Community Health Nursing Lecture

DRUG STUDY:
HERBAL MEDICINES
RA: 8423: Traditional and Alternative Medicine Act (TAMA) of 1997
 Mechanism of Action
The active ingredients exist in the volatile oil, made from the leaves of
SAMBONG (Ngai camphor) sambong which have mostly camphor and limnene; but also has traces of
Blumea balsamifera borneol, saponin, sesquiterpene and tannin.
The camphor in sambong is what typically causes diuresis by increasing
the amount of fluid excretion from the body

Indications
It is an anti-urolithiasis and works as a diuretic.
It functions as an astringent and an expectorant, and has found to have
anti-diarrhea and anti-spasm effects
As an astringent, preparations made of sambong leaves may be used for
wounds and cuts.
The National Kidney and Transplant Institute has promoted the use of this
herbal medicine for many renal patients to avert or delay the need for
dualusis or organ transplantation.

Dosage
Grows in moderately moist partial
grasslands soil at all times light

“Bukadkad or Gabon” 1 glass of solution (240 ml/day) divided into three doses (80 ml).
3 tablespoons (7-12 years old) of minced Sambong leaves
6 tablespoons (13 years old and above) of minced Sambong leaves
Precaution
Sambong use is generally considered safe.
Special precautions and warnings: Drug Classification
Pregnancy and breastfeeding: Not enough is known
Therapeutic: Diuretic, antiuricemic
about the use of sambong during pregnancy and
Pharmacologic: calcium oxalate
breastfeeding, so pregnant and lactating mothers
crystallization inhibitors
should refrain from drinking it.
Pregnancy: C

Interaction
Drug-to-drug: Avoid taking with other diuretics.
Food-to-drug: None known.

Side effect
itching
Skin Irritation
Nursing responsibilities:
Assess patient’s vital signs regularly and watch out for hypotension and dehydration.
R: Patients taking diuretics are prone to decreased fluid volume due to fluid loss.

Instruct patient to monitor urine output.

R: Checks if the herbal drug is effective and to prevent dehydration.

Instruct patient to rise slowly from lying position to standing.

R: Orthostatic hypotension may happen as a result from severe fluid loss.

Suggest patient to divide one glass of sambong solution into 3 doses, taken TID.
R: Helps prevent severe diuresis and avoid drug overdose.

Encourage patient to take food high in potassium, such as Bananas.

R: Taking potassium-rich food helps prevent hypokalemia due to increased electrolyte excretion.
Tsaang gubat (Wild tea) Mechanism of Action
Carmona retusa Studies of tsaang gubat leaves showed a mixture of triterpenes: a-amyrin.
B-amyrin, and baurenol, which accounts for its wide activity, especially in
its anti-diarrheal effect.
Prevents release of histamines from the mast cells, which helps in
preventing allergic reactions and inflammation.

Indications
Medication taken as tea to treat skin allergies, including eczema, scabies,
itchiness, and wounds in childbirth.
Effective in treating intestinal motility
Used as a mouthwash since the leaves have high fluoride content.

Grows in moderately moist partial

Dosage
grasslands soil at all times light
1 glass of solution (240 ml/dose)
“Chaang Bundok” 1 1/2 tablespoons (7-12 years old) of minced Sambong leaves
3 tablespoons (13 years old and above) of minced Sambong leaves
Not recommended for children below 7 years old
Precaution Drug Classification
Therapeutic: Antispasmodic, caries-preventive,
Tsaang gubat use is generally considered safe. anti-diarrheal
Special precautions and warnings: Pharmacologic: H1 histamine receptor
Pregnancy and breastfeeding: Not enough is known antagonist
about the use of Tsaang gubat during pregnancy and Pregnancy: C
breastfeeding, so pregnant and lactating mothers
should refrain from drinking it.

Interaction
Drug-to-drug: Increased anti-allergenic effect if taken
alongside lagundi and sambomg.

Side effect
No research data available.
Nursing responsibilities:
Assess and monitor patient’s stomach pain level and fecal output.
R: To determine the effectiveness of the medicine, and assess

Instruct patient to consult physician immediately when stomach pain worsens.

R: There might be an untoward reaction to the drug, or the root of the pain is a different disease.

Instruct patient to maintain an adequate fluid and electrolyte intake daily.

R: Diarrhea can cause severe electrolyte loss, which can cause dehydration.

Educate patient on anti-allergenic properties of tsaang gubat + lagundi + sambong

R: Helps empower the patient and gives further knowledge on the drug.

Encourage patient to eat foods rich in fiber, such as oats or vegetables.

R: Fiber-rich foods help prevent diarrhea by adding bulk to the stool, and normalizing bowel movements.
Akapulko (Senna alata) Mechanism of Action
Cassia alata
Contains chrysophanic acid, a fungicide used to treat fungal infections.
This includes: ringworms, scabies, and eczema.
Flowers and leaves contain medicinal properties.
Can be used as diuretic and purgative agent (leaves).

Indications
Treatment for skin disease
Tinea infections, insect bites, ringworm, eczema, scabies, and itchiness.
Treatment for intestinal problems through decoction process.
Treatment for hypertension.
Wound healing agent.

Grows in moderately moist partial

grasslands soil at all times light
Dosage
“Katanda or Palochina” Apply to skin topically at least twice a day.
Apply daily within 3 weeks to completely kill the fungus.
Precaution
Akapulko use is safe for use, especially for adults. Drug Classification
Consult a physician first before using Akapulko if taking Therapeutic: Antifungal, broad-spectrum
anti-hypertensive medications. antibiotic
Special precautions and warnings: Pharmacologic: Cell wall synthesis inhibitor
Pregnancy and breastfeeding: This may induce preterm Pregnancy: C (topical); X (Oral)
labor or even abortion if taken orally. Thus, this is not
recommended for pregnant and lactating mothers for
oral use.

Interaction
Drug-to-drug: Can cause increased anti-coagulant and
anti-hypertensive medication effects.

Side effect
None (Topical)
Pregnancy labor (Oral)
Nursing responsibilities:
Assess the patient for pregnancy, if for oral use.
R: Akapulko can induce labor for pregnant women and can lead to abortion.

Assess patient's medical history, and check for any history of hypertension.
R: Effect of hypertensive medicines can be increased when taking oral akapulko.

Instruct patient to immediately stop topical akapulko when skin irritation happems.
R: Irritation is one of the signs of sn untoward reaction to the drug component.

Educate the patient that akapulko plant may aggravate grave symptoms of lupus.
R: Akapulko contains canavanine, an amino acid that may aggravate symptoms of autoimmune diseases.

Instruct the patient to consult a physician if skin infection worsens or persists.

R: The causative agent of the infection may be viral, or the infection has worsened, requiring medical
attention.
Ampalaya (Bitter gourd) Mechanism of Action
Momordica charantia
Increases the production of beta cells by the pancreas. Thus, improving the
body's ability to produce insulin which controls the blood sugar for
diabetics
Best way to eat is by consuming the leaves raw by decoction process. •
Leaves can be used as a tea or salad dressing

Indications
Treatment for type II diabetes
Has antioxidant properties and rich in vitamins A and C
Good for the eyes because of vitamins A
Reduces anti-aging possess and also reduces skin blemishes
Prevents hair loss, dandruff, and split-ends.
Grows in moderately moist partial

Dosage
grasslands soil at all times light

“Amargoso”
6 tablespoons in 2 glassfuls of water
1/3 cup TID PC
900 mg Ampayala fruit OD divided into TID
Precaution
Ampalaya is safe for use, especially for adults. Drug Classification
Excessive amounts may cause hypoglycemia and Therapeutic: Antimetabolic syndrome,
excessive ingestion of seeds may cause comatose. antidiabetes
Special precautions and warnings: Pharmacologic: Gluconeogenesis inhibitor
Pregnancy and breastfeeding: Ampalaya may cause Pregnancy: C
mild uterine stimulation during pregnancy. Take only in
small amounts after checking with the physician.

Interaction
Drug-to-drug: Can cause increased effects of diuretic
medicines.

Side effect
Abdominal pain and diarrhea
Headache, and fever
Hypoglycemia
Nursing responsibilities:
Assess patient’s blood sugar level before and after taking ampalaya extract
R: One side effect of ampalaya is hypoglycemia, and to check effectiveness of the drug.

Caution should be observed in the dosing of the medicine

R: Ampalaya can be toxic in large doses, mainly due to hypoglycemia.

Check patient’s current medical history, especially pregnancy.

R: Excessive doses of ampalaya can cause unintended abortions and preterm labor.

Instruct the patient to not cover the pot and to cool and strain during preparation.
R: Covering the pot during concoction lowers evaporation rate and retains volatile compounds.

Instruct the patient to avoid taking ampalaya with diuretics.

R: Ampalaya can increase diuretic effects of certain medications due to its natural diuretic effect.
 Mechanism of Action
Niyog-niyogan (RANGOON CREEPER)
Quisqualis indica Seeds contain L-quisqualic acid which causes paralysis of the anterior part
of the worm where the CNS is located, while stimulating the posterior part.
Deprives coordinating impulse coming from the central nerve ring which
causes the parasite to not maintain its position on the host gut, and can be
expelled by giving purgatives.

Indications
Eliminate intestinal worms including Ascaris lumbricoides and Trichinella.
Treatment for kidney inflammation, boils and skin ulcer, diarrhea and fever,
dysuria, and anticancer.

Grows in moderately moist partial

Dosage
grasslands soil at all times light
Dosage of seeds to eat based on patient’s age: 4-5 seeds (4-6 years old); 6-
“Lubi-lubi” 7 seeds (7-12 years old); 8-10 seeds (13 years old and above)
If there is still no worm that came out during a bowel movement, you may
use the same dosage after 1 week.
Precaution
Niyog-niyogan use is generally safe for use.
Some people may also experience allergic reactions to the
Drug Classification
plant. Stop intake if skin rashes, ankle swelling, and fever Therapeutic: Antihelminthic
happens. Pharmacologic: Ganglion-stimulant
Special precautions and warnings: (Cholinomimetic)
Pregnancy and breastfeeding: Not enough is known Pregnancy: C
about the use of niyog-niyogan during pregnancy and
breastfeeding, so pregnant and lactating mothers
should refrain from drinking it.

Interaction
Drug-to-drug: No research data available yet.

Side effect
Hiccups
Diarrhea and abdominal pain
Nausea and vomiting
Nursing responsibilities:
Ask patient for any allergies to the drug, perform skin test if possible.
R: To prevent life-threatening anaphylactic eosinophilia reactions

Watch out for any signs of anaphylaxis, like fever, rashes, and swelling of the ankle.
R: Prompt response helps prevent further complications, and provides immediate treatment.

Administer pain medications as needed, especially for abdominal pains

R: Inflammatory response in the GI tract to the parasites may cause abdominal pain.

Instruct the patient to follow recommended dosage.

R: Overdose may cause abdominal distention and diarrhea.

Instruct the patient to continue the regimen after 1 week if no worm came out.
R Helps ensure that no parasites in the intestines survive the medication.
 Mechanism of Action
Asthma
Inhibition of leukotriene production which leads to bronchodilation.
Lagundi (five leaved chase tea) Analgesic
Vitex negundo Anti-inflammatory and pain suppressing activities mediated through PG
synthesis inhibition, antihistamine, membrane stabilizing and
antioxidant activities.

Indications
Asthma
Cough and fever
Dysentery
Skin diseases (Dermatitis, scabies, ulcer, eczema)
Headache
Rheumatism
Aromatic bath for sick patient

Grows in
grasslands
moderately moist
soil at all times
partial
light
Dosage
Boil at least half a cup of Lagundi leaves in 2 cups of water. Drain the liquid and
“Tagabawa” take ½ cup of the decoction 3 times a day.
For adults, you can take half a cup 3 times a day. Children or babies can be given
one tablespoon 3 times a day. For children aged 2 to 6 years old, two tablespoon
3 times a day, and for those aged 7 to 12 years old, ¼ cup 3x a day is
recommended.
Precaution
Lagundi is generally safe for use. Drug Classification
Some people may also experience allergic reactions to the
plant. Stop intake if pruritus and swollen lips occur. Therapeutic: Anti-asthma, Analgesic
Special precautions and warnings: Pharmacologic: Leukotriene inhibitor, PG
Pregnancy and breastfeeding: Moderate use is synthesis inhibitor
recommended for pregnant women and treatment Pregnancy: B
should not exceed one week.

Interaction
Drug-to-drug: No research data available yet.

Side effect
Nausea and vomiting
Nursing responsibilities:
Assess the patient’s type of cough, if dry or wet.
R: Lagundi is a natural antitussive, suppressing the urge to cough; suppressing mucus can lead to pneumonia.

Pound the leaves and apply on wounded part for wound care.
R: Lagundi contains anti-inflammatory and analgesic properties that can help in pain relief.

Instruct patient to decoct leaves in 2 glasses of water in 15 minutes.

R: Decocting for 15 minutes allows the chemical of the herb to dissolve into the solution.

Instruct patient to immediately stop if pruritus or swelling of the lips occur.

R: Pruritus and swelling are signs of allergies. Prompt response avoids complications, such as anaphylaxis.

Instruct the patient to consult a physician if the cough persists after lagundi regimen.
R A stronger dose or type of medicine may be needed or the patient needs a different type of medicine.
uLASIMANG BATO (Shiny bush)
Peperomia pellucida
Mechanism of Action
Pansit-pansitan contains tannins, flavonoids, triterpenoids, and steroids,
which contribute to its effectivity against inflammation, seen in arteritis and
gout.

Indications
Treatment of Arthritis and Gout
Lowers uric acid levels

Dosage
1 & 1/2 cup of leaves decocted in 2 glassfuls of water.
Grows in moderately moist partial
grasslands soil at all times light Divide 1 glass of solution into 3 parts; taken AC TID

“Pansit-pansitan”
Precaution
Ulasimang bato is generally safe for use.
People with hypersensitivity to the plant’s compounds may Drug Classification
experience asthma-like symptoms.
Therapeutic: Anti-arthritis, anti-gout
Special precautions and warnings:
Pharmacologic: Uric acid production inhibitor
Pregnancy and breastfeeding: Not enough is known Pregnancy: C
about the use of Ulasimang bato during pregnancy and
breastfeeding, so pregnant and lactating mothers
should refrain from drinking it.

Interaction
Drug-to-drug: Increases effects of pain reliever
medications, and diuretic effects (pre-clinical).

Side effect
No research data available yet,
Nursing responsibilities:
Assess patient’s blood serum uric levels before and after intake.
R: Helps assess the effectiveness of the drug.

IInstruct patient to immediately stop intake if allergic reactions occur.

R: Prompt response helps prevent further complications, and provides immediate treatment.

Prepare anti-asthma medications and apparatuses, if allergic reaction occurs.

R: Prompt response helps relieve respiratory distress and prevents complications.

Instruct patient to decoct leaves in 2 glasses of water in 15 minutes.

R: Decocting for 15 minutes allows the chemical of the herb to dissolve into the solution.

Instruct the patient to not cover the pot and to cool and strain during preparation.
R: Covering the pot during concoction lowers evaporation rate and retains volatile compounds.
 Bawang (Garlic)
Allium sativum Mechanism of Action
Reduction of serum cholesterol level by deactivating HMG-CoA reductase
via enhances phosphorylation.
Anti-hypertensive by producing nitric acids which triggers pathways leading
to muscle relaxation, leading to vasodilation and BP reduction.

Indications
Lowers serum cholesterol levels
Treatment for tooth pain
Treatment for hypertension.

Dosage
Grows in moderately moist partial
grasslands soil at all times light 2-3 garlic bulbs (soaked in vinegar, sterilized, grilled, or fried in a little oil) 3 times
a day with breakfast, lunch, and dinner.
“Ahos”
Precaution
Can cause burning of the mouth, stomach sweating,
lightheadedness.
Increases risk of bleeding problems (has properties of Drug Classification
blood thinner. Therapeutic: Anti-hypertensive, Anti-
Risk for overproduction of nitric oxide; angiogenesis, hyperlipidemia
mitochondrial dysfunction, and heart failure. Pharmacologic: LDL oxidation inhibitor
Special precautions and warnings: Pregnancy: B
Pregnancy and breastfeeding: Safe during pregnancy
but with caution.

Interaction
Drug-to-drug: Reacts with warfarin, antiplatelets,
saquinavir, antihypertensives, calcium channel blockers,
and hypoglycemic drugs.

Side effect
Vomiting
Heartburn
Halitosis
Allergies and contact dermatitis
Asthma
Nursing responsibilities:
Assess patient’s medication history
R: Helps assess and watch out for potential adverse effects due to drug interactions.

IInstruct patient to immediately stop intake if allergic reactions occur.

R: Prompt response helps prevent further complications, and provides immediate treatment.

Instruct patient to not take garlic with blood thinning medications.

R: Garlic can intensify effects of blood thinners, making the patient prone for bleeding.

Educate patient to blanch, soak in vinegar, or cook the garlic.

R: Helps prevent burning of the mouth, or lessen the spiciness of the garlic.

Monitor nitrate oxide levels if overdosing occurs.

R: High nitrate oxide levels are associated with asthma attacks due to airway inflammation.
 Bayabas (Guava)
Psidium guajava Mechanism of Action
Inhibits microbacterial growth
Removes extra mucus from the intestines
Contains fiber that increases bulk of the stool.

Indications
Treatment for Gingivitis
Rotaviral and Bacterial infections
Treatment for acute diarrhea
Washing wounds

Dosage
Grows in moderately moist partial
grasslands soil at all times light Boil 1 or 2 handfuls of leafy tops of guavas
Not enough scientific information to determine an appropriate range of doses for
“Pidgin, binayabas” guava
Precaution
Bayabas is generally safe for use.
Overdose may cause constipation. Drug Classification
Special precautions and warnings:
Therapeutic: Anti-diarrheal, antiseptic
Pregnancy and breastfeeding: Not enough is known
Pharmacologic: Histamine antagonist
about the use of Bayabas during pregnancy and Pregnancy: C
breastfeeding, so pregnant and lactating mothers
should refrain from drinking it.

Interaction
Drug-to-drug: Increases effects of anti-diarrheal drugs.

Side effect
Nausea and vomiting
May exacerbate eczema
Stomach pain
Nursing responsibilities:
Assess and monitor patient’s stomach pain level and fecal output.
R: To determine the effectiveness of the medicine.

Assess patient’s wound healing process using the REEDA scale.

R: Helps in monitoring and identifying the level of infection.

Instruct patient to take guava with other diarrheal drugs.

R: Guava is rich in fiber and can help in providing bulk in the feces.

Instruct patient to maintain an adequate fluid and electrolyte intake daily.

R: Diarrhea can cause severe electrolyte loss, which can cause dehydration.

Instruct patient to stop guava intake when bowel movements have returned.
R: Stopping when bowel movements have returned helps avoiding constipation.
 Mechanism of Action
Plant yields a volatile oil .22% containing pulegone, menthol, menthene,
Yerba buena (peppermint) menthenone, and limonene, with menthol having the highest component of
Mentha cordifolia the volatile oils.
Menthol provides potent analgesic action and is used externally in
rheumatism, neuralgia, and headaches.

Indications
Headache
Stomachache
Rheumatism and gout
Coughs, colds and insect bites

Dosage
Decoct yerba buena in a pot filled with 2 glasses of water until only left with half
Grows in moderately moist partial glass of solution.
grasslands soil at all times light
Divid into 2 portions. Drink 1 portion, and drink another 1 portion after 3-4 hours if
the pain still persist.
“Herba buena”
Based on patient’s age: 3 tablespoons (7-12 years old); 6 tablespoons (13 years
old and above)
Precaution
Yerba Buena is generally safe for use.
Studies shown that Yerba Buena does not contain any Drug Classification
ingredient that can harm the body.
Therapeutic: Analgesic
Special precautions and warnings:
Pharmacologic: TRPM8 receptors agonist
Pregnancy and breastfeeding: Not enough is known Pregnancy: C
about the use of Yerba Buena during pregnancy and
breastfeeding, so pregnant and lactating mothers
should refrain from drinking it.

Interaction
Drug-to-drug: No research data available yet.

Side effect
Nausea and vomiting
May exacerbate eczema
Stomach pain
Nursing responsibilities:
Assess and monitor patient’s pain level before and after administration
R: To determine the effectiveness of the medicine.

Ask patient to consult a physician first before taking yerba buena.

R: Pain reliever can mask the true nature of a disease.

Instruct patient to take another 1 portion after 3-4 hours only if pain still persists
R: Helps avoid drug overdose and possible adverse reactions.

Instruct patient to decoct leaves in 2 glasses of water in 15 minutes.

R: Decocting for 15 minutes allows the chemical of the herb to dissolve into the solution.

Instruct patient visit a health center and consult if illness still persists.
R: More potent dosage may be needed or the drug regimen needs to be changed.
References
Boy, H. I. A., Rutilla, A. J. H., Santos, K. A., Ty, A. M. T., Yu, A. I.,
Mahboob, T., Tangpoong, J., & Nissapatorn, V. (2018). Recommended
medicinal plants as source of natural products: a review. Digital
Chinese Medicine, 1(2), 131–142. https://doi.org/10.1016/s2589-
3777(19)30018-7

Cadiz, M. R. (2022). Herbal medicine list. Hello Doctor.

https://hellodoctor.com.ph/herbals-and-alternatives/herbal-
medicines/herbal-medicine-list/

Department of Health (n.d.). Directory of herbs.

https://pitahc.gov.ph/directory-of-herbs/

Herbal medicine plants approved by the DOH (2017, July 4). RNpedia.
https://www.rnpedia.com/nursing-notes/community-health-nursing-
notes/herbal-medicine-plants-approved-doh/

Zabat, P. M. (2014). 10 Doh approved medicine.

Slideshare.https://www.slideshare.net/lopao1024/10-doh-approved-
herbal-medicine-pm-zabat
Community Health Nursing Lecture

THANK YOU
Justine Joran Arevalo
BSN 2B