Acupuncture Continuing Education

Safety in Herb-Drug Combinations #4

Samples of Course Materials

Chuang Xiong sample


Select Course

Sample 1

Review of Pharmacological Actions

Drug interactions are both pharmacodynamic and pharmacokinetic. Pharmacodynamics concern the actions of two or more drugs and pharmacokinetics concern the absorption, distribution, metabolism, and/or excretion of one or more drugs affecting another. Interactions can be additive, synergistic, and antagonistic. Additive interactions…

More in course materials...


Sample 2

Anti-estrogenic drugs & breast cancer

Herbs that strengthen Qi, Blood, Jing and Kidney Yang should be used with caution because they may stimulate estrogen production. Careful diagnosis of the Yin and Yang balance and the Heart and Kidney communication is essential to treating patients who are taking anti-estrogenic drugs. It is recommended that these patients have their estrogen levels checked often.

Many tonic herbs have properties that reduce inflammatory responses, benefit the immune system, and encourage the production of red and white blood cells. These responses may be helpful for patients undergoing chemotherapy and radiation treatments.


Breast tissue is stimulated by estrogen
Breast cancer cells need estrogen to grow


Tamoxifen and aromatase inhibitors (Arimidex, Aromasin, Femara) are used to prevent recurrence of estrogen receptor-positive breast cancer in post-menopausal women.

Tamoxifen (Nolvadex, Istubal, Valodex) is an antagonist of estrogen receptors in breast tissue and is an agonist in the endometrium. It is used as a form of anti-estrogen therapy for breast cancer because some forms of breast cancer cells require estrogen to grow. Tamoxifen is an estrogen receptor agonist in bone and therefore inhibits osteoclasts. As a result, tamoxifen prevents osteoporosis.

One of the most serious side effects of tamoxifen use is uterine cancer due to its estrogen receptor agonist actions in the uterus. Tamoxifen may also cause cataracts.


Tamoxifen is estrogenic in the uterus
Raloxifene is anti-estrogenic in the uterus


Raloxifene (Evista) is often used in the treatment of breast cancer instead of tamoxifen because…

More in course materials…


Select Course


Sample 3

Beta-blockers, sedative/hypnotics, antidepressants, and insomnia

Use caution when combining beta blockers with calm spirit herbs due to potential slowing of the heart beat.

Calm spirit herbs combined with heat clearing and phlegm dissolving herbs may significantly improve the condition of patients suffering from mental disorders even though they are already taking medications. The additive and synergistic effects of the calm spirit herbs combined with improvements…

More in course materials…



Sample 4

Case I

A 80 year old male patient is taking a long-acting beta-blocker, metoprolol (Lopressor, Toprol XL), for his irregular heart beat. He is suffering from insomnia, constipation, and his tongue has a red tip and a dry coating. The pulse is small, slow and irregular.

Diagnosis:  Heart Yin deficiency with deficiency heat

The patient was given Bai Zi Ren (Semen Biotae Orientalis). His constipation resolved and his sleep improved significantly but his pulse slowed. Lowering the dosage of Bai Zi Ren (Semen Biotae Orientalis) returned the pulse to normal.

Bai Zi Ren (Semen Biotae Orientalis) lubricated his Large Intestine Yin, nourished the Heart Yin and calmed the mind while the lower dosage prevented the slowing of the heart beat.

More in course materials...


Select Course