomiting.

SPECIALINFORMATION

AND

NATURAL

MEDICINES

BLOOD VISCOSITYREDUC ING AGENTS GENERICNAME pentoxifylline

GENERALDESCRIPTION

a

Blood v iscosity-reduc ing agent s are used to imp rove the f low of blood through small blood vessels, thereby decr easing pain-particularly in the legs- caused by poor blood c ir cu lati on. Unlike anticoagul ants and ant ipl ate let s, these drugs are true "b lood thinners": They reduce the viscosity (t hi ckness, sti ck iness) of red blood ce lls and imp rove their flexibility, thus easing th e flow of blood throughout t he body. See Pentoxifylline for mor e information abo ut a blood v iscosit y- reduc ing agent used to bring relief from leg cr amps and ot her symptoms associated wi th peripheral vascular disease, a chronic blood-vessel disorder in which the infl exibi lit y of red blood cells causes poor blood circulati on in the arms or legs.

♦

gingivit is. (Use as toothpaste and mouthwash.) • co ngesti on of th e lungs, bronchitis, asthm a, headaches, head co lds. (Take bloodroot intern ally.) ♦ fungus , athlete's foot, venereal blisters, rashes, ecze ma, rin gwo rm , wa rt s. (App ly bloodroot externally.)

PREPARATIONS Over the counter: Bloodroot is avai lab le as tincture and dri ed root; it is also an ingr edient in several co mm erci al dental products. At home: Tea: Prepare by boiling 1 oz bloodroot in 1 cup water for 15 to 20 minut es. Drink three time s daily.

Combinations: Blood root can be blended w ith hor ehound and elecampa ne to relieve co ngestion. It can be mi xed with red sage and a pin ch of cayen ne to t reat phary ngitis (irrit ation of the throat).

BONESET

♦

WARNING: Use recom mended amo unt s and only und er a doctor 's supervis ion . Blessed thistle is a stro ng emeti c and indu ces vo mitin g very effec tiv ely. ♦ During pregnancy, avo id b lessed t hi stl e and any compo unds that include the herb. • Avo id using blessed thistle if you have an ulcer, because blessed t hi stle stimulates gastr ic activ ity.

SIDE

EFFECTS

LATIN NAME Eupatorium perfoliatum

Serious: Hi gh doses can cause burning in th e stomach, vomi tin g, nausea, slow ing of th e heart rate , im pair ed vision , intense thir st , and dizziness. Stop using imm ediately if these symptoms develop, and consult yo ur pract ition er.

GENERALDESCRIPTION A tall, hardy pla nt , boneset has nothing to do with setting bones; it is used to treat feve r. Native America ns to ok bo neset for fever-producing illn esses such as cho lera, dengue fever, and typhoid. It then became o ne of the most popu lar herb s among th e co lonists, who kept it on hand for colds and other ailments that give rise to fever. Today herbali sts still reco mm end boneset, also ca lled feverwort and sweat plant, fo r th e aches and pain s th at accompany feve r, especially during bouts of influ enza. Boneset also helps clear mucus fr om th e respir at ory tract. It is also ofte n used for art hritis and rheumat ism. Herb alist s use th e leaves and flower top s, w hich are harvested as soon as th e plant blooms in late summer .

SPECIAL INFORMATION ♦

BLOODROOT

LATINNAME Sanguinaria canade nsis GENERALDESCRIPTION

WARNING : Bloodroot is potentially toxic. Take it int ern al ly only under the supervision of an herb alist or li censed healthc are professiona l. ♦ Avoid using bloodroot int ernall y during pregnancy. • Bloodroot has a long folk history in the t reatm ent of cancer, and it is currently th e subj ect of studi es and experiments. It contains sanguinarin e, a co nstituent that is th ought to imp ede th e formation of tum ors.

Named fo r th e crim son extra ct made from its root , bloodroot not only loo ks fo rbiddin g but is pote nti ally toxic and can cause severe side effects if ingested in excess. For this reason, herb alist s prescribe the root of thi s perennial plant primarily as an external remedy to relieve eczema , venereal bli sters, rashes, and ot her skin disorders. O nly rarely is the bitt er herb taken intern ally, and that is w hen herbali sts reco mm end it

TARGETAILMENTS Take int ernally for: ♦ fever , co lds, flu , co ughs, co ngestion in th e upp er respirat ory tr act , art hritis , and rh eum at ism.

0

Prescription Drug

0

Over-theCounter Drug

O

Weste rn Herb

O

Chinese Herb

A Homeopathic

G:JRemedy

909

,,,

.

CONVENTIONAL

AND

NATURAL

_1

MEDICINES

~

PREPARATIONS Over the counter: Available in health food stores as dried leaves and flo we rs, and as tin ctur es.

BRONC HO DILATORS

At home : Infusion: Pour 1 cup boiling water onto 2 to 3 tsp d ri ed herb and let st eep for 10 to 15 minutes. Drink as hot as possible. For fever or flu , drink a cup every half hour up to 4 cups in 6 hours , and only 6 cups in a 24-hour period. To mask the very bitter taste of bonesec mix it with an herbal tea or add honey and lemon.

GENER IC NAMES Rx: albuterol , epinephrine , ipratropium , salmeterol , terbutaline, theophylline

SIDE EFFECTS

Large doses of boneset can cause nausea , vomiting , or diarrhea. Do not exceed the recommended dosage; cal I your doctor if you experience adverse reactions . SPECIAL INFORMATION Do not use fresh boneset. It contains a toxic chemical , called tremerol , that can cause vomiting, rapid breathing, and at high doses, possibly coma and death. Drying boneset removes the tremerol . ♦ If you have a history of alcoholism, liver disease, or liver cancer, consult your herbalist before taking boneset; it co nt ains pyrrolizidine alkaloids, which are toxic to the liver. ♦ Becau se of its toxic effects , you should not take boneset for more than two weeks at a time. ♦ WARNING:

BRO MPH ENIRAM INE

D RUG CLASS Antihistamines BRAND NAMES Dimetapp in various forms GENERA L DESCRIPTION Brompheniramine is an antihistamine drug with mild sedating effects. See

Antihistamines.

OTC: ephedrine , epinephrine , t heophyl Ii ne GENERAL DESCRIPT ION Bronchodilators relax the muscles in the bronchial tubes and the blood vessels of the lungs by inhibiting certain body chemicals . Some of these drugs also act as central respiratory stimulants to make breathing easier. This relieves spasms and improves lung capacity , thereby alleviating the symptoms of bronchial asthma and bronchitis. Theophylline (found naturally in commercial tea and related to the caffeine found in coffee) acts mainly on the muscles of the respiratory tract. Other bron chodilators act on the sinuses and upper respiratory tract. All of these drugs may act on the hearc arteries, and veins , especially if taken in large doses. For this reason bronchodilators can affect blood pressure and heart function. TARGET AILMENTS ♦ anaphylactic shock from severe allergic reactions. ♦ acute bronchial asthma. ♦ chronic, recurrent bronchial asthma. ♦ bronchitis. ♦ emphysema. ~ hay feve r and cold symptoms (ephedrine). ♦ other chronic obstructive pulmonary diseases. ♦ heart -rhythm probl ems and cardiac arrest (epinephrine). ♦ exercise -induc ed bronchospasms . S ID E EFFECT

S

Not serious: Mild nausea, weakness , insomnia, nervousness or restlessness. Call your doctor if these effects become bothersome. Serious: Change in blood pressure, change in heartbeat (irregular or pounding , for example) , trembling, breathing problems, weakness, anxiety, nervousness , dizziness, lightheadedness, muscle cramps, or nausea or vomiting. Rarely, chest pain or discomfort. Let your doctor know right away if you experience these side effects. SPECIAL INFORMAT ION ♦ These drugs (especially ephedrine and epinephrine) can cause adverse effects in individuals with high blood

9 10

pressure, diabetes , heart disease, seizures , peptic ulcers , or thyroid or prostate problems. If you have any of these conditions do not use bronchodilators-even in their over-thecounter forms-without your doctor 's permission . ♦ WARNING : Your body can build up tolerance to bronchodilators used as inhalants , causing them to become less effective. If this happens , discontinue the drug and tell your doctor . Do not increase the dose. Increasing the dose can lead to serious, perhaps fatal bronchial constriction. ♦ Women who are pregnant or breastfeeding should consult a doctor before using these drugs. PO SS IBLE

INT ERAC TI O N S

Alcohol: increased stomach problems because these drugs have common gastrointestinal effects. Alpha and beta blockers: these drugs decrease the action of bronchodilators, especially ephedrine and epinephrine. Blood pressure medicines, including diuretics: bronchodilators may decrease the actions of these medicines. Caffeine and other central nervous system stimulants: increased nervousness and insomnia. Diabetes medications, including insulin: decreased effectiveness of diabetes medications. Heart medications (such as digoxin): heart-rhythm problems . Levodopa: increased heart-rhythm problems. Your doctor may need to adjust your dosage. Lithium: theophylline may decrease the effectiveness of lithium. MAO inhibitors: possible effects on the heart or blood vessels. Nitrates: decreased effectiveness of nitrates in relieving angina. Other antiasthmatic drugs: do not combine these drugs unless your doctor directs you to do so or unless your prescription contains a combination . Using two bronchodilators may increase the side effects, especially on the heart. Phenytoin: serious cardiovascular effects, such as heart-rhythm problems or very low blood pressure. Thyroid medications: increased bronchodilator effect. Tricyclic antidepressants and maprotiline: increased effects of bronchodilators on the heart and cardiovascular system.

., CONVENTIONAL

BRYONIA

SIDE

AND

doctor before tak ing buchu or any other diuretic. • If yo u pl an to tre at high blood pressure with buchu , do so only und er a doctor 's care as part of a larger treatment plan. ♦ Avo id buchu if you have a history of kidney disease; it s oi l content may be too irrit ati ng.

LATIN NAM E

GENERAL DESCRIPTION Bryonia , or w ild hops, is a creep ing v ine commonly fo und along hedgerows and in fo rest s across southern Europe. It s medicinal va lue was known to the Greeks , who used th e root as a purga tive and may have given th e plant its name, derive d from bryo, meanin g " to thru st or sprout ," a refere nce to how quick ly the vi ne grows. Accidental ingestion of the root can cause tissue inflammation , severe vom itin g, and diarrhea vio lent enoug h to cause death . Homeopathi c physicians prescribe their dilute solutions of Bryonia for illnes ses that are acco mpani ed by simil ar symp tom s. The ho meopat hic rem edy is prepared from the root , which is harvest ed in ear ly spring. An ext ract pressed from the root pu lp is mi xed with alcohol int o an extremely dilute solution . Like most homeopathic pr escr ipt io ns, Bryonia was deve loped as a remedy by observation of the reaction s of healthy indiv idual s to a series of undilu te doses. The mental , emot iona l, and physical changes induced by Bryonia were th en cata loged . W hen a homeopath ic pr actitioner encounte rs a pati ent w ith a set of symptoms t hat matches the cata loged symptoms brought on by Bryonia, the pra ctitioner the n pr escribes it in an extr emely dilut e form. It is presumed th at in this hi ghly di lut e dosage, Bryonia can cou nt er th e symptom s that it induces when it is at fu ll strength. TARGET AILMENTS Take internal ly for: ♦ art hritis w ith sharp , stick ing pains; backaches cent ered in th e small of th e back; bursitis. ♦ co lds acco mpanied by chest co ngest io n; pai nfu l coughs; sore throat , with pain upon swa llowin g; influ enza; severe headac hes th at are wo rsened by light , sound , or any motion ; dizz iness. ♦ nausea, vo miting , co nstip at ion , gastritis (stom ach infl ammation ), acut e diverticulitis (a co lon disorder) , stomach flu , mi graine headach es. ♦ infl amm ation durin g breast -fee din g. PREPARATIONS Bryonia is avail abl e over th e co unt er in va ri ous pot encies, in both liquid and tablet fo rm. Consult you r practitioner for more precise inform ation.

MEDICINES

♦ If yo u are preg nant , co nsult you r

EFFECTS

None expected.

Bryonia alba

NATURAL

BUCHU

LATIN NAME

Agathosma spp. GENERAL DESCRIPTION The leaves of this south ern Afric an shrub con t ain an oi l th at increases the productio n of urine. Afri can peopl e used it fo r urin ary problems lon g before they had contact wit h Europeans. In the 17th century Dut ch sett lers in South Africa used it to treat urinary tract infect ion s and kidn ey st ones. In 1847 , buch u was introduced in the U.S. and hailed as a cu re-all . Today Western herb ali sts continue the tradition, prescr ibin g buc hu for urinary tract infections and as a diuretic , and also for treating premenstrual syndro me and high blood pressure.

BUCKTHORN

LATIN NAME

Rhamnus purshiana GENERAL DESCRIPTION The bark and t he black , pea-sized berries of the buckthorn tre e act as a laxat ive so strong th at West ern herb alists advise using it on ly as a last resort, after other laxatives have fai led. Its effectiveness stems from chemi ca ls known as anthraquin o nes; these substances exert an extremely powerful purgative effect. You should use the herb only in consultation with your doctor.

TARGET AILMENTS Take int erna lly for: ♦ urin ary tract disorders, acute bladder inflammation and infections, irr itab le bladder , kidn ey stones, painful urination.

TARGET AILMENT ♦ constip atio n. (Take intern ally, with care.) PREPARATIONS Over the counter: Buckthorn is availabl e as a tin cture and in dried form. It is a compo nent of the comme rci al laxati ve Movicol .

PREPARATIONS Over the counter: You can obtain buchu dried and as a ti nct ur e at health food stores. The herb is also fo und in Fluid ex and Odrinil , two co mm erc ial diur etics used to tr eat premenstrual syndrome.

At home: Decoctio n: Boil 1 tsp dried buckthorn in 3 cups water and steep 30 minut es. Drink cool , 1 tbsp at a time , before bed .

At home: Infusion: Add 1 to 2 tsp dr ied, crumbled leaves to 1 cup boili ng water and let steep for 10 minut es. Drink up to three times a day.

Tinctu re: Take ½ tsp before bed. Combination: Mix ½ t sp each of dried buckthorn bark , chamomi le, and fennel seed, and steep in 1 cup boiling water for 10 minut es. Drink at bedtim e.

Co mbinatio ns: Mix buchu wi th uva ursi , yarrow, or couch grass to treat cyst itis (b ladd er infl amm at ion ). Co mbin e buchu w ith corn silk or marsh mall ow for dysuria (painful or diff icult urin ation ). SIDE

SIDE

EFFECTS

Not serious: Too large a dose of buchu can cause stomac h upset or d iarrhe a.

SPECIAL INFORMATION • WARNING: Do not take fresh buckth orn. Dry both th e berri es and th e bark for a year or two before using. For faster drying , put th e berries or bark in an ove n at 250 °F for several ho urs. ♦ WARNING : Do not use buckthorn fo r

SPECIAL INFORMATION WARNING: Diuret ics such as buc hu may dep lete the body's potassium levels, so be sure to eat mor e potassiumrich foods, such as bananas and fr esh vegetab les, wh ile t aking buc hu.

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EFFECTS

Serious: Fresh buck t horn can cause vomiting , v iol ent diarrhea , and stomach cra mps. Consult a docto r imm ediately.

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more than two weeks at a time. It can cause laz y bowel syndrome , in which the stool cannot be moved w ithout chemical stimulation. If this occurs, consult a doctor. + WARNING: Do not use buckthorn if you are pre gnant or nursing , or if you have chronic gastrointestinal problems like hemorrhoids, ulcers , and colitis . ♦ Do not use buckthorn with any other laxatives .

BUMETANIDE

DRUG CLASS Diuretics

BRAND NAME Bumex

GENERALDESCRIPTION Bumetanide , a fast-acting and powerful diuretic, is prescribed to eliminate excess body fluid and to treat high blood pressure (hypertension). Introduced in 1983, the drug acts by increasing urine production , thereby removing water from the body and helping to reduce swelling and blood volume. However , because this medication belongs to a group known as nonpotassium-sparing diuretics, salts containing minerals such as sodium , potassium , and calcium are also eliminated; this can sometimes lead to muscle cramps and serious cardiovascular side effects. For information on addition al side effects and possible drug int eractions , see Diuretics . S IDE EFFE CTS

Not serious: Although uncommon , chest and muscle pain and problems with sexual performance may occur with use of this drug. Let your doctor know if you are troubled by these effects.

MEDICINES

and feelings of frustration . Sometimes called hare 's ear or thorowax root, it is characterized in traditional Chinese medi cine as bitter , ac rid , and cool.

TARGETAILMENTS Take internally for: ♦ low-grade fevers. ♦ malaria and malaria-like disorders. ♦ alternating chills and fever , typically accompanied by a bitter taste in the mouth , pain in the side, irritability, vomiting, or difficulty in breathing . ♦ prolapse of the uterus (fallen uterus). ♦ dizziness and vertigo combined with pain in the chest , and tenderness in the side or breast , often accompanied by emotional irritability. ♦ menstrual problems, such as premenstrual syndrome, irregular menstruation, and cramps. ♦ pressure in the chest, bloated abdomen, nausea, and indigestion.

Combinations: White peony root mixed with bupleurum is prescribed for vertigo, dizziness , chest pain , and painful menstrual periods. Irregular menstruation, premenstrual syndrome, and certain kinds of depression may be treated with a blend of bupleurum and field mint. Bupleurum is often combined with bitter orange fruit to alleviate pressure in the chest , abdominal pain, poor appetite, and irregular bowel movements. Chinese herbalists sometimes mix small amounts of licorice with bupleurum to treat hepatitis . For information on specific dosages and additional herbal combinations, consult your Chinese medicine practitioner.

Bupleurum chinense

GENERALDESCRIPTION The long, coarse root known as bupleurum is often used to reduce certain types of fever and to treat irritability

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BRAND NAMES antidepressant: Wellbutrin smoking cessation drug: Zyban

GENERALDESCRIPTION Bupropion is prescribed to treat depression or as an aid to quit smoking. This medication appears to alleviate depression by blocking certain chemicals necessary for nerve transmission in the brain and to boost dopamine and nor epinephrine levels in the brain, reducing symptoms of nicotine withdrawal. See Antidepressants and Smoking Cessation Drugs for additional information.

SPECIALINFORMATION ♦

Warning: Do not take bupropion if you have a seizure disorder . The drug may cause you to have more frequent seizures. ♦ Bupropion has not been tested as a long-term treatment for depression. Your doctor should monitor your condition if you take the antidepressant for longer than 8 weeks. ♦ Un Ii ke other antidepressants, bu propion does not adversely affect sexual function. ♦ Other drugs may alter the metabolism of bupropion. Inform your doctor of all other medications you are taking , including over-the-counter drugs.

BURDOCK

S IDE E F FEC T S

Too large a dose of the herb can cause nausea or vomiting.

♦ Clinical

LATINNAME

DRUG CLASS Antidepressants; Smoking Cessation Drugs

PREPARATIONS The root is available in bulk in Chinese pharmacies, Asian markets , and some Western health food stores. Chinese pharmacies also offer mixtures containing the root.

SPECIALINFORMATION

BUPLEURUM

BUPROPION

experiments have indicated that the herb may be able to reduce fever resulting from infections of the upper respiratory tract. ♦ In test-tube studies, preparations of bupleurum seem to have inhibited the growth of tuberculosis bacteria, as well as influenza and polio viruses.

LATINNAME Arctium Jappa

GENERALDESCRIPTION For several centuries, herbalists have prescribed burdock root to cure a wide range of illnesses. Today, some practitioners use burdock to treat urinary tract infections, arthritic conditions, external wounds, and skin ulcers. This herb works best in conjunction with professional medical treatment. The root has brown bark and a white, spongy interior that hardens when dried . Burdock got its name from its tenacious burrs and from dock, the Old English word for "plant."

TARGET AILMENTS Take intern all y for : ♦ fun gal and bacterial infect ions; skin di sord ers such as ecze ma and psoriasis, which cause dry , scaly skin; urinary tract infections; rheumatism; arthritis.

Apply ext ern all y for: ♦ w ound s and skin co nditions.

er antianxi et y drugs, buspiron e rnay be slow to t ake acti on ; it s effects genera ll y begin after t wo wee ks, and th e tot al treatrnent tirn e rnay be th ree to four weeks. Arnon g its advantages, buspi rone produ ces rnilder side effects, as well as less sedation. Sinc e it is not addicting, buspir o ne can be used in pati ents w ho rnay be pron e to add iction , suc h as alcoholi cs. See Antianxiety Drugs for an overview of this c lass.

PREPARATIONS Ove r the counter: Burdock is ava ilabl e as dried powder, slices of roo t , and t inctur es. You can find the fr esh root in the vegetable sections of health food stores .

TARGET A ILMENTS ♦ anx iety disord ers or short-terrn tr eat rnent of anxiety syrnptorns.

At home: Decoction: Add 1 tsp burdock root to 3 cups water and boil fo r 30 minut es. Drink up to 3 cups a day to treat genit al and urinary tract irrit ations.

Not serious: Nausea, sore throat, nasal co ngestion . Call your do ctor if symptoms continue o r are bothersom e.

Compr ess: Soak a cl ean cloth in burd ock t ea and pl ace it on th e skin to speed healin g of wo unds and skin ulcers . Combinations: Burdo ck can be mix ed w ith ye ll ow dock , red clover , or c leave rs and taken or all y fo r skin disorde rs. Consult an herb ali st for more inform ati o n. SIDE

EFFECTS

Burdo ck may cause stomach discom fo rt if too mu ch is taken. Do not exceed recommend ed dosages. SPECIAL I NFORMATION + WARNING: Do not use burdock if you are pr egna nt ; it stimulate s th e uterus. ♦ Laboratory trials on animals indi cat e that bu rdoc k has possibl e antitumor acti vity. ♦ Do not giv e burdock to child re n yo un ger th an 2 year s of age. Older childr en and peopl e ove r 65 should start w it h lowe r-str ength doses, increasing th ern if neede d.

SIDE

LATIN NAME

Rusc us ac uleatus GENERA L DESCRIPTION Butcher 's-broorn acq uir ed its narne because anc ient Medit err anean but chers used the scrubby sterns and leaves of the tou gh pl ant to sweep rneat scraps off their cutting board s. It s rnedicin al use dates to classical Gre ece, when physicians applied its root s and rhizornes to swellings and pr escrib ed it as a laxative and diur eti c. Today herbalists believe its rhi zo mes have anti-inflarnrnatory properties, and they use it to treat disord ers of the veins. Butcher 's-broorn is an astringent that puckers up th e insides of veins. Arnong its active ingredients are two steroidal co rnponent s called ruscogenin and neuroscogenin , which appear to narrow blood vessels.

EFFECTS

Serious: Di zz iness, drow siness, nervo usness, li ghtheadedness , excitern ent , blurred vision, persistent or severe headache, rin ging in th e ears, chest pain, shortness of breath , fainting , confusion , rnuscl e weakness, un co ntrolled rnov ernents of the body, nurnbn ess or tingling in th e hands or feet. Contact your doctor irnrnediately .

TARGET AILMENTS + circulation disord ers of the legs such as varicose ve ins; hernorrhoid s and oth er rectal inflarnrnation and bleeding. (Use intern ally or extern ally.)

SPECIAL INFORMATION ♦ Buspirone has rnilder sedative effects th an oth er anti anxiety dru gs and no withdrawal syrnptorns. How ever, you should not use buspiron e unless it is clearly needed. Prolon ged periods of use may increase th e lik eliho od of ser ious side effects . ♦ Avoid drivin g and workin g near heavy rnachin ery until yo u learn how this dru g affects yo u. ~ Do not use this drug if your liver or kidneys are irnpaired. ♦ Do not use buspirone if you are pregnant or breast-feeding. POSSIBLE

PREPARATIONS Over the counter: Butch er 's-broorn is ava ilable in dry bulk , capsules, ointrnent , and tin ctur e. At home: Tea: Put 2 tsp powder ed root in 1½ pt boilin g water. Sirnrner slowly in a cov ered container for about 30 rninutes . Drink cold, 2 to 3 tb sp, six tirn es a day.

Cornpr ess: Soak a c lean cloth in tea, and app ly. Ointrn ent: Apply srnall arnounts to hernorrhoids until inflarnrnation is cleared. SPECIAL INFORMATION + Consult your doctor for a di agnosis of circulatory problerns before using any rernedy.

INTERACTIONS

BUSPIRONE

Alcohol, anticonvulsants, antihistamines, barbiturates, benzodiazepines, muscle relaxants, opioid analgesics, sedatives, tricyclic antidepressants: Taking buspirone in cornbination with any of these dru gs rnay cause exc essive sedation.

DRUG CLASS Antianxiety Dru gs

Digoxin: possibl e increased digoxin effec t.

BRAND NAME BuSpar

Haloperidol: possible incr eased halop eridol effect.

GENERAL DESCRIPTION Buspiron e is a nonben zod iazepin e antianxi ety drug whos e act ions on th e body appear to be cornplex and are not c learly und erstood . Cornpar ed with oth-

BUTCHER'S-BROOM

MAO inhibit o rs: significantly increased blood pressur e. Do not cornbine these drugs with buspirone .

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CAFFEINE

DRUG CLASS Analgesics [Adjunct Therapy]

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BRAND NAMES Anacin, Excedrin Extra-Strength, Vivarin GENERAL DESCRIPTION Caffeine, obtained from both natural and synthetic sources, has been used for centuries as a mild central nervous system stimulant. It works by stimulating all parts of the central nervous system, affecting the heart, lungs, other organs, and muscles. Caffeine also affects the blood vessels by temporarily increasing the heart 's rate, contraction force, and output. While these effects usually produce no change in blood pressure for healthy individuals, you should avoid caffeine if you have high blood pressure. Caffeine increases the production of stomach acids. Other effects include a slight diuretic action, a decrease in uterine contractions, and a temporary increase in blood sugar. Some people develop a tolerance to caffeine. When caffeine is used for a long period, abrupt discontinuation can produce withdrawal symptoms such as headache , irritability, dizziness, and unusual tiredness. TARGET AILMENTS • fatigue. ♦ pain. Caffeine is used as an adjunctive (additive) treatment in combination with analgesics, such as aspirin, to enhance relief. ♦ migraine and other vascular headaches; used with ergot preparations. SIDE

EFFECTS

Not serious: Mild stimulation of the central nervous system (jitters), mild digestive upset , mild nausea, insomnia. Call your doctor if these symptoms become bothersome. Serious: Excessive stimulation such as dizziness, increased heart rate, nervousness, tremors; digestive upsets such as nausea, vomiting, diarrhea. Let your doctor know if you have these effects. You may have taken too much caffeine. Overdose symptoms include those above plus headache, vision disturbances such as seeing flashes or lights, delirium, fever, increased sensitivity to pain, ringing in ears. SPECIAL INFORMATION There has been some controversy regarding the use of caffeine by pregnant or nursing women. Although no

♦

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MEDICINES

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proof of birth defects has been found , caffeine does cross the placenta and small amounts also pass into breast milk. Caffeine can cause hyperactivity and insomnia in infants. For this reason, pregnant and nursing women should use caution and limit their intake of caffeine. ♦ Caffeine's effects on children have not been studied. POSSIBLE

and bone strength , calcium comes from many materials , including chalk, coral , and limestone. Perhaps as a reflection of its body-building properties , Calcarea carbonica, also called Cale carb, is used by homeopathic physicians for conditions that are accompanied by symptoms of exhaustion, depression , and anxiety. Calcium carbonate prepared for homeopathic use is ground from oyster shells and used at full strength .

INTERACTIONS

Barbiturates: combining these drugs may decrease the action of both. Beta blockers: combining these drugs may decrease the action of both. Bronchodilators: taking caffeine with these may increase stimulation and other side effects. Cimetidine (ulcer medicine), antacids and supplements that contain calcium: may decrease the elimination of caffeine, possibly increasing its effects. Disulfiram (for alcohol dependency): may decrease the elimination of caffeine, thus intensifying its effects. Erythromycin and troleandomycin: may decrease the elimination of caffeine, possibly increasing its effects. Iron supplements: decreased iron absorption .

TARGET A ILMENTS ♦ lower-back pain, broken bones that are slow to heal, sprains from overexertion, muscle cramps , constipation, chronic ear infections, eye inflammations, headaches, insomnia brought on by anxiety, eczema, allergies, teething problems, gastritis, gallstones, childhood diarrhea, menstrual problems, asthma, palpitations, arthritis. (Take internally .) PREPARATIONS

Calcarea carbonica is avai lable over the counter in various potencies , in both liquid and tablet form, at selected stores and pharmacies . Consult your practitioner for more precise instructions . "y'S IDE EFFECTS

None expected.

Lithium: may increase lithium elimination, decreasing lithium's effectiveness. MAO inhibitors: combining with large amounts of caffeine may produce heart arrhythmias or severe hypertension.

CALCIUM CARBONATE

Oral contraceptives: decreased action of caffeine. Other central nervous system stimulants (amphetamines, pseudoephedrine): may add to stimulation and other adverse effects. Other sources of caffeine or theobromines (related to caffeine) such as tea, coffee, chocolate: may produce an additive effect making side effects more likely.

CALCAREA CARBON ICA

LATIN NAME

Calcarea carbonica GENERAL DESCRIPTION Calcarea carbonica, or calcium carbonate, is a source of calcium, one of the most abundant natural elements in the human body. Essential to cell structure

DRUG CLASS Antacids BRAND NAMES Rolaids, Tums GENERAL DESCRIPTION Calcium carbonate is a calciumcontaining antacid drug that relieves the symptoms of upset and sour stomach, heartburn , acid indigestion, and ulcers. This medication is also used to help prevent calcium-deficiency diseases such as osteoporosis. See Antacids for more information , including facts about side effects and possible drug interactions.

_

CONVENTIONAL

CALCIUM CHANNEL BLOCKERS

I

GENERIC NAMES amlodipine, diltiazem , isradipin e, nifedipine, verapami l GENERAL DESCRIPTION Calcium channel blo ckers block the passage of ca lcium into body ce lls. Thi s action help s slow the contraction of th e heart and arteries , thereby dilating th e arteries, low ering blood pressure, and prev enting some heart spasms. These dru gs are used alone or in carefully selected combinations with other heart and blood pressure medications. For mor e information , see entries for the generic dru gs listed above. TARGET AILMENTS ♦ angina. ♦ heart-rhythm probl ems (especially diltiazem or verapamil). ♦ high blood pressure. ♦ Raynaud's syndrom e (nifedipine ). ♦ prevention of migr aine headaches. SIDE

EFFECTS

Not serious: Gastrointestinal upset (nausea, diarrhea, co nstipation ), weight gain, increased appetite, drowsiness, tiredness , lightheadedness, headach e, flushin g. Call your doctor if these eff ects beco me troublesom e. Serious: Heart problems , such as congestive heart fa ilur e, heart-rhythm irr egularities , or incr eased angina (heart pain ); low blood pressure; swelling of the low er extr emities ; allergic reactions , such as skin rash; bl eeding or tend er gums (rare ). Contact your do ct or imm ediately. SPECIAL INFORMATION ♦ Recent findings have prompt ed warn-

ings from some healthcar e professionals about th e safety of calcium channel blockers , particularly large doses of the short-acting form of nifedipine. Befo re using any of these drugs, be sure to discuss this matter thoroughly with your doctor. If you are already taking a ca lcium channel blocker , do not stop the medi cation without first co nsultin g your doctor. ♦ Pregnant and nursin g women should use calcium channel blockers only if clearly needed. ♦ Let your doctor know if you are suffering from low blo od pressure (hypotension), heart or kidney disease, or pulmonary congestion.

POSSIBLE

AND

INTERACTIONS

NATURAL

MEDICINES

I

CALCIUM POL YCARBOPH IL

All heart drugs, including digoxin, nitroglycerin, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors: calcium channel blo ckers taken in combination with a heart medication may in crease the effect of any of the drugs. How eve r, it is not unco mmon for these drugs to be prescribed together. If you are taking more than one of these medications , your do ctor will want to monitor your reactions closely.

DRUG CLASS Laxatives BRAND NAME FiberCon GENERAL DESCRIPTION Calcium poly carbophil is a bulk-formin g laxati ve drug used to relieve both constipation and diarrhea. This type of laxative should be considered the first choi ce in treating constipation. It may also be especially beneficial to people on low-fiber diets and to those with irrit able bowel syndrome (spastic colon), diverticulitis, or hemorrhoids. See Laxatives for information abo ut side effects and possible drug interactions.

Alcohol: increas ed effect of calcium channel blockers , leading to dangerously low blood pressure; do not drink alcohol while being treat ed with these drugs. Anti-inflammatory drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs): decreas ed effect of cal c ium channel blockers. Blood pressure drugs: can intera ct with ca lcium channel blockers , increasing th e effect of any of the combined drugs and leadin g to excessive lowerin g of blood pressure.

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SPECIAL INFORMATION • When taking this laxative , be sure to drink plenty of water or other fluid to avoid obstruction of th e throat and esophagus. Taking this medi cation without enough liquid may cause choking. • This laxative is slow acting; you may not experience its effects for 12 to 72 hours after taking it .

Calcium supplements: may decr ease the action of calcium channel blockers. Carbamazepine, theophylline: increased blood levels of th ese medications . Cimetidine: may increase the effe ct s of some calcium channel blockers by interfering with stomach action. Cyclosporine: taking calcium channel blockers with cyclosporine may cause to x ic levels of cyclosporine to accumulate in the blood .

CALENDULA

Drugs that reduce blood pressure either directly or indirectly, such as monoamine oxidase (MAO) inhibitors or opioid analgesics: calcium channel blo ckers may incre ase the hypotensive action of these drugs , possibly leadin g to dangerously low blood pressure. Your doctor may have to adjust your dosage of all medicin es.

LATIN NAME Ca/endula officinalis GENERAL DESCRIPTION The therapeutic use of calendula originated in ancient Egypt and spread to Europe . Many varieties of the plant exist, one of which is the common marigold. Calendula 's medically active parts are its flowers. A natural antiseptic and antiinflammatory agent, calendula is one of the best herbs for treating wounds, skin abrasions, and infections. Taken intern ally, it also helps alleviate the symptoms of indigestion and other gastrointestinal disorders. Calendula 's healing power appears to come from components known as terpenes. One of these, cal endulosid e B, is known as a sedative and for its healing effect on ulcers .

Estrogens: may elevate blood pressur e and thus increas e the need for calcium chann el blockers . Lithium: nausea, vomiting, diarrhea, or tremors. Rifampin: reduced effect of calcium channel blockers.

TARGET AILMENTS Take internally for: ♦ indi gestion , gastric and duodenal ul cers, gallbladder problems.

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Use as a gargle for: ♦ sore throat , cold sores.

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Apply externally for: ♦ cuts , wounds, sores, burns; skin rashes from measles, chickenpox, and other eruptive skin diseases; diaper rash; athlete's foot and other fungal infections.

PREPARATIONS Over the counter: Calendula is available in several forms for both internal and external use. You can find lotions, ointments, oils, tinctures, and fresh or dried leaves and florets. At home: Rub lotions, ointments , and oils on injuries, rashes, and infections, as needed.

Poultice: Mash up the leaves, then apply directly to minor burns or scalds. Infusion: Steep 1 oz dried herb in 1 pt boiling water . For acute internal symptoms, drink two to four times a day unt i I symptoms lessen. Combinations: A mixture of marsh mallow root, American cranesbill, and calendula may help digestive problems. Calendula is often combined with slippery elm and applied to soothe skin inflammations and wounds. A mixture of goldenseal, calendula, and myrrh makes an antiseptic lotion.

SPECIALINFORMATION ♦

Calendula flowers can be made into an oil for external use and to ease earaches and other infections.

CAMPHOR

banned all products with a camphor concentration greater than 11 percent , including camphorated oil.

TARGETAILMENTS ♦ cough. ♦ nasal congestion. ♦ pain from arthritis

and minor skin irritations . ♦ minor cuts and scrapes (as an antiseptic). S I DE EFFECTS

Not serious: Minor irritation when applied to skin. Call your doctor if the irritation is troublesome. Serious: Headache, dizziness, delirium, hallucinations , restlessness, confusion, tremors , jerky motions, convulsions, drowsiness, shallow breathing, coma. These symptoms indicate overdose or poisoning. In rare cases, death can result from respiratory failure or extreme convulsions. If any of these symptoms occur, call your doctor or poison control center immediately.

SPECIALINFORMATION ♦ Because it can affect the developing

fetus or pass to an infant through breast milk , camphor is not considered safe for pregnant or nursing women. ♦ Do not apply camphor to deep or serious wounds, since this may allow the drug to enter the bloodstream.

CANTHARIS

toms like those of cantharis poisoning. According to homeopathic tradition , the beetles are collected at daybreak, when they are still sluggish from the cool of the night, and heated in the steam of boiling vinegar until dead. The beetles are then crushed and mixed with successively greater amounts of milk sugar, a pharmaceutical process called trituration. The resulting powder is highly dilute. Like most homeopathic prescriptions, Cantharis was developed as a remedy by observation of the reactions of healthy individuals to a series of undilute doses. The mental, emotional, and physical changes induced by Cantharis were then cataloged. When a homeopathic practitioner encounters a patient with a set of symptoms that matches the cataloged symptoms brought on by Cantharis, the practitioner then prescribes it in an extremely dilute form . It is presumed that in this highly dilute dosage, Cantharis can counter the symptoms that it induces when it is at full strength .

TARGETAILMENTS ♦

bladder infections or cystitis, with a constant desire to urinate accompanied by blood and pain during urination; sunburns, scalds, and blistering second-degree burns. (Take internally.) ♦ stings or bites with intense burning.

PREPARATIONS Cantharis is available over the counter in various potencies, in liquid and tablet form , at selected stores and pharmacies . Consult your homeopathic practitioner for more precise information. S I DE EFFECTS

None expected.

BRAND NAME Vicks VapoRub

GENERALDESCRIPTION A resin from a type of cinnamon tree, camphor has been used for centuries as an insect repellent and as a medication for minor skin irritations. By itself or in combination with menthol, phenol, or methyl salicylate, camphor is found in many over-the-counter products, ranging from pain-relieving Ii n i ments to decongestants and cough suppressants. Camphor is absorbed rapidly through the skin and by inhalation. Exposure to high concentrations of the substance can result in serious, even toxic side effects. Because deaths have occurred from camphor poisonings, the FDA has

916

LATINNAME Cantharis GENERALDESCRIPTION Popularly known as Spanish fly, cantharis is actually a beetle found in southern France and Spain. It produces an irritant so caustic that the skin will blister if exposed to it. Cantharis has had a long career in medicine, used for all manner of disorders from baldness to rheumatism, even as an aphrodisiac. In high concentrations, the irritant can be toxic, prompting abdominal cramps and burning pains in the throat and stomach, vomiting of blood, diarrhea, kidney damage, convulsions, coma, and death. Homeopaths prescribe Cantharis for patients whose ailments are coupled with symp-

CAPTOPRIL

DRUG CLASS Angiotensin-Converting Inhibitors

Enzyme (ACE)

BRAND NAME Capoten

GENERALDESCRIPTION Introduced in 1979, the ACE inhibitor captopril is prescribed for the control of high blood pressure (hypertension) and congestive heart failure. The drug works by blocking a body enzyme essential for

CONVENTIONAL

the prod uct ion of a substance that causes blood vessels to constrict. Thi s act ion relaxes arte ri al walls , lowe r ing blood pressure and decreasin g th e wo rk load of th e heart. For incr eased eff ectiveness in lowe rin g blood pr essur e, captopril is someti mes combined with hydro chlorothi azide. See Angiotensin-Converting Enzyme (ACE) Inhibitors for informat ion o n side effects and possible d rug inter act ions .

'Y SIDE

AND

GENERICNAME loracarbef

GENERALDESCRIPTION Carbacephem drugs, a subcl ass of antibioti cs, work in much th e same w ay as penicillin s and cephalosporins to kill grow ing bact eria. Loracarb ef is the only carb acephem antibiotic on th e market. See Loracarbef for information about side effects and possible interactio ns.

CARBAMAZEPINE

DRUG CLASS Anticonvulsa nt Drugs

BRAND NAME Tegreto l

GENERALDESCRIPTION Wh en first introduced in 196 2, carb amazep ine was approved as a pain reliever fo r rare forms of neur algia. It is now used primarily in th e co ntrol of several types of epileptic seizur es, includin g tonic-clonic (grand mal) seizures, partia l seizures, and mi xed seizure patte rns. Carb amazepi ne is considered a fir st-choice anticonvulsant dru g due to its low toxi city and the rarity of seriou s adverse effects . For more info rm ati on, see Anticonvulsant Drugs.

effects.

Constipation; impaired urin at io n; dry throat and mouth; water retention ; mild nausea and vomiting; loss of appetit e; drow siness; fatigue; increased sensitivity to sunli ght (sunburn , rash, itc hing, redness); headache; dizziness ; unsteadiness; and co nfusio n. Consult your doctor if the se or ot her effects persist or are bot hersome.

CARISOPRODOL ----

TARGETAILMENTS • cert ain types of epileptic seizures. ♦ relief of pain in tri geminal (tic douloureux) and glossopharyngeal neur algia. However , carbam azep ine should never be used to reli eve ordinary aches and pains.

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DRUG CLASS Muscl e Relaxants

Blurr ed or double vision; severe dermatiti s; bone marrow depression (weakness, fever, abnormal bleeding or bruising); liver damage (jaundice); behavioral changes (agitation , hostility ); and mental depr ession. Call yo ur doctor at once.

BRAND NAME Soma

GENERALDESCRIPTION Carisoprod o l is used to rapidly reli eve acute pain associated w ith muscle strain s and spasms. Although its exact mechani sms are unknown , the drug has a sedative effect and it appears to block chemical pain messages from travelin g to the br ain. Carisoprodol is most eff ective if used in conjun ction with rest, physical therapy, and other medic ations , such as analgesics.

SPECIAL INFORMATION • Do not use carbamazepi ne if you: have had an allergic reaction to it or t o any tricyclic antidepressant drug in the past; are nursing or in th e first thr ee months of pregnancy; have a blood cell di sorder, a bone-marrow disorder, o r an active liv er disease. • Tell your doctor if you: are takin g any ot her drugs (prescription or over the count er); co nsume mor e than two alco ho lic drink s a day; have a history of kidney or liver disease, thrombophl ebitis , o r a severe ment al depression or disorder; are planning any medi cal or dental surgery requiring a general anesthesia. • If you are over the age of 60, thi s drug may aggravate glaucoma , angina, and prostate problems. ♦ Carbamazep ine shou ld be taken with food to lessen stomach upset and improve absorbency. ♦ Routi ne testing for early indi catio ns of bone-marrow or blood cell to xic ity is essential. ♦ Carbamazepine may affect blood cell cou nts, liver function t ests, urine pregnancy tests, and various blood t est s. ♦ Do not abruptl y discontinue the drug or swit ch to another anticonvulsant drug unl ess advised to do so by your physici an. • Sudden withdrawal can cause a series of unint errupted seizures. POSSIBLE

MEDICINES

Tranquilizers, narcotics, alcohol, sedatives, and hypnotics: increased sedative

EFFECTS

Not serious:

Serious:

CARBACEPH EMS

NATURAL

TARGETAILMENTS ♦

acute , painful muscle strains and spasms SIDE

EFFECTS

Not serious: Dizzin ess, drowsin ess, flushed face, hiccups, lighth eadedness, nausea, vertigo. Infrequently : headache, irritability , insomnia. Call yo ur doctor if these side effects per sist or become bother some.

Serious: Allergic reactions such as itchin g, welts on skin, skin rash, difficulty breathin g, weakness. Unco mmonly: agitation, confusion , depression, enlarged pupils, fainting , rapid heart rate , speech prob lems, temporary paralysis of arms and legs, tremors , vision problems, vomiting. Discontinu e use and call your doctor immediately.

SPECIALINFORMATION ♦

Women who are pr egnant or nursin g should t ake this medication only under a doctor 's supervision. ♦ This medication may cause drowsiness. Use caution while taking carisoprodol if you must drive or perform other tasks requiring alertness. • Car isoprodo l should be used with caution by pati ents who have kidn ey or liv er problems.

INTERACTIONS

Anticoagulants, doxycycline, oral contraceptives with estrogen, and valproic acid: carbamazep ine can decrease th e effect of these drugs.

Monoamine oxidase (MAO) inhibitors and lithium: may cause severe to x ic reactions when taken with carbamazepine.

0

Prescription Drug

0

Over-the Coun ter Drug

O

Western Herb

O

Chinese He rb

6,

UR

Homeop athic em edy

g1

7

CONVENTIONAL

POSSIBLE

AND

NATURAL

INTERACTIONS

CAYENNE

Alcohol: Increased effects of alcohol.

Antidepressants, sedatives, tranquilizers: Altered effects of these drugs. Consult your doctor before combining carisoprodol with any of these drugs.

D

LATINNAME Nepeta cataria

GENERALDESCRIPTION Herbalists have used the flowers and leaves of catnip , an aromatic member of the mint family, for more than 2,000 years. Today it is prescribed for easing digestion, calming nerves, and relieving muscle spasms, including menstrual cramps. Cats are strongly attracted to catnip and may become intoxicated by eating it ; but the herb has no such effect on humans.

TARGETAILMENTS

Capsicum frutescens

Herbalists regard cayenne as a powerful tonic. The seed-sized fruit stimulates the heart and promotes blood circulation, i~proves digestion , and boosts energy. Like other species of hot garden pepper, such as chi Ii or tabasco, cayenne contains the natural stimulant known as capsaicin. Cayenne was widely grown in Central and South America in preColumbian times; it was carried to Spain and Europe after the early voyages of discovery.

TARGETAILMENTS Take internally for: • poor circulation, indigestion, gas, physical or mental exhaustion, and lowered energy or vitality, particularly in the elderly. Apply externally for: • pain , including that of arthritis and diabetes, strains, sore muscles and joints, the need to stimulate blood flow or to stop external bleeding.

CEFACLOR

DRUG CLASS Antibiotics

[Cephalosporins]

BRAND NAME Ceclor

GENERALDESCRIPTION Introduced in 1979, cefaclor is a cephalosporin antibiotic used to treat certain types of pneumonia and otitis media, as well as strep throat and infections of the skin, skin-structure, and urinary tract. For more information see

Cephalosporins.

CEFADROXIL

Take internally for: • indigestion, gas, tension , difficulty in sleeping, colds, flu , bronchial congestion , fever, colic in infants , menstrual cramps.

PREPARATIONS Over the counter:

Antibiotics

Apply externally for: • cuts and scrapes.

Cayenne is available as powder, capsules, tincture, or oil.

BRAND NAME

At home: PREPARATIONS Over the counter:

Rub the oil on sprains , swelling , sore muscles, and joints to ease pain.

Catnip is available in dried bulk flowers and leaves, tincture , and tea bags.

½ to 1 tsp cayenne powder and steep

At home: To treat minor cuts and scrapes, press crushed catnip leaves into them before washing and bandaging them. Infusion: Pour 1 cup boiling water onto 2 tsp dried leaves and steep for 10 to 15 minutes. Drink three times a day. Combinations: Mix with boneset, elder, yarrow , or cayenne for colds. SIDE

EFFECTS

Not serious: Catnip can produce an upset stomach . If this occurs , discontinue use and call your doctor.

SPECIALINFORMATION • Avoid catnip during pregnancy. • You can give weak , cool infusions to infants with colic. For other children and people over 65, start with weak preparations and increase the strength as necessary.

918

• If you have an ulcer, use cayenne only with the consent of your physician.

LATINNAME GENERALDESCRIPTION

CATNIP

1

(.~ .t. I

MEDICINES

Infusion: Pour 1 cup boiling water onto for 10 minutes. Mix 1 tbsp of the infusion with hot water and drink as needed.

DRUG CLASS [Cephalosporins]

Duricef

GENERALDESCRIPTION A cephalosporin antibiotic introduced in 1977, cefadroxil is used to treat infections of the urinary tract, upper respiratory tract, and skin. For information about side effects and interactions, see

Cephalosporins.

Gargle: Combine cayenne with myrrh to treat laryngitis and as an antiseptic wash. SIDE

EFFECTS

CEFIXIME

Not serious: In large doses, cayenne can produce vomiting, stomach pain, and a type of intoxication. Do not exceed prescribed dosages.

SPECIALINFORMATION • Because it is hot and spicy as an infusion or tincture , cayenne can cause mild nausea when first taken. It 's best to start with a small amount and increase gradually to the recommended dosage. • Do not use cayenne on open cuts, sores, or broken skin.

DRUG CLASS Antibiotics

[Cephalosporins]

BRAND NAME Suprax

GENERALDESCRIPTION Introduced in 1986, cefixime is a cephalosporin antibiotic used to treat respiratory tract infections such as pharyngitis and otitis media, as well as uncomplicated gonorrhea and urinary

CONVENTIONAL

tract infections. For more information , see Cephalosporins.

CEFPROZIL

DRUG CLASS Antibiotics

[Cephalosporins]

BRAND NAME Cefzil

AND

GENERALDESCRIPTION

Inhibitors.

Introduced in 1991, cefprozil is a cephalosporin antibiotic used to treat skin infections and respiratory tract infections such as pharyngitis, otitis media , and bronchitis. For more information see Cephalosporins.

CENTRAL NERVOUS SYSTEM STIMULANTS

CEFUROX IME

DRUG CLASS Antibiotic s [Cephalosporins]

BRAND NAME Ceftin

GENERALDESCRIPTION A cephalosporin antibiotic introduced in 1976, cefuroxime is used to treat respiratory tract infections, such as otitis media , as well as gonorrhea and infections of the urinary tract and skin. This drug is often taken with food to mask its strong, bitter taste. See Cephalosporins for more information.

cefaclor , cefadroxil , cefixime, cefprozil, cefuro xime, cephal exin

GENERALDESCRIPTION Cephalosporins, a subclass of antibiotics related to penicillins , act by destroying growing bacteria. They do not kill fungi or viruses, such as those responsible for colds and the flu . Your doctor may prescribe these drugs if you have an infection caused by bacteria resistant to penicillins. Cephalosporins are available in forms that can be taken orally or injected .

CJ

♦ ♦

otitis media. infections of the respiratory tract , genitourinary tract , skin, or soft tissue. ♦ serious infections of the blood, bones, joints , abdomen, lungs, or heart.

~

GENERALDESCRIPTION

S I DE EFFEC T S

Not serious: Mild nausea, mild diarrhea, yeast infections of the mouth (sore mouth or tongue) or of the vagina (vaginal itching or discharge). Tell your doctor when convenient. Serious: Dizziness , serum sickness (fever accompanied by joint pains and rash), severe diarrhea, a severe allergic reaction, unusual bruising or bleeding , or severe stomach cramps. Call your doctor immediately.

SPECIALINFORMATION ♦

Let your doctor know if you have ever had an allergic reaction to a cephalosporin drug or to penicillins , penicillamine , or a penicillin derivative. Your doctor may decide to prescribe a different drug. About 1O percent of people with allergies to penicillin are also allergic to cephalosporins. Reactions range from mild rashes and fever to I ife-threatening anaphylaxis. ♦ Tell your doctor if you have kidney or liver impairment, phenylketonuria, or a history of bleeding disorders or gastrointestinal disease; cephalosporins can exacerbate these conditions . ♦ Take the full course of your prescrip tion , even if you feel better before f inishing the medication; otherwise , the infection may return. • These drugs may cause false-positive results for the Clinitest urine glucose test. (They do not affect results of

Methylphenidate.

CEPHALEXIN

DRUG CLASS [Cephalosporins]

CELECOXIB GENERALDESCRIPTION

DRUG CLASS Nonsteroidal Anti-Inflammatory (NSAI Os) [COX-2 Inhibitors]

BRAND NAME

Drugs

Introduced in 1969, cephalexin is a cephalosporin antibiotic used to treat respiratory tract infections, such as otitis media, as well as bacterial infections of the skin, bones and joints, and genitourinary tract. For more information, see Cepha/osporins.

Celebrex

0

Prescription Drug

0

O ver-theCounter Dru g

GI

TARGETAILMENTS

The central nervous system (CNS) stimulant class includes a number of drugs that are used to treat various organic, psychological, and behavioral disorders, such as attention deficit disorders, narcolepsy, depression , and obesity . Amphetamines and cocaine are major drugs in this class. Minor drugs include appetite suppressants, bronchodi lat ors, caffeine, and the sympathomimetics . Abuse or chronic use of CNS stimulants can result in drug dependence or addiction. For this reason, dosages must be prescribed on an individual basis, and physician supervision is essential. For information on a specific generic drug used primarily in the treatment of attention deficit disorders in children and in the control of narcolepsy, see

Antibiotics

I

GENERICNAMES

SPECIALINFORMATION • People with the congenital disorder phenylk etonuria should avoid cefprozil in oral suspension, which contains phenylalanine .

MEDICINES

CEPHALOSPORINS

Celecoxib is used to treat two types of arthritis: osteoarthritis and rheumatoid arthritis. Like other COX-2 inhibitors this drug is less likely to cause ulcers ' and stomach bleeding than other NSAI Os and it does not decrease blood clotting time. Celecoxib has been approved as a cancer prevention drug in people at high risk for colon cancer due to the genetic disorder familial adenomatous polyposis. It is in clinical trials to determine if it can prevent colon, skin, esophageal, and bladder cancers in the general population. For additional information about this drug, see COX-2

GENERALDESCRIPTION

NATURAL

O

Western Herb

0

Chinese Herb

~ Homeopathic

~ Remedy

91

g

!I'

CONVENTIONAL

♦

1B

• ♦

♦

AND

NATURAL

Clinistix or Tes-Tape.) Cefuro x ime causes false-negative results in some blood gluco se t est s. Cephalosporins may be taken on a full or on an empty stomach . While most of these drugs are absorb ed mor e qu ickl y on an empt y stomach , cefuroxime is better absorbed when tak en with food. If possible, avo id takin g these drugs if yo u are pregnant or breast-feeding. Cephalosporin s also kill "g ood " intestinal bacteria th at keep harmful fungi and inte stinal bacte ria in check. Eating yogurt co ntainin g Lactob acillus acidophilus culture or taking ac idophilus tablets may help restor e the body 's normal bacteria. Prolon ged use of any antibioti c drug can lead to fun gal infect ions, including candidi asis, o r t o bacteri al infections such as pseudomembranous colitis. POSSIBLE

INTERACTIONS

Aminoglycosides (amik ac in, gent amic in,

kanamycin , neomyci n, neti lmicin , streptomycin, tob ramy c in): ri sk of kidn ey fa ilur e. Bacteriostatic drugs (t etr acyc lin e, erythromycin , chlorampheni co l, sulfon amid es): may imp air cepha losporins' bact eria-kil lin g actio n. Loop diuretics: ri sk of kidn ey failure. Nephrotoxic drugs (vancomyc in, co lis-

tin, polymyxin B): risk of kidney failure. Probenecid: decre ases the kidney s' ability to excrete cephalosporins . Possibl e cep halospo rin tox icit y. Howeve r, this co mbin at ion is sometimes prescribed to treat seriou s inf ection s that require high, prolonged serum levels of cep halospori ns.

MEDICINES

TARGET A ILMENTS

Take intern ally for: • stomach cramps, gas and nervous sto mach, indigestion, ul cers, menstru al cramp s, insomni a, co lic, bladder prob lems. App ly externa ll y for: ♦ swe lling and pain in the j oints, skin infl ammati on and sunburn , cuts and scrapes, t eethin g pain , va ri cose vein s, hemorrhoids , sore or infl amed eyes. Use as a gargle for: • gi ngiviti s and sore thro at. PREPARATIONS Over the counter:

Available as prepared tea, tin ct ur e, essential oi l, and dri ed o r fresh flowers. At home:

Tea: Pour 8 oz boiling wate r over 2 tsp chamomile flowers and steep for 1O minut es. Drink 1 cup three or four tim es daily, or dilute and use as an eye co mpr ess (see below). Compress: Strain the tea through a coffee filt er and dilut e wi th an equa l amount of wate r. Always use fresh t ea (less than 2 4 hours o ld) and refriger ate unu sed porti o ns. (Brin g the dilute t ea to room temp eratur e before using it. ) To make the compress, pour th e liquid on a cloth and app ly to the closed eye. Discontinue if yo ur eye becomes irritat ed. Fomentation : Apply three or four times daily to sore muscl es; sore, swollen joint s; vari cose veins ; and burns and skin wo unds . Herbal bath : Run bathwater ove r 2 o r 3 oz chamomil e flow ers ti ed in cloth , or add no mor e th an 2 drops essential oil of chamomil e to bat hw ater. SIDE

EFFECTS

None expected. SPECIAL INFORMATION

CHAMOMILE

LATIN NAME

Matricaria recutit a GENERA L DESCRIPTION

Of the three types of chamomile plant , the mo st popular and thoroughly studied is German chamomi le, used medicinally around th e world for thousands of years. Mod ern herb alists have identified element s in the oi l of th e chamomile flower that appea r to calm the centr al nervo us system, relax th e digestive tract, and speed the healin g proc ess.

920

♦ Allergies t o chamomile

r'1

~

are rare. Howeve r, anyon e all erg ic to ot her plants in th e daisy fami ly (chrysanth emums , ragwee d, and asters, for example ) should be alert t o possib le allergic reactions to cham omi le, ranging from contact dermatitis to anaphyla x is (itching, rash, and difficult y bre at hin g).

:i~

CHAMOMILLA

LATI N NAM E

Cham omill a GENERA L DESCRIPTION

Cham omill a is made from the fl owe rin g Germ an chamomi le plant co mmon in Europe. The who le plant is crushed, and its jui ces are mi xed w ith equal part s of alco hol , then succ ussed. In hom eopath y, Chamomill a is cons ider ed t o work best for peopl e who are extr eme ly sensitive to pain, ir r itab le, imp ati ent , and im p lacab le. Cham omill a pati ents sweat easily and are sensitive to wind and chills. Chamomilla is most oft en given to childr en who work th emselves int o vio lent t emper tantrums . Like most hom eopathi c prescri ptions, Chamomill a was developed as a remedy by observation of the reactio ns of healthy individu als to a series of undi lute doses. The menta l, emotio nal, and physica l changes induced by Chamomilla we re then cata loged. When a homeopathi c practitioner encount ers a patient w ith a set of symptoms t hat matches the cataloged symptoms brought on by Chamomilla, t he practitioner th en prescribes it in an ext remely dilute form. It is presumed that in this highly di lute dosage, Chamomill a can co unt er the sympt oms that it indu ces w hen it is at full strength. TARGET AILMENTS ♦

irrit abi lit y; to othac hes aggravated by cold air and warm food ; painful menstr ual periods w ith severe cramping and a fee ling of anger or restl essness; ext reme ly painful earaches; t eethin g pain, especia lly if th e child is irri table; difficulty gettin g to sleep; pai nful diarrh ea, especially in children.

PREPARATIONS

Chamomill a is availabl e ove r the co unter or from yo ur hom eopathi c pr actiti oner. Consult your practiti oner for dosage inform at ion. SIDE

EFFECTS

None expected.

I

CONVENTIONAL

AND

NATURAL

MEDICINES

C HI CKWEED

C HI CORY

LATIN NAME

LATIN NAME

LATIN NAME

Vitex agnu s-cas tus

Stellaria m edia

Cichorium intybus

GENERAL DESCRIPTION

GENERAL DESCRIPTION

GENERAL DESCRIPTION

Since anc ient time s, herba list s have used the berries of th e chaste tr ee, sometim es known as chasteberr ies, to manipulat e the functioning of the femal e reprodu ctive system. Chaste tr ee's natur al compounds seem to aid in regulating the menstrual cycle by bringin g int o balance the female sex hormon es, estrogen and progesterone. Besides treating menstrual irr egulariti es, chaste tree is prescribed for reli eving premenstrual syndrom e and to co unt er symptoms of menopa use. It also aids in readju stin g th e body after w ithdr awa l from lon g-t erm use of birth- co ntrol pills, preventin g mi scarriage in the fir st three month s of pregnancy , and promotin g lactat ion. In past eras, the herb was used to damp en the sexual lon gings of Roman wome n whose husbands were abroad on military expedit ion s and to curb the sex drives of medieval monk s. Paradox icall y, chaste tr ee has also had a reputation as an aphrodisi ac.

Rubbed on the body, thi s commo n wee d is one of th e best herbs for relievin g the discomfort of insect bit es and other it chy skin conditions. The components of chickweed known as saponin glycosides exert a soothing effect on th e skin. Taken internally , chickwe ed has a similar soothing and moistenin g effect on th e lun gs and stomach.

A somewhat scraggly plant wit h blue flow ers, chicory flourishes both in gardens and in the wild , and has been known to doctors at least as far back as th e first century AD . Although it has many medi cinal uses, chicory is often used as a food additive. The plant 's leaves, like other leafy green vegetabl es, can be added to a salad or served by themselves, and the roasted and ground chicory root is a common addition to coffee in Europe as well as in th e United States. Chicory added to coffee complements the popular drink, for experiments have shown that lactu cin and lact ucopicrin (two of the substances in chico ry that make it t aste somewhat bitter ) may counteract the effects of caffein e by their sedativ e action on the central nervous system. Chicory is believ ed to be a laxative and is also said to increase the flow of bil e. It may in addition be suitabl e for tr eatin g gout and rheumatism , because it acts as a mild diureti c, incre asing the elimination of fluid from the body. Chi co ry leaves have also been used in compresses to treat skin inflammations and swellings.

CHASTE TREE

TARGET AILMENTS

• premenstrual syndrome, menstrual ir regularities , symptoms of menopause, prevention of miscarriage , promotion of lactati on , horm o ne-rel ated co nsti pation , endo metrio sis (di sorde r of th e uterine linin g), fibroid cysts that occur in smooth muscle tissue, acne in both male and fem ale teenagers. (Take internally.) PREPARATIONS Over the counter:

Chaste tre e is availabl e as berri es, powder, dried herb , capsules, and tincture. At home: Tea: Pour 1 cup boilin g water onto 1 tsp rip e berries and let th em infus e for 10 to 15 minutes. Drink thr ee tim es a day. SPECIAL INFORMATION

• Chaste tr ee seems to regulate hormonal imb alances within 10 days, and reli ef from premenstru al syndrome may be noti ceable by the second menstr ual cycle. For optimal benefit, howeve r, the herb should be taken for six months or lon ger. • Di scontinu e the herb after th e third month of pregnancy, sinc e it may cause prem ature production of milk .

TARGET AILMENTS

Take internally for: ♦ sore throat , co ngestion in the lun gs, stomach and duodenal ulc ers, rheum at ism. Apply exte rnally for: • cuts; wo unds; bites from mosquito es and other insects; eczema, psori asis, and other itchin g skin irritations ; boils , abscesses, skin ulcers ; scalp conditions. PREPARATIONS Over the counter: Chickweed is avail able in dried bulk , o il , ointm ent , and tincture .

At home: Tea: Pour 1 cup boiling water onto 2 tsp dried herb and steep for five minut es. Drink a cup three times a day to reduce it ching .

TARGET AILMENTS

Take intern ally for: • caffe ine-indu ced rapid heartb eat; j aundic e, spleen probl ems, gall ston es; gastritis and other digestive difficul ties; rheum at ism; gout.

Bath: Pour either a strong infusion or fresh herb s into th e bathw ater to reli eve it ching. Cool drink : Combine a handful of fresh her bs w ith pineapple jui ce, process in th e blender , and strain. This drink may relieve skin irritation and rheumatism.

Apply extern ally for: skin inflammations .

♦

PREPARATIONS Over the counter: Chicory is available in bulk as green leaves and dried root s.

Ointment: Add marsh mallow root to the fresh herbs and juice , and blend. Poultice: Grind up fresh leaves and apply to leg ulc ers.

At home: Tea: Simmer 1 tsp rootstock or dried herb with ½ cup water and strain; drink 8 to 12 oz per day for jaundic e, spleen probl ems, gallstones, or gastritis.

SPECIAL INFORMATION ♦

You can eat as much fre sh chickweed as you want, for its therapeutic effects. Chickweed is high in vitamin C, and the fresh herb can be eaten raw in a salad or as a cooked green. ♦ Juice squeezed from the leaves with a mortar and pestle is particularly effectiv e in healing scalp problem s. ♦ Because it cont ains v it amin C, chickweed has been used as a remedy for scurvy.

0

Prescription Drug

0

Over-theCounter Drug

Cl

Nutrition and diet : Squeeze 1 tbsp jui ce from the chi co ry stem with your hands and tak e it in milk or water three tim es daily. Use th e fresh greens in a salad, or saute them as a side dish. SIDE

EFFECTS

Not serious: If yo ur skin becomes red, swo llen , or irritated after you handle chicory, cover

O

Western Herb

0

Chinese Herb

l\ Homeopathic V Remedy

g 1 2

CONVENTIONAL

AND

NATURAL

your hands with gloves and treat the irritated area as needed.

D

CHINESE FOXGLOVE ROOT LATIN NAME

Rehmannia glutinosa

MEDICINES

SPECIAL INFORMATION ♦

WARNING: Individuals who have digestive problems or a tendency to gas and abdominal bloating are advised to use this herb carefully; the cooked herb can distend the abdomen and cause loose stools. ♦ In a trial with a small number of patients, raw Chinese foxglove root was used to treat rheumatoid arthritis. Some improvement in rheumatic symptoms was shown over a period of about six months.

GENERAL DESCRIPTION

The thick, reddish yellow Chinese foxglove root is cooked in wine and used as a tonic. The cooked form of the root is often used in treating disorders associated with aging. It is classified as sweet and warm in traditional Chinese medicine.

T SIDE

EFFEC T S

None expected. SPECIAL INFORMATION ♦

WARNING: Do not use this herb if you are pregnant. In laboratory trials it has caused rabbits to miscarry. ♦ In a clinical test, the herb seemed effective in causing the uterus to contract after childbirth. ♦ The seeds of this plant also are thought to have medicinal properties. They are used for certain types of uterine bleeding.

CHINESE MOTHERWORT CHINESE YAM LATIN NAME

TARGET AILMENTS

Take internally for: ♦ lightheadedness, palpitations, blurred vision, or floaters in vision. ♦ insomnia or the inability to be still and restful. ♦ chronic low-grade fever and night sweats. ♦ constipation with dry, hard stools. ♦ irregular menstruation or uterine bleeding, especially after childbirth. ♦ low-back pain and weak knees; weak, stiff joints. ♦ hearing loss and tinnitus (ringing in the ears). ♦ premature graying of hair. PREPARATIONS

The prepared root and the raw version are available from Chinese pharmacies, Asian markets, and some Western health food stores. When you order, specify that you want the cooked version, which is made by soaking the root in rice wine with spices such as cardamom. Combinations: A mixture with gelatin is prescribed for coughing and vomiting blood , nosebleeds, and bleeding from the uterus. Practitioners also use combinations of the cooked root with cornus and Chinese yam, or with freshwater turtle shell, to treat lightheadedness, insomnia , forgetfulness, and related symptoms. See a Chinese medicine practitioner for information on dosages and further herbal combinations. SIDE ♦

922

EFFECTS

Grains-of-paradise fruit is often added to preparations of Chinese foxglove root to prevent side effects such as diarrhea, nausea, and abdominal pain.

Leonurus heterophyllus GENERAL DESCRIPTION

In a literal translation of its Chinese name, yi mu cao, motherwort means "benefit mother herb," and indeed the leaves are popular among Chinese women as a treatment for menstrual difficulties . When seeking the best variety, look for thin stems and pure green coloring. In traditional Chinese medicine, motherwort is classified as acrid, bitter, and slightly cold. TARGET AILMENTS

Take internally for: ♦ irregular menstruation or light menstrual flow, premenstrual abdominal pain, uterine fibroids, postpartum abdominal pain, infertility. ♦ difficulty in urinating and edema (swelling caused by retention of fluids), particularly when accompanied by blood in the urine. PREPARATIONS

Chinese motherwort is available as leaves or powder in Chinese pharmacies, Asian food markets, and some Western health food stores. Combinations: The herb is often mixed with red peony root, dong quai, and aucklandia to regulate the appropriate timing of the menstrual cycle and alleviate the pain and discomfort of menstruation. Herbalists prescribe a combination with imperata to treat edema associated with the kidney disease nephritis . And a mixture containing Chinese motherwort, polygonati, pyrrosia leaves, and musk mallow seeds is used to treat kidney stones and bloody urine. Check with a Chinese medicine practitioner for information on dosages and additional combinations.

LATIN NAME

Dioscorea opposita GENERAL DESCRIPTION

Chinese yam, a thick, firm root with a white cross section, is used as a tonic. Classified as neutral and sweet in traditional Chinese medicine, the herb is harvested in the winter in the mountains of Hunan and many other Chinese provinces. TARGET AILMENTS ♦

weak digestion with diarrhea and fatigue, reduced appetite, frequent urination, excessive vaginal discharge, chronic coughing and wheezing, symptoms that accompany diabetes. (Take internally.)

PREPARATIONS

Chinese yam is available as a fresh or dried vegetable in Chinese pharmacies, Asian food markets, and some Western health food stores. For symptoms of diabetes, slices of the fresh root are steeped in hot water to make a tea. Combinations: A mixture of Chinese yam, poria, and atractylodes (white) may be prescribed for loose, watery stools. Chinese yam and codonopsis root make up a preparation used to treat fatigue, general weakness, and reduced appetite. Consult a Chinese medicine practitioner for information on dosages and other herbal combinations. SIDE

EFFECTS

None expected. SPECIAL INFORMATION ♦

If symptoms include abdominal swelling and pain, do not use Chinese yam.

I

CONVENTIONAL

POSSIBLE

INTERACTIONS

Do not take Chinese yam with kan-su i root.

CHLORHEXIDINE

DRUG CLASS Antibiotics

[Topical Antibiotics]

BRAND NAME Peridex

GENERALDESCRIPTION Chlorhexidine is used as an oral rinse in the treatment of gingivitis. By reducing the amount of bacteria in the mouth , the drug helps reduce inflamma tion (redness and swelling) and bleeding in the gums. For side effects and other information , see Topical Antibiotics.

CHLORPHENIRAMINE

lipoproteins . It has been shown that high levels of low-density lipoprotein (LDL) cholesterol incr ease th e risk of heart disease, whereas high levels of high-d ensity lipoprotein (HDL) seem to protect against it. These drugs help both to reduce the "bad" LDL cholesterol and to raise the "go od " HDL cholesterol. Cholesterol-reducing drugs are usually prescribed only after diet modifi cation has failed to lower blood cholesterol levels. The medicines serve as a supplement to a proper diet and exercise program. They will not cure cholesterol disorders, but they do help to control them. No one drug is appropriate for treating all cholesterol disorders. There are four major groups of cholesterol-reducing drugs: antihyperlipidemic (gemfibrozil); HMG-CoA reductase inhibitors (atorvastatin lovastatin, pravastatin , simvastatin); bile acid-binding resins (cholestyramine, colestipol); and niacin. The drugs work alone or in carefully prescribed combinations to normalize blood lipid levels. Some work by inhibiting the synthesis of cholesterol and lipoproteins. Others accelerate the clearance of lipoproteins in the bloodstream or hasten their breakdown and elimination. For more information , see entries for the generic drugs listed above.

DRUG CLASS

TARGETAILMENTS

Antihistamines

♦

BRAND NAMES Alka-Seltzer Plus Cold Medicine , ChlorTrimeton , Comtrex Multi-Symptom Cold Reliever, TheraFlu, Triaminic Nite Light , Triaminic Syrup, Triaminicol MultiSymptom Relief, some types of Tylenol Cold for adults and for children

GENERALDESCRIPTION Chlorpheniramine is an antihistamine with mild sedating effects. See

Antihistamines.

CHOLESTEROLREDUCI NG DRUGS GENERICNAMES atorvastatin, cholestyr amine , colestipol, gemfibro-zil, lovastatin , pravastatin, simvastatin

GENERALDESCRIPTION As their name suggests, cholesterolreducing drugs are used to alter levels of cholesterol and other fats in the blood. These fats combine with proteins to form

AND

+

♦

+

+

+

MEDICINES

ders, allergies , alcohol abuse, convulsions, organ transplants, cataracts or visua l problems, chronic muscular disorder, gout or diabetes , low blood pressure, constipation , major surgery (or plan surgery soon), or any other medical problem. Carefully follow the special diet your doctor has recommended: This is essential if the medi cation is to work effectively. See your doctor regularly to have your progress measured and monitored. Do not stop taking the medication without first checking with your doc tor; your blood cholesterol levels may increase again. Cholesterol-reducing drugs may affect the results of laboratory tests. Be sure to inform the healthcare practitioner performing the test if you are taking any of these drugs. Befo re undergoing emergency treatment or medical or dental surgery, be sure to tell your healthcare practitioner if you are taking any of these drugs. POSSIBLE

INTERACTIONS

Oral medications: cholestyramine and colestipol interfere with the absorption of nearly every other drug, as well as with vitamins A, D, E, and K. Be sure to take your other medications at different times of th e day.

EFFECTS

Not serious: Mild stomach pain; diarrhea; heartburn; nausea and vomiting; dizziness ; headache .

CHOLESTYRAMINE

Serious: Severe stomach pain with nausea and vomiting; unusual tiredness or weakness.

DRUG CLASS Cholesterol-Reducing Drugs

BRAND NAME

SPECIALINFORMATION + If you are pregnant or nursing , check

Quest ran

with your doctor before using any of these drugs. Atorvastatin, lovastatin, pravastatin, and simvastatin are not recommended if you are nursing, pregnant , or planning to become pregnant. + Do not use any of these drugs if you have had an allergic reaction to them in the past. ♦ Do not use these drugs without telling your physician if you have or have had impaired liver or kidney function, gallstones or gallbladder disease, peptic ulcers, bleeding disor-

GENERALDESCRIPTION

0

C

Anticoagulants (such as warfarin): increased or decreased blood-thinning effects.

the major types of cholesterol disorders, particularly those in which high levels of blood fats (cholesterol and triglycerides) have been linked to an increased risk of heart disease. SIDE

NATURAL

Presc ription Drug

0

Over-the. Counter Drug

Introduced in 1959, cholestyramine is in the group of medicines known as bile acid-binding resins. These drugs lower blood levels of cholesterol by binding to the bile acids from which cholesterol is made and removing them from the body. See also Cholesterol-

Reducing Drugs. SIDE

EFFECTS

Not serious: Belching , bloating.

O

Western Herb

O

Chinese Herb

0

Homeopathic Remedy

923

CONVENTIONAL

AND

NATURAL

Serious: Constipation; weight loss; black, tarry stool.

D

SPECIAL INFORMATION • Never take this drug in dry form , as it may cause you to choke. Mix powder as directed with water or fruit juice. ♦ Cholestyramine may interfere with your body's ability to absorb certain nutrients. While on this medication, you may need to take supplements of vitamins A, D, E, and K; folic acid; and calcium. Consult your doctor .

MEDICINES

eysuckle are taken for toxic sores. Modern practitioners use a blend containing chrysanthemum, honeysuckle, and dandelion (Taraxacum mongolicum) to treat hypertension (high blood pressure). Check with a Chinese medicine practitioner for details of dosages and additional herbal combinations. SIDE

SPECIAL INFORMATION + WARNING: Be careful about using cicada if you are pregnant, because it might prompt a miscarriage. Check with a Chinese herbalist.

EFFECTS

None expected. SPECIAL INFORMATION ♦ Use cautiously if there is diarrhea. ♦ The herb has a strong antibiotic effect.

POSS I BLE INTERACTIONS

Other medications should be taken two hours before or four to six hours after taking cholestyramine.

Check with a Chinese medicine practitioner for details of dosages and other herbal combinations.

CIMETIDINE

DRUG CLASS Antiulcer Drugs [Histamine H2 Blockers]

CICADA BRAND NAMES

Rx: Tagamet OTC: Tagamet HB

CHRYSANTHEMUM FLOWER LATIN NAME Chrysanthemum indicum GENERAL DESCRIPTION The wild chrysanthemum, growing throughout China, is valued for its antiinflammatory effects. The best flowers for medicinal purposes are yellow and fragrant, with an acrid, bitter taste. In traditional Chinese medicine the herb is characterized as acrid, bitter, and slightly cold. It is harvested in the fall, when the flowers bloom. TARGET AILMENTS

Take internally for: ♦ headaches, dizziness, and hearing problems. ♦ hypertension (high blood pressure). Apply externally as a compress or wash: ♦ eye problems, such as conjunctivitis, red or dry eyes, blurred vision, and spots in front of the eyes. PREPARATIONS Fresh or dried flowers are available in bulk at Chinese pharmacies, Asian food markets, and some Western health food stores. They make a cooling drink.

Combinations: A mixture of chrysanthemum flowers with honeysuckle flowers and other herbs is a formula for colds and flu. A combination of the flowers with prune/la and white mulberry leaf is prescribed for painful, red, swollen eyes. Chrysanthemum flowers mixed with hon-

924

LATIN NAME Cryptotympana atrata GENERAL DESCRIPTION A winged insect with a large head, the cicada is recognized by its characteristic chirping sound. The molted skin of the creature is used as a treatment for skin rashes, sore throats, and other ailments. In traditional Chinese medicine cicada is characterized as sweet and slightly cold. TARGET AILMENTS Take internally for: • swollen, sore throat with loss of voice. ♦ skin rashes, particularly during the early stage of measles or chickenpox. ♦ red, painful, swollen eyes and blurred vision. ♦ high fever in childhood illnesses such as measles, which can cause convulsions, spasms, delirium, and terrifying nightmares in children. PREPARATIONS Dried cicada can be obtained at Chinese pharmacies. Look for yellow, lightweight skins.

Combinations: A blend with field mint is prescribed to ease itchy, red eyes and also to bring the rash out in the early stage of measles, to help shorten the duration of the illness. Herbalists may add chrysanthemum flowers (Chrysanthemum morifolium) and white mulberry leaves to strengthen the mixture's feverreducing qualities. Another treatment for the early stage of measles is a blend of cicada skins with kudzu root and great burdock fruit. A preparation containing cicada skins and sterculia seeds may be prescribed for hoarseness.

GENERAL DESCRIPTION Cimetidine is used both to treat and to prevent u leers of the stomach and duodenum (upper intestine) . It is also prescribed for other conditions characterized by an overproduction of stomach acid, such as Zollinger-Ellison syndrome and gastroesophageal reflux (in which stomach acid flows backward into the esophagus). In some cases, cimetidine is used to help stop upper gastrointestinal bleeding. Cimetidine has also been used experimentally to treat kidney cancer . In the over-the-counter form, cimetidine is used not for ulcers but to relieve acid indigestion and heartburn. Although the OTC version is a lower dose of cimetidine than the prescription form, essentially the same interactions apply, though the side effects are milder. Belonging to the subclass of antiulcer drugs known as histamine H2 blockers, cimetidine works by blocking the stomach's response to the chemical compound histamine, thereby reducing the secretion of the digestive juice hydrochloric acid. For more information on side effects and possible drug interactions, see Antiulcer Drugs. SIDE

EFFECTS

Not serious: Mild diarrhea, skin rash, hives, dizziness, headache, blurred vision, fatigue, muscle and joint pain. Contact your doctor if these symptoms continue or become bothersome. Serious: Confusion, nervousness, delirium and hallucinations, slowed or irregular heartbeat, abnormal bleeding or bruis-

,,

CONVENTIONAL

ing, combined weakness, fever, and sore throat (signs of bone-marrow depression ), hair loss, enlarg ed or painful breasts (in women or men), male impotence , jaundice. Call your doctor immediately. SPECIAL INFORMATION ♦ Inform your doctor if you have a history of arthritis, kidney or liver disease, organic brain syndrome , asthma, or low sperm count. ♦ Avoid this drug if you are pregnant or nursing. • Cimetidine may affect the results of some medical tests, including blood cholesterol levels, liver function tests, and sperm counts. Inform the person giving you the test that you are taking this medication. ♦ This dru g may inhibit your body 's ability to absorb vitamin B12. Talk to your do ctor about B12 supplements. POSSIBLE

INTERACTIONS

This dru g int eracts with many prescription and over-the-counter medications some of which are listed here. Mak e ' sure you inform your doctor of any other drugs you may be taking. Alcohol: cimetidine may interfere with the elimination of alcohol from the body, prolon ging alcohol 's intoxicating effects. Antacids: blocked absorption of cimetidine; space dosages of cimetidine and antacids at least an hour apart. Anticancer drugs: increased risk of blood disorders. Anticoagulants (such as warfarin), oral antidiabetic drugs, benzodiazepines, calcium channel blockers (such as amlodipine and diltiazem), carbamazepine, metoprolol, pentoxifylline, phenytoin, propranolol, theophylline, triamterene, tricyclic antidepressants: increased effects of these drugs, possibly leading to toxicity. Digoxin: decreased digoxin effect. Enteric-coated tablets: changes in stomach acidity may cause these drugs to dissolve prematurely in the stomach; avoid taking enteric-coated medications with cimetidine.

AND

LATIN NAME Cimicifuga foetida (or Cimicifuga dahurica )

CINNAMON BARK

GENERAL DESCRIPTION A popular stimulant in Chinese medicine, cinnamon is harvested from trees usually after they have reached seven years of age. Its outer bark is the common spice; the inner bark contains more oil and has stronger medicinal effects. Cinnamon bark is used to treat abdominal disorders , menstrual pain , infertility, and some forms of asthma. Characterized as hot, acrid, and sweet according to traditional Chinese medicine , the best quality has a thick skin and is oily and fragrant. TARGET AILMENTS • poor digestion, lack of appetite , diarrhea with undigested food, abdominal spasms. • excessive urination, impotence, and lack of sexual desire. • menstrual pain alleviated by applying cold packs, lack of menstruation, infertility. • wheezing from asthma caused by exposure to cold.

PREPARATIONS Cimicifuga is available in dried form at Chinese pharmacies, Asian food markets, and some Western health food stores.

Combinations: When it is combined with great burdock fruit and indigo, the blend brings out skin rashes, such as those that accompany measles. This action helps the disease run its course faster. A mixture with coptis is prescribed for swollen gums, toothache , and ulcers of the mouth and tongue. It is taken internally and also rubbed on the affected areas. Together with bupleurum it is used to treat prolapses of internal organs, and also diarrhea. A Chinese medicine practitioner can provide details of dosages and additional herbal combinations.

PREPARATIONS Cinnamon bark is available fresh or dried at Chinese pharmacies , Asian food markets, and some Western health food stores. It is normally taken in the form of powder , pill , or tinctur e, in which the crushed bark is mixed with alcohol.

Combinations: Chinese herbalists prescribe cinnamon bark together with the roots of Asian ginseng and of Chinese foxglove cooked in wine to treat palpitations of the heart and shortness of breath. A Chinese medicine practitioner can advise you on dosages and additional herbal combinations.

EFFECTS

Iron, ketoconazole, tetracycline: decreased absorption of these drugs into the body. Tobacco: smoking may block the beneficial effects of cimetidine .

SPECIAL INFORMATION • WARNING: Although cimicifuga effectively brings out the skin rash caused by measles in its early stage, the herb should not be used when the disease has fully developed. • WARNING: This herb should not

Presc riptio n Drug

0

Over-theCounter Drug

GI

LATIN NAME Cinnamomum cassia

TARGET AILMENTS Take internally for: • skin rashes, including those of measles; headache accompanying measles. • sore teeth and gums, canker sores, and sore throats. • prolapse (dropping ) of the uterus , rectum , or bladder.

Beware of taking too much cimicifuga: It may cause headaches, vomiting , tremors, and gastroenteritis.

~

-----=----\o/

GENERAL DESCRIPTION Oth erwise known as bugbane , cimicifuga has medicinal properties in the root which should have a black skin withou~ rootlets. The Chinese name of this herb literally translated means "ascending hemp ," an allusion to its alleged ability to lift the pati ent 's energy level. Depending on the species of cimicifuga , the cross section of the root is white light green, or gray. Chinese herbalis~s, following traditional medical practice , characterize cimicifuga as acrid , sweet, and cool.

0

MEDICINES

be taken by pati ents with br eathin g difficulties.

CIMICIFUGA

SIDE

NATURAL

SIDE

EFFECTS

Serious: Large doses can cause changes in breathing , dilation of blood vessels, and convulsions. SPECIAL INFORMATION • WARNING: Use this herb cautiously if you are pregnant. • WARNING: Do not use the herb

O

Western Herb

0

Chinese Herb

A Homeopathic Remedy

lj

g S

2

CONVENTIONAL

D

AND

NATURAL

w hen th ere is fever, inflammation , or hemo rrha gin g. + In a c lini ca l tr ial, an alco ho l-based pr eparat ion of the bark, inj ect ed at an ac upunctur e poi nt associated w ith the lun g, seemed to have a be nef icia l effect o n bron c hi al asthm a. + Cinnamaldehyde, a major co nstitu ent of c inn amon bark , has shown tr anquilizing and pain-relieving effec t s in mice.

MEDICINES

SPECIALINFORMATION • Do not use the herb to treat cases of influen za wit h hi gh fever . • Prep arat ion s of cinnamon twi g have shown a possible ant ibi oti c effect against organisms such as st aphylo coccus and salmon ell a. • The herb is co nsid ered a diuretic.

DRUG CLASS Antibiotics

GENERAL DESCRIPTION

TARGET AILMENTS Take int ern ally for: ♦ colds, influenz a, and low-gr ade feve r accompa nied by c hills . ♦ art hrit is and rheumatism. + gy neco logica l problems suc h as painful menstru ati o n or ut erin e fibroids.

PREPARATIONS Cinnamon t w igs ca n be pur chased in Chin ese pharmacies, Asian m ark ets, and some W estern health food stor es. Combin at ions: A preparation co nt aining cinnamon twigs and licorice that has been fried w ith hon ey is reco mm ended by Chinese herb ali sts for palpit ations and sho rtn ess of breath. When mi xed w it h evodia fruit , the herb is prescribed for abdo minal pain and menstru al disorder s. Consult a Chinese medi c ine practition er abo ut dosages and additional herbal com bination s. SIDE

EFFECTS

Be careful about usin g cinnamon twigs if you are pregnant o r if you menstruate heav ily , becaus e they may ca use mor e bleeding or difficulties w ith the pr egnancy.

926

[Erythrom yc in]

BRAND NAME

GENERALDESCRIPTION

CINNAMON TWIG

Cinnamon twigs , sometimes ca ll ed cassia t w igs, are prescribed for colds , influenza , arthri t is, and minor gyneco logica l problems. Th ose of good quality can be discerned by their strong fragranc e and brownish red color . Whil e cinn amo n twigs have many prop erti es in co mmon w ith ci nnamon bark, Chinese herbalists use each part of the pl ant t o treat a different set of ai lment s. Cinn amon twigs are charact eri zed in traditi o nal Chinese medicin e as wa rm , acr id , and sweet.

DRUG CLASS Antibiotics

Biaxin

CIPROFLOXACIN

LATINNAME Cinnamomum cass ia

CLARITHROMYCIN

[Fluo roquin o lo nes]

BRAND NAME Cipro

GENERALDESCRIPTION Introdu ced in 1984 , c iprofloxacin

is a syntheti c flu oro quinol o ne that is used to tr eat a numb er of inf ect ions, includin g bone and joint infe ction s, bacterial gastroe nt eriti s, and chancroid infecti o ns (genital ulcers) caused by Hemophilu s ducreyi. Fo r mor e inform ation , see

Fluoroquinolones.

SPECIALINFORMATION ♦ Ciprofloxacin

may be ta ken with meals (to prevent stomach upset ); food does not affect ove rall absorption of th e drug . ♦ Take c iprofl oxac in at least two ho ur s before o r six hours after antacid s and similar drugs. (See Fluoroquinolones for further in stru cti ons.) POSSIBLE

INTERACTIONS

Alkalizers (urinary), such as sodium bicarbonate, and citrates: these dru gs reduce th e solubilit y of ciprof loxac in in urine and ca n, in rare instances , lead to c ry stalluri a (c rystals in urin e) or kidn ey toxicity. Cyclosporine (immunosuppressant): inc reased blo od levels of cyclos porin e. Your doct or m ay hav e to adj ust your dose of cyclospo rine . Phenytoin (anticonvulsant): reduc ed phenytoin leve ls and effect iveness. Theophyllines (asthma drugs): c iproflo xaci n may inhibit metaboli sm of these dru gs, increasing the risk of adve rse effects and th eop hylline toxicity .

Clarithromy c in , an antibioti c introdu ced in 199 1, is a type of erythromycin but has fewer side eff ects than oth er drugs in that c lass. Clarithrom yc in 's act ion va ri es with th e t ype of bacte ri a it is used to fight. It kills some and sto ps th e grow th and reprod uction of ot hers.

TARGET AILMENTS • respi rator y tr act infe cti o ns, in c ludin g sinu sitis , ph aryng itis du e t o str ep, to nsi 11it is, branch it is, and some type s of pneumoni a. • inf ect ions of th e ski n and soft tissue. • Al OS-relat ed inf ections due to Mycabacterium avium or Mycoba cterium

intrace l/ulare. SIDE

EFFECTS

Not serious: An unu sual tast e in the mo uth , abdominal pain , mild d iar rh ea, nausea, headache, yeast inf ection s. Consult your doctor if symptoms are prol o nged or bothersome. Serious: Unusual ble ed in g or bruising, possibly signaling a bl ood disorder; inflammation of the co lo n (d iar rh ea that lasts mor e t han 24 ho ur s, cra m ps, fev er). Discontinue use and ca ll your docto r imm ediately .

SPECIALINFORMATION ♦ Some inf ecti ons may req uir e

14 days of treatment. Take th e full cou rse to prevent bacte ri a from beco ming resistant to the medicine. • Tell your docto r if your kidn eys or li ver is imp aire d . You may need to have your dose adjusted . ♦ Let your doctor know if you are allergic to erythromycin, azithromycin, or troleandomycin , because yo u may also be allergic to thi s dru g. ♦ Do not use clarithromycin during pregnancy unl ess clearly needed. Avoid usin g this drug while nursing . POSSIBLE

INTERACTIONS

Rifabutin: dec reased clarithromycin effect. Zidovudine: decreased zidovudine effect.

CONVENTIONAL

(See Erythromycin for ot her possible int eractions.)

CLEMASTINE

DRUG CLASS Antihistamines

BRAND NAME Tavist, Tavist-D

GENERALDESCRIPTION

AND

vagina l preparations, is used to tr eat a great variety of yeast and rin gwor m infections of t he mouth , throat , skin, and vaginal tract. For information on side effects and possibl e drug int erac ti ons, see Antifungal Drugs. Also see Vaginal Antifungal Drugs for inform ation about medications commonly used to treat vagi nal yeast infections.

NATURAL

MEDICINES

zema, and scabies. Chinese herb alists also recommend an oral preparation of cnidium seeds mixed wit h cuscuta and schisandra for impot ence or inf ertility. Consult a Chinese medicine practitioner for adv ice abo ut dosages and oth er herbal combinations. SIDE

EFFECTS

Non e expect ed with recommended dosage.

SPECIALINFORMATION ♦ Lotrisone , a co mbination

of clotrimazole and betamethasone , is an antifung al-corticosteroid medi cation. Its purpose is to destroy fungi and relieve any accompanying skin inflammation. See Betamethasone.

Cl

SPECIAL INFORMATION ♦

Do not use cnidium seeds for hot , sore skin that is excessivel y dry. POSSIBLE

Clemastine is an antihistamine with mildly sedative effects . See Anti-

INTERACTIONS

Chinese her bali sts caution against prescri bi ng cnidium seeds at the same tim e as bark of the tree peony root , cro ton seed, or fritill ari a.

histamines.

CNID IUM SEEDS CLONAZEPAM LATINNAME Cnidium monni eri DRUG CLASS Antianxiety

Drugs [Benzodiazepines]

BRAND NAME Klon op in

GENERALDESCRIPTION Intr oduced in 1977, clonazepam is a benzodiazepine that is prescribed alone or in comb inat ion w ith other drugs to control ep ileptic absence (petit mal ) seizur es as well as myoclo ni c and akineti c seizur es. See Benzodiazepines for information on side effec t s and possibl e drug interactions .

SPECIALINFORMATION ♦ Do not confuse the brand name

Klonopin w ith the generic name Clonidine . Clonidin e is used to treat high blood pressur e.

CLOTRIMAZOLE

DRUG CLASS Antifungal

Drugs

BRAND NAMES Rx: Lotriso ne

OTC: Lotrimin AF GENERALDESCRIPTION Clotrimazole , availabl e in topi ca l or

CODEINE

GENERALDESCRIPTION Cnidium seeds grow throu ghout China and are prescribed typically for skin co mplaint s. A goo d specimen is round , dusky yellow, and fragrant. Chinese med icin e practitioners, following th e tenets of th eir tr aditional medicin e, categorize the seeds as acrid, bitter , and warm.

DRUG CLASS Anal gesics [Opioid Analgesics]

BRAND NAME Tylenol with Codeine

GENERALDESCRIPTION The narcotic codeine, fr equently combined wi th other analgesics such as acetaminophen and aspirin , has been prescribed for decades for mod erate pain relief. Codeine has a calming effect on the brain and nervous syst em and also help s co ntrol coughing by suppressing the cough refl ex . Althou gh th e dru g is less habit-formin g than most other opiates , it should be used with caution. See Opioid Analgesics for inform ation about side effects and possibl e dru g int eractions .

TARGETAILMENTS + it chin g skin, eczema , scabies, ringworm; o r itchy , weeping skin lesions, especi ally in th e genit al area. (App ly exte rn all y.) + vaginal dischar ge. (Use as a dou che.) ♦ mal e impoten ce, female infertility. (Take internally. )

PREPARATIONS Over the counter: Cnidium seeds are availabl e in bulk at Chinese pharmacies, Asian markets , and some West ern health food stores. They can occasionally be found in pill and powder form in combinations.

CODONOPSIS ROOT

At home: For ecze ma and other skin disorders , soak the skin with a cnidium seeds solution , or use as a douche for vagin al problems .

LATINNAME Codonopsis pilosula

Com bin ati ons: A mi xture with the roots of the sophora and stemon a herbs is prescrib ed for itchy, weeping skin lesions. Another prepara t io n, co ntainin g cnidium seeds and calomel , is often appli ed to skin lesions associat ed with acute fl areups of ecze ma, genital ec-

0

Prescription Drug

0

Over -theCounter Drug

GENERALDESCRIPTION The codonopsis root is the basis of a toni c for patients suffering from lethargy and related symptoms. Classified as sweet and neutral in traditional Chinese medicine , the root should be thi ck,

O

Western Herb

O

Chinese Herb

& Remedy Homeopathic VV

92 7

CONVENTIONAL

AND

NATURAL

moi st , and ti ght- ski nned. Herbal ists consider it milder and safer than Asian ginseng, and often use it as a substitute for the stronger herb . Codonopsis grows throu ghout north eastern China.

TARGETAILMENTS

D

Take int ernally for: ♦ diabetes. ♦ chronic cough and shortness of breath. ♦ prolapsed (fa llen) uterus , stomach , or rectum. ♦ lack of appetite, fatigue, and tir ed limbs. • di ar rhea and vomiting. ♦ excessive thirst .

PREPARAT IONS Codonopsis is available in bulk form at Chinese pharmacies , Asian mark ets, and some Western health food stores. It is includ ed in several preparation s designed as tonics. Combinations: Codonopsis mix ed with atra ct ylodes (w hit e) is prescribed for reduc ed appetite , diarrhea , and vo miting , while a co mbin at ion w ith astragalus is recomm ended in cases where shortness of breath is added to these symptoms. A pr epara tion containing the roots of codonopsis and don g quai in addition to Chinese foxglov e root cooked in wine is given to patients suff ering di zz iness, weakness, and lassitude. See a Chinese medi ci ne practitioner for inform atio n on dosages and appropriate herbal combinations. SIDE

EFFECTS

Non e expected .

SPECIALINFORMATION ♦

In labo ratory tests, oral and intravenous doses of co donopsis increased the red blood ce ll counts and hemoglobin levels in rabbits. ♦ Codonopsis has improved th e endur ance of mi ce in a laboratory trial. POSSIBLE

INTERACTIONS

Some Chinese herbalists belie ve th at codonop sis is incompatible with veratrum .

COIX

LATINNAME Coix lachryma jobi

928

MEDICINES

GENERALDESCRIPTION The seeds are the f unct ion al parts of th e coix plant , wh ich is also known as Job'stears , a kind of barley . The full, round, w hite fruit is used as a food, and it s seeds can be ingest ed over a long period of time without produ c ing side effects other than a feeling of dryn ess. In traditional Chinese medicine the seeds are categorized as sweet, bland , and slightly co ld . The fruit is grown throu ghout Chin a and harvested at th e end of fall when the seeds have ripened.

TARGETAILMENTS Take int ernally for : • urinary difficulty , marked by edema (ret enti o n of body fluids). ♦ carbuncles. • lung or intestinal abscesses. • diarrh ea. • coated ton gue (symptomatic of di gestive problems ). • arthritic pains from weather changes. ♦ fever acco mpanied by inadequ at e urin ation . • plant ar warts.

PREPARATIONS Coix seeds are available in bulk at Chinese pharmacies , Asian food market s, and some Western health food stores . The herb can also be obtained in tabl et form from some Chinese pharmaci es. Combinations: A preparation of coix mi xed with poria mushrooms , kudzu root , and atractylodes (white) is often prescribed for traveler 's diarrhea , weak digestion, nausea, vomiting, diarrh ea, constipation, morning sickness, bloatin g, and cramps. When combined with winter melon seed, aduki beans, and akebia cau lis, co ix is give n for inadequate urination. Other combinations are prescr ibed for diarrhea and internal abscesses. Consult a Chin ese medicine practitioner for inform ation on herb al preparations and dosages. SIDE

COLESTIPOL

DRUG CLASS Cholesterol-R educing Drugs

BRAND NAME Colestid

GENERALDESCRIPTION Introduced in 1974 , colestipol is in th e group of medi cines known as bile acid-binding resins. These drugs lower blood levels of cholesterol by binding to the bile acids from which cholesterol is made and remo v ing th em from th e bod y. For mor e information , see

Cholesterol-Reducing Drugs. SIDE

EFFECTS

Not serious:

Belching , bloatin g. Serious:

Constipation ; loss of we ight; black , ta rr y stoo l.

SPECIALINFORMATION ♦

Never take thi s drug in dry form , as it may cause you to choke. Mix powd er as directed with water or fruit juice. ♦ Colestipol may interfere with your body's ability to absorb cert ain nutrients. While on this med ication , you may need to take supplements of vitamins A, D, E, and K; folic acid; and ca lcium. Consult your do ctor. POSSIBLE

INTERACTIONS

Other medicati ons should be t aken two hour s before or four to six hours after co lestipol.

COLTSFOOT

EFFECTS

None expected, except a feeling of dryness.

SPECIALINFORMATION

LATINNAME Tussilago farfara

♦

Practition ers urge pr egnant women to use th e seeds with caution , because of the herb 's drying effect on body tissu es. ♦ Laboratory studies show that oil made from the seeds seems to reduce or eliminate muscle spasms in fro gs. ♦ Clinical trials have indicated an effec t of the oil from coix seeds on br eathing: Low doses of the oil appear to stimulate breathing , while high doses seem to inhibit it. The oil also may cause dilation of the bronchial tube s.

GENERALDESCRIPTION As far back as 2,000 years ago, Asians and European s were using coltsfoot as a cough suppressant for respiratory ailments, and both the dried flow ers and the leaves are still used as a gentle expectorant and cough suppressant. They contain a substance called muc ilage, which may be responsible for soothing the respiratory tract. Another ingredient of coltsfoot leaves is zinc, which may help heal injured skin tissue . Today

l

CONVENTIONAL

coltsfoot is banned in Canada, but in the Unit ed States the Food and Drug Admini stration classifies it as an herb wi th " und efined safety." Co lt sfoot con tains an alkalo id that can seriously damage the liver ; and a Japanese study co ncluded th at th e f lower buds may be carc in ogeni c. Many pract iti oner s in Europe and th e United States, howev er, st ill use co lt sfoot routin ely o n a short t erm basis to treat co ughs and other respirator y ailments.

TARGETAILMENTS ♦ co ughs, asthma , bron chitis, w hoop-

ing co ugh, and emp hysema. (Take intern all y.) ♦ burns, swellin gs, skin ulcers , infl ammati ons, and insect bites . (A pply externa ll y.)

AND

GENERALDESCRIPTION

♦

Over the counter: Avai lab le in tinc tur e, capsules, and in bulk. At home: Tea: Pour 1 cup boilin g water ont o 1 to 3 tsp dri ed f lowe rs or leaves and steep for 10 minut es. Dri nk three t imes a day, as hot as possible.

Compress : Soak a pad in a co ltsfoot infus ion for several minut es, w rin g out, then apply to the affected area. Combinations: For co ughs, co lt sfoot is ofte n comb ined w ith wh ite hor ehound and mull ein; for bronchiti s, co ltsfoot is mi xed with garlic or echin acea .

LATINNAME Copt is chinensis (or Coptis deltoid ea) GENERALDESCRIPTION The rhi zo me of th e co ptis plant , sometimes called Chin ese goldthr ead, is an ant ibio ti c and f ever-re ducing herb fr equent ly prescribed by Chin ese medi c ine practitioners. It con tains th e ant imi crobial substance berber ine, which seems to inhibit many of the bacteria that cause dysentery . Loo k for a redd ish ye llow cross section in Cop tis chin ensis1 the form most often avai lable comme rcially, or fo r a pur e yellow cross section in Cop tis de /toid ea. Chin ese herbalists charac t er ize the herb as co ld and bitter.

SIDE

EFFECTS

Serious: Fever, nausea, vomiti ng, loss of appetit e, di arrh ea, j aundice, or pain in th e upp erri ght abdom en may result from using co lt sfoot. Stop taking th e herb and cal l your do ctor immediately.

wounds, cuts , insect bit es, bruises , ulcers, and inflammat ions. (A pply exte rnally. )

Take int erna lly for: ♦ high fever wi th ir rita bility , disori entation , or delirium. ♦ dysentery w ith hot , bu rnin g diarrhea. ♦ nosebleeds. ♦ bright-red blood in the urin e, stoo l, or vomit. ♦ bad breath or belching wi th bad odo r.

Over the counter: Comfrey is ava ilab le in dry bulk. At home: Poultice: Sprinkle a powder made from dry co mfr ey over cuts, brui ses, insect bites , or wounds , and cover wit h a cl ean cloth .

Apply externally fo r: • toothache, swollen gums, ulc ers of th e tongue and mouth ; red, painful eyes.

SPECIALINFORMATION WARNING: The Americ an Herb Products Associatio n has p laced comfrey on it s restri ct ed list and suggests that this herb be used for external ailments only.

PREPARATIONS You can obtain coptis in bulk at Chinese pharmacies, Asian food store s, and some Western health food stores. It is also possible to buy t he medication in tablet form. Look for a powder or ointment for external use to treat eye problems .

CONJUGATED ESTROGENS

Combin ations: With skull cap and gardenia , coptis fo rm s a pr eparation to t reat conditions mark ed by high fever , irritabilit y, dry mouth and throat, and dark urin e. Comb ined with Chinese foxg love root , copt is is prescrib ed for insomni a and delirium , and also fo r serious illnesses with high fever. Copt is and aucklandi a are mixed to treat dysent ery. And a combination of coptis and Chin ese wild ginger, usually w ith gypsum, is used for t oothach es, swo llen gums, and ulcers of the ton gue and mouth. Consult a Chinese medicin e practitioner for adv ice abo ut dosages and other herbal combinations.

SPECIALINFORMATION ♦ WARNING:

Do not give col tsfoot to chi ldr en under tw o years old, pregnant or nursing wom en, alcohol ics, o r anyone w ith liver disease. ♦ WARN ING: If you dec ide to use coltsfoot , take only medicinal amount s under a practiti oner's superv ision fo r short period s of tim e.

COMFREY

LATINNAME Symphytum off icina/ e

DRUG CLASS Estrogens and Progestins

BRAND NAME Premari n, Premphase , Prempro

GENERALDESCRIPTION Like other estrogens , conjugated estrogens may be prescribed to replace a woma n's estrogen at natur al menopause or after rem ova l of the ovaries o r ut erus, th ereby lessenin g any resulting symptoms such as hot fl ashes. The dru gs are also thou ght to be effective in prevent ing osteoporosis and card iovasc ular disease. For more inform ati o n, see

SIDE

Prescription D rug

0

Over -the Coun ter Drug

EFFECTS

Serious: This herb can injure t he spleen and stom ach if used over lon g peri ods.

Estrogens and Progestins.

0

GI

TARGETAILMENTS

PREPARATIONS

♦

MEDICINES

COPTIS

Praised for centu r ies by herbalists throughout the wo rld , w ho sti ll use it to tr eat disorders rangi ng from cuts to cancer, comfrey nevertheless is rej ected by many practition ers in the Unit ed States as too dangerous for any typ e of internal use. Comfrey co nt ai ns py rro liz idin e alkaloids, w hi ch can cause liver damage w hen consumed in large amounts. The act ive agent in comfrey is allantoin , w hi ch fost ers the growth of new eel Is. A lthoug h th e dr ied roots and leaves are used fo r medi c inal purpos es, the comfrey root contains up to twi ce as mu ch allanto in as th e othe r parts. While it s int ernal use remains questionab le, comfrey can be used safely o n exte rnal injuri es such as cuts and ot her wounds.

TARGETAILMENTS PREPARATIONS

NATURAL

O

West ern He rb

0

Chinese He rb

/[b,.Hom eopathi c V Remedy

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I

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CONVENTIONAL

'

AND

NATURAL

~~

MEDICINES

'. ;

SPECIAL INFORMATION ♦ In clinical trials, coptis seemed to

D

have some effect in tre ating scarlet fever, typhoid fever, and diphtheria. ♦ Local administration of coptis preparations has improv ed cases of inflammatory bowel disease, anal fissures, and infections of th e vagina caused by protozoa. POSSIBLE

INTERACTIONS

Some herbalists believe that coptis should not be taken with pork . They also advise patients to avoid the herb in combination with chrysanthemum flowers (Chrysanthemum morifolium) , scrophularia, dictamnus root bark , and silkworm. Coptis is also believed to counteract the benefi c ial effects of co lt sfoot flower and achyr anth es root.

for urin ary incontinence. Check with a Chinese herbalist for recommended doses and additional combinations. SIDE

EFFECTS

Non e expected. SPECIAL INFORMATION • While cornus is believed to have low toxicity , herbalists wa rn against prescribin g it for some forms of painful , difficult urination involvin g infe ct ion or cystitis. • Laboratory tests indicat e that cornus may have an antibiotic effect on staphylococcus bacteria. ♦ In tests with animals, cornus incre ased urination and reduced blood pressure. POSSIBLE

INTERACTIONS

Some Chinese herbalists adv ise against using cornus in combination with the herbs platycodon, siler, and stephania.

CORNUS CORTICOSTEROIDS LATIN NAME Camus officinalis GENERAL DESCRIPTION Chinese practitioners use co rnu s berries in several medicinal toni cs. Known also as Asiatic carnelian cherry fruit and Asiatic dogwood, it is prescribed for kidney and bladder disorders and for menstrual irre gularity. Grown in several parts of Ch in a, it is harvested in October and Nov ember , when the fruit becomes purplish red . The best variety is fat , thick , soft , and seedless. Traditional Chinese medicine attributes sour and slightly warm characteristics to cornus. TARGET AILMENTS Take internally for: ♦ excessive urination , inco ntin ence, impotence , and other symptoms related to kidney and bladder problems. ♦ excessive sweating. ♦ lightheadedness with weakness of the back and knees. ♦ excessive menstrual bleeding or prolonged menstruation. PREPARATIONS The berries are available at Chinese pharmacies, Asian food markets , and some Western health food stores.

Combinations: A preparation designed to overcome urinary frequ ency, tinnitus (ringing in the ears), and low-back pain co ntains cornus berries as well as Chinese foxglove root, Chinese yam, and other minor ingredients. A blend of cornus and Cherokee rose hip is prescribed

930

GENERIC NAMES Rx: beclomethasone , betam ethasone , mometasone furoate, prednisone , triamcinolone OTC: hydrocortisone GENERAL DESCRIPTION The t erm corticosteroids refers both to natur al hormones produced by the adrenal glands and to synthetic versions of these hormones. Corti cost eroids are powerful drugs , prescribed for a variety of co nditions ranging in severity from skin rash to multiple sclerosis. Because they affect almost al I parts of the body , these drugs must be used with caution. Corticosteroid medications are available in topical creams , nasal inhalers and sprays, lung inhalers and sprays, and oral forms (tablets, syrup, and solutions). For more information , see individual entries for each of the generic drugs list ed above. TARGET AILMENTS ♦ skin disorders, for symptomatic reli ef of rash, inflammation, itching ; treatment of psoriasis, eczema , sunburn , and other skin diseases. (Hydrocortisone, mometasone furoate, and triamc inolone.) ♦ nasal inflammations (seasonal and chronic), including hay fev er (allergi c rhinitis), and nonallergic inflamm ation of the nasal passages. (Beclomethasone and triamcinolone.)

♦

resp ir atory ai Iments such as severe asthma. (Beclomethasone and triamcinolone.) ♦ rheumatic disorders (arthriti s, bursitis, tendonitis), ulcerative colitis , Crohn's disease. (Prednison e.) ♦ itchiness and inflammation associated with fungal infections such as athlete 's foot , jock itch , and yeast inf ections. (Betameth asone, in combination with the antifungal drug clotrimazole.) SIDE

EFFECTS

Not serious: Topical co rticost ero ids: mild and tr ansient skin rash, burning , irritation , dryness, redness, itchiness or scaling. Other corticosteroids: stomach upset, increased or decreased appetit e, restlessness, dizziness , sleeplessness, change in skin color, unusual hair growth on face or body. Serious: Eye pain, loss of or blurred vision; stomach pain or burning; black , tarry stools; severe and lasting skin rash, hive s, or burning , itching, or painful skin; blisters, acne, or other skin prob lems; nausea or vomiting; high blood pressure; foot or leg swelling; rapid weight gain; fluid retention (edema); unusual bruising; menstrual irre gularitie s; prolonged sore throat, fever , cold, or other sign of infection. Contact your doctor immediately . SPECIAL INFORMATION ♦ Topical co rticosteroid s should be

used with caution if you are all ergic to other co rticosteroids ; if you have an inf ection or thin skin at the treatment site; if you have or have had cataracts, glaucoma, diabetes , or tuber culosi s. ♦ Corticosteroid topical creams, as well as nasal and oral sprays or inhalers, may be absorbed into your syst em after prolonged use. Tell your doctor if you are taking any other medi cation , and watch for any significant side effects or possible drug interactions. • Ask your doctor about the ri sks and benefits of corticosteroid treatment if you have or have had any of the following conditions: HIV infection or Al DS, heart disease, hypertension , ulcerative colitis, diabetes , div erticuliti s, gastritis or peptic ulc ers, recent chickenpox or measles, candidiasis or other fungal infections , glaucoma, herpes simplex, liver or kidney disease, myasth enia gravis, osteoporosis, anastomoses, lupus , tuberculo sis, recent intestin al problems, or any infection, such as a cold or flu . ♦ One of the actions of corticosteroids

~

CONVENTIONAL

is to supp ress your immune syst em, thereby making you mo re susceptible to opportunistic infec ti ons. Corticosteroids can also mask symptoms of infe cti on th at occur while you are taking th e drugs; because th e sym ptoms wi ll not appea r, an infecti on may worse n w ithout yo ur bein g aware of it. ♦ Prolon ged use of co rti costero id s can cause birth defects. Pregnant and nur sing wome n should avo id th ese drugs. ♦ Prolonged use of corticoste roid s incre ases the risk of osteoporosis , cat aracts, glaucom a, Cushing' s syndrom e (moo n face\ and diabet es. It can also react ivate tuberculo sis. ♦ Check w ith your doctor befo re you stop using these dru gs. It may be necessary to reduce th e dosage gradually to avo id serious co nsequences. POSSIBLE

AND

(Lig usticum chu anx iong), it is prescrib ed for body aches and headaches. In combi nation wit h fennel , it is used for abdominal pain and hernial disorde rs. Herba lists prescrib e a pr eparation co ntaining coryd ali s and c inn amo n bark for painful menstru atio n. Consu lt a Chin ese med icine practitioner for information on app ropri ate dosages and additional co mbination s. SIDE

CORYDALIS

LATIN NAME Corydalis ya nhusuo GENERAL DESCRIPTION Grown in China 's Zhejiang , Hubei , Hunan, and Jiangsu provin ces, the corydalis root is co nsidered amon g the mo st effective painkillers in traditional Chinese medi cine. Herb alists use it alone or in co mbin at ion to treat almost any kind of pain. It does not seem to cause addiction or to have toxic side effects. The best roots are lar ge, hard , and bright ye llow on th e inside. According to the tenet s of traditi o nal Chines e medicine, co rydal is is an acrid, bitter , and warm herb .

~

MEDICINES

form blood clots. Because of this selecti v ity for th e COX-2 enzyme , these drugs are less lik ely to cause ulc ers and stomach bleeding th an other, nonselective nonsteroid al anti -inflamm at ory drugs (NSAI Os), althou gh th ese side effects may rare ly occur. Unlik e other NSAI Os, these drugs do not int erfere with blood clot formation and so do not incr ease bleeding tim e. For mor e information , see Celecoxib and Rofecoxib.

Ci

EFFECTS

TARGETAILMENTS

None expect ed.

♦

osteoarthritis , rheumatoid art hritis (celecoxib). ♦ ost eoarthritis , acute pain , painf ul menstrual cycles (rofecox ib).

SPECIALINFORMATION ♦

WARN! NG: Pregnant wo men should not use corydalis. ♦ In clinic al t ests, th e root has show n a slight hypn oti c effect on many animal spec ies, causing a lack of alertn ess.

SIDE

EFFECTS

Not serious: headac he, indigestion , nausea, diarrhea , sinus inflammation , edema. Call yo ur doctor if these symptoms persist or become bothersom e.

INTERACTIONS

See Prednisone.

NATURAL

COUGH SUPPRESSAN TS

Serious:

GENERALDESCRIPTION

Gnawin g or burnin g st omach pain , black o r tarry stools, vo mitin g. Rarely, stomach pains, ulc ers. Discontinue use and call your doct or immediately .

Cough suppressants (antitussives) are used to redu ce the intensity and frequency of the dry, nonproducti ve, temporary type of cough associated w ith allergies, co lds, and the flu . Cough suppressants should not be used with a productive (phlegm- or mucu s-produ cing) cough unless the cough is extremely bothersome or disrupts sleep. Some cough suppressant s work in the brain to suppr ess the cough refl ex; others act on th e throat and bronchial passages to soothe irrit ation and relax the muscles. For more inform atio n on a potent, nonnar coti c drug found in many over-the-counter products , see Dextromethorphan. For inform ati on about oth er drugs th at help suppr ess the cough refl ex, see Codeine, Hydrocodone, and

SPECIALINFORMATION ♦

Do not tak e COX-2 inhibitor s if yo u have ul cers or stomach bleedi ng, allergies to aspirin or other NSAI Os, or severe kidney or liver probl ems. • Do not take the se drugs if yo u are pregnant or nur sing. • Do not take celecoxib if you are allergic to sulfa drugs , aspirin , or ot her non steroidal anti-inflammat ory dru gs ( NSAI Os). POSSIBLE

INTERACTIONS

Angiotensin-converting enzyme (ACE) inhibitors: decreased ACE inhibit or effect.

Antacids: Decreased absorption of rofecoxib.

Opioid Analgesics.

Warfarin: Bleeding probl ems. Warfarin dosages may need to be adjusted.

TARGETAILMENTS ♦ pain of many variet ies, includin g ab-

dominal and chest pain , and pain resulting fr o m traumati c injuries , menstruation, rheumatism , and arthritis. (Take int ernally.)

PREPARATIONS Co rydali s is available in Chinese pharmac ies, Asian markets , and some W ester n health food stores. Toasting or frying in vine gar enhan ces it s effec ts in cases of men strual pain and pain caused by trauma . The powd ered form of the root is an extremely strong painkill er. Combin atio ns: Mi xed w ith cnidium root

COX-2 INHIBITORS CROMOLYN GENERICNAMES ce lecox ib , rofecoxib

DRUG CLASS GENERALDESCRIPTION

Asthm a Therapy

The COX-2 Inhibitors reli eve pain and inflammation by blocking th e effects of th e COX-2 enzym e active at sites of inflammati on without inhibiting th e eff ects of the COX-1 enzyme , which acts to protect the stomach and helps

0

Presc ription Drug

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Over -th eCounter Drug

BRAND NAME Rx: I ntal

OTC: Nasalcrom

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Western He rb

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Chines e Herb

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31

CONVENTIONAL

D

AND

NATURAL

GENERAL DESCRIPTION Cro mol yn is an antiasthm at ic and antiallergeni c drug used to prevent bronchi al asthma ep isodes and broncho spasm caused by allerg ens, dry air, airborn e pollutants, or ot her tri ggering facto rs. The d rug, avai lable as a pill, powd er, oral inhalant , and nasal spray, can also be used immedi at ely before exercise t o co ntrol exerciseinduced bronchial problems. Because cro molyn is not fast acting, it should not be used for relief during acute asthma att acks. Cromolyn is also used to treat co ngestion and oth er nasal symptom s of allerg y. In some cases, it is combined with other medi cations for additi ve therapeutic effects. See Asthma Therapy, Bronchodilators , and Corticosteroids for more info rmation on asthma medic at ions. TARGET AILMENTS ♦ bronchial asthma attacks. ♦ bronchospasm from all sourc es (including env iro nm ent al irrit ant s and exe rc ise). • respir ato ry all ergies. • all ergic rhiniti s (nasal spray) . SPECIAL INFORMATION ♦ Pregnant and nursing women should use caution w hen takin g this dru g; however, no adve rse fet al effects have been link ed to oral inhal ati o n of cromolyn . It is not known whether cromolyn shows up in breast milk , but small amounts of the drug do occur in the body following o ral inhal ati o n. Check with your doctor. ♦ If you have a history of heart arrhythmi as or co ron ary art ery disease, let your docto r know ; cromolyn inhal ant s may affec t your con diti o n. SIDE

EFFECTS

Not serious: Cough and hoar seness; less frequently , dryness of the mouth or throat , sneezing, nasal co ngestion , watery eyes, throat irrit ation. Call your doctor if t hese effects beco me troubl esome. If yo u experience an unple asant taste, there is no need to ca ll your doctor. Serious: Uncomm o nly, swelling of the face , lips , eyelids , hands, feet, inside of mouth ; increased bronchospasm (more wheezing, chest tightness , trouble br eathing ); difficult , painf ul , or frequent urination ; joint pain or swelling; severe or co ntinuous headache ; nausea; vo miting ; skin rash, hives, or itching. Rarely, difficulty swa llowing; pn eumoni a (c hest pain, chills, severe breathing difficulty , sweatin g,

932

MEDICINES

wheezing). Call your doctor immedi ately if yo u experience t hese effec t s. POSSIBLE

IN T ERACT I ONS

SPECIAL INFORMATION ♦ The herb is not reco mm ended for use

by patients w ith co nstipat io n and scanty, dark urin e.

Cortisone drugs: incr eased co rti sone effect. Your doctor may decrease yo ur cortisone dosage. lpratropium (asthma inhalant): increased cromolyn effec t.

CUSCUTA

CYCLOBENZAPRINE

DRUG CLASS Muscle Relaxants BRAND NAME Flexer ii

LATIN NAME

Cuscuta chinensis GENERA L DESCRIPTION A co mmon parasiti c grow th on plant s, cuscuta yields grayish ye llow seeds, also known as Chinese dodd er seeds that have med ic inal effects. Among ' other uses, th ey are prescribed to pr event miscarri ages. The seeds are considered to have sweet , acrid , and neutr al characteristics in traditional Chinese medi c ine. TARGET AILMENTS Take internally for: ♦ impotence, nocturn al emissions, pr ematur e ej acul at ion , pro st at e problems. ♦ frequent urination , incontin ence, loose stools or diarrhea with lack of appetit e. ♦ habitual o r thr eate ned mi scarriages . ♦ backach e from muscular weakness. ♦ dizziness , tinn itus (r inging in the ears), blurred vision. PREPARATIONS Cuscuta seeds are avai lable in bulk from Chinese pharm acies, Asian markets, and some Western health food stor es.

Combination s: Practitioners reco mmend a mi x of cuscuta seeds, psoral ea fruit , and _eucommi a bark for prem ature ejacul at ion. A preparation of cuscut a and astragalus seeds (Astraga lus complanatus) may help blurred vision, di zz iness, and tinnitus . And a mi xture of cuscuta Japanese teasel root , mulberry mistl et ~e ste~ns, and euco mmi a bark is often prescrib ed to pr event threatened miscarria ges. Check w ith a Chinese medicin e practitioner for further combinations and doses. SIDE

EFFECTS

None ex pect ed.

GENERAL DESCRIPTION Cyclobe nzap rin e is used along w ith other med ication s to reli eve acut e pain associated with muscle spasms. Although not actually a sedat ive, th e drug act s to reduc e mu scl e hyp eracti v ity, thereby producing a sedative effect. By reducing pain and tightness in muscles , cyclob enzap rin e helps resto re moti o n in affected areas of the body and ca n allow patients to sleep mo re restfull y. Chemically relat ed to tri cyc lic antidepressants, cyc lob enzaprin e may cause such side effects as sedation in some individuals. TARGET AI LMENTS • acut e, painful muscle spasms. SIDE

EFFECTS

Not serious: Dr yness of the mouth , blurred v ision; dizziness or lighth eadedness; dro ws iness. Rare ly: headache, co nfusion , nerv~usness, general r un-do wn fee lin g, tiredn ess; numbn ess, tinglin g, pain , or wea kness in hand s or feet; muscl e tw itchin g, trembling , or weakness, insomnia ; gastrointe stinal problems (such as stomach cra mp s, diarrh ea); poundin g heartbeat, changes in th e sense of t aste. Call your doc tor if these symptoms beco me troublesom e. Serious: Allergic reaction s, including swelling of the face, lips, or tongue; skin rash, hives, or it ching ; mania , unusual dreaming, clumsin ess, fa inting , severe disorientation, depression, ringin g in th e ears; yellow skin; heart-rhythm problems, low blood pressure , breathing difficulties. Call yo ur doctor if you experience t hese effects; you may be havin g an adverse reaction to cyclobenzaprine, or you may have t aken too much .

SPECIAL INFORMATION • Women w ho are pregn ant or nur sing

should t ake this medi cation only under a docto r 's supervisio n. • Since cyclo benzaprin e may redu ce saliva prod uction , you should maintain good dental hygiene to avoid problems such as cari es and per iodont al d isease. • Thi s medication may cause dro wsiness. Use caution while taking cyclobenzaprine if you must driv e o r perform oth er tasks requ ir ing alertn ess. • Before taking this drug , tell your doctor if you have glaucoma , urin ary retenti on, congestive heart failur e, hyp ert ension , or arrhythmia. POSSIBLE

INTERACTIONS

Since cyc lobe nzaprin e is closely relat ed to tri cycl ic antidepr essant s, drug int eractions specifi c to those drugs may also app ly to cyclobe nzaprin e. See Tricyclic Antidepressants for mor e interaction informati on.

Any centra l nervous system depressant (including sedatives, antihistamines, MAO inhibitors, and alcohol): may boost eff ects of the combined dru gs while also increasing risk s associated with side eff ects.

CYPERUS

stores. To incre ase it s pain-redu cing effect s, practitioners suggest frying th e root in vinegar; and to speed it s action , they reco mm end cook ing it in wine.

LATINNAME Cype rus rotundu s

Combin at ions: A preparation of cype rus, bupleurum , and white peony root is pr escr ibed for pain and bloating in th e chest, sides, and breasts. Combin ed with aucklandia and finger citron fruit, it makes a treatm ent for pain in th e upp~r abdom en, indig estion, vomitin g, and di ar rhea. A preparation of cyperus, dong quai, and cnidium root (Ligusticum chuanxiong ) is often prescribed for irregul ar menstruation , while a mi xture of cyperus, bupleurum , and trichos anthes fruit is recomm ended for breast swelling during menstruation . For information on specific dosages and oth er herb al co mbinations , consult a Chinese medi cine practition er.

GENERALDESCRIPTION The root of a plant found in marshy areas and river bottoms throughout Chi na, cy perus is co nsidered one of the best menstrual regulators known to tr aditional Chines e medicine. Practition ers also prescribe it for digestiv e problems. Sometimes called nut-grass rhi zome, this fra grant root at its best is large , solid , and reddish brown. In traditional Chinese med ici ne cyperus is classified as acrid, slightly bitter, and neutral.

TARGETAILMENTS ♦ irregular menstruation , menstrual

SIDE

cra mps, di gestive probl ems such as gas and blo ating , depressi on, moodiness, and inst ability. (Take internally.)

C

EFFECTS

Non e expected.

SPECIAL INFORMATION PREPARATIONS

• In laboratory experiments, inje ctions of the herb und er the skin have increased the pain thresholds of mi ce.

The cy perus root is available in bulk from Chinese pharmacies, Asian markets, and some Western health food

0

Prescription Drug

0

Over- theCounter Drug

O

Western Herb

0

Chinese Herb

& Homeopathic

(cJ Remedy

g

33

~~~

CONVENTIONAL

D

AND

NATURAL

DAM IANA

DANDELION

LATIN NAME Turnera diffusa

LATIN NAME Taraxacum officinale

GENERAL DESCRIPTION Since 1874, when damiana became commercially available in the United States, its effectiveness as an aphrodisiac has been touted by ·some even as it was being dismissed by herbalists and the public. It has been used as a food additive in sweets, baked goods, and liqueurs, and a few of its believers have smoked the leaves and reported a high lasting about 90 minutes. Although some contemporary herbalists think damiana has no medicinal value, others recommend it to support the nervous and endocrine systems. How damiana renders this support has not been proved, but anecdotal evidence suggests that the herb is useful in testosterone production and may stimulate the central nervous system, aiding in the alleviation of depression. It is prescribed to reduce anxiety, depression , or mood disorders of a sexual origin. Damiana may promote digestion and serve as a laxative; it is believed that the minute quantities of volatile oil in the leaf can stimulate the genitourinary tract. The leaves also contain an antimicrobial agent that may be effective in the urinary tract. TARGET AILMENTS Take internally for: ♦ hormone-based disorders such as impotence , hormone imbalance. + prostate problems and ailments of the urinary tr act. ♦ depression, anxiety, listlessness. • poor libido . PREPARATIONS Over the counter: Damiana is available in dry bulk , tinctures, and capsules.

At home: Tea: Steep 1 to 2 tsp dried leaves in 1 cup boiling water for 10 to 15 minutes, and drink three times daily.

Combinations: For nervous anxiety or depression, damiana can be combined with any or all of the following: oats, skullcap, or kola. SIDE

EFFECTS

Not serious: Too much damiana can cause insomnia and headaches. Discontinue use.

934

MEDICINES

-·~

~L

GENERAL DESCRIPTION Long before the European colonists introduced dandelion to the native population of North America, the herb had an established niche in the Chinese and Ayurvedic medical traditions of Asia, the Middle East, and Europe. Dandelion acts as a natural diuretic while also supplying potassium, a nutrient often lost through diuretic use. The plant is rich in vitamins A and (-antioxidants that are believed to help prevent cancer. The young leaves can be eaten fresh or used in herbal preparations. TARGET AILMENTS ♦ poor digestion, gallbladder problems , inflammation of the liver, and disorders such as congestive heart failure and high blood pressure that require diuretic treatment. ♦ As a supplemental diuretic, dandelion may help relieve symptoms associated with high blood pressure , congestive heart failure, premenstrual syndrome, menstrual pain, and general joint pain. PREPARATIONS Over the counter: Available in tinctures, prepared tea, capsules, and dried or fresh leaves or roots .

At home: Tea: Prepare by steeping 1 tbsp dried or 2 tsp fresh leaves per cup of boiling water for 10 minutes. Drink as many as 4 cups a day.

Decoction : Simmer 1 tbsp fresh or dried root per cup of water for 15 minutes. Drink as many as 4 cups a day. Nutrition and diet: Add fresh leaves to a salad, or blend in a juicer with other green vegetables. Use with barberry for liver and gallbladder problems. Use with yarrow for water retention. SIDE

EFFECTS

Not serious: Allergic dermatitis, stomach upset, diarrhea, flulike symptoms, liver pain. Discontinue use and call your doctor when convenient.

or gallbladder disease. Consult an herbalist if you plan to use the herb longer than two or three months. ♦ Use low-strength preparations for adults over 65 and children between the ages of 2 and 12. Do not give to children younger than 2. ♦ See also Diuretics.

DANDELION

LATIN NAME Taraxacum mongolicum GENERAL DESCRIPTION While the Chinese dandelion differs slightly from the Western variety, both have roots with similar medicinal properties. Chinese medical practitioners use dandelion frequently for hepatitis, stomach disorders , and fluid retention. Dandelion root, according to traditional Chinese medicine, is characterized as bitter, sweet , and cold. TARGET AILMENTS Take internally for: ♦ hepat it is, jaundice, and other I iver conditions. ♦ poor lactation in nursing mothers . • painful and difficult urination. • red, painful, swollen eyes.

Use both internally and topically for: ♦ abscesses, boils, carbuncles , and

sores, particularly

on the breast.

PREPARATIONS Dandelion is available in bulk form from Chinese pharmacies, Asian markets, and some Western health food stores. It is also possible to obtain it in tablet form.

Combinations: Mixed with trichosanthes fruit, fritillaria, and myrrh, dandelion root is applied to breast abscesses, carbuncles, and furuncles. Dandelion blended with chrysanthemum flower (Chrysanthemum morifolium) and skullcap is used to treat red, swollen eyes. A preparation that contains dandelion and honeysuckle flower is prescribed for painful, deep-rooted boils. Adding forsythia fruit and chrysanthemum flower strengthens the effect. Consult your herbalist for information on additional combinations and doses.

SPECIAL I NFORMATION ♦ If any of the following

ply, use dandelion only tion with a professional naturopath: pregnancy, tion, inflamed stomach

conditions apin consultaherbalist or heart condior colon, liver

SIDE

EFFECTS

Overdoses of the herb can cause mild diarrhea; some preparations using Chinese dandelion root may cause heartburn.

CONVENTIONAL

SPECIAL INFORMATION • Test-tube studies suggest that the herb may kill staphylococcus and other bacteria that resist other antimicrobial treatments.

DECONGESTANTS

GENERIC NAMES Rx: phenylpropanolamine OTC: oxymetazoline, phenylpropanolamine, pseudoephedrine GENERAL DESCRIPTION Available as sprays or pills in over-thecounter and prescription form , decongestants relieve nasal and sinus congestion and headaches by constricting blood vessels in the nose and other parts of the respiratory system. Because the drugs affect certain receptors in the nervous system, high doses (above recommended amounts) may produce central nervous system side effects. Some of those used orally are chemically related to amphetamines and are banned for athletic use. Decongestants come in both pill and spray forms, depending on the desired effect. Nasal sprays give the fastest results and are used for short-term treatment of nasal congestion. Use of these sprays for extended periods of time or at higher-than-recommended doses may result in nasal irritation or rebound congestion (nasal stuffiness , swelling , and redness without underlying illness). In pi 11form, decongestants are used alone or in combination with other drugs to relieve the symptoms of colds, allergies, and other respiratory problems. Usually, decongestant pills do not produce rebound congestion and therefore are useful for long-term treatment of nasal congestion. Decongestant pills can also be used to treat problems caused by pressure changes during air travel. For more information, see individual entries for the generic drugs listed above. TARGET AILMENTS ♦ congestion of the nose and sinuses caused by allergy or upper-respiratory infection. ♦ congestion of Eustachian tubes, which join the ear with the nose and throat ( pseudoephedr i ne). ♦ bronchial asthma (phenylpropanolamine). ♦ obesity (phenylpropanolamine, used as an appetite suppressant). ♦ urinary incontinence (phenyl propanolamine).

SIDE

AND

EFFECTS

NATURAL

MEDICINES

DESOGESTREL

Not serious: Mild nervousness, restlessness, insomnia, dizziness, lightheadedness, nausea, dryness of mouth or nose, rebound congestion.

DRUG CLASS Estrogens and Progestins

For spray and topical forms: sneezing; burning , stinging , or dryness of nose. Call your doctor if these symptoms continue or become troublesome .

BRAND NAMES Desogen, Ortho-Cept

Serious: Severe headache, nervousness, restlessness, insomnia, pounding or irregular heartbeat, high blood pressure. Contact your doctor immediately.

GENERAL DESCRIPTION Desogestrel is a progestin that is used in combination with estrogens as a contraceptive. See Estrogens and Progestins for information about side effects and possible drug interactions.

SPECIAL INFORMATION • In rare cases, phenylpropanolamine has been associated with serious cardiovascular side effects, including severe high blood pressure and heartrhythm problems, as well as psychotic problems, such as hallucinations and seizures. These effects are associated with high doses of phenylpropanolamine and may be more likely in individuals with similar preexisting problems, such as high blood pressure or neurologic or psychiatric disease. • Check with your doctor before taking any decongestants if you have cardiovascular disease (including angina, coronary artery disease, and hypertension), hyperthyroidism (overactive thyroid), diabetes, or glaucoma. Decongestants may exacerbate these conditions. "f"POSSIBLE

DEVIL'SCLAW

LATIN NAME

Harpagophytum procumbens GENERAL DESCRIPTION An extremely bitter herb, devil's claw grows in arid regions in southern and eastern Africa, where the root is collected at the end of the rainy season. Traditionally, the dried root was made into a tea used to treat indigestion, fevers, and blood disorders, while the fresh root was used for an ointment to put on boils and skin lesions. Since the herb's active ingredient, harpagoside, is believed to reduce pain and inflammation , devil's claw is sometimes recommended for arthritis; this usage, however , was not validated when the herb was clinically tested. Herbalists do recommend trying devil's claw for arthritis on a case-by-case basis, especially if the arthritis is accompanied by severe pain and swelling. Some herbalists believe that devil's claw is helpful in the treatment of liver and lymphatic disorders, and it also may lower blood sugar levels. It is also used to stimulate the appetite and aid digestion. Since it must be imported from Africa, devil's claw is very expensive.

INTERACTIONS

Anticoagulant (blood-thinning) drugs: decreased anticoagulant effect. Beta blockers: oral decongestants can lessen the effectiveness of beta blockers, causing hypertension. Digitalis preparations: taking these drugs with oral decongestants may result in heart-rhythm problems. High blood pressure drugs containing rauwolfia: decreased effectiveness of oral decongestants. MAO inhibitors: increased stimulant action of oral decongestants, causing effects such as hypertension and heartrhythm problems.

TARGET AILMENTS Take internally for: ♦ arthritis, gout. ♦ liver dysfunctions, chronic gallbladder disorders, digestive problems. ♦ diabetes

Stimulants (such as other decongestants, amphetamines, caffeine): increased stimulant effects, leading to excessive nervousness, insomnia, irregular heart rhythm, or seizures. Tricyclic antidepressants (such as amitriptyline): increased action of oxymetazoline and phenylpropanolamine, making serious central nervous system side effects more likely.

0

Prescription Drug

0

Over-theCounter Drug

Apply externally for: ♦ skin lesions and boils.

O

Western Herb

O

Chinese Herb

/1 Homeopathic

~ Remedy

g3 5

CONVENTIONAL

AND

NATURAL

PREPARATIONS Over the counter: Devil's claw is available in bulk and in tinctures and capsules.

At home:

D

To make a decoction: Put ½ to 1 tsp devil 's claw ground to a powder in 1 cup boiling water ; simm er for 15 minutes and strain; drink three times a day for at least one month. Compress: Soak a pad in an infusion of devil's claw for several minutes; wring out and apply to the affected area. Combinations: Devil's claw can be used with bogbean, celery seed, and meadowsweet for arthritis.

SPECIALINFORMATION ♦

Check with your practitioner before using devil 's claw if you are pregnant. ♦ Do not use devil 's claw if you have an acute gallbladder attack or an ulcer.

MEDICINES

GENERALDESCRIPTION Dextrornethorphan is the main ingredient in a large number of widely available over-the-counter cough suppressants (antitussives) and common cold medications. The drug is used for the tempor ary relief of dry coughs caused by the common cold or flu. It should not be used for chronic coughs or for coughs that produce secretions. Like codeine , from which it is derived , dextromethorphan inhibits the cough reflex by acting directly on the cough center, located in the medulla of the brain. Unlike codeine, however, dextromethorphan is not a narcotic. When taken at the recommended dosages, it lacks analgesic and addictive properties and does not depress respiration. For more information, see Codeine, Cough Suppressants, and Opioid Analgesics.

TARGETAILMENTS ♦

dry, nonproductive, and temporary coughing. SIDE

DEXBROMPHENIRAMINE

DRUG CLASS Antihistamines

BRAND NAMES Drixoral Cold and Flu, Drixoral Cold and Allergy

GENERALDESCRIPTION Dexbrompheniramine is an antihistamine with mild sedating effects. It is usually sold in combination products with decongestants. See Antihistamines.

DEXTROMETHORPHAN

DRUG CLASS Cough Suppressants

BRAND NAMES Some types of Comtrex, Contac , and TheraFlu; Vicks DayQuil Liquid or LiquiCaps , Dimetapp DM Elixir, NyQuil, Robitussin-CF, Robitussin-DM , Triaminic Nite Light, Triaminic Sore Throat Formula, Triaminic DM Syrup, Triaminicol Multi-Symptom Relief, Tylenol Cold (adult and children)

EFFECTS

Not serious: Mild drowsiness , mild dizziness , stom ach pain , nausea or vomiting. Call your doctor if these symptoms persist or are bothersome.

Serious: Adverse effects at the recommended nonprescription dosages are mild and rare; for overdose symptoms, see Special Information below.

SPECIALINFORMATION • Overdose symptoms include confusion , hyperactivity, feeling of intoxication, lack of coordination, hallucinations, irritability, and severe nausea and vomiting. Seek immediate medical help. ♦ Do not take dextromethorphan if you have had an allergic reaction to any medications containing this drug. ♦ Before taking dextromethorphan, consult your doctor if you have asthma or impaired liver function , or if your cough is producing mucus or phlegm. • Use dextromethorphan medication only as instructed by your doctor or the label directions. Take it only as long as needed; some reports suggest that this drug may be habit-forming if you use too much for too long. • Check with your doctor if your cough persists for more than 7 to 10 days or if it is accompanied by a skin rash, high fever, or continuing headache. These symptoms may indicate the presence of other medical problems.

POSSIBLE

INTERACTIONS

Central nervous system depressants (anesthetics, antidepressants, antihistamines, anti-insomnia drugs, barbiturates, benzodiazepines, muscle relaxants, narcotics or prescription pain medicines, tranquilizers): increased sedative and depressant effects.

MAO inhibitors: disorientation, psychotic behavior , coma.

DIAZEPAM

DRUG CLASS Antianxiety Drugs [Benzodiazepin es]

BRAND NAME Valium

GENERALDESCRIPTION Since 1963, diazepam has been used to reduce anxiety and nervous tension. Despite its history of being overprescribed, particularly in the years immediately following its introduction, diazepam is effective in up to eighty percent of anxiety patients and is now considered one of the drugs of choice for treating mild to moderate anxiety. However, diazepam should not be used for the stress and anxiety of everyday living. Like other benzodiazepines, the drug is potentially habit-forming, especially when used for extended periods of time or at high dosages. Diazepam may also be used to treat acute alcohol withdrawal and presurgery anxiety, and as an adjunct treatment for skeletal muscle spasms and seizure disorders. See Benzodiazepines for more information on side effects and other possible drug interact ions. POSSIBLE

INTERACTIONS

lsoniazid: increased diazepam effect and possible toxicity.

Phenytoin: possible phenytoin toxicity. Rifampin: decreased diazepam effect.

DICLOFENAC

DRUG CLASS Analgesics [Nonsteroidal AntiInflammatory Drugs (NSAIDs)]

936

CONVENTIONAL

BRAND NAME Volt aren

SPECIAL INFORMATION Do not give this drug to infants under the age of six months . • Do not use dicyclomine if you have ulcerative colitis , paralytic ileus (obstruction of the bowel), urinary retention, myasthenia gravis (muscle weakness), gastroesophageal reflux, esophagitis , or an allergic reaction to anticholinergic drugs . ♦ Before taking this medication , inform your doctor if you have glaucoma, hypertension , angina , coronary artery disease, congestive heart failure , tachycardia, asthma or bronchitis, an enlarged prostate, ulcerative colitis or a peptic ulcer, or if you have kidney, liver, or thyroid disease. You should also tell your doctor if you plan to have surgery within two months that will require anesthesia. ♦ If you are pregnant, consult your doctor and weigh the benefit-to-risk ratio of taking this drug. ♦ Dicyclomine passes into breast milk and lessens the flow; avoid the drug if you are nursing. ♦ Take this medication 30 minutes before meals and at bedtime. ♦ Prolonged use of dicyclomine can result in chronic constipation and possible fecal impaction. • Dicyclomine may cause drowsiness or blurred vision; use caution when driving or operating machinery.

Nonsteroidal Anti-Inflammatory Drugs (NSA/Ds) for side effects and additional drug interaction information. INTERACTIONS

Antidiabetic drugs and insulin: diclofenac may either increase or decrease th e hypoglycemic effect of antidiabetic drugs.

DICYCLOMINE

DRUG CLASS Antispasmodic Drugs GENERAL DESCRIPTION Introduced in 1954, dicyclomine is an antispasmodic drug used to reduce muscle spasms in the gastrointestinal tract. The drug works in two ways: It acts directly on the smooth muscles of the gastrointestinal tract. Dicyclomine also has an anticholinergic effect, meaning that it inhibits the action of a body chemi ca l call ed acetylcholine. This prevents muscles in the GI tract from contracting, ther eby eliminating spasms. TARGET AILMENTS ♦ irritable bowel syndrome (spastic colon ). ♦ infant colic. S I DE EFFECTS

Not serious: Altered sense of taste; decreased perspiration ; nasal congestion; insomnia; dizziness; drowsiness ; constipation; dry mouth , ears, and throat. Call your doctor if these effects become bothersome. Serious: Hives or skin rash, intense itching, headaches, difficulty urinating, nausea and vomiting , confusion or delirium, agitation , heart palpitations, blurred vision, dilated pupils, eye pain , difficulty swallowing and breathing, muscle weakness, lightheadedness , feeling of faintness. Discontinue use and contact your doctor immediately.

POSSIBLE

DIGOXIN

DRUG CLASS Digitalis Preparations BRAND NAME Lanox in GENERAL DESCRIPTION Digoxin is a digitalis preparation that has been used since 1934 to strengthen the heart and to treat heart arrhythmias. Digoxin interacts with many over-thecounter and prescription drugs. TARGET AILMENTS ♦ congestive heart failure (all degrees). ♦ prevention and treatment of heart arrhythmias (atrial fibrillation and flutter; atrioventricular tachycardia; and paroxysmal nodal tachycardia).

Antacids and some antidiarrheal drugs: decreased dicyclomine effect.

SIDE

Other anticholinergics, amantadine, antihistamines, certain antiviral drugs, benzodiazepines, buclizine, MAO inhibitors, meperidine, methylphenidate, orphenadrine, phenothiazines, quinidine, tricyclic antidepressants: increased dicyclomine effect.

Serious: Slow or irregular heartbeat; in children, fast heartbeat; visual disturbances , such as blurred vision or halos around objects; drowsiness, confusion, or depression; headache; fainting; digestive problems, such as pain in the lower stomach, diarrhea, nausea, vomiting, or loss of appetite; unusual tiredness or weakness; allergic reactions (rare), such as skin rash or hives. Call your doctor immediately if you experience any of these effects.

Potassium chloride: risk of intestinal ulcers.

@P

GENERAL DESCRIPTION In use for decades, digitalis preparations have been the drugs of choice in treating various heart ailments , including congestive heart failure and some heart arrhythmias. Originally obtained from plants of the foxglove genus, most digitalis preparations are now produced

Prescription Drug

0

Over -theCounter Drug

EFFECTS

Not serious: None expected; all side effects are potentially serious.

Ketoconazole: decreased ketoconazole effect.

0

MEDICINES

Q

INTERACTIONS

DIGITALIS PREPARATIONS

NATURAL

synthetically because the potency of plant parts is highly variable. Digitalis preparations are effective , but toxicity is a major concern with their use, since the effective dose is often only slightly smaller than a toxic dose. For information about a specific digitalis preparation, including side effects and possible interactions with other drugs, see Digoxin.

♦

GENERAL DESCRIPTION Diclofenac is an NSAI D available in tim ed-release form for treating sympt oms of rheumatoid arthritis , osteoarthri tis , and arthritis of the spine. This drug is also used for general pain relief and for alleviating menstrual discomfort. See

POSSIBLE

AND

O

SPECIAL INFORMATION Do not discontinue this medication without your doctor's knowledge; to do so might cause heart problems. ♦ Check your pulse if directed by your doctor; be sure to report any low pulse rate (less than 60 beats per minute) to your doctor immediately. • Digoxin can cross the placenta and affect the fetus, and it can pass to infants through breast mi Ik. Pregnant and nursing women should therefore ♦

We stern Herb

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Chin ese Herb

A Homeopathic U Remedy

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37

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CONVENTIONAL

AND

NATURAL

use caution when taking this medication. The dosage oft en must be reduced for women who have given birth recently (within six weeks). • Avoid all over-the-counter antacids as well as cough, cold, allergy, and diet drugs, except when advised otherwise by your doctor. POSSIBLE

I:)

INTERACTIONS

Following is a partial list of the drugs and other substances that can interact with digoxin. To compensate for these interactions, your doctor may have to adjust the dosages of digoxin and any other drugs you may be taking.

MEDICINES

BRAND NAMES Cardizem, Dilacor XR

est type of blood cell) and reducing the chance of blood clot formation. For more information , see Anticoagulant and

GENERALDESCRIPTION

Antiplatelet Drugs.

The calcium channel blocker diltiazem has been used since 1977 to treat heartrhythm problems, hypertension, and angina. Like other drugs in its class, diltiazem works to inhibit the passage of calcium into body cells. This dilates the arteries and slows the contraction of the heart and arteries, thereby decreasing the work load on the heart and lowering blood pressure. See Calcium Channel Blockers for information on side effects and possible drug interactions.

Antacids, antidiarrheal drugs (such as kaolin and pectin), antiulcer drugs (including sulfasalazine), dietary fiber, laxatives: inhibited absorption of digoxin, reducing its effectiveness.

DIPHENHYDRAMINE

Diuretics: may increase or decrease the effects of digoxin.

Cold Night Time Medication Liquid, Tylenol PM

Erythromycin: increased absorption of digoxin into the body, thereby increasing its actions and side effects.

GENERALDESCRIPTION Introduced in 1946, diphenhydramine

risk of excess potassium, possibly leading to heart-rhythm problems; do not take potassium supplements with digoxin.

was one of the first antihistamines. Its sedating and drying effects are more pronounced than those of the newer antihistamines. Diphenhydramine is used to treat symptoms of allergies, insomnia, chronic cough, vertigo, and mild Parkinson's disease. One form of diphenhydramine, a drug called dimenhydrinate, is used to treat motion sickness. See

Antihistamines.

DIPYRIDAMOLE

Quinidine or quinine: increased blood concentration of digoxin.

Stimulant drugs, such as amphetamines or over-the-counter decongestants: in-

DRUG CLASS

creased risk of heart-rhythm problems.

Anticoagulant and Antiplatelet

Drugs

GENERALDESCRIPTION Introduced in 1959, dipyridamole is used

DILTIAZEM

DRUG CLASS Calcium Channel Blockers

938

POSSIBLE

INTERACTIONS

DIURETICS

BRAND NAMES Rx: Benadryl OTC: Benadryl, Excedrin PM, Tylenol

Other antiarrhythmiadrugs, calcium supplements, rauwolfia (an antihypertensive drug): increased heart arrhythmias. Potassium supplements (salts): increased

Serious: Chest pains, severe headaches, low blood pressure, rash, breathing problems, wheezing, runny nose, chest tightness.

DRUG CLASS Antihistamines

amounts of digoxin circulating in the blood , possibly leading to heart-rhythm problems.

amounts of digoxin circulating in the blood.

Dizziness, lightheadedness , flushing , weakness, stomach irritation .

~ake_ it possible to reduce the dosage of d1pyr1damole; it may also lessen the drug's side effects. Do not take aspirin for this purpose without first consulting your doctor .

Calcium channel blockers: increased

Fluoxetine: increased di goxi n effects. lndomethadn , a nonsteroidal antiinflammatory ·drug (NSAID): increased

EFFECTS

Aspirin: taken concurrently, aspirin may

Amiodarone (an antiarrhythmia drug): increased amounts of digoxin circulating in the blood , which can lead to heartrhythm problems.

SIDE

Not serious:

to prevent the formation and migration of blood clots (thromboembolism) following heart valve surgery and in other heart and blood conditions. It may be used alone or in combination with aspirin or one of the anticoagulants. Dipyridamole seems to inhibit the action of certain enzymes, thus preventing the aggregation of blood platelets (the small-

GENERICNAMES amiloride, bumetanide, furosemide, hydrochlorothiazide, indapamide, p~tassium chloride (adjunct therapy), tr I amterene

GENERALDESCRIPTION Diuretics, sometimes referred to as water pills , work by increasing the elimina tion of fluids from the body through urination. This action lowers blood volume (and blood pressure), helps reduce swelling, and decreases excess fluid in body tissues. During the excretion of fluid, minerals such as sodium, potassium, magnesium, and calcium are also eliminated, a side effect that can cause problems with the heart, muscles, and other organs. The heart, in particular , can be affected by either too much or too little potassium. For this reason, doctors often prescribe newer, so-called potassiumsparing diuretics (such as amiloride or triamterene), which are designed to lessen the excretion of potassium. In some cases, supplements of potassium chloride are prescribed to restore supplies of that mineral lost through the use of diuretics. For more information see entries for each of the generic drugs listed above.

TARGETAILMENTS • general edema (swelling caused by water retention), especially of the ankles and feet.

CONVENTIONAL

♦

edema associated with various medical conditions , including congestive heart failure and cirrhosis of the liver. ♦ high blood pressure (hypertension ). SIDE

EFFEC T S

Not serious: Headache, blurred vision, diarrhea, diz z iness or lightheadedness when getting up (orthostatic hypotension ), increased risk of sunburn . Let your doctor know if these symptoms continue or become troublesome. Serious: Diur etics can cause dehydration or an electrolyte imbalance, which can result in the following symptoms: nausea or vomiting, fatigue or weakness, irregular or weak pulse, increased thirst , dry mouth , muscle pain or cramps, mood changes, mental confusion. In rare cases, diuretics may cause bleeding in urine or stools , unusual bruising , or a skin rash. Tell your doctor immediately if you experience any of these symptoms . You may be advised to lower your dosage and increase your intake of fluids and minerals. SPECIAL INFORMATION ♦ Taking diuretics in hot weather or while engaged in heavy exertion can cause a dangerous loss of fluids or minerals. Watch for signs of dehydration (fatigue , dizziness, headache, nausea). • Your doctor will closely monitor your potassium levels to prevent heartrhythm problems. If you are not tak ing a potassium-sparing diuretic , you may be given a potassium supplement (such as potassium chloride). If you are currently taking a potassiumsparing diuretic , you should avoid potassium supplements, salt substitutes (which are high in potassium), and potassium-rich foods such as bananas. ♦ When potassium-sparing diuretics are suddenly discontinued after prolonged use, a rebound effect may occur, causing a rapid and potentially dangerous buildup of potassium in the body. Gradual discontinuation of these diuretics is important to prevent potassium toxicity. ♦ Because diuretics have both known and suspected effects on glucose (blood sugar) levels, people with diabetes or who have been diagnosed with borderline diabetes should have their blood sugar levels monitored closely.

AND

Alcohol: increased action of diuretics . Amiodarone: low calcium blood levels and subsequent heart arrhythmias.

SPECIAL INFORMATION This type of laxative should never be t aken with mineral oil ; stool softeners increase the toxicity of min eral oil. • Docusate is often used in combination with the laxative phenolphthal ein, which in rare cases can cause side effects ranging from skin rashes and kidney problems to breathing difficulty and cardiac arrest. ♦

Anticoagulants (such as coumarin derivatives or heparin): thiazide diuretics and furosemide may decrease the action of these drugs . Antigout medications (including probenecid): thiazide diuretics may increase blood uric acid levels. Your doctor may need to adjust your dosage of the antigout medicine. Digitalis and other heart drugs: though thiazide diuretics and furosemide are sometimes taken with heart medications, such combinations can increase the risk of potassium loss and additional heart-rhythm problems. Your doctor will closely monitor your progress.

DONG QUAI

Foods high in potassium (such as bananas and low-salt milk), salt substitutes, potassium supplements: may lead to potassium toxicity if ingested in sufficient amounts while taking a potassiumsparing diuretic.

LATIN NAME

Angelica sinensis GENERAL DESCRIPTION Also known as Chinese angelica root, dong quai is used by Chinese herbalists as a treatment for several gynecological complaints. Look for a long, moist, oily plant as the source of the root, which has brown bark and a white cross section. The fragrant herb is characterized as sweet, acrid, bitter , and warm , according to traditional Chinese medicine.

Lithium: thiazide diuretics and furosemide may increase the risk of lithium toxicity. Nonsteroidal anti-inflammatory drugs (NSAIDs), especially indomethacin: reduced effectiveness of diuretics. Oral antidiabetic drugs, insulin: in rare cases, diuretics may interfere with these medicines or raise blood glucose levels.

TARGET AILMENTS Take internally for: ♦ menstrual irregularity , lack of menstruation , painful or insubstantial menstruation. ♦ stabbing pain , pain caused by traumatic injury . ♦ poor blood circulation , pale complexion , possible anemia. ♦ carbuncles that , according to traditional Chinese medicine, arise from stagnant blood ; abscesses; sores. ♦ lightheadedness, blurred vision , heart palpitations.

Other blood pressure drugs, including angiotensin-converting enzyme (ACE) inhibitors: although diuretics are frequently taken with medications to lower blood pressure, caution should be exercised to ensure that blood pressure does not go too low.

DOCUSATE

PREPARATIONS This root is widely available in bulk and in tablet form at Chinese pharmacies, Asian markets, and Western health food stores. You should avoid the herb if it is dry or has a greenish brown cross section. Frying the herb in vinegar or wine improves its tonic effect on blood circulation. Toasting it to ash increases its ability to stop bleeding.

DRUG CLASS Laxatives BRAND NAMES Colace, Correctol, some types of Ex-Lax GENERAL DESCRIPTION Docusate, a stool-softening type of laxative, is used to relieve constipation. Stool softeners are often taken as a prophylactic to prevent straining during bowel movements after heart attacks, childbirth , or rectal surgery, or when

Prescription Drug

0

Over-theCounter Drug

MEDICINES

hemorrhoid s are present. See Laxatives for information about side effects and possible dru g interactions.

POSS I B L E INT ERAC TI O N S

0

NATURAL

Combinations: Mixed with astragalus, dong quai provides a tonic for treating fatigue and other symptoms associated with loss of blood. A blend of dong quai , white peony root , Chinese foxglove root cooked in wine, and cnidium

O

W estern Herb

O

Chinese Herb

0

Homeopathic Remedy

g Jg

CONVENTIONAL

AND

NATURAL

root (Ligusticum chuanxiong) is prescribed for menstrual irregularity and similar conditions. Dong quai is also combined with honeysuckle flowers and red peony root to form a prep aration that reduces the swel Iing and alleviates the pain of abscesses and sores. Consult a Chinese medicine practitioner for further information on mixtures and doses.

MEDICINES

SPECIAL INFORMATION You should not take doxazosin if you have ever had an al lergic or unusual reaction to it , or to terazosin or pr azosin .

♦

used for the same ailm ents as other tetracyclines and for certain addi tional conditions. These include use by shortterm travelers for the pr evention of malaria in areas where the disease is resistant to other preventives. Doxycycline is also used to prevent and treat traveler's diarrhea in high-risk patients. For more information, see Tetracyclines.

DOXEPIN

D

SIDE

EFFECTS

None expected if used as directed. SPECIAL INFORMATION • You should not take dong quai during the early stages of pregnancy. • Check on the use of this herb with your Chinese medicine practitioner if you have diarrhea or abdominal bloating ; it is not recom mend ed in some cases.

DOXAZOSIN

DRUG CLASS Alpha 1-Adrenergic Blockers BRAND NAME Cardura GENERAL DESCRIPTION Introduced in 1986 , doxazosin is one of several alpha-adrenergic blocking agents used in the treatment of high blood pressure. It can be used alone or in combination with other drugs , depending on the degree of hypertension. For more information , see Alpha1-

Adrenergic Blockers.

940

DRUG CLASS Antidepressants [Tricyclic Antidepressants (TCAs)] GENERAL DESCRIPTION Introduced in 1969, doxepin is among the group of drugs called tricyclic antidepressants, commonly prescribed in the treatment of depressive illnesses. Like other antidepressants, this drug works to restore serotonin and other brain chemicals to their normal levels. Doxepin is also used to treat some kinds of chronic pain, peptic ulcers, and urticaria (hives, skin ulcers ). See Antidepressants for information about side effects and possible drug interactions.

SPECIAL INFORMATION • Unlike most other tetracyclines , doxycycline may be taken with food, milk and other dairy products, or carbonated bever ages with no expected decrease in action. POSSIBLE

INTERACTIONS

Barbiturates and anticonvulsants (such as carbamazepine or phenytoin): decreased doxycycline effect, possibly requiring increased dosage of doxycycline or use of another tetracycline.

DOXYLAMINE

DRUG CLASS Antihistamines

DOXYCYCLINE

DRUG CLASS Antibiotics [Tetracyclines] GENERAL DESCRIPTION Introduced in 1967 , doxycycline is a semisynthetic tetracycline antibiotic,

BRAND NAME NyQuil GENERAL DESCRIPTION Doxylamine is used to treat symptoms such as a runny nose and congestion. Because it causes drowsiness, it is also used as a mild sedative-hypnotic to induce sleep. See Antihistamines.

CONVENTIONAL

ECHINACEA

LATIN NAME

Echinacea spp.

AND

yo unger t han two years old ; start w ith minim al doses fo r older childr en and older adult s. • Check wit h your doctor before using echina cea if you are pregnant or nursi ng.

TARGETAILMENTS Chinese: • feve r and chills, coughing , w heezin g, n_asal and chest congestion, indi ges!1on, stom~chache . (Take intern ally.) ♦ JOlnt swell111g(in combinations).

ENALAPRIL

DRUG CLASS Angiotensin-Converting Inhibitors

App ly exte rn all y for: • boil s, cuts, burns, abscesses, wounds, stings, hives, insect bites , eczema, and herpes.

PREPARATIONS Over the counter: Ava il able in dried form in bulk, and in teas, capsules, and tinctures. At home: Tea: Bo il 2 t sp dried root in 1 cup water, and simmer for 15 minut es. Drink thr ee tim es daily.

Combin ations : Use echinacea with yarrow o r uva ursi to treat cystiti s. SIDE

EFFECTS

No ne expected.

SPECIALINFORMATION ♦ Do not use echin acea continuously

for more th an a few weeks . • Do not give echin acea t o childr en

a

Western: ♦ colds , asthm a, hay feve r, nasal and chest congestion, influ enza, obesity. (Take internally.)

Enzy me (AC E)

BRAND NAME Vasotec

PREPARATIONS

GENERALDESCRIPTION

Over the counter: Available as fluid extrac t, tablets, dri ed bulk herb .

Like other ACE inhibitor s, enalapril relaxes arteri al walls, ther eby low erin g blood pressure and redu cing th e work load of th e heart. For th ese reasons th e drug, introduced in 198 5, is used to man age high blood pressure (hyp ertension) and co ngestive heart failure. Enalapril is sometimes combined with hydro chlorothiazid e for increased blood pressure-lowering action. See Angiotensin-Converting Enzyme (ACE) Inhibitors for information on side effects and possible drug intera ct ions.

At home: Chinese: Prepare by co mbinin g dri ed her bs and wa ter in a wok. Simmer over low heat for 15 minut es.

Combinations: Fo r fever and chills ephedra is mix ed with cinnamon t~ig. A co mbination of ephedra and apricot seed is used for co ughin g and wheezing. For indigestion and stomach aches e_rhe?ra is mi xed with licori ce. Congestion 1stre ated by ephedra combined with dried ginger. Western: A tea is prepar ed by boilin g 1 t sp ephedra with 1 cup w at er for 15 to 20 minu tes. Drink up to 2 cups a day.

TARGETAILMENTS Take inte rn al ly for: ♦ colds, influ enza, and other respiratory illnesses, mononucleosis , ear inf ections, septi cemia (b lood poisoning), and bladder infe ct io ns.

MEDICINES

t io ns on th e strength of over-t hecounter products containing ephedr a. Known as ma huang in China , ephed ra grows abund antly throughout th ~ north ~rn provinces of thi s country . It 1sdescribed in traditi onal Chinese medicine as acrid, bitt er, and wa rm .

GENERALDESCRIPTION Echin acea was amon g th e herbs freq uentl y used by Native Americans of the southwest plains in poultices , mouthwashes , and teas. Now a popular garden perennial, th e pl ant displays purple blossoms and grow s as hi gh as fi ve feet. Herba lists va lue th e dried root of echin acea for its broad-based action against many types of viral and bacter ial illn esses such as co lds, bro nch iti s, ear infections, influ enza, and cystitis. Labo ratory testin g shows that it co nt ains echin acoside , an ingredie nt that may have antibi otic effec ts. Another ingredie nt , echin ace in, is beli eved to block some mechani sms th at enable infectious v iru ses or bacteria to inv ade body ti ssue. In the labo ratory, echin acea seems to bol ster the immun e system's w hite b loo d cells in t heir battle against fo reign microor ganisms; it may increase the production of T cel ls, w hi ch join ot her w hit e blood cells in the fight against inf ect ious agents. Echinacea can also be effec ti ve as a topical medi c ine for ecze ma and other skin problems.

NATURAL

EPHEDRA S IDE EFFECTS

Not serious: Insomni a, dry mouth , nervous ness, irrit abilit y, headac he, diz zi ness.

LATINNAME

Ephedra sinica

Serious: Increased blood pressure, incr eased heart rate, heart palpit ations. If any of these symptoms develop , stop using ephedra immedi ate ly and consult your physici an.

GENERALDESCRIPTION With its joint ed, barkless bran ches th at bear few leaves, the ephedra plant has been used by tr ad it ion al Chinese healers for thousands of years. The root s and aboveground parts of this herb have been adopted by W estern practitioner s as a bronchial decongestant and rem edy for asthma, hay fever, and the co mmon co ld . Its active ingredient s are ephedr ine, pseudoephedrine, and norpseudoeph edrine , all central nervous syst em stimulants. Ephedrine affec t s the body by opening bronchial passages; thi s activates th e heart , increasing blood pr essure and speeding up metaboli sm. For this reason, herbalists warn th at excessive use of ephedra can lead to nervou sness, insomnia , and high blood pressure. In the United States, several states have set restric-

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Prescription Drug

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O ver-th eCounter Dru g

SPECIALINFORMATION ♦ WARNING:

Do not t ake ephedra if you are pregnant or have heart disease, di abetes, glaucoma, or an overacti ve thyroid gland (hyperthyroidism). • WARNING: Ephedra is an ingredient in several weight-loss aids. It s effectiveness in this regard , how ever, derives from its acce lerating effect on th e met abolism , considered an unwa nted side effect; co nsequently , many healthcar e prof ession als warn against using it to aid in losing weight. ♦ If you are takin g any medi cation , consult your physici an befor e using thi s herb .

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Western Herb

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Chinese Herb

A Homeopathic U Remedy

g

41

CONVENTIONAL

AND

NATURAL

♦ Do not take ephedra for more than

4 weeks. ♦ Use low-strength pr eparat ions for children or adults over 65. Do not administer to children under age 2. + WARNING: Because ephedra can cause a number of side effects- and in rare cases, death - consult a practitioner before using it.

MEDICINES

See Bronchodilators for info rm at ion about side effec ts and possible drug int er act io ns.

ERYTHROMYCIN

D

Antibioti cs [Ophthalmic Antibiotics; Erythromycins (systemic )]

BRAND NAMES Ophthalmic: 1lotycin DRUG CLASS Bron chodilators

BRAND NAMES Primatene Dual Action Formula , Primatene Tablets

GENERAL DESCRIPTION Ephedrine , a synthetic ally produced drug chemically similar to the herb ephedra , is a decongest ant that also works as a bronchodilator. It is used to reduce the frequen cy and severity of recurr ent asthma attacks. Ephedrine is ava ilab le in liquid and tablet form, sometime s in combination with aspirin or aceta minophen. See Bronchodilators for further information abo ut side effects and possible dru g int eractions . SIDE

EFFECTS

Not serious: Dr yness of nose and throat, rebound co ngestio n.

EPINEPHRINE

Systemic: E.E.S., E-Mycin , Ery-Tab,

. Eryt hromy cin Base Filmtab , Erythroctn , PCE

GENERALDESCRIPTION Erythromycin, which was introdu ced in 1952 , and other drugs in its class, are used to treat many of th e same inf ections for which penicillins are prescribed. Depending on its tar get and its co ncentr ation , erythromycin may kill bacteria outright (bact eri cidal action) or stop the growth and spread of bacteria (bacteriostatic action) by keeping the organisms from manufa cturin g protein. Once their growth has been halt ed, the bacteria can be eliminat ed by the body's defenses. Erythromycin is particularly useful for people who are all ergic to penicillin or tet racyclin e. When it is used for th e eyes in the fo rm of a soluti on or o intm ent , eryt hromycin has fewer side effects than it does when taken orally or by injecti on for syst emic problem s. The various systemic forms of this dru g includ ~ ery thr omycin estolate, erythromyctn stearate, ery thromycin ethylsu cc inate, and erythromycin base.

TARGETAILMENTS Ophthalmic:

Rx: Adrenalin Chlorid e Solution, Ana-Kit, EpiPen, Sus-Phrine

• eye inf ect ions due to strain s of str ep, staph, Hemophilus influen zae, and other bacteria. (Erythromycin is also used to prevent conjunctivitis in newborns who have been exposed to chl amydia or gonorrhea.)

OTC: Primatene Mist , Primat ene Mist

Systemic:

DRUG CLASS Bronchodi lat ors

BRAND NAMES

Suspension

GENERALDESCRIPTION Since 1900 , epinephrine has been used to relieve the symptoms of bronchial asthm a and allergic nasal congestion. In th e form of eye drops , the drug is used to manage glaucoma. Other uses include the emergency treatment of heart problems and anaphylactic shock.

942

♦ rheum ati c, co ngenital , or va lvu lar

heart d isease; used in shor t-t erm th erapy before dental or upp errespiratory sur gery to prevent endocarditi s, or in continuous th erapy t o prevent strep infection s. SIDE

EFFECTS

Not serious: Systemic: mild nausea, oral candidi asis DRUG CLASS

EPHEDRINE

,__

• respi ratory tract infections, includin g pharyngitis and sinusiti s caused by str ep; otitis media ; some types of pneumonia; w hoopin g co ugh; and legionn aire 's disease. • amoeb ic dysentery. • inf ections of the skin and soft ti ssue. • nonsp ec ific urethritis. ♦ gonorrh ea and syphilis . ♦ chlamydia! infections.

(sore mouth or ton gue), vaginal candidiasis, unusual fatig ue. Call your doctor when co nveni ent.

Serious: Ophthalmic: eye irritation th at develops and persi sts after you begin using this dru g; also it ching , redness, or swelling. These symptom s may indic ate an allergy or superinf ection . Discontinu e use and cal l your doctor ri ght away.

Systemic: diarrhea, abdominal cramps: vomitin g, and fever. Call your doctor 1f these symptoms are severe or prolonged. Hearin g loss; jaundic e (pale sto o ls, dark urine , yellow eyes or skin); anaphylactic react io n (rash, redness, it ching, and hi ves). Discontinu e use and call yo ur doctor right away. SPECIALINFORMATION • With lon g-t erm use, antibiotics can int erf ere with the actions of "good" bacteria and fungi that norm ally populate the intestines, mouth , and vagina; thi s may cause diarrh ea and fun gal inf ect ions, such as candidiasis. If you get a fungal infection w hile t ak ing an antibioti c, continue the medication but call your doctor to find out how to treat th ese pro ble ms. Eatin g yogurt containing Lactobaci !lus acid op hilu s culture , or takin g ac idoph ilu s tablets, can help restore the "good" bacteria that help keep the fun gi in check . ♦ Before startin g erythromycin th erapy, let your doctor know if you have ever had an alle rgic reacti on t o thi s drug or if you have ever used erythromycin estolate. • Tell your doctor if you have hearin g loss, cardi ac arrhythmias , an imp aired liv er, or if you are susceptible to allergies (asthma , eczema, or hiv es). The systemic forms of this dru g may exacerbate th ese conditions. • If you are pregnant, avoid erythromycin estolate, which can cause liver to x icit y during pregnancy. A numb er of health professionals consider other forms of erythromycin to be safe fo r pregnant wo men. Howe ver, if you're pregnant or nursing , be sure to t ell your doctor before taking any form (systemic or ophthalmic) of this dru g.

,"

CONVENTIONAL

POSSIBLE

INTERACTIONS

AND

Systemic: Acidic fruits or juices: decreased effect of eryt hromyc in ; do not consume within an hour of taking erythromycin. Alcohol: possible liv er damage. Alfentanil: increased alfentanil effect. Aminophylline: possible aminophylline toxicity. Anticoagulants: increased anticoagulant effect , risk of bleeding. Bactericidal antibiotics (pen ici llins , cephalosporins): erythromycins decrease the effective ness of these dru gs.

Cyclosporine: possible toxicity of both drugs , risk of kidney damage.

DRUG CLASS Estrogens and Progestin s

SIDE

BRAND NAMES Alora, Climara , Estrace, Estraderm , Fempatch, Vive I le GENERAL DESCRIPTION Used in estrogen replace ment therapy to restore natural estrogen , estradiol is used to treat symptoms of menopause and to prevent osteoporosis and atherosclerosis after surgical removal of the uterus or ovaries. Estradiol is available in pill form and as a skin patch. See Estrogens and Progestins for inform at ion abo ut side effects and possible drug int eract ions.

Estrogens: conjugated estrogens, estradiol , estropipate, ethinyl estradiol , mestranol

Lincomycin: decreased lincomycin effect.

Progestins: desogestrel, ethynodiol diacetat e, levo nor gestrel, medroxyprogesterone, norethindrone, norethindrone acetate, norgestimat e,norgestrel

Midazolam: incr eased midazolam effect. Phenytoin: possible toxicity of both drugs. Theophylline: possible theophylline toxicity. Triazolam: in creased triazolam effect.

ERYTHROMYCINS --------------

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GENERIC NAMES azithromycin, clarithromycin , erythromycin GENERAL DESCRIPTION Introduced in 1952 , erythromycins are a subclass of ant ibiotics used to treat many of the same bacterial inf ect ions for which penicillins are prescribed. See the entries for the generic drugs listed above for information about side effects and possible interactions.

GENERAL DESCRIPTION Estrogens and progestins are natural and synthetic hormones or hormonelike substances that have strong effects on the reproductive organs of animals. The drugs , used for birth control and to treat a range of hormone-related medical conditions, also affect the heart , circulatory system, bones, and other organs. Your doctor will select an oral co ntraceptive based on the relative strength and proportion of each ingredient to best fit your menstrual cycle.

SPECIAL INFORMATION • Do not use estrogens and progestins if you are pregnant or breast-feeding. If you suspect you are pregnant, discontinue use immedi ate ly to avoid severely harming the fetus. ♦ Estrogens may increase blood glucose levels; if you are diabetic , your doctor may have to adjust your dosage of insulin or other antidiabetic drug. • Progestins (alone) used for oral contraception have been associated with higher rates of ectopic (fallopian tube) pregn ancy. ♦ These hormones may cause fluid retention , which can aggravate asthma, epilepsy , migraines , and heart and kidney disease.

TARGET AILMENTS • estrogen- and progestin-deficiency conditions, such as hot flashes, vaginal dryness, and other symptoms occurring at natural menopause or after surgical removal of the ovaries; the drugs can also be prescribed for women who have little or no ovarian function for other reasons. ♦ birth control (oral contraceptives , implants, injections). ♦ possible use in prevention of osteoporosis and heart disease in postmenop ausal women.

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a

Serious: Lumps in the breasts, enlargement of the breasts, changes in menstrual bleeding, spotting, painful or frequent urination, fainting, jaundice, pain or swelling of the upper abdomen , pain in the stomach or right side of the abdomen, increased blood pressure, skin rash not associated with skin patch, dark-colored or new mole , cataracts, vaginitis (itching , irritation , or thick whitish discharge). Let your doctor know if you experience these symptoms. Get medical attention immediately if you experience any of the following: severe pain in leg, chest, or abdomen; sudden headaches; changes in speech, vision, or breathing; weakness or numbness in extremities. (These symptoms may indicate blood clots .)

ESTROGENSAND PROGESTINS

Ergotamine: possible ergotamine toxicity ; impaired circulation , tingling , and burning pain in hands and feet.

EFFECTS

Not serious: Acne; mild nausea; diarrhea ; vomiting ; headache; migraine headac he; abdominal pain ; decrease or increase in appetite; weight gain or loss; fluid retention or swelling of ankles, feet, breasts; breast tenderness; changes in sexual desire ; sodium retention. Less frequent: blotchy spots on skin, increased body hair, loss of hair on scalp, photosensitivity , intolerance to contact lenses, mild dizziness, local skin irritation (w ith skin patch). Let your doctor know if these symptoms persist or become bothersome.

Digoxin: possible digoxin to x icity.

Lovastatin: ri sk of rhabdomyolysis , a severe muscle disease.

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operable cance rs: breast cancer in women and , occasionally , prostate cancer in men. ♦ abnormal uterine bleeding (med roxy progesterone ).

Carbamazepine: possible toxicity of both drugs. Chloramphenicol: increased chloramphen icol effect.

MEDICINES

♦ palliative treatment of advanced in-

ESTRADIOL

Ophthalmic: None expected. While the body 's absorption of ery thromy ci n throu gh th e eyes is negligib le, you should tell your doctor about any other medicine you are using to avoid possibl e int eractions.

NATURAL

POSSIBLE

INTERACTIONS

Anticoagulants: estrogens and progestins may decrease the anticoagulant effect of these medicines.

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Western Herb

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Chinese Herb

A Homeopathic

(2} Remedy

943

CONVENTIONAL

AND

NATURAL

Anti-infective dr ugs: may decrease th e effec ti veness of oral co ntr acept ives by inte rfe rin g w ith estroge n in th e digesti ve system .

ETHINYL ESTRADIOL

EUCALYPTUS

Barbit urates and rifampi n: reduced effecti veness of estro gens and pr ogestins .

D RUG CLASS Estr ogens and Progest ins

LATIN NA M E

BRAND NAM ES Desogen, Demul en, Loest rin FE, Lo/Ov ral, Nord ett e, O rth o- Nov um , Ovco n, Tri -Lev ien, Tr iph asil

GENERA L D ESCRIPTION Nati ve to Austr ali a and a favor it e meal fo r koa las, th e eucalyptus tr ee is sometim es ca lled th e Austr ali an fever tr ee or gum tr ee. The o il extra cted fro m eucalyptu s leaves is an import ant ingredi ent in over-th e-co unt er mouthw ashes and decongest ant s. Herbalists includ e small amount s of th e o il in several preparati ons, includin g gargles for sore thr oat s, to pica l anti septi cs for skin injuri es, rubs fo r art hriti s, and inh alant s for asthm a, bro nchit is, and oth er respiratory co ndi ti ons. The acti ve ingredi ent in t he eucalyptu s leaf , a chemi cal call ed euca lyptol , is believed to be effectiv e both in tr eatin g respir atory probl ems and, because of it s antib acterial acti on, as a t op ica l anti sept ic.

Benzodiazepines and theophylline: oral co ntr acepti ves may alt er th e eff ecti veness of th ese dru gs. Your docto r may have to adjust your dosage.

D

MEDICINES

Beta blockers (usually heart medication): birth -control pill s may int erf ere with some beta blo ckers. Calcium supplements: o ral co ntr acept ives may increas e ca lc ium absorption. Hydrocortisone and related cortisone drugs: estro gens and progestin s may increase th e anti-infl amm at ory eff ect s of t hese dru gs. Your doct o r may lower th e dosage of co rti sones. Tamox ifen: estro gen may decrease th e eff ect s of tamoxif en. Tobacco (smoking): may in crease th e ri sk of cardio vascul ar side effec t s of estr ogens, especi ally in wo men ove r 35.

GENERA L D ESCRIPTION Ethinyl estr adiol is an estro gen t hat is co mbin ed w ith a prog estin , such as norethin d ron e, for use as an oral co ntr acepti ve. See Estrogens and Progestins fo r infor mat ion about side eff ect s and possibl e dru g int eracti ons.

ETHYNO DI O L D IACETATE

Tricycli c ant idepressants and maprot iline: est roge n may increase bl oo d leve ls of th ese dru gs.

DRUG CLASS Estro gens and Progestin s

V itam in C: hi gh doses of v it amin C may inc rease blood levels of estroge ns o r alte r th e body 's respo nse to th em .

BRAND NAME Demul en

ESTROPIPATE

Eucalyp tus globulus

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TARGET AI LMEN TS A ppl y ext ern all y fo r: ♦ arthriti s, rheum ati sm, and min or cut s and scrapes.

G EN ERA L DESCRIPTI ON Ethynodi o l di acetat e, a pro gestin co mbin ed w ith th e estrog en ethin yl estr adio l, is prescrib ed for use as an oral co nt racept ive . See Estrogen s and Prog estins for info rmat ion abou t side effects and possib le drug int eracti ons.

D RUG CLASS Est roge ns and Progest in s BRAN D NAM E Oge n Tabl ets GENERAL D ESCRIPTI ON Estr opip at e is an est roge n co mm onl y pr escrib ed in estrog en repl acement t herapy. It is used t o tr eat sympt oms of natur al menop ause and t o pr event ost eopo ro sis and ath ero scl eros is. Estr opip at e is also prescrib ed aft er sur gica l remo va l of the ut eru s or ova ri es. Fo r info rm ation about side eff ects and possib le dru g int eracti o ns, see Estrogens

and Progestins.

944

_ET_ O_D_O _L_ A_C_ __

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DRUG CLASS A nalgesics [Nonst eroid al AntiInf lamm at ory Dru gs (N SA I Ds)] BRAND NAME Lodin e GENERA L DESCRIPTION A newe r NSAI D, etodol ac may be prescrib ed fo r acute and lon g-t erm management of ost eoarthri t is and pain . It is not generally recomm ended for r heum ato id arthriti s. See Nonsteroidal AntiInflammatory Drugs (NSA/Ds) fo r info rmati on about side eff ect s and possibl e dru g int eractions.

Use as an inh alant in an extr emely dilut e fo rm fo r: ♦ asthm a, influ enza, bron chiti s, w hoo ping co ugh, co lds, and oth er respirat ory i II nesses. PREPARATI ONS O ver the counter: Ava ilable in dry bulk , tin ctur es, and o il s. At home: Inh alant: Put 1 t o 3 drop s of th e o il in a bow l and add 1 pt boilin g wate r; inh ale st eam until t he vapor s disapp ear.

Anti septi c: Dilut e th e oil w ith an equ al amount of an alcohol -based topi cal anti septi c, and appl y t o cuts and other open wo und s aft er yo u have washed th em w ith soap. Rub: Mi x 1 to 5 drop s euca lyptu s o il w ith 1 cup o live o il. SIDE

EFFECTS

No t serious: A skin rash can deve lop w ith ext ern al use. If it does, di scontinue use. SPECIAL I N FORMATION ♦ WA RNI N G: The o il of eucalyptu s in

co ncentr at ed form is poi sonous if yo u ingest it. A teaspoonful can be fat al. Cal I yo ur doctor immedi ately if yo u experi ence stomach upset or di arrh ea w ith any dosage.

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CONVENTIONAL

♦

Do not admini ster int erna lly to children under two years of age. For o lder childr en and o lder adult s, start with minimal doses. • If yo u app ly th e oil to brok en, irritated skin , use small amount s. ♦ Close your eyes w hen inhaling eucalyptus in any form because th e fumes are very powe rful , and be especially ca ref u I in protecting your eyes from any contact with th e oi ls.

AND

nancy. A prep arati o n co nta inin g eucomm1a bark , Japanese teasel root , and Chinese yam is prescr ibed fo r pre gnant wo men who have suffered habitual mi scarri ages. Co nsult a Ch inese practi tioner for advice about dosages and ot her herbal combinations. SIDE

TARGET AILMENTS ♦ premenstrual syndrome, arthritis, dry eyes, hyperact iv ity in childr en, high blood pressure , ecze ma, brittle hair and f ingernails. (Use int ernal ly.) PREPARATIONS Available in capsules and in liquid form. Use as directed.

EFFECTS

The herb has a mild sedative effec t w hen taken in large doses.

SIDE

SPECIAL INFORMATION Eucommia bark appears to have reduced high blood pressure in clinical trials, with the fri ed herb having a stronger effect th an th e dried herb . ♦ It seems t o stimulat e urination w hen tested in dogs, rats, and mi ce.

GENERAL DESCRIPTION Eucommia bark is used t o stren gth en the musculoskeletal system and to pr eve nt mi scarri ages. Yell ow ish brown on the outside, it is dark purp le insid e. When broken , the bark should produ ce thin w hit e threads. Accord ing to tr aditional Chinese medicin e, the herb has acrid , sweet, and warm characteri stics. It is harvested from tr ees at least 15 years o ld in several provi nces of China . TARGET AILMENTS Take internal ly for: ♦ wea k muscles and bo nes, especially in the back and knees, acco mp ani ed by poor c irculation ; low-back pain and soreness, accompanied by fr equent urin at ion . ♦ mild abdo minal pain or slight vagin al b leed ing du rin g pr egnancy, pr evention of miscarriage and stab ili zat ion of pregnancy, back pain in pregn ant wo men. ♦ dizzine ss and ligh t headedness caused by high blood pressure. PREPARATIONS Eucommi a bark is available in bulk or dried fo rm at Chinese pharmacies, Asian markets, and some Western health food stores. It is sometim es possible to obta in it in pills or tablets. Herbalists reco mmend th at yo u fry it in salt water, before yo u decoc t it , w hen you use it as a tonic to str engthen th e lower back and knees, and to tr eat fatigue and frequent urination .

Combinations: Eucommi a bark is sometimes mixed w ith psoralea fruit , co rnu s, and cuscuta for impoten ce or urin ary frequency and incontin ence. It may be co mbin ed w ith Japanese teasel root, cuscut a, and mulberry mistletoe stems fo r low-bac k pain and stab ilizin g preg-

POSSIBLE

EFFECTS

Too mu ch evenin g primrose oil may cause headac hes, skin rashes, and nausea; if thi s happen s, either low er yo ur dosage or discontinue use altogether.

G

SPECIAL INFORMATION ♦ Evenin g primr ose supplem ents must be take n regular ly fo r at least a month before their beneficial effects can be notic ed. ♦ Co nsult a pra ct ition er befor e using evenin g primrose o il medi cinally for childr en.

LATIN NAME

Eucom mi a ulmoides

MEDICINES

coro nary artery d isease.

♦

EUCOMMIA BARK

NATURAL

INTERACTIONS

Some herb ali st s suggest th at euco mmi a bark should not be taken at the same time as scrophularia.

EVENING PRIMROSE OIL EVODIA FRUIT LATIN NAME

Oe nothera biennis

LATIN NAME

Evodia rutaeca rpa

GENERAL DESCRIPTI ON Herbalists reco mmend th e oil from th e seeds of th e plant known as evenin g primrose for a wide range of ailment s that includes art hritis and premenstrual syndrom e. Evening primrose suppl ements may also benefit brittle hair and f ingernails , and may help to keep dry eyes lubricat ed. Native Am eri cans and early settlers in North America used th e o il to tr eat asthm a, gastroint estinal ill s, and bruises. The ther apeuti c component of evening primr ose oil, known as gammalin_olenic acid (GLA), is an essential fatty ac id that th e Western di et ofte n lacks. G LA support s the body's production of ho rmones know n as prost aglandins , w hi ch affect the body's horm one balance. When the body's supply of essential fatty acids such as GLA is deficient the eff ects of premenstrual syndrome , ' di abetes, and ot her disord ers may beco me more pro nounced . Evening primro se oil may also be useful in treatin g sore breast s in nursing mo~hers, th ro ugh it s anti-inflammatory act io n. In addition, recent studies suggest that evening primros e oil may have an anticlottin g action. Some herbalists believe this may be helpful in treatin g

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GENERAL DESCRIPTION Thi_sextremely fragrant herb is prescribed for abdomin al disorders and sometimes for it s painkilling properties. Evodia fruit is character ized in tr aditional Chi nese medi cine as hot acrid and bitt er. Grown in several Chinese ' pro v inces, the fruit is harv ested between August and Oct ober, w hen it is brownish green in color and not full y rip e. TARGET A ILMENTS Take int ernally or app ly poulti ce externally for : ♦ d!arrh ea w ith undi gested food , especially morning diarrhea; headaches with vo miting , and nausea accompani ed by lack of app rec iation of the t aste of food ; pain in the upp er abdomen; hernia .

Apply poultice exte rnally for: indi gestion , high blood pr essure, sores of the mouth or tongu e.

♦

PREPARATIONS Evodia fruit is available in bulk or powdered form at Chin ese pharm acies, Asian markets , and some West ern health food stores.

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Chine se Herb

fe0. H omeopathic V Remedy

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CONVENTIONAL

D

AND

NATURAL

Combinations: Evodia fruit is often mixed with other herbs to treat vom itin g. These preparations frequently include fresh or dried ginger, pinellia root, or coptis. In addition, practitioners recommend that powdered evod ia be comb ined with vinegar to make a poultice. These pastes are then placed on the navel to relieve indi gestion, or on the soles of the feet to treat high blood pressure and sores of the mouth and tongue. Consult a Chinese practitioner for adv ice about dosages and other herb al combinations. SIDE

EFFECTS

Not serious:

An overdose of evodia fruit can cause the throat to become extremely dry. Serious:

Large doses have led to visual disturbances and hallucinations.

MEDICINES

EXPECTORANTS

GENERAL DESCRIPTION

Expectorants help peopl e cough up and remove thick and excessive mucus (also known as phlegm or sput um ) from the lun gs and upper respiratory tract, thus providing symptomatic rel ief from persistent coughs that frequent ly accompany the common cold or flu . These drugs work by redu c ing the stick iness and adhesiveness of mucus, making it easier to cough up and expe l. Expectorants are particularly useful with dry coughs that are producing little, if any, phlegm. Eventually, as the phlegm is expe lled , th e respiratory tract becomes less congested and the need to cough is reduced. For information about a specific gener ic expectorant drug, see Guaifenesin.

SPECIAL INF ORMATION

+ WARNING: Herbalists cons ider evodia slightly toxic. They caution against long-term use and overdosage. They also believe that it can dry out body tissues. • Practitioners often try to reduce side effects by giv ing patients a preparation of licori ce before they take the evodia. ♦ In clinical tests, powdered evodia seems to have been helpful in treating eczema. POSSIBLE

INTERACTIONS

Some herbalists believe that evodia should not be used in comb ination wi th sage root.

946

EYEBRIGHT

LATIN NAME

Euphrasia officin alis GENERAL DESCRIPTION

Eyebri ght is an herb whose name suggests both its action and appeara nce. The red spots on its white or purple flowers seem to resemble bloodshot eyes. Moreover, its dried stems, leaves, and flowers have long been used as a tonic for irritated or infected eyes. Eyebright can be applied to eyes that are itch ing, red, and tearing from hay fever, othe r allergies, or colds. Herba li sts also recommend it to alleviate the symptoms of conjunct ivitis, and some advocates suggest that drinking eyebright tea can help to maintain good vis ion . Eyebright teas are also used to dimin-

ish nasal congest ion and coughs that accompany hay fever, colds, and sinusitis. The herb, indi genous to heaths and pastures t hrou ghout Great Britain and other parts of Europe, by now has become naturalized in the United States. TARGET AILMENTS

Apply externa lly for: ♦ eye irritations includin g redness, itching, and tearing from hay fever, other allergies, or colds; conjunctivitis. Take int erna lly for: • nasal congestion and coughs from colds, sinusitis , or allergies. PREPARATIONS Over the counter:

Available in bulk, capsules, and tinctures. At home:

Tea: Pour 1 cup boiling water onto 2 tsp dried eyeb ri ght and steep for 10 minutes; drink three times daily. Compress: Boil 1 to 2 tbsp of dried eyebright in 1 pt water for 10 minut es. After the water has cooled to a luk ewarm temperature, strai n the mixture to remove al l parts of the herb , dip a sterile cloth in the liquid and wring it out, then put it over your eyes for 15 minutes severa l times daily. Combinations to be taken orally: To treat respiratory and nasal congestion, eyebrig ht is comb ined with goldenrod, elder flow ers, or goldenseal. For hay fever that causes itch y or watery eyes, eyebright is mixed wit h ephedra. Consult an herbal practitioner for dosages. SIDE

EFFECTS

Not serious:

Eyebright may cause a skin rash or nausea. If this occurs, lessen your dose or stop taking complete ly. SPECIAL INFORMATION

Consu lt a practitioner before using eyebr ight to treat children.

FAMOTIDINE

Enteric-coated tablets: changes in stomach acid it y may cause th ese medi cations to di ssolve prematurel y in the stomach; avo id taking them w ith famoti din e.

DRUG CLASS A ntiul cer Drugs [Hi stam ine H 2 Block ers]

Ketoconazole: decreased absorpt ion of ketocon azo le int o the body.

tory of alcoho lism, hepatitis , liver di sease, abnorma l blood clott ing, or estrogen-depe ndent breast tumors. Ani mal stud ies suggest th at fe nnel may exascerbate liver dam age.

BRAND NAMES

Rx: Pepcid

FENUGREEK

OTC: Pepcid AC GENERAL DESCRIPTION Famotidine is used mainly to treat ulcers of th e stomach and duodenum. It is also prescribed for Zollin ger-Ellison syndrome , gastroeso phageal reflu x (in which stomach acid flo ws back into th e esophagus), and other co ndition s involvin g the overproduction of stom ach acid. It also used prevents upp er gastrointestinal bleeding. In the OTC form , famotidine is used ~ot for ulc ers but to relieve acid indi gestion and heartburn. The OTC version, a low er dose th an the prescription version, has milder side eff ect s. The same dru g int eract io ns may apply , alt hough non e have been repo rted for the OTC dru g. Belonging to a subclass of antiul cer dru gs known as histamin e H 2 blockers , famotidine wo rks by blocking the effects of th e chemi cal histamine in th e stomach, thereby reducing the secretion of th e digestive juice hydrochlori c acid. Fo r mor e inform ation on side effects and dru g inter act ions, see Antiulcer Drugs. SIDE

EFFECTS

Not serious: Headaches, mild diarrhea, co nstipati on, di zz iness. Rare : skin rash, dry mouth o r skin, fatigue, insomni a, loss of appetit e, nausea, stomac h pains, swel Ii ng of th e eyelid s. Contact your doctor if symp tom s continu e or beco me both ersom e. Serious: Confusion, depression, anxiety, hair loss, hall~cinations, muscle or joint pain, rin ging in the ears, shortness of breath, tin glin g in fin gers or to es, unu sual bleeding or bruising , jaundice (ye llowin g of skin and eyes). If you experience any of th ese sympt oms, call your doctor immediately. SPECIAL I NFORMAT ION ♦ Avoid while pregnant or nur sing . ♦ Info rm yo ur doctor if yo u have a hi story of liv er or kidn ey di sease. ♦ This dru g can int erfere with skin allergy tests and cause fa lse-negativ e result s. • You may need to avo id dri ving or potentially hazardou s activi t ies. • Antacids can be taken w ith famo tid ine. POSSIBLE

INTERACTIONS

Alcohol, tobacco: may cause decreased effectiveness of fa motidine.

FENNEL LATIN NAM E Trigo nel/a foenum-graecum

LATIN NAME Foeni culum vulgare

GENERA L DESCRIPTION Members of a legume family th at includ es beans and peas, fenugreek seeds have been used fo r centuri es for digestive problems, skin injuri es, sore throats, fever, muscle aches, and impot ence. The seeds contain a large amount of mucilage, w hich becomes gelatinou s when mi xed w ith water; in this form it was thought to soothe irrit ated ti ssue. Some recent studi es suggest that fenugreek has a mild anti-infl ammatory effect. That may be_why herba lists find it useful in treating boil s, rashes, and other skin wou nds, as well as arthritis. It also may be t aken interna lly for sore thro ats and coughs.

GENERAL DESCRIPTION The tiny fruits (seeds) of fennel have been used sinc e ancient times to treat co lic and to increase lactat ion in nursing moth_ers. Fennel may help digestion by relaxing the stomach and ot her digestive organs; it may also reliev e diarrhe a. In add ition , it is believed th at fennel may have effects upon the bod y simil ar to those of estrogen. Because it acts as a mild diur etic , fennel has been used to aid in flu shing kidney stones from the body. And it acts as a soothing eyewash. TARGET A ILME N TS Take internally fo r : ♦ di gestive probl ems, gas, diarrhea. ♦ insuffi cient milk in nur sing moth ers.

TARGET A ILME N TS Take intern ally for : ♦ digestive diso rder s. • sore thro ats and co ughs. ♦ lactation problems of nursin g moth ers. • hi gh cho lestero l or b lood sugar.

Apply ext erna lly fo r: • muscle pain and rheum atism . ♦ conjunctivitis .

App ly ext erna lly for : ♦ ski n injuri es, such as boils, rashes, cuts , or oth er wounds . ♦ pain caused by arthritis .

PREPARATIONS Over the counter: Ava il able in dry bulk , oil , and tin ctu res. At home: To help digestion, chew fresh fenn el fruit.

PREPARATIONS Over the counter: Available in bulk seeds, capsules, and tin ctu res.

Te~:. Steep 2 tsp grou nd fennel in 1 cup boiling wate r for 10 minut es. Drink three times daily to aid digestion. For gas, drink a cup of th e tea half an hour befo re eatin g. Use a weaker dosage w hen t reatin g co lic in childr en under age two. SIDE

At home: Decoc_tion: Mix 2 t sp ground fe nugreek seeds in 1 cup wa ter and simmer for 1O minutes; drin k up to thr ee tim es daily.

EFFECTS

Not serious: Fennel o il, used for inflamed joint s, can cause a rash; discontinu e if this occurs.

Gargle: Mix 1 tbsp grou nd seeds in 1 cup hot water; simmer for 10 minut es, then strain. Gargle three times dail y, every thr ee to four hours, for sore throat pain.

Serious: Do not ingest th e oil; it can cause nausea, vo mitin g, and seizur es. Call you r doctor if any of these symptoms develop.

Poulti ce: Mi x enough boiled seeds in 1 cup warm wate r to make a thick paste. Apply it directly to affected areas daily.

SPECIAL INFORMATION ♦ Do not use fennel if yo u are pregnant or if you can't use birth- co ntrol pills or estrogen suppl ement s. • Do not t ake fennel if yo u have a hi s-

Serious: Fenugreek causes ut er ine contractions. Do not use it if you are pregnant.

0

Presc ription Drug

0

Over-theCounter Drug

GI

SIDE

O

Western Herb

EFFECTS

O

Chine se Herb

M

Homeopathi c

V Remedy

94 7

CONVENTIONAL

AND

NATURAL

SPECIAL I NFORMA TI ON ♦ Do not give to chil dre n und er age two;

for older childr en and adult s, start treatlllent with low- str ength doses.

MEDICINES

177entshad fai led. They believe this relief is du e to th e chelll ical parthenolide , w hich blocks the release of infla177177atory substances fro177the blood. The reatory searchers co nsider these infl a177177 elelll ent s, which affect the wa lls of th e brain's blood vessels, to be key colllponents in the onset of a llligraine .

FERRUM PHOSPHORICUM, ♦

Ferrum phosphoricum

D

GENERAL DESCRIPTI ON

Ferrulll phosphoriculll, also called ferrulll phos or iron phosph ate, is a lllineral C0177po und of iron and phosphorus. Both elelll ent s are pr esent in the body ind ependently; phosph o ru s co ntribut es to bone and 177uscl e health , and iron aids the exc hange of oxy gen in th e blood. Ferrulll phos is deriv ed fr o177lllixin g solutions of iron sulfate, phosphate, and sodiUlll acetat e. The resultin g iron phosphate is ground w ith large quantities of lactose (177ilksugar) to render it nontoxic. Ho 177 eopath ic practitioners co nsider ferrulll phos good for pati ents who suffer fro177 co nditi ons w ith low energy and anelllia. TARGET AILMENTS ♦

Tickling , hacking coughs wi th chest pain, headaches, fevers th at begin slowly , ear infections, incontin ence, rh eulll atic joints, ear ly 177 enstrual peri ods acco lllpanied by headac hes, anellli a, fati gue, nosebleeds, sore throat , vollli tin g, diar rhea, palpitations . (Take int ern ally.)

PREPARATIONS

Ferrulll phos is available in vari ous potencies, in both liquid and tab let forlll , at select ed stores and pharlllacies. Consult your practitioner for 177oreinfor177ation. V' SIDE

llli graine headach es. (Take int erna ll y.)

PREPARATIONS Over the counter:

Av ail ab le in dry bulk , pills, capsul es, and t in ctur es. At home:

Chew two fresh or froz en leaves a day fo r llli gra ines. If yo u find the leaves t oo bitter, substitut e capsules or pills containing 85 177 g of the leaf lll ate ri al, but fresh leaves are best for il77177 ediate results. Tea: Steep 2 tsp dried herb in 1 cup boiling water for 5 to 10 lllinut es; drink two to three cups per day. SIDE

EFFECTS

Serious:

Chewing fresh or dri ed feverfew 177 ay cause int ernal lllouth sores or abdo lllinal pain. If these sy177ptol77s develop , discontinue use and notif y your doctor. SPECIAL INFORMATION ♦ Do not use feverfew

if you are pregnant because it 177aystilllul ate ut er ine co ntr act ions . ♦ Feverfew 177a y interfere with the blood 's clotting abilit y; talk t o you r doctor befo re using if yo u have a c lottin g disorder or take anticoagulant llledicine. ♦ You 177ayneed to take feverfew daily for two to three 1770nth s before it has any effect.

LATIN NAME

M enth a haplocalyx (o r M enth a arvensis) GENERAL DESCRIPT ION

LATI N NAME

Chrysanthemum

parthenium

GENERA L DESCRIPTION

Feverfew is a per enni al w ith Slllall , daisylik e blossollls and leaves that are llledicinal. In the late 1970s, British researchers found feverfew leaves helpful in treating llli graine headaches where ot her treat-

948

Col77binations: A lllixture with prun ella is prescribed for infla177177ation of th e eyes and swelling of the lymph nod es. A preparation prescribed for a sore, swollen thro at co lll bines fie ld mint wi th platycodon and silkworm. Mixed w ith chr ysanthemum fl ower (Chrysanth emum m orifolium) , it is used to relieve headac hes and ot her pains, as wel I as redness and swelling of th e eyes. Practition ers warn against overcooking when prep arin g 177 edi cinal solutions of the mint ; it is usually added to combinations fiv e lllinut es before th e coo kin g is finished. Consult yo ur herb alist for further inform ati on on appropri ate co mbinations and dosages. SIDE

EFFECTS

None expected . SPECIAL INFORMATION ♦

Nursin g mothers should not use this herb , since it may cause insuffi c ient produ ct ion of milk.

FLUORO QU INOLONES

ciprofl oxac in , ofloxacin.

FIELD M INT

FEVERFEW

You can buy field mint in its natur al fo rl77 at Chinese pharmacies , Asian , and Western groce ri es, and health food stores. It is also ava ilable in tablet forlll.

GENERIC NAMES

EFFECTS

None expected.

Take internally for: • rashes in the earl y st ages, sore throa t , red eyes, headache . • emot ional in stability. • gyneco log ica l problellls. ♦ ch ildh ood conv ulsion s. PREPARATIONS

TARGET AILMENTS

LATIN NAME

TARGET A ILME NTS

Chinese her balists belie ve thi s fragrant lllint speeds recovery in diseases such as measles by bringing rashes to th e skin 's surfa ce . Field mint is also pr escr ibed for a range of conditions that includ e gynecological problems and emoti ona l di sturbances. Characterized in Chinese medi cine as an acr id, cool herb , fi eld lllint is cultiv ated throughout China.

GENERAL DESCRIPTION

Introdu ced in the 1980s, fluoroquinolon es are broad-spectrum antibiotics. The drugs , w hi ch belong to a group known as quinolones, work by inhibitin g th e ability of bacteria to make DNA , th ereby prev entin g the organisms' growth and reprodu ction . Because they enter into many part s of the body and are effect ive against a wi de range of organisms, fluo roquinolones have been used to treat many kind s of inf ect ions, includin g those of th e bones, joints, gastrointestinal tr act , respiratory t ract, skin, and urin ary tract , as well as inf ections that are sexually tr ansmitt ed. For more information about specifi c fluoroquinolones, see entri es for th e generic drugs listed above.

CONVENTIONAL

TARGET AILMENTS ♦ bron chiti s (bacterial exace rbation s). ♦ gonorrh ea. ♦ pneumonia (bacte ri al), otitis med ia, sinu siti s. • prostatitis (bacterial ). • inf ections of the skin and soft tissue. ♦ urinary tract infections , pelvic inflammatory disease (Pl D). ♦ travel er 's diarrhea.

shou ld not use fluoroquinolones because of the risk of arthropathy. Some researchers say these dru gs may be safe for use by adolescents who have co mpleted th eir skeletal growt h. • Fluoroquinolon es may cause sensitivity to the sun or to sunlamps. Limit your exposure while on these medications. • Take the full course of your medicine. POSSIBLE

S IDE EFFECTS

Not serious: Mild central nervous system effects, includin g dizziness, lightheadedn ess, drowsiness , headache , nervousness, insomnia; minor gastrointestinal problems , such as pain or discomforC diarrhea, nausea, and vomiting; photosensitivity (rare). Call your doctor if these symptoms per sist or becom e bothersome. Serious: Central nervo us system effec ts, including agitation, confusion, hallucinations, tremors, psychosis; allergic reactions (skin rash, itching or redness; swelling of face or neck; shortness of bre ath); fever or small ulcers on skin ; bloody or cloudy urin e; swelling of feet or legs; Stevens-Johnson syndrome (fever, skin blisters , or blisters and open sores on mucous membranes and genitals , weakness, joint pain). Call your doctor immediately if you have these reactions. A rare cond ition known as pseudomembran ous colitis may occur during or after the use of fluoroquinolones. Call your doctor at once if you experience abdominal or stomach cramps, severe pain and bloatin g, watery and severe diarrhea (may be bloody); fever , increased thirst ; nausea or vomiting ; tir edness o r weakness; unusual weight loss. These symptoms may occur at any time whil e you are usin g fluoroquinolones, or they may strike weeks after you have stopped taking the drug. SPECIAL INFORM ATION • Antibioti cs kill not only harmful bacteria, but also "good" bacteria that keep unwanted fungi and int estinal organisms in check. Eating yogurt containing Lactob aci llus acidophilus culture or taking ac idophilus tabl ets may help restore the body 's normal bacteria. ♦ Prolon ged use of any antibiotic drug can lead to fungal inf ections , including candidiasis, or to bacterial infection s such as pseudomembranous colitis. ♦ Pregnant and nursing women should not take fluoroquinolones because these drugs can cause arthropathy (abnormal development of joints ) in the fetus and infant. • Except in very limited cases, children and adolescents under the age of 18

AND

NATURAL

MEDICINES

FLURBIPROFEN

DRUG CLASS Analgesics [Nonsteroidal AntiInflammatory Drugs (NSAIDs )] BRAND NAME Ansaid

INTERACTIONS

Antacids, didanosine (antiviral), ferrous sulfate, laxatives containing magnesium, sucralfate (antiulcer), zinc: reduced fluoroquinolone effect. (See Ciprofloxacin and Ofloxacin for specific instructions on timing of these medications.)

GENERAL DESCRIPTION Flurbiprofen is an NSAI D useful fo r acute or long-term relief of the symptoms of rheumatoid arthritis and osteoarthritis. See Nonsteroidal AntiInflammatory Drugs (NSA/Ds) for side effects and drug interaction information.

Cimetidine (antiulcer) and probenecid (antigout) : decreased elimination of fluoroquinolones, heightening risk of adverse effects and toxicity (especially w ith ofloxacin).

GI

FUROSEMIDE

Warfarin (anticoagulant): increased anticoagulant effect.

DRUG CLASS Diuretics

FLUOXETINE BRAND NAME Lasix Oral GENERAL DESCRIPTION The fast-acting and powerful diuretic furosemide has been prescribed since l 96~ to treat high blood pressure (hypertension ) and excess fluid retention. The drug acts by increasing urine production, thereby removing water from the body and reducing swelling and blood vo lume. In t_heprocess,. however , salts containing sodium, potassium, calcium , and other vital minerals are also eliminated, sometimes leading to muscle cramps and serious cardiovascular side effects. For information about additional side effects and possible drug inter actio ns, see Diuretics.

DRUG CLASS Antidepressants [Selective Serotonin Reuptake Inhibitors (SSRls)] BRAND NAME Prozac GENERAL DESCRIPTION Fluoxetine, a wel l-k now n antidepressant drug, is prescribed for control of a wide range of depressive illness es. It is also used to treat alcohol dependence and obsessive-compulsive disorder. Fluoxetine belongs to a subclass of antidepressants known as selecti ve serotonin reuptak e inhibitors (SSRls) and works by restoring the neurotransmitter serotonin to normal levels in the brain. Although generally thought effect ive, flu oxetine may exacerbate suicidal tendencies in some people. Its use is considered co ntroversial by some doctors . See Antidepressants for information on side effects and possible drug interactions.

SIDE

SPECIAL INFORMATION ♦ While taking this med icine you may become more photosensitive, meaning your skin will burn more readily when exposed to sunlight. To protect your skin, use a sunblockin g loti on when outside and avoid prolonged exposure to the sun or sunlamps.

SPECIAL INFORMATION Although fluox et ine benefits many of those who take iC a greater percentage of peopl e expe rience side effects wi th this dru g than with other antidepressants. If you have any questions about possible side effects, discuss them with your doctor.

♦

0

Prescript ion Drug

0

Over -the Counter Drug

EFFECTS

Not serious: Increased risk of sunburn.

O

Western Herb

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Chinese Herb

/)\

Homeopathic

U Remedy

949

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CONVENTIONAL

AND

NATURAL

GANODERMA

D

GARLIC

LATI N NAME

LATIN NAME

Canod erma lucidum

Allium sativum

GENERAL DESCRIPTION A variety of mushroom also known as ling zhi in China and as reishi in the West, ganoderma grows in mountainous regions in China. It is a rare fungus that Chinese practitioners value highly for its multiple uses. Practitioners have traditionally used it to treat psychological disturbances as well as respiratory complaints and ulcers. In tr aditional Chinese medicine , where herbs are classified according to heating and cooling properties , ganoderma is categorized as neutral. Ganoderma has also been prescrib ed to boost patients ' immune systems. It appears to help the body to resist a wide range of physical, biological , and environmental stresses.

GENERAL DESCRI PTION Worn or carried as a protective talisman throughout the ages, and valued as a pungent culinary spice, the garlic bulb has gained recognition as a medicinal remedy in Chinese and Western cultures. It can be eaten raw or cooked , to release its th erapeutic effects . Garlic 's acti ve ingr edient is allicin , an amino acid derivative that is also responsible for the herb 's pungent smell. In China this perennial herb is prescribed for colds and coughs , as well as for intestinal and digestive disorders. Chinese herbalists also believe that garlic can be used externally as an antibiotic , to reli eve skin infections. In traditional Chi nese medicine , garlic is characterized as acrid , bitter , and warm . W estern herbalists pr escrib e garlic for many of the same ailments as their Chinese counterparts. It is also thought to strengthen the cardiovascular system, by reducing cholest erol and low ering blood pressur e.

TARG ET A ILMENTS Take internally for : ♦ nervou sness, insomnia, dizziness. • asthma , allergy-r elated chronic bronchitis . • we akened immune systems, tumors , ulc ers, poor blood circulation, mushroom poisonin g. PREPARATI ONS Ganoderma can be found in bulk at Chines e pharmaci es, Asian markets , and som e Western health food stor es (und er the nam e reishi). It is also possible to obt ain it in pi 11 or tabl et form , and in alcohol extract s. Consult a Chinesemed ic in e pr actition er for inform ati o n on dosages. Unlike most other Chines e herbs, ganod erma is not tradition ally combined w ith other substanc es. SIDE

EFFEC T S

Not serious: Patients may experience dizzin ess, sore bones, itchy skin, increased bowel mo ve ments, hard ened feces, and pimplelike eruptions when they use ganoderma. Stop using the herb immediat ely and see your doctor. SPECIAL I NFORMAT ION ♦ Ganoderma has proved useful in conjunction with conventional medical treatment of Al DS and cancer. • In clinical studies, ganoderma seems to have reduced blood pressure in humans and animals .

950

MEDICINES

Combinations: A mix of garlic and sugar w ater is sometimes prescribed for dig estive disord ers, diarrhe a, colds , coughs , food poisoning from shellfish , and conditions that require an enema .

Western: Tincture: Combine 1 cup crushed cloves with 1 qt brandy. Shakedaily for two weeks. Take up to 3 tbsp a day. SIDE

EFFECTS

Not serious: People allergic to garlic may develop a rash from touching or eating the herb . SPECIAL INFORMATION • Consult your practitioner before using gar Iic if you are pregnant. ♦ Garlic has a blood clot-preventing agent. If you have a blood-clotting disord er, consult an herbalist or a licensed healthcare professional. ♦ Although no conclus ive evidence has been found, a string of Western studies suggest that incorporating garlic into the daily diet may low er the risk of heart disease. ♦ Garlic is thought to function as an adjunct treatment for cardiovascular disease. Consult your practitioner before using it in this capacity.

TARGET A ILMEN TS

Chinese: Take int ernally for : ♦ digestive disorders , diarrhea, food po isoning from shellfish , conditions th at requir e an enem a, cold s, cough s, rheumatoid arthritis. Apply externally for : • hookworm , roundworm , ringworm of the scalp , carbuncles , swelling, pinworm , athlete's foot.

Western : • colds , coughs , flu , high cholesterol , high blood pressure , atherosclerosis , digestive disorders , bladder infection , liver and gallbladder problems . (Take internally.) ♦ athlete 's foot, ringworm of the body and scalp, minor skin infections. (Apply externally .) PREPARATIONS

Over the counter: Garlic is available as cloves and in tablet form. At home: Chinese: Nose drops: Combin e 1 part crushed root with 10 parts water . External treatment: Garlic is combined with sesame oil and appli ed externally to treat ringworm of the scalp, pinworm , carbuncles , swelling , athlet e's foot, arthritis , and rh eumatism.

GASTRODIA

LATI N NAME

Castrodia e/ata GENERAL DESCRIPTION The root of this member of the orchid family is prescribed by Chinese-medicine practitioners for conditions that they ascribe to disorders of the liver . A literal English translation would be " heavenly hemp." Look for a fat, solid , translucent , yellowish white root, probably imported from China's Sichuan, Yunnan, or Gui zhou provinces . Gastrodia is categorized in traditional Chinese medicine as a sweet and neutral herb. TARGET AILMENTS • headaches, including migrain es; dizziness; childhood convulsions ; epilepsy. (Take int ernally .) PREPARATIONS Gastrodia is found in bulk or in tablets at Chin ese pharmacies , Asian markets, and some Western health food stores.

Combinations: Mixed with gambir , skullcap, and achyranthes root , it is used for dizziness. Adding scorpion to that mix-

CONVENTIONAL

AND

NATURAL

MEDICINES

I

ture creates a preparation for treatin g seizures. Herbalists prescribe a mix containing gastrodia , Asian ginseng, atr actylodes (white), and silkworm for chronic childhood convulsions. Check with your practitioner for further information on combinations and dosages. SIDE

EFFECTS

None expected. SPECIAL INFORMATION WARNING: Use the herb with caution and in consultation with your practitioner. In one laboratory experiment, rats injected daily with an alcohol extraction of gastrodia showed reduced activity and appetite. In another , rabbits injected with preparations of the herb became lethargic and lost their appetites; their heart rates increased and their EEGsaltered. ♦ Preparations of the herb have halted seizures and inhibited the development of epilepsy-like symptoms in rabbits . Gastrodia , however, proved not as effective as phenobarbital. ♦

GELSEMIUM

LATIN NAME

Celsemium sempervirens GENERAL DESCRIPTION Sometimes called yellow jasmine, gelsemium is not really part of the jasmine family but is related to the plants ignatia and nux vomica. A climbing vine with trumpetlike yellow flowers, it is common to the woods and coastal shoreline of the southern United States. Taken in large doses, gelsemium causes paralysis of the motor nerves, impairing physical and mental functions like vision, balance, thought, and movement; ultimately , poisoning causes convulsions and death. Homeopathic physicians prescribe dilute solutions of gelsemium for ailments that are accompanied by symptoms like those of gelsemium poisoning. In its homeopathic form, Celsemium is prepared from the fresh root , which is chopped, soaked in alcohol, strained, and diluted to the desired, highly dilute potencies. For more information on homeopathic medicine , see page 1027. TARGET AILMENTS ♦ anxiety; flu with aches, chills, and exhaustion; headache, beginning from the back of the head and moving for-

ward; measles; sore throat ; fever with chills that move up and down the spine, although the pati ent may not feel cold. (Take internally.)

GENTIAN

LATIN NAME

PREPARATIONS Celsemium is available over the counter in various potencies, in both liquid and tablet form, from selected stores and pharmacies. Consult your homeopathic practitioner for more precise information. SIDE

Centiana lutea

EFFECTS

None expected.

§J

GEMFIBROZIL

DRUG CLASS Cholesterol-Reducing Drugs BRAND NAME Lapid GENERAL DESCRIPTION Introduced in 1976, gemfibrozil is used to lower cholesterol and triglyceride levels in the blood, thus reducing the risk of coronary artery disease. The drug seems to work by inhibiting production of triglycerides in the liver and accelerating removal of cholesterol from the body. For more information , see Cholesterol-Reducing Drugs. SIDE

PREPARATIONS Over the counter: Gentian is available in bulk as dried roots, and in tincture. At home: Tea: Boil 1 oz gentian root with 1 cup water for 15 to 20 minutes. Drink 15 to 30 minutes before eating, to aid digestion.

Not serious: Moderate increase in blood sugar levels; reduced libido in men. Serious: Fever, chills, sore throat, low-back and side pain, difficult or painful urination. Doubled risk of gallstone formation with long-term use.

Combinations: Use with ginger and cardamom for digestive disorders. SIDE

SPECIAL INFORMATION WARNING: Use only under the direction of an herbalist or a licensed healthcare professional if you are pregnant or have high blood pressure (hypertension), or chronic gastrointestinal conditions. ♦ Use low-strength preparations for children or for adults over 65. Do not give gentian to children under 2 years of age. ♦

INTERACTIONS

Chenodiol and ursodiol: these two medications, prescribed to treat gallstones, have decreased effectiveness when taken with gemfibrozil. Lovastatin: may lead to kidney failure when it is taken concurrently with gemf i broz i I.

Prescription Drug

0

Ove r-theCounter Drug

EFFECTS

Not serious: Upset stomach , nausea, or vomiting may develop from taking gentian.

SPECIAL INFORMATION • This drug is usually taken twice a day, 30 minutes before the morning and evening meals.

0

ca

TARGET AILMENTS • digestive disorders , loss of appetite, arthritis, exhaustion, weakness, irregular menstrual cycle. (Take internally.)

EFFECTS

POSSIBLE

GENERAL DESCRIPTION Distinguished by oval leaves and orange blooms , gentian is believed to act as a general tonic , relieving exhaustion and helping the body rebuild its natural defenses against illness. The root of this herb has been used in different cultures for about 3,000 years to treat digestive disorders and to stimulate the appetite. It was introduced to Western herbalists by Native Americans who used th e plant to alleviate back pains. Today, gentian is prescribed in Western countries primarily as a digestive aid. Because of its bitter properties, it stimulates the secretion of stomach acid and produces saliva. For this reason, contemporary herbalists frequently recommend ingesting this herb before or with large meals. Its most common form is in liqueurs , vermouths, and a variety of other bitter-tasting cocktails.

O

Western Herb

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Chinese Herb

A Ho meopat hic

~ Remedy

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CONVENTIONAL

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NATURAL

GENTIANA

MEDICINES

GINGER

SIDE

EFFECTS

Not serious: Heartburn may result from taking ginger.

D

LATIN NAME

LATIN NAME

Centiana scabra

Zingiber officina/ e

GENERAL DESCRIPTION Several varieties of this herb grow throughout China. Centiana scabra 1 the most widely used, is a long, thick, yellow root, described as cold by Chinese herbalists. They prescribe the herb primarily for disorders of the liver and organs in the pelvic area. Gentiana tastes so bitter that herbalists use it as a standard for judging bitterness in plants.

GENERA L DESCRIPTION Characterized by delicate yellow blooms rimmed with purple , ginger not only is a valued culinary seasoning but also is considered in many cultures a remedy for a range of ailments. Discovered by practitioners of traditional Ayurvedic (Hindu) medicine, the ginger root was originally thought of as a digestive aid . Today both Chinese and Western herbalists believe it relieves motion sickness and dizziness and improves digestion. Ginger is also believed to alleviate menstrual cramps. Its active constituents are gingerols , which soothe the abdomen and relieve excess gas. In China, ginger, called gan-jian, is applied to first- and second-degree burns. It is described in traditional Chinese medicine as acrid and warm.

TARGET AILMENTS Use internally for: ♦ hepatitis, jaundice, and other liver disorders. ♦ sexually transmitted diseases, vaginal discharge, inflammation of the pelvis, pain or swelling in the genital area. ♦ convulsions. PREPARATIONS You can find gentiana in bulk at Chinese pharmacies, Asian markets, and some Western health food stores. While the Chinese variety is not available in pills or tablets, the European root can be obtained in that form .

Combinations: Chinese herbalists prescribe a preparation that contains gentiana, sophora root, and plantago seeds for genital itching and vaginal discharge . A combination of gentiana with cattle gallstone and gambir is given for convulsions, especially when the symp toms appear in children. Check with your practitioner for advice on other combinations and dosages. S IDE E FF EC T S

None expected. SPECIAL INFORMATION Chinese herbalists advise against the use of this root when diarrhea is among the symptoms . ♦ Gentiana is believed to have an antibiotic effect; it is also thought to be toxic to malarial parasites. ♦ WARNING:

TARGET AILMENTS

Chinese: ♦ vomiting, abdominal pain, menstrual irregularity , coughs . (Take internally.) ♦ first- and second-degree burns. (Apply externally.) Western: ♦ motion sickness, morning sickness, digestive disorders, menstrual cramps, colds , flu , arthritis , elevated cholesterol level, high blood pressure . (Take internally.) PREPARATIONS

Over the counter: Ginger is available as fresh or dried root, liquid extract, tablets , capsules, prepared tea. At home: Chinese: Traditional preparation: Wrap fresh ginger roots in five or six layers of rice paper. Bury under warm coals until the paper is blackened. Remove rice paper before using. Rub: Treat first- and second-degree burns by rubbing fresh ginger juice, extracted from the root, on the wound. Combinations: For vomiting, ginger is mixed with pinellia root; when there is also severe abdominal pain, the herb is combined with licorice or galanga. A preparation of ginger and chamomile is used to treat menstrual irregularity. For coughing and headaches, ginger is mixed with dried bamboo.

Western: Tea: Boil 1 oz dried ginger root in 1 cup water for 15 to 20 minutes .

952

SPECIAL INFORMATION ♦ Some We st ern studies show that ginger may help prevent heart disease and strokes by reducing internal blood clotting and lowering blood pressure. ♦ If you are pregnant, consult an herbalist or a licensed healthcare professional before using.

G INKGO

LATIN NAME

Ginkgo bi/oba GENERAL DESCRIPTION Chinese herbalists have used the fanshaped leaves of the deciduous ginkgo tree for thousands of years to treat asthma, chilblains (an inflammation caused by exposure to cold), and swellings. Today, Western herbalists value ginkgo leaves for their action against vascular diseases that typically affect the elderly. One of ginkgo's most important benefits is its ability to increase vasodilation (expansion of blood vessels), and thereby improve blood flow in capillaries and arteries, especially in peripheral areas such as the lower legs and feet. It also appears to improve blood flow to the brain. Herbalists believe that ginkgo may interfere with the development of blood clots and the processes that constrict bronchial tubes during an asthma attack. In addition it may help reduce retinal damage from macular degeneration, a cause of blindness particularly threatening for diabetics. And it may help reverse deafness caused by reduced blood flow to the nerves involved in hearing . TARGET A ILMENTS ♦ vertigo; Alzheimer's disease; tinnitus (ringing in the ears); phlebitis (inflammation of a vein); leg ulcers; cerebral atherosclerosis; diabetic vascular disease; Raynaud's syndrome; headaches; depression; lack of concentration or mental and emotional fatigue in the elderly; asthma; clotting disorders, including strokes and heart attacks. (Take ginkgo internally.) PREPARATIONS Ginkgo leaves are available in dry bulk, capsules, or tincture. You can find a standardized product known as ginkgo

CONVENTIONAL

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biloba extrac t (G BE) in health food stores. Most herbalists reco mmend using only over-the-counter ginkgo products . SIDE

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At home: Tea: Boil 1 oz fresh root with 1 cup wa t er for 15 to 20 minut es. Drink up to 2 cups a day.

SPECIAL I NFORMATION • WARNING : Some people are unable to tol erate ginkgo even in small doses. ♦ Do not use if you have a clottin g di sord er, or if you are pregnant or nur sing. ♦ Do not give ginkgo t o childr en w ith out a doctor's supervision. ♦ Use in medicinal amo unts only in consultation with a health care prof essiona l.

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EFFECTS

Not ser ious: Headaches, insomnia , anx iety, breast soreness, or skin rashes may develop.

PREPARATIONS

Over the counter: Ginseng is availabl e as fr esh or dried root , root powder , capsules, tablets, prepared tea, freeze-dried root , cured rock candy.

Serious: You may expe ri ence asthma attacks, increased blood pressure, heart palpit ations, or postmenopa usal ut erin e bleeding. Stop using ginseng and co nsult your doctor.

At home: Chinese: Boil fresh roots in water for 3 to 7 minutes. Prick roots with needl es. Dry root s in the sun and th en soak in thi ck sugar 10 t o 12 hours.

SPECIAL I NFORMAT ION • WARNING: Do not use Am er ican ginseng if you are also tak ing any ant ihistamin e medic at ion s or other stimulant s, such as caffe ine, amp hetamin es, centr al nervo us stimul ant s, or ephedr a. ♦ Am erican ginseng is considered an endang ered species because of excessive harvest ing.

Combinations: Ginseng, atractylodes (w hit e), and China root are used to treat anorexia, diarrhea , vo miting , and distention of th e abdomen. For fever, thir st , and irritability, ginseng is prep ared with Chinese foxglove coo ked in win e and asparagus tuber. For impotence , ginseng is combined w ith deer antler .

Western: Tea: Boil 1 oz fresh root with 1 cup water for 15 to 20 minut es. Drink up to 2 cups a day.

GINSENG, AMERICAN GINSENG, ASIAN

S IDE EFFECTS

LATIN NAME

Not serious: Head aches, insomni a, anxiety, breast soreness, or skin rashes may develop.

Panax quinquefolius GENERAL DESCRIPTION Native Americans believed American ginseng co uld alleviate painful childbirths and restore energy to the elderly. Found abunda ntl y in th e Cum berl and Gap region of the southern Appala chians, American ginseng is identifi ed by a single stalk crow ned by delicate chartreuse blooms and crimson berri es; its leaflets have sawlike teeth. The active ingredi ent s of Americ an ginseng are panaxosides , w hich are thought to ca lm the stomach and the brain and act as a mild stim ul ant to v it al orga ns. American ginseng is milder than Asian ginseng and is oft en prescrib ed for people who consider Asi an ginseng too potent. Both American and Asian ginseng are fr equently used to tre at th e elderly. TARGET A ILMENTS Take internally for: ♦ depression , fatigue , stress. • colds, influ enza, respiratory problems, infl ammations , damaged immune systems. PREPARATIONS

Over the counter: Ginseng is available as fresh or dri ed root, root powder, capsules, tablets, prepared tea, freeze-dried root, cured rock candy.

MEDICINES

Western: Take int ernally for : • depression , fati gue, stress. ♦ colds, influ enza, respiratory problems, inflammations , dam aged immun e system s.

EFFECTS

Ginkgo can cause irrit abi lity , restl essness, diarrhea, nausea, and vomiting ; if these symptom s develop, check w ith your practitioner to see if you should lower your dosage or stop takin g gink go co mpl ete ly.

NATURAL

LATIN NAME

Serious: Asthma attacks , increased blood pre ssure, heart palpitations , or postmenop ausal ut eri ne bleedin g. Stop using ginseng and consult your doctor.

Panax g inse ng GENERAL DESCRIPTION G inseng means " the essence of the earth in th e form of a man ," and in fact the root's shape suggests th e human form. Growing on mountain slop es in the northeastern provinces of China , Asian ginseng is considered the most potent and expe nsive form of ginseng. With its yello w -green fl owe rs and red berri es, it look s similar to American ginseng, but the stalk is longer. Its active co nstituents are ginsenosides, substances that enhance pituitary-adren al processes to strengthen the immun e syst em and increase the body 's abi lit y to deal w ith fati gue and stress. It is describ ed in tradition al Chinese medicine as sweet, bitt er, and warm.

SPECIAL INFORMATION ♦ If you have any of the following

co ndition s, use gi nseng only under the dire ct ion of an herbalist or a licensed health care professional: pr egnancy, insomni a, hay fever, fibrocystic breasts, asthm a, emphysema, high blood pressure, blood-clotting problems, heart disorders , diabetes .

GINSENG, SIBERIAN

TARGET AILMENTS

Chinese: Take internally for: ♦ fat igue, weakness. • symptoms of shock, profus e sweating , ice-co ld extre miti es, shortn ess of br eath , fever , thirst, irritability. ♦ diarrhea, vomiting, dist ention of the abdomen , anorexia. ♦ impotence .

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Over -the Counter Drug

LATIN NAME

Eleutheroc occus senticosus GENERAL DESCRIPTION Found in the Siberi an regions of Russia and China, Siberian ginseng, also called eleuth ero, affects the body in a manner simil ar to Asian and American ginseng,

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although these effects are more subtle and result in less-pronounced reactions. The active elements of Siberian ginseng are eleutherosides, which stimulate the immune system, increasing the body's resistance to disease, stress, and fatigue. Siberian ginseng has gained popularity as a Western herb because it does not cause the insomnia and anxiety that sometimes occur when Asian or American ginseng is used.

TARGETAILMENTS Take internally for: ♦ depression, fatigue, stress. ♦ colds, influenza, respiratory problems, inflammations, damaged immune systems.

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PREPARATIONS Over the counter: Ginseng is available as fresh or dried root, root powder, capsules, tablets, prepared tea, freeze-dried root, cured rock candy. At home: Tea: Boil 1 oz fresh root with 1 cup water for 15 to 20 minutes. Drink up to 2 cups a day. SIDE

pable of producing the hormone. See Oral Hypoglycemics for more information , including facts about side effects and possible drug interactions.

Serious: Asthma attacks, increased blood pressure, heart palpitations, postmenopausal uterine bleeding.

SPECIALINFORMATION + Siberian ginseng gained popularity in Russia when an extract was massproduced and used in a popular colalike drink called Bodust, meaning "vigor."

GLIPIZIDE

DRUG CLASS Antidiabetic Drugs [Oral Hypoglycemics]

BRAND NAME Glucotrol

GENERALDESCRIPTION Glipizide is used to treat a form of non-insulin-dependent (Type 2) diabetes that cannot be controlled by diet and exercise alone. The drug, introduced in 1972, stimulates the release of existing insulin in people whose bodies are ca-

tis, athlete's foot, impetigo. (Use the herb externally.)

PREPARATIONS Over the counter: The dry root is available in bulk, capsules, and tincture.

GLYBURIDE

DRUG CLASS Antidiabetic Drugs [Oral Hypoglycemics]

BRAND NAMES DiaBeta, Glynase, Micronase

GENERALDESCRIPTION Glyburide, introduced in 1970, is used to treat a form of non-insulin-dependent (Type 2) diabetes that cannot be controlled by diet and exercise alone. The drug stimulates the release of existing insulin in people whose bodies are capable of producing the hormone. See Oral Hypoglycemics for more information, including facts about side effects and possible drug interactions.

At home: Tea: Pour 1 cup boiling water onto 2 tsp goldenseal; steep for 10 to 15 minutes. Drink three times daily.

Douche: Simmer 1 tbsp powdered herb in 1 pt water for 10 minutes. The liquid should be as warm as is tolerable. Douche daily, up to two weeks. Combinations: Use with meadowsweet and chamomile for stomach problems. For a skin wash, mix with distilled witch hazel; for ear infections, make drops using goldenseal and mullein. See your herbalist for exact instructions. SIDE

EFFECTS

Not serious: In high doses, goldenseal can irritate the skin, mouth, throat, and vagina. It may also cause nausea and diarrhea. If any of these develop, stop taking immediately.

SPECIALINFORMATION

EFFECTS

Not serious: Headaches, insomnia, anxiety, breast soreness, skin rashes.

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MEDICINES

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GOLDENSEAL

LATINNAME Hydrastis canadensis GENERALDESCRIPTION Herbalists use the dried and powdered rhizomes and roots of goldenseal, a small perennial with white flowers and red berries, to treat several respiratory and skin infections. The herb acts as a stimulant and seems to affect the body's mucous membranes by drying up secretions, reducing inflammation, and fighting infection through the mild antimicrobial action of its active ingredient, berberine. Goldenseal also aids digestion by promoting the production of saliva, bile, and other digestive enzymes. In addition it may control postpartum bleeding by means of its astringent action.

Do not use goldenseal if you are pregnant; it may stimulate the uterus. ♦ Do not use goldenseal without consulting a physician if you have had heart disease, diabetes, glaucoma, a stroke, or high blood pressure. It stimulates the heart muscle, and the result is increased blood pressure. ♦ Do not give goldenseal to children under two; for older children and older adu Its, start with smal I doses. ♦ Some herbalists consider this herb to be endangered; they recommend using goldenseal that is commercially and organically grown.

GOTU KOLA

LATINNAME Centella asiatica GENERALDESCRIPTION

TARGETAILMENTS ♦ infectious diarrhea, irritable bowel

syndrome, colitis, ulcers, gastritis, gallstones, jaundice, sinusitis, laryngitis, sore throat, infected gums, ear infections, and vaginal yeast infections. (Take internally.) ♦ eczema, ringworm, contact dermati-

The gotu kola plant grows in marshy areas in many parts of the world. Its fanshaped leaves contain the soothing agent known as asiaticoside. As a result they have been used to treat burns, skin grafts, and episiotomies (a surgical technique designed to prevent tearing of the vagina during childbirth). Gotu kola may also help heal outbreaks of psoriasis.

There is some evidence that in addition gotu kola may help decrease edema (the retention of fluid by the body) and promote blood circulation in the legs by strengthening the veins and capillaries . It may therefore be useful in treating phlebitis (inflammation of the leg veins).

TARGETAILMENTS + poor circulation in the legs, edema . (Take internally.) ♦ Burns, cuts, and other skin injuries;

psoriasis. (Use an external compress. )

GENERALDESCRIPTION

warm herb , grains-of-paradise fruit grows in the Chinese provin ces of Guangdong and Guanxi and in several areas of Southeast Asia, where it is harvested in August and September.

Guaifenesin is an expectorant drug , used to provide symptomatic reli ef from coughs, particularly those associated with the common cold or flu . The medication works by thinning and loosening mucus or phlegm from the upper respiratory tract, making it easier to cough up and expel the secretions. As the respiratory tract becomes less congested, the need to cough is reduced. This drug is used in many over-thecounter and prescription cough preparations, often in combination with a decongestant, an antihistamine, or some other medication. Guaifenesin is available in tablet , capsule, or liquid form.

TARGETAILMENTS Take internally for: ♦ nausea and vomiting, abdominal pain, diarrh ea, indigestion , gas, loss of appetite. ♦ morning sickness, pain , and discomfort during pregnancy . ♦ involuntary urination.

PREPARATIONS Over the counter: Available in dry bulk, capsules, and tincture. At home: Tea: Use 1 to 2 tsp dried gotu kola per cup of boiling water; drink twice daily to improve circulation in the legs.

Compress: Soak a pad in gotu kola tea or in a tincture to help treat wounds or psoriasis. Start with a weak solution and increase the concentration of gotu kola if necessary. SIDE

EFFECTS

PREPARATIONS Cardamom is available in bulk or powder from Chinese pharmacies, Asian markets, and some Western health food stores.

None are expected if used precisely in the prescribed dosage.

SPECIALINFORMATION

SPECIALINFORMATION

nant or nursing , or using tranquilizers or sedatives, since gotu kola may have a narcotic effect. ♦ Do not give gotu kola to children under two. For older children and older adults, start with low-strength doses, and incr ease if necessary.

♦ coughs due to the common cold, flu,

and other minor upper respiratory conditions.

Combinations: Mixed with atractylodes (white) and codonopsis root , it is used to treat morning sickness. And for other types of discomfort during pregnancy, herbalists prescribe a mixture with mulberry mistletoe stems. It is generally added to combinations near the end of the cooking period , and should be crushed before it is used.

Not serious: Gotu kola may cause a skin rash or headaches; in either case, lower your dosage or stop taking it.

♦ Do not use gotu kola if you are preg-

TARGETAILMENTS

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Serious: Skin rash, persistent headache, vomiting, high fever. Contact your doctor at once.

EFFECTS

SPECIALINFORMATION ♦ If you are using the extended-release

• Chinese practitioners avoid the use of cardamom in patients with what they call a yin deficiency , a condition marked by symptoms of heat such as fever, thirst, and sweating. Consult your practitioner for advice. • The shell of the fruit is believed to have medicinal properties similar to but weaker than the fruit itself.

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GUAIFENESIN ♦

LATIN NAME Amomum vil/osum (or A xanthioides ) GENERALDESCRIPTION The fragrant, acrid-tasting grains-ofparadise fruit , a kind of cardamom, is prescribed for a variety of abdominal complaints. Grains-of-paradise fruit is considered a stimulant, and great value is placed on its aroma. Chinese herbalists may add it to fruits such as baked pears to reduce the production of mucus in the body. The choicest fruits are large, solid, and extremely aromatic. Classified in traditional Chinese medicine as an acrid,

EFFECTS

Not serious: Stomach pain , diarrhea , nausea, drowsiness, mild weakness (these effects are rare). Contact your doctor if these symptoms persist or become bothersome.

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GRAINS-OF-PARADISE FRUIT

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DRUG CLASS

♦

Expectorants

BRAND NAMES

tablet form of this medication , swallow it whole; do not crush or chew the t ablet before swallowing it. This medication is most effective when taken on an empty stomach. To help guaifenesin loosen mucus from the lungs, drink 8 to 10 glasses of fluid each day, including a glass of water after each dose. If you are pregnant or nursing, check with your doctor before using this medication. Do not give this medication to a child under the age of two without first consulting the child's pediatrician . Do not take this drug for persistent cough due to smoking, asthma, bronchitis, or emphysema. If your cough does not improve within seven days, see your doctor. POSSIBLE

Rx: Duratuss G, Entex LA, Guaifed , Humibid OM, Humibid LA, Hycotuss , Vicotuss

INTERACTIONS

None expected.

OTC: Primatene Dual Action Formula, Robitussin-CF, Robitussin-DM, Triaminic Expect or ant , Vicks DayQu i I Liqu iCaps, Vicks DayQuil Liquid

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CONVENTIONAL

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MEDICINES

GUANFAC INE

TARGETAILMENTS

DRUG CLASS

Not serious:

♦ high blood pressur e (hypertension ).

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Antihyp ert ensive Dru gs

BRAND NAME Tenex

GENERALDESCRIPTION

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Introduced in 1980, guanfacine is used alone or in combination with a thiazide diuretic to help manage mild-tomoderate high blood pressure (hypertension). It decreases both systolic and diastolic blood pressure . Guanfacine works by stimulating the alpha 2-adrenergic receptors in the brain, which causes a reduction in nerve impulses to the heart, kidneys, and arteries. With fewer of these impulses , the blood vessel walls relax and blood flows through them more easily, thus reducing heart rate and lowering blood pressure. This drug does not cure high blood pressure , but it helps to control it. Because untreated hypertension can have serious consequences, you may need to take the medication for the rest of your life. Like other blood-pressurelowering drugs, guanfacine is most effective when combined with regular exercise , stress reduction, weight loss, and a salt-restricted diet. For more information , see Antihypertensive Drugs.

EFFE CT S

Drowsiness ; dry mouth and nose; constipation; headache; dizziness; fatigue; insomnia; decreased sex drive; dry, itching, or burning eyes; nausea or vomiting . Call your doctor if these symptoms persist or are bothersome.

Serious: Confusion , mental depression. Contact your doctor as soon as possible.

SPECIALINFORMATION ♦ Do not take guanfacine

if you have had an allergic reaction to this drug in the past. ♦ Tell your doctor if you are pregnant or planning a pregnancy; are nursing; have heart, kidney, or liver disease; have coronary insufficiency or cerebrovascular disease; or are suffering from depression. ♦ Tell your doctor if you are taking sedatives, hypnotics, or antidepressants, or are planning surgery requiring general anesthesia. ♦ Be sure to check with your doctor before taking any other medications, especially over-the-counter antihistamines; appetite-control pills; medicines for colds, coughs, sinus, or hay fever; pain pills; or muscle relaxants . Some of these medications may increase your blood pressure; others will result in excess drowsiness .

♦ Because guanfacine

can act as a sedative, it may impair your mental alertness, judgment , and coordination. Until you know how the drug will affect you, be cautious about driving , using machines, or engaging in any potentially dangerous activity. To reduce daytime drowsiness, take the drug at bedtime . ♦ Be sure you always have an adequate supply of guanfacine to tide you over during holidays and vacations. You may want to carry a backup prescription for emergency use. ♦ Pay special attention to dental hygiene. Guanfacine can cause mouth dryness, which may increase the likelihood of dental disease . Check with your dentist or doctor if dry mouth continues for more than two weeks. ♦ It usually takes four to six weeks to know if guanfacine will control your high blood pressure. Do not abruptly stop taking the drug: You may experience severe withdrawal effects. PO SS IBLE

INTERA

CTI O N S

Alcohol and other central nervous system depressants, such as antihistamines and muscle relaxants: may increase drowsiness and guanfacine's blood-pressure-lowering effect.

Food: avoid excessive salt.

CONVENTIONAL

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NATURAL

MEDICINES

LATIN NAM E

DRUG CLASS

Crataegus laevigata (or Crataegus oxyacantha)

Ant icoag ul ant and Ant ip latelet Dru gs

Finely ground oyster shell and sulphu r are mi xed to gether and then heated in an airti ght container. The resulting powder is dissolved in hot hydrochloric acid, th en comb ined w ith lactose (milk sugar) in a pharmace uti ca l process of dilution called tritur ation .

GENERAL DESCRIPTION

TARGET AILMENTS

HAWTHORN

GENERAL DESCRIPTION

Herb ali sts use the flowers, fruit, and leaves of the hawthorn , a European shrub wit h thorny branches. They prescrib e th e herb as a mild heart toni c. It is thought to improv e th e flow of blood thr ough the coronary blood vessels, lowe rin g blood pressure. Hawth or n is also believed to incr ease th e pumpin g fo rce of the heart muscle and to eliminate arrhythmias. Some practitioners think hawthorn may have a calming effect on the nervous system, and they sometim es recommend it as a remedy for insomni a. Identifi ed by cr im son berries and blue-green leaves, hawth o rn is also ca lled the mayf lowe r, because its delicate w hit e flowers bloom primaril y in M ay. TARGET A ILME NTS

Take int ern ally in conjunction with co nventi o nal medical treatment for: ♦ high blood pressure, clogged art eries, heart palp itat ion s, angina, inflammation of the heart mu scle. Take int erna lly for: ♦ insomn ia and nervous co ndition s. Use as a garg le for: ♦ sore throat. PREPARATIONS

HEPARIN

Heparin , a very powerful dr ug, is th e anti coagu lant of cho ice w hen an instant effect is requir ed. It wo rk s by inhibi tin g the fo rmation of blood clo t s at var iou s sit es throughout the bod y. Heparin is administered by inj ection o r intravenou s infu sion in a hospit al, clinic settin g, or at home by a trained health care prof essional. If yo u are receiving heparin at home, it is essential that t he medici ne be administ ered exact ly as directed and that yo u have regu lar blo od tests to determine how fast you r b lood is c lottin g. See Anticoagulant and Antiplatelet Drugs for addit io nal inform ati on on side effec ts and drug interacti o ns.

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PREPARATIONS

Hepar sulph is avai lable over the cou nt er in var io us potencies , in both liquid and tablet fo rm , at selected st ores and pharmacies. Consult yo ur practitioner for mo re precise info rm at ion . SIDE

S I DE EFFECTS

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SPECIA L INFORMATION ♦

WARNING: Use haw t horn as a heart tonic only if you have been dia gnosed with angina, card iac arrhythmias, or co ngestive heart failure, and only in cons ultation with a physi c ian. Do not practice self-diagnosis. ♦ Children and pregnant or nur sing women should use hawt horn only under the direction of a medical herbali st o r a licen sed healthc are professional.

LATI N NAME

SPECIAL I NFORMATION

Hibiscus sabdariffa

Because heparin is deri ved from animal tissue , individuals w ith a history of asthm a or allerg ies shou ld t ry a test dose before starting t reat ment.

GENERAL DESCRIPTION

Hibis cus, a w idespread category of annuals w hose lush, showy flowers are nearly syno nymou s wit h tropi cal beaut y, includ es more th an 200 species of plants. Most of th em are believed to have some medi cinal properties ; different species are used in Ayurvedic (Hindu ), Chinese , and Western herba l medi c ines. Hibiscus sabdariffa, also know n as roselle o r Jamai ca sorre l, is valued fo r its mild laxative effect and for it s ability to incr ease urination , attribut ed to two diureti c ingredient s, ascorbic acid and glyco li c acid. Because it contains citric acid, a refrigerant , it is used as a coo ling herb, providing relief durin g hot weather by increasin g the flo w of blood to the skin 's surfa ce and dilatin g the pores to cool th e skin. Hibi scus seeds, leaves, fruits, and roots are used in various folk rem edies, and tea is made from the flower s, in parti cul ar, th e calyx , the leaflik e segment that makes up the outermost part of th e fl owe r. Its fl owe rs are also used in jams and jellies , to impart a tart, refreshing taste.

HEPARSULPHURIS

LATIN NAME

Hepar sulphuris calcareum GENERAL DESCRIPTION

The fl aky inner layer of oyster shells provides the ca lc ium used in this hom eopathic remedy , also called Hepar sulph and co mmonl y known as calcium sulphide. Once an antidot e for merc ury poisoning, calcium sulphide is now used by homeopathic physicians to treat patients with conditions that tend to be infected, often producing pus. These disorders are acco mpanied by symptoms that include mental and physical hyp ersensitivity and an intol era nce of pain and cold.

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EFFECTS

HIBISCUS

Hawthorn is availabl e as fluidextract , dried berries and leaves, capsu les.

Serious: Taking large amo unt s of hawthorn may resu lt in a drama ti c drop in blood pressure , which in turn may cause you t o feel faint.

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None expected .

Ser iou s: Hepar in can cause hemorrh aging. Other serious symptoms includ e chest pain , severe headache, low blo od pressure, rash, breathing problems, w heezi ng, runny nose, and tightness in the chest. Cal I yo ur doctor if you expe ri ence any of these symptoms.

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abscessesthat are swo llen and painful but have not yet ope ned; co lds, sore throat , and earache; infl amed cuts and wounds that may be taking longer than nor mal to heal; aching jo int s; f its of coug hing with chest pain , hoarseness, asthma, emph ysema, cro up; genit al herpes; constipation.

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TARGETAILMENTS Take int ern ally fo r : • constipation , mild bladder infections , mild nausea.

HONEYSUCKLEFLOWER

App ly the her b or extract exter nall y for: ♦ sunburn .

LATINNAME

PREPAR ATIONS

GENERALDESCRIPTION

Over the counter: Fresh or dried hib iscus flowers and te as are avail able in health food stores. At home: Tea: Use 2 tsp crumbl ed, dried blossom or 1 tbsp fresh, chopped blossom per cup of boiling water; steep 10 minutes . Drink up to 3 cups per day. Iced hibiscus tea is also refr eshin g. S I DE EFFECTS

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MEDICINES

Not serious: You might notic e a slight ly dry sensation in the mouth because of the herb 's astrin gent property .

SPECIALINFORMATION ♦ The tart flavor of hibiscus tea may

clash w ith that of other stro ng-t astin g herbs, such as chamom il e or dande lion; mi x w ith mint o r rose hip tea instead. ♦ Because many types of hib iscus are sold, chec k with an herb al practitioner to determine if th e species you are using is an appropriate tr eatm ent. Some species may not be reco mmended for pr egnant wo men.

HISTAMINEH2 BLOCKERS DRUG CLASS Antiulcer

Drugs

GENERIC NAMES Rx: cim etidine , famotidine , niz ati dine ,

Loni cera j apo ni ca

Thi s o rn ame nt al flower is prescribed fo r sores, swe llings , fevers , co lds, and flu . Chin ese med icine pr actitio ners use it as an antibioti c. In addition th e fl ower is believed to have some value in th e tr eatm ent of chronic conjunctivitis and other eye conditions. The best variety of the plant has several large, pale-yellow , unope ned flowers. Considered a sweet , co ld herb in traditional Chin ese medicine, it grows throughout China and is harvested in May and June.

TARGET AILMENTS Take hon eysuckle flow er int ern ally for: ♦ sores and inflammation s, particularly of the breast, throat , and eyes; heat rash; and boils. • fevers , co lds, flu; salmonella and oth er microbial infecti ons. ♦ int estin al abscesses. ♦ pai nful urination and dy sent ery.

PREPARATIONS You can find honeysuckle flowers in bulk at Asian markets and pharmacies and We stern health food store s. The herb is also available in t ablet form. Combin ations : The flowers , to geth er with pl at ycodo n and great burdock fruit, form a mixture used to treat pain and swel lin g in th e throat. A prepar ation with skull cap and copti s is prescribed for high fever. When skull cap alone is added to honeysuck le fl owe rs, th e blend is emp loyed to discharge pus from boils. For advi ce on ot her comb inations and do sages, co nsult a Chin ese medicine pract iti oner. SIDE

EFFECTS

None expec ted .

ranitidin e

OTC: cim etidine , famotidine , ranitidine A subclass of antiul ce r drugs, histamine H2 blockers help redu ce the secretion of cert ain digestive juice s in the stomach. Fo r more inform ation , includin g facts abo ut side effects and possible interactions w ith other medications, see Antiulcer Drugs. For inform ati o n abo ut specifi c histamin e H2 blockers, see Cimetidine, Famotidine, Nizatidine, and

Ranitidine.

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the honeysuck le, w hen prep ared in a soup , also useful in clear ing up abscesses and sores.

SPECIALINFORMATION ♦

Chin ese medicine pra ct iti oners adv ise against using hon eysuckle fl owe r to treat sores exuding cle ar fluid; it should be used only in cases where there is a thick , yellow di scharge. And they do not pr escrib e this herb fo r the type of diarrh ea associated w ith stomach rath er th an int estinal probl ems. • Test-tube studies indic at e a possible antibioti c effect. • In a labo ratory t est , hon eysuckle flower seemed to low er th e cho lest ero l leve ls in rats. ♦ Practitioners have found th e st em of

HOPS

LATIN NAME Humulu s lupulu s

GENERALDESCRIPTION A flavoring and preservativ e in beer since the ninth century , hops has a longer hi sto ry as an herb al remedy. The pl ant is a perennial vine th at grows t o 20 feet; the medicina l part is fo und in tin y glandul ar hair s on th e scaly, coneshaped fruit. Chinese and European healers have valued the herb 's sedativ e act ion and it s ab ility to reli eve mu scle cr amp s. Today hops is still pr escrib ed primarily as a sedative; the act ive ingred ient is lupulinic acid, which depresses the centr al nervou s system and indu ces sleep. Because of it s bitterness , which stimul at es gastric jui ces and decreases gas, hops is also pr escrib ed as a digestive aid. And along with ot her ingred ient s in the hops fruit, z in c has astrin gent or binding effects o n th e body.

TARGETAILMENTS Take int ernally for: • insomni a, anxiety, tension headache ; indi gestion, depressed appetite. Apply ext erna lly for: ♦ neur algia, t ension headache.

PREPARATIONS Ove r the counter: Available in co mmercial herb al remedies, as dried or fresh herbs, and in th e form of capsules, pow der, and tin cture . At home: Tea: Use 2 t sp dried herb per cup of boiling water; st eep 15 minut es. For insomni a, drink 1 cup at night; if a single dose doesn't bring sleep, or for general anxiety, tak e up to 3 cups a day. To sooth e an ac id stomach and aid di gestion , drink the tea cold an ho ur before mealtim es or after a meal.

Poulti ce: Pour boiling wa t er over 1 to 2 cups dried herbs to moist en, st eep f ive minut es, and wrap in a cloth. Apply warm to th e aff ected area for facial pain , neur algia, or tension headac he. Hops pillow: Place freshly dri ed herbs in a pillow case; dampen case with water to keep herbs from rustling .

CONVENTIONAL

Combinations: Used w ith va lerian for stress, t ension headache , or panic atta cks. Used w ith passionflower or valerian for insomnia . SIDE

EFFECTS

Not serious: Upset stomach, constipation, diarrhea, a skin rash, o r irritation to th e eyes from the spines of the fruits. Stop taking and call your do ctor. Serious: Hop s can cause sleepiness or worsen severe depression. Seek professional help .

SPECIALINFORMATION ♦ For prolonged or daytime use, take

hops und er medi ca l supervision. ♦ Do not take during the day if you

operate heavy machinery or drive. ♦ Pregnant wome n and women with

estrogen -depe ndent breast cancer should avoid hops; it may contain an estrogen-lik e chemical and has been known to induce menstruation. ♦ Use low-st rength doses for adults over 65 years or children between 2 and 12 years old. Do not give to children und er 2 years of age. POSSIBLE ♦

INTERACTIONS

Avoid overmedicating; use caution when takin g hops with prescription sedatives or antianxiety medications.

HORSETAIL

AND

TARGETAILMENTS

Equis etum arve nse

GENERALDESCRIPTION Hors eta il has been valued since anci ent tim es for its ability to stem th e flow of blood , bind tissues, and incr ease urin e produ ct ion . It is rich in silica, which helps mend broken bones and form collagen, an important const itu ent of bon es and tissue. Herbalists today prescribe horsetail for urinary problems, wounds, beni gn prostate disord ers, and the pain of rheumatism or arthritis. Mor e closely relat ed to ferns than to flow er ing plants, hors etail is a perennial with hollow stems and shoots that resemble asparagus. All the aboveg round part s of th e plant are used for medicinal purposes.

MEDICINES

HYDROCHLOROTHIAZIDE@J

Take internally for: ♦ bladder infections , cystitis, urethritis , prost at itis, kidney stones, stomach ulcers; broken bones or spra ined tendons; strengthening nails, skin, and hair ; pain of rheumatism or arthritis .

DRUG CLASS Diuretics

Apply externa lly for: ♦ sores, wounds , inflamm ations.

BRAND NAMES

PREPARATIONS Over the counter: Available as dri ed or fresh herb , capsules, and tincture.

GENERALDESCRIPTION

Dyazide , Maxzide-25

Introduced in 1959 , hydrochlorothiazide is a nonpotassium -sparin g diuretic used to treat high blood pressure (hypert ension ), diabetes insipidu s (extrem e thirst and excessive production of urin e), and excess fluid retention. This drug acts by promotin g urine production. But increasin g the flow of urin e also has th e effect of increasing the loss of potassium and other minerals from th e body. This effect is particularly pronoun ced with hydrochlorothiazide. To prev ent potassium loss, the drug is frequently combined with the pot assiumsparing diuretic triamt erene. (Unl ike other diuretics, hydrochlorothiazide appears to decrease the body's loss of calcium .) See Diuretics for information about other side effects and possible drug int eractions. See Triamterene for information on a potassium-sparing diuretic often combined with this drug.

At home: Tea: Steep 2 tsp dried herb or 1 tbsp fresh herb per cup of boilin g water for 15 minutes. For bladder or kidney disorders, drink co ld, up to four cups a day. To prevent kidney irritation, take two tablespoons at a time. Apply tea externally to wounds , sores, or mouth irrit ation s. Sitz bath: Simmer 3 to 4 oz of herb in 2 qt water for 5 minutes; steep 30 minutes and add to bathwater. Comb in ations : Used with hydrangea for prostate problems. SIDE

EFFECTS

Not serious: Upset stomach, diarrhea, increased urination. Discontinue and call your doctor. Serious: Pain in the kidn eys or low er back , or upon urin at ion , w ith nausea or vom iting may indi cate kidney dam age. Cardiac problems , including heart palpitations, may occur in cases of extreme overuse. Call your doctor immediately.

♦

Because excess sodium loss appears more likely with hydrochlorothiazid e than with some other diuretics , a higher risk of cardiovascular side effects is associated with this drug. ♦ Tell your doctor if you have gout ; hydrochlorothiazid e affects uric acid levels. ♦ Tell your doctor if you are allergic to sulfa drugs , such as sulfonamide antibiotics or sulfonylurea antidiabetics; hydrochlorothiazide is chemically related to these medi cat ions and may trigger similar reactions.

♦

WARNING: Do not take intern all y for more than three co nsecutive days and do not exceed the recommended dosage; extended use may cause kidney or cardia c damage. ♦ Use only under a doctor 's care. People with cardiac disease or high blood pressure should use horseta il with caution. ♦ Pregnant women should avoid hor setail. The herb 's high selenium co nt ent can cause birth defects. ♦ The silica in hors etail , which aids in building cartilage, may help menopausal women offset th e bone loss of osteoporosis, although this use has not been clinically tested in hum ans. ♦ Use low-strength doses for adults over 65 and children between 2 and 12 years old. Do not give horset ail to children und er 2. Do not let children put the hollow stalks in their mouths; ingesting the jui ce can make your child ill.

0

Prescription Drug

0

Over-theCounter Drug

Cl

SPECIALINFORMATION

SPECIALINFORMATION LATINNAME

NATURAL

HYDROCODONE

DRUG CLASS Analgesics [Op ioid Analgesics]

BRAND NAMES Lorc et Plus, Lortab , Vicodin, Vicoprofen

GENERALDESCRIPTION Like other opioid analgesics, hydrocodone is often combined with aceta-

O

Western Herb

0

Chinese Herb

A Homeopathi c ½:J Remedy

g Sg

CONVENTIONAL

AND

NATURAL

minophen for mild-to-moderate pain relief and co ugh suppr ession. A narcoti c, hydrocodone may cause drowsiness and ca n be habit-formin g. For info rm at ion abo ut side effects and possible drug int eract ions, see Opioid Analgesics.

HYDROCORTISONE

MEDICINES

GENERALDESCRIPTION Int roduc ed in 1953 , hydro xyzine is an ant ihi st amin e th at appea rs to dep ress the centr al nervous system. It also has antipruriti c, or anti-itch , properties . This medication is used to treat tension , restlessness, and some typ es of anx iety, and to reli eve itching due to all ergi c reactions. Hydroxyz ine has also been prescr ibed for the tr eatm ent of motion sick ness, as a sedative , and as an antinausea medicatio n.

Central nervous system depressants (such as alcohol, antidepressants, antipsychotics, hypnotics, narcotics, pain relievers, sedatives, sleep inducers, and tranquilizers): increased effects of both co mbin ed drugs.

Clozapine: may have a toxic effect on the centr al nervous system.

Nonprescription cold or allergy medications that contain antihistamines: increased drows iness.

TARGETAILMENTS ♦

tension, restlessness, and some types of anxiety. ♦ itc hin g due to allergic reactions.

DRUG CLASS Co rti coste roids

BRAND NAMES Rx: Hytone

SIDE

ID

GENERALDESCRIPTION Hyd roco rtisone cream is used for temporary relief of minor skin problems, including inflamm at ion and rashes caused by eczema, poison ivy, poison oak, poison sumac , insect bites , psoriasis , soaps, deter gents, cosmetics , and j ewe lr y. The dr ug treats only the sympt oms, not th e und erl yi ng causes. See Corticosteroids for more informati o n.

SPECIALINFORMATION ♦ Hydrocortisone

♦

• ♦

♦

should not be used fo r rosacea, acne, viral skin inf ections such as herpes, or fungal inf ections such as athlete's foot. Do not use thi s medi cati o n near your eyes; w ith prolon ged use, doi ng so can cause a numb er of problems , includ ing glaucoma or cat arac t s. If you have diabetes , check w ith your doctor before using hyd rocor tison e. These crea ms may sting slightly when first app lied . Do not use excessive quantities of this medication or bind dressings tightly ove r th e treated area.

POSSIBLE

INTERACT

None expec ted .

HYDRO XYZ INE

Primary side effec t s are dry mouth , drowsiness , and difficult y in urin ati ng; these effec t s usually disappear afte r a few days or when dosage is reduced. Headac hes, although rare, may also develop. No t ify your docto r if these symptoms persist or become bothersome.

Serious: Wheezing, chest tightness , and difficulty in breathing may be signs that yo u are having an adverse react ion to the dru g. Hi gh doses of hydro xyz ine may produce excessive drowsiness, unsteadiness, tr emors, or co nvu lsions. If these symptoms occ ur, call your doctor imm ediately.

SPECIALINFORMATION ♦

♦

• ♦

♦ ♦

I ONS

•

♦

•

DRUG CLASS Anti-Itch

Drugs

BRAND NAME Atarax

EFFECTS

Not serious:

OTC: Co rt aid, Cortizone

Do not t ake if you have had an unusual or allerg ic reaction to thi s drug or to anot her antihistamine in the past. If yo u are pr egnant , consult your doctor befo re using this medication. Hydroxyz ine may pass into breast milk; avo id using it while nur sing. Do not drink alcohol while using. To avo id stomach upset , tr y taking th e medication with food or milk. To help relieve dry mouth (a common side effect ), chew gum or suck on hard candy, and drink plenty of wat er. Because hydro xyz ine can make you drowsy, avo id drivin g, operating hazardou s machinery , or engagi ng in other pot entially dangerou s activiti es that require intense concentration. The body develops a toler ance to hydroxyzine after prolon ged use, reducing th e drug 's effectiveness. Do not take hydro xyz ine with any other prescription medi catio n o r over-t he-co unter drug without f irst co nsultin g your doctor . POSSIBLE

INTERACTIONS

Attapulgite: a decrease in th e eff ect of hydro xyz ine.

960

HYPERICUM

LATIN NAME H ype ri cum perforatum

GENERAL DESCRIPTION Al so known as St.-John's-wort, hypericum grows in woodlands across Europe, Asia, and the United States, blooming wit h a profusion of yello w flowers from June to September. The flo we rs, if bruised , bleed a reddish juic e. The darkgreen leaves of th e plant are dotted wit h oil-producing pores. According to ancient healin g w isdom, because hyper icum seemed to resemble skin, with its pores and its simulation of bleeding on injury , it was co nsidered ideal fo r all manner of fl esh wounds. (See St.-John'swort.) In homeopathy, Hypericum is ofte n prescr ibed for bodily injuri es, among other cond it io ns; but it is selected for the soothin g effect it is said to have on injured nerves rather than for any tr aditional reason. The ent ir e plant is harvested for hom eopat hic use in summer, when it s yellow fl owe rs are in full bloom. It is pounded t o a pulp and soaked in an alcohol solution befo re being wea kened to the desir ed pot encies through a v igorous dilution process.

TARGETAILMENTS • backaches centered along the lowe r spine that may include shooting pains. • bit es and stings from animals and insects, espec ially when th ey have beco me infl amed or includ e nerve damage. ♦ cuts and wo unds to nerve- ri ch parts of th e body, like the f ingers, toes, and lip s, caused by acc id ents or surgery. ♦ dental pain caused by nerve infl amm ation.

PREPARATIONS Hyp eri cum is available over th e co unt er in various strengths, in both liquid and tablet form, at selected stores and phar -

CONVENTIONAL

111acies.Consu lt your practitioner 111orepr ec ise infor111ation. SIDE

fo r

EFFECTS

None expect ed.

HYSSOP

LATINNAME Hyssopu s officinalis

AND

SPECIALINFORMATION

TARGETAILMENTS Take int erna lly for: • cou ghs, co111mon co lds, bronchitis ; indi gestion , gas; anxiety , hysteri a, petit mal (a form of epilepsy). Apply externally for : • cold sores, genit al herp es sores, burn s, wounds , skin irrit atio ns.

PREPARATIONS Over the counter: Available dri ed or fr esh and as tin cture. At home: Tea: Steep 2 tsp dried herb per cup of boiling wa ter for 10 to 15 minutes. Drink thr ee t imes a day for cough (add honey , sugar, or lemon to i111provethe flavor); gargl e three times a day for sore throat. Apply to burns and wounds.

Compress: Steep 1 oz dried herb in 1 pt boiling wa ter for 15 minute s; soak clean c loth in solution and apply warm to cold sores or genital herpes sores; place on the chest to relieve congestion. Combin ation s: Used wi th w hite hor ehound and coltsfoot for coughs and bronchitis; with boneset , elder flower , and peppermint for cold symptoms; and with sage as a gargle for sore throats.

Use hyssop only und er medi ca l supervis ion if you use it for more than thr ee consecutive day s. ♦ Pregnant women should avoid hyssop; it was on ce used to induce abo rtion . • Use low-stren gth preparations for adult s ov er 65 or children between 2 and 12 years of age. Do not giv e to ch ildren under 2 years o ld.

IBUPROFEN

DRUG CLASS Analgesics [Nonsteroidal AntiI nflam111atory Drugs (NSAI Ds)]

EFFECTS

Not serious: Upset stomach or diarrhea. Discontinue use and ca ll your do ctor.

·

a

TARGETAILMENTS • anx iety ; dry, tickling coughs ; a sore throat that feels lik e there is a lump in it; painful tension headaches; indi gestion ; insomnia ; irritabl e bowe l syndrome; painful hemorrhoids; effects of gr ief , shock , or di sappo intment , or depression where the patient tends to sigh frequently. (Take internally.)

BRAND NAMES Rx: Children's Motrin I bu prof en Suspension , variou s forms of Motrin for adults

OTC: Advil, Advil Cold and Sinus, Motrin I B, Nuprin

GENERALDESCRIPTION PREPARAT IONS

Introdu ced in 1969, ibuprofen was th e f irst of two new arthritis and pain NSAI Ds to become available for the ark et in th e 1980s and 1990s. OTC 111 The drug may be used to reliev e the pain of headaches, menstrual cramps, muscl e aches, min or ac hes and pains of the common cold , rheum atoid arthriti s, and osteoarthritis. I bu prof en also reduces inflammation and fever. For information about side effects and possible drug interactions , see Nonsteroidal

lgna tia is availabl e over the co unt er in various pot enci es, in both liquid and tablet form, at selected stores and pharmac ies. Consult a hom eopathic practition er for more precis e infor111ation. SIDE

EFFECTS

None expected .

Anti-Inflammatory Drugs (NSA/Ds).

IND APAMIDE

SPECIALINFORMATION ♦ Because ibuprof en can cause prob-

lems in th e unborn child or with delivery, this drug should not be taken during the last three months of pregnancy unless dir ected by a physician.

DRUG CLASS Diuretics

BRAND NAME Lozo l

GENERALDESCRIPTION

IGNATIA

I ndapamide is a relativ ely new diuretic prescribed to tre at high blood pressure (hyp erten sion ) and exc ess fluid retention. Among the group of dru gs known as nonpot assium-sparing diur etics , indapamide increases the loss of potassiu111 and other minerals from the body as it promotes urine production. See Diurete information , including othics for 111or er side effects and drug interactions.

LATINNAME lgnati a amara

GENERALDESCRIPTION SIDE

MEDICINES

nat ive to China and th e Philippines. Sevente enth-c entury Spanish missionaries in th e Philippines were introdu ced to th e seeds by the loca ls, who wor e th em as amul ets to wa rd off disease. Small doses of th e seed can pro du ce mild but unpl easant symptoms of poisoning, includin g incre ased salivation , pounding headache, cra mps, giddin ess, twit chin g, and trembling; lar ge doses can be fatal . Hom eopat hs may prescribe lgnatia, a dilute solution of the seed, for ailments that include symptoms lik e thos e associated with 111ildpoisoning . For th e hom eopathi c preparation, the seeds are collected and ground to a powder , then mixed with alcohol. When th e powde r is thoroughl y saturated, th e 111i xt ure is strained and diluted until it beco111esa nont ox ic substance.

♦

GENERALDESCRIPTION After centuri es of use in Europe, hyssop was such a popular re111edyfor co ughs and other respiratory ills that European co loni st s brou ght it to North A111erica. A shrub w ith white , pink , or blue flowers, hyssop is part of the 111intfa111ily.It is used as an expectorant , digestive aid , sedati ve, and 111usclerelaxant. Volatile oi ls in t he leaves and flowers , bitt er t astin g and w ith a strong ca111phorlike c us and stimulate odor, help loosen 111u co ughin g, and decrease gas. Hyssop is also used as an antiseptic; its oils may heal wounds and herpes simplex sores.

NATURAL

The beans of this plant, someti111es called St. Ignatius bean , are in fact seeds fro111the fruit of a small tree

0

Prescription Drug

0

Over-theCounter Drug

O

Western Herb

0

Chinese Herb

/\

Homeopathic

(:V Remedy

g

61

CONVENTIONAL

AND

NATURAL

SPECIAL INFORMATION • Tell your doctor if you are allergic to sulfa drugs, such as sulfon amide antibiotics or sulfonylur ea antidiabetics; indapamide is ch emic ally related to th ese medic ation s and may tri gger similar reactions .

INSU LIN

§J

DRUG CLASS Antidiabetic Drugs BRAND NAMES Humulin N, Humulin R, Humulin U, Humulin 50 / 50 , Humulin 70/3 0, lletin I NPH , Novolin 70/ 30 GENERAL DESCRIPTION In sulin , a hormone naturally produced by th e pancreas , help s regul at e levels of glucos e (blood sugar) in th e body . The insulin used tod ay in th e treatm ent of diabetes is either manufactured semisynthetically or derived from beef or pork . The drug is inj ected dir ectly beneath th e skin of insulin-d ependent (Type 1) diabetics , whose bodies are unable to produce th e hormone on th eir own. Insulin is also used to treat some non-insulin-dependent (Type 2) diab etics experiencing a severe blood sugar imbal ance. Such an imb alance can lead to ketoa cidosi s-in w hich a buildup of ketones (by-product s of metab o li sm) causes the blood to become increasingly acidic- and possibly to a life -thr eat ening diab eti c com a. TARGET AI LMEN TS ♦ insulin-dependent (Type 1) di abetes. • non-insulin-depend ent (Type 2) diabetes that is not properly controll ed by diet , exerc ise, and w eight reduction . ♦ severe blood sugar imbal ances occurr ing in nondiab etic s as a result of pregnancy , surgery , acute stress, or shock. S ID E E F F EC T S

Not serious: Allergic reactions ; a breakdown of fatty tissue at the site of the inje ction , which may cause a depression in the skin ; an accumulation of fat under the skin as a resu It of an overdepend ence on the same site for injection .

962

MEDICINES

Serious: Di abeti c coma or hyper glyce mi a (hi gh bl ood sugar) fro m und erdosing; hypoglycemia (low blood sugar) from ov erdosing. Call your doctor imm edi at ely if yo u ex peri ence int ense it chin g (sometim es with hives or rash) or if you feel faint after a dose. See overdose and underdose symptoms below. SPECIAL I NFORMAT ION o An overdose of insulin can result in low blood sugar (hypoglyc emia). Symptoms include excessive hunger, cold sweats, shakiness, nervousness or anxiety, rapid pulse, headache, drowsiness, confusion , nausea, cool or pale skin. Keep hard candy or fruit juic e handy to counteract hypoglycemia. ♦ An underdose of insulin can result in high blood sugar (hyperglycemi a). Symptoms include drowsin ess, dry mouth, fruity breath, incr eased fr equency of urination, loss of appetite , stoma ch pain, nausea or vomiting , unusual thirst, trouble breathin g, tir edness, flushed or dry skin. Hyper glycemi a can lead to ketoacidosi s or a lif ethr eat ening diabeti c com a. Take a dose of insulin as soon as you realize you have missed one, or as soon as you begin to experi ence symptoms. M ake advance preparation s for a fri end, colleague, or family member to administer the dose if you are unable. • Insulin is considered safe for p1·egnant and nursing women , since the dru g does not pass into br east milk. Stri ct adh erence t o a pr escrib ed regimen of di et and exercise is essent ial to controlling the disease. • I I lness and exercise can alter yo ur insulin requir ements. ♦ Blood and urine should be monitor ed regularly for sugar and ketone levels. Do not change the brand or type of insulin you use or stop taking the dru g w ithout consultin g yo ur doctor. ♦ Be pr epared for a diab eti c emergency. Read about first aid for di abetics (page 318) and discuss a plan of action with your doctor , family members, friends , and co-work ers. ♦ Smoking affects insulin requir ements. If you stop smoking cigarettes or begin wearing a nicotine patch while t akin g insulin , your blood sugar level may change. You may need to adjust your dosage. ♦ Semisynthetic insulin is oft en prescrib ed for patients who are pregnant , allergic to other types of insulin , need th e drug for only a short period (such as during surgery), or are newly diagnosed with diabetes. This typ e causes fewer allergic reactions than insulin derived from animals.

POSSIBLE

INTERACTI

ON S

Insulin can interact with a number of oth er dru gs. Check with your doctor or pharm ac ist before taking any oth er medi cations and be sure to read all labels fo r sugar co ntent. Alcohol, anabo lic steroids, clofibrate, fenfluramine, guanethidine, MAO inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), phenylbutazone, salicylates, sulfinpyrazone, tetracycline: these drugs decrease blood sugar levels and may affect insulin dosages. Amphetamines, baclofen, corticosteroids, corticotropin (ACTH), danazol, dextrothyroxine, epinephrine, estrogens, eth~crynic acid, furosemide, glucagon, molmdone, phenytoin, thiazide diuretics, thyroid hormones, and triamterene: may : aise blood sugar levels, incr easing the risk of hyperglycemia. Beta-adrenergic blockers: may mask the symptoms of hypoglycemia when used concu1·rently with insulin.

IPECAC

LATI N NAME lpecacu anha GENERAL DESCRIPTION The lpe cacuanha shrub , nativ e to Centr al and South America , wa s named by Portu guese colonists , who called it "_roadside sick-making plant " in recognition of it s ability to induce vomitin g. Vary, ng doses of its root can produce a vari ety of symptoms that includes mild appetit e stimulation , sweating , expectoration , vomiting, gastritis, inflammation of the lun gs, and cardiac failure. Other h_ea_lth disorders can display symptoms similar to thos e of mild ipecac poisoning, and it is these symptoms that homeopathic pr actition ers hope to counteract wh en th ey prescribe ipecac. The homeopathic remedy is made from the root, the most potent part of the plant. The root is dried and th en ground into a coarse powder , which is dilut ed either in milk sugar as a dry substance or in a water-alcohol base. Both pr eparations are weakened to a nonto xic level. For mor e information on homeopathic medi c ine, see page 1027. TARGET AILMENTS • persist ent nausea, vomiting, motion sickn ess; menstrual problems; asthma; dry , irritatin g cough accompanied

CONVENTIONAL

by w heezing; diarrhea, f lu w ith nausea, co li c, gastro ent er iti s. (Take int ern ally.)

PREPARATIONS Ip ecac is avai lable over th e counter in va rious potencies , in both liquid and t ab let form, at selected sto res and pharmacies. Consult your practit ioner for more precise inform ati on. SIDE

AND

GENERALDESCRIPTION

BRAND NAMES

lsoc arbo xazid belongs to the subclass of antid epressant s known as mo noamin e ox idase (MAO) inhibitor s. Like ot her MAO inhibitors , this dru g is used to t reat depression w hen other antid epr essant drugs have fai led. See Monoamine Oxidase (MAO) Inhibitors for information about side effec ts, w arnings, and possibl e dru g int eraction s.

lm dur , lsmo, Monoket

lsosorb ide mononitr ate is used to prevent angina attacks . Thi s medi cati on rela xes smooth muscle of blood vessels, increasin g the flow of blood , and oxygen, to th e heart. lsosorbide mon onitrat e does not tr eat acute angin a attacks. For mor e information , see

Nitrates.

EFFECTS

SPECIALINFORMATION ♦

ISOSORBIDE DINITRATE

§J

DRUG CLASS Nitrates

Bronchodilators

lsordil

BRAND NAME

GENERALDESCRIPTION

Atro ve nt

GENERALDESCRIPTION lpratropium is prescribed to prevent and to reli eve the symptoms of chroni c bronchitis and emp hysema by openin g up the bronchia l tube s. U nl ike many ot her bronchodilators , ipr atropium is not used to trea t acute bronchial asthma atta cks because it is not a fast- actin g medication . See Bronchodilators for informa tion abo ut side effects and possible drug int eractions.

Antid epressants [Monoam ine Oxid ase (M AO ) Inhibitors]

GI

Like other dru gs in it s class, isosorbid e dinitr ate is used to control angina . 1n some cases it is also used as a comp lement ary tr eat ment for congestive heart fa ilur e. lsosorbid e dinitrate , introduced in 1959 , is avai lable in a variety of forms; each is prescribed acco rding to its the rapeuti c use. Sublin gual tablets (t hose that are dissolved und er the ton gue) and chewab le tablets are prescribed for imm ediate relief from angina, w hil e standard and extended -use tablets are offered for lo ng-term management of the co ndition. See Nitrates for inform at ion about side eff ects and possible dru g int eractions.

§J

DRUG CLASS

BRAND NAME

Warnin g: An overdos e of isosorbid e mononitrate could be fatal. Co ntact a poison co ntr o l center or seek emergency tr eatm ent if you have taken more than the prescribed amou nt. ♦ lsosorbide mononitr ate must be t aken on a precise, sometimes asymmetr ical , schedu le to avo id developin g a toler ance to the drug. ♦ Take this drug with a half glass of liquid , wit h or without food .

BRAND NAME

DRUG CLASS

ISOCARBOXAZID

MEDICINES

GENERAL DESCRIPTION

None expected.

IPRATROPIUM

NATURAL

DRUG CLASS Calcium Channel Blockers

BRAND NAME Dyn aCir c

GENERALDESCRIPTION

§J

ISOSORBIDE MONONITRATE DRUG CLASS N itr ates

Marp lan

0

Prescription Drug

0

Ove r-theCounter Drug

§J

ISRADIPI NE

O

Like ot her calcium channel block ers, isradip ine inhibits the passage of calc ium into body cel ls, thu s slow ing the contraction of the heart and arteri es, dilating the arter ies, and lowering blood pressure. This dru g is used prim arily in the treatment of mild-to-moderat e high blood pr essure (hyp ertension ), alth ough in some cases it is pr escribed to help manage angina. See Calcium Channel Blockers for inform ation about side effects and possible drug int eractions .

Western Herb

O

Chinese Herb

/\

Homeopathic

~ Remedy

g

63

CONVENTIONAL

AND

NATURAL

JUNIPER

LATIN NAME Juniperus commun,s GENERAL DESCRIPTION The berrylike juniper cone , a purple fruit, is produced by female varieties of an evergreen shrub that can grow 6 to 25 feet tall. Juniper is known for giving gin its tart bite . It also acts as a diuretic, since it includes among its components terpinen-4-ol, which increases the r_ate at which the kidneys filter body fluids. Because of this diuretic action, juniper is used to treat high blood pressure and prem enstrual syndrome. Juniper oil is thou ght to have anti-inflammato~y effects , considered useful for treating arthritis and gout. Juniper teas can be t aken for digestive problems .

ID

TARGET A ILMENTS Take int ernally for : + bladder infections , cystitis, edema (wate r retention ), digestive problems. + menstrual irregularities and premenstrual syndrome. ♦ high blood pressure.

Apply externally for: ♦ arthriti s. ♦ gout. PREPARATIONS Over the counter: Available in w hol e berries , bulk , cap sules, and tinctures.

At home: Tea: Steep 1 tsp ground juniper berri es in 1 cup boiling wa ter for 10 to 20 minutes . Drink at least two times daily. Do not use for mor e than six weeks at a time . SIDE

EFFECTS

Not serious: Individuals with hay fever may develop allergy symptoms such as nasal congestion when taking juniper. If this happens, stop taking the herb and call your doctor . Serious: Juniper in high doses can irritate and damage the kidneys and urinary tract. If you develop diarrhea , intestinal pain ,. kidney pain , blood in the urine, pur~l1sh urine , or a faster heartbeat , stop taking juniper immediately and see your doctor as soon as possible. SPECIAL I NFORMA TI ON + WARNING: Because it can irritate the kidneys and urinary tract, juniper is suitable for short-term use only.

964

MEDICINES

+ WA RNING : Do not use junip er if yo u have a kidn ey infe ction or a history of kidney problems . • Animal studies indicat e that the herb prompts th e uterus to co ntract , suggesting that it may also bring on menstrual periods. + Pregnant women should not use juniper , beca use it may stimulate contraction of the uterus.

KALI BICHROMICUM

LATIN NAME Kali bichromicum GENERAL DESCRIPTION Kali bichromicum is often called potassium bichrom ate ; it is a chemical compound that may be acquired fron: chromium iron ore or by proc essing potassium chromate with one of a num ber of strong acids. A highly corrosive substance, it is used primarily in textile dyeing, in the staining of wood , and as a component in electric batteries. It is also a very powerful poison. Homeopathic practitioners believe Kali .. bichromicum works best for cond1t1ons that are accompanied by the symptom of pain in a distinct spot, where the ache is easily located with a fingertip. For homeop athic use, this caustic chemi cal, also call ed Kali bi, is diluted to nontoxic levels with large amounts of milk sugar, a pharmaceutical process called trituration. Like most homeop athic prescriptions, Kali bi was developed as a rem edy by studying the reactions of healthy individuals to a series of undilute doses. The mental, emotional, and physical changes induced by Kali bi were then cataloged. When a homeopathic practitioner encounters a patient with a set of symptoms that matches the cataloged symptoms brou ght on by Kali bi1 the practitioner then prescribes it in an extremely dilute form. It is presumed that in this highly dilute dosage, Kali bi can counter the symptoms that it induces when it is at full str ength. For mor e information on homeopathic medicine , see page 1027 . TARGET AILMENTS + acute bronchitis , colds in which th ere is a thick mucus discharge and a heavy cough that produces pain in the chest, croup, sinusitis and resulting headaches, indigestion, pains in the joints .

PREPARATIONS Kali bichromicum is available over th e co unt er in va ri o us potencies, in both liquid and tablet form, at select ed stores and pharmaci es. Consult your pr actitioner for more precise inform ation. SIDE

EFFECTS

None expec ted .

KAVA

LATIN NAME Piper methysticum GENERAL DESCRIPTION Drinking kava, a beverage brewed from th e dried roots and rhizomes of an indi genous pepper plant , has been a feature of some South Pacific religious rituals for many centuries. Today kava is frequently prescribed , for that same euphoric effect, as an antidepressant; practitioners find it useful for treating anxiety and tension. Because of its diuretic action, it is also used to treat gout and rheumatism. In addition kava is believed to act as an antiseptic and anti-inflammatory agent in the urinary tract, making it suitable for treating urinary tract infections such as cystitis; it is also used for prostatitis (inflammation of the prostate gland) that may arise from bacteria traveling from the ur ethra. Western herbalists recommend kava for its sedative properties, which do not seem to impair the user's mental alertness. The active ingredients , called kavalactones, act on the stem and other parts of the brain to yield kava's mild tranquilizing effect. While kava compounds do not seem to be addictive in the same way as alcohol or pharmaceutical drugs , the herb still must be used with caution. TARGET A ILMENTS Take internally for: + urinary disorders , prostate inflammations. ♦ gout, rheumatism. ♦ insomnia, depression , anxiety, muscle spasms. PREPARATIONS Available in dry bulk, capsules, and tinctures. SIDE

EFFECTS

Not serious: Chronic use can cause a type of dermatitis that will clear up when you stop taking kava.

CONVENTIONAL

Serious:

Like most sedati ve substa nces, too much kava can cause intoxication or drow siness. If thi s happens , low er your do sage or stop taking kava . SPECIAL I NFORMATION ♦

WARNING: Long-t er m, constant, larg e-dose use of kava has been associated w ith damage to the liv er, ski n, eyes, and even th e spinal cord. ♦ Do not take this herb w ith alcohol or if you are also takin g any antidepressant or anti-psychoti c medicine. Kava can dan gero usly enhance the eff ects of tho se medication s. ♦ Do not use kava if you are pre gnant or breast-feeding.

AND

S ID E E F FEC T S

SPECIAL INFORMA TI ON ♦ WA~NI ~G : If yo u are alr eady taking

med1cat1on fo r hyperthyroidism (ove racti ve th yro id), kelp supplements could wo rsen th e co ndition . ♦ WARNING : Do not gat her your own w ild kelp for use; coastal co lonies may be contaminated by offs hore pol Iutants . • WARNING: Check with your practitioner befor e using kelp if you have a history of thyroid probl ems or high blood pr essur e.

SIDE

Dizziness , drowsiness , headache, abdominal pain , diarrhea , mild nausea or ~omi_tin g, skin irrit ation (itchin g, sting111g , 111cr eased risk of sunburn ). Call your do ctor if thes e symptoms persist or beco me bother some. Serious:

Signs of li ver di sease, includin g nausea, loss of appetite , dark urine , light- co lored stools, j aundic e (yellow eyes and skin ); d_epression. Cal I yo ur doctor if you experien ce any of the se symptoms . SPECIAL INFORMATION

• Do not take this drug if you have an activ e liver disease. ♦ Weigh th e risks and benef its of this drug with your do cto r if you have hypo chlorhydri a, a history of alcoholism, impaired liver function, or liv er disease. • Tell yo ur doctor if yo u are allergic to other antifun gal drugs or are taking any other medi cat ions. ♦ In some cases, this drug can be seve rely toxic to the liver ; your doctor may want to perform periodi c liver function test s. ♦ While you are taking this medi ci ne, your skin may burn more read ily when ex posed to sunlight. To protect yo ur ski n, wea r sunblock and avoid prol onged exposure to the sun and sunlamps. ♦ Avoid taking this drug if you are pr egnant or nursin g. • Hi gh doses of this drug can suppr ess cor ti costeroid secretion in yo ur body, reduce testosteron e levels , decrease male libido, and cause breast enlargement or impoten ce in men , and menstrual irr egulariti es in women. ♦ Take ketoconazole with food t o increa se absorption of the dru g int o the body and lessen stomach irrit at ion . ♦ Some infections require that ketoconazole be taken for many months. If you are und ergo ing long-term tre atm ent w ith this drug , be sure to contact your doctor for periodi c evaluat_ions and monitoring. Do not stop taking ketocon azo le without co nsulting your doctor.

DRUG CLASS

Extracts of iod ine-rich kelp, one of many forms of seaweed , provided an effect ive go iter remedy for many years. Today some herbalists rely on anoth er co mpon ent of kelp's stemlike and leaflike parts , an agent kno w n as sodium algi nate . Because of its action , kelp is prescribed to aid in th e tr eat ment of heavy-m et al enviro nm ent al pollutants includin g bar ium and cad mium, and to prevent th e body from absor bin g strontium 90 , a radioa cti ve subst ance created in nucl ear power plants. Some practitioners of alternati ve medicine also recomm end taking kelp supplem ent s for thyroid disorders such as mild hypot hyroidi sm (underacti ve t hy roid ). TARGET AILMENTS

Take int ernall y for: ♦ go it er, hypothyroidism , radiation exposure , heavy- metal env ironm ent al pol Iut ant s. PREPARATIONS Over the counter:

Available in dry bulk , capsules, and tin cture s. At home:

Infusion: Steep 2 to 3 tsp dried or powdere d kelp in 1 cup boilin g wa ter for 10 minut es; drink thr ee times daily .

EFFECTS

Not serious:

KELP

GENERAL DESCRIPTION

MEDICINES

• ringworm (t inea) of the body , skin, groi n (jock itch ), and feet (at hlete's foot ). • seborrheic derm atitis ; dandruff. • Cushin g's syndrom e and prostate cancer (occasion ally ).

None expec t ed .

KETO CONAZO LE

LATI N NAME Fucus spp.

NATURAL

Antifungal

Dru gs

BRAND NAMES Rx: Nizoral OTC: Nizor al AD GENERA L DESCRIPTION

Ket oco nazol e, introduc ed in 198 1 is a powerful antifungal medi cat ion ~hat is used to tr eat a wide variety of skin , lung , and systemic fungal infections, including yeast infec tions (ca ndidiasis ) and ringworm (t inea). The drug wo rk s by preventing the growth and reprodu ct ion of fungal ce lls; in high co ncentratio ns, ketocon azo le actuall y destroys fungal cells. Thi s medicatio n is availabl e in cream, shampoo, oral suspension, or t ablet form . Ketoconazole is also an anti adrenal drug. Because it suppress es th e excess prod uction of ad renal corticosteroid ho rmones and testosterone, ketoconazole is occasionally used in the treatment of prostat e cancer and Cushing's syndrome , in which the body produces excessive amounts of cortico steroid hormon es. For more inform ation , see Antifungal Drugs. TARGET AILMENTS ♦ f ungal diseases of the lun gs, includin g

blastomycosis, coccidioidomycosis, histoplasmo sis, and para cocc idioidomycosis. • yeast infections (ca ndidi asis) of the mouth , skin, and internal organs , such as thru sh, peritonitis , pneumonia , and urin ary tract inf ection. ♦ chromomycosis (a chronic, usually tropical skin infection ).

POSSIBLE

K

INTERACTIONS

Alcohol and hepatoxic (liver) medications: increased ri sk of stomach ulcera-

tion and li ver dam age.

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CONVENTIONAL

AND

NATURAL

Antacids, histamine H2 blockers, and other medications that reduce stomach acid: these medicines may counteract the effects of antifungal drugs by preventing their full absorption into the body. Anticholinergics and omeprazole: may decrease the effectiveness of antifungal drugs. Cyclosporine: ketoconazole may increase the absorption of cyclosporine to potentially toxic levels. Didanosine: both ketoconazole and didanosine, when taken together, may be absorbed into the body less efficiently. Take these medications two hours apart. Oral corticosteroids: ketoconazole may increase the blood levels of these drugs, which may lead to potentially fatal heart arrhythmias. Phenytoin: blood levels of phenytoin may rise and those of the antifungal drug may decrease when these two medications are taken together. Rifampin, isoniazid: may decrease blood levels, and thus the effectiveness, of ketoconazole.

D

Sucralfate: decreased absorption of ketoconazole. Take sucralfate two hours after ketoconazole. Theophylline: blood levels of this drug (which is used to treat asthma) may decrease when taken with antifungal drugs, possibly precipitating an asthma attack.

MEDICINES

GENERAL DESCRIPTION A new, nonnarcotic NSAI D, ketorolac may be prescribed for short-term pain management, without the side effects of sedation or addiction. It is often used to relieve eye inflammation due to trau ma and irritation. Unlike many other NSAI Os, ketorolac is not routinely used for treatment of arthritis. For information about side effects and possible drug interactions, see Nonsteroidal AntiInflammatory Drugs (NSAIDs). SPECIAL INFORMATION ♦ If NSAIDs upset your stomach, take them with food or milk. ♦ Do not use NSAI Os if you are allergic to them or to aspirin. NSAI Os may cause bronchoconstriction or anaphylaxis in aspirin-sensitive asthmatics. ♦ Avoid these drugs or consult your doctor before using them if you have asthma, peptic ulcer, enteritis, high blood pressure, bleeding problems, epilepsy, Parkinson's disease, or impaired liver or kidney function. • Do not take more than the recommended dose and always seek emergency help in case of overdose. Possible symptoms include drowsiness, increased sweating, rapid heartbeat, abdominal pain, vomiting, nausea, gastrointestinal bleeding, and disorientation. ♦ NSAI Os are not recommended for pregnant women, especially during the last trimester, or for nursing mothers.

Warfarin: the anticoagulant effects of warfarin may increase when taken with an antifungal drug.

KETOROLAC LATIN NAME Cola vera (or Cola nitada)

BRAND NAME Toradol

966

TARGET AILMENTS • depression, migraine headaches, poor appetite, diarrhea caused by nervousness, motion sickness, fluid retention, respiratory problems such as asthma. (Take internally.) PREPARATIONS Over the counter: Available in dry bulk, capsules, and tinctures. At home: Soft drinks containing kola (or cola) syrups are probably the easiest way to use the herb medicinally, especially for children.

Decoction: Boil and simmer ½ tsp powdered seeds in 1 cup water for 10 minutes, and drink three times daily. Combinations: For depression use kola mixed with any or all of the following: oats, damiana, and skullcap. SIDE

KOLA

DRUG CLASS Analgesics [Nonsteroidal AntiInflammatory Drugs (NSAI Os)]

the bronchial passages, helping asthmatics to breathe more easily. The effective ingredient in kola is caffeine; kola nuts contain more in proportion than coffee beans, although cola beverages generally contain considerably less caffeine than coffee. Kola has a long history of medicinal use in West Africa. Brought to the Americas by slaves, it earned a reputation among 19th-century practitioners as a treatment for depression, diarrhea, pneumonia, migraine headaches, morning sickness, and typhoid fever.

GENERAL DESCRIPTION The seed of the 40-foot kola tree, source of the world's most popular soft drink flavoring, is a stimulant that herbalists prescribe for overall mental fatigue or depression. It is in addition used to treat diarrhea caused by nervousness; headaches; motion sickness; and loss of appetite. Medical evidence suggests that the herb also may open

EFFECTS

Not serious: Kola may be too strong a stimulant for individuals who are sensitive to caffeine. If you feel nervous or have trouble sleeping, decrease your dose or stop taking kola. SPECIAL INFORMATION + WARNING: Individuals with diabetes, insomnia, anxiety disorders, digestive disorders, chronic high blood pressure, high cholesterol, heart disease, or a history of strokes should not use kola. ♦ WARNING: Pregnant women should check with a practitioner before using kola, since it contains caffeine.

CONVENTIONAL

AND

NATURAL

MEDICINES

LACHESIS

LAVENDER

LAXATIVES

LATIN NAME Lachesis

LATIN NAME Lavandula officinalis

GENERIC NAMES Bulk: calcium polycarbophil, methylcellulose, psyllium hydrophilic mucilloid

GENERAL DESCRIPTION The South American bushmaster snake grows to a length of seven feet and ki I ls its prey, both animal and human, by constriction or by injection of its highly poisonous venom, known as lachesis, from which this homeopathic remedy is derived. Small doses of the venom can destroy red blood cells and impair the clotting of blood. Larger amounts of lachesis poison the heart. Homeopathic practitioners believe that the conditions best treated with Lachesis are those with symptoms similar to the ones induced by the venom. To prepare the homeopathic remedy, venom is extracted from the snake and diluted in large quantities of lactose (milk sugar). Like most homeopathic prescriptions, Lachesis was developed as a remedy by observation of the reactions of healthy individuals to a series of undilute doses. The mental , emotional, and physical changes induced by Lachesis were then cataloged . When a homeopathic practitioner encounters a patient with a set of symptoms that matches the cataloged symptoms brought on by Lachesis, the practitioner then prescribes it in an extremely dilute form. It is presumed that in this highly dilute dosage, Lachesis can counter the symptoms that it induces when it is at full strength. For more information on homeopathic medicine, see page 1027.

GENERAL DESCRIPTION A fr agrant herb that scents clothes and helps to drive away moths , lavender also has medicinal properties. Herbalists prescribe lavender tea and the essential oil of lavender, both made from the plant's blue-violet flowers, to treat common minor ailments such as insomnia, headaches, nausea, and flatulence. Years of anecdotal evidence suggest that lavender has a calming and soothing effect that relieves anxiety and promotes gastrointestinal relaxation. Its aroma is thought to stimulate mental processes and help alleviate depression, especially when it is used with other herbs. Like many aromatic essential oils, lavender oil has antiseptic qualities that may kill several types of disease-causing bacteria, and herbalists use it to treat skin ailments such as fungus , burns, wounds , eczema, and acne.

TARGET AILMENTS ♦ choking coughs, croup, a constricted feeling in the throat, earaches that are worse during swallowing , leftsided sore throats, indigestion , throbbing headaches, especially those that appear during menopause, insomnia, hot flashes, heart arrhythmias , hemorrhoids, sciatica. (Take internally.) PREPARATIONS Lachesis is available over the counter in various potencies, in both liquid and tablet form, at selected stores and pharmacies. Consult your practitioner for more precise information . SIDE

EFFECTS

None expected.

Stimulant: phenolphthalein , sennosides Stool Softener: docusate

GENERAL DESCRIPTION Laxatives are used for the temporary relief of occasional constipation and other bowel problems , and to prevent straining during bowel movements. The drugs can be taken orally in powder, liquid , granular , wafer , or pill form, or rectally as suppositories or enemas. The bulk-forming types, considered the safest, work by absorbing water and expanding, thus increasing the moisture content of the stool to make passage easier. Increased bulk also encourages the bowels' motility. Stimulant laxatives are believed to promote evacuation by increasing peristalsis (waves of contractions) in the intestinal muscles. Stool softeners add to the bowels ' liquid content, softening the stool. For more information, see entries for the individual generic drugs listed above.

TARGET AILMENTS Take internally for: ♦ insomnia, depression, or headache, especially when caused by stress. ♦ poor digestion, nausea, flatulence, colic.

GI

TARGET AILMENTS • constipation. ♦ diarrhea (bulk-forming types). ♦ irritable bowel syndrome, or spastic colon (bulk-forming types). ♦ straining during bowel movements following rectal surgery, heart attacks, childbirth, or when hemorrhoids are present.

Apply externally for: ♦ burns , wounds , eczema, acne, fungal infections such as candidiasis or ringworm. • rheumatism. PREPARATIONS Over the counter:

SIDE

EFFECTS

Not serious:

Available in dried bulk, capsules, oils, and tinctures.

The dye in some laxatives can cause urine discoloration . In rare cases, the following additional side effects may occur: Suppositories may cause rectal irritation. Stimulant types may cause intestinal cramping, nausea, belching, or diarrhea. Stool softeners (liquid forms) may cause stomach cramps or throat irritation.

At home:

Tea: Steep 1 tsp dried flowers in 1 cup boiling water for 10 minutes; drink three times daily. Oil: To relax, use a few drops of th e essential oil in a bath; rub the oil on your skin to mitigate rheumatic pains, or use a few drops in a steam inhalation for coughs, colds, and flu.

Serious:

Some laxatives can cause skin rashes. If you develop a rash, discontinue use and see your doctor. You should also call your doctor if the laxative fails to have the desired effect after one week of use, or if rectal bleeding or an infection develops from suppositories.

Combinations: For depression , lavender can be used with rosemary, skullcap , or kola. SPECIAL INFORMATION ♦ WARNING: Do not use oil of lavender internally.

SPECIAL INFORMATION • If you experience a sudden change in bowel habits that lasts longer than

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Over-theCounter Drug

O

Western Herb

0

Chinese Herb

/:\

Homeopathic

~ Remedy

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CONVENTIONAL

♦

•

♦

•

♦

♦

•

♦

D

♦

♦

•

AND

NATURAL

t wo wee ks, yo u should co nsult you r doc t or befor e using a laxati ve. If yo u are pr egnant or nursing, con sult your doct o r befor e using any kin d of laxati ve. Unl ess prescri bed by yo ur physic ian, laxati ves should not be give n t o childr en und er th e age of six. Bulk- fo rmin g laxati ves are best fo r geri atri c pati ents w ith poorl y functi o nin g co lons. Take bu lk-formin g laxati ves w ith pl ent y of wa ter or oth er liquid t o avo id esopha geal o r throat obstru cti o n. Laxati ves can be habit-formin g. Use th em infr equentl y, at th e lowest effective dosage, and fo r no lo nger th an o ne w eek. Long-term use, parti cu lar ly of stimul ant laxativ es, can cause physical dependence, result ing in loss of no rm al bowe l fun cti on and chr oni c con stip ati on. Do not use laxati ves if you have sympto ms of appendi citi s, includin g abdo min al pain, nausea, or vo mitin g, or if yo u think yo u may have an intest inal obstru ct ion. If yo u have co ngestive heart fa ilur e or rect al bleedin g of unkno w n cause, do not use laxati ves w ithout yo ur doctor 's consent. If yo u are diabeti c, avoid sennosides and psyllium -t ype laxati ves th at co nt ain large amount s of sugar; inst ead, use sugar-fr ee types t hat co nta in th e art if ic ial sweet ener aspartam e. If yo u have hype rt ension o r are o n a low-sod ium di et , avoi d laxati ves co nta inin g sodium . If yo u have di ff icult y sw all ow ing- as w it h dysp hagia-do not t ake bu lkfor m ing laxati ves, w hi ch can cause an esophageal obstru cti on. Ch ro ni c use of laxati ves may cause excessive loss of pot assium in t he body. POSSIBLE

INTERACTIONS

Antacids, histamine H2 blockers (cimetidine, fam otidine, nizatidine, ranitidine), milk: if t aken wi thin an hour of some t ypes of stimul ant laxati ves, th ese medicati o ns may cause gastri c upset by dissolv ing th e out er coatin g of th e laxati ve too qui ckly. Laxatives that may contain danthron, minera l oil, or phenolphthalein: incr eased absorption of th ese substan ces, incr easing the possibility of to x ic effects. Oral anticoagulants, digitalis, salicylate, tetracycline: th ese dru gs may be less effecti ve w hen t aken co ncurr entl y w ith bulk- fo rming laxat ives. After takin g any of th ese medication s, w ait t w o hour s befo re t akin g a laxat ive.

968

MEDICINES

LEDUM

LEMONGRASS

LATI N NAM E Ledum pa lu stre

LATI N NAM E Cymbop ogo n citratus

GENE RAL D ESC RIPTI ON

G EN ERA L D ESCRIPTION

Ledum , sometim es called marsh t ea, can be found in bogs across north ern Europe, Canada, and t he Un it ed St at es. The herb has an anti septi c smell, and its upp er branches are covered w ith a coat of tiny brown hairs. These may have given ledum its name; in Gr eek, ledos means " wo oll y ro be." On ce used in Scandin avia fo r insect co ntro l, ledum has also served as a tea substitut e and rep laced hops in beer, alth ough overconsumpti on has result ed in di zz iness and a splittin g headache- even befo re t he hangover. Homeop athi c practiti oners co nsider dilut e doses of Ledum helpf ul for conditi ons th at may be acco mpanied by signs of infect ion or inflamm ati on. The homeopathi c remedy is pr epared fro m th e w ho le pl ant , w hi ch is gat hered, dri ed, and cru shed t o a pow der. This is dilut ed to nont ox ic levels in a wa t er-alco ho l mi x. Like most homeopath ic prescripti ons, Ledum was deve lo ped as a reme dy by observati on of th e reacti ons of health y individu als to a seri es of undilut e doses. The ment al, emotion al, and physica l changes induced by Led um were th en cat aloged. Wh en a homeopathi c practi ti oner enco unt ers a pati ent w ith a set of symptom s th at mat ches th e cat aloged symptom s brou ght on by Ledum , th e prac t iti oner th en prescr ibes it in an extre mely di lut e fo rm. It is presumed t hat in thi s highly d ilut e dosage, Ledum can co unt er th e symptom s th at it indu ces w hen it is at full str ength . For mo re info rm ati o n on homeopat hic medi c ine, see page 1027.

Lemongrass, a t rop ica l pl ant th at can grow as high as f ive f eet in dr y soils, has uses th at ext end beyon d its t angy ro le in Thai cui sine. Tea made from bl ades of lemongrass is a tr aditional Caribb ean remedy for fevers, and Brazi lians have a long hi sto ry of using t he herb fo r gastroi nt estin al and nervo us d isord ers. Nati ves of th e A mazon also ho ld th at lemo ngrass is an eff ecti ve co ntr acept ive . The results of a clini ca l study to pinpoi nt the herb's th erapeuti c propertie s suggest that myrcene, one of th e activ e ingredi ents isolat ed in th e essenti al oil of lemongrass, may serve as a sit especif ic painkill er, affe ctin g parti cul ar part s of th e body; herb ali st s diffe rentiat e thi s t ype fr om syst emi c pai nkill ers such as aspirin. Thi s analgesic action of myr cene may also expl ain th e apparent sedati ve eff ect of lemo ngrass tea, a ta rt beverage long enj oyed in th e Amazo n regio n. Some pra cti t io ners use th e o il of lemongrass as a rub to tr eat cir cul atory prob lems and t o enhance mu scle ton e by increasing t he bl ood flo w to th e affect ed area.

TARGET AI LMENTS

• anim al bit es or insect stin gs, brui ses that have alr eady di scolo red th e skin , deep cut s or pun ctu re wo und s whe re ther e is danger of infecti o n, gout , achin g j o int s. PREPARAT IONS Ledum is avail able ove r th e count er in

variou s poten cies, in bot h liquid and t ablet form , at select ed st ores and pharmacies. Consult your pr actition er for mor e prec ise informati on. SIDE

EFFECTS

Non e expected.

TARG ET A ILM EN TS

Take int ernally for : • diarrhe a and stomachache, headache, fever , inf luenza. App ly ext ernally fo r: ♦ athl et e's fo ot, acne, cir cul ato ry pro bl ems. PREPARATI ON S O ver the counter: Available in dri ed bulk.

At home: Tea: Use 1 t o 2 t sp fres h or dr ied bl ades in 1 cup boilin g wa t er and st eep for 1O t o 15 minut es; drink as oft en as needed until symptom s improve. 'Y SIDE

EFFECTS

No ne expected. SPECIA L I N FORMAT ION

• The oils fr om several cl osely related specie s of lemon grass are used to make c it ro nell a candl es to repel insects .

CONVENTIONAL

LEVODOPA

DRUG CLASS A nt i-Park insoni sm Dru gs

BRAND NAME Sinemet

GENERALDESCRIPTION Levodo pa is used to treat the t rembling , stiffn ess, indistinct speech, and oth er sympt oms that characterize Par_kinson's disease. In the brain , levodopa 1s co nverted int o dopamine, a chemi ca l necessary for proper transmission of th e nerve impulses that co ntr ol muscle mov ement. Peopl e wit h Parkinson 's disease have a short age of dopamine due to dege neration of the ce ll s that produ ce the chemi cal. Sinemet is a combination of levo dopa and carbidopa , a chemical that prevents levo dopa from breakin g down in t he system before reachin g th e brain. Carbidopa and levod opa may also be prescr ibed separatel y.

TARGETAILMENT ♦

Parkin son's disease. SIDE

EFFECTS

Not serious: H eadac he, urine discolor ati on, loss of appetit e, dry mouth and drooling, deel lect ual creased atte ntion span or 111t funct ionin g, mental co nf usion, insomnia , skin rash, drowsiness, fatigue . Consult your docto r if th ese sympto ms persist or beco me bothersom e.

♦

+

+

+

♦

AND

melanom a, glaucoma , asthm a, psychos is, heart attack, kidn ey d isease, li ve r disease. You shou ld also t ell your physician if you are plann ing sur gery. If levodopa upset s yo ur stomach, try taking it w ith food , although this w ill slow th e dru g's absorption. Levodopa may cause drowsin ess; use caution w hen driving or operating mac hin ery. It may tak e severa l weeks or months for t he medication to reach maximum effective ness. Laborato ry t ests that may be affected by levodopa include: complete blood ce ll co unt s, blood thyro x ine leve ls, urine sugar or ketone tests. Dosages must be determin ed on . an indi v idu al basis. Adjustm ents 111 quant ity and dosing frequ ency are un avo idab le. POSSIBLE

SPECIALINFORMATION + Levodopa may int erf ere w ith no rm al fetal development ; if you are pregnanC discuss th e risk-to-b enef it rat io with your doctor before using th e drug . Do not take levodopa if yo u are nur sing. . ♦ Inform yo ur doctor if you have a history of any of the following ailm ents: diabetes, epilepsy, urin e ret enti o n, peptic ulcer , heart or lun g disease,

MEDICINES

LEVOTHYROXINE

DRUG CLASS Thyro id Hormones

BRAND NAMES Levothyro id, Levox ine, Levoxy l, Synthroid

GENERALDESCRIPTIO N Introdu ced in 1953, synthetically produc ed levot hyr ox ine is the drug of choice for thyroid replacement th erapy because of it s standard hormon e co ntent and predictable effec t . Hormones produc ed by t he th yro id gla nd regulat e functions such as metabo lism and pro t ein synt hesis, general body grow th , and deve lopment of t he bones and centr al nervo us system. They also affect th e heart rate. Thyroid hormone th erapy usually mu st be maintained throu ghout th e pati ent' s lif e unl ess it is prescribed for a transient co ndition affecting th yroid function. Because these horm ones are so criti cal to no rm al grow th and develo pm ent, childr en should be tested to ensure th at their thyroid glands are functionin g nor mall y; those w hose bodies are not producing sufficient quantities must be given suppl ement al thyroid hormon es as soon as possible. Thyr o id medication s are sometimes used di agnostically to check for thyroid disease.

INTERACTIONS

Antacids, metoclopramid e: increased levodopa effect.

Anticholinergics, methionine, papaverine, phenothiazines, phenytoin, pyridoxine, tricyclic antidepressants: decreas ed levodopa effect.

Some MAO inhibitors: may cause a severe ri se in body temperature and blood pressure; th ese medication s shou ld_be disco ntinu ed two to four weeks prior to your t akin g levodopa.

TARGETAILMENTS + hypo th yroidism (u nderacti ve or non -

GI

functioning thyroid ) or as tr eat ment following remova l of th yro id gland. + go it er (enl arge ment of thyroid ). + some types of thyroid cancer , for prevention and treatment, especially aft er radiation th erapy to the neck.

LEVONORGESTREL

Serious: A sudd en drop in blood pressure upon st and ing; uncontrollable movements of the hands, arms , legs, neck, face, eye lid s, mouth, or tongue ; doubl e o r blurred v ision; marked changes 111mood o r ment al state; irregular or rap id heart beat ; difficulty urinatin g; severe or persistent nausea or vo mitin g; we ight change; bitter taste or burning sensatio n on ton gue; sto mach ble edin g or ulc er. If yo u expe ri ence any of th ese sympto ms, co nt act your doctor promp t ly.

NATURAL

DRUG CLASS Estrogens and Progestins

SIDE

BRAND NAMES

EFFECTS

Not serious:

Nordette, Tri-Le v ien, Triphasil

Rarely, except at beginning of tr eatment , changes in menstrual period s; clumsiness; co ldn ess; constipation ; dry , puffy skin ; headac he; sleepiness; tiredness; heart palpitations; weakness; mu scle aches; weight gain. Call your doctor if these effects persist or are troubl esome. (Some hair loss may occur in children during ear ly treatment , but thi s condition is usually temporary.)

GENERALDESCRIPTION Levonorgest rel is a synthetic progestin that is comb ined with the estroge n et hinyl estrad iol for use as an ora l co ntr aceptive . It is ava ilable as_tablets _and as lon g-act ing implants , which are inserted und er th e skin. See Estrogens and Progestins for informati o n about side effects and possib le dru g interactions.

Serious: Rarely, allergic react ion s such as skin rash or hives, severe persistent and ongoing headac he, changes in menstrn atio n, change s in appetit e, chest pa111 , irre gular heartbeat , fever, hand tremors , irrit ability, leg cramps, nervousness, sensitivity to heat , sweating, weight loss. Conta ct your doctor , w ho may redu ce the dosage.

0

Prescription D rug

0

Ov er-theCounter Drug

O

Western Herb

0

Chinese He rb

b, Homeopathic Qy Remedy

g6g

I

CONVENTIONAL

AND

NATURAL

SPECIAL INFORMATION ♦ Your doctor may tell you to continu e

+

+

♦

♦

using thyroid hormones while you ' re pregnant or nursing . Although small amounts of these hormones may cross the placenta or be present in br east milk , no studies have show n harm to the fetus or breast-feeding baby. Tell your doctor if you have cardiovascular disease, or if you have diabetes or other hormone problems, such as low pituitary gland secretions. Your doctor may decide not to use thyroid hormone or to lower the dosage. Absorption of levothyroxine through the digestive tract may be affected by food. Take on an empty stomach (one hour before or two hours after a meal) . The dosage for older people and people with severe hypothyroidism or cardiovascular problems must be monitored closely . Dosages for older patients are usually lower than those prescribed for younger ones. In rare cases after long-term use at high dosages, levothyroxine may cause bone loss.

PO SS IBLE

D

INT ERAC TI O N S

Anticoagulant and antiplatelet drugs (such as warfarin): increased anticlotting action. Your doctor may have to adjust the dosage of anticlotting drugs . Antidepressants, including tricyclic antidepressants such as amitriptyline: increased action and side effects of both combined drugs, leading to heartrhythm problems and other signs of excess stimulation. Antidiabetic drugs (such as insulin): increased need for insulin or other diabetic drugs , perhaps leading to higher blood sugar levels . Your doctor may need to adjust your insulin dose. Cholesterol-reducing drugs (such as cholestyramine): blocked or delayed absorption of thyroid hormones, decreasing their effectiveness. Take thyroid hormones one hour before or four to five hours after cholesterol-reducing drugs. Heart-stimulating drugs (such as epinephrine or pseudoephedrine): increased effects of both combined drugs, potentially causing heart problems or increased chance of thyroid hormone overdose. Other hormones (such as estrogen): may interfere with thyroid hormone action, necessitating higher doses.

970

MEDICINES

LICOR ICE

LATI N NAME

Clycyrrhiza uralensis GENERAL DESCRIPTION The licorice root is often used to flavor herbal formulas, but it has important medicinal properties of its own . Chinese herbalists prescribe it for several digestive and stomach problems and for coughs and colds . Licorice is also considered an anti-inflammatory medication, useful in treating skin diseases, and it is prescribed as well for ulcers. The best form of the herb is powdery , with a thin, unwrinkled , reddish brown outer skin and a white cross section. The raw form is characterized as neutral in traditional Chinese medicine; when fried in honey it is believed to be a warm herb. TARGET AILMENTS Take internally for: ♦ coughing and wheezing , asthma, sore throat. ♦ poor digestion, stomach and duodenal ulcers, abdominal pains and spasms. ♦ carbuncles and sores. PREPARATIONS Licorice can be purchased in bulk from Chinese pharmacies, Asian markets , and some Western health food stores, and is also available in tablet form.

Combinations: Mixed with ephedra stem and apricot seed, licorice is prescribed for coughing and wheezing. A preparation of licorice and mung bean is believed to be an antidote to aconite and several other toxins. And combined with honeysuckle flowers it is used to treat rashes or acne. For details on dosages and preparations, check with a Chinese medicine practitioner. S IDE EFF EC T S

Serious: There is some evidence that licorice affects the body's balance between salt and potassium, retaining salt while depleting potassium. This can cause some people to retain fluid. You should probably take potassium supplements when using this herb. Consult a Chinese medicine practitioner for advice. SPECIAL INFORMATION Individuals with edema (the retention of fluids in the body) and high blood pressure should avoid the herb. ♦ Practitioners speculate that an extract made from licorice may prevent tooth decay and gum disease. ♦

♦ See also the species of licorice

known as Clycyrrhiza glabra , regarded as a Western herb.

P OSS I B L E INTER

AC T IO N S

Euphorbia, genkwa flower, kan-sui root , sargassum seaweed, and polygala are considered incompatible with licorice.

LICOR ICE

LATIN NAME

Clycyrrhiza glabra GENERAL DESCRIPTION Distinguished by tiny violet flowers that bloom in the summer, licorice is one of the most commonly used medicinal herbs. Its sweet taste , alleged to be 50 times sweeter than sugar, masks the bitterness in any herbal mixture. Chinese and Western herbalists use licorice root as a cough suppressant and maintain that it also soothes the mouth and throat. In addition they prescribe it for digestive disorders, believing that it acts as a mild laxative and prevents stomach ulcers by forming a protective coating on the stomach wall. Applying licorice as an external antibiotic, practitioners think it relieves skin irritations such as eczema and herpes sores. TARGET AILMENTS Take internally for: ♦ cough, sore throat, colic, constipation, heartburn, stomach ulcers, arthritis, hepatitis, cirrhosis.

Apply externally for:

+ skin infections, eczema , herpes sores. PREPARATIONS Over the counter: Licorice is available as dried root , liquid extract, and capsules. At home: Tea: Prepare by boiling 1 oz licorice root in 1 cup water for 15 to 20 minutes. Drink up to 2 cups daily.

Antibiotic: Sprinkle licorice powder directly on the infection or sore. S ID E EF F EC T S

Not serious: You may experience upset stomach, diarrhea, headache , facial puffiness, ankle swelling, edema (fluid retention), grogginess, weakness.

'

CONVENTIONAL

SPECIALINFORMATION ♦

WARNING: While licorice is safe in moderate, short-term doses, taken in large amounts over a long period it can affect the body's electro lyt e balance, retaining sodium but depleting the body of potassium. This in turn can lead to high blood pressure and edema. Consult your practitioner for advice. ♦ Do not use licorice root if you have edema, high blood pressure, kidney disease, or glaucoma. ♦ Avoid the herb if you are pregnant. It causes increased production of aldosterone, a hormone that regulates the salt and water balance of the body, resulting in a rise of blood pressure.

AND

rhoid preparations because of two claims . The ingredient is purported to speed the healing of injured skin by stimulat ing the skin's intake of oxygen . Live yeast-cell derivative also may help in the building of connective tissue, one of the steps in wound healing.

MEDICINES

At home: Tea: Steep ¼ to ½ tsp dried leaves in 1 cup boiling water for 10 to 15 minutes; drink three times daily .

Compress: Soak a piece of fabric in a lob elia infusion for several minutes; wring out and apply to affected area. Combinations: For asthma 1 use with cayenne , skunk cabbage, and ginger.

TARGETAILMENTS • burning and itching of the anorecta l surface due to hemorrhoids .

SIDE

SPECIALINFORMATION ♦

NATURAL

EFFECTS

Serious: WARNING: Symptoms of toxic doses of lobelia include vomiting, nausea, excessive salivation, diarrhea, hearin g and vision problems, weakness, and mental confusion. If not treated promptly, acute cases of poisoning can bring on respiratory fai lur e and even death. If you develop any side effects, call your doctor immediately.

In case of rectal bleeding or persistent itching, see your physician.

LOBELIA LISINOPRIL

SPECIALINFORMATION

LATINNAME

♦

WARNING: Use lobelia only in doses prescribed by your practitioner. • If your practitioner prescribes lobelia for your child , monitor the chi ld frequently for the development of any side effects. • Do not use this herb if you are pregnant.

Lobelia inflata

GENERALDESCRIPTION

DRUG CLASS Angiotensin-Converting Inhibitors

Enzyme (ACE)

BRAND NAMES Prinivil, Zestril

GENERALDESCRIPTION Introduced in 1988, the ACE inhibitor lisinopril relaxes arterial walls, thereby lowering blood pressure. It is used in the management of hyp ertens ion (m ildto-severe high blood pressure) and congestive heart failure. For increased blood-pressure- lowerin g action , lisinopril is sometimes combined with hydroch lorothiazide. See AngiotensinConverting Enzyme (ACE) Inhibitors for information on side effects and possible drug interactions.

LIVE YEAST-CELL DERIVATIVE

Lobelia, sometimes called Indi an tobacco, is prescribed for both respiratory ai lments and external conditions, but it can be extreme ly toxic. Herbalists use the whole hairy plant, which grows up to three feet high and contains a milky sap; the seeds, however, are the most potent part. Two of lobelia's active ingredients, lob elin e and isolobelanine, may give the plant the ability to act as a relaxant for the entire body even while it stimu lates the respiratory system. Lobeline mildly mimics the effect of nicotine; this has prompted people who are trying to quit smoking to use it as a temporary substitute. Because it is thought to relax overworked bronchial muscles and promote coughing, which helps to clear mucus from the lungs, lobelia is most widely used to treat respiratory illnesses such as asthma, bronchitis, pneumonia, and whooping cough. Lobelia compresses have also been used to treat skin injuries, fungus infections, and muscle sprains.

LOPERAMIDE

DRUG CLASS Antidiarrheal

Drugs

BRAND NAME lmodium A-D

GENERALDESCRIPTION Introduced in 1977, loperamide is used primarily for symptomatic control of diarrhea and cramping. It should be taken on an empty stomach. See Antidiarrheal Drugs for more information and possible interactions.

TARGETAILMENTS DRUG CLASS Antihemorrhoid

Drugs

BRAND NAME Preparation H

GENERALDESCRIPTION Used in preparations for hemorr hoids , live yeast-cell derivative is tentatively classified as a wound healer. Thou gh its safety and efficacy are only condit ionally accepted by the FDA, Iive yeast-eel I derivative is included in some hemor-

SPECIALINFORMATION

Take int erna lly for: ♦ pneumonia, asthma, bronchitis, smoking.

Do not use loperamide if: • diarrhea is accompanied by high fever (101°F or higher). ♦ blood or mucus is present in stool. • you have a rash or other allergic reaction to the drug. ♦ you are taking ant ibiotics or have a history of liver disease or colitis. ♦ you are pregnant or nursing a baby. Consult a doctor before using the drug.

Apply externa lly for: ♦ bruises, insect bites 1 poison ivy, fungus inf ections including ringworm, sprains.

PREPARATIONS Over the counter: Available in dried bulk, capsules, and tinctures.

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Prescription Drug

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Over-theCounter Drug

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Western Herb

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Chinese Herb

/2'\Homeopathic

C:;JRemedy

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71

CONVENTIONAL

AND

NATURAL

LORACARBEF

DRUG CLASS Antibiotics

[Carb acep hems]

BRAND NAME Lor abid

GENERAL DESCRIPTION Loracarbef , introdu ced in 1992 , is the first of the carbacephem antibiotics, a subcl ass of drugs that work in mu ch the same way as peni cillins and cep halosporins do to kill grow ing bact eri a.

TARGETAILMENTS ♦

bacterial infecti ons, such as bronchitis, otitis media , strep throat, some pneumonias , sinu siti s, inf ecti o ns of th e skin and soft ti ssue, and urin ary tract inf ection s. SIDE

EFFECTS

Not serious: N ausea, abdom inal pain , mil d d iarr hea, lo ss of appetite. Consult your doctor if th ese symptoms co ntinue for mor e than two days or are both ersome.

Serious:

D

Severe itching, rash, or difficulty breathing (possib ly indi cat ing an anaphylactic reacti on); severe diarrhea, severe abdomin al pain, or stomach cramps. Call your doctor imm ed iate ly; yo u may need to alt er yo ur current prescription o r sw it ch to a diff erent medici ne. Oth er possible side effec t s that can beco me serious if th ey continue or are severe: dizz iness, headache , dro wsi ness, in somni a, nervousness, and vagina l it chin g and di scharge. Consult yo ur docto r.

SPECIAL INFORMATION ♦

♦

• •

♦

972

Tell your doctor if yo u are al lergic to peni ci llins or cep halosporin s; if so, you are likely t o be allergic t o loracarb ef as well. All ergic reactions to th ese drugs can be life-threatenin g. Tell you r doctor if your kidn eys are imp aired; yo u may requ ir e a smal ler dose of loracarb ef or you may need a diff erent drug alto get her. Take this drug one hour befor e or t wo hours after a meal. If thi s drug causes severe di arrh ea, co nsult your doctor before t akin g any ant idi arrh eal medi cine. For mild diarrhea, use only antidiarrheal pr eparations containing kaolin or attapulgite. To prevent reinf ecti on, tak e the full course of your prescription , even if you feel better before you 've t aken all th e medicin e.

MEDICINES

♦

Carbacephems kill not only harmf ul bacteria but also " good" intesti nal bacteria that keep harm ful fungi and int estinal bacteri a in chec k. Eating yogurt co ntainin g Lac tobac illus ac idophilu s culture o r taking acidophilus tabl ets may help restor e the body 's norm al bacteria. ♦ Prolon ged use of any antibiotic can lead to fun gal infe ct ions, includin g candidi asis, or to bacterial inf ecti ons such as pseudomembranous colitis. ♦ Unl ess it is clearly needed, avoid taking lor acarbef if you are pregn ant o r breast-f eeding. T POSSIBLE

INTERACTIONS

Probenecid: decreases the kidney s' ability to excrete loracarb ef. Possible lor acarbef to x ic ity. NOTE: Carbacep hems are a relative ly new antibiotic subc lass, and research into th eir interactions is ongoing. See entries for two simil ar antibiotic subcl asses, Penicillins and Cephalosporins, for oth er possib le dru g int erac tion s.

LORAZEPAM

DRUG CLASS Anti anx iet y Dru gs [Benzodi azepin es]

BRAND NAME Ativan

GENERALDESCRIPTION Introduced as an injectabl e drug in 196 3 and as a tabl et in 1984 , lorazepam is a benzodiazepine prescribed for th e treatm ent of anxiety, severe nervous tension , and insomnia. In injection for m, it is also used to reli eve presurgery anxiety. See Benzodiazepines for information on side effects and possibl e drug int eractions.

LOVASTAT IN

DRUG CLASS

LORATADINE

Cholesterol-Reducing

Dru gs

BRAND NAME Mevacor

DRUG CLASS

GENERALDESCRIPTION

Antihistamines

Introduced in 1987, lovast at in is one of several HMG-CoA reductas e inhibitors th at lower th e levels of cholest ero l and other blood fats. These drugs wo rk by bl oc king a liv er enzy me needed in the production of chol esterol. For more info rm at ion , see Cholesterol -Reducing

BRAND NAME Clar itin, Claritin-D

GENERALDESCRIPTION A newer , nonsedatin g antihi st am ine, loratad ine is common ly prescribed for seasonal allerg ies. It generally do esn't cause th e drowsiness, jitt ers, or dry mo uth associated w ith drugs of its kind . See Antihistamines for additional side effec ts and int eraction information.

Co nstipation , gas, decreased sex dri ve, insomnia .

SPECIAL INFORMATION

Serious:

♦

If your liv er is impair ed, loratadin e can build up in you r body and provo ke lif e-threatenin g heart problems. Dependin g on the severity of your liver condition, your doctor may prescribe a different antihist amine. POSSIBLE

INTERACTIONS

Azithromycin, cimetidine, clarithromycin, erythromycin, itraconazole, ketoconazole, ranitidine, theophylline, and troleandomycin: may int erfere w ith th e body 's met abolism of lorat adine , possibly causing life-thre ate ning cardiac effects. Do not take lorat adine in combination w ith any of the se drugs .

Drugs. S I DE EFFEC T S

Not serious:

Fever, muscle aches, cramps , blurred vision.

SPECIAL INFORMATION ♦

Lovastatin works better when taken with food. ♦ If you becom e pr egnant w hile takin g this drug , stop using it immediately and inform your doctor . POSSIBLE

INTERACTIONS

Erythromycin, immunosuppressants, and niacin: severe muscle pain , kidne y failure.

CONVENTIONAL

LYCIUM FRUIT

LATINNAME Lyci um barbarum (or Lyc ium chinense)

GENERALDESCRIPTION Similar in appea rance and action, the berries of both Lycium barbarum and Lycium chin ense are large, soft , and red. The fruit is sometim es known as wolfberry. Ripenin g in the summer , lyc ium has thi ck flesh and small seeds. In tr aditional Chinese medi ca l ter ms, th e two herbs are classified as sweet and neutr al . Lyc ium chinense appears lar gely in Hebei Province, w hil e the mor e co mmon Lycium barbarum grows in a num ber of Chin ese provinces .

AND

tioners also use the fruit to treat co nsumpti ve cou ghs, w hen it is combi ned wit h op hiop ogon tuber , anemarrhena , and fritillari a. If used for chroni c diarrhea, it should be toast ed fo r maximum effective ness. For furt her inform ation on appropri at e preparations and dosages, check w ith yo ur herbal practitioner.

PREPARATIONS Lyci um fruit can be obtained from Chinese pharmacies, Asian markets, and some Western health food stores, both fresh and in the form of tablets. Lyc ium fr uit is usuall y added durin g th e last five minutes of cook ing. Com bin ati ons: When mixed with cuscut a, eucommi a bark, and Chinese fo xglove root cooke d in wine, lycium fruit is prescribed for impotence , dizziness , and tinnitus (ri nging in the ears). Practi-

MEDICINES

wo rsen in the early even ing. Pollen is extra ct ed from the spores and diluted with milk sugar to cre at e the homeopathic remedy. Like most homeopat hic prescriptions , Lycopod ium was deve lop ed as a remedy by observa tion of reaction s of healthy indi vidual s to a seri es of undilute doses. The mental , emotional , and physical changes indu ced by Lycopodium we re than cataloged. When a homeopa thi c practitioner enco unters a patient w ith a set of sympto ms that matches the cata loged symptoms brought on by Lycopodi um, th e practitioner th en pr escrib es it in an extremely dilut e form. It is presumed that in this highly dilute dosage, Lycopodium can co unt er the sympto ms th at it induces w hen it is at full strength . For mor e information on ho meopathi c medici ne, see page 1027.

SPECIALINFORMATION • You should not take thi s herb if you suffe r from an infl amma t ory ailm ent , weak di gestion, or a t endency to beco me blo ated.

LYCO PODIUM

TARGETAILMENTS Take int erna lly for: ♦ night blindness, tinnitu s (ringin g in the ears), dizziness, and blurred vision. ♦ dry co ughs. • d iabetes. ♦ sore back, knees, and legs. ♦ impotence and nocturnal emission.

NATURAL

TARGETAILMENTS • backache with stiffn ess and soreness in th e lower back, bedwetting, co lds with stuffy nose, constipation , coug hs wit h mucus pr esent, cysti tis, headache w ith throbbin g pain th at is at its worst between 4 and 8 p.m., gout , indig estion accompanied by abdom inal cramps, gas, heartburn , joint pain, sciatica , r ight- sided sore thro at, eczema.

LATIN NAME Lycopodium clavatum

GENERALDESCRIPTION Lycopo dium , also known as club moss, grows in pastur es and woodlands throughout Great Britain , north ern Europe , and North America. Its spores contain a highly flammable pollen that was once used in fireworks and ot her pyrotechnics. Powde r made from its gro und-up spores has been used for internal complaints lik e di arr hea and dysentery since the 17th centur y. Hom eopathic physicians use dilute doses of Lycopod ium for co mpl aint s t hat are accompa nied by symptoms of d igestive upset, ailment s th at seem to develop on th e right side of the body, a stro ng desire for sweets, anx iety, and symptoms that

0

Prescription Drug

0

Over-th eCounter Drug

PREPARATIONS Lycopodi um is available over the cou nter in va ri ous pot encies, in both liquid and tablet form, at selecte d stores and pharmac ies. Consult yo ur hom eopat hi c phy sician fo r mor e precise information . SIDE

L

EFFECTS

None expec ted.

O

Wes tern Herb

0

Chinese Herb

A Homeopathic

~ Remedy

973

CONVENTIONAL

AND

NATURAL

MEDICINES

MAGNESIUMHYDROXIDE~

practitioner for details of other mixtures and doses.

DRUG CLASS

Not serious: Because of its hairy textur e, the herb can irritate the throat. Rub the herb with cotton cloth or place it in cheesec loth before mixing it into a solution. In addition, overdoses can cause dizziness and red eyes.

SIDE

Antacids

BRAND NAMES Phillips ' Milk of Magnesia , Rolaids, some types of Maalox and Mylant a

EFFECTS

GENERALDESCRIPTION Magnesium hydroxid e is a magnesiumcontaining antacid drug used to relieve sympto ms of upset and sour stomach, ac id indigestion , heartburn , and ulcers. The most common side effect is a laxative act ion or di arr hea. See Antacids for information about additional side effects and possible drug int eract ion s.

MARSH MALLOW

',

At home: Decoction: Simmer 1 to 2 tsp finely chopp ed or crus hed root in 1 cup water for 10 to 15 minutes; drink three times daily. Use the decoction as a gargle for mouth problems.

Gel: Add just enough water to the finely chopped root to give it a gel- lik e consistency and use for skin problems.

SPECIALINFORMATION • The campf ire candy named marshmallow contains none of the herb although the marsh mallow plant w~s considered a delicacy by the Romans, who used it to make candy. ♦ Marsh mallow can be given in low doses to infants and children.

LATINNAME Althaea off icinali s

SPECIALINFORMATION ♦

Magnesium-containing antacids increase the risk of magnesium toxicity; do not take these drugs if you have kidney disease.

MAGNOLIA FLOWER

LATINNAME Magnolia liliflora (or M. denudata)

D

GENERALDESCRIPTION More accurate ly described as magnolia buds, this herb is the unopened magnolia flower. Chinese medicine practitioners prescribe it for blocked nasal and sinus passages. The best-quality buds are green and dry; they should includ e none of the stems or branches. The herb is characterized in traditional Chinese medicine as acrid and warm. Growing in several Chinese provinces, magnolia is harvested in early spring, before the flowers unfold.

TARGETAILMENTS • nasal co ngestion , nasal discharge , sinus headaches, other sinus disorders. (Take internally.)

PREPARATIONS Magnolia buds are avai lab le in bulk at Chinese pharmacies , Asian markets, and some Western health food stores. Combinations: Magnolia flowers are mixed with xanthium, angelica (Angelica dahurica), and field mint to treat nasal co ngestion and sinus headaches, and with chrysanthemum flowers (Chrysanthemum morifolium) and siegesbeckia for frontal sinusitis. Consult an herbal

974

GENERALDESCRIPTION For centuries, people in Europe and the Middle East have eaten wild-growing marsh mallow when their crops failed. Today it is still reco gnized as a wilderness forage food. Herbali sts use the roots , and sometimes the leaves, of this downy, erect, five-foot-high perennial that grows in damp soils; they prescribe it for cuts and wounds, mouth sores, stomach distress, and other ai lments . And teething, irritable babies and toddlers have traditionally found comfort in sucking on a root of marsh mal low . The healing substance in marsh mallow is mucilage, a spongy root material that forms a gel when mixed with water and is especially soothing to infl amed mucous membranes. One study suggests that mucilage supports the immune system's white blood cells in their fight against invading microbes. Another trial, using animals, indicated that marsh mallow may help to low er blood sugar.

§1

MEDROXYPROGESTERONE

DRUG CLASS Estrogens and Progestins

BRAND NAME Premphase, Prempro, Provera

GENERALDESCRIPTION Medroxyprogesterone is a progestin used to treat menstrual problems that are caused by hormonal imbal ance and to alleviate the side effects of estrogen in estroge n replacement therapy . The drug also induces uterine bleeding to allow the uter ine lining to be shed. In inj ect ion form , medroxypro gesterone is sometimes used as a contraceptive, with one dose every three months. See Estrogens and Progestins for information about side effects and possible drug interactions.

TARGETAILMENTS Take marsh mallow int erna lly for: ♦ sore throat , coughs, colds, flu , bronchitis, sinusitis. • upset stomach , peptic ulc ers, gastr itis (sto mach irritation), colitis (inflam ed co lon ). ♦ cyst itis, bladder infections, uret hritis (infl ammation of the urethra), kidney stones. Apply marsh mallow externally for: ♦ abscesses, boils, skin ulcers , cut s, burns , scrapes, other wounds. • varicose veins. ♦ dental abscesses and gingiv iti s.

PREPARATIONS Over the counter: Available in dried bulk, capsules, tincture.

MENTHOL

BRAND NAMES Ben-Gay, Halls Mentho-Lyptus cough drops , N' lce cough drops , Vicks VapoRub

GENERALDESCRIPTION Menthol, an aromat ic oil from the peppermint plant, is a natural alcohol that is now usually produced synthetically. For centuries the drug has been used, eit her alone or in combination with other substances, in a wide variety of medicina l produ ct s, from rubs and linim ents for

CONVENTIONAL

itchy skin and achin g muscl es to gargles and lozenges for rnouth and throat irrit ations. Mentho l has been shown effec ti ve in reli eving the itchin g and pain of hernorrhoids and rninor skin irrit at ions. It is also a useful rnedication for soothing sore throat and suppressing coug hs. Menthol wo rks by penetrating the skin or rnuco us rnernbranes to cairn nerve endin gs. It rnay also help ki ll sorne types of bacteria . The dr ug is ava il ab le in rnany forms, includin g co ugh drop s and lozenges, var ious topi ca l preparatio ns and rubs, and inhalants. Menthol is also used as an ingred ient in rnouthwashes , toothpastes , th roat sprays, and foods such as candy and chewing gurn.

TARGETAILMENTS ♦

it chy and painful skin.

♦ hemo rrh oids (to relieve itching and ♦ ♦

♦

•

pain ). cough; minor sore throat and irrita tio ns of th e throa t . arthriti s, rnuscle strain (ofte n in corn bination w ith rnet hy l sali cy late and carnphor). co ngesti on associated with co lds or all ergies (often in co rnbin at ion w ith carnp hor and desoxyep hed rin e). co ld sores (to sooth e and relieve pain). SIDE

EFFECTS

Not serious:

Mentho l rnay cause loca l ir ritat ion or a cooling sensation as part of it s therapeuti c act ion as a counterirritant. You need not ca ll your doctor unl ess the se syrnptoms becorne bothersorne . To ease the syrnpt orns, try using less of the dru g. Serious:

None expected; rnenthol , whe n used alone, is cons idered safe in th e doses ava il able. However , w hen cornb ined with rnethyl salicylate (as in sorne o intrnents for reli ev ing sore rnuscles), the rned icat ion may cause redn ess of skin . Discontinue use if red ness develops. Also, w hen app lied to the skin or mu cous mernbranes, high concentrations of rnenthol or pure pepperrn int o il (w hi ch co nta ins a high concentration of rnenthol ) can cause serious irritation that rnay require rnedical atte ntion .

SPECIALINFORMATION ♦ Because instance s of choking hav e

been reporte d in very yo ung c hildr en, rnent hol coug h drops are not cons idered safe for children und er five. ♦ Co nsult your doct o r befo re using rnent hol linirn ent s on childr en und er the age of two. • Because very littl e menth o l is absorb ed int o the blood , low concent ra-

AND

tions are generally cons idered safe for pregnant and nur sing worne n. Ho wever, you shou ld check w ith your doctor before using any rnedic ation th at co ntains rnenthol.

NATURAL

MEDICINES

MESTRANOL

DRUG CLASS Estrogens and Progestins

BRAND NAME Ortho-Novurn

MERCURIUS VIVUS

1/50

GENERALDESCRIPTIO N Mestranol is an estro gen used in cornbi nation wi th the progestin nor ethindron e in oral contraceptives. See Estrogens and Progestins for inforrnation about side effects and possible drug inter act ions.

LATINNAME Mereurius vivus GENERALDESCRIPTION O ne of the rnetall ic chernical elernents, rnercury , also call ed qui cksilver, was known in anci ent Chin ese and Hindu civ ili zat io ns and has had a long history of rnedicinal use. Ingestin g certain rnercury cornpo und s can cause increased perspir at ion and salivati on; and so in ancie nt medicine mercury was used, alon g w it h bloodletting and purging , as a rneans of riddin g the body of impurities . Undilut e rnercury is toxic , however, and severe syrnptorns of rnercury po isoning rnay includ e nausea, infl arnrnati on of the di gesti ve tract, and kidney failure. Horn eopa thi c practiti o ners pr escr ibe Mere vivus, as the horn eopat hic preparation of rnercury is call ed, for cond itions accornpan ied by syrnpto rns of shakin g, hot and co ld sweats , and restlessness. Mere vivus is rnade frorn the cherni cal elem ent rnercur y by diluti on w ith large quantities of rnilk sugar. For rnor e inforrnation on horneopa thic rnedicin e, see page 1027.

METHYLSALICYLA TE

DRUG CLASS Anal gesic s [Top ical Ana lgesics)

BRAND NAME Ben-Gay

GENERALDESCRIPTION Obtained fr om the leaves and bark of plants in th e Caultheria, birch, and popl ar fam ili es, or produced synth etically, rnethyl salicylate is used as a topic al rnedicine for relieving pain in rnuscles and joints. Sornetirnes called wi ntergr een oil , th e substance works as a co unterirritant ; it stimul ates skin receptor s, providing ternporary re lief of aches and pains. M ethyl salicylate is avai labl e in a vari ety of gels, linirnen ts, lotion s, and o intrnents, usuall y in co rnbin ati on w ith rnentho l or carn phor. The concentration of rnet hyl salicylate in these products varies frorn 10 percent to 60 percent. Poisonous if ingested, methyl salicylate is relat ively safe for ext ernal use.

TARGETAILMENTS abscesses, especially dental or glandular; backac he with burning, shooting pain s in the lower back ; chickenpox; co lds with an excep ti ona lly runny nose and pain in the nostrils; cyst iti s wi th slow urin atio n; painful diarrhea; influ enza; earac he with d ischarge of pus; eye infl arnrnat ion ; indi gestio n; rnouth ulcers ; burning sore thro at; tooth ache w ith increased sali vat ion.

TARGET AILMENTS • rninor mu scle and joint aches and pains frorn arthritis , sprains, strains, and bruises ( use only if ski 11 is int act ).

PREPARATIONS Mere vivus is ava il ab le over the co unter

SIDE

in vario us poten cies, in both liquid and tablet form, at selecte d sto res and pharmacies. Consult a horn eopat hic physic ian for furt her inforrnat ion. SIDE

Loca l skin redness or irritation. Discon tinu e use and co nta ct your do cto r if th ese effects becorne troublesorne. Serious:

EFFECTS

Prescription Drug

EFFECTS

Not serious:

Salicy late to xicity (di zz iness, rin ging in ears, nausea, vo rnitin g), a rare co nditi on caused by absorption throu gh the skin int o the blo od . Discontinue use and contact your doctor .

None expected.

0

GI

0

Ov er-theCounter Drug

O

Western Herb

0

Chinese Herb

A Homeopathic \Y Remedy

g S

7

CONVENTIONAL

AND

NATURAL

SPECIALINFORMATION

MEDICINES

tern Stimulants for more information.

♦

Heat and humidit y increase the absorptio n of methyl sali cy late through th e skin, thus incre asing the risk of salicy late toxicity. Do not exerc ise vigoro usly in hoc humid weather after application or use a heating pad immediately after app li cat ion . ♦ To reduce risk of irritation , avoid co ntact with eyes; mucous membranes; or broken , ir rit ated skin.

TARGETAILMENTS ♦

♦ ♦

♦ ♦

atte ntion deficit disord ers in childr en (formerly called hyper act ivity , minimal brain dysfunction , or minimal bra in dama ge). narcolepsy (uncontroll able spell s of drowsiness or sleep). mild-to-moderate depression. apathy and withdrawal in th e elderly. chron ic pain (used wit h other drugs ). SIDE

METHYLCELLULOSE

BRAND NAME Citrucel

GENERALDESCRIPTION M ethylcellulose is a bulk-forming laxative used to temporarily reli eve const ipation and diarrhea and to prevent strai nin g during bowel movements. This type of laxative may be especia lly beneficia l to people on low-fiber diets , and patients with postpartum constipation, irritable bowel syndrome , diverticulitis , or hemorrhoids . See Laxatives for addit ional inform at ion.

Severe ski n rash or hives, irregular or fast heartbeat , chest pain , unusual bruising, blurred vision, joint pain , sore throat and fever, weight loss, mood or mental changes, abnormal behavior patterns , psychotic reactions. Contact your doctor immediately. Also see overdose symptoms below.

SPECIALINFORMATION ♦ Seek immediate medical help for over-

♦

METHYLPHENIDATE

§1 ♦

DRUG CLASS Central Nervous System Stimulants

BRAND NAME

♦

Ritalin ♦

GENERALDESCRIPTION Methylphenidate is a mild central nervous system (CNS) stimulant that seems to work by activating the brainstem aro usal system and cerebral cortex. For some children with an attention deficit disorder, CNS stimulation decreases motor restlessness,increases attention span, and improves concentration . In adults, it can lead to increased motor activity and mental alertness, decreased fatigue, cheerier outlook, and mild euphoria. Because methylph enidate is an amp hetamine-like drug, it can be habitforming, leading to marked tolerance and serious physical and psychological dependence. See Central Nervous Sys-

976

dose. Signs of overdose includ e rapid , pounding, or irregular heartbeat; fever and sweat ing; confusion, co nvulsions , hallu cinations, agitation, delirium, vom itin g, dry mouth , trembling , muscle twitching, increased blood pressure, and loss of consciousness. Do not take if yo u have had an allergic reaction to this drug; have glauco ma or motor tics ; or are suffe rin g from severe tension , agit ation , anx iety, or emot ional depression. Befo re taking, tell your doctor if you have hi gh blood pressure , epilepsy, angina, liver problems , or a hi story of alco holism or drug dependence. Sleeping problems may be avoided if you take the last dose before 6 p.m. Although methylphenidate may be th e primary agent in treating attention deficit disorders, its long-term effects are unknown. Your doctor may recommend occasional drug-free periods during treatment and discontinuance of the drug after pub erty. POSSIBLE

DRUG CLASS

BRAND NAMES Lopressor, Toprol

GENERALDESCRIPTION

Serious:

Laxatives

METOPROLOL

Beta-Adrenergic Blockers

Nervousness, trouble sleeping, loss of appetite, headache, dizziness , nausea, stomach pains, mild skin rash, unusual tiredness. See you r doctor if symptoms persist.

DRUG CLASS

D

EFFECTS

Not serious:

methylphenidate should not be taken w ithin t wo wee ks of using MAO inhibitors. Concurrent use of the two dru gs co uld cause dangerously hi gh blood pressure and severe convulsions.

INT ERACTIONS

Anticholinergics, anticoagulants, anticonvulsants, and antidepressants (tricyclic): methylphenidate may increase the effects of these drugs.

Antihypertensives, guanethidine, minoxidil, and terazosin: methylphenidat e may decrease the effects of these drugs.

Monoamine oxidase (MAO) inhibitors:

A cardiose lective beta-blocking drug , metoprolol is prescribed to help manage hyp ertensio n (high blood pressure), angina, and myocardial infarction (heart attack). By blocking the action of certain parts of the nervous system, metoprolol slows the heart rate and relaxes blood vessels, th ereby lowering blood pressure and easing the work load on the heart. See Beta-Adrenergic Blockers for mor e inform at ion about these drugs , including side effects and possibl e drug int eractio ns.

MICONAZOLE

DRUG CLASS Antifungal Drugs

BRAND NAMES Rx: Monistat-Derm , Monistat Dual-Pak, Monistat 3 Vaginal Suppositories

OTC: Monistat 3, Monistat 7 GENERALDESCRIPTION Miconazole , available in topical and vaginal preparations, is used to treat a variety of fu ngal infections. See Antifungal Drugs for more information, including sid e effects and possible drug int eractions. For information about other medications com monly used to treat vaginal yeast infections, see Vaginal Antifungal Drugs.

SPECIALINFORMATION • Topical creams, lotions , and powders are app lied directly to the skin to combat the fungi that cause body ringworm, jock itch, and athlete's foot. They can be used twice a day for up to one month.

,

.

CONVENTIONAL

+ Vagin al creams and suppos it ori es are insert ed direc tl y into th e vagina, usually at bedt ime, fo r a per iod of t hree t o seven days.

AND

MEDICIN

.ES

+ Acco rd ing t o a str ing of studi es con -

S I DE EFFEC T S

du cted ove r th e last 25 years in Germany, mistlet oe imp air s th e growt h of tumor ce lls in t est t ubes. No co nclusio ns have been reached, alth ough research is stil l being co ndu cted to det ermin e th e herb's potent ial use in cancer chemoth erapy.

N ot serious:

Beca use t aking milk thi stl e inc reases bile secr et ion, yo u may develop loose st oo ls. SPECIAL I N FORMATION

MILKTHISTLE

NATURAL

+ WA RNI NG : If yo u thin k t hat you have a liver d isorder, seek med ical adv ice.

MOMETASONE FUROATE

LATI N N AME

Sil yb um mari anum

MISTLET OE G ENERAL D ESCRI PTI ON

M il k t hi stl e, a plant th at reaches fi ve feet in height and thri ves both in th e w ild and in th e gard en, is used by herbalist s to tr eat such live r di sorders as ci rrhosi s and hepat iti s. The acti ve ingredi ent , silym arin , is fo und in t he seeds. It is believed th at silymarin pro mpt s t he manufactur e of new, healt hy liver ce lls w it ho ut enco uraging th e grow t h of any malignant live r tis sue th at may be pr esent. Silym ar in, it is th o ught , also serves as an ant ioxidant , prot ectin g liver ce lls fr om damage by fr ee radicals, w hich are harm fu l by-pro duct s of many bodily processes includin g ce llul ar metabo lism. The use of sil ymar in by healt hy peop le can increase by as much as oneth ir d t he liver 's cont ent of glutat hio ne, a key subst ance in det ox ify ing many pot ent ially damaging horm ones, chemica ls, and d rugs. Ext ract s of silym arin appear t o neutr alize to x ins fro m th e death cup mu shroom , w hi ch can infli ct leth al inju ry on th e live r. Mi lk thistl e also is beli eved to ease out bre aks of psor iasis, since th ese may w o rsen w hen th e li ver fa ils to neutr alize cert ain toxi ns t hat circul ate in t he bloodst ream. TARGET AILME N TS

Take milk t hi stl e int ern ally fo r: ♦ liver prob lems, in cl ud ing c irr hosis and hepatit is. + inflam matio n of th e gall bladder du ct. ♦ po isoni ng from ingesti on of th e death cup m ushroom. + psorias is. PREPARATI ONS Ove r the counter:

Ava ilable in dri ed bulk , capsules, extr act. At hom e:

Tea: Steep 1 tsp fr eshl y gro und seeds in 1 cup bo il ing w ater for 10 t o 15 min utes, and drink thre e tim es daily. As an alternat ive to tea, eat 1 t sp of th e fr eshly grou nd seeds. Milk thistl e extr act may be more eff ectiv e than t eas, since silym arin is only slightly solubl e in w at er. See an herbalist fo r furth er inform ati on.

D RUG CLASS

Co rti costero ids LATIN NAME

BRAND NAM E

Viscum album

Eloco n

G ENERAL DESCR IPTI ON

G ENERA L DESCRI PTI ON

M istleto e was sacr ed t o th e Celti c Dru ids of Europe, who depend ed o n thi s parasit ic, evergreen plant , found o n th e br anches of deciduous tr ees, t o guard t hem fro m ev il . Today mi stl et oe is w idely know n as part of a Chri stm as kissing ri tu al. There is a great deal of co ntro versy co ncernin g mi stl et oe's medi cinal va lue. A lth ough th e leaves are reput ed to be an effec ti ve remedy fo r high bloo d pressure, th e U .S. Food and Dr ug Ad mini strati on has labeled thi s herb " unsafe" and does not approv e of its use in tr eat ing any illn esses. The acti ve co nstitu ent s responsibl e for mi stl etoe's tox icity are prote ins ca lled v iscot ox ins, w hi ch slow and weaken th e heartb eat and constr ict bloo d vessels. Mistl etoe is believed to be a poisonous plant, to be used, if at all, only under th e supervision of a health care professional.

M omet asone fu roat e is a topi ca l co rt icost eroid , co mm only used for th e tempor ary relief of infl amm ation and itchiness associat ed w it h var ious comm on skin d iseases. The drug is ava il able in cream, loti on, or o intm ent form and, w hen used sparin gly fo r a bri ef peri od, has minim al side eff ect s. See Corticosteroids for more info rmati on. SPECIA L IN FORMAT ION ♦

Do not use momet asone furo ate if you are sensiti ve to this dru g or t o oth er co rt icostero ids. + Mom et asone f uroat e should not be used fo r tr eat ing acne, rosacea, or perior al derm at it is (lesions aroun d th e mo ut h and on th e chin). ♦ Do not use t hi s medi cation near your eyes; do ing so can cause a num ber of prob lems, includ ing glauco ma or cat aract s w ith pro longed use. + Unl ess your doctor advises oth erw ise, do not cover tr eated skin with a plasti c bandage or oth er occlusiv e dr essing.

TARGET AI LMEN TS

+ hi gh bl ood pr essure, cance r. (In co njun ct ion w ith conve nti o nal med ical t reat ment .)

POSS I BLE I NTERACT

PREPARATI ONS

Home remed ies using mi stl et oe are not reco mm ended. Chec k w ith an herb ali st fo r ot her herb s th at serv e t he same fun cti ons. SIDE

GI

I ONS

Non e expect ed.

MONOAMINE OXIDASE (MAO) INHIBITORS

EFFECTS

Serious:

Sympt oms of t ox ic it y includ e nausea, vo mitin g, d iarrh ea, headache, decre ased heart rat e, hallu c ination s, mu scle spasms, and co nvul sio ns.

~

'lJ

G ENERIC NAM ES

isocarboxaz id, phenelzine, tr anylcy promin e

SPECIA L IN FO RMA TI ON ♦

WA RNING : Mi stleto e is a po isonous her b, pot enti ally fatal . You should not t ake it unl ess instructed to do so by a health care professional .

0

Prescri ption Drug

0

O ver-the Counter Dru g

G ENERA L DESCR IPTI ON

MAO inhibi to rs, a subclass of antid epressant dru gs, are generally used w hen other medicati ons have failed . They are

O

Western Herb

0

Chinese Herb

A Remedy Homeopathi c V

g 77

CONVENTIONAL

AND

NATURAL

believed to work by stopping th e breakdow n of neurotransmitters in th e brain , all ow ing these che mic als to maintain normal brai n function. MAO inhibitors require more supervision by your doctor th an do most drugs because they are known t o have many side effec t s and adve rse intera cti ons with other drugs and even foods; th ey are not consid ered to be drugs of first choi ce in treating depression. For informati on about spec ifi c MA O inhibit ors, see the entries for the generi c dru gs list ed above; fo r information abo ut other antidepressant medications , see Antidepressants. TARGET AILMENTS ♦ major depre ssion, especially if th e co nditi o n has not responded to ot her drugs. • panic disorder (especially phenel z ine). ♦ pr evention of vascular headach e (includin g mi gra ine) o r tension headache. SIDE

EFFECTS

Not serious: Mild restl essness, insomni a, headache, shakin ess or trembling , dizziness , wea kness, blurred vision, drowsiness, decreased sexual ability , increased appetite , carbohydrate craving, weight gain or loss. Let you r doct or know if these symptoms are bothersome. (Some of these effec ts may be all eviated if your doctor low ers the dosage.)

ID

Serious: Severe blood pr essure changes, severe dizziness or lighth eadedness when chang ing position . Infrequ entl y: skin rash or bruising, diarrhea , swelling of lowe r body , excessive stimulation (po unding heartbeat , unu sual exc it ement, ner vo usness). Rarely: ye llo w skin , fever, sore throat, Parkinson's-like symptoms (slurr ed speech, diffi cu lty w alking). Call yo ur doctor imm ediatel y. Seek med ical help imm ed iate ly if yo u expe ri ence severe headach e, palpit ation s, or neck stiffn ess or sorene ss while taking MAO inhibitors. These could be signs of ove rdose. SPECIAL INF ORMA TI ON • Let your doctor know if yo u have diabetes, epilepsy, hyperthyroidism , or mani c or suicidal tend encies, or if yo u have had a strok e. ♦ MAO inhibitor s may suppress heart pain , thereby masking heart problems. Let your doctor know if yo u have any history of angina or other heart disease. ♦ MAO inhibitor s react with man y drug s and foods. Follo w ing are some of th e substan ces you should avoid when t aki ng th ese dru gs: high-pr otein

978

MEDICINES

foods th at are aged, fermented , or pickled , including (but not limit ed to ) aged or processed cheeses; sour cream; alco hol, especially wine and beer (includin g alcoho l-fre e wine and beer); pickled fish; dry sausages (salami) ; soy sauce; bean cu rd ; yogurt; liv er; f igs; raisins; bananas; avocados; choco lat e; papaya; meat t enderi zers; and fava beans. Also avo id caffe in e. WARN! NG: This is on ly a parti al list. Talk to your doctor and pharmacist abou t other drugs and foods yo u sho uld avo id . • The full eff ects of MAO inhibitors may not be seen until after severa l weeks of ther apy. ♦ Use the se dru gs durin g pr egnancy o r breast-feeding only if your doctor says that th e benefits outweigh the risks. POSSIBLE

INTERACTIONS

Amphetamines and other stimulant drugs (including prescription and OTC cold or hay fever products): can cause a seri ous rise in blood pressure. Anticoagulants (such as warfarin): increased anticoagulant effect. Antihistamines: incr eased action of MAO inhibit o rs. Taking these drugs with MA O inhibit ors may increase the side effects of antihistamines , espec iall y drowsiness. Report any gastrointestinal probl ems t o your doctor imm ediate ly; th ey co uld be signs of paralytic ileu s (lack of int estinal activity), which requir es emergency tr eatment. Caffeine: severe heart-rh ythm prob lems or hi gh blo od pressure. Drugs: MAO inhibitors are known to interact with many dru gs and may interact w ith ot hers. Contact yo ur doctor and pharm acist before takin g any drug (prescription or OTC ) w hil e yo u are taking MAO inhibit ors . Also tell your doctor about any medication you tak e one or two wee ks before you st art MA O th erapy and one or two weeks after yo u stop. Food: see Special Information , left. Other antidepressants: taking these with or wit hin a week of taking MAO inhibitor s may cause an additiv e effect for either drug or both, possibly leading to serious side effec ts, includin g severe convulsions, changes in psychological states, severe hypert ension, coma, and death. Sedatives, including alcohol and barbiturates: high leve ls of sedation , very low blood pressure, possibly death .

MUGWORT LEAF

LATIN NAME

Artemisia argyi (or A. vulgaris) GENERAL DESCRIPTION The aromatic mugwort leaf is prescribed for a range of gyneco logica l problems . In China, mugw o rt is harv ested at t he end of spring or in earl y summe r, w hen the leaves are grow ing vigorous ly but flowers have not yet bloom ed. Traditional Chinese med icin e cha ract er izes the herb as bitter , acrid , and wa rm . The best leaves are grayish w hit e in co lor, w ith a thick, hairy t extur e. TARGET AILMENTS • excessive menstru al bleeding, menstru al cra mps, uterine bleeding , vaginal pain and bleeding during pregnancy, threatened mi scar ri age. (Take intern ally.) PREPARATI ONS Mu gwort leaves are available in bulk at Chinese pharmacies , Asian markets, and some Western health food stores. The herb is also avai labl e in pills . The dried, aged, powdere d herb can be ro lled int o a cigar -like cyl inder, using tissue paper; one end is burned near the sit e of an injury t o increase blood cir culat ion and relieve pain. Acupuncturists sometim es use thi s technique instead of inserting needles.

Comb inations: A mi xt ur e w ith gelatin is prescribed for vagina l bleeding and pain during pregnancy, o r spotting betwee n periods. Co mbinin g mugwort with dried ginger targets menstrua l pain. And a preparation of mugwort leaves and kochia fruit is app li ed to itching lesions o n the skin. For information on dosages and other preparations, check w ith an herba l practitioner. SIDE

EFFECTS

None expected. SPECIAL INFORMA TI ON ♦ Crushed fresh mugwort leaves were placed over warts in a clinical trial; some of the warts fel I off w ith in 10 days. • The herb seems to indi cat e an antibiotic effec t in test-tube studi es.

MULLEIN

LATIN NAME

Verbascum thapsus GENERAL DESCRIPTION Mullein, a co mmon roads ide wildflower that may reach six feet in height , has large, velvety leaves and small, dense, ye llo w flowers. Owing to its astrin gent or binding actio n on tissue, it is usefu l in treating diarrhea and hemorrhoid s. As an expector ant , it helps the body remov e excess mucus fr om th e lun gs and is used to tr eat bronchitis and coughs. The dried leaves, flowers , and roots all serve as remedies. TARGET AILMENTS Take int ern ally for: ♦ respir ato ry co ndition s such as bronchitis, coug hs, colds, flu, asthma; gastroint estinal ailments such as stomach cramps , diarrhea. App ly externally for: ♦ external ulcers, tum ors, hemorrh o ids. ♦ ear probl ems. PREPARATIONS Over the counter: Mu llein is available as tinctures and as dried leaves, flowers , or roo t s.

At home: Tea: Steep 1 to 2 tsp dried leaves, flowers, or roots per cup of boiling water for 10 to 15 minutes. Drink as many as 3 cups a day.

Comp ress: Make a tea using vinegar, all ow to coo l; soak dry bandages in the tea, and apply to ulcers , tumors , or hemorrhoid s. Inhalant : Boil fresh leaves in water and inhale the steam to relieve coughs and co ngestion. Combin ations: Used w ith elder and red c lover to ease painful coug hing. Mixed w ith gumw eed for asthma. Used as an ext ract in o live oil to app ly to external ulcers , hemo rrhoids , and tumors, and fo r ear problems. It also comb ines we ll w ith w hit e hor ehound , co lt sfoot , and lobelia for treating bron chit is.

taking thi s herb internally , since the tann in fou nd in m ull ein is thought to have cancer-causing act ions. ♦ WARN ! NG: Although the leaves, flowers, and roots seem to cause no adverse effects, mullein seeds are toxic. ♦ WARN! NG: Do not take mulle in if yo u are pregnant or nur sing a baby.

bark of several species of shrub s native to northeast Africa and Arabia. The oil hard ens into teardrop-shaped nuggets, called gum resin, w hich is powdered to make the healin g herb. Myrrh fi ghts infection by stimul atin g production of w hit e blood cells and by a direct antiba cteria l action. Thi s herb was used in biblical times for embalm ing, making perfume, and repellin g insects and is still used as a fragrance in soaps, cosmetics , and perfumes.

MUPIROCIN TARGET AILMENTS ♦ mouth and thro at infections , gum disease, pharyngitis. (Use as a mouth wash or gargle.) ♦ sinu siti s, asthma, chest congestion , co ughs, colds, boils. (Take int ernally.) ♦ wounds, abrasions. (Apply extern ally.)

DRUG CLASS Ant ibiotics [Topica l Antibiotics] BRAND NAME Bactroban

PREPARATIONS Over the counter: Myrrh is availabl e as tinctures and as an ingr edient in commercial toothp astes. A powder ed herb is made from t he resin.

GENERAL DESCRIPTION Mupirocin is used to tre at impetigo , a skin infection caused by cert ain strains of Staphylococcus and Streptococcus bacter ia. Thi s drug sho uld not be applied to the eyes or mu co us membranes. For side effects and ot her info rmation , see Topical Antibiotics.

At home: Mouthwash : Steep 1 tsp powdered herb and 1 t sp boric acid in 1 pt boiling wa ter . Let stand 30 minut es and strain; use when coo l.

Tea: Steep 1 to 2 tsp powdered herb per cup of boiling water for 10 to 15 minut es. Drink three times a day.

MUSCLERELAXANTS

Combin ations: With distilled witch hazel, app lied externa lly. SIDE

GEN ERAL DESCRIPTION Muscle rel axants are a class of drugs th at block messages from skeletal muscles to the brain. Some of these medications act at the site of the muscle, w hile others act at the brain or brainstem. They usually work by int erfer ing with the body's response to var ious chemicals that tran smit electri cal impulses from the muscl es to t he brain. Drugs in this class are used for pain relief and for relaxing muscles in preparation for surgery. For information on specific muscle relaxants , see Carisoprodol and Cyclobenzaprine; for infor mation on another drug th at is used for this purpose, see Diazepam.

Serious: Large amounts may have violent laxative acti on and may cause sweat ing, nausea, vo mitin g, kidney problems , or accelerated heartbeat. Discontinu e use and ca ll your doctor. SPECIAL INFORMATION ♦ WARN! NG: Any resin tends to be difficult to eliminate and can cause minor damage to th e kidneys if taken internally for ext ended periods. Consult your physi cian or herb ali st before using if yo u are pregnant or nur sing, or have kidney disease. Do not exceed recommended doses and do not give to childr en younger th an two years old. • Preliminary studies indicate myrrh may prevent heart disease by reducing cho lest erol and preventing the formation of blo od clots .

S I DE EFFECTS

Not serious: You may expe rien ce mild sto mach upset o r diarrh ea. Use less mull ein or disco ntinue using it altogeth er; co nsult your doctor w hen co nve ni ent. SPECIAL INFORMAT ION • WARNING: If you have a history of cancer, co nsult your doctor befo re

Cl

EFFECTS

Not serious: Myrrh may cause stomach upset or diarrh ea. Use a smaller amount less frequentl y, or stop using.

MYRRH

LATIN NAME

Commiphora mo/mo/ GENERAL DESCRIPTION Myrrh is a pale-yellow oil fo und in th e

0

Prescription Dru g

0

Over-theCounter D rug

O

Western H erb

O

Chinese He rb

Homeopathic Remedy

g

79

CONVENTIONAL

AND

NATURAL

§1

NABUMETONE

NAPROXEN

DRUG CLASS

DRUG CLASS

Analgesics [Nonsteroid al AntiInfl ammatory Drugs (N SAIDs)]

Analgesics [Nonsteroidal AntiInflammatory Drugs (NSAI Ds)]

BRAND NAME

BRAND NAMES

Relafen

Nat mur is availabl e over the counter in various potencies , both in liquid and in tablet form. Consult a homeop athi c physician for more information. SIDE

EFFECTS

None expected.

Rx: Anaprox DS, Napcalen, Naprosyn

Introduced in 1984, nabumetone may be prescribed for the treatment of rheumatoid arthritis and osteoarthritis. Since it is a prodrug-a type of medication that exhibits pharmaceutical action only after the body changes it to another form-nabumetone must be metabo1 ized by the liver to become effective. For information about side effects and other possible drug interactions , see

Nonsteroidal Anti-Inflammatory (NSA/Ds). POSSIBLE

PREPARATIONS

OTC: Aleve

GENERALDESCRIPTION

INTERACTION

S

Tricyclic antidepressants (such as amitriptyline): decreas ed effects of these drugs.

NADOLOL

Made available in the 1990s, naproxen is used to treat rheumatoid arthritis and osteoarthritis. Like other NSAI Ds, this drug is used to relieve muscle , joint , and menstrual pain and to reduce fever. See Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) for further information.

§1

DRUG CLASS Beta-Adrenergic Block ers

BRAND NAME Corgard

GENERALDESCRIPTION Introduced in 1976 , nadolol is a nonselect ive beta-blocking drug commonly pr escribed in the management of high blood pressure (hypertension) and angina. By blocking the action of certain parts of the nervous system, the drug reduces the oxygen requirements and contraction force of the heart while also relax ing blood vessels, thereby lowering blood pressure and easing the work load of the heart. See Beta-Adrenergic Blockers for information about side effects and possible drug int eractions.

NEOMYCIN

DRUG CLASS Antibiotics

[Topical Antibiotics]

BRAND NAME Neosporin

GENERALDESCRIPTION

NATRUMMURIATICUM

Benzodiazepines (such as chlordiazepoxide, diazepam, and oxazepam): decreased effects of these drugs .

m

GENERALDESCRIPTION

Drugs

Antipsychotic drugs (such as chlorpromazine and clozapine): decreased effects of these drugs.

980

MEDICINES

LATINNAME Natrum muriaticum

GENERALDESCRIPTION Natrum muriaticum is simply salt, or sodium chloride, a substance present in th e natural world in quantities greater than any other except water. Essential to life and health , salt has been valued in hum an commerce throughout history . Roman soldiers were given a stipend, called a salarium, which they used to buy salt; from this we get the word "sa lary. " Homeopaths prescribe dilute solutions of Nat mur, as they call it, for conditions that are coupled with symptoms of extreme thirst, emotional sensitivity , and a strong desire for salt. Nat mur is prepared by adding pure sodium chloride to boiling water. Once the salt has dissolved, the solution is filtered and crystallized by evaporation. The final product is diluted in water to the desired potency. For more information on homeopathic medicine, see page 1027.

Neomycin is an aminoglycoside, an antibiotic with a broad spectrum of activity and effect iveness. In oral forms the drug can be used to treat gastrointestinal inf ections , although it is rarely given orally because of the high risk of kidney and hearing damage. Neomycin is available over the counter as a topical ointment by itself , or in combination with polymyxin B and bacitracin. This combination is used on the skin to prevent infections in minor cuts, scrapes, and burns . For side effects and other information, see Topical Antibiotics. POSSIBLE

INTERACTIONS

Other aminoglycosides: possibl e hyp ersensitivity reaction and toxicity leading to permanent deafness.

NEOMYCIN, POLYMYXINB, AND HYDROCORTISONE

§1

DRUG CLASS Antibiotics

[Topical Antibiotics]

GENERALDESCRIPTION TARGETAILMENTS ♦

backaches that are relieved by firm pressure; cold sores, especially in the corners of the mouth ; colds with sneezing, watery eyes, and runny nose; constipation; fevers accompanied by weakness and chills; genital herpes; eczema; anemia; hay fever; migraine headaches; menstrual irregularity; indigestion; depression caused by grief, with a desire to be alone.

This steroid-antibiotic combination is used to treat bacterial infections of the external ear canal. Other forms are used to treat inflammation of th e skin or eyes where bacterial infection exists or is likely to occur. Don 't use this drug in your ears if your eardrum is ruptured , and don't use it at all if you are sensitive to any of the ingredients. For side effects and other information, see Hydrocortisone and Topical Antibiotics.

CONVENTIONAL

1

SPECIALINFORMATION + Do not use this co mbi nation if you are allergic to any of the component drugs , or if you have a fungal, v ir al, or herpes simplex infe ction.

NETTLE

AND

+ WARNING : Nettle is a diuretic, and it may th erefore remo ve potassium from th e body. If you use it frequently, eat foods high in pot assium , such as bananas and fresh vegetables. ♦ Do not give nettle to children you nger than two years o ld. + To harvest , wear gloves, long sleeves, and long pants to avoid nettle's stin g. + Do not take large doses of nettle if you are pr egnant.

♦ ♦

♦

LATINNAME

Urtica dioica

♦

NICOTINE

GENERALDESCRIPTION Notorious for the stinging needles along its leaves, nettle can be safely ingested when th e irritant is tamed by boilin g or drying. A tonic made from the leaves and stems is said to strengthen the body. Herbali sts consider nett le a diuretic capable of removing toxins, and its iron . and vitamin C may help prevent anemia. Nettle has an erect stem and serrated, dark-green , heart-sh aped leaves.

TARGETAILMENTS Take int ernally for: + arthritis, gout, hay fever, premenstrual syndrome, vaginal yeast infe ct ions, excessive menstru al flow, hemorrhoids , ecze ma, di ar rhea, chronic cystitis. Use int ern ally only und er the supervision of a physician for: + hi gh blood pressur e, congestive heart failure.

DRUG CLASS

BRAND NAMES Rx: Habitrol , Nicotrol , Zyban OTC: Nicod erm , Nicorett e, Nicotrol

QD

♦

GENERALDESCRIPTION Nicotine transdermal (skin) patches are designed to release a specific amount of nicotine through the skin and into the bloodstream every 24 hours. Nicotine gum and inhal ers can be used as needed. The dru g allows gradual nicotine withdrawal for people who want to stop smoking but find abrupt cessation dif~icult and physically painful. See Smokmg Cessation Drugs for additional information .

PREPARATIONS Over the counter:

TARGETAILMENTS

Nettle is ava ilable as tinctures, capsules, and dried leaves and stems.

♦

At home: Tea: Steep 1 to 2 tsp dri ed herb in 1 cup boilin g water for 10 minutes. Drink up to 2 cups a day. Juice: Add 2 tsp juice squeezed from nettle to a fresh vegetable or fruit drink. Combinations: Nettle co mbines well w ith figwort and burdo ck to treat ecze ma; take orally as juice or tea. SIDE

EFFECTS

Not serious: Large do ses of nett le tea . may cause . stoma ch irrit ation, constIpatIon, burnmg skin, or urinary suppression. Stop taking the herb and call your doctor.

SPECIAL INFORMATION + WARNING: Do not use uncook ed nettle. To do so may cause kidney damage and other symptoms of poisonin g.

+

Smoking Cessation Drugs

♦

♦

♦

EFFECTS

DRUG CLASS

BRAND NAMES Adalat , Procardia XL

GENERALDESCRIPTION Used since 1972 to control high blood pressure, nifedipine inhibits the passage of calcium into certain body cells, retarding electrical stimulation of the heart, dilating the arteries, and slowing contraction of the heart and arteries. Nifedipine

+ In order for nicotine repl acement drugs to be safe and effective, stop smoking completely at th e beginning of treatment. + Extremely high doses of ni cotine can

Over-theCounter Drug

Cl

Calcium Channel Blockers

SPECIALINFORMATION

0

INTERACTIONS

NIFEDIPINE

Serious: Chest pain, irr egular heartbeat , allergic reactions (hives, rash, swelling) . Check with your doctor. Also see signs of overdose below.

Prescription Drug

produce toxic symptoms, even in heavy smokers ; ni cotine overdose can be fatal. Do not use mor e than one form of nicotine at one time. Call your doctor immediately if you have any of the fo llo wi ng symptoms of toxic overdos e: nausea, vomiting, abdominal cramps, diarrhea , dizziness, sweating, hearing or vision problems, confusion, weakness. Nicotine repla cement products should not be used by nonsmokers or others who are not addicted to the drug. Do not use this drug if you have had an allergic reaction to it befor e. Consult your doctor if you have angina or an abnormal heart rhythm; have had a recent heart attack; or are pregnant, planning pr egnancy, or nursing. Tell your doctor if you have diabetes, high blood pressure, skin disease, overactive thyroid, adrenaline-producing tumors , peptic ulcer, or liver or kidney disease, or if you get rashes from adhesive bandages or tape. Tell your doctor what other medications you take: Changes in nicotine levels may requir e dosage adjustments for other drugs, especially those affecting the nervous system. Nicotine can be very harmful to childr en and pets. Be sure to dispose of used patches carefully. Do not use nicotine replacem ent drugs for more than 12 to 20 weeks (depending on the system) if you have stopped smoking. Continued use can be harmful and addictive. POSSIBLE

Not serious: Mild , temporary irritation (redness, tingling, itchiness) at the patch site, fast heartbeat, increased appetite , mild headache, irritability, nervousness, coughing, dry mouth , mild dizziness or lightheadedness, muscle or joint pain , unusual dr eams. Call your doctor if these symptoms persist or are bothersom e.

0

MEDICINES

Bronchodilators, insulin, propoxyphene, and propranolol and other betaadrenergic blockers: you may need decreased amounts of these drugs with smokin g cessation.

smoking cessation. nicotine withdrawal. SIDE

NATURAL

O

Western Herb

0

Chinese Herb

A Homeopathic

~ Remedy

981

•

I

CONVENTIONAL

AND

NATURAL

is used to treat mild-to -moderat e high blood pressure (hypert ension) and to prevent angina. It is also sometimes used to treat Raynaud's syndrome . Recent findings have prompted warnings from healthcare professionals about the safety of nifedipin e, especially when t aken in large doses of the short-acting form. Before using this drug , be sure to discuss this matter thorou ghly with your doctor . If you are already taking nifedipin e, do not stop the medi cation without fir st consulting your doctor. See Calcium Channel Blockers for information on side effects and drug int eractions.

MEDICINES

ately if you experience any of th e following symptoms while using th ese drugs: blurred vision; severe or prolong ed headache; feelings of pressure in your head; fever; convulsions; dizziness or fainting; weakness or change in heartbe at ; bluish ting e to lips, fin gernails, or palms of hands; a skin rash not from an ointment or patch . SPECIAL INFORMATION ♦

•

NITRATES

§1

•

GENERIC NAMES

isosorbide dinitrate, isosorbide monotrat e, nitroglycerin GENERAL DESCRIPTION

Used for decades to relieve chest pain associated with angina, nitrates relax and dilate the muscles of blood vessels. This dilation , which mostly aff ects the veins, relieves pressure on th e heart by reducing its work load and its need for oxygen. In most cases, dilation also lowers blood pressure, especially systolic. Nitr at es come in a variety of forms; your medical condition will determine which form you receive. For example, sublingual tablets (tho se that are dissolved under the tongue ) and chewable tablets , both of which are fast acting, are prescribed for the treatment of acute angina. Standard pill s and skin pat ches are commonly used to prevent angina attacks. Other uses of nitrates includ e the treatment of some kinds of co ngestive heart failure. TARGET A ILMENTS ♦

acute angina pectoris. chronic angina pectoris. ♦ hyp ert ension (nitro glycerin ). ♦ congestive heart failure. ♦ heart attack (adjunct treatment). ♦

SIDE

EFFECTS

Not serious:

Headaches and lightheadedness when changing position (orthostatic hypotension ), flushing of the face and neck , nausea or vomiting, restlessness, fast heartbeat. Call your doctor if these persist or become troublesom e. Serious:

In rare cases, nitrates may cause serious side effects. Call your doctor imm edi-

982

• ♦

♦

The safety of nitrates has not been established for pregnant or nursing women or for children; consult your doctor before using these drugs. Standard oral dosages should be taken on an empty stomach (either one hour before or two hours after meals) and with a full glass of water. This will improve absorption of the drug . Toleran ce to nitrates may occur, requiring an adjustment (increase) of dosage over time to achieve the same therapeutic result. If tolerance becomes a problem for you, your doctor may advise that you take this medication int ermittently , with a medicationfr ee period each day. How ever, intermittent therapy can be don e only so long as symptoms are under control and your doctor orders it. Discontinuation should be gradual to prevent rebound symptoms of angina. Tell your doctor if you have severe anemia, recent head trauma , glaucoma, an overactive thyroid , or a digestiv e absorption problem. Your doctor may decide not to use nitrates or to give you a smaller dose. Nitr at es may cause th e Zl atkis-Z ak cholest erol test to show a lower -thanactual cholesterol level . POSSIBLE

I NTERACTIONS

Alcohol: increased risk of orthostatic

hypotension; do not drink while using nitrates . Norepinephrine and histamine: de-

creased action of these medications. Other cardiovascular medicines (including beta blockers, vasodilators, and other nitrates): use these drugs only under

your doctor's direction; combining them with nitrates may cause a lowering of blood pressure and other side effects. Stimulants (such as amphetamines, pseudoephedrine): decreased action of nitrates.

NITROFURANTOIN

DRUG CLASS

Antibioti cs BRAND NAMES

Macrobid , Macrodantin GENERAL DESCRIPTION

Used since 1953 to treat urina ry tract infections, nitrofurantoin is a synthetic, broad-spectrum antibacterial agent. Its mode of action, unique among antibacterials, is to react chemically with bacterial enzymes, producing new substances that inactivate or alter vit al prot eins in the organism. Depending on the concentration of nitrofurantoin used, these changes either kill the organism outright or retard its growth . Because of its mode of action , bacterial resistance to this drug is rare. Use of nitrofurantoin is limited to the prevention and treatment of urinary tract infections caused by susceptible bacteria , including f . coli and some species of Enterococci and Staphylococci. Nitrofurantoin does have potentially serious side effects that may require discontinuation of the drug. TARGET AILMENTS ♦

urinary tract infections (prevention and treatment). SIDE

EFFECTS

Not serious:

Gastrointestinal upset (stomach pain, diarrhea, or nausea). Let your doctor know if these symptoms become troublesome. (A rusty or brownish color in th e urine does not require a doctor's attention.) Serious:

Pneumonitis (pneumonia symptoms , such as fever, cough, chest pain, difficulty in breathing) . Less frequently: blood problems , such as reduced white cell count (manifested as sore throat and fever) ; tiredness or weakness; dizziness, drowsiness, headache; nerve prob lems (numbness, tingling, a burning sensation in the face or mouth); unusual muscle weakness. Rarely: allergi c react ions, such as skin rash; pale skin; unusual tiredness or weakness; liver problems (jaundice). Call your doctor immediately if you experience any of these symptoms . SPECIAL INFORMATION ♦

Take this medication with food or milk to reduce possible gastrointestinal effects. ♦ Nitrofurantoin should not be used by

I

CONVENTIONAL

♦

♦

•

♦

women who are pregnant and near term or at delivery , or by women who are nursing. The drug can cross the placent a and affect the fetus. It also can enter breast milk in small amounts , possibly causing anemia in breast-feeding infants. Caution is advised for use during early pregnancy. Consult your doctor. Do not give nitrofur antoin to infant s less than one month old; th e drug may cause anemia. Nitrofur antoin may exacerbate peripheral neuropathy (a tingling sensation caused by a nervous system disorder), especially if you have G6PD deficiency (glucose enzyme), lung disease, or kidney problems. Antibiotics kill not only harmful bact eria but also "good" bact eria that keep unwanted fungi and intestinal organisms in check. Eating yogurt containing Lactobacillus acidophilus culture (or taking acidophilus tablet s) may help restore normal bacteria. Prolonged use of any antibiotic can lead to fungal infections , including candidiasis, or to bacterial infections such as pseudomembranous colitis. POSSIBLE

INT ERACTIONS

Nitrofurantoin may interact with a numb er of drugs that affect th e blood , liver, or nervous system. Consult your do cto r before taking any medi cation with nitrofurantoin. Anticholinergic (atropine-like) drugs: increased nitrofurantoin effect. Magnesium trisilicate antacids: redu ced nitrofurantoin effect. Nalidixic acid and quinolones: nitrofu rantoin int erf eres with the action of th ese drugs. Probenecid and sulfinpyrazone (antigout): increased levels and effectiveness of nitrofurantoin; risk of nitrofurantoin toxicity.

NITROGLYCERIN

DRUG CLASS Ni t rates BRAND NAMES Minitran , Nitro-Dur , Nitrostat , Transderm-Nitro GENERAL DESCRIPTION Since 1847, nitroglycerin has been prescribed for cardiovascular disease. The drug is most commonly used to provide

AND

effective relief of acute chest pain. It is also offered as a pr eventiv e treatment for angina attacks and as a complement ary treatment for congestive heart failure and heart attack. Nitroglycerin comes in a variety of forms; each is prescribed acco rdin g to its therapeutic use. For fast action, sub1ingual tablets (those that are dissolved under the tongu e) or a spray form may be used. For lon g-term ther apy, your doctor may prescribe standard tablets , ointment, or skin patch es. See Nitrates for information about other side effects and possible drug interactions. SIDE

POSSIBLE

Antacids containing aluminum and magnesium hydroxide: reduced effects of nizatidine; avoid taking antacids within two hours of taking nizatidine.

SPECIAL INFORMATION Keep sublingual tablets in the original cont ainer. Aft er each use, replace the cap tightly to prevent loss of the drug 's potency.

Aspirin: increased effect of aspirin if large doses of aspirin are being taken. Enteric-coated tablets: changes in stomach acidity, causing these medications to dissolve prematurely in the stomach; avoid taking enteric-coated drugs with nizatidine. Ketoconazole: increased ketoconazol e effect.

NIZATIDINE

DRUG CLASS Antiulcer Drugs [Histamine H2 Blockers]

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAID s)

BRAND NAME Axid GENERAL DESCRIPTION Nizatidine is used primarily to treat ulcers of the stomach and duodenum (upper intestine). It is also pr escribed for Zollinger-Ellison syndrome, gastroesophageal reflux (in which stomach acid flows backward into the esophagus), and other conditions involving the overproduction of stomach acid. In some cases, nizatidine is used to prevent upp er gastrointestinal bleeding . Belonging to the subclass of antiulcer drugs known as histamine H2 block ers, nizatidine works by blocking the effects of the chemical compound histamine in the stomach, thereby reducing the secretion of the digestive juice hydrochloric acid. For mor e information on side effects , possible drug interactions, and special information, see Antiulcer Drugs.

GENERIC NAMES Rx: diclofenac , etodolac, flurb iprofen, ibuprofen , ketorolac, nabumetone , naproxen, oxaprozin ; celecoxib, rofecoxib (Cox-2 Inhibitors) OTC: ibuprofen, naproxen

GENERAL DESCRIPTION NSAI Ds are nonnarcotic analgesic drugs that reduce inflammation , especia lly from arthritis. These drugs are used by people who cannot take aspirin , or when aspirin or acetaminophen is not effective. In addition to reducing inflammation , NSAI Ds reliev e pain and reduce fever. For mor e information, see the entries for the generic drugs listed above. TARGET AILMENTS ♦ inflammation , especially related to osteoarthritis and rheumatoid arthritis. ♦ pain , especially from inflammation , dental and other surgeries, menstruation , migraines. • fever.

EFFECTS

Not serious: Drowsiness and increased sweating. Call your doctor if these symptoms persist or become bothersome.

Prescription D rug

INTERACTIONS

Alcohol, tobacco: increased stomach acidity , leading to decreased effectiveness of nizatidine.

EFFECTS

♦

0

MEDICINES

SPECIAL INFORMATION • Inform your doctor if you have a hist ory of kidney or liver disease or are taking large doses of aspirin. ♦ If you are also using antacids for relief from ulcer pain, take th e antacid at least two hours before or afte r taking nizatidine . ♦ If this drug causes dizziness or drowsine ss, restrict your driving or your involv ement in other potentially hazardous activities.

Not serious: Local skin irritation near application site of ointm ent or tr ansdermal patch.

SIDE

NATURAL

0

O ver-theCounter D rug

O

Western Herb

0

Chinese Herb

/2:.. Ho meopathic

~ Remedy

gS

3

CONVENTIONAL

SIDE

AND

NATURAL

EFFECTS

MEDICINES

Beta-adrenergic blockers: decreased

Not serious:

antihypert ensive effect.

Dizziness , drowsiness , headach e, abd?min al pain or cramps, constipation, diarrh ea, heartburn , nausea. Consult your doctor if these symptoms persist.

Cimetidine: may incr ease or decrease the effect of the NSAI D.

Serious: Anaphylactic reaction (hives, rash, intense itching, and trouble breathing). Seek emergency help. Discontinue use and call your doctor imm ed iately if you notice any of the following symptoms: chest pain or irregul~r heartbeat; diminished hearing or ringing in the ears; trouble breathing; fluid retention; black or tarry stools; blood in urine; photosensitivity ; jaun~ice (indica ted by bleeding, bruising, tiredn ess, tenderness in upper abdome n, and yellow eyes or skin).

NORG ESTIMATE

Colchicine: possibility of bleeding and

DRUG CLASS

ulcers when co mbin ed w ith certain NSAIDs.

Estrogens and Progestin s

Corticosteroids: possibl e bleeding and ulcers. Don't combine unless direct ed by your doctor.

Cyclosporine: increased ri sk of kidn ey damage.

Diuretics: reduced diuretic effect. Methotrexate: increas ed toxicity of methotrexate; possibly fatal poisoning.

Probenecid: increased NSAID effect ' possible NSAI D toxicity.

BRAND NAMES Ortho Tri-Cy clen, Ortho-Cyclen

GENERALDESCRIPTION Norgestimate is a progestin that is combined with an estrogen, such as ethinyl e_s tradiol, for use as an oral contracep~1ve.See.Estrogens and Progestins for 1nformat1on about side effects and possible drug interactions.

Sulfonamides: possible sulfonamide toxicity.

SPECIALINFORMATION • If NSAI Ds upset your stomach, take th em with food or milk. • Do not use NSAI Ds if you are allergic to th em or to aspirin. NSAI Ds may cause bronchoconstriction or anaphylaxis in aspirin-sensitive asthmatics. ♦ Avoid these drugs or consult your doctor before usin g them if you have asthma, peptic ulcer , enteritis (intestinal inflammation) , high blood pressure, bleeding problems, epil epsy, Parkinson's disease, or impair ed liver or kidney function. • Do not take mor e than the recommended dose and seek emergency help 111 case of overdose. Possible symptoms indude drowsiness, increased sweating, rapid heartbeat , abdo minal pain, vomitin g, nausea, gastrointestinal bleeding, and disorientation. • NSAI Ds are not recom mended for pregnant women, especially during the last trimester, or for nursing moth ers. POSSIBLE

INTERACTIONS

Because NSAI Ds interact with many substances, check with your doctor or pharm ac ist before taking in combination with other drugs. NSAI Ds can affect liver and kidney fun ction , thereby increasing the to xicity of other drugs.

Acetaminophen: incr eased risk of ad-

Lo/Ovra l

DRUG CLASS Estrogens and Progestins

BRAND NAMES Loestrin FE, Ortho-Novum , Ovcon

GENERALDESCRIPTION A progestin drug, nor et hindrone is prescribed 111combination with an estrogen as an oral contraceptive. See Estrogens and Progestins for inform at ion about side effects and drug int eract ions.

NORETHINDRONE ACETATE DRUG CLASS

increased action of phenytoin. creased hypoglycemic effect.

Aspirin: increased risk of stomach problems.

NORTRIPTYLINE

DRUG CLASS Antidepressants [Tricyclic Antid epressants (TCAs)]

BRAND NAME Pamelor

BRAND NAMES

GENERALDESCRIPTION

GENERALDESCRIPTION

Antidiabetic drugs and insulin: in-

GENERALDESCRIPTION A progestin used to induce uterine bleeding, norge strel is combined with estro gen as an oral contraceptive. See Estrogens and Progestins for information about si_deeffects and possible drug 111teract1ons.

Estrogens and Progestins

Alcohol: possible bleeding and ulc ers. Antacids: decreased NSAI D effect. coagulant effect, possible bleeding.

Estrogens and Progestins

BRAND NAME

Aygestin, Estrostep 21 , Estrostep FE

Anticonvulsant drugs (phenytoin):

NORGESTREL

DRUG CLASS

NORETHINDRONE

verse liv er or kidn ey effect.

Anticoagulant drugs: increased anti-

984

Verapamil: increased toxicity.

Nore_thindrone acetate is a progestin that 1sused to treat abnormal uterine bleeding or lack of menstruation due to hormonal imbalance. It may also be combined with an estrogen, such as et hinyl estradiol, for use as an oral contrac _eptive. S_eeEstrogens and Progestins for 111format1onabout side effects and possible drug interactions .

In use for three decades, nortriptyline is presc_ribed for tr~atment of primary depression and panic attacks. It is also used in combination with other drugs to manage chronic pain. Like other tricyclic antidepressants, nortriptyline acts to restore normal levels of important brain chemicals such as serotonin and nor ep inephrin e. See Antidepressants for information about side effects and possible drug interactions.

NOTOGINSENG ROOT

LATIN NAME

Panax notoginseng GENERAL DESCRIPTION

Notogins eng root is used to stop bleeding, reduce swe llin g, and all eviate pain from injuri es. Unlike Western med ications , th e root seems to halt th e ble eding without making the blood clot , and to stop the clotting or hematoma with o ut causing bleedin g. Western pr act it ion ers of sport s medicine frequently use thi s herb as a toni c to improve stamin a. The best vari ety is lar ge, solid , and dark brown, with thin skin. Also known as pseudoginsen g roo t (Panax pse udogi nseng), it is grow n in several Chin ese provinces and harvest ed in t he fa ll or winter of th e plant 's third o r seventh year, after th e fruit is rip e. Chinese herbalists classify it as sweet, b itter , and w arm. TARGET AILMENTS

Take int ern ally for: • internal b leedi ng such as nosebleeds and b lood in the stoo l and urine , co ugh ing up blood. Take both int ernally and exte rnall y for: ♦ bleeding from injuri es; swelling and

pain of fractur es; falls; contusion s and sprains, cuts, and gunshot wou nds. PREPARAT IO NS

Notoginsen g root is ava ilable in bulk from Chines e pharm ac ies, Asian markets, and Weste rn health food stores, where it is sold as loo se, dried roots or in the form of tablets . Comb inations: Noto gi nseng can be made into a liniment for swell ing and pain and is includ ed in many inju ry tonics. It is also take n internally to heal injuries, cuts, and even gunshot wounds. A preparation containing notogins eng root and bl etilla root is prescrib ed for vomit ing, and for coughing up blood , nosebleeds , and blood in the urin e. A mixture with dragon bone and gallnut from th e Chinese sumac makes a poultice for bleeding caused by trauma. For inform at io n on appropriate preparat ions and doses, check w ith an herb al practiti one r. SIDE

♦

Powdered notog inseng has been used to treat indi v iduals with coronary arte ry disease w ho compla in primarily of chest pain. Man y seemed to im prove. Some also expe ri enced redu ctions in blood pressure. • In a small study, th e herb appeared to reduce cho lestero l levels. • Notogins eng is sometimes used to treat acute attacks of Crohn 's disease.

SPECIAL INFORMATION ♦ Pregnant wo men should avo id this

It is repo rt ed that in some Midd le Eastern cu ltur es, nutmeg is used in love potions as an aphrodisiac.

NUXVOMICA

LATIN NAME

Nux vomica

NUTMEG

GENERAL DESCRIPTION

Nux vomica , also known as poison nut, is a remedy made from seeds of an evergreen tree indi genous to part s of India , Thai land, China, and Austr alia. The seeds conta in strychnine and have a bitter , unpl easant taste. Small doses of the seed stimul ate the appet it e, w hil e somewhat larger doses decrease th e appetite and cause motor dysfunction , including stiffness in the arm s and legs and a staggered wa lk. Toxic doses can cause co nvu lsions and death. Nux vomica is prescribed by homeopaths for ailments that occur fr om overindulgence in food, coffee, or alco hol , usually acco mpanied by irrit abi lit y. To prepare the hom eopathi c rem edy, poison-nut seeds are ground to a powde r and th en diluted with milk sugar t o the desir ed pot ency. For mo re information on hom eopat hic medici ne, see page 1027.

LATIN NAME

Myristica fragrans GENERAL DESCRIPTION

As early as th e seventh century , Arabs used nutm eg for di gestiv e disorders, kidney problems , and lymph ati c ailments. Today it is used principally as a spice in cooki ng and as a tr eatm ent fo r diarrhea , insom nia, indi gestion , and flatulence. It relaxes muscl es, sedates the body, and helps remov e gas from the digestive tract. Early reports described hal luc inogeni c reactio ns to ingestin g w ho le seeds, but th ese have not been substantiated. Nut meg is native to a province of Indonesi a once known as the Spice Islands, where it is still used as a culinary seasoning and medi c inal herb . It co mes from an evergreen tr ee that produces a fruit called the nutm eg app le. Nutmeg comes from th e nut , which is removed and dried.

TARGET AILMENTS

• colic and stomach cramps brought on by ove reatin g, co lds with sneezing and a stuffy nose, co nstipati on resulting from physical inacti vi t y, cystiti s, headache w ith di zz iness, fevers w ith chill s, gas and gas pains, hangovers, indi gestion , insomni a, irritabl e bowel syndrome , nausea (especiall y morning sic kness), menstru al cramps with a heavy fl ow , sinusitis, stomach flu , vomiting brou ght on by overeating or eatin g rich food s, mi graine headaches with painful vomiting.

TARGET A ILME NTS ♦

d iarrhea , indi gestion , loss of appet it e, co li c, flatul ence, insomni a. (Take internally.)

PREPARATIONS

Nutmeg is available as a powder and tincture. T SIDE

EFFECTS PREPARATIONS

Serious:

Nux vomica is available over the counter in various potencies, in both liquid and tablet form. Consult a homeopathic physician for more precise inform atio n.

• Myristicin, a co mponent of nutmeg, has narcoti c properties. As little as a teaspoon of thi s substan ce can cause toxic symptoms in humans. In gestion of 6 to 12 tsp or 1 to 2 oz of gro und nutm eg can cause prolonged delirium , disorient at ion , and drunkenness.

SIDE

EFFECTS

Notoginseng may cause a mi scarri age in at-risk pregnancies.

herb.

♦

EFFECTS

None expected. SPECIAL I NFORMATION

• WARNING: Women have suff ered toxic reaction s when attempting to use nutme g to induce abortions. It is no longer thought to precipitate abor tion .

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Prescript ion Drug

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Over -theCounter Drug

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Western Herb

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Chinese Herb

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Homeopathic Remedy

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CONVENTIONAL

AND

NATURAL

OFLOXACIN

DRUG CLASS Antibiotics [Fluoroquinolones] BRAND NAME Floxin GENERAL DESCRIPTION Introduced in 1984, ofloxacin is a synthetic fluoroquinolone that shares a wide range of uses with other drugs of its type. In addition to the ailments typically targeted by fluoroquinolones, ofloxacin is used to fight infections caused by Chlamydia trachomatis bacteria. See Fluoroquinolones for more information about uses, side effects, and possible drug interactions. SPECIAL INFORMATION • Take ofloxacin at least two hours before or two hours after taking antacids and similar drugs. POSSIBLE

INTERACTIONS

Theophyllines (asthma drugs): ofloxacin may inhibit metabolism of these drugs , increasing the risk of adverse effects and theophylline toxicity. (Generally, ofloxacin has less effect on theophylline metabolism than ciprofloxacin, another fluoroquinolone drug.)

OMEPRAZOLE

DRUG CLASS Antiulcer Drugs BRAND NAME Prilosec GENERAL DESCRIPTION Omeprazole is used to treat several conditions associated with excessive production of stomach acid, such as ulcers of the stomach and duodenum (first portion of the small intestine), Zollinger-Ellison syndrome, multiple endocrine neoplasia, systemic mastocytosis, gastritis , gastroesophageal reflux (in which stomach acid flows backward into the esophagus), and gastrointestinal symptoms associated with the use of nonsteroidal anti-inflammatory drugs (NSAI Ds) and aspirin. The drug works by inhibiting the action of enzymes in the acid-producing cells of the stomach

986

MEDICINES

lining. For more information on side effects and possible drug int eractions , see Antiulcer Drugs. SIDE

EFFECTS

Not serious : Abdominal or stomach pain , skin rash or itching, headache, heartburn , dizziness, mild drowsiness, unusual tiredness, muscle pain, indigestion and gas, nausea and vomiting, diarrhea or loose stools, constipation. See your doctor if these symptoms persist or become bothersome. Serious: Mouth sores or ulcers, bloody or cloudy urine, difficult or painful urination, frequent urge to urinate, urinary tract infection, sore throat and fever, severe drowsiness , unusual bleeding or bruising, jaundice. If you experience these symptoms, contact your doctor at once. SPECIAL INFORMATION • While being treated with omeprazole, you may use antacids for relief of ulcer pain, but check with your doctor first. • Inform your doctor if you have a history of liver disease, thyroid disease, Addison's disease, Cushing's syndrome, or any type of bone-marrow or blood cell disorder. ♦ Avoid taking omeprazole if you are pregnant or nursing. ♦ This drug may affect the results of some medical tests, including blood glucose levels and liver function tests. Inform the person giving you the test that you are taking this drug. • Because this drug may cause dizziness or drowsiness, you may need to restrict your driving or your involvement in other potentially hazardous activities. POSSIBLE

INTERACTIONS

Alcohol, caffeine, spicy or highly seasoned foods, tobacco: decreased omeprazole effect. Anticoagulants (such as warfarin), diazepam, phenytoin: increased effects of these drugs. Iron, ketoconazole: decreased effects of these drugs.

OPHTHALMIC ANTIBIOTICS GENERIC NAMES erythromycin , tobramycin GENERAL DESCRIPTION Ophthalmic antibiotics, available as ointments or eye drops , fight eye infections caused by bacteria. The generic drugs used in these eye medications may also come in the form of tablets, skin creams, or injectables for treating other, nonocular infections. However, you should never use these forms interchangeably; use each form only for its intended purpose. For more information, see the entries for the generic drugs listed above. TARGET AILMENTS ♦ eye infections due to strains of strep, staph, Hemophilus influenzae, and other bacteria. SIDE

EFFECTS

Not serious: Blurred vision, slight burning, or stinging that occurs momentarily upon each application. Serious: Eye irritation that develops and persists after using these drugs; itching, redness, or swelling. These may indicate an allergy or a superinfection. Discontinue use and call your doctor right away. SPECIAL INFORMATION • Tell your doctor if you have ever had an allergic reaction to these drugs. You may need a different treatment. • Prolonged use of ophthalmic antibiotics may result in a superinfection in the eye, with symptoms of a worsening infection. Discontinue the antibiotic and call your doctor. • Do not use these drugs if you are pregnant or breast-feeding unless they are clearly needed. POSSIBLE

INTERACTIONS

None expected for ophthalmic forms. However, since systemic absorption through the eyes can occur, you should tell your doctor about any other medicine you are using.

♦ Seek emergen cy medi cal care if you

OPIOID ANALGESICS

GENERIC NAMES cod eine, hydrocodone, oxycodon e, propoxyphene GENERAL DESCRIPTION Opioid analgesics are narcotic drugs that act on the central nervous system (the spinal cord and brain) to alter the perception of pain. They are used to treat temporary moderate-to-severe pain and are often combined with nonnarcotic analgesics such as aspirin or acetaminophen. As narcotics, opioid analgesics may cause physical and psychological dependence, especially if used for long periods of time . See entries for generic drugs listed above for additional information . TARGET AILMENTS ♦ moderat e-to-severe pain, especially short-term pain from acute trauma or surgery. ♦ moderate-to -severe tension headaches. ♦ nonprodu ctive cough in bronchial disorders (codeine , hydrocodone) . S IDE E F FECTS

Not serious: Dry mouth , dizziness, fatigue , drowsiness, headache, nervousness, difficulty in urination , frequent urge to urinate , mild nausea, mild constipation. Consult your doctor if symptoms continue or are bothersome. Serious: Discontinue use and call your doctor if your symptoms include: slow or shallow breathing ; somnolence; skin rash, hives or itching , or facial swelling ; decrease in blood pressure or heart rate; fast heartbeat with increased sweating and shortness of breath ; severe constipation, nausea, stomach pain, or vomiting.

Propoxyphene only: reduced liver function (brownish urine or whitish stool) or jaundice.

• •

♦

♦

♦

ORA L HYPOG LYCEM ICS

overdose on opioid analgesics. Symptoms of overd ose inc lud e pinpoint pupils; slow, shallow, or troubled breathing , and slow heartbeat ; extreme dizzines s or weakness; confusion; convulsions. These drugs are not recommended if you are pregnant or breast-f eeding . Befor e taking th ese drugs, tell your physi c ian if you have kidney or liver impairment, asthma , breathing problems, glaucoma , a stomach ulc er, a history of convulsions or drug abuse, inflammatory bowel disease, gallbladder disease, hypothyroidism, a bladder obstruction , or prostate problems. Do not drive or operate machinery until you know how the drug you are taking affects you. Do not drink alcoholic beverages while you are taking the se drugs. Some opioid analgesic drugs also contain a nonnarcotic analgesic, such as aspirin or acetaminophen. Before taking any oth er medication, read the label carefully to avoid accidental overdose. POSSIBLE

INTERAC

DRUG CLASS Antidiabeti c Drugs GENERIC NAMES glipizide , glyburide GENERAL DESCRIPTION A subclass of antidiabetic dru gs, oral hypoglycemics (also known as sulfonylureas) are used to tr eat a form of noninsul in-dependent (Type 2) diabetes that cannot be controlled by diet and exercise alone. Oral hypoglycemic drugs stimulate th e release of existing insulin in people whose bodies are capable of producing insulin. These drugs do not lower blood sugar on their own but can work effectively when used in conjunc tion with a prescribed diet and exercis e program. For information on specific oral hypoglycemics , see entries for the generic drugs listed above. For information about other medications used to tr eat diabetes , see Antidiabetic Drugs and Insulin.

T IONS

TARGET AILMENTS ♦ non-insulin-depend ent (Type 2) diabetes.

Anticholinergic drugs: opioid dru gs may increase the effects of these drugs; risk of severe constipation and urinary retention (difficulty in urination with frequent urge to urinate).

S IDE EFFECT

Antidepressants [especially monoamine oxidase (MAO) inhibitors]: increased sedative effect and serious to x icity. Antidiarrheal drugs: risk of severe constipation. Antihypertensives, diuretics: may low er blood pressure causing orthostatic hypotension (dizziness related to change in body position ).

Serious: Sore throat, unusual bleeding or bruising, water retention (edema), weight gain , yellowing of th e skin or eyes (jaundice ), abnormally light-colored stools, low-gr ade fever, fatigue , chills. Contact your doctor immediately . Also see overdos e symptoms below.

Central nervous system depressants and drugs with sedative effects (such as alcohol, antihistamines, benzodiazepines, and other opioid drugs): increased sedative effects; risk of coma.

Nonnarcotic analgesics: see Aspirin and

Acetaminophen.

SPECIAL INFORMATION ♦ Opioid analgesics can lead to addiction , both physical and psychological. ♦ Tell your doctor if you notice the following withdrawal symptoms after you stop taking an opioid drug : fever , runny nose, or sneezing; diarrhea; goose flesh; unusually large pupils; nervousness or irritability; fast heartbeat.

Prescription Drug

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Over-the Counter Drug

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SPECIAL INFORMATION • An overdose of these drugs can result in hypoglycemia (abnormally small concentrations of sugar in the blood). Signs of hypoglycemia include excessive hunger, cold sweats, shakiness, nervousness or anxi ety, rapid pulse, headache, drowsiness , confusion , nausea, and cool , pale skin. Keep hard candy or fruit juice handy to raise your blood sugar level and counteract hypoglyc emia. Call your doctor. ♦ Tell your doctor if you are allergic to other sulfa drugs; you may also be all ergic to oral hypoglycemics.

Metoclopramide: opioids render this drug less effective.

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Not serious: Constipation, diarrhea, nausea, vomiting, stomach pain, indi gestion , dizzi ness, mild drowsiness , headache, heartburn , appetit e changes, skin allergies, weakness, tingling of hands and feet.

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CONVENTIONAL

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+ Avoid oral antidiabetic dru gs if you

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are pregnant or nur sing; abnormal blood sugar levels have been associated with birth defects in labor ato ry animals. Inject ab le insulin is mor e effective than or al med ication s at maintainin g close-to-normal blood sugar concentrations in women who are pregnant or nursing. People who are elderly , debilit at ed, or malnourish ed, as well as those w ith adrenal , thyroid , pituit ary, kidney, or liver problems , have an incr eased susceptibility to the hypoglycemic action of antidiabetic drugs and should use th em with caution . Do not stop takin g this medi cat ion without your doctor 's approval. Mild stress may reduce the eff ect iveness of oral hypo glycemics. Some studies have shown that the use of oral hypogly cemi c drug s to co ntrol diabetes is mor e likely to lead to fatal heart problems than the use of diet alon e or diet in co njunction with insulin . Your docto r can help determine th e best co urse of treatment. These drugs may cause photos ensitivity; avo id prolonged exposur e to the sun and sunlamps. It is important to self-monitor your glucose level when taking these drugs. Strict adherence to your prescribed regim en of diet and exercis e is requir ed for these medications to be effec ti ve. POSSIB

L E INTERACTIONS

Oral hypo glycemi cs may interact with a numb er of other drugs. Check with you r doctor or pharm ac ist before taking any medi cation , and be sure to read all label s for sugar content.

MEDICINES

Alcohol, aspirin, and other salicylates:

GENERALDESCRIPTION

avoid these substances whi le takin g o ral hypogly cemics.

A narcotic pain reliever, oxycod one is pr escr ibed for moderate-to-s evere pain relief , often in combination with acetaminophen or aspirin. See Opioid Analgesics for inform ation about side effec ts and possible dru g interactions.

Beta-adrenergic blockers, bumetanide, diazoxide, estrogens, ethacrynic acid, oral contraceptives, phenytoin, rifampin: decr eased effec t s of ora l hypoglycemics .

Cimetidine, clofibrate, fenfluramine, monoamine oxidase (MAO) inhibitors, phenylbutazone, ranitidine: incr eased effec ts of oral hypogly cem ics.

DRUG CLASS

OXAPROZIN

Decongestants

BRAND NAME Afr in

DRUG CLASS Analgesics [Nonsteroid al Anti1 nflammatory Drugs (NSAIDs)]

GENERALDESCRIPTION

OXYCODONE

Used as an active ingredi ent in overthe -co unter nose sprays, oxymetazoline relie ves nasal co ngestion due t o co lds, allergies, or sinu siti s by co nstri cti ng blood vessels in nasal passages. It s best use is as a short-term (severa l days) deco ngestant. While short-term use as dir ected on the labe l usually produces minimal side effects, lon g-term use or over use may result in rebo und co ngestion or absorption into the bloodstream , produ cing central nervous system effects similar to thos e of or al decongest ant s (diz zin ess, headach e, insomnia, nervo usness, high blood pressure, heart rhythm probl ems). For mor e information, see Decongestants.

DRUG CLASS

Tricyclic antidepressants (such as amitriptyline): increased serious centr al

BRAND NAME Daypro

GENERALDESCRIPTION Introduced in 1992 , oxaprozin is an NSAI D used in the treatment of osteoarthriti s and rheumatoid arthritis. See Nonsteroidal Anti-Inflammatory Drugs (NSA/Ds) for further inform ati on.

POSSIBLE

Analgesics [Op ioid Analg esics]

BRAND NAMES Percocet , Percodan , Roxicet, Rox icodone

988

OXYMETAZOLINE

INTERACTIONS

nervous system side effe cts if oxy metazo l ine is absorb ed into the bloodstream.

CONVENTIONAL

PAROXETINE

DRUG CLASS Antid epr essant s [Selecti ve Se rot on in Reuptake Inhibitors (SSRls)]

AND

At home: Tea: Steep 1 to 2 tsp dried leaves or roots per cup of boiling w ater for 5 to 10 minut es in a closed container. Drink up to 3 cups a day. Or steep chopped fresh leaves and stems in hot water .

SIDE

Paxil

PREPARATIONS

At home: Tea: Steep 2 tsp dried herb per· cup of boiling water for 15 minutes. For insomnia, drink 1 cup in the evening.

EFFECTS

None expected.

PARSLEY

SPECIALINFORMATION

Tincture: 1 dropperful in warm water, up to four times a day, for anxiety in adults and in children weighing more than 100 pounds. For hyperactivity in smaller children, use 3 to 10 drops (depending on the child's weight and the advic e of a trained practitioner) in water every 30 minutes, not to exceed 50 drops per four-hour period. Give to children only under medical supervision.

♦

WARN! NG: Pregnant and nursing women should not take parsley juice or oil in medicinal doses, because it may stimulate uterine contractions. A few sprigs served as garnish will probably not cause any harm if eaten. ♦ WARN! NG: If you use this herb frequently as a medicine , you should increase your intake of foods high in potassium, such as bananas and fresh vegetables, because diuretics deplete the body of potassium. ♦ Do not give medicinal doses to children younger than two years old. ♦ Only experienced field botanists should pick wild parsley, because of its resemblance to toxic plants.

Combinations: For insomnia, used with valerian, hops, Jamaican dogwood, or chamomile. SIDE

Serious: Sleepiness may occur.

Petroselinum crispum

GENERALDESCRIPTION

TARGETAILMENTS ♦ indigestion , congestion from coughs

and colds , asthma , irregular menstruation, premenstrual syndrome , fever. (Take internally.) ♦ high blood pressure , congestive heart failure. (Take internally under the supervision of your physician.)

PASSIONFLOWER

SPECIALINFORMATION • WARN! NG: Because passionflower can cause sleepiness, do not take this herb during the day if you operate heavy machinery or drive. ♦ Always use passionflower under medical supervision. ♦ Many herbalists recommend using only professionally prepared remedies; another species, Passiflora caerulea, contains cyanide, and there is some fear that this may be used instead. ♦ Pregnant women should avoid passionflower , since it may stimulate the uterine muscles. ♦ Use low-strength preparations for adults over 65 or children between 2 and 12 years old. Do not give to children under 2 years of age. • Passionflower is sometimes substituted for prescription sedatives in people who are addicted to drugs or alcohol. ♦ Homeopathic uses may differ from herbal uses; for more information, consult a licensed homeopath.

LATINNAME Passiflora incarnata

GENERALDESCRIPTION Passionflower, a long , climbing vine native to North America, was so named by Spanish explorers who saw in the ornate design of its flowers the crown of thorns, nails, and other elements of the "passion ," or suffering , of Christ. Native Americans in the southeastern United States, particularly the Cherokee, used the pleasant-tasting herb in healing; it soon became popular in Europe , in part for its Christian symbolism. Today, passionflower is thought to have a calming effect on the central nervous system. Modern herbalists recommend it as a sedative, as a digestive aid, and as a pain reliever. Because it dilates blood vessels, it is also being tested as a heart disease preventive.

TARGETAILMENTS PREPARATIONS Over the counter: Available as tinctures and as fresh or dried leaves, seeds, stems, and roots.

EFFECTS

Not serious: Upset stomach, nausea, vomiting, diarrhea. Discontinue and call your doctor.

LATINNAME

The feathery leaves of parsley, added to salads and cooked foods or used as a decorative garnish, are also a source of chlorophyll and vitamins C and A, as well as a versatile herbal remedy. Because of its ability to ease muscle spasms or cramps , parsley is used as a digestive aid . Parsley is also considered an expectorant to be taken for coughs and asthma. And it is prescribed as a diuretic and mild laxative. Native to the eastern Mediterran ean area, parsley is now cultivated around the world. One of the first herbs to appear in the spring , the plant develops tiny chartreuse flowers on an umbrella-shaped canopy.

aid with -

Over the counter: Available in commercial homeopathi c or herbal remedies and as dried or fresh leaves, capsules, and tincture.

GENERALDESCRIPTION Paroxetine belongs to a subclass of antidepressants known as selective serotonin reuptake inhibitors (SSRls), but it is chemically unrelated to other similaracting drugs used to treat depressive illness. Although this drug has not been shown to be habit-forming , long-term studies have not been completed on its addictive potential. See Antidepressants for information on side effects and possibl e drug interactions.

MEDICINES

and addictiv e disorders-to drawal. (Take internally .)

Nutrition and diet: Eat raw , green leaves as a breath freshener.

BRAND NAME

NATURAL

♦

POSSIBLE

insomnia, anxiety , tension , neuralgia, shingles, persistent hiccups, menstrual cramps, hyperactivity in children, the seizures of Parkinson 's disease, epilepsy, asthma, whooping cough,

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Prescription Drug

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Over-theCounter Drug

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INTERACTIONS

Use caution when taking passionflower with prescription sedatives and anti-anxiety medications to avoid overmedication.

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MEDICINES

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PAU D'ARCO

LATIN NAME

Tabebuia impetiginosa GENERAL DESCRIPTION Pau d'arco is the name of both a tree and a medicinal extract from the tree's bark or heartwood. The extract is believed to be effective against bacterial, fungal, viral, and parasitic infections, and is also considered an anti-inflammatory agent. It is thought to destroy microorganisms by increasing the supply of oxygen to cells. For centuries before modern science isolated some 20 of its chemical ingredients, pau d'arco was used as a folk remedy. The pau d'arco tree, also called the trumpet tree, is native to Central and South America and the West Indies; it can reach a height of 125 feet. TARGET AILMENTS ♦ bacterial, fungal, viral, and parasitic infections; indigestion. (Take internally.) PREPARATIONS

Over the counter: Pau d'arco is available as capsules, tinctures, and dried bark. At home: Decoction: Boil 1 tbsp bark in 2 to 3 cups water for 10 to 15 minutes. Drink 2 to 8 cups a day. S IDE

EFFE CTS

None expected.

tion of nerve endings in these areas. Pectin is sometimes used in cough drops, lozenges , mouth rinses, gargles, and sprays. (It has not been shown effective against cold sores.) To work, pectin must be applied in sufficient quantities and thickness to form a solid or semisolid coating over the affected area. Because of its protectant action and its ability to absorb liquids, pectin also serves as a safe and effective antidiarrheal agent. TARGET AILMENTS ♦ mouth and throat irritations. ♦ diarrhea and intestinal cramps. SIDE

EFFEC T S

Not serious: When it is taken in an antidiarrheal medication, pectin can sometimes cause constipation.

BRAND NAMES Kaopectate, Luden's cough drops GENERAL DESCRIPTION Pectin, a fruit extract, has been used for centuries to help jell fruit preserves and as an ingredient in numerous other foods and medicines. It is generally believed to be a safe ingredient for medications, although experts disagree over its effectiveness in some products. Pectin is recognized as a safe and effective demulcenC or soother, for the membranes of the mouth and throat. It also has been shown to form a protective coating over sore or ulcerated areas in the mouth and throaC helping to relieve pain by preventing further stimula-

990

TARGET AILMENTS ♦ Each generic drug listed above targets a different spectrum of disease organisms, including Escherichia coli; Hemophilus influenzae, as well as the streptococcal, staphylococcal , and gonorrheal bacteria. These organisms are responsible for a number of disorders, including otitis media, sinusitis, infections of the skin and soft tissues, pharyngitis, pneumonia, and genitourinary tract infections. SIDE

EFFECTS

Serious: None expected, although an overdose of this medication may lead to an inability to defecate. Call your doctor .

Not serious: Mild nausea, mild diarrhea, oral candidiasis (sore mouth or tongue t vaginal candidiasis. Tell your doctor when convenient.

SPECIAL INFORMATION When taken in an antidiarrheal medication, pectin may interfere with the absorption of other drugs . For this reason, you should exercise caution in combining it with other oral medicines. Take pectin at least two hours before or after other drugs.

Serious: Allergic reaction (skin rash, hives, intense itching, or difficulty breathing). Severe allergic reactions (anaphylactic shock) can be life-threatening; call your doctor, 911, or your emergency number immediately. Unusual bruising or bleeding, sore throat with fever, severe abdominal pain with diarrhea, seizures: Call your doctor immediately .

♦

POSS I BLE INT ERACTIONS

Digitalis preparations, such as digoxin: pectin may interfere with the absorption of digitalis preparations , decreasing their effectiveness. Make sure that you take the different medications at least two hours apart.

PECTIN

D

Penicillins work by attacking a bacterium's cell wall. Because body cells have a membr ane but no cell wa l I, the drugs can selectively destroy invading bacteria without harming body tissues. See entries for the generic drugs listed above for more information.

PENICILLINS

GENERIC NAMES amoxicillin, amoxicillin pen icillin V

and clavulanate,

GENERAL DESCRIPTION A subclass of antibiotic drugs, penicillins act by killing sensitive strains of growing bacteria. Penicillins are ineffective against fungi, viruses, and parasites. When discovered in 1928, "penicillin" referred to a single drug. Today, more than 20 penicillins-some derived from molds or bacteria, others proused to treat duced synthetically-are a wide range of bacterial infections.

SPECIAL INFORMATION ♦ Take the full course of your prescription , even if you feel better before finishing the medicine; otherwise , the infection may return. ♦ Most penicillins are better absorbed if taken on an empty stomach . However, amoxicillin, amoxicillin and clavulanate, and penicillin V work equally well whether taken on a full or on an empty stomach. ♦ Tell your doctor if you are allergic to cephalosporins; you may also be allergic to penicillins. ♦ Let your doctor know if you have impaired kidneys, gastrointestinal disease, or a history of bleeding disorders . Your doctor may need to adjust your dosage, monitor you more closely, or prescribe a different drug. ♦ Penicillins also kill " good" intestinal bacteria that keep harmful fungi and intestinal bacteria in check. Eating yogurt containing Lactobacillus acidophilus culture or taking acidophilus tablets may help restore the body 's normal bacteria.

CONVENTIONAL

♦ Prolonged use of any antibiotic

drug can lead to fungal infections, including candidiasis, or to bact eria l infections such as pseudomembr anous co liti s. ♦ Taking amox icillin whe n you have mononucleosis may produce a skin rash. • Penicillin may cause false-positive results in tests for glucose and protein in urine. ♦ If possible , avoid taking penicillins if yo u are pregnant or breast-feeding. POSSIBLE

INTERACTIONS

Allopurinol: may cause a skin rash. Bacteriostatic drugs (chloramphenicol, erythromycins, sulfonamides, tetracyclines): these medicines can int erfe re with the bacteria-killing action of all penicillins. Disulfiram: do not comb ine w ith amoxicillin and clavulanat e. Estrogen (oral contraceptives): decr eased effi cacy of co ntrac ept ives w hen t aken with penicillin V. Probenecid: decreases the kidn eys' abilit y to excrete penicillins. Possible penicillin toxicity . How ever, probenecid is sometimes pr escribed in combination w ith penicillin when the tr eatment of severe inf ections requir es that high levels of penicillin rem ain in the body.

PENICILLIN V

AND

BRAND NAMES Betapen-VK , Penicillin VK, Veetids GENERAL DESCRIPTION Introduced in 1953 , penicillin Vis commonly used to treat otitis medi a and other infe ct ions of the respiratory tract , and skin inf ect ions. It may be prescribed to prevent endocarditis and rheumatic fever . This type of penicillin is not used to treat severe inf ect ions . For more information on side effec ts, interactions, and the possibility of anaphyla ctic shock, see Penicillins. PO SSIBLE

INTERACTIONS

Estrogen (oral contraceptives): decreased effectiveness in preventing pregnancy.

MEDICINES

PENNYROYAL

PENTOXIFYLLINE

LATIN NAME

DRUG CLASS Blood Viscosity-Reducing Agents

Mentha pulegium GENERAL DESCRIPTION Pennyroyal , a plant wi th smooth oval leaves, has been used since ancient times as a cough remedy and di gestive aid, as well as a flea repell ent. The strong aroma of its infusion acts as a decongestant and possibly as an expec torant , helping to remove excess mu cus from the lungs; it is therefore useful for coughs. While the dried herb is safe in recomm ended doses, the oil of th e pennyroyal plant should not be ingested , since even small amo unt s of it are to xic.

BRAND NAME Trenta l GENERAL DESCRIPTION Since 1972, pentoxifylline (also known as oxypent ifyl Ii ne) has been used to re1 ieve painful leg cramps and int ermittent claudicati on (b lood- vessel spasms) associated with peripheral vascular disease, a chronic blood-v essel disorder that primarily affects the legs. The cramping , wh ich usually occurs during walking, is the result of leg muscles' becoming depri ved of oxygen. Pentoxify lline eases the pain by improving blood flow to the small vessels in the legs, thus increasing the supply of oxygen to the leg muscles. As the first real "bloo d thinn er," pentoxi fy lline works by reducing blood viscosity (thickn ess), incre asing th e flexibility of oxygen-carrying red blood cells, and preventing the formation of red blood cells and plat elet s. When taken at th e recommended dosages, th e drug usually produces no side effects. See Blood Viscosity-Reducing Agents for add it ion a I information .

TARGET AILMENTS ♦ colds, co ughs, premenstrual syndrom e, menstru al cramps, gas, indigestion , anxiety. (Use int erna lly.) • fleas o n pets. (Use as you would commercial flea powder.) PREPARATIONS Over the counter: Pennyroyal is available as tinctures and as dried leaves and flowers . At home: Tea: Steep 1 to 2 t sp dri ed leaves in 1 cup boiling water for 10 to 15 minute s. Drink up to 2 cups a day. Or mi x 1 tb sp dried herb with 1 cup warm water. SIDE

TARGET A I LMENT ♦ intermitt ent claudication (bloc ked blood vessels in th e legs) associated with periph eral vascular disease.

EFFECTS

None expected if used pre cisely as directed. DRUG CLASS Antibiotics [Penicillin s]

NATURAL

SIDE

SPECIAL I NFORMAT ION ♦ WARNING: Present-day practitioners adv ise against t aking pennyroyal o il in any amount , because of its toxicity. • Do not exceed the reco mmend ed dose of the herb and do not t ake for long er th an a wee k at a time . • Pennyroyal stimulates ute r ine co ntractions and should not be used during pr egnancy . • In th e past pennyroyal has been used to indu ce abortion because of its ability to stimulate menstru ation and strengthen uterin e contractions; but it should never be used for that purpose, since it may cause serious co mplications , such as hemorrha ge or co nvul sions . The amount needed to abort a fetus is c lose to a lethal dose. ♦ Do not give to children younger than two years of age.

0

Prescriptio n Drug

0

Ov er-theCounter Drug

EFFECTS

Not serious: Head ache, di zzi ness, tremors , indigestion , nausea, vo mitin g. Contact yo ur doct or if these symptoms persist or are bother some.

GI

Serious: Chest pains, irregular heart rhyt hms. Conta ct your doctor promptly . SPECIAL INFORMATION In managin g peripheral vascular disease, pento x ifyllin e should be part of an overall treatment that includes phy sical exercise and a low-fat diet. ♦ Do not tak e pento x ifylline if you have had an allergic reaction to thi s dru g in the past. • Befo re takin g pento xify llin e, tell your do ctor if you smoke tobacco , are tak ing any antihyperten sive dru gs, or are allergic to caffeine , theobromine, th eophylline , or other xanthine dru gs. • Before taking this drug, tell your phy sician if yo u have angi na or cere♦

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CONVENTIONAL

+ +

+

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AND

NATURAL

bral art heroscleros is, kidney or l iver disease, lo w blo od pressure, or any cond ition (suc h as a stroke) in which there is a risk of bleeding. Do not use pento xify llin e during th e first thre e month s of pregnancy or w hil e nursing. Do not stop usin g this drug on yo ur ow n: It takes several wee ks for pent ox ifylline to work , and at least three months to assess it s full effect ive ness in preventing or eas in g leg pains: Pentoxifylline should be taken with m ea ls or with antacids to lessen the c hanc e of stomach ups et. Tab lets should be swallowed whole. D o not smoke tobacco. Ni co tin e constricts blood vesse ls and m ay make yo ur co ndition worse.

MEDICINES

PREPARATIONS Over the counter: Peppermint is ava il able as commercia l t ea, tin ct ures , and fr esh or dried leaves and flowers. At home: Tea: Drink com mer cia l brands , o r st eep 1 t o 2 heap in g tsp dr ied herb per cup of bo ilin g wate r for 10 minutes. Drink up to 3 c up s a day. Bath: Fill a cloth bag w ith seve ral handf ul s of dried or fresh herb and let hot water run over it. Combinations: For colds and flu , peppermint m ay be used as a t ea or tin ctur e w ith boneset, elder flo we r, and yarrow. SIDE

POSSIBLE

INTERACTIONS

Alcohol and antihypertensive drugs: may in c rease blood pr essur e- lo we ring effects of both medication s. Anticoagu lants: pento x ifyllin e also inhi b it s blood clott ing; co nc urr ent use m ay in c rease the risk of unw ant ed bleeding. Caffeine and nicotine: m ay decrease t he effec ti ve ness of pentox ify llin e.

PEPPERMINT

LATIN NAME

Mentha pipe rita

EFFECTS

No ne expected.

SPECIALINFORMATION + WARNING: Do not in gest pure menthol or pure peppermint; these substances are extremel y toxic. Pure peppermint m ay ca use card iac arrhythmias , and pur e menthol ca n be fata l in a dos e as small as a t easpoon. + Do not use peppermint if you are hav in g an acute gallstone att ac k or if you have a hiatal herni a. + Give o nly ve ry dilut e preparations to c hildr en younger th an two years old and only under the supervision of a doctor or an herbalist. + Pregnant women with mornin g sickness sho uld use a dilut e t ea rather than a more potent infusion. Peppermint sho uld not be used by wome n who have a histor y of mi sca rri age.

GENERALDESCRIPTION

D

Peppermint plants , which reac h a ~eight of two feet or mor e, have st ems with a p urpli sh cast; lon g, ser rate d leaves; and a familiar minty aroma. Thi s pleasanttast ing herb has been used as a rerr:iedy fo r indigestion since th e era of anci ent Egypt. Menthol, the principal acti ve ingre di ent of pepp ermint , stimulates the st o mac h lining , thereby red uc ing the amount of time food spends in th e stomac h . It a lso relaxes the mus c les of the digestive system. Peppermint ca_n_begrown easily from root cuttin gs; but 1f_it Is not co nfined , it tends to spread rapidly.

TARGETAILMENTS + Cramps (in cludin g m enstr u ~I) , storr:iach pain, gas, naus ea assoc iated with mi graine headach es, mornin ~ sick- . ness, travel sickn ess, insomni a, anxiety, fever , colds , flu. (Take int ernally.) + Itching and inflammation . (Apply a few drops externally.)

992

PHENELZINE

DRUG CLASS Antidepressants [Monoamin e Oxidase (MAO) Inhibitors ]

BRAND NAME Nardil

GENERALDESCRIPTION Introdu ce d in 1961, phenel z in e-lik

e other medi cations in the sub c lass of antid ep ressant s known as MAO i~hibitor s- is used to treat depression , anx iety, and phobias w hen other antidep ressant drugs have failed. Se~ .

Monoamine Oxidase (MAO) lnhlb,tors for information about side effects, warnin gs, and possible drug inter act ions .

PHENOL

DRUG CLASS A nt iseptics

BRAND NAME Anbesol

GENERALDESCRIPTION Phenol was discovered in 18 34 as a component of coa l tar (hen ce it s other name, ca rboli c ac id) . Used alone, phenol is ext remely toxic and pot enti ally fatal, so this antis eptic is used only in small amount s and in combination wi th other c hemi ca ls. Th ese prep ara ti o ns are used to inhib it the grow th o f bacteria and to redu ce th e c hance of infe ct io n in minor scrapes, c uts , and burn s. Sometim es phenol is included in pr eparation s used to treat poison ivy rash es and insect bit es, o r to relieve th e pain assoc iated with t oo th ac hes, teethin g, fever blisters, and other soreness of the gum s, mouth , and throat . Combined with ce rtain other drugs, such as benzocaine, ph enol has an analgesic or _local anesth et ic effec t , w hich makes It usef ul in t emp o rarily red ucing pain and it c hin g w hen app li ed dir ec tly on the skin .

TARGETAILMENTS + min o r c ut s, scrapes, and burns (used as a fir st-aid antiseptic ).

+ lo ca l infe ct ion s (to limit th e development and spread of infe ct ion). ♦ pain and soreness of gum s and mouth

ca used by br aces or dentur es, toothac he o r teething, sore throat , canker sores, and f eve r blisters (cold so re s). ♦ pain and it ch in g due to in sect bites or poison ivy . SIDE

EFFECTS

Not serious: When used accord ing to package label instru ct ion s, products containing phenol are considered safe and effective and ve ry rarely produce side effects. Serious: If irritation, pain, redness , rash, swelling , or fever develops, discontinue use and contact your doctor promptly. O ve rus e o r overapplication of this drug can lead to serious, potenti ally lif et hre ate nin g side effects. See the warnings below for more inform at io n .

SPECIAL INFORMATION + This drug is potentially fatal if swallow ed; keep away from children.

+ Do not use phenol if you are allergic to local anesthetics containing benzocaine.

~

CONVENTIONAL

AND

NATURAL

~

MEDICINES

"'

♦ Do not swallow this drug or use it ♦

♦

♦

♦

♦

♦

near the eyes. Do not use on children und er age tw o or for diaper rash, as this medication is easily absorbed into the skin . Do not appl y topi ca l prep aration s over large areas of skin, and never cover th e treated area with a bandage or dressing . Do not use for longer than seven days; if the irritation has not improved within that period , see your do ctor or dentist. If you are pregnant or nursing, check with your doctor before using this drug. To treat a teething baby, use only the recommended amount. Do not overdose. If you have an infection or many sores in your mouth, check with your doctor or dentist before using oral preparations containing phenol. POSS I B L E I NTERACT

I ONS

Phenol pr eparations have not been shown to interact with any specific drugs. However , befor e using these medications , be sure to inform your doctor, dentist, or pharmacist of any other prescription or nonprescription dru g you are t aking.

PHENOLPHTHALEIN

effects include irritability , confusion , skin rash, breathing diffi culty , burning sensation when urinating , kidney problems, respiratory problems , and heartrhythm problems that could lead to cardiac arrest. Discontinue the drug and ca ll your doctor imm edi at ely.

Anti co nvul sant Dru gs

SPECIALINFORMATION

BRAND NAME

S ID E E FF EC T S

Not serious:

Rectal irritation , pink or red urine or feces, belching, cramps, nausea, diarrhea. If these symptoms become bothersome , call your doctor. Serious:

In rare cases, phenolphthalein may cause an allergic reaction, most often displayed on the skin in the form of increased pigmentation , eruptions , rashes, burning , and itching. Other rare side

Introduced in 1938 , phenytoin is one of several hydantoin anticonvulsant drugs used primarily in the suppression and control of epileptic seizures. This drug , formerly known as diphenylhydantoin, is used to treat all types of epilepsy except absence (petit mal) seizures. It may be used alone or in combination with other anticonvulsants. For more information, see Anticonvulsant Drugs.

TARGETAILMENTS ♦ epileptic seizures, except absence

(petit mal ) type. prevention and treatment of seizur es during and following neurosurgery. ♦ relief of pain in trigeminal neuralgia (tic douloureux). May be used alone or with carbamazepine. ♦

DRUG CLASS Decongestants

BRAND NAMES Rx: 0uratuss, Entex LA, Zefrex LA OTC: Alka-Seltzer Plus, Comtrex Liqui-

S I DE EFFECTS

Not serious:

Gel, 0exatrim (diet aid), 0imetapp (for adults and children), Robitussin-CF , Tavist-0 , Triaminic OM Syrup , Triaminic Expectorant, Triaminicol Multi-Symptom Relief, Triaminic Syrup , Tylenol Cold (effervesc ent formula )

GENERALDESCRIPTION

Phenolphthalein is a stimulant type of laxative used to relieve constipation. See Laxatives for additional information about side effects and possible drug interactions.

GENERALDESCRIPTION

PHENYLPROPANOLAMINE

A nasal decongest ant sometimes used as an appetite suppressant, phenylpropanolamine is widely used in over-thecounter cold and allergy products. This medication is banned for use during athletic competition. See Decongestants for information about other side effects and possible drug interactions.

GENERALDESCRIPTION

Dilantin

of this drug may result in an electrolyte imbalance. Symptoms include irregular heartbeat , confusion , unusual tiredness or weakness, and muscle cramps . ♦ Do not use phenolphthalein or any other stimulant type of laxative if you think you may have an intestinal obstruction.

Laxati ves

Corr ectol , some types of Ex-Lax

DRUG CLASS

♦ Overdose or prolonged use or misuse

DRUG CLASS

BRAND NAMES

PHENYTOIN

SIDE

Mild sluggishness and fatigue, diarrhea, excessive growth of facial and body hair , enlargement of jaw , widening of nose tip , thickening of lips, swollen breasts (in males), muscle twitching, nausea and vomiting , headache , dizziness, insomnia. Consult your doctor if these effects persist or are bothersome . Serious:

Gum overgrowth , bleeding or tender gums, fever, enlarged glands in underarms or neck , mood changes, increase in seizures, muscle pain or weakness, excitability or nervousness, severe skin rash, joint pain and swelling, blurred or double vision , elevated blood sugar, bone-marrow depression (sore throat, weakness, fever, abnormal bruising or bleeding) , discolored urine , druginduced hepatitis or nephritis . Contact your doctor immediately. Also see overdose symptoms below.

EFFECTS

Serious:

In rare cases, phenylpropanolamine has been associated with serious cardiovascular, central nervous system , and psychological effects such as stroke , irregular heart rhythms, high blood pressure , hallucinations , and seizures. These effects may be more likely in individuals who take high dosages or who have an underlying cardiovascular or psychological illness.

0

Prescription Drug

0

Ov er-theCounter Drug

GI

SPECIALINFORMATION ♦ Seek immediate medical help for

overdose. Overdose signs include: double or blurred vision; jerky or rolling eye movements; slurred speech or stuttering; severe clumsiness, unsteadiness, confusion, and trembling; and staggering walk. ♦ Do not use phenytoin if you have had an allergic reaction to this drug

O

W estern Herb

0

Chinese Herb

0

Homeopathic Remedy

gg3

CONVENTIONAL

♦

♦

•

♦

♦

AND

NATURAL

or to any of the hydantoin drugs in the past. Tel I your doctor if you: are taking any other drugs (prescription or over the counter) ; have diabetes , heart disease, or low blood pressure; have a hi story of impair ed liver function or liver disease; or may soon have surgery under general anesthesia . Using phenytoin during pregnancy increases the risk of birth defects (" fetal hydantoin syndrome"). Be sure to tell your doctor if you are pregnant or planning to become pregnant soon. Since phenytoin can cause gum problems (bleeding, tenderness, abnormal growth ), good oral hygiene is essential: Be sure to brush and floss your teeth and massage your gums regularly and carefully. You should also see your dentist every three months to have your teeth cleaned. Phenytoin may affect complete blood cell counts; blood cholesterol , calcium , glucose , thyroid hormone , and other levels; and liver function tests. Do not abruptly discontinue this drug or switch to another brand or generic unless advised by your physician. POSSIBLE

INTERACTI

ON S

Phenytoin interacts with a vast number of drugs , only a few of which are described here. Be sure to check with your physician before taking any other medication.

Alcohol, antidepressants (tricyclic), antacids, antihistamines, central nervous system depressants, diazoxide, and rifampin: decreased effectiveness of phenytoin in controlling epileptic seizures .

D

Anticoagulants, drugs for high blood pressure, sedatives, propranolol and other beta-adrenergic blockers, caffeine, corticosteroids, cyclosporine, doxycycline, and oral contraceptives: phenytoi n may increase or decrease the effects of these drugs. Cimetidine, sulfonamides, and valproic acid: increased effects of phenytoin and increased risk of severe side effects.

PHOSPHORUS

PLANTAIN

LATIN NAME

LATI N NAME

Phosphorus

Plantago major

GENERAL DESCRIPTION The chemical element phosphorus can be found in the cellular fluid of all living tissue . Phosphorus plays a vital role in the activity of the body 's cells, most importantly in the transfer of genetic information. Many phosphorus compounds are used commercially in toothpaste, fertilizer, and laundry detergent. Phosphorus poisoning causes irritation of the mucous membranes and inflammation of tissue; over time, it can destroy bone. As a homeopathic remedy, minute doses are prescribed by practitioners for conditions accompanied by symptoms of fatigue and nervousness, with a tendency to bleed easily and an unquenchable thirst for cold water. Pure Phosphorus is diluted in large quantities of milk sugar to prepare the homeopathic remedy. Like most homeopathic prescriptions, Phosphorus was developed as a remedy by observation of the reactions of healthy individuals to a series of undilute doses. The mental, emotional, and physical changes induced by Phosphorus were then cataloged. When a homeopathic practitioner encounters a patient with a set of symptoms that matches the cataloged symptoms brought on by Phosphorus, the practitioner then prescribes it in an extremely dilute form. It is presumed that in this highly dilute dosage, phosphorus can counter the symptoms that it induces when it is at full strength.

GENERAL DESCRIPTION A perennial weed, plantain bears leaves that grow low to the ground and a spiked stalk with inconspicuous flowers. It is as useful to the herbalist as it is annoying to the homeowner trying to grow an attractive lawn. Due to its astringent or binding properties , it can aid in the treatment of diarrhea and hemorrhoids. Plantain also helps the body remove excess mucus from the lungs and soothes inflamed and sore membranes, making it useful for treating coughs and mild bronchitis. And its antimicrobial and anti-inflammatory actions help in healing skin wounds.

TARGET A ILMENTS ♦ bronchitis, pneumonia, coughs with congestion and burning pains in the chest, high fever, visual problems resulting from eyestrain , gastritis, nosebleeds, indigestion accompanied by vomiting or pain, stomach ulcers, kidney infections, nasal polyps, hepatitis, anemia , hemorrhages , diarrhea, menstrual problems, food poisoning. (Take internally.) PREPARATIONS Phosphorus is available over the counter in various potencies, in both liquid and tablet form, at selected stores and pharmacies. Consult your homeopathic physician for further information. SIDE

EFFECTS

None expected.

994

';

MEDICINES

TARGET AILMENTS ♦ diarrhea , jaundice , neuralgia, kidney and bladder infection , urinary incontinence, thrush, hemorrhoids, loss of appetite. (Take internally.) ♦ external tumors and ulcers; itching, burning, or inflamed skin; cuts; snake and insect bites. (Apply externally.) PREPARATIONS

Over the counter: Plantain is available as tinctures , powdered seeds, dried leaves, seeds, and aboveground parts. At ho me: Tea: Steep 2 tsp dried herb per cup of boiling water for 10 minutes. Drink 3 to 4 cups a day. Decoction: Simmer 1 oz seeds in 1½ pt water until reduced to 1 pt. Sweeten with honey. Take 1 tbsp three to four times a day. Powdered seeds: Take 1 tsp dissolved in juice three times a day as a laxative. Dressing: Use the tincture as a dressing for cuts, wounds, bruises, and bites. Combinations: A liniment made from plantain juice (or tea) and rose oil can be used externally for gout. S ID E EF F E CT S

None expected. SPECIAL INFORMATION • A piece of cotton may be soaked with plantain juice or tincture and applied to a tooth to control toothache until you get to a dentist.

CONVENTIONAL

POLYGONUM

LATINNAME Polygonum multiflorum (roo t )

GENERALDESCRIPTION Polygonum is also know n as fl eeceflow er root , and frequently ca lled fo-ti by sellers, users, and practitioners. It is prescribed for a wide variety of disorders that include such disparate condition s as signs of prem ature aging and symptoms of malari a. The herb usually appears heavy, solid , and reddi sh brown. In tr aditional Chinese medicin e it is classified as bitt er, sweet, astringent , and slightly warm.

AND

gonum and lico ri ce root , w hich seemed to have some effect in reducing their sympto ms. • In test-tube studi es, the root seems to have an antibiotic effect. POSSIBLE

Black stools (a symptom of gastro inte stinal bleeding) , severe vo mitin g. Excessive doses of potassium chlorid e can lead to high pota ssium levels in the blood , causing heart -rhyt hm problems and mental co nfusion . If you experience an irregular heartbeat or feel confused, call your doctor imm ed iately . Elevated potassium levels in th e blood can also cause muscle cramps, a less serious side eff ect but one that also warrants consultation with your doctor.

INTERACTIONS

SPECIALINFORMATION

POLYMYXINB

♦ Inform your doctor if you have stom-

ach ulcers ; potassium chloride can cause stomach irritation. ♦ Do not use this dru g if you are takin g potassium-sparing diur eti cs or salt substitut es.

DRUG CLASS [Topical Antibiotics]

TARGETAILMENTS Take intern ally for: + dizziness and blurr ed v ision. ♦ insomnia . ♦ prematur ely gray hair. + nocturnal emission. ♦ vaginal discharge. + carbuncl es, sores, abscesses, scroful a (a form of t uberculo sis in the neck ), goite r, and neck lump s. ♦ co nstip atio n. • sore knees and back. ♦ malaria (t he chroni c, weake ned cond ition , not the ac ute stages).

PREPARATIONS Po lygo num is available at Chinese pharmacies, Asian markets , and some Western health food stores. You can also find it in pill fo rm. Combinations: With lycium fruit, psorol ea fruit , and cuscuta it is pr escr ibed for sore knees and back, dizzin ess, and premature aging. A preparation containing polygonum, scrophularia , and fo rsythia fruit is prescribed for scrofula , abscesses, and other swellings. And a comb ination w ith Asian ginseng, don g qu ai, and tanger ine peel is reco mmended for chronic malari al symptoms. For information on dosages and additional pr eparation s, check with a Chinese medicine practitioner. SIDE

EFFECTS

Not serious: Some patients have noti ced flu shing of th e face and increased fr equ ency of bowe l mo vements, diarrhea, and mild abdominal pain.

BRAND NAME Rx: Neospo rin OTC: Neosporin

for patients with phl egm or diarrhea. + M alaria pat ients, in a study, were tr eat ed with a prepa ration of poly -

POSSIBLE

INTERACTIONS

Angiotensin-converting enzyme (ACE) inhibitors: increased potassium chloride level s.

GENERAL DESCRIPTION

Digoxin: increas ed di gox in levels.

Ove r-th e-co unter fo rm s of polymyxin B, combined with bac itracin and neomy c in, are used topi ca lly to prevent infections in minor cuts , scrapes, and burns. The pre scr iption form, also in combination with bacitracin and neomycin , is an eye drop used to treat eye inf ect ion s. See Topical Antibiotics for side effects and other inform ation .

Potassium-sparing diuretics (such as amiloride or triamterene): incre ased potassium chloride levels.

PRAVASTATIN

DRUG CLASS

POTASSIUM CHLORIDE

Cholesterol-Reducing

Drugs

BRAND NAME Pravachol

DRUG CLASS GENERALDESCRIPT ION

Diureti cs [Adjun ct Ther apy]

Introduced in 1986, pravastatin is an HMG-CoA reductase inhibitor , a type of drug that alters blood levels of cholesterol and other fats. It works by blocking a liv er enzyme needed in the production of cholesterol. Pravastatin may also incr ease the blood level of high-density lipoproteins (HDLs) , the so-called good cholesterol that seems to prot ect against heart disease. For mor e information, see

BRAND NAMES K-Dur, Klor-Con 10, Micro-K 10, Slow-K

GENERALDESCRIPTION Potassium chloride is a mineral supplement pre scribed for the prevention and treatm ent of potassium depletion. Such depl etion usually results from the use of dru gs known as nonpotassiumsparing diuretics , which promot e the excretion of miner als through incr eased urine flow. For mor e information , see

SIDE

Constipation , gas.

EFFECTS

Serious: Fever, muscl e aches, cramps, blurred vision.

Gastrointestinal upset. (To help alleviate this discomfort , tak e th e medication with meals.)

Prescription Drug

EFFECTS

Not serious:

Not serious:

0

GI

Cholesterol-Reducing Drugs.

Diuretics. SIDE

SPECIALINFORMATION + Practition ers do not prescribe the herb

MEDICINES

Serious:

Some traditional sources suggest th at you should not t ake this herb with onion s, ch ives, or garli c.

Antibiotics

NATURAL

0

Over -theCounter D rug

O

Western Herb

0

Chinese Herb

A Homeopathic

~ Remedy

ggS

SPECIAL INFORMATION If you become pregnant while taking this drug, stop using it imm ed iate ly and inform your doctor.

♦

POSSIBLE

INTERACTIONS

Erythromycin , immunosuppressants, and niacin: may cause severe muscle pain or kidney failure if used w ith pravastatin. Gemfibrozil: may affect the absorption and excre tion of pravastatin ; do not take concu rrently.

PREDNISONE

DRUG CLASS Cort icostero ids BRAND NAME Deltasone GENERAL DESCRIPTION Introduced in 1955 , prednisone is a powerful medication used to treat a w ide var iety of disord ers, includin g ulcera ti ve col itis , Crohn 's disease, serious skin problems, severe aller gies (such as hay fever and asthma ), and rheumatic disorders (including bursitis, tendonitis, and arthritis). Prednisone is also used to speed recovery from acute attacks of multiple sclerosis; to prevent rejection of transplanted organs ; as replacement therapy in adrenocorti ca l deficiency; and in some cancer cases. See Corticosteroids for more inform at ion . .... POSSIBLE

D

INTERACTIONS

Aminoglutethimide, antacids, barbiturates, phenytoin, and rifampin: decreased effectiveness of cort icostero ids. Diuretics: decreased effective ness of both combined drugs. Growth hormones, isoniazid, potassium supplements, and salicylates: corticosteroids may decrease the effectiveness of these drugs. Oral anticoagulants: corticosteroids may increase or decrease the effective ness of oral anticoagulants. Vaccines (live virus, other immunizations): corticosteroids may make you more susceptible to the inje cted virus.

996

PROCH LORPERAZI NE

DRUG CLASS Antinausea Drugs BRAND NAME Compaz ine

ask for prochlorperazine in suppositor y or inj ection form. • The dru g may cause unusu al sensitivity to the sun or to sun lamp s. • Prochlorp erazine can cause a decrease in wh ite blood ce ll count, an increase in li ver enzy mes and bilirubin , and fa lse-positive pregnancy test resu Its. • Prochlorp eraz ine should not be given to children under age two or w ho weigh less than 20 pounds. Chi ldr en wit h acute illnesses, such as measles, chi cke npo x, or flulike infection s, are very suscept ibl e to adverse reactions to this drug.

GENERAL DESCRIPTION Prochlorperazine , introduced in 1956, is one of a group of drugs ca ll ed phenothiazines. These drugs control nausea and vomiting by blocking stimulation of the area of the brain that co ntrol s vomitin g. This drug must be used with care, as it s antiemetic action can mask signs of overdosage of other drugs and obscure symptoms of other diseases, such as inte stinal obstructions , Reye's syndrome, and brain tumor. See Antinausea Drugs fo r additional inform ation.

Prochlorp eraz ine interacts unfavor ably with many OTC cold, cough , and all ergy medications , and with many prescription drugs . Ask your pharma cist or physician for assistance.

TARGET AILMENTS • nausea and vomiting.

Alcohol, barbiturates, tranquilizers, narcotics, sedatives: increased sedative and depressiv e effects.

SIDE

EFFECTS

Not serious: Drowsiness , dizziness, blurred vis ion ; dry mouth , nasal congestion , const ipation; impaired urination , pink- or purple-colored urin e; decreased sex drive, menstrual irregularitie s, swollen breasts. See your doctor if these symptoms persist or are bothersome. Serious: Jaundi ce, muscle spasms of th e face and neck , extreme restlessness or agitation , tremors , disorientation, fainting, ski n rashes. Contact your doctor imm ediately . SPECIAL INFORMATION • Do not take prochlorperazin e if you have had an allergic reaction to it in the past or if you have a blood or bone-marrow disease, Parkinson 's disease, breast cancer, or any Iiver or kidney disease. • Tell your doctor if you: are planning surgery w ithin two months; have dia betes, asth ma, glaucoma , emphysema, or heart disease; have a history of lupus erythematosus , prostate problems, or seizure disorders; or are pregnant or nursing. ♦ Prochlorperazine interacts with many other drugs. Be sure to tell your doctor if you are taking any pr escr ibed or over-the-counter medications. • Thi s drug has many different side effects. Report any unusual symptoms to your physician. • If you are too nauseat ed to swallow tab lets, capsules, or syrup, you can

POSSIBLE

INTERACTION

S

Antacids (containing aluminum or magnesium), benztropine, trihexy phenidyl: dec reased prochlorp erazine effect. Atropine-like drugs: prochlorper azine can increase th e effects of these dru gs, possibly leading to nervous system toxicity . Guanethidine: decreased guanethidine effect. Propranolol: increased effects of both drugs.

PROMETHAZINE

DRUG CLASS Antihistamines BRAND NAME Phenergan GENERAL DESCRIPTION Prometh az ine is a sedating antihistamine that can cause the following side effects: dryness of the nose, throat, or mouth ; reduced sweating; incre ased heart rate; dilated pupils; clumsin ess; flushing ; and short ness of breath. Promethazine is prescribed for allergies as we ll as for motion sickness, nausea related to anesthesia , and pain control following surgery. See Antihistamines for additional side effects and drug interaction information.

CONVENTIONAL

PROPOXYPHENE

DRUG CLASS A nalgesics [Opioid Anal gesics]

BRAND NAMES Darvocet-N 100, Propacet 100

GENERALDESCRIPTION A narcotic prescribed for mild-to-mod erate pain relief, propoxyphene is frequently combined with acetamin ophen. It is less likely to cause dependence and severe wi thdra wa l symptoms than other opiate dr ugs. See Opioid Analgesics for additional inform ation on side effects and possible drug interactions.

SPECIALINFORMATION • Rarely, propoxyphene can cause j aundic e and reduced liver function, which may include such symptoms as weakness, loss of appetite , and nausea. ♦ Combining propoxyphene with alco hol , tr anquili zers, sedati ves, muscle relaxant s, o r antidepr essants can lead to death. Do not combine these drugs without your doctor 's knowledg e. POSSIBLE

INTERACTIONS

Amphetamines: risk of co nvulsion s if a patient taking amphetam ines takes an ove rdose of pro poxyphene .

Anticoagulants: may increase th e effects

high blood pressure (hypertension) , heart-rhythm disorders , angina, tremors , and myoca rdi al infarction (heart att ack) . Ot her uses includ e the prevention of migraine headaches. By blocking the act ion of cert ain part s of the nervous system, propranolol reduces th e oxyge n req uir ements and co ntr act ion force of the heart while also relaxing blood vessels, thereby low erin g blood pressure and easing the heart's work load. The drug also affects th e movement of nerve impul ses in the heart, helpin g to co ntrol some heartrhythm probl ems. Since propr anolol has a stron ger effect on the centr al nervou s syst em than other beta-adrenergic blockers, it is more likely to cause tir edness or di zz iness. See Beta-Adrenergic Blockers for more informati on about these drugs, including side eff ects and possible dru g int eract ions.

crease the effects of propoxyphene.

Tobacco: may decrease th e effect s of propoxyphene.

PROPRANOLOL

DRUG CLASS Beta-Adrenergic Blockers

BRAND NAMES lnderal , lnd eral LA

GENERALDESCRIPTION A nonselect ive beta-blocking drug, pro pranolol is prescribed to help manage

of both combin ed drugs. Your doctor may have to adjust the dosage of both medi cation s.

PSYLLIUM

LATINNAME

Plantago psyllium GENERALDESCRIPTION For centuries , traditi onal Chinese and Ayurvedic (Hindu ) physicians have used psy llium to treat di arr hea, constipation , hemorrh o ids, and urin ary probl ems. The ground-up seeds, ri ch in fiber , make a safe, gentl e, bulk -fo rmin g laxat ive and are the act ive ingredient in many commercia l laxative products. Both diarrhea and co nstipation may be tr eated, because the herb absorbs excess fluid in th e inte stinal tra ct and increases stoo l vo lume. Recentl y it has been suggested that psy llium may help prevent heart disease by clearing excess cholesterol from the body. Thi s 18-inch-t all herb produ ces white flow ers and abundant, small, brown seed pods.

Rx: Allegra-D, Claritin-D

OTC: Actifed, Advil Cold and Sinus,

TARGETAILMENTS • ulcers, co liti s, const ipatio n, hemorrhoid al irritation , diarrhea. (Take int ernally. )

PREPARATIONS Over the counter: Psyllium is availabl e as whole seeds, ground or powd ered seeds, and in var ious commercial bulk-forming laxati ve preparations.

Pseudoephedrin e is a synthetic decongest ant dru g modeled on th e ephedr ine fo und in plants of the Ephedra genus. The drug is used to treat congestion of th e nasal, sinus, and Eustachian passages caused by colds, allergies, or related respirator y problems. Pseudoephedrine is banned for use during athletic competition. See Decongestants for information about side effects and other possible drug interactions.

Prescription Drug

0

Over-theCounter Drug

•

Drink: Mi x 1 tsp gro und seeds or powder in 1 cup cool liquid . Drink 2 to 3 cups a day. Seeds: Take 1 tsp seeds with wate r at mealtim es. SIDE

EFFECTS

Not serious: Psyllium can cause all ergic reacti ons in peopl e who have allergies to dust or grasses. Call your doctor if both ersome.

Some prepar ations that co nt ain pseudoephedrine also contain antihist amines , which can cause other side effects , including dro ws iness. See Antihistamines for f urth er information.

0

GI

At home:

SPECIALINFORMATION ♦

INTERACTIONS

creased ri sk of heart-r hyt hm problems.

BRAND NAMES

GENERALDESCRIPT ION

Cimetidine: possible centr al nervou s

MEDICINES

Thyroid hormones: increased effects

Decongestants

system to xicity.

fects of carba mazepin e, leading to an increased r isk of to x icity.

POSSIBLE

DRUG CLASS

Smoking cessation drugs, such as nicotine patches or chewing gum: may in-

Carbamazepine: may increase the ef-

NATURAL

Levodopa (anti-Parkinsonism drug): in-

PSEUDOEPHEDRINE

Comtrex Multi-Symptom Cold Reliever Tablet s or Liquid , Contac, Dri xo ral , NyQ uil , Sudafed, Tavist-D , TheraFlu , Triaminic Nite Light , Triamini c Sore Thro at Formul a, Tylenol Allergy Sinus, Tylenol Cold (adults and childr en), Tylenol Sinus

of some ant icoagulant s.

AND

Serious: Severe allergic reactio ns are rare; if you have difficulty breathing, seek emergency help .

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We stern Herb

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Chinese Herb

A Homeopathic V Remedy

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CONVENTIONAL

AND

NATURAL

SPECIAL INFORMATION WARNING: You must drink 8 to 10 glasses of water throughout the day when taking psyllium as a laxative, to prevent blockage of the intestines. ♦ Start using this herb gradually, so your body can adjust to the increase in fiber. ♦ Do not use psyllium to treat ulcers or colitis without consulting your doctor. ♦ Do not use this herb if you have a bowel obstruction or intestinal or esophageal narrowing. ♦ Oral medication should be taken away from psyllium as the herb may delay the absorption of the other medication. ♦ Do not give this herb to children younger than two years of age. Consult your pediatrician if your infant or child is constipated. ♦ Pregnant women should avoid psyllium and all laxatives, because they stimulate the lower pelvis near the uterus. ♦

PSYLLIUM HYDROPHILIC MUC ILLOID DRUG CLASS Laxatives BRAND NAME Metamucil GENERAL DESCRIPTION Psyllium hydrophilic mucilloid is a bulkforming laxative used to relieve chronic constipation. It also helps relieve chronic, watery diarrhea. This type of laxative may be especially beneficial to people on low-fiber diets and to those with irritable bowel syndrome (spastic colon), diverticulitis, or hemorrhoids. See Laxatives for information about other side effects and possible drug interactions. S IDE EFFE CT S

Serious: In rare cases, people with respiratory problems may have adverse reactions

998

MEDICINES

to inhaled particles from powder preparations. SPECIAL INFORMATION ♦ When taking this laxative, be sure to drink plenty of water or other fluid to avoid obstruction of the throat and esophagus. Taking this medication without enough liquid may cause choking. ♦ This laxative is slow-acting; you may not experience its effects for 12 to 72 hours after taking it.

PULSATILLA

LATIN NAME

Pulsatilla nigricans GENERAL DESCRIPTION Common to meadowlands in northern and central Europe, the pulsatilla, or windflower, contains a caustic substance, and chewing the plant may cause blisters in the mouth and throat. Homeopathic physicians often prescribe Pulsatilla to patients with conditions accompanied by a thick yellow or white discharge. For homeopathic use, Pulsatilla is collected when in full bloom and pounded to a pulp. The pulp is steeped in an alcohol-and-water solution and then strained and diluted. Like most homeopathic prescriptions, pulsatilla was developed as a remedy by observation of the reactions of healthy individuals to a series of undilute doses. The mental, emotional, and physical changes induced by Pulsatilla were then cataloged. When a homeopathic practitioner encounters a patient with a set of symptoms that matches the cataloged symptoms brought on by pulsatilla, the practitioner then prescribes it in an extremely dilute form. It is presumed that in this highly dilute dosage, Pulsatilla can counter the symptoms that it induces when it is at full strength. TARGET AILMENTS ♦ bedwetting, breast infections, chickenpox; conjunctivitis; coughs that

·

cause a rattling sound in the chest and interfere with sleep; headaches in the forehead; eye inflammation, if the eyes ache and there is a thick discharge; fever with chills; hay fever; incontinence; indigestion from rich, fatty foods; aching joints that improve with movement and cold compresses; urethritis in men; late menstrual periods; endometriosis, otitis media (middle ear infection); sciatica; sinusitis; varicose veins; depression with excessive weeping. PREPARATIONS Pulsatilla is available over the counter in various potencies, both in liquid and in tablet form, at selected stores and pharmacies. Consult your homeopathic physician for more precise information. SIDE

EF F EC T S

None expected.

QUINAPRIL

DRUG CLASS Angiotensin-Converting Inhibitors

Enzyme (ACE)

BRAND NAME Accupril GENERAL DESCRIPTION Quinapril is prescribed to treat hypertension (mild-to-moderate high blood pressure) and congestive heart failure. Like other ACE inhibitors, this drug works by relaxing the artery walls, thereby lowering blood pressure. See

Angiotensin-Converting Enzyme (ACE) Inhibitors for information on side effects and other possible drug interactions. POSSIBLE

INTERACTIONS

Drugs that interact with magnesium, such as tetracycline and diuretics: because of its high magnesium content, quinapril may reduce the body's absorption of these medications.

-

CONVENTIONAL

RAMIPRIL

of breasts or breast soreness (in women or men). Call your doctor if these symptoms persist or become bothersome.

DRUG CLASS

Allergic reaction (burning , redness, or swelling of the skin). Rare: irregular heartb eat, tightness in the chest, confusion, fever , sore throat , unusual bleeding or bruising, unusual tiredness or weakness. Call your doctor immediately if you experience these symptoms.

AND

Enzyme (ACE)

BRAND NAME Altace

GENERALDESCRIPTION Because it relaxes arterial walls and lowers blood pressure, the ACE inhibitor ramipril is prescribed for mildto-severe high blood pressure (hypertension). See Angiotensin-Converting Enzyme (ACE) Inhibitors for information on side effects and possible drug interactions .

SPECIALINFORMATION ♦

• •

•

RANITIDINE •

DRUG CLASS Antiulcer Drugs [Histamine H2 Blockers]

♦

TARGETAILMENTS

You may need to take this drug for several days before experiencing any relief from stomach pain. Tell your doctor if you have a history of kidney or liver disease. If you are also using antacids for relief from ulcer pain, take the antacid at least two hours before or after taking ranitidine. Because this drug may cause dizziness or drowsiness, you may need to restrict your driving or involvement in potentially hazardous activities. Avoid this drug if you are pregnant or nursing. Ranitidine may cause a false-positive result in urine protein tests. POSSIBLE

MEDICINES

pectorant in China, and as a cure for asthma in Russia. Other cultures have used it to treat skin sores and eye irritations, and as a diuretic . Herbalists today prescribe red clover for skin ailments , indigestion, and coughs . It is an antiinflammatory agent and also, as an expectorant , helps remove excess mucus from the lungs. In addition, the herb appears to act like the female hormone estrogen; it is believed that it might help women with menopausal symptoms.

Serious: Angiotensin-Converting Inhibitors

NATURAL

Take internally for: • coughs, bronchitis, whooping cough, indigestion, menopausal symptoms. Use internally and externally for: • skin problems such as eczema and psoriasis.

PREPARATIONS Over the counter: Red clover is available in dried bulk and tincture.

At home: Infusion: Steep 1 to 3 tsp dried flower tops in 1 cup boiling water for 10 to 15 minutes. Drink up to 3 cups a day. Compress: Soak a clean cloth in the infusion and apply to the skin.

INTERACTIONS

BRAND NAMES Rx: Tritec , Zantac 150 , Zantac 300

Alcohol: significantly increased concentration of alcohol in the blood.

Serious:

OTC: Zantac 75

Antacids: decreased absorption of ranitidine into the body; avoid taking antacids within two hours of ranitidine.

Overdoses of red clover may cause stomachaches or diarrhea. Discontinue if you experience these symptoms.

GENERALDESCRIPTION Ranitidine is used primarily to treat ulcers of the stomach and duodenum (up per intestine). It is also prescribed for Zollinger-Ellison syndrome , gastroesophageal reflux (in which stomach acid flows backward into the esophagus), and other conditions involving the overproduction of stomach acid. In some cases, ranitidine is used to prevent upper gastrointestinal bleeding. Belonging to the subclass of antiulcer drugs known as histamine H2 blockers , ranitidine works by blocking the effects of the chemical compound histamine in the stomach, thereby reducing the secretion of the digestive juice hydrochloric acid . For more information on side effects and possible drug interactions, see Antiu/cer Drugs. S I DE EFFECTS

Not serious: Constipation , diarrhea , dizziness, drowsiness, headache, nausea or vomiting, skin rash. Less common: blurred vision, joint or muscle pain , hair loss, decreased libido, decreased sexual ability, swelling

SIDE

Diazepam: inhibited absorption of diazepam into the body.

SPECIALINFORMATION • WARNING: Do not use red clover if you are pregnant, because of its estrogen-like behavior. + WARNING: Avoid the herb if you have estrogen-dependent cancer or a history of heart disease, stroke , or thrombophlebitis. ♦ Do not use red clover if you are taking blood thinning medicine. The herb's blood thinning properties will poteniate the medication. • If you are taking birth-control pills, consult your doctor before using red clover. ♦ Do not give the herb to children under 2 years of age. Older children and people over 65 should start with a low dose and increase as needed. • Red clover contains four antitumor compounds among its chemical components, and some herbalists believe it may find use in combination with more powerful drugs to treat cancers that are not aggravated by estrogen.

Glipizide, glyburide, theophylline: increased effects of these drugs.

Warfarin: decreased elimination of warfarin from the body, possibly resulting in bleeding complications.

RED CLOVER

LATINNAME Trifolium pratense

GENERALDESCRIPTION The perennial plant known as red clover grows as high as two feet. Its medicinal parts are the red or purple ball-shaped flowers, which are gathered between May and September. Red clover has been used medicinally in many parts of the world. It was prescribed as an ex-

0

Prescription Drug

0

Over-theCounter Drug

EFFECTS

O

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CONVENTIONAL

AND

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MEDICINES

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RED RASPBERRY

RHUS TOX ICODENDRON

LATIN NAME

LATIN NAME

Rub us idaeus

Rhus toxicode nd ron

GENERA L DESCRIPTION The berry of thi s bienni al bush is co mmonl y used in gourm et dessert s, but herbalist s va lue th e leaves. These have hi gh co ncentr ation s of ta nnin , a chemica l th at herbalists believe is eff ect ive in t reat ing diarrh ea, nausea, vo miting , and mo rnin g sickness in pregnancy. It is also t hought th at tannin , an astrin gent substance, helps pr event mi scarri ages and, durin g labor, str ength ens co ntr action s, checks hemo rrh aging, and red uces labor pains; yo u should not, howeve r, use red raspberr y fo r t hi s pur pose at home. Red raspberr y leaves are includ ed in several herbal pr egnancy fo rmul as sold in th e Unit ed States. The herb is also used as a gargle for sore thro at s.

GENERA L DESCRIPTION Thi s v inelik e shr ub, also know n as po ison ivy, grows throu ghout Nor th Am er ica and is we ll know n fo r t he it chy, red rash its o i I can cause on t he skin . The med ic inal history of it s leaves and st alk began in th e late 18th century , w hen it was used t o tr eat condition s such as paralysis and rheum atism . The effec t s of it s und ilut e fo rm can range fr om a rash to nausea, feve r, del irium , swo llen glands, and ul cers in th e oral cavi t y. For thi s reason, homeop athi c pr act it io ners use Rhu s tox ico dend ron, or Rhus tax, as it is also ca lled, to tre at co ndi t io ns t hat may be acco mpanied by a fever, restlessness, and swollen glands. Rhu s tax is prep ared fro m pl ant s gath ered at night , w hen th e o il is said t o be in it s most pot ent st at e. The leaves and st alks are pound ed to a pul p and mi xed w ith alco ho l, th en str ained and dilut ed. Like most homeopathi c prescr ipti ons, Rhus tax was develop ed as a remedy by stu dy ing t he reactions of health y ind iv idu als to a seri es of undilut e doses. The ment al, emoti onal, and phy sica l changes indu ced by Rhus tax we re th en cataloged. When a home opath ic pr acti ti oner enco unt ers a pati ent wi th a set of symptoms th at mat ches the cata loged sympt oms br ought on by Rhus tax, t he pr actiti oner then pr escri bes it in an extr emely dilut e form. It is· presumed t hat in thi s highl y d ilut e dosage, Rhus tax can co unt er th e sympt o ms th at it indu ces w hen it is at full strength. For mo re info rm ati on on homeopathi c medicine, see page 102 7.

mac ies. Consult you r homeopath ic physic ian for more prec ise info rmat ion . SIDE

TARG ET A ILMEN TS ♦ mornin g sickness, thr eat ened mi scarri age, problem s ari sing dur ing labo r, di arrh ea, mouth ulcers, bl eedin g gums. (Take int ern all y.) PREPARATI ONS Over the counter: Red raspberr y is ava ilabl e as dr ied leaves or berri es, and as a tin ctu re.

At home: Inf usio n: Use 1 t o 2 t sp dried leaves or berr ies per cup of bo ilin g wat er. Steep fo r 10 t o 15 minut es. Drin k co ld and as desir ed. D uri ng pr egnancy and w ith the co nsent of your physicia n, dri nk up to 3 cups daily. For childr en, d ilute t he infusion with mor e w ater. SIDE

EFFECTS

N ot serious: Red raspberry may cause stomach upset or di arrh ea if you exceed t he reco mmended do se. SPECIAL INFORMATION ♦ Pregnant w om en should t ake red raspberry only w ith th e co nsent and superv ision of a phy sician. ♦ A nim al t ests suggest th at red raspberr y may redu ce levels of gluco se (bl ood sugar) in animals, and hence may help in th e management of di abet es.

TARGET AILMENTS ♦ arthri t is w it h stiffn ess th at is wo rse in the mo rnin g and bett er fr om moti on; bac kache w ith stiffn ess along th e spine; bur sitis; carp al tunnel syndr ome; eye infl amm ation w ith sw ellin g and itc hin g, and with sticky matter betw een th e eyelids ; genit al herpes; hamstrin g injury ; influ enza w it h pai nful jo int s; headaches; hives th at it ch, stin g, and inten sify aft er scrat ching; j o int and back pains bro ught on by overexertion ; imp eti go; po ison ivy; sprains w ith sti ff ness; t ooth aches. PREPARATIONS Rhus tax is available ov er th e co unt er in vari ous pot encies, both in liqui d and in t abl et fo rm , at select ed st ores and phar-

1000

EFFECTS

None expected .

RO FECOXIB

DRUG C LASS Nonst ero idal Anti-Infl amm at ory Dru g (NSA ID s) [CO X-2 Inhibito rs] BRAND NAM E Vioxx GENERAL DESCRIPTION Rofecox ib is used t o tre at osteoart hr iti s (degenerati ve j o int disease), acut e pain in adult s, and painful menstru al cycl es. It is a t ype of no nsteroidal anti -i nfl ammat ory dr ug (NSAI D) th at selecti ve ly inhibits th e COX -2 enzy me act ive at sites of infla mm at ion. Rofecox ib does not inhibit th e COX- 1 enzy me pr esent in th e st omach. Because of thi s selecti vity fo r COX-2 , it is less lik ely t o cause ul cers and st omach bleedin g th an nonselecti ve NSAI Ds. Fo r addition al inform ati on, see

COX-2 Inhibitors.

ROSE HIP

LATIN NAME Rosa spp. GENERAL DESCRIPTION In th e 1930s, her bali sts di scovered v it amin C in fr esh rose hips- th e cherr ysized, bri ght red fruit s that remain aft er th e rose pet als have fa llen off. Since th en, scient ist s have found th at rose hip s also co nt ain fl avonoid s, w hi ch increase th e body's utili zation of th e v it amin . Fo r th ese reasons, herb ali st s pr escrib e rose hip s for colds and flu . Bet wee n 45 and 90 percent of the v itamin is lost , how ever, wh en th e herb is dri ed. Bewa re w hen buy ing pr epackaged rose hip t eas, j ams, extr acts, pur ees, and soups; w hil e oft en co nsumed fo r th eir natur al vit amin C, t hey may actu ally co nt ain ve ry small amount s of it.

., CONVENTIONAL -

-

TARGETAILMENTS

AND

a pl easant frag rance and fl avo r.

TARGETAILMENTS Over the counter: Rose hips are avail abl e as dr ied bul k and in t inct ure. At home:

Inf usion: Use 2 to 3 tsp dri ed, chopped hip s per cup of boilin g wa t er. Steep fo r 10 minut es. Drink hot or wa rm , as desir ed. Jam: Co ll ect th e hip s aft er t he fi rst fr ost and do not use any th at have been sprayed w ith insecti c ide. Place in a heavy, st ainl ess st eel pan and simm er until t ender, using 1 cup wa ter t o 1 lb rose hi ps. Rub throu gh a f ine sieve. We igh th e pul p and add 1 lb heated sugar fo r each lb pulp. Simm er until t hick. SIDE

EFFECTS

Not serious: Hi gh doses of v itamin C may cause di arrhea and may slightl y str ain th e kidn eys.

SPECIAL INFORMATION + If you have a kidn ey inf ection, co nsult yo ur doctor befor e t akin g large quantiti es of rose hip s. + Do not use x pot ency dilution s of thi s remedy if yo u are severely sensit ive t o po ison ivy.

ROSEMARY

LATIN NAME Rosmarinus officina/is GENERAL DESCRIPTION The evergreen perennial known as rosemary has a pl etho ra of uses in addition t o serv ing as a culin ary spice . Herbalist s believe th at it s leaves stimul ate th e cir cul at ory and nervo us systems and th erefo re serve as an ant id epr essant. Rosemary leaves also are thou ght to co ntain antisp asmodi c chemi ca ls th at relax th e smooth musc le linin g of the dig estive tr act. In additi on th ey are used t o treat muscl e pain. In recent years, ro semary has developed a reput ation for antiba cte ri al and ant if ungal action , and herb alists reco mm end th at the leaves be used ext ernally for skin infe cti o ns. Rosemar y is also pr escri bed as a gar gle for bad breath . Befor e refri ger ati o n was invented, cru shed rosemar y leaves we re w rapped around meats t o pr event them fr om beco min g ranc id, and t o give them

MEDICINES

Romans, w ho valued it fo r it s medi cinal prope rti es. Ruta co mes fro m th e Gr eek reuo, meaning " to set free ," an allu sio n to its hi stori cal popul arit y as a cure fo r numerou s co mplaint s, includ ing headaches, co ughs, and cro up. Th ro ugh centuri es of use, t hi s small shrub, somet imes called ru e or rue bitt erwo rt, has spread t o herb gardens w orld w ide. In large doses, Ruta has to xic properti es, but homeopathi c physicians pr escrib e minute doses to tr eat co nditi ons or injuri es th at may be acco mpanied by symptom s of w eakness o r a bruis ed sensati on. The pl ant is co ll ected for homeopathi c use ju st befor e bl ossomin g; it is pounded t o a pulp and pressed for its jui ce, w hich is th en dilut ed in a wat erand- alcoh o l base. Like most homeopat hi c prescripti ons, Ruta was developed as a rem edy by study ing t he reaction s of healthy indi v idu als t o a seri es of und ilut e doses. The ment al, emot ion al, and physical changes induced by Ruta w ere then cataloged. Wh en a home opathi c pract iti o ner encount ers a patient w ith a set of symptom s that match es the cat aloged symptom s brou ght on by Ruta, th e pr actit io ner th en pr escrib es it in an extremely dilute form. It is pr esumed th at in thi s highl y dilut e dosage, Ruta can count er th e symptoms th at it indu ces w hen it is at full stren gth . For mor e info rm ation on homeop athic medicin e, see page 1027 .

+ co lds and f lu . (Take int er nally.) PREPARATIONS

NATURAL

-

Take int ernally fo r: ♦ ind igestio n, upper-respir at ory inf ecti ons th at requi re a deco ngest ant , t ension, mu scl e pain, sprains, rh eum ati sm, neur algia. Appl y ext ernally, as an anti sept ic, fo r :

+ skin inf ect ions.

PREPARATIONS Over the counter: Rosemary is avail able as dri ed bulk , in tin ctur e, and as two typ es of o il, one fo r int ern al use and th e oth er for ext ern al appli cation . At home: Infu sion: Use 1 t sp crushed leaves per cup of bo ilin g wa t er. Steep 10 to 15 minut es. To settl e th e stomach or cl ear a stuffy nose, drink 3 cup s a day. For childr en yo unger th an t wo years, dilut e th e infusion with more w ater. SIDE

EFFECT

S

Not serious: Rosemary o il for int ern al use may cause mild stom ach, kidn ey, and int estinal irrit ati on, even in small do ses. If yo u experi ence any of the se disco mfort s, co nsult your physic ian. Serious: Rosemary o il, taken int ern ally in large amounts, can be po isonous. Keep to t he pr escribed do sage.

TARGETAILMENTS + carpal tu nnel syndr ome; eyestr ain caused by over work , and accomp anied by heat and pain; sc iati ca; gro in str ain; sprain s w ith pain and a bruis ed sensation ; tennis elbow ; inj ur ies of t endons and cart ilage.

SPECIALINFORMATION + WARN! N G: Do not co nfuse ro semary oil fo r int ernal use w ith th at appli ed ext ernall y. Neve r ingest the ext ernal vari ety. ♦ Pregnant w om en should avo id rosemary. It may stimulat e the ut erus. + So me herb alist s suggest put ti ng ro semary leaves in bath s fo r relaxation and even rubbin g them on th e head t o redr ess prem ature baldn ess. + Recent studies indicat e that rosem ary may con ta in antio xid ant ch emical s th at may help t o pre ve nt fo od po isoning and to fight tumor s.

PREPARATIONS Ruta is avail abl e ove r th e coun te r in vari ous pot encie s, in both liquid and t ablet form , at select ed stor es and pharmacies. Consult your homeopathi c physician for fur t her info rmati o n. SIDE

EFFECTS

a

No ne expect ed.

RUTA

LATINNAME Ruta graveo/ens GENERALDESCRIPTION Nati ve to south ern Europe, rut a spread across th e co ntin ent in th e wa ke of the

0

Prescription Dru g

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O ver-theCounter Dru g

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Western Herb

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Chinese Herb

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Homeopathic Remedy

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CONVENTIONAL

AND

NATURAL

SAFFLOWER FLOWER

LATIN NAME

MEDICINES

SPECIAL INFORMATION

SPECIAL INFORMATION

♦

♦

Do not use safflower flowers if you are pregnant, because there is evidence that the herb stimulates the uterus.

Carthamus tinctorius GENERAL DESCRIPTION

The Chinese name of this herb, hong hua, means "red flower, " and herbalists prescribe safflower flower for several conditions related to the flow of blood through the body. It is harvested in several Chinese provinces throughout June and July, when the color of the flowers changes from yellow to red; traditionalists prefer picking safflower flower on the morning of a cloudy day, before the dew has dried. In addition to their fresh red color, the best safflower flowers have long petals and feel soft. According to traditional Chinese medicine, the herb is characterized as acrid and warm. TARGET AILMENTS

Take internally for: ♦ delayed menstruation , poor blood circulation, blood clots , stabbing chest pain. Apply externally for: burns, bruises, and other injuries to the skin.

♦

Use both internally and externally for: sores and carbuncles, measles in its early stages.

♦

PREPARATIONS

Dried safflower flower is available in bulk at Chinese pharmacies, Asian markets, and some Western health food stores. You can also obtain it in tablet form. It is frequently sold in liniments for treating bruises and injuries.

ID

Combinations: Safflower flower is mixed with cnidium root (Ligusticum chuanxiong) for chest pain. It is combined with dong quai and sappan wood to make a preparation for treating the pain and swelling associated with trauma. A mixture with Chinese foxglove root, red peony root, and forsythia fruit is prescribed for pain, redness, and swelling of the eyes. Safflower flowers and groomwell root are combined into a decoction and taken internally or used externally to treat boils, carbuncles, and childhood measles. For information on dosages and additional preparations, check with a Chinese medicine practitioner. SIDE

EFFECTS

None expected.

1002

SAFFRON

LATIN NAME

WARNING: In large amounts, saffron is highly toxic. Take the herb only in the recommended dosage, in consultation with your practitioner. • Do not use saffron to induce an abortion. Women have died as a result of taking an overdose, in an attempt to end their pregnancies. ♦ Do not give saffron to children under 2 years of age. For older children and adults over 65, begin with lowstrength preparations and increase gradually.

Crocus sativus GENERAL DESCRIPTION

Saffron is one of the most expensive herbs, with prices ranging from $55 to $250 an ounce. The price is high because the valuable components are not the leaves or the violet petals but the three tiny, orange, antenna-like stigmas inside the flower of this member of the crocus family. An ingredient of the stigmas known as crocetin is the active agent. To produce one ounce of saffron, you would need to harvest almost 5,000 flowers. Even if you have that energy, you should never try to harvest your own saffron; you might use the wrong kind of crocus. Herbalists prescribe saffron primarily in conjunction with the conventional treatment for high blood pressure and heart disease. Laboratory studies have indicated that injections of crocetin may decrease cholesterol levels in animals. Some herbalists believe that saffron may increase the amount of oxygen in the blood; the oxygen , in turn , may slow the growth of artery-clogging plaque deposits. Crocetin is also thought to stimulate the uterus and the digestive process, and so practitioners also recommend saffron for digestion and to promote menstruation. TARGET AILMENTS

• high cholesterol , high blood pressure, atherosclerosis, indigestion , delayed menstruation. (Take internally.) PREPARATIONS Over the counter: Saffron is available as dried powder and dried stigmas.

At home: Infusion: Place 12 to 15 stigmas in 1 cup boiling water. Steep 10 minutes . Drink up to 1 cup a day. SIDE

EFFECTS

None expected.

SAGE

LATIN NAME

Salvia officinalis GENERAL DESCRIPTION

The scientific name of sage, Salvia, derives from the Latin for "to save," which underscores the herb's early reputation as a cure-all. Modern herbalists are more specific. They believe that sage contains an aromatic oil that reduces excessive perspiration and the night sweats associated with such diseases as tuberculosis. In addition, the oil, which is antiseptic, combines with another component, the astringent tannin , to relieve sore throats or gums. This savory herb, whose gray-green, oval leaves are familiar to most gardeners, has also been used to cleanse wounds , stem lactation in nursing mothers, aid digestion, and preserve meat. TARGET AILMENTS

Take internally for: • indigestion, gas, nausea, and to stem lactation or reduce the night sweats of menopause. Use as a mouthwash or gargle for: mouth and throat infections, inflammations, and ulcers, including canker sores, bleeding gums, sore throats, and tonsillitis.

♦

Apply externally for: • bacterial infections in wounds; insect bites. PREPARATIONS Over the counter: Available as tinctures, prepared tea, or dried or fresh leaves.

At home: Infusion: Steep 2 to 3 tsp leaves per cup of boiling water for 10 minutes. Drink 3 cups a day, hot or cold, or use

as a wash for bacterial infections in wounds. Compress: Soak a clean cloth in the infusion and apply to insect bites. Tincture: Take 1 to 1½ tsp three times daily with water or juice . Mouthwash: Add 3 tsp leaves to 1 pt water, bring to a boil, and let stand covered for 15 minutes. Gargle the warm liquid three times daily. Fresh: Apply fresh sage leaves to minor cuts or scrapes before washing and bandaging. SIDE

EFFECTS

Not serious: Drinking the tea may inflame the lips and mouth lining. SPECIAL INFORMATION + WARNING: Sage contains the toxic chemical thujone, which can lead to convulsions if taken in high doses. However , the heat of cooking or preparing an infusion reduces toxicity. Sage oil should not be ingeste_ d. + Because it may cause convulsions, sage is best avoided by persons with epilepsy. + Do not take sage if you are pregnant or nursing. + Use dilute preparations for children under 12 and adults over 65.

Take internally, in consultation with an herbalist or a doctor for: ♦ depression.

bronchodilators or with inh aled or oral steroids. For side effects and drug int eract ions, see Bronchodilators.

PREPARATIONS

SPECIAL INFORMATION + WARNING: Do not take salmeterol if you have an irregular heart rhythm or if you have taken a mono amine oxidase (MAO) inhibitor within th e past two weeks . + WARNING: Do not take salmeterol for an acute asthma attack or if your asthma is getting worse; use a shortacting bronchodilator or oral steroids instead.

Over the counter: Available as dried leaves and flowers, tinctures, extract, oil, ointment, capsules, and prepared tea . At home: Tea: Add 1 to 2 tsp dried herb to 1 cup boiling water; steep for 15 minutes. Drink up to 3 cups a day. Oil: Use a commercial pr eparation , or make by soaking the flowers in almond or olive oil until the oil turns bright red. Ointment: Use a commercial preparation , or make by warming the leaves in hot petroleum jelly or a mixture of beeswax and almond oil.

SARGASSUMSEAWEED

Fresh: Apply crushed leaves and flowers to cleaned wounds. LATIN NAME Sargassum pallidum

Tincture: Add ¼ to 1 tsp to an 8-oz glass of water and drink daily. SIDE

GENERAL DESCRIPTION More commonly known as seaweed, sargassum is collected from the coastal provinces of China, and from other coastlines around the world. Its high content of the element iodine makes it effective in treating a variety of ailments related to the thyroid gland. It also pro motes urination and is traditionally pr escribed for the pain of hernia. In traditional Chinese medicine sargassum is characterized as a cold, salty herb.

EFFECTS

Serious: High blood pressure, headaches, stiff neck, nausea, and vomiting. In the fairskinned, it can exacerbate sunburn and cause blistering after sun exposure. SPECIAL INFORMATION Consult a doctor or an herbalist before using St.-John's-wort. If you are taking any antidepressant medications , take St.-John's-wort only with your physician's consent. + Do not take St.-John's-wort if you are pregnant. ♦

ST.-JOHN'S-WORT

TARGET AILMENTS Take internally for: + nodules in the neck, which include goiter (a thyroid problem ) and other thyroid disorders; scrofula (a form of tuberculosis). + inadequate urination ; edema (retention of fluids in the body); pain from hernia; swollen, pai nf u I testes.

LATIN NAME Hypericum perforatum GENERAL DESCRIPTION Herbalists now know that the flowers of the plant called St.-John's-wort, ~sed for centuries to heal wounds, contain hypericin, a substance with germicidal, anti-inflammatory, and antidepressant properties. These blooms also hold high concentrations of chemicals known as flavonoids, which are thought to boost the immune system. The plant ( wort means " plant" in Old English) was named for St. John the Baptist , because its blood-red flowers are said to bloom on the anniversary of his execution. A woody perennial, its leaves are dotted with glands that produce a red oil when pinched. TARGET A ILMENTS Use externally for : + wounds, including cuts, abrasions, burns; scar tissue.

SALMETEROL

PREPARATIONS Sargassum is available in bulk at Chinese pharmacies, Asian markets, and Western health food stores.

DRUG CLASS Bronchodi lat ors BRAND NAME Serevent

Combinations: A mixture of sargassum, silkworm, prunella , and scrophularia is used for goiter and scrofula. The same symptoms can also be treated with a preparation of sargassum and licorice; some traditional texts suggest that these two herbs are incompatible, although animal experiments have shown no adverse reactions. A combination of sargassum and water chestnut is prescrib ed for the lung disease silicosis. For information on dosages and other preparations , consult a Chinese med icine practitioner.

GENERAL DESCRIPTION Used principally as a treatment for chronic asthma, salmeterol causes the bronchial smooth muscles to rela x, relieving spasms and opening the airways. If taken regularly, this drug helps relieve symptoms of asthma, including asthma induced by exercise. Salmeterol, available as an aerosol inhaler and as a powdered inhalant , may be used in conjunction with short-acting inhaled

0

Prescriptio n Drug

0

Over -theCounter Drug

O

W estern Herb

O

Chinese Herb

~ Homeopathic 1003 U Remedy

CONVENTIONAL

AND

NATURAL

S ID E E FF EC T S

None expected. SPECIAL INFORMATION ♦ Sargassum's ability to stimulate the excretion of fluids from the body makes it useful for individuals trying to lose weight; but the herb is not appropriate for all weight-loss patients, because its impact on the thyroid gland affects the metabolism rate. Consult a Chinese medicine practitioner before using this herb. ♦ In laboratory tests, extracts of the herb inhibited the growth of fungi .

SASSAFRAS

LATIN NAME

Sassafras albidum GENERAL DESCRIPTION The root bark of this native American tree yields a tea with not only a pleasant taste but also a wide reputation as a tonic. It contains a volatile oil once prized as a flavoring for root beer and other beverages. Laboratory tests in the 1960s, however, revealed that the main component of the oil, safrole, is carcinogenic in rats and mice, and the U.S. Food and Drug Administration has prohibited the internal use of sassafras containing safrole. Until the ban, the herb was widely used for a variety of ailments, including colic, rheumatism, and poison ivy. The essential oil of the root bark has recently been found to have mild antiseptic action and is still used to combat external infections. TARGET AILMENTS The only approved applications are external. Use as liniment for: ♦ rheumatism.

D

Use a compress for:

+ skin irritations such as acne, boils, poison ivy, and poison oak. PREPARATIONS Over the counter: Sassafras is available as an essential oil and tincture and as fresh or dried root bark, although internal use is prohibited.

At home: Liniment: Mix 1 oz each of the tinctures of sassafras, prickly ash, cayenne, myrrh, and camphor with 3 oz water; shake well, and apply to areas afflicted by rheumatism.

1004

MEDICINES

SIDE

EFFEC T S

None expected if used externally.

SAW PALMETTO

LATIN NAME

Serenoa repens GENERAL DESCRIPTION An extract made from the berries of this shrub is used to treat and strengthen the male reproductive system. It is particularly recommended for benign enlargement of the prostate gland . This disorder is indicated by urination difficulties and can lead to bladder infections and kidney problems. Common among men over 50, the condition is thought to be caused by an accumulation of a testosterone derivative called dihydrotestosterone, which saw palmetto appears to block the production of. The herb has also been used as an expectorant, diuretic, tonic, antiseptic, sedative, and digestive aid. It is native to the sandy coast of the southeastern United States, where the plant reaches a height of about 10 feet. TARGET AILMENTS + benign prostatic hyperplasia (enlargement of the prostate gland); nasal congestion; asthma and bronchitis ; coughs due to colds; sore throats ; sinus ailments. (Use internally.)

,

SPECIAL INFORMATION ♦ WARNING: Do not substitute saw palmetto for medical treatment. Although saw palmetto is thought to be effectiv e for treating an enlarged prostate , it has no known effect against prostate cancer. Because the symptoms of prostate enlargement and prostate cancer are similar , men should see a doctor when they have urological symptoms such as urine retention, dribbling, and passage of blood in the urine . ♦ Do not use saw palmetto if you are pregnant.

SCALLION

LATIN NAME

Allium Pstulosum GENERAL DESCRIPTION The white bulb and green parts of scallions, or spring onions, are prescribed to improve digestion and help regulate the metabolism rate. They affect the body in a manner similar to garlic but are often preferred because of their less powerful odor. Traditional Chinese medicine characterizes the herb as acrid and warm. TARGET AILMENTS Take internally for: + chills and fevers , nasal congestion , abdominal pain and distention.

Apply externally for: + sores and abscesses.

PREPARATIONS Over the counter: Available as fresh or dried berries and in powder or capsule form. Gel capsules are preferable to tea or tincture, because the active ingredients of the herb are fat soluble and do not dissolve well in water.

PREPARATIONS Over the counter: Scallions are available at Chinese pharmacies as well as at Asian and Western food markets. You can also obtain tablets containing the herb.

At home: Infusion: If you have fresh berries, prepare by steeping ½ to 1 tsp berries per cup of boiling water for 10 minutes. Drink 6 oz, two or three times a day.

At home: Tea: Chop two to five scallions and steep in a cup of boiling water. Top th e brew with honey and drink at the first signs of chills and fever.

Decoction: Add ½ to 1 tsp dried berries to 1 cup water, bring to a boil, and simmer for 5 minutes . Drink three times daily.

Poultice: Mix scallions with honey, wrap in a cloth, and apply to sores and abscesses.

Tincture: Drink 15 to 60 drops in water two or three times daily. SIDE

EFFECTS

None expected.

Combinations: The herb is prepared with soybeans for chills , fever, and nasal congestion. For more information on appropriate preparations and doses, check with a Chinese medicine practitioner . SIDE

EFFEC T S

None expected.

CONVENTIONAL

SPECIALINFORMATIO N + Do not use scal lions if you are sweating profus ely, since t he herb pro motes sweat ing. ♦ In a cli nica l t r ial, a comb ination of scall ions, pi nelli a root , and ginger ju ice, given as an enema, seemed useful in trea ti ng acute mastitis (breast inf lamm atio n). + The essent ial oils of scalli ons seemed to inhi bit th e spread of staphylococcus, streptococcus, and ot her types of bacter ia in t r ials w ith diseased persons.

SCHISANDRA

AND

fulness. W hen comb ined w it h Asia n ginse ng and op hi opogo n t uber, it is prescri bed for shor tn ess of breath accompani ed by co ughin g and thirst , and fo r irregu lar heartbeat or palpit at ions. Other comb inatio ns are used to tr eat th e chro nic co ughin g of tu bercul osis. For add itio nal info rmat ion, consult a Chinese medi cine prac titi oner. T SIDE

LATIN NAME

GENERALDESCRIPTION The fr uit of schi sand ra, a member of th e magno lia fa mily , is va lued fo r it s medi cinal prope rt ies. Loo k fo r shin y, pur plish red frui t t hat is thi ck, fl eshy, and o ily. Chin ese medi cine pr actiti oners pr escribe it for a vari et y of di sorders as varied as allergic skin react ions, insom nia, and hepatit is. Western herbalists ofte n use it as a t oni c to help th e body resist physical, b iol og ical, and env iron mental stresses. Tradi ti onal Chin ese medi cine charact eriz es th e fr uit as sour and slight ly war m.

TARGETAILMENTS Take inte rn ally for : ♦ chr on ic coug hs and wheez ing, asthm a. • al lergic skin reacti o ns. ♦ excessive sweatin g, insomnia , ir rit abilit y, fo rgetf uln ess, dreamd isturb ed sleep, genera l leth argy. ♦ irr egul ar heartb eat wi th co ughin g and t hirst, palpit at ions, sho rtn ess of br eath. ♦ hepat iti s-to impr ove liver fun ct ions. + nocturn al emission, vaginal d ischarge, fr equent ur inat ion. ♦ skin irr it atio ns.

PREPARATIONS Dr ied schi sand ra fr uit is available at Chine se pharm ac ies, Asian mark et s, and some West ern health fo od stores. The fr uit also co mes in t ab let fo rm . It is somet im es prepa red in w ine as a t oni c. In 160 proof alcoh o l, it makes a medi cinal w ine fo r it chin ess and other irritations of the skin.

MEDICINES

SENNA

LATIN NAME

Cassia senna GENERAL DESCRIPTION Senna is a powe rful laxati ve th at shou ld not be t aken light ly. Thi s woo dy shrub co ntains co lon-stimul atin g chemicals know n as anthr aquin ones, w hich in high doses act as cath arti cs, or extr emely strong laxati ves. Both leaves and seedpods are used medi cinally, alth ough t he pods are mild er. Anthr aquin ones, deri ved fr om senna and oth er herbs, are among th e ingredients of many co mmercial laxati ves. The medi cinal use of senna dates t o ancient civili zat ions; it was int roduce d into Euro pean medi cine by Arab healers in th e ninth centur y. The herb grows primaril y in Indi a and Egypt.

EFFECTS

N ot serious: Schi sandr a occasiona lly causes heartburn. Ove rdoses can also lead t o restlessness, in somni a, o r di ff icult ies in breathin g.

SPECIAL INFORMATION ♦

Schisandra chinensis

NATURAL

The herb is not reco mm ended fo r use in th e early stages of coug hs or rashes. ♦ In test s wit h health vo lunt eers, preparat io ns of schi sandr a seemed t o improve v isual acuit y. ♦ In o ne clin ica l tria l, a preparati on of schi sand ra fr uit seemed useful in tr eati ng patie nt s w it h infect ious hepatiti s.

TARGET AILMENTS • co nstipati on. (Take inte rnall y.)

PREPARATIONS Over the counter: Ava il abl e in prepared t ea bags, syrup s, and tabl et s, as we ll as in th e fo rm of dri ed leaves and seedpod s.

SELECTI V E SERO TON IN REUPTA KE IN HIBIT O RS (SSRls)

At home : Infu sion: Steep 1 to 2 t sp dri ed leaves per cup of co ld wa ter and let sit ove rni ght. Drink co ld, ½ cup a day, in th e mornin g or at night for a maximum of t hr ee days. If desir ed, off set th e bitt er ta ste by addin g anise, peppermint , fennel, lemon, or a sweet ener.

DRUG CLASS A nti dep ressant s

GENERIC NAMES f luoxet ine, paroxe ti ne, sertra li ne

Decoc ti on: Simmer four chopped pods in 1 cup wa rm wa t er fo r 5 t o 10 minut es; dri nk as above.

GENERAL DESCRIPTIO N D rugs in thi s subclass of antid epressant medi cat io ns wo rk by restor ing th e neurotra nsmi tter seroto nin to norma l levels in th e brain . This group includ es th e w idely used d rug flu oxet ine, whi ch is bett er know n by t he br and name Proz ac. See Antidepressants fo r informati on about side effe ct s and possibl e dru g inte ract io ns.

Tin ctur e: Take ½ to 1 tsp in jui ce or wa t er once a day in th e mornin g or at night for no mor e th an thre e days. T SIDE

EFFECTS

Not serious: M ild gast ro inte stin al cra mp s (can be offset by drin king co ld); skin rash. Serious: Large do ses can cause di arrh ea, nausea, severe stom ach cra mp s, or dehydr at io n. Di scontinu e use and call your doctor imm edi at ely.

SPECIAL INFORMATION ♦ The severi t y of any side eff ect s may

dec rease w ith tim e (aft er t wo w eeks) or w ith lowe red dosages. If yo u have any qu esti o ns abo ut pot enti al side effects, d iscuss th em w ith yo ur doct or.

SPECIAL INFORMATION • WA RNING : Avo id senna if yo u are pr egnant , nur sing, or have gastr oint estin al ai lm ent s such as ulcers, co liti s, or hemorrh oi ds. • WA RN! N G: Long-t erm use of senna can depl ete electrol yt es, parti cularl y pot assium , so yo u should co nsult

Co mbin ati ons: Schi sandra is mi xed w ith zizy phu s and Chin ese foxg love roo t to tr eat in somni a, ir r ita bil ity, and forge t -

0

Prescription Drug

0

O ver-theCounter D rug

O

Western Herb

0

Chinese Herb

A Remedy Homeo pathic 100 5 U

i)

CONVENTIONAL

AND

NATURAL

your physician before taking senna if you are also taking any heart medica tions. ♦ Because of senna's strength, try mild er laxatives first, such as fiberri ch foods ; consider also a gentler anthraquinone. ♦ Overdependence on senna can result in lazy bowel syndrome; use this herb fo r no more than thr ee days.

SENNOS IDES

DRUG CLASS Laxativ es BRAND NAME Ex-Lax Gentle Natur al Laxative Pills GENERAL DESCRIPTION A stimulant type of laxati ve, sennasides is used to relieve constip atio n. See Laxatives for additional information about side effects and possible drug interactions. SPECIAL INFORMATION • An overdose or prolon ged use of this dru g may result in an electrolyte imbalance. Symptoms include irregular heartbeat , confusion , unusual tiredness or weakness, and muscle cramps. ♦ Do not use sennosides or any other stim ulant type of laxative if you think you may have an int estinal obstru ction.

MEDICINES

toms includ e apathy 1 moodi ness, and weakness. The cuttlefish ink is co llected fo r th e hom eopathic preparation and diluted with large quantities of milk sugar for final use. Like most homeopathi c prescriptions , Sepia was developed as a remed y by observation of the reaction s of health y individuals to a series of undilute doses. The ment al1 emotional , and physical changes induc ed by Sepia we re th en cat aloged. When a hom eopathi c practition er encounters a pati ent with a set of symptoms that matches th e cat aloged symptoms brought on by th e her b, the practition er then prescrib es it in an extremely dilute form. It is pr esum ed that in thi s highly dilute do sage, Sepia can counter th e symptoms that it indu ces w hen it is at f ull strength. For mo re information on homeopathi c medici ne, see page 1027 . TARGET AILMENTS ♦ backaches and weakness in th e small of th e back 1 violent fits of co ughin g, cold sores and fever blist ers aro und the mouth 1 exhaustion , genit al herpes1 hair loss, gas, headaches with throbbing pain 1 sinusitis , urin ary inco ntinence , menopaus al hot fl ashes1 menstrual cramps with int ense1 bearin g-dow n pain , nausea resulting from motion sickness or during pregnancy, brown spots on the skin. PREPARATIONS Sepia is available over the co unter in vari ous pote ncies, in both liqui d and tablet form, at selected stores and pharmaci es. Consult your hom eopathi c physician for further inform at ion. SIDE

EFFECTS

None expected.

SEPIA SERTRALINE LATI N NAME

ID

Sepia GENERAL DESCRIPTION The cuttlefish is a soft-bodied mollusk with eight arms that is closely related to th e squid and octopus; it prop els itself by squirting jets of water from special organs in its body. When thre at ened, it releases spurts of dark ink called sepia that cloud the water and camouflage its retr eat. Sepia has been used for artistic purposes, although its ingestion , such as when a painter licks th e brush, can brin g about unpleasant side effects. Hom eopathic physician s prescribe Sepia to pat ients with conditi o ns whose symp-

1006

DRUG CLASS Antidepressants [Selective Seroto nin Reuptake Inhibitors (SSRls)]

treatm ent of depression and obsessivecompulsive disorder. See Antidepressants for info rm ation abo ut side effect s and possible dru g interaction s.

SESAMEOIL

LATIN NAME

Sesarnurn indicum GENERAL DESCRIPTION The o il is prepared from large, round , black sesame seeds, w hich have a sweet ta st e. Chin ese medicine pra ctitioner s often prescribe the oil, sometimes ca lled hu ma you1 for constipation. They also use th e sesame seeds as a laxati ve. Tradition al Chinese medicine characterizes sesame oil as sweet and neutr al. TARGET AILMENTS • constipation; certain types of blurred vision , tinnitu s (ringing in th e ears), and dizziness; recuperation afte r severe illn ess- to help restore th e vitality th at serio us illness depl et es. (Take intern ally.) PREPARATIONS Sesame seeds or oil is available at Chinese pharm acies, Asian mark ets, and Western health food stores. The seeds are also avail abl e in tablet form. A tab lespoo nfu l of the oil by it self in the evenin g is co nsidered effect ive for constipation.

Combinations: Sesame oil is also mi xed with therapeutic oils th at co nt ain other medicinally useful herbs. One remedy for co nstipation combines th e seeds w ith chicken eggs; another formula mixes sesame seeds1 dong quai , and biota seeds. Chinese medicin e practition ers prescribe a co mbination of sesame seeds and white mulberr y leaf fo r dizziness, blurred vision , tinnitus (rin gi ng in th e ears), and headach es. For infor matio n on do sages and other preparations, chec k with a Chinese medicine pr act it ion er. SIDE

EFFECTS

BRAND NAME Zoloft

None expected.

GENERAL DESCRIPTION Introdu ced in 1986 , sertraline belongs to a subclass of antidepressants known as selective serotonin reupt ake inhibitors (SSRls) and works by restor ing levels of seroto nin 1 an important brain chemical. Thi s medication is prescribed for

♦

SPECIAL INFORMATION WARNING: Do not use this herb if you have di ar rhea .

CONVENTIONAL

SHARK LIVER OIL

Apply externally fo r: • itchy skin rashes such as hives and poison ivy; mild skin abrasio ns.

DRUG CLASS

Over the counte r: Available as tinctures , capsu les, and pr epared tea , or as fresh or dried plant parts (leaves, root , flowers , st ems) in combination with ot her herbs. Capsules may harm the kidneys , so th e fres h or dried plant is pr efe rred .

Antihemorrhoid

AND

NATURAL

MEDICINES

useful in shrinkin g cancerous tum ors; they base this hope on the fact that lenti nan has slowed th e growt h of malignanci es in several animal studie s.

PREPARATIONS Dru gs

BRAND NAME Preparation H

GENERALDESCRIPTION A brown fatty oil, ri ch in vit amin A, shark liver oil is a skin protectant, a chemi ca lly inactive substance that provides a physical barrier betwe en the skin and the environment. Shark liver oil is used only in combination w ith other skin prot ectant s, such as cocoa butt er, lanolin , petrolatum, and glyce rin. In hemorrh o id med icati ons, shark live r oi l coat s th e skin in th e anore ctal area, prot ecting it against rough , chafin g bowel movement s. Like other skin protectants, thi s oil helps prevent loss of moisture for temporary relief of skin irritation and burnin g assoc iated with hemorrhoids .

TARGETAILMENTS ♦ burning and itching of th e anorectal

surfa ce due to hemorrhoids.

SPECIALINFORMATION • In case of rect al bl eeding or persistent itchin g, see your phy sician .

SHEEPSORREL

TARGETAILMENTS Take int erna lly for: ~ high blood cho lest ero l. • dep ressed immune system disorders, chroni c fatigue syndrome , and possi?ly, some forms of cancer. (Use only 111consultation with a doct or.)

At home: Infusion: Steep leaves or stems for 5 minutes, or roots for 10 minut es, in hot (not boilin g) water and drink two or three tim es a day.

PREPARATIONS Over the counter: Availabl e dried or in capsules. At home: Tea: Cover a handful of dried shiit akes w ith boiling water; soak 10 to 30 minutes. Strain the liquid and drink th e tea ; you can use the mushrooms in cooking.

Tin ctur e: Stir 30 drops into a glass of water and drink 4 glasses (120 drops) daily. SIDE

EFFECTS

Food: After soaking mushrooms in boiling water, eat one a day (many recipes are avai lable ) to maint ain good health . Chinese medicin e practitioners recommend eating two to four oun ces of shiitake mushrooms t wo or three times a week for general health benefits .

Not serious: Some patients may experience nausea ' tinglin g ton gue, severe headache. Serious: WARNING: Large doses can be toxic because sheep sorrel contains high levels of oxalic acid, which can cause kidney stones, worsen existing kidney ailments , and otherwise irrit ate th e kidneys.

SIDE

SPECIAL INFORMATION ♦

EFFECTS

Non e expected .

SPECIALINFORMATION

WARNING: If you have kidn ey problems, do not t ake sheep sorrel.

• Shiitak e mushroom s are rich in protein, in v itamins B1, B2, B12, niacin, and in pantothenic ac id .

SHIITAKE SILDENAFIL

LATINNAME Rum ex acetose /la GENERAL DESCRIPTION Herbalists use the leaves, roo ts, st ems, and flo wers of sheep sorrel, a common, native European weed. They believe the herb possesses astringent properties th at are helpful for mild ulcer ative conditions , such as mouth and throat ulcers. A topi ca l wash of sheep sorrel is also recomm ended for it chy skin rashes. And the jui ce of th e fresh plant is said to help urinary conditions. Recently sheep sorrel has been used in treating the side effe ct s of chemotherapy. It s mechanism of action is not wel I under stood .

TARGETAILMENTS Take int ernally for : • constipation; diarrhea; cysts; mouth , throat , and stomach ulcers; excessive men struati on.

LATIN NAME Lentinus edodes

DRUG CLASS Anti-Impot ence Dru gs

GENERALDESCRIPTION The shiitake mushroom , a tast y, meat yflavor ed fun gus that grows on the trunks of dead trees , has long been a staple of Chinese cuisine. And in both China and Japan, shiitake mushroom s have been used for hundr eds of years as cancer- fighting agents. Today Chinese herb alists also use the mushroom as a medicine to lower blood cholest erol . Th~ fungu~ contains cortinelin , a strong ant1bacter1al agent that kills many disease-causing germs. A sulfid e component of shiit ake mushrooms also has antibiotic prop erties. Mor eove r th ese mushrooms contain a polysac char ide complex called lentinan, which studies indic ate may be eff ectiv e in stimulatin g the immun e syst em. Herba li st s think that this chemical may eventu ally prov e

0

Prescription Drug

0

Over-theCounter Drug

BRAND NAME Vi agra

GENERALDESCRIPTION Sildenafil is th e first oral dru g appro ved to tr eat impoten ce. In many cases, impot ence is caused by a decre ased blood flow to the penis. Sildenafil maintain s that blood flow and prolongs the erection by delaying the breakdown of a chemical that ordinarily relaxes the smooth muscle in the penis. This dru g c~n prol_ong an erection following sexual st1mulat1on, but it cannot initi ate erection in the absence of sexual aro usal.

O

Western Herb

0

Chinese Herb

/!¥:... Home?pathic

~ Remeoy

El

1OO7

I

I

CONVENTIONAL

SIDE

AND

NATURAL

EFFECTS

Not serious: Headache, flushin g, stomach upset , nasal stuffiness, diarrh ea. Serious: Dizziness, fainting , painful or prolonged erec tion , rash, edem a (swo llen feet or ankl es), v ision probl ems, light sensitivity, chest pain , seizures. Call yo ur doctor imm ediat ely. SPECIAL I NFORMATION + WARNING: Do not t ake sild enafil if you are taking any nitr ate medications . The combination co uld be fatal. + WARNING: Use sildenafil with caution if you have a cardi ovascular disease; increased sexual acti vit y associat ed w ith si lden afi I has caused cardi ac arrest , heart att acks, brain hemo rrhages, and other serious cardiovascular eve nt s in men with heart conditions. + Men with liver disease, severe kidney disease, and ov er age 65 should be start ed on low doses of this dru g. ♦ Consult your doctor before taking any other prescription or over-theco unter drugs. The effects of either or both medications could be altered. POSSIBLE

INTERACTIONS

Nitrates, either short- or long-acting and including nitrate patches: dangerously low blood pressure levels, perhaps causing death.

MEDICINES

Silica was developed as a remedy by observat io n of th e react ions of healt hy indiv iduals to a series of undilute doses. The menta l, emotional , and physical changes indu ced by Silica were then cat aloged. When a hom eopathic pract iti oner encounters a patient wi th a set of symptoms th at mat ches the cataloged symptoms brought on by Silica, th e practitioner then prescribes it in an extr emely dilute form. It is presumed that in thi s highly di lut e dosage, Silica can counter th e sympt oms th at it indu ces w hen it is at full str ength. For more inform ation on homeop athic medicine , see page 1027 . TARGET A ILMENTS • at hl et e's foot, constip ation resultin g from large stools , wo unds that are infl amed due to foreign matter , earac he with decr eased hear ing and a st op ped- up sensation, fingernails th at have white spots and split easily, headaches beginning in the back of th e head and spreading forward to the eyes, abscesses, swollen glands in the neck, gum inf ect ion s, hemorrhoids, breast cysts. PREPARATIONS Sili ca is available over the co unt er in variou s potencies , in both liquid and t abl et form, at selected stores and pharmacies. Consult your hom eopathi c physician for further information. SIDE

EFFECTS

None expecte d.

SILICA

,

surface tension of small gas bubbl es in t he stomach , causing them to coa lesce and form larger ones. These large r bubbles are more easily expelled through belching or passing flatus. Simet hi co ne is often co mbin ed with antacids for the dua l reli ef of gas and heartburn. TARGET A ILMENTS • sympto ms of gas: bloating, abdomin al cramps, intestinal pressure, and fullness; postoperative gaseous distention. SIDE

EFFECTS

Not serious: Simethicone is nontoxic ; when used as indi cat ed, th e drug produces no side effects. A possible adverse effect cou ld inc lud e excessive exp ulsion of gas in belching or fl atus . SPECIAL INFORMATION ♦ Do not t ake this drug if you have kidney disease. ♦ The adult dosages of this dru g are not reco mm ended for treating infant co lic. Infa nt drops are available, but check w ith your pediatri cian fo r guidance on their use. • Tablets should be chewed thorou ghl y before swallowing. ♦ Do not take this medication for more than t wo weeks, and do not exceed the recommended dosage. POSSIBLE

INTERACTIONS

• Although unlik ely, this drug may inter act with some medications. Check w ith yo ur doctor before using a product co nt ainin g simethicone if yo u are takin g other drugs.

SIMETHI CONE LATIN NAME

Silica

D

GENERA L DESCRIPTION Silica, also called flint , is a mineral that is present in the human body in only tra ce amounts but is v it al to the development of bones, the fl exib il ity of cartilage, and the health of th e skin and connective tissues. Many industrial operations rely on silica, including the manufacture of concrete, paper, glass, and enamelware. Flint 's medicinal use is limited to homeopathy . Minut e doses are pr escr ibed for patients with conditions accompanied by excessive sweating, weakness, and extreme sensiti vity to co ld . For homeopathi c use, silica powder is mixed with sodium car bonate through a pharmaceutical process of dry substance dilution . Like most homeopathic prescriptions,

1008

SIMV ASTATIN DRUG CLASS Anti gas BRAND NAMES Tums Antigas / Antacid formula; some types of Mylanta; Mylanta Gas; some types of M aalox GENERAL DESCRIPTION Simethicone is an antigas dru g used to relieve the pain, cramping , bloating, intestinal pr essure , and "f ull " sensation th at acco mp any flatulenc e, or gas. Gas can build up in the gastrointestinal tr act as a result of excessive swallowing of air or from eat ing foods the body does not tolerat e well. The defoa ming properties of simethicone act in the gastrointestinal tract to disperse gas bubbles and to prevent their formation. The drug changes the

DRUG CLASS Chol est ero l-Reducing Drugs BRAND NAME Zocor GENERAL DESCRIPTION Introdu ced in 1986 , simvastatin is an HMG-CoA reductase inhibitor , a t ype of drug that alt ers the blood leve ls of cholesterol and other fats. These dru gs work by blocking a liver enzyme needed in the production of cholesterol. Simvast atin may also increase the blood level of hi gh-density lipoproteins (HDLs), the so-called good chol est erol that seems to protect against heart disease. See Cholesterol-Reducing Drugs.

CONVENTIONAL

SIDE

EFFECTS

Not serious: Const ipation , gas. Serious: Fever, muscle aches, cramps. SPECIAL INFORMATION + If you beco me pre gnant w hile tak ing t hi s dru g, stop using it imm ed iate ly and inform yo ur do ctor. POSSIBLE

INTERACTIONS

Erythromycin, immunosu ppressants, and niacin: severe muscl e pain or kidn ey fa ilur e. Gemfibrozil: may affec t t he absorpt io n and excret ion of sim vast atin ; do not t ake concur rentl y.

prescribed for high fever and irrit ability. Skullcap root mi xed w ith anemarrhena is tho ught to alleviate chron ic coug hs. For further information on preparations and doses, co nsult a Chinese medicine pr act it ioner. SIDE

At home: Tea: Pour a cup of boi lin g water over 2 tsp dri ed leaves and steep for 10 to 15 minut es; drink thi s amount up to thr ee times da ily.

EFFECTS

Tin cture: Take ½ to 1 t sp per 8-oz glass of wa rm wa ter.

SPECIAL INF ORMA TI ON ♦ Before using skullcap to tr eat diarrhea or problems of pregnancy , ch eck wit h a Chin ese medicin e pract ition er. ♦ The root seemed to have a diuretic effect in labora t ory t ests on healthy anim als and human s. • Skull cap has been shown t o have broad antimi crob ial effect in the labora tory .

SIDE

PREPARATIONS Skullcap root is availabl e in bulk from Chine se pharmacies , Asian mark ets, and Western health food stores. You can also obtain t he herb as pi ll s. The root is usually decocted . Befo re decocting , it can be fri ed d ry for use in pregn ancy and to tr eat diarrhea and infect ion s of the urinary tract, o r cooked in w ine for upper-respir atory inf ect ions and redness of th e face and eyes.

EFFECTS

Not serious: Stomach upset or di arrh ea. Reduce int ake or st op using it. SPECIAL I NFORMATION

+ WARNING: Skullcap may cause drowsiness. Do not operate a car or heavy machin ery after takin g it. ♦ WARNING: Large amounts of t he tin cture may cause confusion, giddin ess, twitching, and possibly , conv ul sions. + Use skull cap in medicinal amou nts only under professional superv ision. + Two Japanese anima l studies showed th at skullcap increases levels of th e "good" kind of cho lesterol , raising the possibility that skullcap may one day be useful in preventing heart disease and strokes.

INTERACTIONS

Some sourc es in traditional Chin ese medicine suggest that skullcap counteracts the effects of mout an and verat rum .

SKULLCAP

TARGET A ILMENT S Take int ern ally for: ♦ diarrhe a, dysent ery. + upp er-r espir atory inf ectio ns w ith fever. + urinar y tract infection s, jaundice , hepatit is. ♦ nervou s tension, irrit ability , headache , insomni a, epilepsy and oth er seizures. • red face or eyes. + coughing up or vomiting blood , nosebleeds, blood in th e stoo l. + abdomin al pain and vaginal bl eed ing, threat ened miscarri age during pregnancy, pr emenstru al stress.

MEDICINES

PREPARATIONS

LATIN NAME Scute ll ar ia baica /ensi s GENERAL DESCRIPTION Ch inese herba list s prescribe the long , th ick , skin less yello w root of skull cap fo r a w id e range of disorders. In tr adi tional Chin ese medicin e skullcap is characteri zed as bitt er and cold.

NATURAL

Over the counter: Avai lable as prepar ed tea, tinctur es, dried leaves, capsu les.

Non e expec ted .

POSSIBLE

SKULLCAP

AND

LATIN NAME Scutellaria laterifl ora GENERAL DESCRIPTION The leaves and blue flowers of this twofoot-ta ll perenni al are used as an ingre di ent in many ove r-t he-coun te r herbal sleep remedies. Some researchers, especia lly in Europe and Asia , report that skull cap cont ains chem ica ls t hat ca lm th e nervous system . Chinese medicine physicians believe that skullc ap is ef'.ective for treating hepatitis , a seri o us liver disease. In th e United States, howe ver, skullcap is conside red co nt roversial and even useless by many medi ca l authorities, at least partly because of its early- and unearned-reput ation for curing rabies , for wh ich it garnered the now archaic name of mad dog wee d. It s cu rr ent name co mes from an elongated, caplik e appe ndage on the upp er lip of the flower .

SLIPPERYELM

LATIN NAME U lmu s fulva GENERA L DESCRIPTION The U.S. Food and Drug Administration calls slipp ery elm a good demulc ent, or soothing agent. Herbalists recommend its use exte rnally to ease wo und s and skin problems, and int ernally to soothe sore throats , coughing , and diarrhea and other gastrointesti nal disorders. Slipp ery elm 's active ingredie nt is fou nd in the w hit e inner bark, whose mucilaginous cells expand into a spongy mass whe n mi xed w ith water. Elm t rees we re priz ed in th e 18th and 19th centuri es by American settlers , for w hom slippery elm was a va luable cu re. They soaked it in water and appli ed it to wo unds, whe re it dried into a natural bandage. In add it ion, th ey wrapped it aro und meats and oth er perishabl e foods t o prevent spoilage. Mi xed wit h water, it made a soothing gruel for chil dr en and sick peop le. While lozenges,

TARGET A ILMENTS Take internally for: + nervo us t ension , headach es and musc le aches caused by ten sion, insomni a, co nvul sions, drug or alco ho l w ithdra wa l. ♦ sympto ms of premenst rual syndrom e aggravated or caused by str ess.

Comb inat ions: A mixtu re w it h coptis is

0

Prescript ion D rug

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Over-th eCounter Drug

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Western Herb

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Chinese He rb

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~ Remedy

CONVENTIONAL

AND

NATURAL

MEDICINES ~

powder, and other elm products are still avai Iable in health food stores, the great elm forests once common throughout the East Coast of the United States have been ravaged by Dutch elm disease.

irritability , nervousness , drowsiness, fatigue , headache , and nicotine craving . There is no evidence that these drugs work unless the smoker participates in a medically supervised stop-smoking program. For more information, see Nicotine and Bupropion .

Over the counter: Available as capsules, tea, powder.

Antacids

nally for itching and inflammation , and internally for digesti ve ailments , cold s, and insomnia. This perennial, fast-spreading plant , which has distinctive whorls of small white , pink, or lilac flowers, is praised in an Egypti an papyru s deemed the world 's oldest surviving medical text. Spearmint was used by the Greeks and Romans for ailments from hiccups to leprosy. Chinese and Ayurvedic (Hindu ) physicians have used it for centuries to treat indigestion, colds, coughs, and fever. Many herbalists prescribe spearmint and peppermint interchangeably as medicines, although the latter is considered more potent.

BRAND NAME

TARGETAILMENTS

At home: Poultice: For wounds that have been thoroughly cleaned with soap and water, moisten powdered bark with enough water to make a paste; apply to wound and allow to dry. This forms a natural bandage that delivers soothing agents to the wound.

Alka-Seltzer

TARGETAILMENTS Apply externally for: ♦ wounds, cuts, abrasions . Take internally for: • coughing, sore throats, digestive complaints. Use externally and internally for: ♦ gynecological problems.

PREPARATIONS

Tea: Add 2 tsp powder to a cup of boiling water; simmer for 15 minutes. Drink up to 3 cups a day for throat, digestive, and gynecological problems. Food: Mix slippery elm powder with water or milk until it has the consistency of a thin porridge. S ID E EFFECTS

Some people may be allergic to the powdered bark. If you experience any problems , stop using it. Consult your doctor before taking doses that are larger than recommended.

SPECIAL INFORMATION ♦ Consult your doctor if your symptoms

do not improve significantly within two weeks.

SODIUM BICARBONATE AND CITRIC ACID DRUG CLASS

GENERALDESCRIPTION The combination of sodium bicarbonate and citric acid is used to relieve symptoms of upset and sour stomach, acid indigestion, and heartburn. The drug is absorbed quickly and easily into the body . If taken by itself for a long time, sodium bicarbonate may cause systemic alkalosis, a condition in which the blood becomes less acidic than normal. This can adversely affect the blood and kidneys. Citric acid is added to sodium bicarbonate to add acidity to the stomach and help correct the imbalance. See Antacids for information about additional side effects and possible drug interactions.

SPECIALINFORMATION ♦

Do not take antacids containing sodium if you have high blood pressure, congestive heart failure , cirrhosis , renal failure, or edema, or if you are on a low-sodium diet; the high sodium content of the drugs may exacerbate these problems.

Take internally for: ♦ upset stomach, stomach spasms, flatulence, heartburn, stomach cramps, morning sickness during pregnancy. ♦ nasal, sinus, and chest congestion; colds; headache; sore mouth or throat. Take internally and apply externally for: • muscle pains, external infections, chapped hands.

PREPARATIONS Over the counter: Available as capsules, prepared tea, fresh or dried leaves, tinctures, oil. At home: Tea: Boil 1 to 2 tsp dried herb or several fresh leaves per cup of water; steep 10 minutes. Drink up to 3 cups a day.

Tincture : Add ¼ to 1 tsp to an 8-oz glass of wa t er and drink up to three glasses a day. Herbal bath: Fill a cloth bag with a few handfuls of dried or fresh spearmint leaves and add to running bathwater. SIDE

EFFECTS

None expected.

SPECIAL INFORMATION

D

SMOKING CESSATION DRUGS GENERICNAMES bupropion, nicotine

GENERALDESCRIPTION Smoking cessation drugs are used to reduce nicotine craving and withdrawal effects in people who want to stop smoking. By slowly reducing nicotine intake with nicotine replacements, or by changing the brain chemistry with bupropion, these products can reduce smoking-withdrawal effects, such as

10 10

SPEARMINT

♦

Spearmint oil (carvone) may cause stomach upseT if- rnges-tee-.-The oil is recommended for external use only. ♦ For children under two, dilute spearmint tea or tincture with water.

LATINNAME

Mentha spicata GENERALDESCRIPTION Spearmint has been valued since ancient times to promote digestion, heal wounds, and relieve colds and congestion. When the lance-shaped, serrated leaves are crushed or boiled, they release carvone, a chemical similar to but milder than the menthol found in peppermint, a close relative. Modern herbalists suggest using spearmint exter-

SUCRALFATE

DRUG CLASS Antiulcer Drugs

BRAND NAME Carafate

-

"

CONVENTIONAL

GENERAL DESCRIPTION Sucralfate is used primarily in th e treat ment and prevention of ulcers of the stomach and duodenum (f ir st portion of the small intestine) . It is also sometime s used to treat gastro esophageal ref lux and gastro int estina l symptoms associated wit h the use of nonsteroidal ant iinfl ammato ry drugs (NSAI Ds) and aspirin . The precise mech anism s by which sucralfat e works are not clearly und erstoo d. How ever, th e dru g is believed t o inhibit the digestive action of pepsin, o ne of th e stomach 's digestive j ui ces. Sucralfate may also form a coatin g over ul ce rs, protecting th em from the erosive effect of anoth er di gestiv e fluid , hydrochloric acid . Although sucralfat e is ofte n used alone, it is somet imes prescr ibed in conjuncti o n w ith ant acids for pain reli ef. For mor e inform ation on side effects and other possible dru g interactio ns, see Antiulcer Drugs. SIDE

EFFECTS

Not serious: Co nstip at ion , mild back pain. Rare: di arrh ea, nausea, vom itin g, st omach cra mpin g, dry mouth , rash, itchin g, dizziness, dro ws iness. See your do ctor if these sympt oms continue o r become bothersome. Serious: None expect ed. SPECIAL I N FORMATION ♦ Sucralfate may int erfer e with the absorpt io n of v itamin s A, D, E, and K; if you are taking v it amin suppl ements, wait an hour befo re taking a dose of sucr alfate . ♦ If you are also using antacids fo r reli ef from ulc er pain , tak e the antacid at least 30 minut es before or after tak ing sucra lfate . ♦ Because this drug may cause dizziness o r dro ws iness, you may need to restrict yo ur dri vi ng or yo ur involvement in ot her potentially hazard ous activiti es. ♦ If yo u have had kidney o r liver disease or any diseases th at have caused obst ru ction of th e gastrointestin al tract, weig h carefully th e risk s and benefits of using this dru g. POSSIBLE

INTERACTIONS

Aluminum-containing antidiarrheal drugs, aspirin buffered with aluminum, and aluminum-containing vaginal douch es: in creased absorption of aluminum into th e body , possibly to tox ic levels. Vitamins A, D, E, and K: decreased absorpti on of t hese vit am ins.

AND

DRUG CLASS Antibiotics [Sulfon amide s in Co mbin ati on] BRAND NAME Bactrim , Cotr im , Septra GENERAL DESCRIPTION Sulfamethoxazole, a sulfonamide antibiotic, is often combined with th e antibiotic drug trimethoprim to incr ease the effect iveness of both medi cation s. Thi s comb ination is sometimes known as cot rimo xazo le or TMP-SM Z. Both component dru gs work by int erferin g with the abilit y of cert ain di sease-causing bacter ia to synth esize folic acid, thereby inhibitin g the or ganisms' growth . For mor e info rmation , see Sulfonamides in

POSSIBLE

Birth-control pills containing estrogen: may result in decreased con tr acept ive effectiveness and incr eased breakthrough bleeding. Cyclosporine: decreased effecti veness of cyclospor i ne.

EFFEC T S

Digoxin: dec reased di goxi n effects.

Not serious: Gastrointestinal problems (includin g d iarr hea and nausea), headac he or dizziness, photosensitivity. Let your doctor know if these symptoms beco me troublesome.

Methotrexate: increased meth otre xate effects.

Serious: A llergic react ion s (feve r, it ching skin rash). Less fr equently: bl oo d abnormal ities causing feve r, sore throat, unusu al bleeding, bruising, tiredness, or weakness; liver problems, in cluding j aundi ce; Stevens-Johnson syndrom e (fever, skin blisters or blisters and open sores on mucous memb ranes and genital s, weakness, joint pain) . Rarely : urinary problems resultin g in burning with urination , back pain; go iter ; bluish fingernails , skin, or lips ; difficulty in breathing. Call yo ur doctor imm ediately .

SULFONAMIDESIN COMBINATION GENERAL DESCRIPTION Sulfonamid es, a subclass of antibioti cs, are synthetic derivatives of a compound that interfer es with the abilit y of bact eri a to produce folic acid, necessary for cell growth and development. Whil e this doesn't imm ediatel y kill bacteria , it inhibits th eir growth and aids the body in it s fight against infe ct ion. These drugs are oft en used in combinations to enhance the effectiv eness of other medi cation s and to offset possibl e bact eri al resistance to sulfonamid es. For inform ation abo ut a specific sulfonamide, see

SPECIAL I NFORMA TI ON ♦ Pregnant and nu rsing women shoul d

avoid using this combination since it may int erfere w it h folic acid metab olism in th e fetus and infant, especially near birth.

0

O ver -th eCounter Drug

T IONS

Anticoagulants (warfarin), anticonvulsants (hydantoin), oral antidiabetics, phenylbutazone (NSAID), or sulfinpyrazone (antigout): may interfer e with action or met abo li sm of these drugs and cou Id resu It in increas ed effects or tox icit y. Your doctor may need t o adjust th e dosage.

TARGET AILMENTS ♦ bronchitis (caused by H emophilus influenzae or Streptococcus pneumoniae ). ♦ urin ary tr act infe ction s. ♦ enterocolitis (caused by ce rt ain species of Shigelfa). + acute otiti s medi a (in childr en). ♦ prevention and treatment of pneumonia (Pneumo cyst is carinii) in people w ith compromised immun e systems (includin g Al DS patients). ♦ tr aveler' s diarrhea. ♦ numerous ot her infections.

Presc riptio n Drug

INTERAC

Th is combination can int eract w ith a number of dru gs, especially thos e th at affect the li ver or blood. Consult your doctor before taking any other medication .

Combination.

0

MEDICINES

• Cotr im oxazo le may cause sensiti vity to the sun or sunlamp s. Limit your exposur e w hil e on th is dru g. • Cross-sensitivity reactions: If you are sensitive to thi azide diuretics , PABA, loca l anesthetics (benzocain e), or oral antidi abetic medicin es, you may also have sensiti vity to cotr imo xazo le. Advise yo ur doctor of yo ur sensitivity. + Many peop le are sensitive to th ese drugs , so be sure to t ell yo ur doctor if you have severe allergies or bronchial asthma. ♦ To pr event reinfecti on, complete the full course of yo ur medication. • When t aking these drugs , drink plenty of fluids to prev ent formation of cryst als in the urin e.

SULFAMETHOXAZOLE AND TRIMETHOPRIM

SIDE

NATURAL

Su/famethoxazole and Trimethoprim.

O

Western Herb

O

Chinese Herb

/;;,.. Home opat hic

Q9 Remedy

Q 1

1 1

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CONVENTIONAL

AND

l

NATURAL

SPECIAL INFORMATION ♦ Antibiotics affect not o nly harmful bacteria, but also "good" bacte ri a that keep unwant ed fungi and inte stinal orga nisms in chec k. Eating yogu rt co nt ainin g Lac tob ac illu s ac idop hilus cultur e or taking acidoph ilu s tablets may help restore the body's normal bacteria. ♦ Prolonged use of any antibi ot ic drug can lead to f ungal infect ions, including cand idia sis, or to seri ous bacterial infections such as pseudomembrano us colitis.

SULFONYLUREAS

GENERAL DESCRIPTION Sulfonylureas form a subcl ass of antidiabetic drugs also known as ora l hypo glycemics. For mor e informat io n abo ut medications used to tr eat diabetes, see Antidiabetic Drugs, Insulin, and Oral

Hypoglycemics.

MEDICINES

cata loged. When a homeop at hi c prac t itioner encounters a patient w ith a set of symptoms that matches the cataloged sympt oms brought on by Sulphw ; the pr actitioner t hen prescrib es it in an extr emely dilute form. It is pr esum ed th at in th is highly dilute dosage, Sulph ur ca n counter th e symptoms that it indu ces when it is at full strength. For more information on homeopat hic medicin e, see page 1027. TARGET AILMENTS • asthm a that is worse at night and is acco mp ani ed by rattlin g mucus, co ugh with chest pain, mornin g diarrhea, eye infl amm ation , bursitis, headac hes w ith burning pain , ind igestion , j o int pain , anal it chin g w ith redness, burning vaginal d ischarge, ecze ma wi th intense it ching and burning. PREPARATIO NS

Sulphur is avai lable over the co unte r in var io us potencies , in both liquid and tablet fo rm , at select ed stores and pharmacies. Consult yo ur hom eopathic phys icia n for furthe r infor mation. SIDE

EFFECTS

None expect ed.

SULPHUR SUMATRIPTAN LATIN NAME

Sulphur

ID

GENERA L DESCRIPTION The chemica l element sulphu r, or more commonly sulfu r, is present in all living tissue. It was known to anc ient societ ies, and in the Bible it is called brimstone. Among th e vario us co nditio ns to w hi ch it has been appli ed as a medication , for some 2,000 years, are skin disord ers such as scabies. Com mercia lly, sulfur is used in the production of dyes, fungicides , and gunpowder. Homeop athic physicians may prescribe dilute doses of th e remedy Sulphur to treat co nditions acco mpanied by irrit ability , intense itching, burnin g pains, and offensive odors . The hom eopathi c remedy is made from pur e sulfur powder that is diluted w ith either milk sugar or a wate r-and-alcohol solut io n. Like most hom eopat hi c prescriptions , Sulphur was deve lop ed as a remedy by observa ti on of th e reactions of health y individual s to a series of undilut e doses. The ment al, emotional, and physical changes induced by Sulphur were then

1012

DRUG CLASS Antimigraine Drugs BRAND NAME lmi trex GENERAL DESCRIPTION Int roduced in 1993 , sumatriptan is an antimigraine dru g used to treat classic migraine headac hes (those preceded by the wa rnin g sensation known as an aur a) as we ll as co mm on migraines (thos e without an aura) . The drug -o ri ginally sold only in inj ectab le form but now also availabl e as a tablet and as a nasal spray-provides fast relief from th e int ense pain associated w ith these typ es of headaches. Sumatriptan , a vasoco nstri cto r, works by narrowing dilated blood vessels and reduci ng th e amount of blood flowing through them. Swollen crani al blood vessels are believed to be a major cause of mi graine headach es. Sumatriptan may also act as an anti-inflammatory,

wh ich appears to further reduce th e swel lin g. In add ition , the medi cat ion relieve s the nausea, vo miti ng, and int ense light and sound sensitivit y that frequently acco mpany migraines. TARGET AILMENTS ♦ m igrain e headaches. SIDE

EFFECTS

Not serious: Tightness in the chest, j aw, or neck immediate ly afte r the drug is inj ect ed; pain, redness, or burning at the inj ecti on site; nausea or vomiting; dizziness or fai ntin g; drowsiness; flu shin g, tin gl ing, or numbness; co nfusion; excessive thirst; frequent urination. If these effects cont inue for more than an hour, cont act yo ur doctor. Serious: Conti nuin g pain or tightness in t he chest; swellin g of the face, lip s, or eyelid s; w heezing, changes in heart rate or blood pressure; skin rash; difficulty in swallow ing or breathing. If yo u notice th ese symptoms, call your doc tor immediately. SPECIAL INFORMATION • Do not use thi s drug if you have ever had an allergic reaction to it. • Do not use sumatript an fo r the treatment of hem ipl egic (restri ct ed to one side of the head) or basilar (restr icted to the base of the skull) mi graine. • Do not use this drug if you have unco ntroll ed high blood pressure (hypert ension) or Prinzmetal's angina, or if you have had a heart attack or stroke. • Inform your doctor and use th is drug with caut ion if you are pregnant or nursing; or if you have liver, kidney , or heart d isease; coronary artery disease; heart arr hythmia ; Raynaud's syndrome; or epi lepsy; or are taking high b lood pressure medicatio ns or other prescription or over-theco unter drugs, especially other migraine-relieving medications. ♦ Take at t he first sign of a migraine. If you r first dose fails to relieve you r migra ine, do not take a second one without first checking w ith yo ur doctor. POSSIBLE

INTERACTIONS

Alcohol: may cause excess sedat ion and make headac hes worse. Ergotamine: may increase the effects of sumatript an. Allow at least 24 hours between tak ing ergot amine and sumatripta n. Lithium, MAO inhibitors, antidepressants: may result in excessive quantiti es of t he neurotra nsmitte r serotonin in th e brain.

~ CONVENTIONAL

TAMOXIFEN

DRUG CLASS Anti cance r Drugs BRAND NAME Nolvadex GENERAL DESCRIPTION Tamox ifen is an antiestrogen drug used to pr event or delay the recurrence of breast cancer after primary therapy, including breast surgery, radiation therapy, and chemotherapy. The drug may be given in conjunction with chemotherapy treatments after surgery or used alone to treat metastatic breast cancer. TARGET AILMENTS ♦ breast cancer (in women and men although male breast cancer is rar~) . SIDE

EFFECTS

Not serious: Hot flash es, nausea, vomiting, skin rash, menstru al irregularities, genital it ching , increased flaring pain in tumor or bone , and impotence and loss of libido in men. Consult your doctor if th ese effects continue or are bothersom e. Serious: Changes in vaginal bleeding or discharge; confusion. Call your doctor promptly. Rarely, these risks may be associated with use of this drug: thrombotic event s, including pulmonar y embolism (shortn ess of breath ), deep vein thrombosis, or superficial phlebitis ; liver damage (no symptoms); retinopathy , cataracts, corneal changes; abnormally high blood calcium levels (confusion); endometrial cancer, endometrial polyps, or endometrial hyperplasia (abnormal vaginal bl eeding, pain or pressure in pelvis, change in vaginal discharg e); low w hite blood cell count (fever, infections ) or low platelet count (bleeding). Call your doctor promptly. SPECIAL INFORMATION • Do not use tamoxifen if you have had a serious adverse reaction to it. • Tell your doctor if you have ever had thrombophlebitis, pulmonary embolism , impaired liver function, cataracts, a blood cell or bonemarrow disorder , or abnormally high blood calcium levels. Your doctor may lower your dose of tamoxifen or pr escribe a different drug. • This drug may decrease your blood cell counts, so use with caution if you have signific;antly low levels of white blood cells or platelets.

AND

♦

Maintain routine gynecologic care while taking t amoxifen . Report abnormal vaginal bleeding to your doctor. • Do not use hormonal contraceptives with tamoxifen because they decrease t amoxifen 's effects. • Do not use t amo xife n during pregnancy or breast-feeding , or become pre gnant while using this drug. POSSIBLE

NATURAL

MEDICINES

:,:

And a preparation cont aining tan geri ne peel and pinellia root is used to tre at a stifling feeling in the chest that makes deep breathing difficult, together with an excess of phlegm . For further inform ation on appro pri at e preparations and doses, check w ith an herbal pr actitioner. SIDE

EFFECTS

None expected.

INTERACTIONS

SPECIAL INFORMATION • Do not use thi s herb if you have a dry cough or an excessively red tongu e, or if you are spitting up blood . ♦ A mixtur e of aged tangerine peel and licorice has been used in a clinical study to treat mastitis (inflammation of the breast). • ~erbalists use the red part of tan gerin e peel (w hen dri ed, some parts are orange and others red) to control vomitin g and belching. • Chinese practitioners also prescribe young , or green, tangerine peel for breast and side pain and for hernia pain. The green peel has recently been used to raise blood pressure when it is too low .

Antacids and some antiulcer drugs (cimetidine, famotidine, and ranitidine): prematurely dissolve tamoxifen's enteric coating. Take these medications one to two hours before taking tamoxifen. Anticancer drugs (bleomycin, daunorubicin, doxorubicin, fluorouracil, hydrox yurea, methotrexate, mitotane, mitoxantrone, procarbazine, and vincristine): incr eased risk of thromboembolism. Anticoagulants (such as warfarin): increased anticoagulant effect. Estrogen or oral contraceptives: decreased tamoxifen effect.

TANGERINE PEEL TEA TREEOIL LATIN NAME

Citrus reticu/ata LATIN NAME

GENERAL DESCRIPTION So.metime_scall ed mandarin orange peel, this herb 1s prescribed for di gestive disorders. Chin ese medicine practitioner s believe that th e peel gets better as it ages, and its Chinese name, chen pt, can be translated into English as "aged peel." The best samples of the fruit are thin-skinned , pliable , oily , and fragrant. Chin ese herbalists characterize the herb as acrid, bitter, and warm.

Mela/euca spp. GENERAL DESCRIPTION The first Europeans to reach Australia made tea from the leaves of what th en became known as the tea tree, which should not be confused with the common tea pl ant. For centuries before th e Europeans arrived, native Australians we re using the leaves of this tre e as an antisepti c. Eventually the Europeans learned to use the leaves' volatile oil to treat cuts, abrasions, burns, insect bites , and other minor skin ailments. Modern studies show that the strong germicidal activity of tea tree oil is caused primarily by a single ingredient, terpineol . The oil, which smells like nutmeg, is extracted from the leaves by steam distill ation . During World War II , tea tree oil was added to machine oils to reduce infections in the hands of workers during metal fabrication. The ?ii: of some species of Mela/euca may irritate the skin and are not used.

TARGET AILMENTS • indigestion , gas; a feeling of swelling, bloatedness, or fullness in the abdomen; nausea and vomiting; loose stools; bringing up phlegm. (Take internally.) PREPARATIONS Tangerine peel is available at any Chinese pharmacy or Asian food market , as well as at Western health food stores. It is also available as pills .

Combinations: In a preparation with Asian ginseng, tangerine peel is used as a digestive stimulant. Chinese herbalists p_rescr_ibe a mixture of tangerine peel, ripe bitter orange, and aucklandia for abdominal distention, fullness, and pain.

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Prescription Drug

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Over-theCounter Drug

GI

TARGET AILMENTS Apply externally for : • cuts, abrasions, insect bites, acne seen

O

Western Herb

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Chinese Herb

/\ Homeopathic Q V Remedy 1 13

•

CONVENTIONAL

AND

NATURAL

in teenagers, fungal infecti ons such as athlete's foot , and other skin ailments. ♦ minor vagi nal infections. (Use as a douche .) ♦ flea shampoos for pets.

PREPARATIONS Over the counter: Available as oil and also as an add iti ve t o health and beauty products such as toothpast e, soap, and shampoo .

MEDICINES

GENERALDESCRIPTION Introduced in 1987, terazosin is one of several alph a-adrenergic blocking agents used in the tr eatment of high blood pressur e (hype rt ension). It can be used alon e or in co mbin ation w ith ot her drugs, depending on th e degree of hyperte nsion. Fo r mor e inform atio n, see Alpha,-Adrenergic Blockers. SIDE

formation abo ut thi s drug, including other side effects as well as possible drug interactions, see Antifungal Drugs and Vaginal Antifungal Drugs.

TETRACYC LINE

EFFECTS

At home:

Not serious:

App ly fresh leaves directly to wo und s.

Although rare, a slight (two- to thr eepound) weight gain is possible with use of this drug.

Antibiotics

SPECIALINFORMATION

Sumycin

S I DE EFFECTS

[Tetracyclines]

BRAND NAME

No t serious: Local skin and vaginal irrit atio n may deve lop in sensiti ve indi v idu als. Let yo ur docto r know if it persists.

SPECIALINFORMATION ♦

DRUG CLASS

♦

You should not take ter azosin if yo u have ever had an allergi c or unusual reaction to it , or to do xazosin or prazosin.

People w ith sensiti ve skin should dilut e tea tr ee oi l wit h a bland oil , such as vegetab le o i I.

TERBUTALINE

TEMAZEPAM

GENERALDESCRIPTION Introduced in 195 3, tetracycline is an antibiotic drug produced or derived from a strain of bacteria known as Streptomyces aureofaciens and used to treat a wid e range of bacteria- caused diseases. Like most other drugs of its type , t etra cycline should be taken on an empty stomach. See Tetracyclines for information about side effe cts and possible drug interactions.

DRUG CLASS Bronchodi lat ors

BRAND NAMES

DRUG CLASS Antianxiety

Drugs [Benzodiazepines]

Brethaire, Bret hine , Bricanyl

GENERALDESCRIPTION

BRAND NAME Restoril

GENERALDESCRIPTION A mild sedative- hyp not ic, temazepa m is prescribed for th e short-term t reatme nt of insomnia. See Benzodiazepines fo r information on side eff ects and possible drug interact ions.

Introdu ced in 1974 , terbutaline is prescrib ed to reli eve the sympt oms of bronchial asthma and the asthmalike symptom s of chroni c bronchitis and emphysema. The drug may also be used to inhibit premature labo r. See Bronchodilators for informatio n abo ut side effects and possible dru g interactions.

SPECIALINFORMATION • Do not use this dru g unle ss yo u ca n al low yourse lf seven or eight hour s of sleep every night for the duration of the tr eatment. If you don't give the medication time to wear off , yo u may experi ence t empora ry amn esia, perhaps lasting severa l hours .

D

TERCONAZOLE

DRUG CLASS Antifungal Dru gs [Vaginal Antifungal Drugs]

BRAND NAME Terazol

TERAZOSIN

GENERALDESCRIPTION DRUG CLASS Alpha,-Adrenergic

BRAND NAME Hytr in

1014

TETRACYCLINES

Blockers

The antifungal drug terconazole is availab le in vaginal cream s and suppositories for the treatment of vaginal yeast infections (candidiasis ). A co mmon side effect of terconazole is headache, which afflic t s about one-fourth of the women w ho use the medicat ion. For mor e in-

GENERICNAMES doxycycline, tetracycline

GENERALDESCRIPTION Tetracy clines are natural or semisynt heti c antibiotics developed from a particular strain of bacteria . The drug s work by inhibiting protein synthesis in certain disease-causing bacteria, including many that cause sexually transmitted diseases. Tetracyclines are also useful in treating many mosquito- and tick-borne diseases, such as Rocky Mountain spotted fever. Tetr acyc lines are important for com bating bacterial strains resistant to penicillin , or for use by patients who are sensitive or allergic to penicillin or other antibiotics. They are also useful for treating serious acne, which can cause lesion s and scarring. Although their full actions in treating acne are not known , t etra cyclines reduc e concentrations of fatty acids in oil-gland secretions , suppress inflammation, and kill susceptible bacteria on the skin. These effects probably co mbin e to reduce acne lesions. For more information, see the entries for th e generic dru gs list ed above.

CONVENTIONAL

AND

NATURAL

MEDICINES l

TARGET AILMENTS ♦

♦

♦ ♦

+ ♦

+ +

some sexually transmitted diseases, includin g syphilis , gonorrhea , and chlamydia. urinary t ract infection s. acne vulgaris (characteri zed by lesions and cysts). mosquit o-borne diseases, such as malari a, and tick-born e diseases, such as Rocky Mountain spotted fever and Lyme disease. infection s of the skin and soft ti ssue. pr evention and tre atm ent of chronic bronchiti s and pneum onia. sinusitis . certain peptic ulcers. SIDE

EFFECTS

Not serious:

Lighthe adedness, diz z iness, gastroint estinal upsets (cr amps, burning sensation in stomach, diarrhe a, nausea, vo mitin g), photosensitivity . Less frequently: fungal inf ect ion of the mouth, genital, or rectal area; darkenin g or discoloration of th e tongue. Let your doctor know if th ese symptoms persist or beco me troubl esome. Serious:

Discoloration of the te eth in infants or children , serious photo sensitivity , apparent symptom s of diab et es (noticeabl e increa se in vo lume of urin e or frequency of urin at ion, incre ased thirst, unusual tiredness or weakness). Rarely: liver or pancreas toxicity (yellowin g of skin, abdominal pain, nausea, vomiting). Call yo ur do ctor immediately.

♦

Never take outd ated tetracyclines or t hose th at have changed in color , taste, or appearance; they may br eak down into toxic substances in the body. • These drugs may cause increased sensiti vity to th e sun or to sunl amps. Limit your expos ure wh ile on these medications . • Most tetracyclines (except doxycycline) should be taken on an empty stomach. POSSIBLE

sedatives to relieve anxiety from asthm a att acks. For inform ation about side effects and possible drug inte racti ons, see

Bronchodilators.

THYROID HORMONES

GENERIC NAMES

INTERACTIONS

levothyroxine, thyroid USP

Tell your doctor if you are taking lithium , insulin , di gox in, or an anticoagulant drug. Your dosage of these drugs may need to be adjusted.

GENERAL DESCRIPTION

Thyroid hormones are naturall y or syntheti cally produc ed drugs-usually given orally-that are used to repl ace or supplement the norm al secretions of the thyroid gla nd. Most preparations contain a mi xture of several different th yroid hormones in varying ratios. Hormones produ ced by the thyroid gland regulate functions such as metabolism and protein synthesis, general body growth, and developm ent of the bones and central nervous system. They also affect the heart rate . Thyroid hormon e therapy usually must be maintain ed throughout the pati ent's life unless it is prescribed for a tr ansient condition that may affect thyroid function. Because these hormones are so critical to normal growth and developm ent, children should be t ested to ensure that their thyroid glands are functioning normall y; those w hose bodies are not producin g suff icient quantities must be giv en supplemental thyroid hormone s as soon as possible. Thyroid medi cat ions are sometimes used di agnostic ally to check for thyroid disease.

Antacids, bicarbonate of soda, calcium, iron, laxatives, magnesium supplements:

decreased absorption of t etracyc line s. Take tetrac ycl ines one to two hours before or two to three hours after taking any of these products . Cholesterol-reducing drugs, such as cholestyramine: reduced absorption and

effectiv eness of tetracyclin es. Allow severa l hours to pass betwe en doses of t etra cyclines and these drugs. Cimetidine (antiulcer): may decrease ab-

sorption of tetracycline. Estrogen-containing contraceptives or medications: reduced birth- co ntrol ef-

fect; possible pregnancy or breakthrough bleedin g. Penicillins: may int erfere with tetracyclines, reducin g effect of both drugs.

SPECIAL I N FORMATION ♦

+

+

+ +

Tetracycl ines kill not only harmful bacteria , but also "good " bacteria that keep unwanted fungi and int estinal organisms in check. Eating yogurt containing Lactobacil/us acidophilus culture (or taking acidophilus tabl ets) may help restore the body 's normal bacteria. Prolon ged use of any antibiotic drug can lead to fungal infections, includin g candidiasis, or to bacte rial infections such as pseudomembranous colitis. Tetracyclines should not be taken by pregnant or nursing women or by children under nine years of age. The drugs may cause perman ent discoloration of teeth, underd evelopment of tooth enamel, and skeletal growth problem s in the fetus, in nursing infants , and in young children who take them. Tetracycl ines may cause liver toxi city or renal problems in some individu als. Do not take these dru gs with milk or dairy prod ucts. Take t etracyclin es one to two hours befor e or two to thr ee hour s afte r consuming dairy produ ct s.

THEOPHYLLINE

TARGET AILMENTS ♦

hypothyroidism (underactive or nonfunctioning thyroid ) or as tre atment following removal of th yro id gland. • goiter (enlargement of thyroid ). ♦ some types of thyroid cancer, especially after radiati o n therapy to the neck.

DRUG CLASS

Bronchodi lat ors BRAND NAMES Rx: Slo-Bid , Theo-Dur OTC: Primatene Dual Action Formula ,

SIDE

Primat ene Tablets

EFFECTS

Not serious:

Rarely, except at beginning of tr eatment , changes in menstrual period s, clumsiness, coldness, co nstipation , dry puffy skin, headach e, sleepiness, tiredness, heart palpitations, weakness, muscle aches, weight gain. Call your docto r if th ese effects persist or are troublesome. (Some hair loss may occur in children during early treatment, but this condition is usually t emporary.)

GENERAL DESCRIPTION

Introduced in 1900 , theophyllin e is an antiasthmatic dru g that acts by relaxin g the muscles in the bronchial tubes as well as the blood vessels in th e lungs. It is prescribed for symptoms of acute bron chial asthma, chronic bronchitis, and emphysema , and to help prevent bronchial-asthma episodes. Theophyllin e may be combin ed with other drugs such as ephedrine to provide additional reli ef of asthma symptoms , and w ith mild

0

Prescription Drug

0

Over -theCounter D rug

O

Western Herb

0

Chinese Herb

Cl

~ Homeopathic 1Q15

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I

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;, ·..

CONVENTIONAL

-

AND

NATURAL

Serious: Rarely, all ergic rea ction s such as skin rash or hi ves, severe persistent and ongoi ng headache , changes in menstrual per iods , c hanges in appet it e, chest pain , irregular heartb eat, fever, hand tremors, irritabilit y, leg cramp s, nervou sness, sensiti vi t y to heat , swea tin g, weig ht loss. Contact your doctor , w ho may reduce th e dosage.

SPECIALINFORMATION ♦ Your doctor may t ell yo u to co ntinu e

using th yro id horm ones w hil e yo u're pregnant or nur sing. Although small amou nt s of th ese hormon es may cross th e placenta or be present in breast milk, no studies have shown harm to the fetus or br east- feed ing baby. ♦ Tell you r do ct o r if you have cardiovascul ar disease, or diabetes or other horm one probl ems suc h as low pituitar y gla nd secretions. Your doctor may decide not to use thyroid hormones or to lowe r th e do sage. P OSS IBL E INTE RAC TI O N S

MEDICINES

}

THYROID USP

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DRUG CLASS Thyroid Hormon es

TOBRAMYCIN

Armour Th yro id

DRUG CLASS

GENERALDESCRIPTION Thyro id USP is a natural form of thyroid ho rm o nes obtained from the thyroid glands of domestic an im als. It is not th e most w id ely used dru g for tre at in g hypothyroidism (under acti ve th yroid ) beca use it doesn 't hav e a predi cta bl e hormone con t ent ; however , yo ur doctor may prescribe it for you. Although USP (U nit ed States Pharmacology) standa rds fo r thyroid we re recently revised, it is still difficult to determine th ese ratio s ~nd the stand ards hav e not been full/ implem ent ed. See Thyroid Hormones for inform ation on side effects and possibl e int erac tion s.

Antidiabetic drugs (such as insulin): increased need for i nsu Ii n or ot her di abet ic dru gs, perhaps leading to higher blood sugar level s. Your doctor may need to adjust your insulin dose. Cholesterol-reducing drugs (such as cholestyramine): blocked or delayed absorption of thyroid hormon es, de creasing th eir effect ive ness. Take thyroid hormo nes one hour before or four to five hour s after chole st ero l-redu c ing drugs .

Heart-stimulating drugs (such as epinephrine or pseudoephedrine): increased effects_of both combined dru gs, potenti all y causing heart problems or increased chanc e of thyroid hormone overdose.

D

~ther horn:iones (such as estrogen): may interfer e with thyroid hormone action , requiring hi gher do ses.

(Ophthalmic

Antibiotics]

BRAND NAME Tobrex

GENERALDESCRIPTION Tobramycin is an aminoglycoside antibiot ic drug that works by killing bacteria. Tobramycin is adm inist ered by inj ect ion to treat severe systemic infections . When used for th e eyes in solution or ointment form, tobramycin has fewer side effects and possibl e drug interactions than the injectable forms used for systemic problems. For more information, see Ophthalmic Antibiotics.

SPECIALINFORMATION

TIMOLOL

@J

DRUG CLASS Beta-Adrenergic

Blockers

may slow the healing of corneal wounds.

TOLNAFTATE

BRAND NAME Blocadr en, Timoptic

(ophthalmic )

GENERALDESCRIPTION In oral form , the nonselectiv e betablocking drug timolol is prescribed to help man age high blood pr essur e (hypertension ), heart attack (myoca rdi al infa rction), and migraine headaches. In ophthalmic, or eye drop , form, the drug is used to control glaucom a and to prevent increased eye pressure during eye sur gery. See Beta-Adrenergic Blockers for information about th e side eff ects and possible drug interactions of nonophthalmic forms of these drugs. S ID E EF F EC T S (op hthalmic only )

Not serious: Itching , stinging, or watering of the eye. Contact yo ur doctor for advice if these effects are prolonged or both ersome.

Serious: Redness of the eyes or inside the eye lids, blepharitis (inflammation of the eyelid), ~o~ju~ctivitis_, keratitis (severe swelling, 1rr1tat1on, or inflammation of th e cornea), droopy upper eyelid, doubl e or

1016

Antibiotics

♦ Tobramycin

Antidepressants, including tricyclic antidepressants such as amitriptyline: increased action and side effec t s of both combined drugs, lead ing to heartrhythm problems and other signs of excess stimulation.

@J

BRAND NAME

Anticoagulant and antiplatelet drugs (such as warfarin): incr eased anticlottin g action. Your doctor may have to adjust th e dosage of anticlotting dru gs.

b lur red vision , or other change in vis ion. Tell your docto r about these symptom s.

DRUG CLASS Antifungal

Drugs

BRAND NAME Tin actin

GENERALDESCRIPTION Tolnaftate , available in topical aerosol, powder, c ream, gel, or solution form, is used to tr eat several types of superficial fungal infections. It can also help prevent the development of some types of athlete's foot. Tolnaftate is not an effective treatment for bacterial or yeast infections (ca ndidiasis ). For more information , see Antifungal Drugs.

TARGETAILMENTS ♦ jock itch . ♦ body ringworm. ♦ white-brown skin patches (a ring-

worm infection also known as tinea versicolor). • athlete's foot.

~

CONVENTIONAL

SIDE

EFFECTS

Not serious: Skin may become slightly irritated at th e site of application. If this becomes bothersome, discontinue use and consu lt yo ur doctor.

Serious: None expected.

SPECIALINFORMATION ♦ Do not use on children

♦

• •

•

♦

♦

under age two or for diaper rash witho ut consultin g your doctor. Contact your doctor if your symptoms worsen or do not improve within 10 days. Do not allow medi cat ion to come in contact w ith your eyes. Because it lacks antibacterial properties, tolnaftate is most effect ive for the dry , scaly type of ath lete 's foot. Although it may stin g slightly when first applied, tolnaftat e ca n be applied to broken skin. To prevent reinfection of fungal infections in volving the feet or genit als, wear cotton rather than synt heti cfiber socks or underwear during treatment. Avoid wearing tight underwear if you have jock it ch .

POSSIBLE

INTERACTIONS

inf ecti?n is und er way, your do ctor may pr escr ibe a stron ger medi cati on. See the entri es for th e generi c dru gs for more information.

§1~

GENERICNAMES Rx: chlorhexidine (for gums); mupiro ci n (for skin); comb ination of neomycin , polymyxin B, and hydrocortisone (antibioti c-corticos teroid for ears)

GENERALDESCRIPTION

~

MEDICINES

DRUG CLASS

TARGETAILMENTS

Antid ep ressant s [Mo noa min e O x id ase (MAO ) Inhibitor s]

♦

minor cut s, scr apes, and burn s (bac itracin , neomycin , polymy x in B, to prevent bacterial infe ction ) . ♦ gin givit is (ch lorhex idin e) . ~ imp et igo (mupirocin ) . ♦ external ear canal infe ctions (neomycin , polymyxin B, and hydro co rti sone in comb inati on ) .

BRAND NAME Parn at e

GENERALDESCRIPTION Tranylcypromine, like other medications in the subc lass of antid epressants that is known as monoamine oxidase (MAO) inhi_bitors , is used to treat depression, anx iety , and phobias w hen other antide pressant drugs have fa il ed . See Monoamine Oxidase (MAO) Inhibitors for inform_ation on side effects, warnings , and possible drug interactions.

S I DE EFFECTS

Not serious: Chlorhexidine: stained teeth , increased tartar, irritation on the in side of the mouth, temporary changes in your sense of taste. Ca ll your doctor if thes e symptoms become bothersome .

Serious: Bacitracin, mupirocin, neomycin, and polymyxin B: allergic react ion (it ching,

TRETINOIN

stin ging , rash , redness , or swe llin g at the app lic at ion site). Call your doctor immediately.

Chlorhexidine: anaphy lacti c reaction DRUG CLASS

(nasa l congest ion , difficulty in breathing , rash, hi ves, facial swelling). Seek medical help immediately.

Antiacne Drugs

BRAND NAME Avita, Retin-A (in var ious formulations)

may result if extensive systemic absorption of neomycin occurs v ia application over large areas of the body or through prolon ged use. Call your doctor imm ed iately.

GENERALDESCRIPTION

ty react ion and toxicity, leading to permanent deafness if combined with neomycin, w hich is also an aminoglycoside .

Tretinoin, a derivative of vitami n A is used topically to treat skin conditi~ns such as acne. It is sometimes used in conjunction with other drugs, incl uding benzoyl peroxide or antib iotic s, to treat severe acne , although you should not combine it with other acne medications without your doctor's knowledge. Although the exact mechanism by which tretinoin works has not been established, it is classified as a cell stimulant. The drug also appears to weaken the attac hment of certain skin cells to each other. These actions cause skin and other ce ll s to slough off the body's surface, possibly preventing plugs that block ski n pores. Mild inflamm ation often accompa nies its use. _Tret inoin does not cure acne; your skm _WI II return to its pretherapy state w 1t_h1 n three to six weeks after you stop takin g the drug. Its effec ti ve ness in reversing skin damage ca used by exposure to ultraviolet radiation has not been confirmed.

For other possible interaction s, see the entri es for th e gener ic drugs listed above.

TARGETAILMENTS

SPECIALINFORMATION ♦ Check with yo ur doctor

♦

•

OTC: bacitracin, neomy ci n, polymyxin B

Topical antibiotics are used to prevent or clear up bacterial infection s of the skin, ears, or gum s. They should never be used interchangeably; drugs for the skin, for example , should not be applied to the ears or mouth. Each drug is effective against a specific group of bacteria. For self-tr eatm ent of minor skin wo unds it may ther efo re be useful to choose a~ over-the-counter product that combines two or more antibacterial ingredients. Over-the-counter topical antibiotics are available in an ointment base that helps close and soothe wounds. In general, though , OT C drugs are used to guard against possible infections. Once a skin

NATURAL

TRANYLCYPROMI NE

Neomycin: kidney damage or hearing loss

None expected.

TOPICAL ANTIBIOTICS

AND

• ♦

if you notice no improvement after using these medications for two or three days. Prolonged use of a prescription topical antibioti c may result in fungal supe rinfe ct ion . The use of topical antibiotics increases the r_iskof kidney damage or hearing loss 111peopl e with impaired kidney function who are already taking neph rotoxic (kidney damaging) medicines. If you are allergic to a topical antib iotic, you should not use that drug. If _you are pregnant or nursing, check wit h your doctor before using.

POSSIBLE

INTERACTIONS

Aminoglycosides: possible hyper sensiti vi-

GI

♦ acne (used alone or in combination

with other dru gs). ♦ skin disorders such as keratinization

,

keratosis , and f lat wa rts .

0

Prescription Drug

0

Over-the Counter Drug

O

Western Herb

0

Chinese Herb

/4)\Homeopathic

U Remedy

Q

1 17

CONVENTIONAL

AND

NATURAL

S ID E E F F EC T S

MEDICINES

TRIAMC INO LON E

Not serious: Warming or reddening of the skin , mild stinging or peeling of the skin. Consult your doctor if these symptoms become excessive . However , mild inflammation and peeling of the skin may represent the normal action of the drug and may lessen with time.

§J

DRUG CLASS Corticosteroid s

BRAND NAMES Azmacort, Nasacort

Serious: Crusting, blistering, swelling, and darkening or lightening of the skin; severe reddening or burning of the skin. Consult your doctor, who may tell you to stop using the drug or to use it less often, depending on the severity of the symptoms. Rarely, when absorbed through the skin , tretinoin may cause toxicity symptoms, including dizziness, headache, nausea, diarrhea, and ringing in the ears. Contact your doctor immediately if you have these symptoms.

SPECIALINFORMATION ♦

♦

♦

♦

♦

To avoid irritation, be careful not to get any tretinoin in your eyes, mouth, nose, or other mucous membranes. Tretinoin may cause increased sensitivity to the sun and to ultraviolet radiation. Wear a sunscreen or cover affected skin when outdoors , and do not use a sunlamp. Acne may appear to worsen for up to a week after tretinoin is applied, because lesions just under the skin are made more prominent by the drug. You may wear nonmedicated cosmetics, but be sure to wash your skin thoroughly to remove any cosmetics before applying tr etinoin . Tretinoin may cause increased sensitivity to cold or wind. PO S SIBL E INTE R A CTION S

tretinoin except under a doctor's direction , because the two medications may be incompatible.

None expected with low-dose, shortterm use.

of the skin.

Minoxidil (topical for hair growth, especially in bald men or women): tretinoin increases the absorption of minoxidil and may increase its side effects, which include low blood pressure, heart-rhythm problems, and impotence. Let your doctor know if you are using minoxidil.

1018

TRIAMTERENE

cessive irritation or drying of the skin. Consult your doctor before using these products. sive irritation

EFFECTS

Increased risk of sunburn.

SPECIAL INFORMATION • Because triamterene inhibits potassium excretion, you should not take potassium supplements (including salt substitutes) while on this medication. Excess potassium can lead to heartrhythm problems. ♦ While you are taking this medicin e, your skin may burn more readily when exposed to sunlight. To protect your skin , use a sunblocking lotion when outside and avoid prolonged exposure to the sun and sunlamps.

TRIAZO LAM

Not serious: White patches in mouth , throat , or nose; throat irritation; stuffy or runny nose, and burning or dryness inside the nose. See your doctor if these symptoms per sist or if there is no improvement in your condition in three weeks.

Serious:

Medicated cosmetics: may cause exces-

SIDE

Not serious:

S ID E E F FEC T S

Benzoyl peroxide: do not use with

Medicated, abrasive, or peeling acne products (such as benzoyl peroxide or medicated soaps); perfumes or astringents containing alcohol: may cause ex-

D

GENERALDESCRIPTION Triamcinolone is a potent adrenal corticosteroid, available in nasal spray and oral inhaler forms. The drug, introduced in 1985, is normally prescribed when a person 's medical condition does not respond to other treatments . Oral inhalant forms of triamcinolone are used to treat bronchial asthma; they are intended to prevent, not relieve, acute asthma attacks. Previous use of other oral or inhalant bronchodilators may increase the effectiveness of triamcinolone. In nasal spray form , triamcinolone is used to treat allergic rhinitis (nasal inflammation). It is also used for severe seasonal or perennial hay fever when decongestants are inadequate (although clearing your nasal passages with a decongestant spray before using triamcinolone may improve the drug's effectiveness). Some systemic absorption may occur with long-term use of triamcinolone. See Corticosteroids for more information.

kidney and li ver problems associated with fluid retention. Because it pr events the excess excr etion of potassium from th e body , tr iamt eren e is frequently used in combination with nonpotassiumsparing diuretics, such as hydrochlorothiazid e. See Diuretics for more information , including side effects and possible drug interactions. For information about a nonpotassium-sparing diur etic often used in combination with this drug , see Hydrochlorothiazide.

DRUG CLASS Diuretics

BRAND NAMES Dyaz ide, Maxzide

GENERALDESCRIPTION Triamterene, among the drugs known as potassium-sparing diuretics, is prescribed for high blood pressure (hypertension), congestive heart failure, and

DRUG CLASS Antianxiety

Drugs [Benzodiazepines]

BRAND NAME Halcion

GENERALDESCRIPTION A mild sedative-hypnotic , triazolam is prescribed for the treatment of insomnia. Triazolam is more likely than most other benzodiazepines to cause shortterm amnesia if you have to wake up and be alert before the drug's effects have worn off. See Benzodiazepines for more information on side effects and possible drug interactions. 'y PO SS IBLE

INTERACTION

S

Erythromycin: increased triazolam effect.

lsoniazid: increased triazolam effect and possible toxicity.

CONVENTIONAL

TRICYCLIC ANTI DEPRESSANTS (TCAs)

r:J ~

AND

NATURAL

MEDICINES

Apply ext er nally for : skin inf ect ions.

TRIPROLIDINE

♦

Western: Take internally for: 9 digestive disorders , feve r, chest congestion , menstru al irr egul arit y, aches and pains of arthriti s.

DRUG CLASS Antidepress ants

DRUG CLASS Antihist amines

GENERIC NAMES amitriptyline , doxepin , nortriptyline

BRAND NAME Actifed

Appl y externally for: • pain and swel lin g caused by tr auma.

GENERAL DESCRIPTION An important group of antidepressant drugs , tricyclic antidepressants (TCAs) are widely used to treat depressive illnesses and , less often, in the treatment of ulcers. See Antidepressants for information about side effects and other possibl e drug interactions .

GENERAL DESCRIPTION Triprolidin e is an antihist amine w ith mild sedative effects. See Antihistamines.

PREPARATIONS Ove r the counter: Turm eri c is availabl e as powdered root , capsul es, and liquid extract.

SPECIAL I NFORMATION • Before taking these drugs, let your doctor know if you are suffering from glaucoma, urinary retention , epilepsy, or hyperthyroidism. POSSIBLE

INTERACTIONS

Cimetidine (antiulcer): increased TCA effects. Clonidine (blood pressure medication): may cause a dangerous increase in blood pressure. Haloperidol (antipsychotic), oral contraceptives, phenothiazines (antipsychotic), levodopa (anti-Parkinsonism): decreased levels of TCAs. Tobacco (smoking): increased elimination of TCAs from th e body, lessening their effec ti veness.

TRIMETHOPRIM

GENERAL DESCRIPTION Trimethoprim is a generic antibiotic drug often used in combination with sulfamethoxazole. For more information , see Su/famethoxazole and

At home: Chinese: Combinations: For shoulder pain, turm eric is mixed w ith cinnamon twi g and astra galus. Men strual cramps and pain after childbirth may be allevi ated with a com bination of turm eric and cinnamon bark; for menstrual irregul arit y the herb is combin ed with dong quai. Turmeric is mixed with sesame or salad oil and appli ed externally to swollen areas.

TURMER IC

LATIN NAME

Curcuma longa GENERAL DESCRIPTION The turm eric root , an ingredient of I ndian curri es for thousands of years, also has medi cinal properties. Today in Ayurvedi c (Hindu ) medi c ine, turmeric is used for several purpos es, includin g as a digestive aid. On e of its active ingr edients, curcumin, induces the flow of bile , which in turn br eaks down fats. Curcumin is also an anti-inflammatory agent and thus relieves the aches and pains associated with arthritis. Turmeric also contains a volatil e oil, which functions as an external antibiotic, preventing bacterial infection in wo unds. In tradition al Chin ese medic ine turmeric is categorized as acrid, bitter, and warm . The turmeric pl ant is recogniz ed by spongy, orange bulbs and ye llow trump et-shaped flower s.

Western: Deco ction: Steep 1 tsp turmeric powd er in 1 cup milk for 15 to 20 minut es. Drink up to 3 cups a day. SIDE

EFFECTS

Not serious: Possible heartburn or upset stomach. Reduce dosage or disco ntinu e use and consult your practitioner. SPECIAL INFORMATION • If yo u are pregnant , consu lt your pr actition er before using. ♦ One animal study indicated th at the herb redu ces fertility. If you are trying to conceive or if you have a hist ory of fertility probl ems, co nsult your practitioner before using. • If you have a blood -c lottin g disord er consult your practitioner before using. Turm eri c is th ought to have an anticlotting effect on the bod y. • Use low-str ength preparations for children, or adults over 65. Do not give to children under 2 years of age.

TARGET AILMENTS Chinese: Take int ernally for: ♦ shoulder pain, menstru al cramps, pain after childbirth , menstrual irregularity.

Trimethoprim.

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0

Prescription D rug

0

Ov er-theCounter Drug

O

Western Herb

O

Chinese Herb

[D.Homeopathic Q g V Remedy 1 1

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CONVENTIONAL

AND

NATURAL

USNEA

MEDICINES

co ncentr ations may cause digesti ve problem s. ♦ Do not use for more than three consecutive weeks.

LATIN NAME Usnea spp. GENERAL DESCRIPTION Usnea, o r larch moss, refers to a gro up of li che ns, w hi c h are plants made up of algae and fungi that grow to get her in an int erdepe ndent relationship. Larc h moss is fou nd hangin g from the lar c h and many ot her tre es in the Northern Hemisphere . Sometimes ca ll ed old-man 'sbeard for its shaggy appea rance, it frequently appears in fruit orchards. Th e activ e ingredient, usnic acid , seems to hav e an antibioti c eff ect against the Gram-positive class of bacteria , which includ es, fo r exampl e, strept ococc us. It may also be effectiv e against some fungi and protozoans. U snea is believed to work by disrupt ing th e ce ll met abo li sm of bacte ri a and other simp le organisms , alt hou gh it does not dam age human cells. Herb alist s co nsider it an immun e syst em stimulant and a muscle rel axant. Some species of usnea, includin g at least four found in th e weste rn Unit ed States, are also used as herb al remedie s and serve as food for some anim als and peop le.

GENERAL DESCRIPTION The leaves of the uva ursi shrub have been used wor ldw ide fo r urinary prob lems for at least 1,000 years. The leaves co ntain arbut in, which is co nver ted in the urinary t ract to hydr oq uinon e, a widely used antisep ti c. They also contain tannin , an astring ent useful in treating wounds, and allantoin, which s?ot hes and acce lerat es the healin g of tissue. Uva ursi , w hi ch lit erally means " bearberry ," is an ingredie nt in mo st herbal t eas that are taken for urin ary problems. Thi s woody, mat-fo rmin g, everg reen shrub, which appears throughout the North ern H emisphere , prefers poor , grave ll y soil and rar ely grows mor e than a few inches tall.

TARGET AILMENTS Take int ern ally for: • co lds, inf luen za, sore throats , respirato ry inf ection s. ♦ gastrointestinal irri tations.

TARGET A ILM ENTS Take intern all y for: ♦ mild urin ary tract infect ions, such as urethriti s and cystitis , hi gh blood pressur e, menstrual blo atin g.

Apply exte rnally for: ♦ ski n ul cers and fungal infect ions suc h as at hl ete's foot. ♦ ur inary tract infe ctions such as urethritis and cystitis, vaginal inf ect ions. (Use as a dou che.)

Apply ext ernally for : ♦ minor skin problems such as cut s and abrasio ns.

PREPARATIONS Over the counter: Th e dried herb is ava il able in bulk, powd er, or tinctur e. At home: Tea: Steep 2 to 3 tsp dried li chen or 1 to 2 tsp of powder in 1 cup bo ilin g water . Take thre e times daily . SIDE

!D

EFFECTS

Not serious: If digestive disord ers arise, redu ce dosage. Call your doctor if these symptoms persist. SPECIAL INFORMATION Pregnant women should avoid using this herb , because it may stimulate uterine contractions . • Dilut e tinctur e before ingesting; high ♦ WARNING:

1020

Serious: Ringing in th e ears, nausea, and co nvulsions were reported in a 1949 study invo lvin g very hi gh doses of isolated hydroqui none. Prescr ibed do ses of the w ho le herb are co nsidered safe, but in case of side effects, discontinue ta kin g until you contact your doctor .

UVA URSI

LATIN NAME

Arctostaphylos uva-ursi

PREPARATIONS Over the counter: Uva ur si is avai labl e in th e form of d r ied leaves; as a tin ct ure ; and as a t ea, alo ne or in co mbin ation w ith other ingredients. At home: Tea: Simmer in hot water for 5 to 10 minu t es, and allow to st and fo r 12 to 24 hours. To co unteract th e effect of th e t annin content, add peppermint or chamomile. Drink three cups a day.

Compress: Make a t ea; strain and disca rd th e herb . Soak a pad in the t ea and ap ply . SIDE

EFFECTS

Not serious: Taking uva ur si may result in th e pro duction of dark-green urin e; this is harmless. In addition stomach upset may be caused by the herb 's high t annin content.

SPECIAL I NFORMAT ION ♦ Uv a ursi 's disinfectant prop erti es work only in an alkaline enviro nment. When taking this herb, avo id acidic foods , such as mo st fruit jui ces, sauerkraut, and vit amin C. • Because hyd roq uinone is t ox ic in high doses, use uva ursi only in recomm ended amou nt s. ♦ Pregnant wo men should not use uva ursi, because it may stimul ate uterin e co ntraction s.

VAGINAL ANTIFUNGAL DRUGS

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DRUG CLASS Antifungal Dru gs GENERIC NAMES Rx: c lot rima zo le, micon azo le, terconazole OTC: clotrim azo le, micon azo le GENERAL DESCRIPTION Vaginal antifung al drugs are com monl y prescribed in th e treatm ent of vag inal yeast infecti ons. These medicatio ns work by damaging th e membr anes of fungal ce ll s and inhibiting th e enzyme acti v ity essenti al for the ce ll s' grow th and reproduction. The dru gs are availab le in the form of vag inal creams and suppositories. For more inform ation , see ent ri es for the gener ic dru gs li st ed above. Also see Antifungal Drugs. TARGET AILMENTS ♦ yeast infections (ca ndidi asis) of the vu lva and vagi na. S ID E EFFECTS

Not serious: Heada ches, mild abdomin al or stomach cramps; in rare cases, irrit ati on to th e sexual partner 's penis. Serious: If you experien ce vagi nal burnin g, itch ing, or discharge; or skin rash, hiv es, or other skin irrit at ion, discontinu e th e medi cation and co ntact your doctor.

:

CONVENTIONAL

SPECIALINFORMATION + If yo u are pregnant or nur sing, do not

•

+

♦

+ +

+

+ + +

use a vaginal antifungal medication w ithout co nsulting your doctor . Do not use these medications if you have a fever above 100°F; abdomina l, shou lder, or back pain; or a malodorous vaginal discharge. Be sure to use these medi cat ions for the prescribed amount of time , even during menstruation or if your symp toms abate. If you are using a vagina l cream, protect clot hin g from possible soiling by wearing panty lin ers or sanitary napkins. Avoid possible reinfection by wea rin g cotton rather than synthetic-fiber underwear. Refrain from sexual act ivity during treatment to avo id possible transmis sion and reinfection. Also , some vaginal antifun gal preparations contain a vegetable oi l base that might weaken lat ex condoms, diaphragms, or cervica l caps. If your male partner has any penile discomfort , burning , irritation, or itchiness , he may require simultaneous treatment for inf ect ion. He should consult his doctor. Douching may or may not be advised w hile using this med ication; consult your doctor. If your sympto ms do not show improvement within three to seven days, consult your doctor . If your symptoms return within two months, see your doctor; you may be pregnant or have a serious disorder , such as diabetes or an HIV infection .

POSSIBLE

INTERACTION

AND

mornin g grogginess and do not interfere wit h the vivid dreaming sleep known as REM sleep. It is not habit -form ing and produces no withdrawal symptoms when discontinued. The plant is a hardy perennial that reaches a height of about five feet. As th e roots dry , they develop an unple asant odor compared by one herbalist to that of dirty socks. Most peop le add sugar or honey to make valerian tea more palatable.

VALERIAN

Introduced in 1967, valproic acid is used in the co ntrol of epi lepti c seizu res, primarily th e simpl e and complex absence types (petit mal ). It is also used alone or as an adjunct to other anticonvulsant dru gs to treat other typ es of epilepsy. For more information , see An-

ticonvulsant Drugs. TARGETAILMENTS ♦ epileptic seizures, absence types.

TARGETAILMENTS

+ epileptic seizures, other types.

Take int ernally for: + insomnia, anxiety, nervousness, anxiety-induced heart palpitations. + headache. + intestinal pain s. + menstrual cramps.

+ prevention and tr eatme nt of bipolar disorder (manic-depression). SIDE

Some of the more common side effects experienced include: loss of appetite, indi gestio n, mild nausea, vomiting and diarrhea, unusual weight loss or gain, skin rash, trembling arms and hands, change in menstrual periods, lethargy , drowsiness , dizziness, unsteadiness, emotional changes. Call your physician if these or other side effects persist or are bothersome.

PREPARATIONS Over the counter:

Valerian is widely ava ilable dried or as capsules, tinctures , and teas. At home:

Steep 2 tsp dried , chopped root in 1 cup boiling water. Let stand 8 to 12 hours. Drink 1 cup before bed. .

SIDE

Serious:

EFFECTS

Bizarre behavior , hallucinations , unusual ble eding or bruising, yellow eyes or skin, severe stomach cramps, double vision, spots in front of your eyes, jerky or rolling eye movem ents, swelling of the face, continual nausea or vomiting. Seek medical care immediately. Also see overdose symptoms below.

Not serious:

A mild headac he or upset stomach may develop. Reduce dosage, and let your doctor know if it persists. Serious:

More severe headache, restlessness, nausea, morning grogginess, or blurred vision may be caused by using too much valerian . Contact your doctor , who will probably tell you to take less or to stop using the herb.

SPECIALINFORMATION + Valproic acid overdose can be fatal :

SPECIALINFORMATION ♦

Do not take valerian with conventional tranquilizers or sedatives, because of possible additiv e effects . + Paradoxically, valerian may produce exc it ability in some people. + Since it has sedative effects, be careful about driving until you know how the herb affects you.

♦

+

Valeriana officinalis

GENERALDESCRIPTION

VALPROIC ACID

+

DRUG CLASS Anticonvulsant

Drugs

BRAND NAME Depakote

+

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Prescription D rug

EFFECTS

Not serious:

LATINNAME

Valerian root has been used for more than 1,000 years for its calming qualities, and recent research has confirmed its eff icacy and safety as a mild tranquilizer and sleep aid. For sufferers of insomnia, valerian has been found to hasten the onset of sleep, improve sleep quality , and reduce nighttime awakenings. Unlike barbiturates or benzodiazepines , prescribed amounts leave no

MEDICINES

GENERALDESCRIPTION

S

None expecte d.

NATURAL

0

Over-theCoun ter Drug

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Western Herb

Seek emergency help. Overdose symptoms include restlessness, hand tremors, hallucinations , and deep coma. Do not use valproic acid if you have had an allergic reaction to this drug , an active liv er disease or significant liv er function impairment, or a bleeding disorder. Tell your physician if you are taking anticoagulants, other anticonvulsants, or any other drugs (prescription or over the counter), especially those that depress the central nervous system, such as antihistamines, antidepressants, tranquilizers , barbiturates, narcotics , sedatives, pain medication, sleeping pills, or muscle relaxants. Before using this drug , tell your doctor if you have a history of brain, blood, liver, or kidney disease; are pregnant or planning pregnancy; or are anticipating surgery or dental extraction. You can take valproic acid with food to reduce stomach upset. To prevent

0

Chinese Herb

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A Homeopathic t:JRemedy 1 021

CONVENTIONAL

♦

♦ ♦

♦

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irrit ation of th e mouth or thro at, swal low the tablets or capsules whole, without chew ing or breaking them. Older adults are mor e likely to develop side effec ts from this dru g and should be tr eat ed w ith smaller dosages. Blood cell counts may show decreased white ce ll s and platel et s. Valproic acid may affect some laborator y t ests, inc ludin g liver function tests. Be sure to t el l any healthcare pr actitioner who gives you a lab test th at you are takin g this medication . Do not stop t akin g this drug or sw it ch brands without checking with your physician. POSSIBLE

MEDICINES

co ld , di arrh ea, fatigue . Call yo ur doctor if thes e symptoms persist or become bothersome.

SPECIAL INFORMATION ♦ This drug can harm the developm ent

of an unborn child ; do not take va lsartan if yo u are pregnant. If yo u are nur sing, co nsult with your do ct or before t akin g this drug. ♦ Valsartan should be used with caution if yo u have kidn ey or I ive r disease. ♦ Valsart an should be combi ned with exercis e, stress reduction , weight loss, and a salt-restricted diet to best control blood pressure.

Anticoagulant and antiplatelet drugs, including aspirin: incr eased risk of ble edin g.

Phenytoin and other anticonvulsants: concurrent use of phenytoin or another anticonvulsant with valproic acid may increase the risk of breakthrough seizures.

VALSARTAN

DRUG CLASS Antihypertensive

POSSIBLE

INTERACTIONS

Alcohol, aspirin, and other salicylates: avo id these when t akin g warfarin.

Vitamin K: counteracts war fa rin . Avoid eat ing large quantities of foods rich in vitamin K, includ ing leafy green veget ables, dairy products , bacon , beef liver , cabbage, cauliflower, and f ish.

WHITE WILLOW

Drugs

Calcium Channel Blo ckers

BRAND NAMES Calan SR, lsoptin SR, Verelan

GENERALDESCRIPTION

GENERALDESCRIPTION White willow, lik e other w ill ows, is a natural source of salic in , a precursor of mode rn aspirin, and inde ed it has been used for centuries worldwide as a pain reliever. Althou gh all part s of th e plant co nt ai n some salicin, th e best source is the mature bark , either fresh or dried. Like other salici n-pro duc ing plants, whit e wi llo w also reduces fever and inflammation, prob ably by suppressing th e act ion of pro staglandins (hor mo ne-lik e substances), w hi ch are produced by th e body in response to injuries. In addition to salicin, willow bark co ntains oth er co mpounds that the body metaboli zes t o sali cy lic acid. For thi s reason w ill ow bark acts mor e slowly and over a lon ger period of time th an aspirin does.

GENERALDESCRIPTION Valsartan is one dru g in a new class of blood pressure medications known as angiotensin 11 receptor antagonists. These dru gs inhibit the angiotensin 11 horm one from caus ing blood vessels to constrict, improvin g blood flow and lowerin g blood pressure. Valsartan may be used alone or in combination with other antihypertensiv e drugs. For more inform ation , see Antihypertensive

Drugs.

TARGETAILMENTS high blood pressure (hypertension ). EFFECTS

Not serious: Heada che, dizzines s, fever, sore throat , upper respiratory inf ections , cough ,

LATINNAME Salix alba

A calcium channel blocker introdu ced in 1967 , ve rapamil is prescribed for high blood pressure, angina, and heartrhythm probl ems. The drug works by blockin g th e passage of ca lcium into body cells, thus slowing th e contraction of the heart and art eri es, dilating th e ar t eries, and lowe ring b lood pressure. Verapamil is sometim es used to control c luster headac hes and panic atta cks. See Calcium Channel Blockers for information on side effects and possible drug interactions.

Diovan

1022

Minor bleeding, mild skin rash.

DRUG CLASS

BRAND NAME

SIDE

EFFECTS

Not serious:

VERAPAMIL

sedativ e effects .

D

T SIDE

INTERACTIONS

Alcohol, antidepressants, barbiturates, sedatives, tranquilizers, and other depressant drugs: increased depressive and

♦

have periodic blood te sts to monitor clot tin g tim e. See Anticoagulant and Ant iplatelet Drugs for imp ort ant information on serious side effects, such as hemorrhagin g, and drug int eractions.

WARFARIN

TARGETAILMENTS

Coumadin

Take intern ally for: ♦ gout , minor mu scle strains, menstru al cramps, headac he, fever, aches and pains, pain and inflamm ation of arthritis.

GENERALDESCRIPTION Warfarin , introduced in 1941 , is a pow -

Apply extern ally for: ♦ sores and burns , pain and infl amm ation of arthriti s.

DRUG CLASS Anticoa gul ant and Antipl ate let Dru gs

BRAND NAME

erful anticoagulant. It inhibits blood c lotting by blocking the action of vitamin K, a central ingredient in the production of four essential blood-clotting factors. W arfarin is administered or ally and can be extremely dangerous if not used properly. It is essential that you

PREPARATIONS Over the counter: Available as dri ed bark , tin ctur e, tea, and capsules.

At home: Tea: Steep 1 to 2 t sp of powdered bark

CONVENTIONAL

in 1 cup boiling water for eight hours ; strain. Drink up to 3 cups a day. The bitter taste can be impro ved by mixing with honey and lemon or another herba l tea. SIDE

EFFECTS

Not serious: Upset sto mach, nausea, or ringing in the ears may result. Low er the dosage or stop using white willow; call your doctor if symptoms persist. SPECIAL INFORMATION

+ WARNING: Children under the age of 16 should not use white willow if they have a cold, influenza , or other viral illnes s. Using salicylates may cause Reye's syndrome , a potentially fatal condition. + Individuals with ulcers or other stomach problems should use white willow with caution , because it can worse n stomach ills. + If you are taking blood thinnin g medications , use white willow only with the consent of your physician. POSSIBLE

INTERACTIONS

Do not mix white willow with oth er salicylate s, such as aspirin or wintergreen oil, because of the potential for add itiv e side effects.

AND

TARGET AILMENTS ♦ menstru al cramps , nausea due to pregnancy , morning sickness, urinary tract disorders, inte stinal colic, rheumatoid arthritis. (Take int ernally. )

NATURAL

MEDICINES

Eurasia, yarrow is widely planted in flower and herb gardens and found growing wild in most areas of the United States. TARGET AILMENTS Take internally for: fever, digestive disorders , menstrual cra mps, colds, flu, hi gh blood pressure.

PREPARATIONS Over the counter: Wild yam is available as dried rooc tincture , or capsul es.

At home: Tea: Boil 1 oz wild yam root with 1 cup wa t er for 15 to 20 minutes. Drink thr ee times daily.

Apply externally for: ♦ minor wounds, bleeding. + vaginal irritations. (Use as a douche.)

Combinations: For intestinal colic, wild yam is combined with calamus, chamomile, and ginger. Rheumatoid arthritis is treated w ith a mix of wild yam and black co hosh. Herbalists use a combination of wild yam and cramp bark for menstrual cramps.

PREPARATIONS Over the counter: Available as dried herb or tea.

At home: Tea: Steep 1 to 2 tsp of dried herb in 1 cup boiling water for 10 to 15 minutes. Drink up to 3 cups a day.

SPECIAL INFORMATION Wild yam is sometim es prescribed by herbalists for its supposed progesterone-lik e properties for women undergoing menopause. There is still a great deal of controversy , however , as to the effectiveness of this tr eatment. You should consult a practitioner before using wild yam as a progesterone supplement.

SIDE

♦

EFFECTS

Not serious: Rash, nausea, or diarrhea may result from taking yarrow. Stop using the herb and consult your doctor. SPECIAL INFORMATION

+ If you are allergic to ragweed, you may develop a rash from ingesting yarrow. + Do not take yarrow internally if you are pregnant.

YARROW WILD YAM ZOLPIDEM LATIN NAME LATIN NAME

Achi/lea mi// efo/ium

Dioscorea villosa GENERAL DESCRIPTION Used during the 18th and 19th centuries as a remedy for menstrual pain and complications associated with childbearing , wild yam is a perennial vine that entwines itself around fences and bushes. It is recognized by a slender reddish brown stern and drooping yellow flowers that bloom during the summer . Wild yam extract, taken from the root, contains an alkaloid substance that relaxes the muscles of the entire abdominal region. Consequently, it is prescribed to alleviate menstrual cramps and to relieve the nausea and muscle tension associ ated with pregnancy . Wild yam also contains steroidal saponins, believed to act as anti-inflammatory agents, and used to reduce the swelling caused by rheumatoid arthritis.

DRUG CLASS Anti-Insomnia Drugs

GENERAL DESCRIPTION Yarrow has been used to heal wounds since ancie nt times ; the Greek hero of the Trojan War, Achilles, is said to have stopped th e bleeding of his warriors' wounds by applying the crushed leaves of yarrow. Modern investigation has revealed many chemicals in yarrow that have anti-inflammatory and painrelieving effects. The leaves, stems, and flower tops contain more than 10 different active ingredients, including salicylic acid, menthol , and camphor. Two major constituents, achilletin and achilleine, are thought to help blood coag ul ate, w hile thujone (also found in chamomile) has mild sedative properties. Because yarrow may have diuretic properties, it is sometimes used to treat menstrual bloating and high blood pressure. The somewhat bitter taste of yarrow tea can be relieved by adding sweeteners or other herbs. A naturalized, three-foot-tall perennial from

0

Prescription Drug

0

Over-theCounter Drug

BRAND NAME Ambien GENERAL DESCRIPTION Zolpidem , introduced in 1993 , is the most commonly prescribed drug for the short-term (7 to 10 days) management of sleeping problems in adults. Its major advantages include a low incidence of adverse effects, rapid absorption and elimination, and minimal interferenc e with normal sleep patterns, which includes the rapid eye movement (REM) stage. A nonbenzodiazepine medication, zolpidem works by binding to a specific receptor in the brain to simulate normal sleep proc esses. Most users report few side effects, and little or no hangover effects, memory loss, or "rebound" insomnia when not using the drug. For

O

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Chinese Herb

A Homeop athi c 1 Ql V Remedy 3

CONVENTIONAL

AND

NATURAL

mor e information , see Anti -Insomnia Drugs.

TARGETAILMENTS ♦

insomnia. SIDE

EFFECTS

Not serious: Daytime drowsine ss, dizzin ess, lightheadedness, blurr ed visio n, dry mouth , memory problems , abdo min al o r gastri c pain, diarrhea , nausea, vo mitin g, headac he, unusual dreams, malaise. See your doctor if these symptoms persist or are bothersome.

Serious: Clum siness, conf usion, unstead iness and fa llin g, mental depres sion, ski n rash, agitat io n, irritabilit y, w heezing or difficulty in breathing , hallu cinations , increased insomnia. Cont act yo ur doctor as soon as possibl e.

D 1024

MEDICINES

SPECIALINFORMATION

♦ O lder adult s may be more sensitive

• Do not take zo lpid em if you have had an allerg ic reaction to the drug in the past. Befo re taking zo lpid em, tell your doctor if any of th e fo llow ing co nditi ons apply: you are pregna nt , p lan to become pregn ant , or are nursing ; you have a kidney o r liver di sease; yo u have sleep apnea; yo u have asthm a, bronchitis, emph ysema, or other chronic lun g disease; yo u have a hi sto ry of mental depr ession or disorder; you have a hi story of alco ho lism or drug dependence . • Zolpidem is most rapidly absorb ed wh en t aken on an empty stomach (at least two hours after eatin g). ♦ Because zolpidem wo rk s so fast, it should be taken j ust before bedt im e. ♦ Take zolpidem only if yo u have time to get a f ull night 's sleep (seven or eight hours ). Oth erw ise, the drug will not have time to wear off, and you may experience hangov er effec t s, includin g drowsiness and memo ry problems.

to th e dru g's effect s and side effects and may require a smaller do sage. ♦ Until you know how you react to zo lpi dem, do not drive , operate machin ery, or do anything requirin g unimp ai red coo rdination and cl ear v ision. ♦ Long-te rm use of zolpidem may result in dependence. Withdrawal symp toms may occur w hen yo u stop ta king th e drug. POSSIBLE

INTERA

CTIONS

Alcohol and other central nervous system depressants (anesthetics, antidepressants, antihistamines, barbiturates, benzodiazepines, monoamine oxidase (MAO) inhibitors, muscle relaxants, narcotics or prescription pain medicines, tranquilizers): increased anti-i nsom niac and depressant effect.

Caffeine and nicotine: these are stimulant s t hat can int erfere w ith zo lpid em 's anti-insomniac effects.

ABOUT

ABO U T HERBA

@©

REMEDIES

.

►I

Use herbs with caution at all times. Be especially careful if you have allergies, are sensitive to drugs, are taking drugs for a chronic illness, or are older than 65 or younger than 12 years of age. Start with the lowest dose appropriate for you to help ensure against adverse reactions. Herbs are best absorbed on an empty stomach; if nausea occurs, take them with meals or immediately afterward. If you consistently develop nausea, diarrhea, or headache within two hours of taking an herb, discontinue its use. Call your practitioner if the symptoms are prolonged. Herbs can interact with drugs, so check with your physician before you start taking herbs. Pregnant and breast-feeding women are advised not to ingest medicinal amounts of herbs without first consulting their obstetrician. Many herbalists recommend purchasing herbs as a safer practice than harvesting your own plants. You can buy dried and fresh herbs, herbal capsules, tinctures, teas, tablets, ointments, and oils at herb stores, at some health food stores and pharmacies, and through mail order. Obtain herbs and herb preparations from a reputable source to guard against frauds such as substitution or adulteration of an herb with a different, cheaper plant. Whether dried, fresh, powdered, or in liquid extract, all herbs lose their potency after time, so look for a source that provides the freshest possible product .

TEAS/INFUSIONS An herbal tea, or infusion, is made with the leaves, flowers, or soft stems of a plant. To make a tea, measure 1 to 2 tsp dried herb directly in a cup or into a tea ball. Triple the amount if you're using fresh herbs. Pour 1 cup hot water, just off the boil, over the herb and let it sit (steep) for 10 to 20 minutes. Strain before drinking. If you need to mask a bitter taste, add sugar, lemon, or honey. The leaves and flowers are not boiled, because boiling disperses too many of their volatile constituents. You can make larger quantities, using ½ to 1 oz dried herb ( 1 to 2 oz fresh) for every 2 cups water. Another option is to buy herbal tea bags from an herb store . Note that prepackaged tea bags are less potent than fresh bulk herbs sold in herb stores or prepared at home. Herbal teas lose their medicinal value after a few hours when exposed to the air, but if stored in a tightly sealed glass jar and refrigerated, the teas will last up to three days. DECOCTIONS A decoction is a water extract made from the root, bark, and sometimes twigs, berries, or seeds of a plant. Unlike the less dense plant parts that are prepared as teas, these woody plant materials require boiling before their active constituents can be extracted. To make a decoction, break or cut into pieces 1 tbsp dried herb , or 2 to 3 tbsp fresh herb, and put into a saucepan; glass, ceramic, or enameled pans are best. Pour 2 cups cold water over the herb, bring to a boil, and simmer for 10 to 15 minutes . Strain the solid matter from the liquid. You can drink the decoction hot or cold. As with teas, it's best to make fresh batches as you need them, but you can store larger quantities in the refrigerator in a tightly covered glass jar for two to three days.

Prescription Drug

HOMEOPATHIC

TINCTURES Tinctures use alcohol to make a more concentrated extract than teas and decoctions. The recipes vary in the proportion of herb and alcohol and in the preparation time , but a fairly standard recipe cal Is for 4 oz of ground or chopped dried herb and 2 cups of at least 100 proof vodka. The alcohol should cover the herb completely, so use more if necessary. If you're using fresh herbs, double the amount of herb and alcohol. Put the herb in an opaque jar or bottle that can be sealed tightly, pour the vodka over it, cover, and store the mixture in a warm place, about 80 ° F, but out of direct sunlight. Do not leave the jar

~

0

AND

L PR E PARATIONS

HERBAL RECIPES Preparing herbs for therapeutic use is typically more art than science, and recipes abound. Homemade preparations will differ in strength from those sold in stores, and even these will vary from store to store. So you may find that the dose labeled on an over-the-counter remedy is different from that given in a recipe for home preparation. The three basic herbal preparations for taking internally are decoctions, tinctures, and teas, also known as infusions. They can be made from the fresh or dried plant. The amount of herb used and the time of preparation may vary, depending on the particular plant. Preparations for external use include compresses and poultices-for care of wounds and relief of strained muscles-and infused oils, creams, and ointments, which alleviate skin ailments. Some herbs work best when taken together with others. Chinese herbs, for example, are almost always used in combinations; since mixing herbs is a tricky business, you should check with your Chinese herbal practitioner for these dosages.

O

HERBAL

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Over-theCounter Drug

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Western Herb

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Chinese Herb

J\ Remedy Homeo pat hic 1 V 02 5

ABOUT

HERBAL

AND

HOMEOPATHIC

ABOUT

REMEDIES

HERBAL

on good furnitur e or other surfaces that could corrode if the jar leaks. Shake the jar twice a day for two weeks . After two weeks , decant the liquid into another opaque jar or dark bottle , and store it in a cool place away from direct sunlight, to avoid weakening the tincture. The usual dose ranges from 10 to 30 drops taken straight or mixed with water or syrup, two to four times daily. The alcohol in tinctures gives them a shelf life of at least two years, but tinctures made from fresh herbs may not last as long as those made from dried herbs. Tinctures are a basic ingredient in other preparations such as herbal compresses and ointments, and can be added to baths. Rum, gin, and brandy are also good solvents. Never use methyl alcohol, rubbing alcohol, or industrial alcohol to make a tincture, because these forms are extremely toxic. Pregnant women , children, diabetics, and others who need to avoid alcohol can use tinctures prepared with apple cider vinegar or glycerin instead of distilled spirits. Another option is to remove alcohol from a tincture by putting the tincture dose in a cup and adding 2 tbsp of almost boiling water. By the time the mixture cools , most of the alcohol will have evaporated.

SYRUPS Used to relieve coughing or to mask the flavor of a tincture , syrups are prepared by combining in a saucepan 1 lb sugar and 1 cup water. Bring to a boi I and let simmer until all the crystals are dissolved, stirring constantly. Let the syrup cool and store it in a dark bottle in the refrigerator. Add syrup to a tincture as needed to make it palatable.

COMPRESSES To make a hot compress, also known as a fomentation, soak a soft cotton or linen cloth in a hot infusion or decoction. Wring the cloth and place it against the injured area. Repeat the process as the compress cools . For headaches , make a cold compress using a cold infusion.

POULTICES A pou ltice is used lik e a compress, but th e herb itself is applied to the skin. Pour a small amount of boiling water over chopped or crushed fresh herbs. Let sit two to five minutes , then squeeze out the water. You can also use dri ed herbs boiled for three to five minutes , or powders mixed with enough water to make a paste. To apply the poultice, place gauze or a thin strip of cotton over the affected area, and spread the herb directly on the gauze. Cover the herb with a second piece of gauze or plastic wrap. Hold the poultice in place with gauze or cotton strips , and leave it in place for an hour. Repeat , depending on the condition.

OILS Herbal oils are used for massage and in creams and ointments . You can purchase essential oils, made by a complex distillation process. These highly concentrated oils are so potent that the dosage is measured in drops. When

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PREPARATIONS

essential oils are appli ed to th e skin , they usually are first mixed with a carrier oil such as almond or sunflower oil. Infused oi ls are used in the same way as essential oils but can be prepared at home. The two ways of making infused oil are called cold infusion and hot infusion; the method you use depends on the herb. Use the hot infusion for roots and the dense, woody leaves of herbs like rosemary. Gently heat 1 to 2 oz dried herb (double or triple this for fresh herb) in a double boiler with 2 cups olive, sunflower, or almond oil. Make sure you have enough oil to completely cover the herbs. Watch carefully, because overheating will make the oil rancid and medicinally useless. Simply warm the oil; do not let it boil or smoke. After two hours, strain the mixture. To strain, pour the mixture through a cloth or into a sieve lined with cheesecloth. Store in a glass bottle and seal tightly. For flowers and soft leaves, use the cold-infusion method. Cut up the dried herb, pack it in a clear jar, and cover it with oil. Seal the jar and set it in the sun for two days. Then place it in a well-lighted room out of direct sunlight for two to three weeks , shaking the jar daily. Filter by pouring through cheesecloth. Store the infused oil in a dark glass jar. For a more concentrated infusion, repeat the process one more time with the infused oil and more of the dried herb.

CREAMS A cream is an oil-and-water

mixture that is easily absorbed in the skin and relieves dry , flaking skin; insect bites; or sunburn. For a simple herbal cream , mix 10 drops of the desired essential oi I with 2 ½ oz of a pure vegetable face cre am th at you can buy at a health food stor e.

OINTMENTS O intm e nts are w aterles s, waxy or oily salves that form a protective layer over the skin , guarding it from moisture that can cause such skin irritations as diaper rash or chafing. To prepare an ointment, combine in a saucepan 4 parts petroleum jelly and 1 part herb. Simmer on very low heat for on e hour. Do not overh eat; simply warm the petroleum jelly. Strain the liquid using fine gauze. Pour the ointment into a glass jar; allow it to cool and resolidify before sealing. The herbs can be flowers , leaves, or roots , either fresh or dri ed . If you use fresh herbs , simmer them long enough to evaporate the water; otherwise the water in the plant will turn the ointment rancid. POWDERS Herbal powders are ground from dried herbs , and are sprinkled on food and in drinks, mixed with wat er to make a poultice, or used to make capsules .

CAPSULES Capsules can be made at home using standard capsule cases (size 00) that hold about ¼ to ½ tsp of the powdered herb. Scoop the powder into each half of the case and fit the two halves together. Store in an opaque jar. ■

ABOUT

ABOUT

HOMEOPATHIC

Homeopathic treatment should not be confused with any other type of medicinal care. Its guiding principles are unlike those for herbal therapies or conventional drugs, and the testing, prescribing, and rules of use for homeopathic remedies have been developed for this form of treatment alone. If you choose homeopathy, follow its precepts precisely, and do not substitute other substances or drugs for the ones recom mended by your practitioner.

PROVINGS Most homeopathic remedies are prepared from herbal and plant extracts , many of which are poisonous. The toxicity of these extracts , or " mother tinctures," is what makes them homeopathical ly valuable; a substance that, undiluted, can induce a certain group of symptoms in a healthy person is believed capable, in a highly dilute form, of curing similar symptoms in a person who is sick. Tests to determine which substance is best for treating a specific set of symptoms have been carried out for years. These trials - known as provings-are conducted with healthy individuals, who are given undiluted or lightly diluted doses of a mother tincture. Mental , emotional, and physical symptoms brought on by this intentional, but not fatal , poisoning are recorded and compiled to create a full picture of the symptoms caused by the substance. The extract is then diluted to the desired homeopathic potency. Since the early 19th century, more than 2,000 remedies have been " proved " in this manner.

REMEDIES

REMEDIES

Symptom analysis is the key to any successful prescription. If, for example, a patient has a high fever, flushed face, and delirium during sleep, the homeopathic practitioner may prescribe Belladonna, because its symptom picture matches those that the patient is experiencing. If the correct remedy has been prescribed, healing usually begins immediately or within a few days. Sometimes the symptoms temporarily worsen-a situation homeopaths call an "aggravation." If the first remedy does not relieve the symptoms, your homeopathic practitioner will study your symptoms again; perhaps symptoms were missed , which might indicate another remedy. Your practitioner may then prescribe a second one; this process will continue until the correctly matched remedy is found. Once your symptoms begin to disappear , stop taking the remedy. According to some, homeopathy is like jumpstarting a car; once a healing process has been initiated, your body can finish the work. Most practitioners follow classical homeopathy, in which only one remedy is prescribed at a time. However, new over-the-counter combinations may be useful for some acute conditions. For chronic conditions or for treatments that demand personal attention, a single remedy at a time under a homeopath's supervision is usually recommended. Two people suffering from the same disorder , such as the flu, may not receive the same prescription. Sickness can elicit different mental , emotional , and physical symptoms from different people, and symptom-based homeopathic prescribing is extremely individualized. Remedies are available in a variety of forms. Tablets can include soft, easily dissolved pills; hard, chewable pills; and tiny, round pills known as globules. There are also powders, wafers, and liquids in an alcohol base. ■

POTENCIES

A few basic rules apply to the use of homeopathic remedies. When administering a remedy, only the patient should touch the pills. If tablets are spilled, throw them away. In both cases, homeopaths believe that such pills become contaminated and do not have the full intended effect. Pills should be allowed to dissolve on or under the tongue unless a hard, chewable pill has been prescribed. Practitioners recommend that the mouth be clean of flavors 15 minutes before and after taking a remedy. Strong flavors and aromas, including camphor, coffee, and heavily scented perfumes, should be avoided for the duration of treatment.

Prescription Drug

HOMEOPATHIC

SELECTINGA REMEDY

Th e pot ency of a hom eopathi c remedy is based on th e dilution ratio : the ratio of active substance to inactive base.

0

AND

Dilution ratios are expressed either decimally , by a factor of 10, or centesimally , by a factor of 100. Decimal ratios are labeled with an x and indicate that the remedy consists of 1 part mother tincture mixed with 9 parts of a water-and-alcohol base; centesimal ratios, labeled with a c, consist of 1 part mother tincture and 99 parts base. Further dilutions are represented by a number in front of the x or c. For example , a remedy labeled 30c has first been mixed 1 part to 99; then, 1 part of the resulting mixture is diluted again with 99 parts of the base, and this process is repeated for a total of 30 times. Most homeopaths feel that , since all remedies are highly diluted, it would be impossible to overdose on homeopathic drugs; the number of pills required for a toxic effect would simply be too high to consume at once. Practitioners also believe that if a remedy does not seem to be working, increasing the number of pills will not help. If a remedy is not having the desired effect, stop taking it and return to your homeopathic practitioner for another prescription.

•.

ij

HERBAL

0

Ov er-theCounter Drug

O

Western Herb

0

Chinese Herb

0

Homeopathic Remedy

l Q2 7

CONTENTS Basic Nutrition ................................................

1030

The Food Guide Pyramid ........................................

1031

Essential Vitamins and Minerals ...................................

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1029

BASIC

NUTRITION

ating a balanced diet is a major factor in a healthy lifestyle. Your body requires more than 40 nutrients for energy, growth , and tissue maintenance. As the most plentiful component in the body, water is also crucial to survival. It is the medium for such bodily fluids as blood and lymph, and it transports nutrients into cells and carries waste products and toxins out. Carbohydrates, proteins, and fats-a group known as macronutrients or "energy nutrients" provide fuel in the form of calories. Carbohydrates, the body's main energy source, are divided into two types: Simple carbohydrates are sugars; complex carbohydrates include starches, such as those found in potatoes and bread. Proteins support tissue growth and repair, and help produce antibodies, hormones, and enzymes-which are essential for all chemical reactions in the body. Dietary protein sources include meat, fish, dairy products, poultry, dried beans, nuts, and eggs. Dietary fat protects internal organs, provides energy, insulates against cold, and helps the body absorb certain vitamins. There are three kinds of fats: saturated, found in meat, dairy food, and coconut oil; monounsaturated , in olive, peanut, and canola oils; and polyunsaturated, in corn, cottonseed, safflower, soy, and sunflower oi Is. Your diet also supplies the important micronutrients we call vitamins and minerals. They are needed only in trace amounts, but the absence or deficiency of just one vitamin or mineral can cause major illness. Your body also needs a supply of dietary fiber, the indigestible portion of plant foods. A high-fiber diet reduces the risks of various gastrointestinal problems and promotes cardiovascular health. Science is continually making discoveries about nutrients and their effects on health. As a result, the Food and Nutrition Board of the National Research Council, National Academy of Sciences, routinely revises its recommended dietary allowances (RDA)-also known as the recommended daily allowances-for essential nutrients. In general, most Americans eat far more fat, protein, cholesterol, sugar, and salt than they need. The official dietary guidelines, established jointly by the U.S. Departments of Agriculture

1030

and Health and Human Services, include seven basic recommendations: ♦ Eat a variety of foods. This will help ensure

♦

♦

♦

♦ ♦

♦

you get enough calories, protein, and fiber, as well as the vitamins, minerals, and other nutrients you need. Control your weight. Keep within recommended weight limits for your age, sex, and build. Obesity is defined as being 20 percent above normal weight. Eat a low-fat, low-cholesterol diet. I deal ly, no more than 30 percent of your daily calories should come from fat, and no more than 10 percent should come from saturated fat. Choose polyunsaturated fats over saturated fats when possible. Eat plenty of vegetables, fruits, and grains. They are rich in nutrients, fiber, and complex carbohydrates, but low in fat. More than half of your daily calories should come from carbohydrates, and 80 percent of those calories should come from complex carbohydrates. Eat sugar in moderation. Sugar is high in calories and promotes tooth decay. Use salt in moderation. Too much salt increases the risk of developing high blood pressure. Prepared foods are notoriously high in salt or other forms of sodium, so read labels carefully. If you drink alcohol, do so in moderation. Alcohol provides calories but no nutrients, and too much is harmful. "Moderation" generally means one drink for women or two drinks for men daily.

If you consistently eat a well-balanced diet of fresh fruits, vegetables, grains, and some animal protein, you probably don't require a nutritional supplement. Multinutrient supplements offer insurance for those times when eating well is a challenge-and can be indispensable during pregnancy and times of disease, injury, and extreme stress or physical exertion. Always take supplements in moderation; they are safe in doses at or below RDAs, but higher doses may be harmful and should be taken only under a doctor's or registered dietitian's guidance. ■

THE

FOOD

GUIDE

PYRAMID

FATS, OILS, & SWEETSGROUP Use Spa rin g ly

MILK, YOGURT, & CHEESEGROUP 2-3 Servings

►

MEAT, POULTRY, FISH, DRIED BEANS, EGGS, & NUTS GROUP 2-3 Servings

◄ FRUIT GROUP 2-4 Servings

VEGETABLE GROUP 3-5 Servings

◄

►

BREAD, CEREAL, RICE, & PASTA GROUP 6-11 Servings

T

he Food Guide Pyramid-developed on the advice of nutritional scientists-makes healthy eating easier by showing how much of each type of food you should eat for good nutrition . Each of the groups provides some of the nutrients you need each day; no one group provides them all. Variety within and among groups is key. The foundation of the pyramid is grain-based foods, which provide complex carbohydrates, vitamins, minerals, and fiber. On the next level are fruits and vegetables, which are rich in vitamins, minerals, and fiber but low in fat. The next two groups are critical sources of protein, calcium, iron, zinc, and other nutrients, but many of these foods are also high in fat and cholesterol. Fats, oils, and sweets occupy the tip of the pyramid and should be eaten sparingly. The pyramid suggests a range of daily servings for each group. Your actual needs depend on your daily caloric requirements. Experts recom-

mend about 1,600 calories for older adults and sedentary women; 2,200 calories for children, teenage girls, active women, and sedentary men; and 2,800 calories for teenage boys, active men, and very active women. One vegetable serving equals 1 cup of raw leafy greens, ½ cup of other vegetables, or ¾ cup of vegetable juice. One serving from the fruit group is equal to one apple, orange, or banana; ½ cup of chopped, cooked, or canned fruit; or ¾ cup of fruit juice. One grain serving equals one slice of bread; half a bun, bagel, or muffin; 1 oz of dry cereal; or ½ cup of cooked cereal, rice, or pasta. One dairy serving equals 1 cup of milk or yogurt, 1½ oz of natural cheese, or 2 oz of processed cheese. One serving from t he meat group equals 2 to 3 oz of cooked lean meat, poultry, or fish. You can substitute one egg, ½ cup of cooked dried beans, or 2 tbsp of peanut ■ butter for each ounce of lean meat.

Cross references are indi cated by bold italics.

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E SS ENTI A L VIT A MIN S A ND our body requires vitamins and minerals to function properly. Known as micronutrients because they are needed in minute amounts, vitamins and minerals contribute to virtually every biochemical process in your body. With a few exceptions, the body does not manufacture micronutrients and so must obtain them from food. Thirteen vitamins and some twenty minerals, most of which are described below, are considered essential for human health. The Food and Nutrition Board of the National Research Council, National Academy of Sciences, has determined a recommended dietary allowance (RDA)-a n appropriate range of intake with built -in margins to allow for variations in individual nutritional needs. Essential nutrients that do not yet have RDAs are assigned a safe and adequate daily intake or an estimated minimum daily requirement (EMDR). Taking vitamins or minerals in excess can upset the natural balance of nutrient s. The four fat-soluble vitamins-A, D, E, and K-can be retained in your body and can be toxic in high amounts. The rest are watersoluble and are unlikely to be toxic, since excess amounts are excreted in the urine.

V IT AM I NS BI O TIN

(VITAMIN

B7,

VITAMIN H)

EMDR: 30 mcg to 100 mcg Along with other B vitamins , biotin helps conv ert food to ener gy and is required for the synthesis of carb ohydrates , proteins, and fatty ac ids. Biot in is espec ially important for healthy hair , skin, and nails. Among th e types of food that are good dietary sources of biotin are cheese, kidneys , salmon, soybeans, sunf lower seeds, nuts , bro cco li , and sweet potato es. Biotin deficiency is rare , and supp lements are unnecessary. People can become biotin deficient through long-term use of antibiotics or by regularly eating raw egg whites , which contain avidin, a protein that blocks the body's absorption of biotin. Because breast milk contains littl e biotin , infants who are breast-fed can suffer biotin defi c iency, although this is uncommon . Signs of biotin deficiency include a scaly, oily skin rash; hai r loss; nausea; vomiting; muscl e pain; loss of appetite; a red, inflamed ton gue; and fatigue. Research has not revealed a toxic level for biotin.

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MIN ERA L S

F O LIC

A C ID

(V ITAMIN B9)

RDA: men, 200 mcg; women, 180 mcg; women of childbearing age, 400 mcg Healthy hair, skin, nails, nerv es, mucous membrane s, and blood all depend on foli c acid- somet imes called vita min B9, folacin, or folate. A critical co mponent of RNA and DNA -t he genetic material that co ntrols th e growth and repair of all cells-folic acid supports immune function and may help deter atherosclerosis as well as some cancers of the muco us membr anes. Sour ces of folic acid include liv er, kidneys, avocados, beans, beets, celery, eggs, fish , green leafy vegetables, nuts , seeds, peas, orange juice , and fortifi ed break fast cere als. A healthy diet should provide adequate folic acid, but the need increases during pre gnancy, wi t h injury , with some di seases-espec ially cancer-a nd with lon g-t erm use of drugs such as aspirin and oral contraceptives. Suppl ements tak en durin g pregnancy may help deter th e birth defects spina bifida and cleft palate. For this reason, experts now recommend that all women of childbearing age consume 400 mcg daily. High doses of folic acid are not toxic but may mask the symptoms of vitamin B12 deficiency . Therefore, it 's best to increase folic acid int ake through diet or a multivitamin that contains low-dose folic acid , rather than throu gh individual supplements , which have to be prescribed by a doctor. Extreme vitamin Bg deficiency may cause megaloblastic anemia, a disease characterized by red blood ce ll s that are too few in number and malform ed. Symptoms include pallor; fatigue; loss of appetite; insomnia ; d iarrh ea; and a red , inflamed tongue. Those who are most susceptible to folic acid defi c iency include alco holics , people with gastroint estinal diseases, adolescents who subsist mainly on junk food, women taking oral contraceptives, and pregn ant women who are not tak ing supp leme nt s.

N IAC I N

(V ITAMIN B3)

RDA: men, 19 mg; women, 15 mg; pregnant women, 17 mg Niacin contributes to more than 50 vital bodily processes: It helps convert food into energy; build red blood cells; synthesize hormones , fatty acids, and steroids; maintain skin, nerve s, and blood vessels; support th e gastrointestinal tract ; stabiliz e mental health ; and detoxify certain dru gs and chemicals in the body. In addition, it helps insulin regulat e blood sugar levels.

► Niacin is also a powerful dru g, capabl e of lowering blood cholesterol and tri glycerides , dilating blood vessels to improve circulation, and alleviating depression, insomnia, and hyperactivity. Nia c in-ri c h foods in clude liver , poultry , lean meats, fish, nuts, peanut butter, and enrich ed flour. If you get enough protein, you are probably receiving adequate niacin as well. If adequate vitamin B6 is present, th e body can also produce niacin from the amino acid tryptophan, which is found in milk, eggs, and cheese. Signs of nia c in deficiency include indigestion; diarrhea; muscle weakness; loss of appetite; dermatitis that is wors ened by exposure to sunlight; mouth sores; a red , inflamed tongue; headaches; irritability; anxiety; or depression. Pregnant or breast-fe eding women , the elderly alcoholics, and people with hyperthyroidi sm are most likely to be niacin deficient. Extrem e deficie ncy results in pellagra , characterized by diarrhea, dermatitis, and mental illness. Pellagra was common until the discovery that niacin was a cure; the disease is now vir tually nonexistent in the U.S. thanks to niacin-enriched flour and other foods . Multivit amin supplements can raise niacin levels safely. Vitamin B3 is toxic in hi gh amounts , so megadoses should be taken only under a doctor 's supervision. Nausea is the first symptom , which often prevents further intake ; continued overuse may cause a rash, itchy skin, and liv er damage.

VITAMIN

A

(BETA CAROTENE, RETINOL)

RDA: men, 5,000 IU (or 3 mg beta carotene); women, 4,000 IU (or 2.4 mg beta carotene) The first vitamin ever dis cov ered, vitamin A is essential for good vision-especially in dim light-and for healthy skin , hair, and mucous membranes of th e nose, throat , respiratory system, and digestive system. This vitamin is also necessary for th e proper growth and development of bones and teeth . It stimulates wound healing and is used to treat some skin disorders. Beta carotene, the precursor to vitamin A, is a carotenoid, a type of pigment found in plants. Your skin stores beta carotene and your body metabolizes it to produce vitamin A as needed . Excess beta carotene, along with other carotenoids such as alpha carotene, acts as an antioxidant and supports immune function, so it incr eases your resistance to infection; it may help pr event some cancers and vision problems such as night blindness. Beta carotene may also help lower cholesterol leve ls and reduce the risk of heart disease.

Vitamin A is present in orange and yel low vegetables and fruits ; dark- green leafy vegetables such as collard and mustard greens and kale; whole milk , cream , and butter; and organ meats such as liver. Because it is fat -so lubl e, vitamin A is stored in th e body lo ng-term and supplements are gener ally not recommended . Too mu ch vitamin A can cause headaches, vision problems, nausea, vomiting, dry and flakin g skin, or an enlarged liv er or spleen. Other names for vitamin A are retinol , retinene, retinoic acid, and retinyl palmitate.

VITAMIN

B COMPLEX

RDA: See individual vitami n entries As it s nam e implies , vitamin B complex is a combination , or mixture , of eight essential vitamins. Although each is chemically distinct , the B vitamins coexist in many of the same foods and often work t oget her to bolster metabolism, maintain healthy skin and muscle ton e, enhance immune and nervous system function, and promote cell growth and division - including that of th e red blood ce lls that help pr event anemia. Together they may also combat stress, depression , and cardiovascu lar disease. Foods rich in B-complex vitamins include liver and other organ meats, fish, poultry, brewer's yeast, eggs, beans and peas, dark- green leafy vegetables, wholegrain cerea ls, and dairy produ cts. B vitamins, which are water-soluble , are dispersed throughout the body and must be replenished daily; any excess is excr eted in urine. People susceptib le to vitamin B def iciency include pre gnant women , nursing mothers , vegetarians , alcoholic s, " sugar-holies, " the eld er ly, and people with malabsorption conditions or who take certain antibi-

otics lon g-te rm ; the symptoms include oily and scaly skin, upset stomach , headaches, anxiety, moodin ess, and heart arrhythmias. A def icien cy of one B vitamin usually means that int ake of all B vitamins is low. If your doctor suggests you need mor e B vitamins, tak e a daily multivitamin or B-compl ex supplement rather than individual B-vitamin supplements. Most B vitamins are nontoxi c unless taken in excessively large amounts.

VITAMIN

B1

(TH IAMINE)

RDA: men, 1.5 mg; women, 1.1 mg Thiamine is sometimes called the "energy vitamin" because it is needed to metabolize carbohydrates, fats, and proteins , and it helps convert excess glu cose into stor ed fat. Vitamin B1 also ensures proper nerve-

Cross references are indica ted by bo ld italics.

1033

E SS ENTI A L V IT A MIN S AND impulse transmIssIon and contributes to maintaining normal appetite , muscle tone, and mental health. In the 1930s thiamine was discovered to be the cure for the crippling and potentially fatal disease beriberi. Now that rice , flour, and bread are generally enriched with thiamine, beriberi is relatively rare. A diet that regularly includes lean pork, milk , whole

than anyone needs. Diet changes are better, or you should take a multivitamin supplement. It is best to take the supplements with food, which increases their absorption tremendously compared with tablets alone.

grains, peas, beans, peanuts, or soybeans generally provides enough thiamine. Athletes, laborers, pregnant women, and other people who burn great amounts of energy may require more than the adult RDA of thiamine. Mild deficiency may cause fatigue, loss of appetite, nausea, moodiness, confusion , anemia, and possibly heart arrhythmias. Alcohol suppresses thiamine

The Greek term pan in pantothenic acid means "everywhere," indicating this vitamin's abundance. Along with other B vitamins, pantothenic acid is required for converting food to energy; building red blood cells; making bile; and synthesizing fats , adrenal gland steroids , antibodies, and acetylcholine and other neurotransmitters-chemicals that permit nerve transmission. Pantothenic acid in dexpanthenol lotions and creams relieves the pain of burns, cuts, and abrasions; reduces skin inflammation; and speeds wound healing. Vitamin Bs is abundant in organ meats, dark turkey meat, salmon , wheat bran, brewer 's yeast, brown rice , lentils, nuts, beans, corn, peas, sweet potatoes, and eggs. Excess pantothenic acid may cause diarrhea. A deficiency in this vitamin does not seem to occur naturally in humans and is likely only with extreme starvation. A pantothenic acid supplement, calcium pantothenate, is available.

absorption; for this reason and because of typically poor diets, alcoholics are likely to be deficient in thiamine and other nutrients. To increase thiamine levels, try changing your diet or taking a multivitamin instead of thiamine supplements. Large doses up to 100 mg of thiamine may alleviate itching from insect bites; otherwise, megasupplements are not known to be either harmful or helpful.

B2 (RIBOFLAVIN) RDA: men, 1.7 mg; women, 1.3 mg; pregnant women, 1 .6 mg VIT A MIN

Like other members of the vitamin B complex, riboflavin helps produce energy from carbohydrates, fats, and proteins. Riboflavin also promotes healthy skin , hair , nails, and mucous membranes; aids the production of red blood cells, corticosteroids, and thyroid hormones; and is required for the proper function of the nerves, eyes, and adrenal glands . It is often used to treat acne, anemia, cataracts, and depression. A well-balanced diet provides most people with adequate riboflavin, although athletes and others who need a great deal of energy may require more than the RDA. Lean organ meats, enriched bread and flour, cheese, yogurt, eggs, almonds, soybean products such as tofu, and green leafy vegetables-especially broccoli-are good sources. Store these foods in the dark, because vitamin B2 breaks down in sunlight. Alcoholics and elderly people are susceptible to riboflavin deficiency: The signs include oily, scaly skin rash; sores, especially on the lips and corners of the mouth; a swollen, red, painful tongue; sensitivity to light; and burning or red, itchy eyes. Although vitamin B2 supplements are available, they provide far more riboflavin

1034

MINERALS

VIT A MIN

B s (PANTOT H ENIC ACID)

EMDR:4 mg to 7 mg

VITAMIN

B s (PYRIDOXINE) RDA: men, 2 mg; women, 1.6 mg; pregnant women, 2.2 mg Vitamin B6 encompasses a family of compounds that includes pyridoxine, pyridoxamine, and pyridoxal. This vitamin supports immune function, nerve-impulse transmission (especially in the brain), energy metabolism, and red blood cell synthesis. Prescribed as a drug, vitamin B6 can sometimes alleviate carpal tunnel syndrome, infant seizures, and premenstrual syndrome. A healthy diet provides enough vitamin B6 for most people. Brown rice, lean meats, poultry, fish, bananas, avocados, whole grains, corn, and nuts are rich in vitamin B6. People most likely to be at risk for vitamin B6 deficiency include anyone with a malabsorption problem such as lactose intolerance or celiac disease; diabetic or elderly people; and women who are pregnant, nursing, or taking oral contraceptives . Severe deficiency is rare. Mild deficiency may cause acne and inflamed skin, insomnia, muscle weakness, nausea, irritability, depression, and fatigue. A daily multivitamin supplement is usually recommended to boost low vita-

► min B6 levels. Taking too much or too little vitamin B6 can impair nerve function and mental health. If high levels (2,000 mg to 5,000 mg) are taken for several months, vitamin B6 can become habit-forming and may induce sleepiness as well as tingling, numb hands and feet. These symptoms will most likely disappear when the vitamin B6 intake is reduced, and there is usually no permanent damage.

VITAMIN

B12 (COBALAMIN) RDA: adults, 2 mcg; pregnant women, 2.2 mcg Vitamin B12 is the largest and most complex family of the B vitamins; it includes several chemical compounds known as cobalamins. Cyanocobalamin, the most stable form , is the one most likely to be found in supplements. Like other B vitamins, B12 is important for converting fats , carbohydrates, and protein into energy, and assisting in the synthesis of red blood cells. It is critical for producing the genetic materials RNA and DNA , as well as myelin, a fatty substance that forms a protective sheath around nerves. Unlike other B vitamins, vitamin B12needs several hours to be absorbed in the digestive tract. Excess vitamin B12 is excreted in urine, even though a backup supply can be stored for several years in the liver. Vitamin B12is not produced by plants but is supplied through animal products such as organ meats, fish , eggs, and dairy products. Dietary deficiency is uncommon and usually limited to alcoholics, strict vegetarians, and pregnant or nursing women-who should take supplements. More often, deficiency stems from an inability to absorb the vitamin, a problem that may occur for years before symptoms show; it tends to affect the elderly, those who have had stomach surgery, or people who have a disease of malabsorption, such as colitis. Lack of calcium, vitamin B6, or iron may also interfere with the normal absorption of B12- Signs of vitamin B12 deficiency include a sore tongue , weakness, weight loss, body odor, back pains, and tingling arms and legs. Severe deficiency leads to pernicious anemia, causing fatigue, a tendency to bleed, lemon yellow pallor, abdominal pain, stiff arms and legs, irritability,

and depression. Without treatment, pernicious anemia can lead to permanent nerve damage and possibly death; the disease can be controlled, although not cured, with regular B12 injections. Vitamin B12 is considered nontoxic, even when taken at several times the RDA.

VITAMIN

C

(ASCORB IC ACID)

RDA: adults, 60 mg; pregnant women, 70 mg Vitamin C is well known for its ability to prevent and treat scurvy , a disease that causes swollen and bleeding gums, aching bones and muscles, and in some cases even death. Connective tissue throu ghout the body is made of collagen, which depends on vitamin C for its production. In this role, vitamin C helps heal wounds, burns , bruises , and broken bones. As a powerful antioxidant and immune system booster, vitamin C may alleviate the pain of rheumatoid arthritis, protect against atherosclerosis and heart disease, and help prevent some forms of cancer, and has the reputed potential (yet unproved) to prevent the common cold. More than the RDA may be needed under conditions of physical or emotional stress. Sources of vitamin C include citrus fruits, rose hips, bell peppers, strawberries, broccoli, cantaloupes, tomatoes , and leafy greens. Vitamin C breaks down faster than any other vitamin, so it is best to eat fruits and vegetables when fresh, and to cook them minimally or not at all. Slight vitamin C deficiency is rather common , although severe deficiencies are rare in the United States today. Symptoms of deficiency include weight loss, fatigue, bleeding gums, easy bruising , reduced resistance to colds and other infections, and slow-healing wounds and fractures. Because it is water-soluble , excess vitamin C is excreted in the urine, so large amounts of it may usually be taken without fear of toxicity. Doses larger than

1,000 mg a day have been suggested for preventing cancer, infections including the common cold , and other ailments. In some people , large doses may induce such side effects as nausea, diarrhea, reduced selenium and copper absorption , excessive iron absorption , increased kidney stone formation, and false-positive reaction to diabetes tests .

VITAMIN

D

(CHOLECALCIFEROL, ERGOCALCIFEROL) RDA: adults, 200 IU (5 mcg); children, adolescents and pregnant women, 400 I U (10 mcg) Vitamin D not only promotes healthy bones and teeth by regulating the absorption and balance of calcium and phosphorus, but also fosters normal muscle contraction and nerve function. Vitamin D prevents rickets, a disease of calcium-deprived bone that results in bowlegs , knock-knees , and other bone defects. Vitamin

Cro ss references are indic ated by bold italics.

10 35

ESSENTIAL

VITAMINS

D supplements may help treat psoriasis and slow or even reverse some cancers, such as myeloid leukemia. Fatty fish such as herring, salmon, and tuna , followed by dairy products, are the richest natural sources of this nutrient. Few other foods naturally contain vitamin D, but 10 minutes in midday summer sun enables the body to produce about 200 I U of it. Milk , breakfast cereals, and infant formulas are fortified with vitamin D. In adults, vitamin D deficiency can cause nervousness and diarrhea, insomnia, muscle twitches, and bone weakening, and it may worsen osteoporosis. Too much vitamin D raises the calcium level in the blood, which in turn may induce headaches, nausea, loss of appetite, excessive thirst , muscle weakness, and even heart , liver , or kidney damage as calcium deposits accumulate in soft tissue. Vitamin D is fat-solubl e; excess amounts of it are stored in the body. Because of its potentially toxic effects, vitamin D should not be taken in supplements of mor e than 400 I U daily unless prescribed by a doctor.

VITAMIN

E

RDA: women, 12 I U (8 mg); men and pregnant or nursing women, 15 I U (10 mg) Vitamin E encompasses a family of compounds called tocopherols , of which alpha-tocopherol is the most com mon. It is required for proper function of the immune system, endocrine system, and sex glands. As a powe rful antioxidant , it prevents unstable molecules known as free radicals from damagin g cells and tissues. In this capacity, vitamin E deters atherosclerosis, accelerates wound healing , protects lung tissue from inhaled pollutants, may reduc e risk for heart disease, and may prevent premature skin aging. Researchers suspect that vitamin E has other beneficial effects ranging from preventing cancer and cataracts to alleviating rheumatoid arthritis and a skin disorder associated with lupus. Most people get enough vitamin E through diet and don't need supplements. Vegetabl e oils, nuts , darkgreen leafy vegetables, organ meats , seafood, eggs, and avocados are rich food sources. Symptoms of vitamin E deficiency, such as fluid retention and hemolytic anemia, are rare in adults but are sometimes seen in premature infants. Because of its many suggested therapeutic roles , vitamin E is popular as an oral supplement and an ingredient of skin-care products. Although it is fat-soluble , vitamin Eis considered nontoxic , because it do es no harm except in extremely high doses.

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VITAMIN K (MENAD IONE, PHYTONADIONE) RDA: men, 80 mcg; women, 65 mcg Vitamin K is needed in a small but critical amount to form essential proteins , mainly for blood clotting but also for kidney function and bone metabolism. Vitamin K exists in two natural forms th at require some dietary fat for absorption. Bacteria living in the intestines produce about half the body 's needs; the rest comes from diet. Good food sources include spinach, cabbage, bro cco li, turnip greens, or other leafy vegetables; beef liver; green tea; cheese; and oats. Vitamin K deficiency is extremely rare in adults but may occur in newborns until their intestinal bacteria begin producing the vitamin. To enhance a newborn's blood-clotting ability, the mother may take vitamin K supplements before delivery , and infants usually receive them after birth. Otherwise , supplements are neither necessary nor recommended . Megadoses higher than 500 mcg can be toxic or cause allergic reaction , and must be prescribed by a doctor. Large doses of vitamin E may interfere with vitamin K's blood-clotting effects.

MINERALS CALCIUM RDA: adults, 800 mg; pregnant women and young adults, 1,200 mg Calcium, the most abundant min era l in the body, is essential for the growth and maintenance of bones and teeth . It enables muscles , including your heart , to contract ; it is essential for normal blood clotting, proper nerve-impulse transmission , and connective-tissue maintenance. It helps keep blood pressure norm al and may reduce the risk of heart disease; taken with vitamin D, it may help lessen the risk of colorectal cancer. It helps prevent rickets in children and osteoporosis in adults. Good sources include dairy products , dark-green leafy vegetables, sardines, salmon , and almonds. Calcium is needed in varying amounts by different people. Too much calcium can lead to constipation and to calcium deposits in soft tissue, causing damage to the heart , liver , or kidneys. For calcium to be properly absorbed, the body must have sufficient levels of vitamin D and of hydrochloric acid in the stomach, and a balance of other minerals, including magnesium and phosphorus. A sedentary lifestyle and consuming too much

►I alcohol, dietary fiber, and fat can interfere with calcium absorption; too much protein and caffeine results in calcium being excreted in urine. Supplemental calcium is available in many forms ; the form that is best absorbed by the body is calcium c itrate-malate.

quirements of some diabetic children , and to relieve symptoms of hypoglycemia. Taken regularly in supplements greater than 1,000 mcg, however , chromium inhibits insulin 's activity and can be toxic.

CHLORIDE

RDA/EMDR:not established

EMDR:adults, 750 mg

The mineral cobalt is a constituent of cobalamin ( vitamin 812); Cobalt helps form red blood cells and maintain nerve tissue. Consuming large amounts of inorganic cobalt stimulates growt h of the thyroid gland and may lead to the overproduction of red blood eel Is, a disorder known as polycythemia . To be biologically useful, cobalt must be obtained from foods such as liver, kidneys , milk, oysters, clams , or sea vegetables, or from vitamin B 12 supplements. Inorganic cobalt has no nutritional valu e but is sometimes added to beer as an antifoaming agent.

COBALT

A natural salt of the mineral chlorine , chloride works with sodium and potassium to help maintain the proper distribution and pH of all bodily fluids and encourage healthy nerve and muscle function. Independently, c hloride contributes to digestion and waste elimination. It is a key component of hydrochloric acid, one of the gastric juices that digest food. A di et of unprocessed natural foods provides more than enough c hloride for human health. Just a pinch of table salt contains about 250 mg, one-third of the RDA. Chloride deficiency is extremely rare and is usually due to illn ess. Excessive vomiting can reduce the stomach's c hlorid e level , upsetting its pH balance and causing sweating, diarrhea, loss of appetite, slow and shallow breathing, listlessness, and muscle cramps. Although toxic in lar ge amounts, excess chloride is excreted in urine , preventing potentially dangerous accumulation.

CHROMIUM EMDR:adults, 50 mcg to 200 mcg As a compone nt of a natural substance cal led glucose tolerance factor, chromium works with insulin to regulate the body 's use of sugar and is essential to fatty-acid metabolism. Its contribution to metabolism makes chromium a helpful supplement in weight-loss programs. Additional evidence suggests that chromium may help deter atherosclerosis and reduc e risk of cardiovascular disease. Inadequate chromium can result in alcohol intoleran ce, elevate blood sugar levels, and possibly induce diabetes-like symptoms such as tingling in the extremities and reduced muscle coordination . Trace amounts of chromium are found in many foods, including brewer 's yeast, liver, lean meats, poultry, molasses, whole grains, eggs, and cheese. Chromium is not absorbed well, so the body must take in far more than it actually uses. Most people do not get enough dietary chromium and some may benefit from a multinutrient supplement, such as chromium citrate or chromium picolinate. Supplemental chromium may be used to treat some cases of adult-onset diabetes, to reduce insulin re-

COPPER EMDR:adults, 1.5 mg to 3 mg Copper is indispensable to human health. Its many functions includ e the following: helping to form hemoglobin in the blood; facilitating the absorption and use of iron so red blood cells can transport oxygen to tissues; assisting in the regulation of blood pressure and heart rate ; stren gthening blood vessels, bones, tendons , and nerves; promoting fertility; and ensuring normal skin and hair pigmentation . Some evidence suggests that copper helps prevent cardiovascular problems such as high blood pressure and heart arrhythmias and that it may help treat arthritis and scoliosis. Copper may also protect tissue from damage by free radicals, support the body's immune function , and contribute to preventing cancer. Most adults get enough copper from a normal , varied diet. Seafood and organ meats are the richest sources; blackstrap molasses, nuts, seeds, green vegetables, black pepper, cocoa, and water passed through copper pipes also contain significant quantities. Supplemental copper should be taken only on a doctor's advice. Common supplemental forms are copper aspartate, copper citrate, and copper picolinate. Excess calcium and zinc will interfere with copper absorption, but a true copper deficiency is rare and tends to be limited to people either with certain inherited diseases that inhibit copper absorption, such as albinism, or with acquired malabsorption ailments , such as Crohn's

Cross references ar e indi cate d by bold italics.

1037

E SS ENTIAL

VITAMINS

disease and celiac disease. The deficiency may also occur in infants who are not breast-fed and some premature babies. Symptoms of copper def iciency include br ittle , discolored hair ; skeletal defects; anemia; high blood pressure; heart arrhythmias; and infertility. Taking more than 10 mg of copper daily can bring on nausea, vomiting , muscle pain, and stomachaches. Women who are pregnant or taking birth-control pills are suscept ible to excess blood levels of copper. Some research suggests that high levels of copper and iron may play a role in hyperactivity and autism .

FLUORIDE EMDR: adults, 1.5 mg to 4 mg Fluoride, a natural form of the mineral fluorine, is required for healthy teeth and bones. It helps form the tough enamel that protects teeth from decay and cavities , and increases bone strength and stability. Since the 1950s, many U.S. cities have added fluoride to municipal drinking water at a rat io of about 1 part per million (ppm) , or 1 mg per lit er. Many believe this practice is responsible for the 40 to 70 percent reduction in tooth decay that dentists have since observed . Fluoride's decay-reducing effects are strongest if children are exposed to the mineral whi le their te eth are forming. Fluoride toothpaste is helpful , but it is not nearly as effective as regularly ingested fluoride . Fluoridated water provides most individuals with at least 1 mg of fluoride daily; other dietary sources are dried seaweed, seafood-especially sardines and salmon-cheese, meat, and tea. Nursing babies and ch ildr en who do not regularly drink fluoridated water should be given supplements, but only as prescribed by a dentist or doctor , because excess fluoride can have adverse effects: At levels of 2 ppm to 8 ppm , the teeth may soften and discolor; at over 8 ppm , fluoride toxicity can depress growth, harden I igaments and tendons , make bones brittle, and induce degeneration of major body systems; 50 ppm may cause fatal poisoning. The low fluoride leve ls in fluoridated drinking water, however, pose no harm ful effects to health.

IODINE RDA: adults, 150 mcg; pregnant women, 175 mcg Iodine was one of the first minerals recognized as essentia l to human health. For centuries, it has been known to prevent and treat goiter-enlargement of the thyroid gland . As part of several thyroid hormones,

1038

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MINERALS

iodine strongly influences nutrient metabolism; nerve and muscle function ; skin, hair, tooth, and nail condition; and physical and mental development. Iodine may also help convert beta carotene into vitamin A, and it is an effective antiseptic and water steri lizer. Kelp, seafood , and vegetab les grown in iodine-rich soils are excellent sources of this mineral. More than half of all the salt consumed in the U.S. is iodized, supplying suff icient iodine in a regular diet. Supplements are usually unnecessary, but pregnant women should have sufficient intake for themse lves and their babies to prevent potential ment al retardation or cretinism , a form of dwarfism in infants. Iodine deficiency is now uncommon; besides goiter , its effects include weight gain, hair loss, listlessness, insomnia, and some forms of mental retardation . Most excess iodin e is excreted by the kidneys, but extremely high intake may cause nervousness, hyperactivity, headache, rashes, a metallic taste in the mouth , and goiter-in this case du e to thyroid hyperactivity.

IRON RDA: adults, 10 mg; premenopausal women, 15 mg; pregnant women, 30 mg Iron is found in hemoglobin , the protein in red b lood cell s that transports oxygen from the lungs to body tissues. It is also a component of myoglobin , a protein that provides extra fuel to muscl es during exertion. Di etary iron exists in two forms : heme iron, found in red meat , chicken, seafood , and other animal produ cts; and nonheme iron, found in dark-green vegetables, whol e grains, nuts, dried fruit , and other plant foods. Many flour-based food products are fortified w ith iron. Heme iron is easier to absorb , but eating foods cont aining nonheme iron along with foods that have heme iron or vitamin Cwill maximize iron absorpt ion . Coffee, tea , soy-based foods, antacids, and tetracycline inhibit iron absorption, as do excessive amounts of calcium, zinc, and manganese. Lack of iron deprives body tissues of oxygen and may cause iron deficiency anemia; warning signs include fatigue, paleness, dizziness, sensitivit y to cold, listlessness, irritability, poor conc entration, and heart palpitatio ns. Because iron strengthens immune function , iron deficiency also may increase susceptibil ity to infection. Women need mor e iron before menopause than after , because menstruation causes iron loss each month. People who have specia l iron intake needs include menstruating or pregnant

► women , children under two years of age, vegetarians , anyone with bleeding conditions such as hemorrhoids or bleeding stomach ulcers, and anyone taking the medications listed above. On a doctor's recommendation , adults can augment their iron intake by means of a multinutrient supplement ; straight iron supplements should be taken only under a doctor 's supervision. Excess iron inhibits absorption of phosphorus, interferes with immune function, and may increase your risk of developing cancer, cirrhosis, or heart attack. Symptoms of iron toxicity include diarrhea, vomiting, headache, dizziness, fatigue, stomach cramps , and weak pulse. Though uncommon , severe iron poisoning can result in coma, heart failure, and death . Children should never be given adult iron supplements, which can easily poison them. If your pediatrician recommends an iron supplement , make sure it is a specific , child-formulated variety.

MAGNE

S IUM

RDA: men, 350 mg; women, 280 mg; pregnant women, 320 mg Magnesium contributes to health in many ways. Along with calcium and phosphorus, it is a main ingredient of bone. A proper balance of calcium and magnesium is essential for healthy bones and teeth, reduces the risk of developin g osteoporosis, and may minimize the effects of existing osteoporosis. Calcium and magnesium also help regulate muscle activity: While calcium stimulates contraction, magnesium induces relaxation. Magnesium is essential for metabolism - converting food to energy-and for building proteins. Adequate blood levels of magnesium protect the body from cardiovascular disease, heart arrhythmias, and possibly, stroke due to blood clotting in the brain. On average, people get enough (or nearly enough) magnesium in their diet. Fish, green leafy vegetables, milk , nuts , seeds, and whole grains are good sources. Many over-the-counter antacids, laxatives, and analgesics contain magnesium, but these medications should not be used as magnesium supplements . A multinutrient supplement is a relatively safe way to augment your magnesium intake. Take specific magne sium supplements only under a doctor's supervision . Of the supplemental forms, magnesium citrate-malate is the easiest to absorb , while magnesium glycinate is least likely to cause diarrhea at high doses. The body 's need for magnesium increases with

stress or illness. Administered as a supplement , magnesium may successfully treat insomnia, muscle cramps, premenstrual syndrome, and cardiovascular problems including high blood pressure, angina due to coronary artery spasm, and pain and cramping due to insufficient blood flow to the legs. Studies indicate that giving magnesium immediately to a heart attack patient greatly increases the chance of survival. The body processes magnesium efficiently ; the kidneys conserve it as needed and excrete any excess amounts , so the incidences of both severe deficiency and toxicity are rare. These conditions are dangerous when they do occur, however. Magnesium deficiency may cause nausea, vomiting, listlessness, muscle weakness, tremor, disorientation, and heart palpitations. Toxicity can induce diarrhea, fatigue, muscle weakness, and in extreme cases, severely depressed heart rate and blood pressure, shallow breathing, loss of reflexes , coma, and possibly, death. People who abuse laxatives or experience kidney failure are most vulnerable to magnesium poisoning.

M A N GA NE S E EMDR: 2.5 mg to 5 mg Manganese is essential for the proper formation and maintenance of bone , cartilage, and connective tissue; it contributes to the synthesis of proteins and genetic material; it helps produce energy from foods; it acts as an antioxidant; and it assists in normal blood clotting. Most people get enough manganese through diet alone; for example, a breakfast of orange juice, a 1-oz serving of bran cereal, and a banana provides just over 2.5 mg of manganese. Other food sources include brown rice, nuts, seeds, wheat germ , beans, whole grains, peas, and strawberries. Manganese citrate, a supplement, may help repair damaged tendons and ligaments. Excess dietary manganese is not considered toxic , and manganese deficiency is extremely rare.

MOL Y BDENU

M

EMDR: adults, 75 mcg to 250 mcg The obscure mineral molybdenum is an enzyme component. It helps generate energy, process waste for excretion, mobilize stored iron for the body's use, and detoxify sulfites-chemicals used as food preservatives . As such, molybdenum is essential to normal development, particularly of the nervous system. It is also an ingredient of tooth enamel and may help prevent tooth decay.

Cro ss refer ences are indi cated by bold italics.

1039

ESSENTIAL

VITAMINS

Molybdenum is present in peas, beans, cereals, pastas, leafy vegetables, yeast, milk , and organ meats . People generally get enough through diet; deficiency is virtually nonexistent. Toxicity is also rare in humans. Molybdenum is available in supplement form as molybdenum picolinate; however , prolonged intake of more than 1O mg daily can cause gout like symptoms such as joint pain and swelling .

PHOSPHORUS RDA: adults over 25 years old, 800 mg; young adults and pregnant women, 1,200 mg Phosphorus is the second most plentiful mineral in the body and is found in every cell. Like calcium, phosphorus is essential for bone formation and maintenance; more than 75 percent of the body's phosphorus is contained in bones and teeth. Phosphorus stimulates muscle contraction and contributes to tissue growth and repair, energy production, nerve-impulse transmission, and heart and kidney function. Phosphorus exists to some degree in nearly all foods, especially meats, poultry, eggs, fish, nuts, dairy products, whole grains, and soft drinks. Deficiency is rare-most people take in far more phosphorus than they need-but may be induced by long-term use of antacids or anticonvulsant drugs that contain aluminum hydroxide. Symptoms of phosphorus deficiency include general weakness, loss of appetite , bone pain, and increas ed susceptibility to bone fracture. Excess phos phorus in the bloodstream promotes calcium loss, which may weaken bones. Extreme phosphorus toxicity is rare, except in the event of kidney disease.

POTASSIUM EMDR: adults, 2,000 mg Potassium is the third most abundant mineral in the body , after calcium and phosphorus. It works closely with sodium and chloride to maintain fluid distribution and pH balance and to augment nerve-impulse transmission , muscle contraction, and regulation of heartbeat and blood pressure. Potassium is also required for protein synthesis, carbohydrate metabolism, and insulin secretion by the pancreas. Studies suggest that people who regularly eat potassium-rich foods are less likely to develop atherosclerosis, heart disease, and high blood pressure, or to die of a stroke. Dietary sources include lean meats, raw vegetables, and fruits-especially citrus fruits, bananas, and avoca-

1040

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MINERALS

dos-a nd potatoes. M any Americans may get only marginal amounts of potassium, but supplements , such as potassium aspartate, are best taken only under a doctor's guidance. Marginal potassium deficiency causes no symptoms but may increase the risk of developing high blood pressure or aggravate existing heart disease. More severe deficiency can result in nausea, vomiting, diarrhea, muscle cramps and muscle weakness, poor reflexes, poor concentration, heart arrhythmias, and rarely, death due to heart failure. Acute potassium to xicity may have similar effects, including possible heart failure. However, acute toxicity is rarely linked to diet and tends to occur only in the event of kidney failure.

SELENIUM RDA: men, 70 mcg; women, 55 mcg; pregnant women, 65 mcg An antioxidant, selenium protects cells and tissues from damage wrought by free radicals. Because its antioxidant effects complement those of vitamin £, the two are said to potentiate , or reinforce, each other. Selenium also supports immune function and neutralizes certain poisonous substances such as cadmium, mercury, and arsenic that may be ingested or inhaled . Although its full therapeutic value is unknown , adequate selenium levels may help combat arthritis, deter heart disease, and prevent cancer. Whole grains , asparagus, garlic, eggs, and mushrooms are typically good sources , as are lean meats and seafood. Very littl e selenium is requir ed for good health, and most people get adequate amounts through diet alone. High-dose supplements such as selenium citrate and selenium picolinate should be taken only if prescribed by a doctor. Selenium can be toxic in extremely high doses, causing hair loss, nail problems, accelerated tooth decay, and swelling of th e fingers , among other symptoms. Some multinutrient s contain selenium, but always in small, safe amounts.

SODIUM EMDR: adults, 500 mg All bodily fluids-including blood, tears, and perspira tion-contain sodium. Together with potassium and chloride, sodium maintains fluid distribution and pH balance; with potassium, sodium also helps control muscle contraction and nerve function. Most of the sodium in American diets is from table salt. Among many other sources are processed foods ,

soft drinks , meats, shellfish, condiments, snack foods , food additi ves, and over-the-counter laxatives. Americans generally consume far too much sodium . A single teaspoon of salt contains 2,000 mg-four times the daily minimum-but aver age daily consumption in the U.S. ran ges from 3,000 mg to 7,000 mg. Keepin g sodium intak e within reasonable limits is critical for long-term health. When sodium levels are persistently elevated, the body loses potassium and retains water, making blood pressure rise. Adopting a low-sodium diet can reduce high blood pressure and co rrect a potassium deficiency. Overexertion can induce temporary sodium deficiency , characterized by nausea, dehydration, muscle cramps, and other symptoms of heatstroke (see Emergencies/First Aid: Heatstroke and Heat Exhaustion). Drinking several glasses of water with a pinch of salt added replaces the sodium and eases th e symptoms.

SULFUR RDA/EMDR:not established Accounting for some 10 percent of the body 's mineral content, sulfur is part of every cell, especially in the protein-rich tissues of hair, nails, muscle, and skin. It assists in metabolism as a part of vitamin 81, biotin, and vitami n 8 5; helps regulate blood sugar levels as a constituent of insulin; and helps regulate blood clotting . Sulfur is also known to co nvert some toxic substances into nontoxic ones th at can then be excreted and therefo re is used to treat poisoning from aluminum, cadmium, lead , and mercury . Any diet that provid es sufficient protein is also providing adequate sulfur. Meat , fish , poultry, eggs, dairy products, peas, and beans are ri ch in both nutrients . Neither sulfur deficien cy nor toxi c ity occurs naturally in humans. Inorganic sulfur ingested in large amounts ca n be harmful , but excess organic sulfur from food is readily excreted.

VANADIUM RDA/EMDR:not established Vanadium is a trac e mineral whose role in human nutrition is littl e known , but possibly essential. Limited evidence suggests that vanadium lowers blood sugar levels in some people and inhibits tumor development, and therefore may protect against diabetes and some forms of cancer. It also appears to contribute to cholesterol metabolism and hormone production. Vanadium exists

in whole grains, nuts, root vegetables , liv er, fish, and vegetable oils. Because vanadium deficiency symptoms are unknown , research ers assume that humans requir e only a small amount , which diet apparently provides.

ZINC RDA: adults, 15 mg; pregnant women, 30 mg The mineral zinc is integral to the synthesis of RNA and DNA , the genetic material that controls cell growth, division, and function. In various proteins , enzymes, hormon es, and hormonelike substances ca lled prostaglandins, zinc contributes to many bodily processes, includin g bone development and growth; cell respira tion; energy metabolism ; wound healing; the liver 's abi Iity to remov e toxic substances such as alcohol from the body; immune function; and the regulation of heart rate and blood pressure. An adequate zinc intake enhances the ability to taste, promotes healthy skin and hair , enhances reproductive functions, and may improve short-term memory and attention span. As an anti-inflammatory agent, zinc is sometimes used to treat acne, rheumatoid arthritis, and prostatitis. Taking supplemental zinc may boost resistance to infection, especially in the elderly, and stimulate wound healing . Zinc is most easily obtained from lean meat and seafood, but it is also found in eggs, soybeans, peanuts , wheat bran , cheese, oysters , and other foods . Many Ameri can diets are slightly low in zinc. Youn g childr en, pregnant women , vegetarians, and elderly people are most susceptible to zinc deficiency. Loss of taste is usually the first warning; other symptoms are hair loss or discolor ation, white streaks on th e nails , dermatitis, loss of appetite, fatigue, and poor wound healing. In children, zinc deficien cy can retard growth and stunt sexual development in boys. On the other hand, ingesting extreme amounts of zinc daily can impair immune function and cause nausea, headaches, vomiting, dehydration, stomachaches, poor muscle coordination, fatigue, and possibly kidn ey failure. Experts recommend increasing zinc levels by increasing the zinc-rich foods in your diet or by taking a multinutrient supplement that include s zinc chelate, zinc pi co linate , or zinc aspartate, the three most easily absorbed forms. If zinc is used for more than three to six months to treat a chronic condition , it is essential to consult a nutritionist to avoid creating a mineral imbalance. Zinc ointment, which contains zinc oxide, is the most common topical form , ■ useful in skin disord ers, burns, and other wounds.

Cross refe rences are indicated by bold italics.

1041

he photographs on the following pages show the visible symptoms of a variety of L=::::======1

conditions, ranging from childhood illnesses and benign skin disorders to more se-

rious diseases such as cancer. This section is intended to help you distinguish among different conditions that look similar and are often confused with one another. Keep in mind that symptoms can vary greatly in appearance, depending on such factors as the severity of an individual case; always consult your doctor for a proper diagnosis. For more information on many of the disorders included here, refer to the appropriate entries in the Ailments and Options section of the book.

CONTENTS Children's Problems ............................................

1044

Mouth Problems ...............................................

1045

Skin Growths

1046

.................................................

Rashes, Insect Bites, and Skin Discolorations .........................

1048

Eye Problems .................................................

1051

1043

CHILDREN

' S PROBLEMS

CANDIDIASIS

CHICKENPOX

DIAPER RASH

INFANTILE

Often confused with diaper rash, candidiasis is a type of yeast infection that may appear on the buttocks and genital area of infants. In most cases, the characteristic bright red spots come together to form a rash with a scalloped border. See also Yeast Infections.

A highly contagious childhood disease, chickenpox usually begins with an itchy red rash that then develops into small fluid-filled blisters (above); the blisters eventually rupture and become crusty . The rash first appears on the torso, then spreads to the face.

Infants often develop a rash in the area covered by a diaper. The rash can vary from slight redness to severe inflammation (above). Diaper rash is caused by exposure to moisture, heat, urine, and feces. Excessive bathing can also contribute to the problem.

This form of eczema usually occurs in infants during their first year. The condition is characterized by extremely dry skin that appears as a red, rough, patchy rash, usually on the cheeks, forehead, and elbows . In severe cases the rash can cover the entire body.

GERMAN

ECZEMA

MEASLES

Often confused wi t h measles, German measles (or rubella) is less severe. As with measles, the rash appears first on the face and then spreads to the rest of the body, and is accompanied by fever, swollen lymph nodes, upper respiratory tract infection, and joint pain. The rash consists of tiny , light red spots that come together to form an evenly colored patch .

1044

MEASLES

STRAWBERRY

This highly contagious childhood disease is characterized by flat, dark pink spots that form blotches on the skin. The blotches first appear on the forehead and behind the ears, rapidly spreading to the torso, arms , and legs. It may be confused with German measles.

The raised, bright red patch of a strawberry nevus usually appears within the first few months of a child's life; in rare cases, it may be present at birth. This benign skin growth is more common in girls and can occur anywhere on the body, but typically appears on the scalp, face, back, or chest. It will eventually shrink and fade, usually between the ages of three and nine .

NEVUS

MOUTH

PROBLEMS

CANKER SORE

COLD SORE

Mouth ulcers that occur on the inside surface of the mouth are called canker sores. They can appear on the inside of the cheeks or lips, on the tongue, or at the base of the gums. The sores are painful, typically have a white or yellow center with a red border, and often appear in clusters. They are most common in children and young adults .

Herpes simplex, a contagious viral infection, is usually found on the face, particularly around the nose and mouth. The first symptom is typically a burning, itching sensation around the lips; later, small fluid-filled blisters will form . The blisters are painful and may come together to form a larger blister.

ORAL CANCER

Squamous cell carcinoma-the most common type of cancer affecting the mouth - often appears on the out side of the lip but may also occur on any tissue inside the mouth . More frequent in people over 60, the cancer begins as a small, painless ulcer that eventually develops into a rough, raised sore. At the relatively advanced st age show n at left, the sore can be confused w ith a w art.

IMPETIGO

ORAL THRUSH

A contagious bacterial infection more common in children but sometimes seen in adult s, impetigo usually occurs on the face, particularly around the mouth and nose. Water -filled blisters w ill gradually spread and rupture, creating a thick yellow crust.

Most common in infants and the elderly, oral thrush is a yeast infection that results when illness or the use of antibiotics disturbs the balance of naturally occurring microorganisms in the mouth. A raised, creamy white patch resembling cottage cheese usually appears on the inside of the cheek . With treatment , the infection typically clears up within 5 to 10 days.

Cro ss references are ind icate d by bold italics.

1045

SK IN GROWT

HS

CALLUS

CORN

MOLE

Caused by constant friction against the skin, calluses consist of a raised patch of hard, dead skin. They typically appear on the ball of the foot, on the palm of the hand, on fingers, or over a bunion. If they become painful or exceedingly thick or if they tear, consult your doctor . Calluses on the sole of the foot can sometimes be confused with plantar warts.

Smaller than calluses, corns are caused by pressure and friction on or between the toes. Hard corns are commonly found on the upper surface of the toes or on the outside of a little toe . Soft corns appear where moisture is trapped between the toes . Often painful, corns can be chemically or surgically removed .

Sometimes confused with melanoma, moles are benign growths that come in a wide variety of shapes and sizes. They can develop at any age and on any part of the body. Most tend to be dark and circular in shape, and can be smooth and flat, or raised and wrinkled. If any change in color or size occurs or if a mole starts to bleed, call your doctor .

SEBORRHEIC KERATOSIS

This benign skin condition consists of dark, oval, wartlike growths that range in size from one-third to one inch across; the growths typically occur in large numbers, are slightly raised, and may have a pastedon, waxy appearance . Most often seen among the elderly, they usually occur on the face, neck, scalp, chest, and back. They can be frozen off or surgically removed by a doctor.

1046

COMMON

WART

Typically found on the hands and feet either singly or in clusters, common warts vary in size but average a quarter inch in diameter. The flesh-colored bumps tend to be circular, feel hard, and are rough to the touch. They pose no health risks and will eventually disappear, but they can also be removed with over-thecounter medications.

SKIN CANCER

SKIN CANCER

SKIN CANCER

Basal Cell Carcinoma The most common of the three types of skin cancer, basal cell carcinoma is a malignancy that grows slowly and rarely spreads to other organs. A small bump typically in areas routinely exposed to the sun-develops a central crater that eventually erodes, crusts, and bleeds. This type of cancer is most common in fairskinned people over 40 .

Melanoma The most serious form of skin cancer, melanoma may develop from an existing mole with an irregular border or in an area where there was no previous mole. The dark spot can become inflamed and change shape, color, size, and elevation. If any of these conditions develops or if the growth bleeds spontaneously, call your doctor immediately .

Squamous Cell Carcinoma Continual overexposure to the sun is the most frequent cause of this cancer; fairskinned people over 60 are the most susceptible. The tumor typically appears as a hard lump with a scaly, crusted surface. Growths develop most often on the lips, ears, hands, neck, and arms. More aggressive than basal cell carcinoma, this cancer can spread to internal organs .

FLAT WARTS

PLANTAR WARTS

Children and young adults are the most likely to develop flat warts, which often occur in clusters of 10 to 30. The warts are slightly raised, smooth, and tan or flesh-colored; they are often barely visible . Flat warts typically appear on the neck, face, wrists, backs of the hands, and knees. In children, they most often appear on the face .

Caused by the common wart virus, plantar warts appear on the sole of the foot, usually at pressure points such as the heel. They begin as small, painful warts that become flattened and pressed into the skin. The soft core of the wart is surrounded by a hard calluslike ring that may be peppered with tiny blood clots that appear as black dots .

Cross refere nces are indi cated by bold italics.

1047

RASHES

, INSECT

BITES

, AND

SKIN

DISCOLORATIONS

ATOPIC DERMATITIS Also known as eczema, this type of dermatitis is most common in infants and young children . It usually appears in th e inne r crease of the elbows and the knees, and begins as an itchy rash with small red pimples that leak; the rash may spread into thick, scaly patches . People with inherited allergies are more likely to develop atopic dermatitis.

CONTACT DERMATITIS This rash results from contact with various substances, including certain types of plants, cosmetics, jewelry, medications, and detergents . Symptoms include small bumps or blisters that develop-over a period of weeks or months-into a red rash. The rash is usually very itchy, and skin may flake in affected areas.

1048

NUMMULAR DERMATITIS

SEBORRHEIC DERMATITIS

Most often occurring in adults, nummular dermatitis consists of itchy, scaly, circular patches appearing anywhere on the body but usually on the forearms and the shins. It can be confused with the fungal infection ringworm, which has almost identical symptoms. The cause of nummular dermatitis is unknown.

Usually developing during periods of stress, seborrheic dermatitis appears on the face, scalp, chest, back, eyelids, and outer surface of the ears. The rash is marked by yellow crusts and dry or greasy scales, and is often accompanied by chronic itching . Lower humidity during the winter can make the condition worse .

HIVES

INSECT BITE

LYME DISEASE

Often an allerg ic reaction to certain foods and drugs or airborne irritants such as pollen, hives can also result from an illness or even from emotional stress. The rash-con sisting of itchy, raised w elts wi th pale center s and red borders-can occur anywhere on the body. In advanced stages, separate rashes can grow together to create larger patches.

When an insect bites, it injects venom into the skin, causing inflammation. Depend ing on the type of insect and on the individual, the reaction can range from small, itchy red bumps (above) to a large, puffy swell ing; the bite may subside quickly or last for several days. The most likely culprits are fleas, mosquitoes, gnats, bedbugs , and lice. See also Insect and Spider Bites.

The bite of a t ick carrying Lyme disease first appears as a tiny red dot, which gradually expands to form a red rash up to eight inches or more across. Lyme disease is accompanied by flulike symptoms-fever, headache, muscle ache, and joint inflammation-that may take as long as a week to develop . Call your doctor ; Lyme disease can have serious consequences if left untreated.

SPIDER BITE Brown Recluse Venom from the bite of a brown recluse spider causes mild stinging and local redness, followed by intense pain about four hours later. A fluid-filled blister (left) forms within days, eventually rubbing off and leaving an ulcerated sore. Other symptoms include nausea, vomiting, fever, and joint pain . Seek treatment immediately. See also Insect and Spider Bites.

Cross references are indicat ed by bold italics.

1049

RASHES

, INSECT

BITES

, AND

SKIN

DISCOLORATIONS

PSORIASIS

RINGWORM

Usually occurring around the knees, elbows, and scalp, psoriasis is characterized by thick, silvery scales. There may be some itching but usually only a vague feeling of discomfort. Emotional stress and poor health can contribute to an outbreak of psoriasis; heredity is also a factor . Psoriasis is most common between the ages of 10 and 40 .

A contagious fungal infection, ringworm starts out as a small red patch and eventually grows into a ringshaped, scaly, itchy rash; the center of the rash remains clear as the ring spreads (left). Typical sites include the groin, feet, scalp, and torso. Ringworm is most common in children and can be contracted from infected domestic animals and other infected children . See Infections for information about treatment. (The name refers to the infection's appearance; the condition is not caused by any kind of worm.)

SCABIES

Most often afflicting children and young adults, scabies is contagious; it is contracted from small mites that burrow under the skin and lay eggs . Tiny swellings-typically around the lower abdomen and back and in the webs of the fingers-develop into red bumps that are extremely itchy. Scratching causes the bumps to become more inflamed, scaly, and red.

SHINGLES

Localized over one side of the body, shingles is the result of the herpes zoster virus; its most common victims are people over 50. Symptoms begin with a tingling sensation, followed by severe pain, and eventually a raised red rash consisting of small, fluidfilled blisters. The blisters will dry out and crust over, then slough off, leaving small scars.

1050

EYE

PROBLEMS

CONJUNCTIVITIS

Also known as pinkeye , conjunctivitis is a contagious infection, usually bacterial, that causes inflammation of the conjunctivathe eye's mucous membrane . Symptoms include itchiness, swelling, and redness of the eyelid, and a thick discharge causing the eye to look bloodshot. Conjunctivitis is most common in children and adults who have allergies .

SUBCONJUNCTIVAL

HEMORRHAGE

Usually resulting from an injury to the eye or a severe bout of coughing or sneezing that causes small blood vessels to leak, subconjunctival hemorrhages appear as one or more irregular red spots in the white of the eye. They are harmless and generally disappear within two or three weeks . Call your doctor if the hemorrhages cause any discomfort or if they recur.

STY

A sty results from a bacterial infection at the root of an eyelash, typically at the inner corner of the eye. It causes the follicle of the eyelash to become inflamed (left); a pus-filled bump wi ll form and then rupture. A sty can be painful, but it typically clears up on its own within a week.

Cros s references are ind icated by bold italics.

1051

ATLAS

OF

THE

BODY

CONTENTS The Muscular System ............................................

1054

The Skeletal System .............................................

1056

The Torso .....................................................

1058

The Digestive System ............................................

1059

The Circulatory and Respiratory Systems ............................

1060

The Urinary / Reproductive Systems .................................

1062

The Nervous System ............................................

1064

The Endocrine/Immune Systems ...................................

1065

The Senses ....................................................

1066

1053

.'1 ATLAS

OF

THE

BODY

]

THE MUSCULAR

SYSTEM Muscles are parallel bundles of interlo c king fibers that contract in response to signals from nerves. The body's more than 600 named muscles vary from less than a quarter inch to about a foot in length. There are three ma in types. Striated muscles , which are tethered to bones, ligaments , tendons , and other muscles , carry out voluntary movements. Smooth muscles , found in such hollow organs as the blad-

FRONTALIS TEMPO RAUS ORBICULARIS OCULI ORBICULARIS ORIS

MASSETER STERNOHYOID

STERNOCLEIDOMASTOID

PLATYSMA

SCALENE TRAPEZIUS

DELTOID

PECTORALIS MAJOR

PECTORALIS MINOR SERRATUS ANTERIOR

BICEPS

INTER COSTAL

BRACHIALIS EXTERNAL ABDOMINAL

RECTUS ABDOMINUS INTERNAL ABDOMINAL

OBLIQUE

BRACHIORADIALIS

_

OBLIQUE

BRACHIORADIALIS EXTENSOR CARPI RADIALIS LONGUS FLEXOR POLLICIS LONGUS FLEXOR DIGITORUM PROFUNDUS FLEXOR CARPI ULNARIS

TENSOR FASCIAE LATAE ILIOPSOAS PECTINEUS ADDUCTOR LONGUS GRACI LIS SARTORIUS

V1

a.. UJ

u

0:: VASTUS MEDIALIS

VASTUS MEDIALIS

VASTUS LATERALIS

VASTUS LATERALIS

TIBIALIS ANTERIOR

TIBIALIS ANTERIOR

PERONEUS LONGUS

0