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ACOSO SEXUAL EN EL TRABAJO

EL ACOSO SEXUAL ES UNA CUESTIÓN DEL PODER

C

ontraindiCations

Not for use except under the supervision of an expert quali- fied in the appropriate use of this substance (Felter and Lloyd 1898; Wood and LaWall 1926).

o

ther

P

reCautions

None known.

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rugand

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uPPlement

i

nteraCtions

Based on the presence of cardiac glycosides in spread- ing dogbane and Indian hemp, caution should be used in patients taking cardiac medications (Genkina et al. 1974; Grundmann and Gerlach 1967; Lee et al. 1972).

n

otiCe

Emetic (Felter and Lloyd 1898; Wood and LaWall 1926); see Appendix 2.

Diuretic (Felter and Lloyd 1898; Wood and LaWall 1926);

see Appendix 2.

a

dverse

e

ventsand

s

ide

e

ffeCts

May cause irritation of the gastrointestinal tract, nausea, vomiting, and increased perspiration (Felter and Lloyd 1898; Wood and LaWall 1926).

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harmaCologiCal

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onsiderations

Medical texts from the late 1800s and early 1900s indicate that use of spreading dogbane almost invariably produces nausea or vomiting (sometimes copious), copious perspira- tion, diuretic activity, and “acts powerfully upon the heart, slowing its action and raising arterial tension” (Felter and Lloyd 1898; Graham 1909; Wood and LaWall 1926).

P

regnanCyand

l

aCtation

No information on the safety of spreading dogbane and Indian hemp in pregnancy or lactation was identified in the scientific or traditional literature. Based on the pharmacologi- cal activity, use during pregnancy is not recommended except under the supervision of a qualified healthcare practitioner.

While this review did not identify any concerns for use while nursing, safety has not been conclusively established, and this substance is not recommended for use except under the supervision of an expert qualified in its appropriate use.

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eview

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etailS

i. d

rugand

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uPPlement

i

nteraCtions

Clinical trials of drug or supplement interactions

No clinical trials of drug or supplement interactions were identified.

Case reports of suspected drug or supplement interactions

No case reports of suspected drug or supplement interac- tions were identified.

animal trials of drug or supplement interactions

No animal trials of drug or supplement interactions were identified.

ii. a

dverse

e

vents

Case reports of adverse events

No case reports of adverse events were identified.

iii. P

harmaCologyand

P

harmaCokinetiCs human pharmacological studies

No relevant human pharmacological studies were identified.

animal pharmacological studies

Slowing of heart rate and increased urination were observed in cats, dogs, and frogs treated with varying doses of spread- ing dogbane (Graham 1909; Wood and LaWall 1926).

in Vitro pharmacological studies

Slowing of heart rate was observed in excised rabbit hearts treated with varying doses of spreading dogbane (Graham 1909).

iv. P

regnanCyand

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aCtation

No information on the safety of spreading dogbane or Indian hemp in pregnancy or lactation was identified.

Aralia californica

A

v. t

oxiCity

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tudies

acute toxicity

The LD50 of a t incture of spreading dogbane administered

intravenously to frogs is 5.1 ml/kg (Graham 1909).

Cytotoxicity

Fractions of a water-alcohol extract of spreading dogbane exhibited cytotoxic activity in human nasopharynx carci- noma cells (Kupchan et al. 1964).

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iteRatuRe

c

iteD

Felter, H.W., and J.U. Lloyd. 1898. King’s American dispensatory . 18th ed., 3rd rev. 2 vols. Cincinnati: Ohio Valley Co.

Genkina, G.L., K.K. Khodzhaev , T.T. Shakirov, and N.K. Abubakirov. 1974. An investigation of the r oots of Apocynum

androsaemifolium and A. cannabinum for their cardenolide con- tent. Chem. Nat. Compd. 8(3):316-318.

Graham, J.C. 1909. The pharmacology of Apocynum cannabinum.

Biochem. J. 4(9):385-404.

Grundmann, W., and H. Gerlach. 1967. Cardiac glycosides from the roots of Apocynum cannabinum: Quantitative determination of glycosides in photometry cymarin apocannoside. Pharm. Zentralh. 106(8):501-508.

Kupchan, S.M., R.J. Hemingway, and R.W. Doskotch. 1964. Tumor inhibitors. IV. Apocannoside and cymarin, the cytotoxic prin- ciples of Apocynum cannabinum L. J. Med. Chem. 7:803-804. Lee, P.K., D.P. Carew, and J. Rosazza. 1972. Apocynum cannabinum tis-

sue culture. Growth and chemical analysis. Lloydia 35(2):150-156. Wood, H., and C. LaWall. 1926. The dispensatory of the United States

of America. Philadelphia: J.B. Lippincott.

Aralia californica s. Watson araliaceae

sCn: California spikenard

oCn: elk clover part: rhizome, root

Q

uick

R

efeRence

S

ummaRy

Safety Class: 1

Interaction Class: A

C

ontraindiCations None known.

o

ther

P

reCautions None known.

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ditors

’ n

ote

A reference text on medicinal plants of western America does not list any cautions or contraindications for use of California spikenard (Moore 2003).

d

rugand

s

uPPlement

i

nteraCtions

None known.

a

dverse

e

ventsand

s

ide

e

ffeCts

None known.

P

harmaCologiCal

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onsiderations

None known.

P

regnanCyand

l

aCtation

No information on the safety of California spikenard in pregnancy or lactation was identified in the scientific or tra- ditional literature. Although this review did not identify any concerns for use while pregnant or nursing, safety has not been conclusively established.

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eview

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etailS

i. d

rugand

s

uPPlement

i

nteraCtions

Clinical trials of drug or supplement interactions

No clinical trials of drug or supplement interactions were identified.

Case reports of suspected drug or supplement interactions

No case reports of suspected drug or supplement interac- tions were identified.

animal trials of drug or supplement interactions

No animal trials of drug or supplement interactions were identified.

ii. a

dverse

e

vents

Case reports of adverse events

A

iii. P

harmaCologyand

P

harmaCokinetiCs human pharmacological studies

No relevant human pharmacological studies were identified.

animal pharmacological studies

No relevant animal pharmacological studies were identified.

in Vitro pharmacological studies

No relevant in vitro pharmacological studies were identified.

iv. P

regnanCyand

l

aCtation

No information on the use of California spikenard during pregnancy or lactation was identified.

v. t

oxiCity

s

tudies

No toxicity studies were identified.

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iteRatuRe

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Moore, M. 1993. Medicinal plants of the Pacific West. Santa Fe: Red Crane Books.

Aralia nudicaulis L. araliaceae

sCn: small spikenard

oCn: false sarsaparilla; wild sarsaparilla part: rhizome

Q

uick

R

efeRence

S

ummaRy

Safety Class: 1

Interaction Class:

A

C

ontraindiCations None known.

o

ther

P

reCautions None known.

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rugand

s

uPPlement

i

nteraCtions

None known.

e

ditors

’ n

ote

No cautions for use of small spikenard are reported in historical American medical texts (Felter and Lloyd 1898; Remington and Wood 1918).

a

dverse

e

ventsand

s

ide

e

ffeCts

None known.

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harmaCologiCal

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onsiderations

None known.

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regnanCyand

l

aCtation

No information on the safety of small spikenard in preg- nancy or lactation was identified in the scientific or tradi- tional literature. Although this review did not identify any concerns for use while pregnant or nursing, safety has not been conclusively established.

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eview

D

etailS

i. d

rugand

s

uPPlement

i

nteraCtions

Clinical trials of drug or supplement interactions

No clinical trials of drug or supplement interactions were identified.

Case reports of suspected drug or supplement interactions

No case reports of suspected drug or supplement interac- tions were identified.

animal trials of drug or supplement interactions

No animal trials of drug or supplement interactions were identified.

ii. a

dverse

e

vents

Case reports of adverse events

No case reports of adverse events were identified.

iii. P

harmaCologyand

P

harmaCokinetiCs human pharmacological studies

Aralia racemosa

A

animal pharmacological studies

No relevant animal pharmacological studies were identified.

in Vitro pharmacological studies

No relevant in vitro pharmacological studies were identified.

iv. P

regnanCyand

l

aCtation

No information on the use of small spikenard during preg- nancy or lactation was identified.

v. t

oxiCity

s

tudies

No toxicity studies were identified.

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iteRatuRe

c

iteD

Felter, H.W., and J.U. Lloyd. 1898. King’s American dispensatory .

18th ed., 3rd rev. 2 vols. Cincinnati: Ohio Valley Co. Remington, J.P., and H.C. Wood. 1918. The dispensatory of the United States of America. 20th ed. Philadelphia: Lippincott.

Aralia racemosa L. araliaceae

sCn: spikenard

oCn: American spikenard part: rhizome

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uick

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efeRence

S

ummaRy

Safety Class:

2b

Interaction Class: A

C

ontraindiCations

Not for use in pregnancy except under the supervision of a qualified healthcare practitioner (Densmore 1928; Herrick 1977).

o

ther

P

reCautions

None known.

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rugand

s

uPPlement

i

nteraCtions

None known.

a

dverse

e

ventsand

s

ide

e

ffeCts

None known.

P

harmaCologiCal

C

onsiderations

None known.

P

regnanCyand

l

aCtation

Spikenard is reported to have been used as an abortifacient by the Chippewa and Iroquois (Densmore 1928; Herrick 1977). Based on this information, use during pregnancy is not recommended except under the supervision of a quali- fied healthcare practitioner.

No information on the safety of spikenard use during lacta- tion was identified. While this review did not identify any concerns for use while nursing, safety has not been conclu- sively established.

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eview

D

etailS

i. d

rugand

s

uPPlement

i

nteraCtions

Clinical trials of drug or supplement interactions

No clinical trials of drug or supplement interactions were identified.

Case reports of suspected drug or supplement interactions

No case reports of suspected drug or supplement interac- tions were identified.

animal trials of drug or supplement interactions

No animal trials of drug or supplement interactions were identified.

ii. a

dverse

e

vents

Case reports of adverse events

No case reports of adverse events were identified.

iii. P

harmaCologyand

P

harmaCokinetiCs human pharmacological studies

No relevant human pharmacological studies were identified.

animal pharmacological studies

No relevant animal pharmacological studies were identified.

in Vitro pharmacological studies

A

iv. P

regnanCyand

l

aCtation

Spikenard is reported to have been used as an abortifacient by the Chippewa and Iroquois (Densmore 1928; Herrick 1977).

No information on the safety of spikenard use during lacta- tion was identified.

v. t

oxiCity

s

tudies

No toxicity studies were identified.

l

iteRatuRe

c

iteD

Densmore, F. 1928. Uses of plants by the Chippewa Indians.

Smithsonian Inst. Bur. Am. Ethnol. Annu. Rep. 44:273-379. Herrick, J.W. 1977. Iroquois medical botany. Ph.D. Thesis. State University of New York, Albany.

Arctium lappa L. asteraceae

sCn: burdock

pn: niu bang zi (fruit) oCn:part: root, seed gobo; goboshi; great burdock

Q

uick

R

efeRence

S

ummaRy

Safety Class: 1

Interaction Class: A

C

ontraindiCations None known.

o

ther

P

reCautions None known.

d

rugand

s

uPPlement

i

nteraCtions

None known.

a

dverse

e

ventsand

s

ide

e

ffeCts

An anaphylactic reaction to burdock root has been reported (Sasaki et al. 2003). Several cases of contact dermatitis have been reported after topical applications of burdock root plasters (Rodriguez et al. 1995).

Cases of atropine poisoning have been reported in persons that took adulterated burdock root products (Bryson et al. 1978; Fletcher and Cantwell 1978; Gandolfo and Accascina 1953; Rhoads et al. 1984). Atropine is not a known constituent of burdock (Leung and Foster 1996; Mills and Bone 2005).

P

harmaCologiCal

C

onsiderations

None known.

P

regnanCyand

l

aCtation

One animal study indicated no adverse effects of burdock on fetal development (Matsui et al. 1967). No other information on the safety of this herb in pregnancy or lactation was iden- tified in the scientific or traditional literature. Although this review did not identify any concerns for use while pregnant or nursing, safety has not been conclusively established.

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eview

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etailS

i. d

rugand

s

uPPlement

i

nteraCtions

Clinical trials of drug or supplement interactions

No clinical trials of drug or supplement interactions were identified.

Case reports of suspected drug or supplement interactions

No case reports of suspected drug or supplement interac- tions were identified.

animal trials of drug or supplement interactions

No animal trials of drug or supplement interactions were identified.

ii. a

dverse

e

vents

Case reports of adverse events

Several cases of atropine poisoning have been reported in persons consuming tea labeled as burdock root (Bryson et al. 1978; Fletcher and Cantwell 1978; Gandolfo and Accascina 1953; Rhoads et al. 1984). Atropine is not a known constitu- ent of burdock; its presence was a result of contamination (Leung and Foster 1996; Mills and Bone 2005).

An anaphylactic reaction to cooked burdock root has been reported. The patient tested positively to skin prick tests with raw and boiled burdock root, and raw and boiled carrot (Sasaki et al. 2003). Allergic contact dermatitis has been reported in three patients who topically applied bur- dock root plasters. All three patients tested positively in closed but not open patch tests, and none reported allergies

Arctostaphylos uva-ursi

A

to other Asteraceae family plants. A positive patch test for nickel was reported in one patient. Tests with a s esquiter- pene lactone mix were not completed (Rodriguez et al. 1995).

iii. P

harmaCologyand

P

harmaCokinetiCs human pharmacological studies

No relevant human pharmacological studies were identified.

animal pharmacological studies

Some earlier reviews indicated a hypoglycemic effect of bur- dock root (Bever and Zahnd 1979; Farnsworth and Segelman 1971).

No adverse effects on fertility were seen in mice subcu- taneously administered 0.05 to 0.2 ml of an aqueous burdock extract (part unspecified) twice daily for 5 days (Matsui et al. 1967).

in Vitro pharmacological studies

An extract of burdock root weakly inhibited the CYP isoen- zymes CYP3A4, CYP19, and CYP2C19 (Scott et al. 2006).

An aqueous extract of burdock seed inhibited platelet- activating factor binding at a c oncentration of 200 µg/ml (Iwakami et al. 1992).

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regnanCyand

l

aCtation

No teratogenic effects were seen in offspring of pregnant mice subcutaneously administered 0.05 to 0.2 ml of an aque- ous burdock extract (part unspecified) twice daily for 5 days (Matsui et al. 1967).

No information on the safety of burdock root or seed during lactation was identified.

v. t

oxiCity

s

tudies

acute toxicity

The LD50 of orally administered alcohol extract of burdock

root in rats is 700 mg/kg (Sharma et al. 1978).

subchronic toxicity

No toxic effects were observed in rats fed burdock root as 30% of the diet for 4 months (Hirono et al. 1978).

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iteRatuRe

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Bever, B., and G. Zahnd. 1979. Plants with oral hypoglycemic activity. Q. J. Crude Drug Res. 17:139-196.

Bryson, P.D., A.S. Watanabe, B.H. Rumack, and R.C. Murphy . 1978. Burdock root tea poisoning. Case report involving a com- mercial preparation. J. Am. Med. Assoc. 239(20):2157.

Farnsworth, N., and A. Segelman. 1971. Hypoglycemic plants. Tile

Till 57:52-56.

Fletcher, G.F., and J.D. Cantwell. 1978. Burdock root tea poisoning.

J. Am. Med. Assoc. 240(15):1586.

Gandolfo, N., and G. Accascina. 1953. Atropine poisoning by ingestion of decoction of bur dock roots. Rend. Ist. Sup. Sanit. 16(10-11-12):844-851.

Hirono, I., H. Mori, K. Kato, et al. 1978. Safety examination of some edible plants, Part 2. J. Environ. Pathol. Toxicol. 1(1):71-74. Iwakami, S., J.B. Wu, Y. Ebizuka, and U. Sankawa. 1992. Platelet activating factor (P AF) antagonists contained in medicinal plants: Lignans and sesquiterpenes. Chem. Pharm. Bull. (Tokyo) 40(5):1196-1198.

Leung, A.Y., and S. Foster. 1996. Encyclopedia of common natural ingre-

dients used in food, drugs, and cosmetics. 2nd ed. New York: Wiley.

Matsui, A.S., J. Rogers, Y.K. Woo, and W.C. Cutting. 1967. Effects of some natural pr oducts on fertility in mice. Med. Pharmacol.

Exp. Int. J. Exp. Med. 16(5):414-424.

Mills, S., and K. Bone. 2005. The essential guide to herbal safety . St. Louis: Elsevier.

Rhoads, P.M., T.G. Tong, W. Banner, Jr., and R. Anderson. 1984. Anticholinergic poisonings associated with commercial bur- dock root tea. J. Toxicol. Clin. Toxicol. 22(6):581-584.

Rodriguez, P., J. Blanco, S. Juste, et al. 1995. Allergic contact dermati- tis due to burdock (Arctium lappa). Contact Dermat. 33(2):134-135. Sasaki, Y., Y. Kimura, T. Tsunoda, and H. Tagami. 2003. Anaphylaxis

due to burdock. Int. J. Dermatol. 42(6):472-473.

Scott, I.M., R.I. Leduc, A.J. Burt, et al. 2006. The inhibition of human cytochrome P450 by ethanol extracts of North American botan- icals. Pharm. Biol. 44(5):315-327.

Sharma, M.L., N. Chandokhe, B.J. Ghatak, et al. 1978.

Pharmacological screening of Indian medicinal plants. Indian J.

Exp. Biol. 16(2):228-240.

Arctostaphylos uva-ursi (L.) spreng. ericaceae

sCn: uva-ursi

oCn: bearberry; kinnickinick part: leaf

Q

uick

R

efeRence

S

ummaRy

Safety Class: 1

Interaction Class: A

C

ontraindiCations

A

o

ther

P

reCautions

None known.

d

rugand

s

uPPlement

i

nteraCtions

None known.

n

otiCe

Tannins (6.0–27.5%, usually around 10%) (Leung and Foster 1996; Wichtl 2004); see Appendix 1.

e

ditors

’ n

otes

Although some herbal reference texts indicate that uva-ursi is contraindicated in kidney disorders (Bradley 1992; ESCOP 2003), a recent review of the literature found no evidence to support this contraindication (Upton et al. 2008). Some evi- dence of kidney damage has been observed in rats chroni- cally administered the compound hydroquinone, which may have been the basis for contraindication in kidney disorders (Hoffman-Bohm and Simon 1992; Kari et al. 1992; Shibata et al. 1991). The kidney damage was seen primarily in aged male rats, a population that is predisposed to kidney damage (DeCaprio 1999; McGregor 2007).

One herbal reference text notes that “hydroquinone appears to be nontoxic with the administration of uva-ursi leaf tea, however hydroquinone must remain in suspicion with regard to having mutagenic and possibly carcinogenic effects” (Wichtl 2004). Reviews of the compound hydroqui- none indicate that although genotoxic effects were observed in vitro and in animal tests using intraperitoneal or subcu- taneous administration, such effects were generally not seen in animals orally administered the compound (DeCaprio 1999; McGregor 2007).

Uva-ursi contains arbutin and other hydroquinone glu- cosides, present at up to 12% of the dried leaf (Hegnauer 1966). The exposure to hydroquinone, however, depends on multiple factors including concentration in the leaf, concentration in the extract or other dosage form, and the

absorption and distribution of hydroquinone in the body, which have yet to be fully investigated (Upton et al. 2008).

a

dverse

e

ventsand

s

ide

e

ffeCts

A case of maculopathy was reported after long-term con- sumption of uva-ursi (Wang and Del Priore 2004).

Ingestion of uva-ursi has been reported to change urine to a b rown-green color due to hydroquinone metabolites (Upton et al. 2008).

P

harmaCologiCal

C

onsiderations

Although several herbal reference texts indicate that con- comitant use of uva-ursi and medications that can acidify the urine may result in a decrease in efficacy of uva-ursi with acidic urine or in conjunction with remedies that produce acidic urine (Blumenthal et al. 1998; Bradley 1992; ESCOP 2003; Weiss and Meuss 2001), a r eview of uva-ursi indicated that this concern appears to be theoretical, with no data available to support such an interaction (Upton et al. 2008).

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regnanCyand

l

aCtation

No studies on the safety of uva-ursi in pregnancy were iden- tified. A number of reproductive toxicity studies have been completed on the compounds arbutin and hydroquinone. The no-observed-effect level (NOEL) for arbutin in rats was 100 mg/kg daily (Itabashi et al. 1988). The NOEL for hydro- quinone in rats was 100 mg/kg daily (Murphy et al. 1992). In rabbits, the NOEL for maternal toxicity of hydroquinone was 25 mg/kg, while the developmental toxicity NOEL was 75 mg/kg (Murphy et al. 1992).

In a t wo-generation reproductive toxicity study, no significant changes in rat pup development were observed (Blacker et al. 1993).

No information on the safety of uva-ursi during lacta- tion was identified. While this review did not identify any concerns for use while nursing, safety has not been conclu- sively established.

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eview

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etailS

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uPPlement

i

nteraCtions

Clinical trials of drug or supplement interactions

No clinical trials of drug or supplement interactions were identified.

Case reports of suspected drug or supplement interactions

No case reports of drug or supplement interactions were identified. Several reference texts indicate that concomitant use of uva-ursi with medications that can acidify the urine may result in a decrease of effectiveness of uva-ursi (Bradley 1992; ESCOP 2003; Weiss and Meuss 2001). The acidity of cranberry, another botanical commonly use to treat urinary tract infections, is often cited as a r eason to avoid taking

cranberry and uva-ursi together. Studies on the ability of cranberry to acidify the urine generally indicate that any such effects are mild or nonexistent (Upton 2002).

animal trials of drug or supplement interactions

Studies of uva-ursi in rats, mice, and rabbits have indicated that uva-ursi may potentiate the anti-inflammatory effects of dexamethasone, prednisolone, and indomethacin (Matsuda et al. 1990, 1991, 1992).

ii. a

dverse

e

vents

adverse events reported in Clinical trials

No adverse effects or abnormal values in hematology or uri- nalysis were reported in men or women administered 300

Arctostaphylos uva-ursi

A

or 500 mg daily of purified hydroquinone for 3 to 5 months (Carlson and Brewer 1953).

Case reports of adverse events

A case of bull’s-eye maculopathy was reported in a 56-year- old woman who had been taking uva-ursi tea “regularly” (dose and frequency not reported) for 3 years. The woman reported a decrease in visual acuity in the third year. The reporting authors noted that hydroquinone compounds are known inhibitors of tyrosine kinase and thus melanin syn- thesis, and that decreased melanin in the eye might account for the maculopathy (Wang and Del Priore 2004).

iii. P

harmaCologyand

P

harmaCokinetiCs human pharmacological studies

No adverse effects were observed in healthy volunteers administered uva-ursi standardized extract or gastric juice- resistant tablet containing the same extract (Paper et al. 1993).

No adverse event data were reported in studies of uri- nary arbutin levels in persons taking uva-ursi (Quintus et al. 2005; Siegers et al. 1997).

animal pharmacological studies

Some extracts of uva-ursi may have inhibitory effects on melanin synthesis, melasma, and other abnormal pigmenta- tions in animals (Maeda and Fukuda 1996; Matsuda et al. 1992, 1996; Ortiz et al. 1999).

in Vitro pharmacological studies

Aqueous and methanolic extracts of uva-ursi inhibited the drug-metabolizing CYP isoenzymes CYP3A5, CYP3A7,