- 1. ALZHEIMERS DISEASE -(AD) ANDITSHERBALTREATMENT Presented
by---K.Swathi priya ( regd no.609209506005 )Under the esteemed
guidance ofprof. Ganga rao Bottu . M.Pharm.,Ph.D.( INDIA
2. The Impact of AD Once considered a rare disorder, Alzheimers
disease is now seen as a major public health problem that is
seriously affecting millions of older peopleand their families. 3.
What is Alzheimers disease (AD)? Alzheimers disease is an
irreversible, progressive brain disease that slowly destroys memory
and thinking skills. Although the risk of developing AD increases
with age in most people with AD, symptoms first appear after age 60
AD is not a part of normal aging. It is caused by a fatal disease
that affects the brain. 4.
- AD is the most common cause of dementia among people age 65 and
- Scientists estimate that around 4.5 million people now have
- For every 5-year age group beyond 65, the percentage of people
with AD doubles.
- By 2050, 13.2 million older people are expected to have AD if
the current numbers hold and no preventive treatments become
5. Inside the Human Brain To understand Alzheimers disease, its
important to know a bit about the brain
- The Brains Vital Statistics
- Adult weight:about 3 pounds
- Adult size:a medium cauliflower
- Number of neurons: 100,000,000,000(100 billion)
- Number of synapses(the gap between neurons):
6. Inside the Human Brain The Three Main Players
- 1. Cerebral Hemispheres where sensory information received from
the outside world is processed; this part of the brain controls
voluntary movement and regulates conscious thought and mental
- accounts for 85% of brains weight
- consists of two hemispheres connected by the corpus
- is covered by an outer layer called the cerebral cortex
7. Inside the Human Brain The Three Main Players
- 2. Cerebellum in charge of balance and coordination:
- takes up about 10% of brain
- consists of two hemispheres
- receives information from eyes, ears, and muscles and joints
about bodys movements and position
8. Inside the Human Brain The Three Main Players
- 3. Brain Stem connects the spinal cord with the brain
- relays and receives messages to and from muscles, skin, and
- controls automatic functions such as heart rate, blood
pressure, and breathing
9. Inside the Human Brain Other Crucial Parts
- Hippocampus:where short-term memories are converted to
- Thalamus:receives sensory and limbic information and sends to
- Hypothalamus:monitors certain activities and controls bodys
- Limbic system:controls emotions and instinctive behavior
(includes the hippocampus and parts of the cortex)
10. Inside the Human Brain The Brain in Action Hearing
WordsSpeaking WordsSeeing WordsThinking about Words Different
mental activities take place in different parts of the brain.
Positron emission tomography (PET) scans can measure this
activity.. 11. Inside the Human Brain Neurons
- The brain has billions of neurons, each with an axon and many
- To stay healthy, neurons must communicate with each other,
carry out metabolism, and repair themselves.
- AD disrupts all three of these essential jobs.
- Plaques and Tangles: The Hallmarks of AD
- The brains of people with AD have an abundance of two abnormal
- beta-amyloid plaques, which are dense deposits of protein and
cellular material that accumulate outside and around nerve
- neurofibrillary tangles, which are twisted fibers that build up
inside the nerve cell
- Amyloid precursor protein (APP) is the precursor to amyloid
- 1. APP sticks through the neuronmembrane.
- 2. Enzymes cut the APP into fragmentsof protein, including
- 3. Beta-amyloid fragments come togetherin clumps to form
In AD, many of these clumps form, disrupting the work of
neurons. This affects the hippocampus and other areas of the
cerebral cortex. 14.
Neurons have an internal support structure partly made up of
microtubules. A protein calledtauhelps stabilize microtubules. In
AD,tauchanges, causing microtubules to collapse, andtauproteins
clump together to form neurofibrillary tangles. 15. 16. No one
knows what causes AD to begin, but we do know a lot about what
happens in the brain once AD takes hold. Preclinical AD 17. Mild to
Moderate AD 18. Severe AD 19. Types The two main types of AD are
early-onset and late-onset:
- Early-onset AD is rare, usually affecting people aged 30 to 60
and usually running in families. Researchers have identified
mutations in three genes that cause early-onset AD.
- Late-onset AD is more common. It usually affects people over
age 65. Researchers
have identified a gene that produces a protein called
apolipoprotein E (ApoE). Scientists believe this protein is
involved in the formation of beta-amyloid plaques. 20. Signs and
- Increasing and persistent forgetfulness
- Difficulties with abstract thinking.
- Difficulty finding the right word.
- Difficulty performing familiar tasks.
- Infections. Untreated urinary tract infections can lead to more
serious, life-threatening infections.
- Falls and their complications.
- Serious head injuries (bleeding of brain).
- Surgery to repair injury carries risks.
- Prolonged immobilization increases the risk of pulmonary
embolism, which can be life-threatening.
- Apart from synthetic drugs, Alzheimer's disease can be cured as
well as prevented by natural herbal drugs. This is regarded
asComplementary Alternative Medicine system . Which is been widely
used due to less risk of side effects.
23. Herbal drugs used to treat Alzheimer's disease
24. Ginkgo biloba (maidenhair tree)
25. Active constituents :
26. Mechanism of action: 27. Other pharmacological
- Effects on tinnitus, geriatrics and psychiatric disorders
28. Adverse effects:
- Gastrointestinal problems
29. Herbal drug-drug interactions :
- Anti coagulant drugs leading to hemorrhage
- Anti depressants (trazadone) leading to mental disorders
- Doses of 120mg to 240mg daily..
- Ginkgolic acid(alkyl phenol) toxic in nature
- Hence, the concentration ofGashould be less than 5ppm
30. In Market:
- It can be taken in its original form or it is available in the
market in the form of capsules.
- Jarrows formulation-- Jarrows ginkgo biloba-- 120mg,60
31. Galanthus woronowii:
snowdrop 32. Active constiuents:
- An alkaloid obtained from the bulbs and flowers ofgalanthus
Structure : 33. Mechanism of action: 34. Absorption,
bioavailability and distribution:
- Absorption : rapid and complete
- Max plasma conc: 0.5 2 hours.
- Food decreases rate of absorption
- Bioavailability: 80% to 100%.
- Distribution : large volumes, rapid and
non-specificdistribution of the drug.
35. Metabolism and Excretion :
- Metabolism -major route liver.
- The dose of galantamine should not exceed 16mg/day..
- If they have peptic ulcers, Parkinson's, heart diseases,
hypotension or if the patient is pregnant.
36. Adverse effects: Herbal drug-drug interactions :
- Gastrointestinal problems
- Antagonizes the action of anticholinergic drugs.
- Cimetidine increases galantamine bioavailabiliy.
- It shows interactions with digoxin, warfarin etc.
37. In market: It is available in the form of capsules Reminyl
ER (extended release galantamine hydrobromide) Life Enhancement,
GalantaMind, Memory Function Support, 90 Capsules 38. Curcuma longa
turmeric 39. Active constiuents:
Keto form Enolform 40. Mechanism of action:
- Inhibits beta-amyloid plaque formation
- Inhibits damage to neuronal synapse
41. Other pharmacological properties:
42. Dosage :
- Turmeric can be used in food and it is readily available in
powdered form. Curcumin extracts in liquid form are also available.
Turmeric powder can be consumed with herb based teas, honey or hot
- Usually about a half to a quarter teaspoon of powdered turmeric
should be consumed two to three times a day.
- Curcumin capsules with a dosage 250-500 mg can also be taken
three times a day.
- It has been found that, in vitro, turmeric can have
antiplatelet effects with antiplatelet or anticoagulant drugs
Interactions: 43. Centella asiatica: (Gotu Kola )
44. Active constiuents:
- brahmoside, brahminoside, asiaticoside, indocentelloside
- Also contains mesoinosetol, a new oligosaccharide, centellose,
45. Mechanism of action:
- Oxidative stress also leads to AD because of harmful production
of free radicals
46. Other pharmacological properties:
47. Dosage :
- 1000mg/ 3 times a day and about 1 hour before meal.
- It shows interaction with CNS depressants as result increases
sleeping time .
- There is concern that gotu kola might cause liver damage.
People who already have a liver disease such as hepatitis should
avoid using gotu kola. It might make liver problems worse .. It is
safe during pregnancy
Safety and precautions: 48. In market: It is available in the
form of capsules, tablets GOTU KOLA - VALLARAI - TABLETS Centella
Asiatica IMPCOPS - ORGANIC AND WILD 100 tablets of 500 mg 49. Other
herbal drugs: Withania somnifera:
Ashwagandha 50. Bacopa monnieri:
brahmi 51. Macleaya cordata:
Plume poppy 52. Vinca minor:
periwinkle 53. Allium sativum :
garlic 54. Coptis chinenses :
Chinese goldthread 55. Rosemarinus officanalis:
rosemary 56. Panax ginseng:
ginseng 57. Lycoris radiata:
Red spider lily 58. Melissa officinalis:
Lemon balm 59. Conclusion
- Alzheimers disease develops when Genetic, life style and
environmental factors work together to cause the disease process to
- Herbal treatment for Alzheimer's disease helps in management of
the disease but its not a complete cure.
- Though herbal drugs contain less or null side effects compared
to synthetic drugs, in the case of Alzheimer's they play a half
- For complete cure of Alzheimer's disease it is necessary to
know the cause, and should have changes in the lifestyle in
addition with herbal treatment.
- Medical anthropology by Bianca Brijnath
- anatomy and physiology by Ross and Wilson
- Aging in INDIA (Alzheimer's disease)- by A.B.bose