Medication

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====There are two main classes of drugs in Conventional Medication that are prescribed to treat influenza. These medications include neuraminidase inhibitors such as oseltamivir (Tamiflu®), zanamivir (Relenza®), as well as adamantane derived medications such as rimantadine (Flumadine®) and amantadine (Symmetrel®). ====

Complementary and Alternative Medicine
==== Complementary and Alternative Treatment involves medicines that have been used for centuries to treat disease and infection. Many modern pharmaceutical drugs have their origins from herbs. The antiviral medication Tamiflu has its origins from the herb //Illicium verum// (Star Anise), taking its constituent, shikimic acid, and chemically modifying it into the drug ostelamivir. Scarce sourcing of star anise and subsequent low yield of shikimic acid was blamed for the shortage of oseltamivir during the 2009 swine flu epidemic. ====

**Lack of medication availability to treat any infectious disease is a situation that needs to be prevented. It is imperative that the antiviral properties of other herbal medicines be researched in order for alternative medications to be made available.**

[[image:andrographis_pills.jpg width="254" height="245" align="left" caption="Figure 3. Andrographis paniculata"]]
====Complementary and alternative medicine includes a variety of herbs, nutrients, and therapies. Perhaps the most well researched are herbal medicines. The Sambucus nigra, //Echinace purpurea//, and Andrographis paniculata have been used for centuries in various cultures for their medicinal qualities. These herbs have been scientifically studied and tested to verify their potent affect against viral infection. ====


====Sambucus nigra, //Echinace purpurea//, and Andrographis paniculata **are therefore potent antiviral medicines in their own right and further research into their constituents could create effective conventional medications for future treatment of influenza.** ====

__Figures:__

 Figure 1. Tamiflu medication. Image Source Page: @http://rxmedicinepills.com/buying-tamiflu-75mg-swine-flu-treatment/ Figure 2. Star Anise. Image Source Page : []  Figure 3. Andrographis paniculata. Image Source Page: @http://www.passeportsante.net/fr/Solutions/PlantesSupplements/Fiche.aspx?doc=andrographis_ps

Conventional medication prescribed for influenza include two classes, neuraminidase (NA) inhibitors and adamantanes. NA inhibitors, such as oseltamivir (Tamiflu®) and zanamivir (Relenza®) prevent the detachment of viruses from their host cell, thereby preventing the spread of infection. Adamantanes, such as rimantadine (Flumadine®) and amantadine (Symmetrel®) inhibit the replication of the virus within the cell, halting the infection spread at the bud. Virus mutation unfortunately creates progeny that are resistant to these treatments, in particular to adamantanes. Global stock of NA inhibitor medication is estimated to be sufficient to treat only 5% of the world’s population were a pandemic to occur (Rasmussen). Complementary and alternative medicine includes a variety of herbs, nutrients, and therapies. Perhaps the most well researched are herbal medicines, such as //Sambucus nigra//, //Echinacea purpurea//, and //Andrographis paniculata// and they have been shown to have comparable to greater effect to conventional medications. The antiviral effects of //Sambucus nigra// flavonoids are comparable to those of oseltamivir in Tamiflu®, making them a viable alternative to the medication. This alternative would ease strains on Tamiflu® manufacturing in a pandemic situation, preventing a shortage like that seen in the 2009 H1N1 pandemic. //Echinace purpurea// prevented the emergence of resistant viral strains in comparison to Tamiflu®. Although //Echinacea// has its systemic contraindications that prevent its use as a mass medication, further studies into its specific mode of action could create alternative medications without side effects but which also prevent resistant viruses from developing. //Andrographis paniculata// treatment for influenza patients was shown to be significantly more effective at reducing symptoms and severity of infection in comparison to the conventional medication amantadine. While already potent antiviral medicines in their own right, further research into the constituents of //Sambucus nigra, Echinacea purpurea// and //Andrographis paniculata// could create effective conventional medications for future treatment of influenza.