No Plant Class AE / AR / SE AE / AR / SE

(APHA) (MEYLER)
1 Arnica Safety Class: 3 Side Effect : Side Effect : Gastroenteritis (tea form)
montana (internal use), Arnica contains sesquiterpene lactones that Case reports of adverse events :
(arnica) 2d (external produce contact dermatitis in sensitive 27-year-old woman presented with a rapidly
use) persons. enlarging necrotic lesion on her face and
Interaction Case reports of adverse events : left leg together with malaise and high fever
Class: A Topical application of a cream containing (10). She reported that she had applied a
1.5% arnica was reported to trigger a case of 1.5% arnica cream to her face before these
leukemia related Sweet’s syndrome. symptoms had occurred.

A young man mistakenly consumed tea made

from an unknown amount of arnica flower and
leaf. Two hours later he experienced myalgia,
headache, chills, and developed
hyperthermia, tachycardia, hypotension, and
elevated serum levels of creatinine, aspartate
aminotransferase, and alanine
aminotransferase.

Stomach cramping followed by death was

reported in a man who had consumed 70 g of
arnica tincture. Poisoning with arnica has been
reported to cause death due to circulatory
paralysis with secondary respiratory arrest
(product and dose not specified).

An older herbal text indicated that internal use

of “large doses” of arnica may cause “heat in
the throat, nausea, vomiting, purging,
spasmodic contractions of the limbs,
difficulty of respiration, and sometimes
inflammation of the alimentary canal, and
 coma”.
2 Allium Safety Class : Adverse Effect : Breath and body odor. Other Side Effect :
Sativum 1 effects, noted Respiratory
(garlic) Interaction as possible but not proven, included flatulence, Occupational inhalation of garlic powder can
Class : C esophageal lead to Asthma. Nervous system A
and abdominal pain, small intestinal obstruction, spontaneous spinal epidural hematoma
derma- resulting in paraplegia in an 87-year-old
titis, rhinitis, asthma, and bleeding patient was attributed to chronic excessive
use of garlic cloves.
Case Reports of Adverse Events
Several cases of abnormal bleeding have been Case Reports of Adverse Events
reported in Hematologic
association with garlic ingestion. These cases Bleeding due to impaired platelet function
include spinal has been
epidural hematoma with platelet dysfunction attributed to garlic.
(Rose et al. -
1990) A 54-year-old woman underwent strabismus
Allergic reactions to garlic, including surgery and had bilateral retrobulbar
anaphylactic reac- hemorrhages intraoperatively. In the
tions, have been reported (Perez-Pimiento et absence of other possible causes, the authors
al. 1999). Topical thought that the bleeding had been due to
exposure to raw garlic has caused irritant, garlic pills prescribed by a naturopath. On
allergic and protein the day of surgery, she had taken five pills,
contact dermatitis, contact urticaria, induction of equivalent to about 5 g of fresh garlic bulb.
pemphigus Platelet function, measured 2 weeks later,
(blisters) and combinations thereof (Jappe et al. was normal. Garlic has well-documented
1999) effects on platelet aggregation.
Skin - Topical administration of garlic can
lead to allergic contact dermatitis or burn-
like skinlesions
3. Laurus Safety Class: 1 Adverse Effect & Side Effect : Adverse Effect :
Nobilis Interaction Allergic contact dermatitis, confirmed by patch Laurel oil obtained from the berries of L.
Class: A testing, has nobilis is a potent skin sensitizer, owing to
 been reported after contact with foods or topical the presence of allergenic sesquiterpene
products lactones, and is usually seen in aromathera-
containing bay leaf or bay essential oil (Adisen pists or their clients.
and Onder Case Reports of Adverse Events :
2007; Foussereau et al. 1975; Jirasek and Skach A 55-year-old woman developed erythema
1962; Opdyke and edema over her knees (15). She had
1979; Ozden et al. 2001). applied laurel oil, obtained from a herbalist,
to her knees to relieve joint pain 15 days
earlier. After 3 days, the erythema and
edema had begun to appear. She had
erythema, edema, and papules over her
patellae, and eczema around the eye. She
was treated with an oral antihistamine and a
topical glucocorticoid. Two days later, the
lesions worsened and systemic
glucocorticoid therapy was needed. The
lesions started to heal, leaving slight
postinflammatory hyperpigmentation. Patch-
testing was performed with a European
standard series and commercial laurel oil 1
month later. There was a +++ reaction to the
oil only, and no reaction to either fragrance
mix or Myroxylon pereirae resin in the
standard series. The same formulation of
laurel oil was negative on patch-testing in 15
control subjects.

4. Aloe Vera Safety Class Caused dermatitis contact, ex : itching. Caused muscle weakness, cardiac dys-
Latex 2B : Not To Henoch-Schönlein purpura (purple spot on skin, rhythmias, peripheral edema, bloody
(Lidah Be Used join pain, GITract and kidney problem) diarrhea, weight loss, stomach cramps,
Buaya) During itching, redness, rash, pruritus, and a red
Pregnancy coloration of the urine.
5. Andrographis Safety Class Caused gastric discomfort and loss of appetite, Caused urticaria, pruritus, fatigue, headache,
 Paniculata 2B : Not To allergic reac- tions, including an anaphylactic diarrhea.
Herb Be Used reaction.
(Sambiloto) During
Pregnancy
6. Prunus Safety Class: 3 Ingestion of 50 to 120 seeds has resulted in When ingested in sufficient quantities
ameniaca Interaction fatal poisoning. Poisoning from the cyanogenic Prunus species cause cyanide poisoning.
(apricot) Class: A glycoside content results in symptoms such as For instance, a total consumption of about 48
salivation, gastric discomfort, nausea, apricot kernels produced forceful vomiting,
vomiting, abdominal pain, diarrhea, headache, flushing, heavy sweating,
headache, dizziness, weakness, difficulty dizziness, and faintness before vomiting
breathing, restlessness, terror, and was induced in the emergency room,
palpitations. In severe cases, symptoms may whereafter the symptoms rapidly subsided.
include coma, cyanosis, dilated pupils, and
death by respiratory failure. Case reports of adverse events :
A 67-year-old woman with lymphoma
A suspension of the powdered kernel is presented with a neuromyopathy following
considered four to five times as toxic as a d treatment with laetrile. She had high blood
ecoction of the seed. Boiling reduces the and urinary thiocyanate and cyanide
toxicity of the kernel. concentrations (7). Sural nerve biopsy
specimen showed a mixed pattern of
Case reports of adverse events : demyelination and axonal degeneration,
Fatal cyanide poisoning occurred in a 3 -year- the latter being prominent. Gastrocnemius
old girl who ingested an unspecified number of muscle biopsy specimen showed a mixed
apricot kernels. Analysis of apricot kernels from pattern of denervation and myopathy with
the same lot that caused the poisoning showed type II atrophy.
an average of 2.15 mg cyanide per kernel.

A 41-year-old woman became weak and had

difficulty breathing after ingesting 30 apricot
kernels (estimated total, 15 g) purchased at a
health food store. She became comatose and
hypothermic but responded promptly to
 antidotal therapy for cyanide poisoning.

Nonfatal cyanide poisoning was reported in a

49-year- old woman with lymphoma who had
eaten 20 to 40 bitter apricot seeds.

Other cases of cyanide poisoning in children

and adults have been reported
7. Ginko Biloba Safety Class: 1 Adverse Events and Side Effects Ginkgo biloba (maidenhair tree, silver
Interaction Reviews and meta-analyses of clinical trials apricot) contains ginkgolides, which inhibit
Class: B have shown platelet activating factor, reducing
that ginkgo leaf is generally well tolerated, with aggregability; this may contribute to
adverse bleeding disorders in patients taking G.
events similar to those of placebo biloba. Ginkgo has small beneficial effects in
patients with intermittent claudication (1)
and dementias (1,2). Extracts from the leaves
of G. biloba are marketed in some countries
for the treatment of cerebral dysfunction and
of intermittent claudication. In a review it
was con-
cluded that seven out of eight controlled
trials of good quality showed positive effects
of G. biloba compared with placebo on the
following symptoms: memory difficulties,
dizziness, tinnitus, headache, and emotional
instability with anxiety (3). For intermittent
claudication,
the evidence for efficacy was judged
unconvincing. No serious adverse effects
have been noted in any trial. However, G.
biloba has been associated with
gastrointestinal complaints, headache, and
allergic skin reactions (SED-13, 538).
 Bleeding has been associated with chronic
G. biloba ingestion because of its adverse
effects on platelet aggregability, since the
ginkgolide constituents of G. biloba inhibit
platelet-activating factor.

Adverse effects
Ginkgo biloba has been associated with
gastrointestinal complaints, headache,
antiplatelet effects, and allergic skin
reactions.
Nervous system Ginkgo biloba can
precipitate seizures in patients with well-
controlled epilepsy
8. Myroxylon Safety Class: Adverse Events and Side Effects Adverse effects
spp. 2d Interaction Allergic reactions and sensitization to tolu Balsam of Peru is a topical photosensitizer
Class: A balsam tree and (SEDA-19, 162) and can cause contact
balsam-of-Peru tree are relatively common and urticaria (72,73). A systemic contact
have been dermatitis has been reported after oral
reported after topical and internal use (Pfutzner administration (74). In one case an allergic
et al. 2003; contact dermatitis in a patient sensitive to
Salam and Fowler 2001; Wichtl 2004; Zug et al. balsam of Peru caused a primary
2009). eruption on the face with secondary purpuric
vasculitislike eruptions on both legs (75)
9. Symphytum Safety Class Caused nausea, vomiting, lethargy. Caused hepatotoxic, as well as mutagenic
Officinale 2A: For and carcinogenic. They can produce veno-
Leaf, Root External Use occlusive disease of the liver with clinical
Only features like abdominal pain with ascites,
hepatomegaly, splenomegaly, anorexia, nau-
sea, vomiting, and diarrhea. Sometimes there
is also damage to the lungs.
10. Glyxyrhizza Safety Class: Adverse events associated with licorice Adverse Event Most individuals can
spp. 2b, 2d consumption are primarily related to the consume 400 mg of glycyrrhizin daily
 Interaction mineralocorticoid effects (see Human without adverse effects, but some individuals
Class: B pharmacological studies), with symptoms such develop adverse effects following regular
as sodium and fluid retention, increased blood daily intake of as little as 100 mg of
pressure, and decreased serum levels of glycyrrhizin (36). Cardiovascular Liquorice
potassium (hypokalemia) and aldosterone. can cause hyperaldosteronism and hence
Multiple forms of licorice products have been hypertension. Sensory systems Five patients
associated with adverse events, including who had consumed large amounts (0.1– 1
licorice candies, teas, and capsules. Most kg) of licorice subsequently had transient
reports of adverse events are associated with visual loss/ aberrations (39). Glycyrrhizinic
ingestion of at least 35 g per day of licorice acid in licorice causes vasoconstriction in
candies. One case of cardiac arrest was reported vascular smooth muscle and the authors
in a p atient with licorice-induced hypokalemia therefore speculated that vasospasm of the
retinal or occipital artery had caused the
problems. Electrolyte balance
The active ingredients of licorice inhibit the
breakdown of mineralocorticoids by
inhibiting 11-beta-hydroxysteroid
dehydrogenase type 2, and its adverse effects
relate mainly to mineralocorticoid excess,
with sodium retention, potassium loss, and
inhibition of the renin–angiotensin–
aldosterone system (40).
In two cases prolonged intake of relatively
small
amounts of licorice resulted in hypertension,
encephalo- pathy, and
pseudohyperaldosteronism (41). Both
patients
were highly susceptible to the adverse
effects of glycyrrhizinic acid because of 11-
beta hydroxysteroid dehydrogenase
deficiency.
11. Veratrum Safety Class: 3 Flushing of the face, sweating, burning of the vomiting, hypotension, and bradycardia,
 viride Interaction mouth vomiting accompanied by nausea, a heartburn and vomiting, bradydysrhythmias,
(poke India, Class: A slowed heart rate (bradycardia), atrioventricular dissociation, and
hellebore muscular weakness, reduced body temperature, vasodilatation
India, cold sweat, dizziness, faintness, failure of sight, with hypotension
hellebore dilatissson of
palsu, green
the pupils, slow and shallow breathing, syncope,
false hellebore
atau raksasa and atrioventricular
false- block
helleborine)
12. Prunus Safety Class: 3 Poisoning from the cyanogenic glycosides
armeniaca Interaction results in
Class: A symptoms such as salivation, gastric

Nama Anggota Kelompok :

1. Clarissa Natalie S. 190117004

2. Jane Netta Meilia 190117009
3. Shang Rani A. Lyberta 190117033