Pharmacological aspect of

Medicinal Plant
Santun Bhekti Rahimah Herri S. Sastramihardja

Depart. of Pharmacology & Therapy Medical SchoolSchoolBandung Islamic University

Background


Plants had been used for medicinal purposes by all culture throughout history People in different part of the globe tended to use similar plants for the same purposes The herbal products today symbolise safety in contrast to the synthetics that ar regarded as unsafe to human and environment.

Background
 

Over three-quarters of the world population relies threemainly on plants and plant extracts for health care. plant drugs constitute as much as 80% of the total 80% drugs in fast developing countries such as China and India. India. Of the 2,50,000 higher plant species on earth, more than 80,000 are medicinal. Many drugs commonly used to day are or herbal origin, for examples aspirin (from willow bark), digokxin ( from digitalis), quinine (from cinchonar digitalis), poppy) bark) & morphin (from opium poppy)

How do herbs work ?



For most herbs, the specific ingredient herbs, that cause a therapeutic effect is not known Whole herbs contain many ingredients (alkaloids, terpenoid, saponin, flavonoids, phenols, volatile oils, etc) that work together to produce the desired medicinal effect

Many things must take into account when prescribing herbs, i.e :
   

Variety of plant The plants habitat How it was stored & processed Whether or not there are contaminants

Table 1. Comparism of modern phamacology and herbalism

Modern pharmacology

Herbalism

Isolated One active ingredients One effect that measurable & repeatable

Holistic Whole plants Synergistic effect of its components

Pharmacology characteristics of medicinal plants

 

Have a broad therapeutics range Onset of action occurred after a latent period (weeks or months) The action have usually been observed empirically in human patient treated with the herbs

Pharmacology characteristic


(continued)

Accurate pharmacokinetic data for extracts ccurate that have a complex composition is difficult to obtain Subjective assessments by the patients or physician used to evaluate efficacy Do not indicate to use in emergency or acute situations

Demand & advantages of herbal remedies



Demand is rooted partly in the emotional perception that natural products are gentler & less hazardous than chemical products Greater trust on the part of the patients that herbal remedies are safe & tolerable

Table 2. Phytomedicines that have undergone

pharmacology testing
Herb extract

Pharmacological action

uses

Ginkgo biloba Leaf extracts

Anti ischemic Anti hemorrheologic anti PAF hypolipidemic Antithrombotic fibrinolytic Hypotensive positive inotropic anti arrythmic coronary vasodilatation

Cerebral insufficiency Peripheral vascular disense Dyslipidemia CVCV-disorders

Garlic cloves (Allum satium)

Hawthorn extract (Cratageus monogyna)

mild heart failure (St. II NYHA) NYHA)

Table 3. The nine priority of Indonesian

medicinal plant ( =IMP ) =IMP
Herb extract

Pharmacological action
hypolipidemic antiinflammatory antioxidant apetite stimulant galactogogue

uses
dyslipidemia GI disorder hepatic disorder anorexia flow of milk PP uterine resolution dyslipidemia rheumatic disease diare / dyspepsie hepatic disorder gingivitis

Curcuma xanthorizae (= temu lawak)

Curcuma domestica ( = kunyit)

hypolipidemic antiinflammatory antispasmodic stomachic carminative thrombolytic

Table 4. The nine priority of IMP

Herb extract

(continued..) (continued..)

Pharmacological action

uses
Rheumatic disease common cold chronic leukemia Peptic ulcer atheroselerotic disease DM otitis

Andrographis paniculata (=sambiloto)

antipyretic Antiinflammatory Immunostimulant Antispasmodic Antisecretory mucosal protectivle antithrombotic Hypoglycemic antibcterial

Guazuma ulmifolia (= jati belanda)

astringent Diaphroretic Lipase stimulation hypolipidemic

dyslipidemia diarhe / dyspepsie Leucorrhoe

Table 5. The nine priority of IMP

Herb extract

(continued..)

Pharmacological action

uses
motion sickness emesis intestinal colic diarrhe / dyspepsie chronic leukemia

Zingiber officinale (= jahe merah)

antiemetic carminative antispasmodic antiinflammatory alkylating antioxidant hyportensive hypoglikemic

Morinda citrifolia ( = mengkudu ) Piper retropraktum ( = cabe jawa)

hepatic disorder hypertension DM

antispasmodic carminative antiinflamatory apphrodisiac counter irritant

dyspepsie PVD neuralgic rheumatic pain (local) aroma therapy sexsual dysfunction

Table 6.The nine priority of IMP

Herb extract

(continued..)

Pharmacological action
astringent carminative hypoglycemic hypotensive

uses

Eugenia polyantha ( = daun salam)

diarrhe / dyspepsie gastritis DM Hypertension

Psidium guajava (daun jambu biji)

imunomodulation antiviral thrrombosiy

DHF

Table 7. Potential interaction between herbal

and conventional drugs Herb

Conventional drugs
anabolic steroids, methotrexate, amiodarone, ketoconazole immunosuppresants

problem
hepatotoxicity

echinacea > 8 week

antagonist effect altered bleeding time

garlic, ginger, ginkgo ginseng

warfarin

warfarin estrogens, corticosteroids

altered bleeding time additive effects

valerian

barbiturates

additive effects (exessive sedation)

SOP in Formal health services

HISTORY EXAMINATION DIAGNOSE

TREATMENT

without drugs

with drugs

EBM ?

Standard diagnostic

Standard treatment

Levels of Evidence-Ratings EvidenceI. II. III.

From a systematic review of all relevant RCT From at least one properly designed RCT 1. From well-designed pseudo-RCT wellpseudo(Alternate allocation or some other method) 2. From comparative studies with concurent controls & nonrandomized allocation (cohort studies), case-control casestudies or interrupted time series with a control group. group. 3. From comparative studies with historical control or interupted time series without a pararel control group. group.

IV. IV.

From case series

Herbal drug Development



Medical plants play a vital role for the development of new drugs The important aspect are:
justify the correct part of the plant active chemical contituent essential for the pharmacology activity  Preliminary phytochemical screening  The selection of solvent  Extraction process  Other methodology


The use of medical plants



Faced with many constraint:

 Not

fully identified, inventoried and characterized  Information and knowledge not being adequately  Alarming commercial , over exploitasi  Consequent genetic erosion of medical plants

Conclusion
The results from appropriate pharmacological testing and clinical study base on GCP is the good EBM to established the medicinal plant usage in formal health services

Refference


Joy PP, Thomas J., Mathew S., skaria BP, Medicinal Plants, Kerala Agricultural university, Aromatic and Medicinal Plants Research Station, 1998. Station, Verma S., Singh SP, Current and Future status of Herbal medicine, vet.world vol.1 No II, 2008. Tamya A., herbal Drug Developmant and Pharmacological http://www.pharmatutor.org/, potensial of Some Herbs, http://www.pharmatutor.org/, diunduh tagl 1 November 2011. Batugal PA., Kanmid J, et all. Medicinal Plants Research in Asia Vol. I: The Framework and Projeck Workplans. Workplans.

Thank you

CURRICULUM VITAE
    

Nama TTL Agama Pangkat Jabatan

: : : : :

Santun Bhekti Rahimah, dr.M.Kes Bandung,23 Juni 1976 Bandung, 1976 Islam Assisten Ahli / IIIa Staff Bag. Farmakologi FK UNISBA

CURRICULUM VITAE
Nama TTL Agama Pangkat Jabatan : Prof. DR.dr.Herri S. Sastramihardja, SpFK. : Cianjur,8 April 1944 : Islam : Guru Besar / IV-e : Kepala Bag. Farmakologi FK UNPAD / Farmakologi Klinik RSHS Dekan FK UNISBA

Riwayat pendidikan, antara lain

       

Dokter (1971). Kursus Farmakologi Klinik Nasional (1979). AKTA V (1984). Internasional Course on Drugs Epidemiology (1988). Traning Monitoring Efek Samping Obat (1992). Spesialis Farmakologi Klinik (1994). Doktor (1995). National Workshop on Teaching of Rational Drug Use (1996).