Tedavi Amacıyla Kullanılan Bitkiler Ve Bitkisel Ürünlerin Yan Etkileri

Yıl 2009, Cilt: 66 Sayı: 3, 133 - 141, 01.09.2009

Solmaz Erdem Pınar Ata Eren

Öz

Son yıllarda çok sayıda kişi koruyucu ya da tedavi edici amaçlarla çeşitli bitki ve bitkisel ürünleri kullanmaktadır. Medyada yer alan eksik bilgilendirme, doğal olan her şeyin zararsız olduğu şeklinde yaygın bir inanışa yol açmaktadır. Halbuki “doğal olan her şey yararlıdır” düşüncesi yanlıştır. Bitkilerin içerdiği yüzlerce çeşit bileşene bağlı olarak beklenmedik yan etkiler gelişebilir. Bunun yanı sıra bazıları toksisite gösterebilir ya da alınan diğer ilaçlarla etkileşime girerek kişinin rahatsızlığının artmasına neden olabilirler. Bitkilerle tedavide görülebilecek yan etkilerin sağlık çalışanları ve tüketiciler tarafından bilinmesi gerekmektedir. Bu nedenle bu konudaki bilimsel çalışmalar arttırılmalı ve gerekli yasal düzenlemeler yapılmalıdır

Anahtar Kelimeler

Bitkilerle tedavi, yan etkiler, toksisite

Adverse Effects of Herbal Medicines and Products

Öz

Recently, many people have used various herbs and herbal products with the aim of protection from diseases or for curing them. The inaccurate information given by the media leads to a common belief that everything which is natural is harmless. Nevertheless, the idea of ‘everything is beneficial if it is natural’ is wrong. Depending on hundreds kinds of components which plants contain, there might be unexpected adverse effects. Besides, some plants could show high toxicity, or they may interact with the other medications and cause the condition of the individual to get worse. These should be known by health workers and consumers. Therefore, more scientific studies on this subject must be conducted and legal arrangements should be done

Anahtar Kelimeler

Herbal remedies, adverse effects, toxicity

Kaynakça

• Calixto JB. Efficacy,safety,quality control,marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents). Braz J Med Biol Res 2000; 33: 179-89.
• Pinn G. Adverse effects associated with herbal medicine. Aust Fam Physician 2001; 30: 1070-5.
• Peters D, Donaldson J, Chaussalet T, Toffa S, Whitehouse J, Carroll D, et al. Time for a new approach for reporting herbal medicine adverse events? Alternat Complement Therapies 2003; 9: 607-9.
• Ernst E. Herbal medicines: balancing benefits and risks. Novartis Found Symp 2007; 282: 154-67.
• Tomlinson B, Chan TY, Chan JC, Critchley JA, Butt PP. Toxicity of complementary therapies: an eastern perspective. J Clin Pharmacol 2000; 40: 451-6.
• NCAHF Home Page, NCAHF Position Paper on Overthe Counter Herbal Remedies 1995; www.ncahf.org, 25.04.2009.
• Van Breemen RB, Fong HH, Farnsworth NR. Ensuring the safety of botanical dietary supplements. Am J Clin Nutr 2008; 87: 5095-135.
• Means C. Selected herbal hazards. Vet Clin North Am Small Animal Pract 2002; 32: 367-82.
• Valerio LG Jr, Gonzales GF. Toxicological aspects of the South American herbs cat’s claw and Maca: a critical synopsis. Toxicol Rev 2005; 24: 11-35.
• Tatçı Ç, Şimşek S, Şengül M, Gez S. Teucrium chamaedrys ve Plantago major L.’nin antimikrobiyal aktiviteleri, I. Babadağ Sempozyumu, Bildiri Metinleri Kitabı PAÜ Yay. 1999; 117-124.
• Cecchini C, Cresci A,Coman MM, Ricciutelli M. Antimicrobial activity of seven Hypericum entities from central Italy. Planta Med 2007; 73: 564-6.
• Gözüm S, Arıkan D, Büyükavcı M. Complementary and alternative medicine use in pediatric oncology patients in eastern Turkey. Cancer Nurs 2007; 30: 38-44.
• Sibinga EM, Shindell DL, Casella JF, Duggan AK, Wilson MH. Pediatric patients with sickle cell disease: use of complementary and alternative therapies. J Altern Complement Med 2006; 12: 291-8.
• Ernst E, Pitler MH. Risks associated with herbal medicinal products. Wien Med Wochenschr 2002; 152: 183-9.
• Kuruvilla A. Herbal formulations as pharmacotherapeutic agents. Indian J Exp Biol 2002; 40: 7-11.
• Gianni LM, Dreitlein WB. Some popular OTC herbals can interact with anticoagulant therapy. US Pharmacist 1998; 23: 80-6.
• Almedia JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam (letter). Ann Intern Med 1996; 125: 940-1.
• Jappe U, Franke I, Reinhold D, Gollnick HP. Sebotropic drug reaction resulting from kava-kava extract therapy: a new entity? J Am Acad Dermatol 1998; 38: 104-6.
• Schelosky L, Raffauf C, Jendroska K, Poewe W. Kava and dopamine antagonism (letter). J Neurol Neurosurg Psychiatry 1995; 58: 639-40.
• Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997; 54: 692-3.
• Bush TM, Rayburn KS, Holloway SW, Sanchez-Yamamoto DS, Allen BL, Lam T, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007; 13: 30-5.
• Bhattaram VA, Graefe U, Kohlert C, Veit M, Derendorf H. Pharmacokinetics and bioavaibility of herbal medicinal products. Phytomedicine 2002; 3: 1-3.
• Street RA, Stirk WA, Van Staden J. South African traditiomedicinal plant trade: challenges in regulating quality,safety and efficacy. J Ethnopharmacol 2008; 119: 705-10.
• Fong HH. Integration of herbal medicine into modern medical practices: issues and prospects. Integr Cancer Ther 2002; 1: 287-93.
• Chan K. Some aspects of toxic contaminants in herbal medicines. Chemosphere 2003; 52: 1361-71.
• Ko RJ. A US perspective on the adverse reactions from traditional Chinese medicines. J Chin Med Assoc 2004; 67: 109-16.
• Cupp MJ. Toxicology and Clinical Pharmacology of Herbal Products. Humana Press, 2000.
• Molassiotis A, Xu M. Quality and safety issues of webbased information about herbal medicines in the treatment of cancer. Complement Ther Med 2004; 12: 217-27.
• Boullata JI, Nace AM. Safety issues with herbal medicine. Pharmacotherapy 2000; 20: 257-69.
• Haller C, Benowitz N. Adverse cardiovascular and central nervous system, events associated with dietary supplements containing ephedra alkoloids. N Engl J Med 2000; 343: 1833-8.
• Bent S, Tiedt T, Odden M, Shlipak M. The relative safety of ephedra compared with other herbal products. Ann Intern Med 2003; 138: 468-71.
• Bents R, Marsh E. Patterns of ephedra and other stimulant use in collegiate hockey athletes. Int J Sport Nutr Exerc Metab 2006; 16: 636-43.
• Bohn A, Khodaee M, Schwenk T. Ephedrine and other stimulants as ergogenic acids. Curr Sports Med Rep 2003; 2: 220-5.
• Calfee R, Fadale P. Popular ergogenic drugs and supplements in young athletes. Pediatrics 2006; 117: 577-89.
• Shekelle PG, Hardy ML, Morton SC, Maqlione M, Mojica WA, Suttorp MJ, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003; 289: 1537-45.
• Haller C, Duan M, Benowitz N, Jacob P. Concentrations of ephedra alkaloids and caffeine in commercial dietary supplements. J Anal Toxicol 2004; 28: 145-51.
• Gurley B, Gardner S, Hubbard M. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000; 57: 963-9
• Ernst E. Adverse effects of herbal drugs in dermatology. Br J Dermatol 2000; 143: 923-9.
• Woolf A, Watson W, Smolinske S, Litovitz T. The severity of toxic reactions to ephedra: comparisons to other botanical products and national trends from 1993-2002. Clin Toxicol 2005; 43: 347-55.
• Holmes RO, Tavee J. Vasospasm and stroke attributable to ephedra free xenadrine. Military Med 2008; 173: 708-10
• Powell T, Hsu FF, Turk J, Hruska K. Ma huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis 1998; 32: 153-9
• Ernst E, Rand JI, Barnes J, Stevinson C. Adverse effects profile of the herbal antidepressant St.John’s wort (H. perforatum L.). Eur J Clin Pharmacol 1998; 54: 589-94. http://www.fda.gov/bbs/topics/NEWS/2004/ NEW01021.html)..
• Schey KL, Patat S, Chignell CF, Datillo M, Wang RH, Roberts JE. Photooxidation of lens alpha-crystallin by hypericin (active ingredient in St.John’s wort). Photochem Photobiol 2000; 72: 200-3.
• Gordon JB. SSRIs and St.John’s wort:possible toxicity? (letter). Am Fam Physician 1998; 57: 950-3.
• Woelk H, Burkand G, Grunwald J. Benefits and risks of the Hypericum extract L1160: drug monitoring study with 3250 patients. J Geriatr Psychiatry Neurol 1994; (Suppl 1), S34-8.
• Golsch S, Vocks E, Rakoski J, Brochow K, Ring J. Reversible increase in photosensitivity to UV-B caused by St.John’s wort extract. Hautarzt 1997; 48: 249-52.
• Bove GM. Acute neuropathy after exposure to sun in a patient treated with St.John’s wort (letter). Lancet 1998; 352: 1121-2.
• Parker V, Wong AH, Boon HS, Seeman MV. Adverse reactions to St.John’s wort. Can J Psychiatry 2001; 46: 77-9.
• Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of G. biloba extract (letter). N Engl J Med 1997; 336: 1108.
• Matthews MK. Association of G. biloba with intracerebral haemorrhage (letter). Neurology 1998; 50: 1933-4.
• Rowin J, Lewis SL. Spontaneous bilateral subdural hematomas associated with chronic G. biloba ingestion. Neurology 1997; 48: 1137.
• Gilbert GJ. G. biloba (letter). Neurology 1997; 48: 1137.
• Meisel C, Johne A, Roots I. Fatal intracerebral mass bleeding associated with G. biloba and ibuprofen. Atherosclerosis 2003; 167: 367.
• Fong KC, Kinnear PE. Retrobulbar haemorrhage associated with chronic G. biloba ingestion. Postgrad Med J 2003; 79: 531-2.
• Galluzi S, Zanetti O, Binetti G, Trabucchi M, Frisoni GB. Coma in a patient with Alzheimer’s disease taking low dose trazodone and G. biloba. J Neurol Neurosurg Psychiatry 2000; 68: 679-83.
• Davydov L, Stirling AL. Stevens-Johnson syndrome with G. biloba. J Herbal Pharmacother 2001; 1: 65-9.
• Bejamin J, Muir T, Briggs K, Pentland B. A case of cerebral haemorrhage- can G. biloba be implicated? Postgrad Med J 2001; 77: 112-3.
• Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St.John’s wort, Ginseng, Echinacea, saw palmetto and kava. Ann Intern Med 2002; 136: 42-53.
• Ernst E. Cardiovascular adverse effects of herbal medicines: a systematic review of the recent literature. Can J Cardiol 2003; 19: 818-27.
• Ernst E. Serious psychiatric and neurological adverse effects of herbal medicines, a systematic review. Acta Psychiatr Scand 2003; 108: 83-91.
• Lanski SL, Greenwald M, Perkins A, Simon HK. Herbal therapy use in a pediatric emergency department population: expected to unexpected. Pediatrics 2003; 111: 981-5.
• Sool Mah JK, Barlow K, Hamwka L, Wirrell E. Use of complementary and alternative medical therapies in a pediatric neurology clinic. Can J Neurol Sci 2005; 32: 524-8.
• Martel D, Bussieres JF, Theoret Y, Lebel D, Kish S, Moqhrabi A, et al. Use of alternative and complementary therapies in children with cancer. Pediatr Blood Cancer 2005; 44: 660-8.
• McLean TW, Kemper KJ. Complementary and alternative medicine therapies in pediatric oncology patients. J Soc Integr Oncol 2006; 4: 40-5.
• Corns CM. Herbal remedies and clinical biochemistry. Ann Clin Biochem 2003; 40: 489-507.
• Little JW. Complementary and alternative medicine: impact on dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 137-45.
• Manocha A, Pillai KK, Husain SZ. Influence of G. biloba on the effect of anticonvulsants. Indian J Pharmacol 1996; 28: 84-7.
• Cupp MJ. Herbal remedies: adverse effects and drug interactions. Am Fam Physician 1999; 59: 1239-44.
• Aruna D, Naidu MU. Pharmacodynamic interaction studies of G. biloba with cilastazol and clopidogrel in helthy human subjects. Br J Clin Pharmacol 2006.
• Routledge PA. The European Herbal Medicines Directive: could it have saved the lives of Romeo and Juliet? Drug Saf 2008; 31: 416-8.
• Clement YN, Williams AF, Khan K, Bernard T, Bhola S, Fortune M, et al. A gap between acceptance and knowledge of herbal remedies by physicians: the need for educational intervention. BMC Complement Altern Med 2005; 5: 20.
• Silano M, De Vincenzi M, De Vincenzi A, Silano V. The new European legislation on traditional herbal medicines: Main features and perspectives. Fitotherapia 2004; 75: 107-16.
• Calapai G. European legislation on herbal medicines: a look into the future. Drug Saf 2008; 31: 428-31.
• Başaran N, Başaran A, Erol K, Gülbahar K, Cingi M İ, Güneş, HV, Erdem S: Salvia triloba yapraklarının diüretik etkilerinin araştırılması. VI. Bitkisel İlaç Hammaddeleri Toplantısı, Bildiri Kitabı G.Ü. Yay. No: 113, 1987; 375-30.
• Kırımer N, Tanrıverdi H, Başaran A, Timuralp G, Şimşek S, Başer K H C: Research into diuretic effect of Sideritis dichotoma Huter. FABAD J Pharm. Sci., 1996; 22: 101-3.
• Bağcı C, Ozansoy E, Şimşek S, Çakmak E A., Uyanık B S, Solak M, Yiğitoğlu M R: Keberenin (C. ovata Desf.) farelerde karaciğer enzimleri ile bazı kan parametreleri üzerine etkileri. Genel Tıp Derg., 1999; 9 : 123-5,
• Gez S, Şimşek S: Babadağ’ın tıbbi bitkileri, I. Babadağ Sempozyumu, Bildiri Metinleri Kitabı. PAÜ Yay., 1999; 128-35,
• Şimşek S, Çallı N, Gez S, Fıstık T: The effects of Capparis ovata Desf. on liver and kidney for long term administering in mice. Kocatepe Tıp Derg., 2000; 1: 101-3.
• Gez S, Şimşek S, Fıstık T, Şengül M, Arıkan N: Capparis ovata Desf’. nin analjezik ve antimikrobiyal etkileri yönünden bir ön çalısma, Kocatepe Tıp Derg. 2000; 1: 169-72.