They are marketed without FDA or other governmental premarketing review of efficacy or safety

There is also little governmental oversight of purity, variations in potency, or adverse effects

use:decrease duration and intensity of cold symptoms

nature: leaves and roots - contains flavonoids, polyacetylenes, and caffeoyl conjugates

Pharmacology: has cytokine activation and anti-inflammatory properties

Tox.: unpleasant taste and GI effects

- some dizziness or headache

- no drug interactions reported

use: treatment of respiratory ailments such as bronchitis and asthma, and as a CNS stimulant

nature:  major chemical constituents = ephedrine (which is Rx drug) and pseudoephedrine (which is OTC decongestants); The FDA has banned marketing of dietary supplements containing ephedrine alkaloids (they pose cardiovascular risk); The ban not applied to Chinese herbal remedies

Pharmacology: indirect-acting sympathomimetics that release norepinephrine from sympathetic nerve endings

- ephedrine is a pressor agent

- commonly used for treatment of respiratory dysfunction, including bronchitis and asthma, and a s mild CNS stimulants

- In Chinese medicine, used for cold and flu sx, diuresis, and bone or joint pain

- ephedirine alkaloids = weight loss and enhancement of althletic performance

Toxicity: dizziness, insomina, anorexia, flushing, palpitations, tachycardia, and urinary retention

- in high doses = ↑ BP, cardiac arrhythmias, and toxic psychosis

use: cholesterol lowering and atherosclerosis

Nature: contains organic thiosulfinates that can form allicin (this is the ODOR)

Pharmacology: - allicin inhibits hepatic hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase and angotensin-converting enzyme (ACE), blocks plately aggregation, increases nitric oxide (NO), in fibrinolytic, has antimicrobial activity, and reduces carinogen activation

- some evidence that it is more effective at lowering total cholestrol

toxicity: nausea, hypotension, and allergic reactions may occur

- antiplatelet action - so watch patients on anticoags or anti antiplatelets

use: treatment of intermittent claudication, and cerebral insufficiency and dementia

nature: leaves = flavone glycosides and terpenoids

pharmacology: -anti-oxidant and radical scavenging effects and increases nitric oxide formation

- animal studies: blood viscosity and changes in CNS neurotransmitters

- may reduce markers of oxidative stress associated with coronary artery bypass surgery

toxicity: GI effects, anxiety, insomina, and headache occur

- possible antiplatelet action, so monitor pts on anticoags or antiplatelet druggs

- maybe epileptogenic - don't give to those with seizure hx

use: improvement of physical and mental performance

nature: plants = triterpenoid saponin glycosides (except the Siberian or Brazilian plants)

pharm.: - COLD prevention and lowering postprandial glucose

toxicity: estrogenic effects = mastalgia and vaginal bleeding

- insomina, nervousness, hypertension

- use with CAUTION in pts receiving anticoags, antihypertensives, hypoglycemic meds, and psych meds

use: limitation of hepatic injury and as an antidote to Amanita mushroom poisoning

nature: fruit and seeds = contain flavonolignans such as silymarin

pharm.: in vitro studies = reduces lipid peroxidation, scavenges free radicals, enhances superoxide dismutase, inhibits formation of leukotrienes, and icnreases heptocyte RNA polymease activity

Tox: loose stools

use: treatment of mild to moderate depression

Nature: dried flowers = hypericin and hyperforin

Pharm. Hyperforin = decreased activity of serotonergic reuptake systems

- downregulation of adrenoceptors and upregulations of 5-HT receptors

- hypericin, when photoactivated, may have antiviral and anticancer effects

Tox.: mild GI effects and photosensization

- avoid in pts taking selective serotonin reuptake inhibitors or MAO inhibitors and those with history of bipolar or psychotic disorder

- formation of P450 isoforms and P-glycoprotein drug transporters

- it decreases the effectiveness of:

* birth control pills

* cyclosporine

*digoxin

*HIV protease inhibitors

*warfarin

use: improvement in sx of benign prostatic hyperplasia

nature: dervied from berries = contains phytosterols, aliphatic alcohols, polyprenes, and flavonoids

pharm: inhibition of 5alpha-reductase

tox: abdominal pain with GI distress, decreased libido, headache, and htn; no effect on PSA

use: improvement of ischemic heart disease and for Parkinson's disease

nature: ubiquinone = benzoquinone; serves as cofactor in the mitochondrial electron transport chain --> reduced to ubiquinol (an important antioxidant)

pharm: small degree of efficacy in reducing systolic and diastolic blood pressure and in treating coronary artery disease and chronic stable angina

- may have some efficacy in reducing muscle pain in patients with statin-related myopathy

tox: GI distrubances; rare effects include rash, thrombocytopenia, irritability, dizziness, and headache

- structural similarity to vitamin K and decrease the effects of warfarin

use: reduction of pain associated with osteoarthritis

nature: amino sugar that serves as the precursor of nitrogen-containing sugars (major constituent of CT, including the carilage in joints)

pharm: trials = mixed results

toxicity: occasionally cause diarrhea and nausea but otherwise is well tolerated

- it is prepared from crustaceans, there is some concern about cross-allergenicity in people with shellfish allergy

use: decrease jet lag symptoms and a sleep aid

nature: a serotonin derivative produced in pineal gland - regulates sleep wake cycles;

- other purported activities include contraception, prevention of aging, protection against oxidative stress, and the treatment of cancer, major depression, and HIV infection

pharm: FDA approved for insomnia

tox: sedation and next-day drowsiness and headache

- can suppress the midcycle susrge of luteinizing hormone (LH)

- DO NOT USE IN PREGNANCY or women attempting to conceive

- decrease prolactin levels = should not be used by nursing mothers

- can decrease sperm levels in healthy men