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Presented By M.D JAHA SULTANA, M.PHARMACY (Pharmaceutics) A PROSPECTIVE ON HERBAL MEDICINES AND HEBRAL SUPPLEMENTS 6/28/2014 1

CONTENTS:

CONTENTS Introduction Types of Alternative System of Medicines Herbal Medicines Herbal Supplements Conclusion References 6/28/2014 2 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

INTRODUCTION:

INTRODUCTION Herbal medicine is one of the alternative system of medicine which is employed for all the healing practices that do not fall within the realm of conventional medicine. Including herbal medicines the Alternative system of medicine also includes a variety of therapeutic and preventive health care practices such as Ayurveda , Homeopathy, Naturopathy, Chiropractice , Aromatherapy, Acupuncture, Magnetotherapy and Yoga. Alternative system of medicine also referred to as complementary, supporting or assisting medicine that are used along with or instead of the standard care provided by doctors or allied health professionals such as nurses, pharmacists, physical therapists. 6/28/2014 3 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

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Alternative medicine has been prevalent in various countries like India and china much before the development of the present day medical science. For example in India Ayurveda, Medication, Yoga, Unani herbal medicine and Siddha have been used since ancient period to heal the body. Alternative system includes a vast spectrum of philosophies, practices and treatments that range from ancient and traditional medicine based on folk knowledge, spiritual beliefs to the newly conceived approaches in natural healing. Many of these systems combine traditional knowledge about healing methods and herbal agents that has been passed down from one person to another for centuries with spiritual and cultural beliefs. 6/28/2014 4 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

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6/28/2014 5 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN TYPES OF ALTERNATIVE SYSTEM OF MEDICINES AYURVEDIC SYSTEM OF MEDICINE The term Ayurveda is derived from the Sanskrit word Ayur meaning ‘life’ and veda meaning ‘knowledge or science’ i.e., ‘ science of life’. It is the most ancient system of Indian medicine over 5000 years ago which was spiritually enlightened by rishis or sages. Ayurvedic formulation includes: DOSAGE FORMS EXAMPLES solid dosage forms Churnas (powders), Vatika (pills), Guggule (plant exudations). Liquid dosage forms Swarasa (fruit juices), Kasaya (extracts), Taila (medicated oils), Asava , arista (tinctures), Kanjika (vinegars). Semi-solid dosage forms Kalka (ointments and pastes), Avaleha (soft extract).

CHURNAS:

6/28/2014 6 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN CHURNAS SWARASA TAILAM LEHUM

HOMEOPATHY SYSTEM OF MEDICINE:

HOMEOPATHY SYSTEM OF MEDICINE The term Homeopathy is derived from the Greak word Homois means ‘ like’ and Pathos means ‘ treatment’ . It was founded by a German physician and chemist Dr. Christian Frederick Samuel Hahemann (1755 - 1843). Homeopathy is based on the law of similar or the law of cure which transaltes to “like are cured by like”. 6/28/2014 7 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN DRUGS USES Atropa belladonna Ear ache, headache, neuralgia and to control chicken pox and measles. Allium cepa (onion) Common cold and flu Cinchona Digestive disorders during convalesence

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6/28/2014 8 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

NATUROPATHY SYSTEM OF MEDICINE:

NATUROPATHY SYSTEM OF MEDICINE Naturopathy, or naturopathic medicine, is a form of alternative medicine based on a belief in vitalism , which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation. The term "naturopathy" is derived from Greek and Latin, and literally translates as "nature disease“. 6/28/2014 9 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

CHIROPRACTICE SYSTEM OF MEDICINE :

CHIROPRACTICE SYSTEM OF MEDICINE The Chiropractic is a complementary and alternative medicine health care profession and an approach to healing concerned with the diagnosis, treatment and prevention of disorders of the neuromuscular skeletal system and the effects of these disorders on general health. Daniel David Palmer ( founder) Invented in 1895 . 6/28/2014 10 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

AROMATHERAPY SYSTEM OF MEDICINE:

AROMATHERAPY SYSTEM OF MEDICINE It is a form of alternative medicine that uses volatile plant materials, known as essential oils, and other aromatic compounds for the purpose of altering a person's mind, mood, cognitive function or health. 6/28/2014 11 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

ACUPUNCTURE SYSTEM OF MEDICINE:

ACUPUNCTURE SYSTEM OF MEDICINE The Acupuncture is a collection of procedures involving penetration of the skin with needles to stimulate certain points on the body. In its classical form it is a characteristic component of traditional Chinese medicine (TCM). Acupuncture is generally safe when administered using Clean Needle Technique (CNT) and carries a very low risk of serious adverse effects . 6/28/2014 12 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

MAGNETOTHERAPY SYSTEM OF MEDICINE:

MAGNETOTHERAPY SYSTEM OF MEDICINE It is a pseudoscientific alternative medical therapy in which the placement of magnets or magnetic devices on the skin is thought to prevent or treat symptoms of disease, especially pain. It is also known as magnet therapy or magnetic therapy. 6/28/2014 13 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

YOGA SYSTEM OF MEDICINE:

YOGA SYSTEM OF MEDICINE It is the physical, mental, and spiritual practices or disciplines which originated in ancient India with a view to attain a state of permanent peace. The term yoga is a Sanskrit word which means ’ to yoke’ or ’ to concentrate’ .  It has also been popularly defined as "union with the divine" in other contexts and traditions. 6/28/2014 14 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

HERBAL SYSTEM OF MEDICINE:

HERBAL SYSTEM OF MEDICINE Herbalism  or "herbal medicine" is the study of use of plants for medicinal purposes. Modern medicine recognizes herbalism as a form of alternative medicine as the practice of herbalism is not strictly based on evidence gathered using the scientific method.  6/28/2014 15 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

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HERBAL ISM:

HERBAL ISM Herbalism  or "herbal medicine" is the study of use of plants for medicinal purposes. Modern medicine recognizes Herbalism as a form of alternative medicine as the practice of Herbalism is not strictly based on evidence gathered using the scientific method.  National Institute of Medical Herbalists 1864 (professional body) Phytotherapy - the science of herbalism 6/28/2014 17 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

HERBAL MEDICINES:

HERBAL MEDICINES The study or use of medicinal herbs to prevent and treat diseases and ailments or to promote health and healing. It is also called botanical medicine or phytomedicine . Medical practices based on the use of Plant‘s seeds Leaves Roots Bark Flowers 6/28/2014 18 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

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6/28/2014 19 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN HISTORY From 60,000 year ago plants are cultivated as medicines. Ancient Chinese and Egyptian papyrus writings describe medical uses for plants

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6/28/2014 20 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN 2,500 year ago Hippocrates the father of medical literature used only food and herbs and is best known for the sayings: “Let your food be your medicine and let medicine be your food” “Sickness is caused by the body’s inability to digest its environment” In the early 19 th century, when chemical analysis first became available, scientists began to extract and modify the active ingredients from plants.  In the last 20 th in the united states Public dissatisfaction with the cost of prescribed medication Interest in returning to natural and organic remedies.

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6/28/2014 21 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN SYSTEMATIC INVESTIGATION OF HERBAL PLANTS The various steps involved in the systemic investigation of plants for their beneficial active constituents are: Obtaining the raw plant material and its subsequent quality control Extraction, purification to obtain the constituents of pharmaceutical interests. Investigating the biosynthetic pathways involved in the biosynthesis of the desired constituents. Quantitative evaluation

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6/28/2014 22 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN EXTRACTION OF HERBAL MEDICINES

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6/28/2014 23 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN ISOLATION OF HERBAL MEDICINES

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6/28/2014 24 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN IDENIFICATION OF HERBAL MEDICINES

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6/28/2014 25 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN ANALYSIS OF HERBAL MEDICINES

SIGNIFICANCE OF HERBAL MEDICINES:

6/28/2014 26 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Herbal Medicine is used to treat many condition such as Asthma, Eczema, Premenstrual syndrome, Rheumatoid arthritis, Migraine, Menopausal symptoms, Chronic fatigue, Irritable  bowel syndrome, and cancer. SIGNIFICANCE OF HERBAL MEDICINES

HERBAL SUPPLEMENTS:

HERBAL SUPPLEMENTS 6/28/2014 27 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Herbal supplements are classified as: Dietary supplements by U.S. Dietary supplement Health and Education Act (DSHEA) of 1994.

SIGNIFICANCE OF HERBAL SUPPLEMENTS:

6/28/2014 28 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Ginkgo ( Ginkgo biloba ) has been used in traditional medicine to treat circulatory disorders and enhance memory.  Kava kava ( Piper methysticum ) is said to elevate mood, enhance well being and contentment, and produce a feeling of relaxation.  Saw palmetto ( Serenoa repens )  is used by more than 2 million men in the United States for the treatment of benign prostatic hyperplasia (BPH), a non cancerous enlargement of the prostate gland. Valerian ( Valeriana officinalis )  is a popular alternative to commonly prescribed medications for sleep problems  Echinacea preparations ( Echinacea purpurea  and other  Echinacea  species) may improve the body's natural immunity. St John’s Wort - Mild depression SIGNIFICANCE OF HERBAL SUPPLEMENTS

SIDE EFFECTS OF HERBAL SUPPLEMENTS:

6/28/2014 29 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Kava kava has been linked to liver toxicity. Kava has been taken off the market in several countries because of liver toxicity. Valerian may cause sleepiness, and in some people it may even have the unexpected effect of over stimulating instead of sedating. Garlic, ginkgo, feverfew, and ginger, among other herbs, may increase the risk of bleeding. Evening primrose  ( Oenothera biennis )  may increase the risk of seizures. SIDE EFFECTS OF HERBAL SUPPLEMENTS

REGULATION OF HERBAL MEDICINES:

6/28/2014 30 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Licensed: Marketing authorisation (product license) issued by Medicines and Health Care products Regulatory Agency (MHRA). Have to meet safety, quality and efficacy standards similar to conventional drugs. Unlicensed: Exempt from licensing requirements (Section 12 of Medicines act 1968) . REGULATION OF HERBAL MEDICINES

SECTION 12 MEDICINES ACT 1968:

SECTION 12 MEDICINES ACT 1968 6/28/2014 31 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Section 12 (1) person can make, sell and supply herbal remedy as part of business provided remedy is manufactured on the premises and supplied as the consequence of a consultation between patient and herbalist 12(2) allows manufacture and supply where Process of manufacture consists of drying, crushing. Remedy sold without any written recommendation as to its use Remedy sold under a designation which only specifies the plant and the process and does not apply any other name to the remed y

STANDARDISATION OF HERBAL PREPARATIONS:

STANDARDISATION OF HERBAL PREPARATIONS 6/28/2014 32 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Some herbal preparations are standardized, meaning that the preparation is guaranteed to contain a specific amount of active ingredients of herbs. However, it is still important to ask companies making standardized herbal products about their herbal’s guarantee.

SAFETY ISSUES:

6/28/2014 33 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Remember Herbal remedies are medicines Report adverse reactions to doctor or pharmacist May interact with other medicines Natural does not mean safe SAFETY ISSUES

DUTY OF PHYSICIAN WHEN PRESCRIBING:

6/28/2014 34 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN To facilitate full and informed consent. To do no harm. Negligence – Proven breach of duty of care and harm to patient DUTY OF PHYSICIAN WHEN PRESCRIBING CONSIDERATIONS WHEN PRESCRIBING Always ask the patient what else they are taking Including Over the Counter medication and Herbal medicines Consider potential drug interactions

PRESCRIPTION BY AYURVEDIC PHYSICIAN:

PRESCRIPTION BY AYURVEDIC PHYSICIAN 6/28/2014 35 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN The parallel of two approaches with the same goal: Health

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6/28/2014 36 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Current challenges facing herbal/traditional products

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6/28/2014 37 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN The medicinal properties of popular herbs and plants

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6/28/2014 38 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Prospects for some herbal/traditional remedies Herbal/Traditional Options: Positive Outlook Phythosterols (plant sterols) Honey Spices: ginger, cumin, cinnamon, clove, turmeric, saffron, fennel seeds Capsaicin from chili peppers Garlic Fibre Goldenseal Hawthorn Grape seed extract Herbal/Traditional Options: Negative Outlook St. John’s Wort Black cohosh Red yeast rice Ephedra Valerian Kava Comfrey

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6/28/2014 39 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Future impact of herbal/traditional products on OTC drugs

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6/28/2014 40 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Dietary supplements to dominate future sales

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6/28/2014 41 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Herbal/traditional products SWOT analysis Industry Questionable products still exist in the marketplace. The industry is working to denounce illegal or unethical producers and remove deceiving products from reaching consumers. Many companies are introducing a wider array of products for different consumer segments Consumers Consumers are paying more attention to novel “safe and natural” options as they become more proactive in their health. The fear of “toxic” conventional drugs pushes some people to try herbal/traditional products. Industry Only a few products can rightfully claim health benefits backed by scientific evidence. Reliable information about the interactions of herbal/ traditional products and conventional drugs is very limited or non-existent. Contaminated and tainted herbal/traditional products lead to mistrust that can affect future purchases. Consumer watchdog groups and members of the medical community are applying pressure to inform the public on the dangers of “quack” or “fake” remedies tied to herbal/traditional remedies Consumers

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6/28/2014 42 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Industry are recognising and supporting the use of herbal/traditional products. Traditional and Complementary Alternative Medicine (CAM) are becoming more common as treatments. Consumers Consumers may be willing to adopt healthy lifestyles and increase their expenditure on herbal/ traditional products as the economy improves. Digital media can create positive awareness about alternative treatments. Industry Stricter regulation on good manufacturing practice (GMP). Increasing pressure to provide scientific evidence that supports quality, safety and efficacy. Consumers Competitive pressure and heavy advertising can lure consumers back to conventional drugs. The risk of negative interactions with prescription drugs in ageing populations may slow growth in sales.

DRUGS FROM PLANT SOURCE:

DRUGS FROM PLANT SOURCE 6/28/2014 43 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Aspirin Codeine Cocaine Quinidine Scopolamine Tubocurarine Ergotamine Morphine Digoxin Pilocarpine

PROBLEMS:

PROBLEMS 6/28/2014 44 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN Poor manufacturing process Adulteration to include toxic substances and conventional drugs Misidentification of herbs Substitution of herbs Varying strengths of preparations Incomplete labelling Incorrect dosage and instructions

CONCULSION:

CONCULSION Nature always have a solution, but we have to dig deeper! 6/28/2014 45 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

REFERENCE:

REFERENCE C.k . Kokate , A.P. Purohit , S.B. Gokhale ; pharmacognosy;47 th edition; page.no: 17.1 – 17.11. Varro E. Tyler, Lynn R. Brady, James E. Robbers; pharmacognosy ; 9 th edition; page. No: 456 – 458. W.C. Evans; Trease and Evans pharmacognsy ; 15 th edition, page. No: 460 -466. Sujata V. Bhat , B.A. Nagasampagi , S.Meenakshi ; Natural Products Chemistry and Applications; Sanju Nanda, Arun Nanda, Roop K. Khar ; cosmetic technology; page. No: 109- 116. Thomas, K et al., Use and expenditure on complementary therapies in England: a population based survey. Complementary Therapies in Medicine 2001; 9(1): 2-11 . 6/28/2014 46 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN

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6/28/2014 47 VIJAYA INSTITUTE OF PHARMACEUTICAL SCIENCES FOR WOMEN THANK YOU

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