Classification class
Seaweed
Commercial name
Multicomponent preparation: Albita tea licorice root, albita tea licoris stick, full potency liquorice root vege cup, Gaia herb liquorice root A / F, Gaia herb liquoris root SFSE, Licorice ATC concentrate, licorice and garlic, licorice root extract,, Natrol Licorice Root Capsules, Natural Arthro-Rx, Nature & # 39; s Answer licorice root alcohol and alcohol free, natural herbal licorice phytosome capsule, natural herbs Licorice power certified potency capsule, Sora Lei Licorice Organic licorice licorice liquorice bar and chew of barnyards, tummy sake.
Common form
Capsule: 100 - 520 mg licorice root
Liquid extract: licorice extract, deglycyrrhizinated licorice extract
Tablet: 7 mg of licorice and 333 mg of pure concentrated garlic
You can also use candy, chewing gum, herb tea, throat lozenge, tobacco products.
Source
Most medicines use perennial herbs or low growth shrubs Glycyrrhiza gZabra root and dried rhizomes. Licorice of Spain is the most common variety, G. glabra var. typica. Licorice is unique to the Mediterranean, but widely grown in the United States, Russia, Spain, Turkey, Greece, India, Italy, Iran and Iraq.
Chemical composition
Rhizomes and roots contain 5% to 9% glycyrrhizin (glycyrrhizic acid), glycosides are 50 times sweeter than sugars. Hydrolysis of glycyrrhizin yields glycyrrhetinic acid, which is not sweet. Other compounds include ammonia, olein triterpenoids, glucose, mannose, and sucrose. The aqueous extract of licorice contains 10% to 20% glycyrrhizin.
Behavior
Glycyrrhizin is hydrolyzed to a pharmacologically active form of glycyrrhetinic acid by the intestinal flora. The main effect of licorice is to mimic rather than mimic the endogenous steroid.
Studies in animals suggest that glycyrrhizin and glycyrrhetinic acid have a mild anti-inflammatory effect. Glycyrrhizin can stimulate gastric mucus synthesis via action on prostaglandins that can account for their ulcer healing properties.
Anecdotally, licorice has effective slimming (sedation) and expectorant properties and mild laxative and antispasmodic effects. Chinese licorice preparation called Zhigancao has been found to have antiarrhythmic effects including prolonged PR and QT interval. Glycyrrhizin can also lower cholesterol and triglyceride levels and exert antianemic, anti-hepatotoxic, and immunosuppressive effects.
Reported use
For its use as an example for gastric irritation, licorice derivatives have been studied for antiemetic effects. Licorice was also evaluated as a remedy for Addison's disease and found to enhance mineralocorticoid activity, but it could not be imitated if there was no adrenal gland activity.
Glycyrrhizic acid has been used as a shampoo for cold scars, eczema and oral ulcers, reducing sebum secretion from the scalp.
In the United States, glycyrrhizin is mainly used as a bitter drug, beverage, candy, chewing gum, tobacco product, toothpaste flavoring and sweetener. It is also added to some cough stops and cold preparations due to the effects of expectorants and paralysis drugs.
Dosage
In case of peptic ulcer, according to German Commission E. 200 mg to 600 mg of glycyrrhizin is administered daily within 6 weeks.
The following tea is believed to provide glycyrrhizin in the middle of this dosage range: 1 tsp (2 to 4 g) to boiling water yoke cup (2 to 4 g of crude licorice), cooked for 5 minutes. It is cold and distorted, taking PO after food.
Side effect
CNS: Hypertensive encephalopathy.
CV: Heart failure and cardiac arrest (overdose), ventricular tachycardia.
EENT: Temporary visual loss and disorder after ingesting 1.4-2 lb candies.
Endocrine: growth retardation lowered serum testosterone levels.
GU: renal tubular damage.
Metabolism: hypokalemia pseudopregnancy high aldosteronism.
Musculoskeletal: muscle weakness (hypokalemia), myopathy, rhabdomyolysis.
Respiratory organ: pulmonary edema.
Interaction
Antihypertensive drugs, diuretics: Some diuretics may increase the effect of hypokalemia. Avoid administration of licorice.
Corticosteroids (including topical agents): May enhance the effect. Please use it carefully together.
Digoxin: It may induce hypokalemia. Risk of digitalis toxicity. Avoid administration of licorice.
Loratadine, procaine amide, quinidine, drugs that potentially extend the QT interval: There may be additive effects. Please use it carefully together.
Spironolactone: It may block licorice ulcer healing and aldosterone-like action. Avoid administration of licorice.
Contraindications and precautionary measures
Licorice is contraindicated for patients with arrhythmia. CV, kidney or liver disease; or hypertension. Do not use for pregnant or breast-feeding patients. The effect is unknown. Use carefully under medical supervision of elderly patients.
Special Considerations
Monitor hypokalemia in patients receiving diuretics.
A single large amount of licorice is less likely to cause toxicity than a smaller amount of long-term intake.
Warning licorice poisoning may be potential. Monitor pseudodrenal hyperaldosteronism that causes mineralocorticoid-like effects (headache, lethargy, sodium and water retention, hypokalemia, hypertension, and heart failure). Monitoring of electrolyte (potassium, calcium, sodium) imbalance, alkalosis, electrocardiogram abnormality, and hypertension.
Please pay attention to the patient about the risk of excessive chronic licorice intake, such as liquid retention or electrolyte imbalance.
Inform the patient of potential drug interactions.
Interested point
Licorice has been used pharmacologically since the Roman era and is popular in Chinese herbal medicine.
Most "licorice candy" sold in the United States is seasoned with anise oil and does not actually contain licorice.
Commentary
Although licorice derivatives have been studied for use against peptic ulcer disease, such products do not show better performance than H 2 antagonists and may be less tolerable. Glycyrrhetinic acid may play a role in increasing the local effects of low-potency steroids while minimizing systemic effects, but this study is still preliminary. Glycyrrhetinic acid is a major cause of liquorice-induced pseudohyddepaldosterone syndrome seen in licorice intake due to its inhibitory effect on enzyme 11 beta-hydroxysteroid dehydrogenase. Surprisingly, all forms of licorice, such as candies, need to be carefully considered that low dose and high dose chronic intake can be toxic, and numerous serious adverse events described in the literature Are exemplified.
