Acupuncture Continuing Education

Safety in Herb-Drug Combinations #3

Sample of Course Materials

Medications

 

 

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Sample of Course Materials:

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 are those wherein the effects of two or more chemicals taken together is equal to the sum of taking them separately. Synergistic interactions occur when taking two or more substances together results in a stronger action than the sum of taking them separately. The substances increase each others’ effects. Antagonistic interactions are when taking substances together weakens their overall effect.

Chinese Medicine (CM) uses differential diagnosis in determining the appropriate herbs. Herbal choices are based on the functions of the individual herbs and the overall function of a formula. When patients consume western medications with herbs, care must be taken not to alter the effects of the western medicine such that adverse reactions...   (more in course materials...)

 

 

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Sample #2:

Raise blood pressure & increase heart beat drugs

Medications may be used to intentionally raise blood pressure, heart beat rate, and strengthen contractility or these very same effects may be the adverse effects of medications and are undesirable consequences. Herbal medicine may serve to assist the functions of the medications in a synergistic or additive function or they may serve to quell the unwanted side effects of medications. Additionally, herbal medicine may have antagonistic effects thereby reducing the functional power of the medications.

Herbs that warm the interior and strengthen Kidney Yang and Qi must be used with caution when patients take drugs that raise the blood pressure or increase heart contractility (force of contraction). The herbs and the drugs have similar functions and therefore may have a synergistic or additive effect when combined. Care must be taken with the tonic herbs as not to induce tachycardia or...  (more in course materials...)

 

 

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Sample #3:

Patients taking drugs that raise blood pressure and heart contractility should use caution if taking alpha-agonists such as pseudoephedrine (Sudafed). It is an agonist at alpha and beta adrenergic receptors which causes the release of endogenous norepinephrine (noradrenaline). It is known for causing vasoconstriction.

Pseudoephedrine also occurs in its natural form, ephedrine, in Ma Huang (ephedra). Caution is indicated when using Ma Huang with patients taking pseudoephedrine due to synergistic and...  (more in course materials...)

 

Sample #4:

Fu Zi (RadLateralis Aconiti Carmichaeli) strengthens the devastated Yang and benefits the Qi and Yang. It is toxic and is contraindicated during pregnancy. Use extreme caution with patients who have a history of cardiovascular disorders or are taking antiarrhythmic drugs.

Overdose of Fu Zi may be treated with Rou Gui if taken within the first several hours. The Rou Gui tea induces vomiting within approximately 15 minutes and the toxin is expelled. Overdose symptoms include tremors, numbness of the lips, mouth, and tongue; irregularities of the heat rate and rhythm, excess salivation, nausea, dizziness, vomiting, diarrhea, difficulty breathing, and decreased blood pressure. Overdose may be fatal...  (more in course materials...)

 

Sample #5:

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...  (more in course materials...)


Drug

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...  (more in course materials...)

 

 

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Sample #6:

Herbs

Ren Shen (Radix Ginseng) strengthens the source Qi and calms the Shen. Ren Shen enhances the immune system and strengthens patients undergoing chemotherapy who suffer from leukopenia. It is used to strengthen the patient so that they may endure the chemotherapy.

Ren Shen is known to be an immunostimulant and raises the total count of IgM. IgM (Immunoglobulin M) is an antibody and appears early in response to infections. Antibodies are produced by the immune system when foreign antigens are introduced into the body. The antibodies kill or neutralize the antigen.

Shu Di Huang (Radix Rehmanniae Glutinosae Conquitae) and Sheng Di Huang (Radux Rehmanniae Glutinosae ) nourish the blood, Yin and Jing. Shu Di Huang is stronger at nourishing. Shen Di Huang cools the heat in the blood. Sheng Di Huang increases levels of adrenocortical hormone which may be partially responsible for its anti-inflammatory effects.

Dang Gui (Radix Angelicae Sinensis) promotes blood circulation and nourishes the blood. Combined with Huang Qi (Radix Astragali), it helps to raise the RBC (red blood cell) and WBC (white blood cell) counts in patients undergoing chemotherapy.

Lu Rong (Cornu Cervi Parvum) strengthens the Kidney Yang and Jing. Lu Rong increases levels of RBCs when used for a long duration.

Ge Jie (Gecko) warms the Kidney Yang and nourishes Kidney Jing. Ge Jie increases levels of adrenocortical hormone and white blood cells. Ge Jie increases the phagocytic activity of macrophages...  (more in course materials...)

 

 

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