ÍTEM 9B. OTRA INFORMACIÓN
ÍTEM 15. ANEXOS, CUADROS DE LOS ESTADOS FINANCIEROS
Overdose: Nausea, vomiting, dizziness, confusion, tachycardia, shock
Reproductive: Uterine contractions and spasms, spontaneous abortion Interactions
Drug
Antiarrhythmics, antihypertensives, cardiac glycosides: Broom may increase the effect of antiarrhythmics, antihypertensives, and cardiac glycosides;
do not use concurrently.
Antidiabetics (glyburide, insulin, miglitol): Broom decreases the hypo-glycemic effect of these agents; avoid concurrent use.
MAOIs: Scotch broom may cause hypertensive crisis when used with MAOIs;
do not use concurrently (Jellin et al, 2008).
Lab Test
AST, ALT, alkaline phosphatase, creatinine: Broom may increase these levels.
Primary Chemical Components and Possible Actions
Chemical Class Individual Component Possible Action
Alkaloid Sparteine Antiarrhythmic IA; oxytoxic
Flavone glycoside Scoparoside Diuretic Kaempferol; Quercetin
derivatives
Antiinfl ammatory Oxysparteine; Spiraeoside;
Lupanine; Genitoside;
Isoquercetin Isofl avone Sarothamnoside Caffeic acid
derivative Essential oil
Client Considerations Assess
• Assess the reason the client is taking broom medicinally.
• Assess cardiac status (blood pressure; pulse, including character; rhythm). Identify any other cardiac agents (antiarrhythmics, antihypertensives, cardiac glycosides) the client is taking.
• Identify MAOIs the client is taking; broom should not be used with MAOIs because of high tyramine content.
• Assess for overdose symptoms such as nausea, vomiting, dizziness, confusion, tachycardia, and shock. If any of these symptoms are present, use of this herb should be discontinued immediately.
Administer
• Inform the client that there is no consensus on dosage.
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116 Buchu
= Pregnancy = Pediatric = Alert = Popular Herb Teach Client/Family
• Because broom can cause spontaneous abortion, caution the client not to use this herb during pregnancy.
• Advise the client not to use broom in children or those who are breastfeeding until more research is available.
• Caution the client that the FDA considers this herb unsafe because of its hepato-toxic effects.
• Caution the client that using this herb to induce abortion is unsafe; a follow-up therapeutic abortion may be needed.
• Teach the client the symptoms of overdose (nausea, vomiting, dizziness, confusion, tachycardia, shock).
Buchu
(boo’choo)
Scientifi c names: Barosma betulina (Agathosma betulina), Barosma serrati folia, Barosma crenulata
Other common names: Agathosma, betuline, bocco Origin: Buchu is found in South Africa.
Uses
Buchu is used as a diuretic and an antiseptic, and for the treatment of the common cold, stomachaches, rheumatism (Simpson, 1998), gout, leukorrhea, yeast infec-tions, and urinary tract infecinfec-tions, including cystitis. Buchu is also used in combina-tion with uva-ursi for benign prostatic hyperplasia.
Actions
No substantial information exists to document any of the actions or uses of this herb.
Diuretic Action
Two of the fl avonoid components of buchu, diosphenol and terpen-4-ol, may be responsible for its diuretic action. However, diosphenol and terpen-4-ol are not considered to be a more powerful diuretic than caffeine or any other xanthane product (Simpson, 1998).
Antibacterial Action
A douche made from an infusion of buchu leaves may be used as an antibacterial treatment for yeast infections and leukorrhea. Diosphenol may be responsible for the antibacterial effect (Chevallier, 1996). One study suggests there is little potential for buchu to be used as an antimicrobial (Lis-Balchin, 2001).
Other Actions
One of the fl avonoids, quercetin, is an antiinfl ammatory. Pulegone is a powerful abortifacient.
Product Availability
Decoction, dried leaves, fl uid extract, tablets, tincture Plant Part Used: Leaves
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Buchu 117
Adverse effects: Underline = life-threatening
B
Dosages• Adult PO infusion: 3-6 g dried leaves/day (Mills, Bone, 2000)
• Adult PO tea: 1 cup of tea (1 g dry leaf in 150 ml of water, boil 5-10 min, strain) given several times per day (Jellin et al, 2008)
• Adult PO fl uid extract: 2-4 ml/day (1:2 dilution) (Mills, Bone, 2000)
• Adult PO tincture: 5-10 ml/day (1:5 dilution) (Mills, Bone, 2000)
Contraindications
Pregnancy category is 3; breastfeeding category is 3A.
Buchu should not be given to children. It should not be used by persons with severe hepatic or renal disease.
Side Effects/Adverse Reactions
GI: Nausea, vomiting, anorexia, diarrhea, hepatotoxicity
GU: Increased menstrual fl ow, spontaneous abortion, nephritis Interactions
Drug
Anticoagulants (heparin, warfarin), antiplatelets: Buchu can increase the action of anticoagulants, antiplatelets causing bleeding; avoid concurrent use.
Antidiabetics(glyburide, insulin, miglitol): Buchu decreases the hypoglycemic effect; avoid concurrent use.
Lab Test
AST, ALT, alkaline phosphatase, PT, INR: Buchu may increase these levels.
Primary Chemical Components and Possible Actions Chemical Class Individual Component Possible Action
Flavonoid Diosphenol Antibacterial; diuretic
Quercetin Antiinfl ammatory
Diosmin; Rutin;
Diosmetin; Terpene-4-ol
Volatile oil Pulegone Hepatotoxicity;
abortifacient
Limonene Menthone Diuretic
Mucilage Resin Coumarin
Client Considerations Assess
• Assess the reason the client is taking buchu medicinally.
• Assess hepatic function test results (ALT, AST, bilirubin); buchu can cause hepato-toxicity. Watch for jaundice, right upper-quadrant pain, and clay-colored stools. If symptoms occur, use of this herb should be discontinued.
• Assess for use of anticoagulants (see Interactions).
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118 Buckthorn
= Pregnancy = Pediatric = Alert = Popular Herb Diuretic Use
• Assess urinary status (intake and output, bladder distention, pain, burning during urination); watch for beginning nephritis. If these symptoms occur, use of this herb should be discontinued.
Administer
• Instruct the client to take PO as dried leaves, infusion, fl uid extract, or tincture.
Buchu should not be boiled; boiling robs the herb of its healing properties.
• Instruct the client to store buchu in a cool, dry place, away from heat and moisture.
Teach Client/Family
• Inform the client that pregnancy category is 3 and breastfeeding category is 3A.
• Advise the client not to use buchu in children.
• Advise the client to report changes in urinary status, jaundice, and stool color.
Buckthorn
(buhk’thawrn)
Scientifi c name: Rhamnus cathartica
Other common names: Common buckthorn, European buckthorn, hartsthorn, purging buckthorn, waythorn
Origin: Buckthorn is found in Canada, Europe, and the United States.
Uses
Buckthorn is used as a powerful laxative.
Actions Laxative Action
The laxative action of the anthranoid components of buckthorn is well documented in the mainstream pharmacologic literature. This action results from direct chemical irritation of the colon, which increases the rate at which stool is propelled through the bowel. A similar laxative herb is cascara.
Product Availability Crushed herb, syrup
Plant Parts Used: Bark, fruit Dosages
• Adult PO: 20-30 mg hydroxyanthracene derivative (glucofrangulin A) (Blumenthal, 1998)
Contraindications Class 2b/2c/2d herb.
Buckthorn should not be used during pregnancy and breastfeeding and should not be given to children younger than 12 years of age. This herb should not be used by elderly persons or persons with the following disorders: colitis, irritable bowel syndrome, Crohn’s disease, gastrointestinal obstruction, unknown abdominal pain, appendicitis, gastrointestinal bleeding, hepatic disease. Dehydration and electrolyte loss may occur if buckthorn is used for more than 8 to 10 days.
Buckthorn 119
Adverse effects: Underline = life-threatening