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Herbal summary all lectures

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Herbal Medicine (WBFA05805)

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Rijksuniversiteit Groningen (RuG)

All lectures are in this document included, the key points are used which were given by the professor. It was said that you can pass the course when learning the key points. The exam was 55% about the general info lecture 1-5, and 45% about the herbal medicines. In the lectures a lot of informatio...

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Herbal medicine
Herbal medicine..................................................................................................... 1
Lecture 1................................................................................................................ 4
What is pharmacognosy, what are natural products?..........................................4
Plant derived drugs: pure chemical entities, examples (to be recognised).........4
Plant derived drugs: herbal medicines................................................................4
What are supply problems and how can these be solved....................................4
Steps in medicinal plant discovery......................................................................4
Plant organs as botanical drugs..........................................................................4
Binomial nomenclature of plant names...............................................................5
Hierarchical classification system of Plant Kingdom............................................5
Synonyms, homonyms........................................................................................ 5
Chemotaxonomy (taxonomy and (chemo)systmetatics).....................................5
Global classification of the plant kingdom...........................................................5
What are secondary metabolites, examples?......................................................5
Ethnopharmacology and drug development.......................................................5
Convention of Rio................................................................................................ 6
General aspects and characteristics of oriental traditional medicine..................6
Traditional medicinal systems in non- western countries....................................6
Global description of CAM, anthroposophy, aromatherapy.................................8
Homeopathy characteristics................................................................................ 9
Phytotherapy definition, characteristics............................................................10
International ‘bodies’ involved: WHO, ESCOP, EMA...........................................10
Lecture 2.............................................................................................................. 11
Production and product quality.........................................................................11
Quality in relation to HMPs: GACP, CLP, GMP; international guidelines, quality
Parameters........................................................................................................ 11
Wildcrafted plants versus cultivated.................................................................11
Quality control, where in process......................................................................11
Role of Ph. Eur................................................................................................... 12
DNA-based methods.......................................................................................... 12
What are extracts, how are they prepared (standardised, non-standardised)...13
Drug (herb)-extract ratio, drug-solvent ratio.....................................................13
Maceration, percolation..................................................................................... 14
Influence of extraction fluid on extract..............................................................14

, Adulteration and contamination........................................................................14
Counterfeit products.......................................................................................... 15
Phyto-equivalence............................................................................................. 15
Lecture 3->slide 6+7............................................................................................ 16
Lecture 4.............................................................................................................. 17
General aspects of toxicity of plants and plant constituents.............................17
Risks of use of herbals....................................................................................... 17
Safety related to quality aspects.......................................................................18
Composition of product in relation to safety......................................................18
Types of adverse effects.................................................................................... 18
Determinants of adverse effects.......................................................................19
Pharmacovigilance of herbals, signals, causality...............................................19
Herbal Preparations Decree to protect consumer..............................................20
Pyrrolizidine alkaloids........................................................................................ 21
Aristolochic acids............................................................................................... 21
(Mechanism of toxicity) of various secondary metabolite groups......................22
Herb-drug interactions: mechanism, clinical relevance.....................................23
Pharmacokinetic and pharmacodynamic interactions.......................................23
Role of the pharmacist...................................................................................... 24
Lecture 5.............................................................................................................. 25
Pharmacology and clinical efficacy....................................................................25
HMPs: antagonism and synergism.....................................................................25
Polyvalent action of HMPs................................................................................. 25
Effect of extract versus effect of isolated compound........................................25
Possibilities and limitations with HMP in health care.........................................26
Levels of evidence of efficacy, limitations.........................................................26
Cases studies, observational studies, interventional studies............................27
Examples of proved effective, plausible effective and traditional HM...............27
Herbal medicine list.............................................................................................. 29
Central nervous system..................................................................................... 29
St. John’s wort, gingko, cannabis...................................................................29
Circulatory tract disorders................................................................................. 32
Hawthorn, gingko, horse chestnut, garlic, red rice yeast...............................32
Digestive tract................................................................................................... 34
Artichoke, turmeric, ginger, liquorice, milk thistle, laxatives (bulk formers and
anthranoids)................................................................................................... 34
Respiratory tract................................................................................................... 40

, Ivy, liquorice, other plants in groups (e.g. diaphoretics, cough).....................40
Skin................................................................................................................... 43
Arnica, marigold, chamomile, St. John’s wort oil, aloe, tea tree oil, centella. .43
Urinary and genital tract................................................................................... 46
Bearberry, cranberry, saw palmetto, chasterberry, black cohosh,
phytoestrogens.............................................................................................. 46
Pain and inflammation....................................................................................... 50
Peppermint oil, feverfew, willow bark, devil’s claw........................................50
Immune system................................................................................................. 53
Adaptogenic, immunostimulant, ginseng, taiga, umckaloabo and mistloee,
mushrooms.................................................................................................... 53
Pharmacovigilance for herbal and traditional medicines......................................56
Definitions......................................................................................................... 56
Why is causality assessment difficult for herbal medicines?.............................56
First example 1.................................................................................................. 57
Why is pharmacovigilance important?..............................................................58
Case study examples........................................................................................ 60
Safety example 1.............................................................................................. 60
Safety example 2.............................................................................................. 61
Third example................................................................................................... 61
Safety example 4.............................................................................................. 62
Example 5: nice up of tea.................................................................................. 62

,Lecture 1

What is pharmacognosy, what are natural products?
=is the science of biogenic or nature-derived pharmaceuticals and poisons (natural products)
- Plants, bacteria, fungi, animals
- Healthcare, therapeutics-oriented
- Pharmaceutical biology

Plant derived drugs: pure chemical entities, examples (to be recognised)
› Pure chemical entities (active pharmaceutical ingredients (API), licensed drugs)
- Isolated natural products (morphine, digoxin, quinine, vincristine, atropine, paclitaxel, galantamine)
- Semi-synthetic derivatives of natural products (etoposide, arteether, topotecan)
- Synthetics based on natural product template (atropine, morphine, cocaine and tubocurarine)

1. Etoposide:
- rhizome of podophyllum peltatum L.mayapple.
- Use: lung, testicular and lymphoid cancer

2. Arteether :
- from annual wormwood.
- Use: resistant forms of malaria

3. Topotecan :
- from happy tree.
- Use: metalized ovarian cancer, lung cancer

Plant derived drugs: herbal medicines
› Botanical drugs (from specific medicinal plant parts)
§ ‘Herbal medicines’
- Herbal substances (raw materials)
- Herbal preparations (e.g., extracts)
- Herbal medicinal products (HMPs, phytomedicines)

What are supply problems and how can these be solved
Supply problems:
1. Environmental (climate related, political situation)
2. Plant related (slow growth, cultivation problems)
3. Isolation and purification (low concentration, many closely
related structures)
Solutions:
- Other plant sources (chemosystematics: related plant species
often contain similar constituents)
- Selection (high-producing plants, plants with a different metabolic pattern)
- Use of more abundant precursors (from plants) (semi-synthetic derivatisation, enzymatic
derivatisation)
- Biotechnology (plant cell and tissue cultures, heterologous expression systems)
- Organic synthesis

Steps in medicinal plant discovery
› Increased recognition of plants as source of potential drug leads
› Starting point: ethnobotanical use (ethnopharmacology)
› From basis preclinical research to clinical trials

Plant organs as botanical drugs
› Derived from a plant and transformed into a drug by drying certain plant parts, or sometimes the whole plant
› Obtained from a plant, but no longer retains the structure of the plant or its organs
§ Essential oil, gum, resin, balm
› Isolated pure natural products are not botanical drugs

› Aerial parts or herb (herba)
› Leaf (folia)
› Flower (flos)
› Fruit (fructus)

, › Bark (cortex)
› Root (radix)
› Rhizome (rhizoma)
› Bulb (bulbus)
› Seed (semen

Binomial nomenclature of plant names
› Species name is binomial
§ Papaver somniferum L. (opium poppy)
› Genus name plus (specific) epithet (italic) with authority (abbreviated, not italic)

Hierarchical classification system of Plant Kingdom

- Species: somniferum (sleep-producing)
- Genus: Papaver- contains group of species
- Family: Papaveraceae- group of genera
- Order: Papaverales
- Class: Magnoliatae
- Division (=phylum): Spermatophyta (seed-bearing plants)
- Kingdom: Plantae (plants; other kingdoms: animals, fungi)

Synonyms, homonyms
Synonyms: one plant, many names (many languages)
Homonyms: same name for different plant species-> false

Chemotaxonomy (taxonomy and (chemo)systmetatics)
=science of naming organisms and correct integration into existing system of nomenclature
- (based on taxa, hierarchic system, from small to big, relationship (morphology, chemistry)
Chemosystematics: closely related plants contain similar constituents
- Related species within one genus
- Related genera within one family
- Genetic background

Global classification of the plant kingdom
1. Green algae
2. Bryophytes
3. Pteridophytes
4. Conifers
5. dicots

What are secondary metabolites, examples?

- Not essential to the functioning of plant
- Ecological role, protection against microbes
Examples:
- Isoprenoids
- Phenolic compounds
- Essential oils
- Glycosides
- Alkaloids
- Carbohydrates
- Fats

Ethnopharmacology and drug development
Ethnobotany, ethnopharmacology
› Traditional medicine used for novel drug development
- Many commonly used drugs are developed by studying indigenous remedies
- Local knowledge (e.g., traditional healers; oral and written) scientifically developed
› Ethnobotany: study of relationships between humans and plants in all its complexity
- Observations and study of the use a society makes of plants, including beliefs and cultural practices
- Medicinal use, food, poison, building material, fertilisers, colouring agents, ornamentals
- Ethnobotanists live with the endogenous people

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