Pharmacist's Letter Continued!

For those of you in the UA course, I presented info from the pharmacist's letter database on turmeric. The database is designed to show any info that is related to medications including natural supplements that allow pharmacists to convey information including interactions, safety, and effectiveness. Recall that turmeric is only possibly safe when used orally or topically in medicinal amounts and likely safe when used in amounts commonly found in food. I found similar information using the same database regarding the scientific article from last Monday where they tested several active spice-derived components and how effective they were at being anti-inflammatories. This may be a long blog so sorry in advance. I just found it really interesting. I tried to bold anything related to inflammation to bring attention to them.

1. Black Mustard (allyl isothiocyanate)
-Uses: the oil is used for the common cold, rheumatism and osteoarthritis; orally - used to induce vomiting, a diuretic, and an appetite stimulant; topically - pneumonia, osteoarthritis, aching feet, and as a counterirritant (something that causes inflammation in one area to lessen it in another)
-Safety: likely safe when used orally in the amounts commonly found in foods; there is insufficient reliable information available about the safety of black mustard when used orally or topically for medicinal purposes
-Effectiveness: There is insufficient reliable information about the effectiveness of black mustard
-Mechanism of action: applicable part are the seed, oil, leaf, and powder; the powder contains glucosinolate sinigrin, which produces allyl isothiocyanate when mixed with warm water that has strong antimicrobial (bacterial and fungal) properties and can act as a counterirritant when diluted; seed, oil, and powder can have powerful irritant properties that can cause pain and increase inflammation of the skin
-Interactions with Herbs & Supplements, Drug, Foods, Lab Test, and Disease or Conditions - None known
-Adverse Reactions: Large amounts orally - vomiting, stomach pain, diarrhea, cardiac failure, breathing difficulties, coma, and possibly death
-The interesting thing I found was that this drug is such a potent so when applied topically for too long (longer than 10 minutes), it can lead to severe skin irritation and even burns and the concentrations as a counterirritant is 0.5% to 5% and used 3-4 times a day

2. Garlic (diallyl disulfide)
-Uses: hypertension, hyperlipidemia, coronary heart disease, earaches, chronic fatigue syndrome, prevention of colon cancer and other cancers of the breast, lung, prostrate, and bladder, osteoarthritis, allergic rhinitis, colds, flu, TB, whooping cough, and a lot of other random things; topically - oil is used for scalp diseases and vaginitis
Safety: Likely safe when used orally and appropriately; has been used safely in clinical studies lasting up to 7 years without significant toxicity; possibly unsafe when used topically - can cause severe skin irritation; possible safe for children in appropriate oral amounts and possibly unsafe in large amounts; pregnancy - likely safe when used orally in amounts commonly found in foods; possibly unsafe - orally in medicinal amounts
-Effectiveness: possibly effective to treat atherosclerosis at 300 mg per day, some evidence associated with decreasing the risk of developing stomach cancer, and come clinical research shows that taken orally, garlic can modestly reduce blood pressure
-Mechanism of action: bulb mostly used as an antihyperlipidemic, antihypertension, antifungal, and has also been reported to have antibacterial, antihelmintic, antiviral, antispasmodic, antithrombotic, and an immunostimulant
-Based on this info and other info that I found off the database, I didn't find any clinical evidence that suggests that garlic has no evidence of having anti-inflammatory properties. If it did, this database would discuss it because it talks about everything related in clinical terms regarding supplements.

3. Ginger (zingerone)
-Uses: Orally - motion sickness, morning sickness, dyspepsia, rheumatoid arthritis, loss of appetite, osteoarthritis, migraines, headache, anorexia, cough, bronchitis, stomachache, and others; Fresh ginger - orally for malaria, rheumatism, and toothaches
-Safety: likely safe - when used orally and appropriately; has been used in clinical trials (includes trial info in the database)
-Effectiveness: can reduce severity of nausea and vomiting in pregnant patients and postoperative patients and insufficient reliable evidence to treat chemo-induced nausea and vomiting; preliminary evidence shows modest benefits in OA - extract at 170 mg a day three times daily for 3 weeks is effective in reducing pain; some preliminary evidence shows that ginger might help in decreasing joint pain in patients with RA
-Mechanism of action: pharmacological properties - antipyretic, analgesic, anti-inflammatory, sedative, antibiotic, and other properties

4. Black Pepper (piperine)
-Uses: stomach upset, bronchitis, and cancer
-Safety: Likely safe when used orally in amounts commonly found in foods; possibly safe when used orally and appropriately in medicinal amounts; black pepper oil is used topically and is nonirritating and typically well tolerated; likely safe in children, pregnancy, and lactation
-Effectiveness: Insufficient reliable information about the effectiveness of black pepper
-Mechanism of Action: a typical diet provides 360 mg of black pepper provides about 60-110 micromolar of piperine that seems to increase oral absorption of drugs and other substances
-There doesn't seem to be much clinical evidence that black pepper works as an anti-inflammatory

In conclusion, only two out of the four anti-inflammatory agents mentioned in the article seem to have any clinical evidence. It will be interesting to see if new research sheds any more light on black pepper and garlic.