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Phenobarb Energetics

by marneemadsen - May 26, 2009

Howdy,
I know this has probably been discussed at class, but trying to remember how PB fits into Chinese medicine energetics....

Intitally, anxiety/agitation or sedation - HEAT? (maybe not valid for hormesis since in beginning/lower doses?)

PU/PD/PP - DAMP? DAMP HEAT?

Liver enzymes - DAMP HEAT? STASIS? LIVER BLOOD DEF?

Lethargy, depression, ataxia - DAMP, PHLEGM, YANG DESCENDING?

Anemia, thrombocytopenia, neutropenia
BLOOD DEF, HEAT??

Taste is bitter - COOLING?

So, it seems: nourishing/moistening, cooling,descends Yang

Might work best in cases of:
Yin Def with heat and Yang rising

Might be a disaster in cases with:
Damp Heat
Phlegm
Liver Blood Def??

Might not work at all:
Qi Deficiency

Can you correct/fill in the gaps?

If low dose really gorks them, could you say already Damp/Phlegm present? If you said it, would it be true?

Thanks!

My next project is omeprazole....

by naturevet

May 27, 2009

Hi Marnee,

I haven't had a chance to look into PB yet. My impressions are, though, that long term use tends to create deficient animals, and that it tends to make Damp animals even more sedate. We should have used it as a class project! I guess I wonder about whether it depletes Yang, creating hypotension, lethargy, somnolence, bradycardia, respiratory depression and apnea. It also predisposes to urticaria type rashes, and could thus damage Qi as well as Yang. Certainly Qi and Yang deficiency would cause anemia and aggravate Spleen deficient animals to ironically increase their Damp production. These are the latent tendencies it tends to bring out. Toxicity symptoms indicate what it does - PU/PD/PP and markedly elevated liver enzymes are all consistent with severe Heat, possibly due to Damp Heat. So in animals that become dopey and somnolent, but are not seizuring, use of a Qi tonic may be the best approach to balance out the drug. We've done that in several cases, using Bu Zhong Yi Qi Tang and Ban Xia Bai Zhu Tian Ma Tang. Unfortunately, if you discontinue the drug, you may then be too tonifying and the seizures return. So if the drug is to be discontinued, another draining formula should theoretically take its place, like Long Dan Xie Gan Tang or something.

That's what we've put together on phenobarbital thus far, anyway.

Have fun!

Steve

by marneemadsen

June 2, 2009

So, if the toxicity is heat and damp heat, are the actions warming and moistening? I think I am not getting it.....

by naturevet

June 3, 2009

Side effects tell us what the formula does (via what symptoms it brings out). Overt toxicity tells you what the formula treats. That's the way I piece it together anyway. Granted you asked about a very challenging drug, but that is my basic perspective.

So phenobarb cools and dries (often excessively so to create Qi deficiency and severe lassitude).

That's my best effort on this one!

S

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