Pharmacognosy-I (Part-3)

8/14/2019 Pharmacognosy-I (Part-3)

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Complementary / alternative

medicine


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Are complementary medicine and

alternative medicine different

from each other?


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Yes, they are different


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Complementary medicineis usedtogether withconventional medicine. An

example of a complementary therapy isusing aromatherapy to help lessen apatients discomfort following surgery.

Alternative medicineis used in placeofconventional medicine. An example ofan alternative therapy is using a specialdiet to treat cancer instead of undergoing

surgery, radiation, or chemotherapy thathas been recommended by a conventionaldoctor.


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What are the major types ofcomplementary and alternative

medicine?


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NCCAM classifies CAM

therapies into fivecategories, or domains


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Medical Herbalism


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Aspects of medical herbalism1. Herbalism takes an holistic approach.

2. Herbalists select herbs on an individual basis for each

patient.

3. Herbalists aim to identify the underlying cause (e.g.

stress) of a patients illness and to consider this in the

treatment plan.

4. Herbs are used to stimulate the bodys healing

capacity, to

strengthen

bodily systems and tocorrectdisturbed body functions rather than to treat

presenting symptoms directly.

5. Herbs may be used to provide long-term relief from

the particular condition.


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One of the tenets of herbalism is thatthe different constituents of a herb act

together in some way that hasbeneficial effects. These could be:

1. Additive effect:

The combined effect of two drugs isequalto the sum of their individualactions.

2. Synergistic effect:

The combined effect of two drugs isgreaterthan the sum of the individualeffects.


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Conditions treated

Medical herbalists treat a wide rangeof acute and chronic conditions. e.g.

1. Irritable bowel syndrome

2. Premenstrual syndrome

3. Menopausal symptoms4. Eczema

5. Types of arthritis

6. Depression

7. Acne and other skin conditions8. Cystitis (Inflammation of the urinary bladder)

9. Migraine

10. Chronic fatigue syndrome


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Herbalists prescriptions

Generally, a combination of severaldifferent herbs (usually 4-6) is used inthe treatment of a particular patient.

sometimes, a single herb may be given,e.g. chasteberry (vitex agnus castus) forpremenstrual syndrome anddysmenorrhea.

Each patients treatment is reviewedregularly and is likely to be changeddepending on whether or not there has

been a response.


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Comparison of herbalism with

rational phytotherapy

Herbalism1. Assume that synergy or

additive effects occurbetween herbs.

2. Holistic prescribing.3. Preparations mainly

formulated as tinctures.

4. Mainly uses combinationsof herbs.

5. Opposition towardsstandardization.

6. Not scientificallyevaluated.

Rational phytotherapy1. Seek evidence that

synergy or additive effectsoccur between herbs.

2. No holistic.3. Preparations mainly

formulated as tablets andcapsules.

4. Single-herb products usedmainly.

5. Using standardization.

6. Science-based approach.


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Generally, medicinal herbs fall into two basic

categories: tonicandstimulating.

Tonicshelp cells, tissues, and organs to maintain

tone, or balance, throughout the body. Some

tonics activate and invigorate bodily processes or

parts. Other tonics supply important nutrients

that cells, tissues, and organs need to function

properly. Tonics ordinarily are taken regularly for

three to nine months at a time to gently

strengthen and improve overall health and/or

certain organ functions. Stimulating herbshave much stronger actions

and are used to treat particular ailments. They

should be taken in smaller doses than tonic

herbs, and for shorter periods of time.


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Evidence of efficacy and safety


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Homoeopathy


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Homoeopathy was founded

around 200 years ago bySamuel Hahnemann (1755-1843),a German physician and

apothecary.Today, around 1200

Homoeopathic remedies arecommonly used.

H h tli d th b i i i l


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Hahnemann outlined three basic principles

of homoeopathy, which form the basis of

classical Homoeopathy

1. A substance which, used in large doses, causesa symptom(s) in a healthy person can be usedto treat that symptom(s) in a person who is ill.For example, Coffee, a remedy prepared fromthe coffee bean (a constituent, caffeine, is acentral nervous system stimulant) would beused to treat insomnia. This is the so-called likecures likeconcept.

2. The minimal dose of the substance should beused in order to prevent toxicity.

3. Only a single remedy or substance should be

used in a patient at any one time.


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Modern homoeopathy

Hahnemanns principles of homoeopathy stillform the basis of modern homoeopathicpractice, with the exception of the single

remedy rule, which is ignored by manyhomoeopaths in favor of multiple prescribing.

Modern-day provings have involved rigorousstudy design (randomized, double-blind,placebo-controlled), while Hahnemann did notuse rigorous study design.


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In addition to the basic principles of homoeopathy,

modern homoeopaths also believe:

1. That illness results from the bodys inability tocope with challenging factors such as poor dietand adverse environmental conditions.

2. That the signs and symptoms of diseaserepresent the bodys attempt to restore order.

3. That homoeopathic remedies work bystimulating the bodys own healing activity

(the

vital force

) rather than by acting directlyon the disease process.

4. That the vital forceis expressed differently ineach individual, so treatment must be chosen

on an individual (holistic) basis.


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Homoeopathic remedies

Homoeopathic remedies and herbal medicinesare often confused and/or deemed to besimilar. The fundamental differences betweenthe two types of preparation are:

1. Homoeopathic remedies are (mostly) highly

dilute whereas herbal medicines are used at

material strengths.

2. Many homoeopathic remedies (around 65%)

originate from plants, whereas by definition all

herbal medicines originate from plants.


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Many of the plants from which homoeopathicremedies are derived have a history ofmedicinal use.

Other types of material used in thepreparation of homoeopathic remediesinclude animal, insect, biological,drug/chemical and mineral.

The starting point for the production of mosthomoeopathic remedies is a mother tincture,usually an alcohol/water extract of crudeplant material. The mother tincture is thendiluted according to either the decimal(dilution steps of 1 in 10; denoted by D or X)or centesimal(dilution steps of 1 in 100;denoted by C or cH) scale to formhomoeopathic remedies or potencies.


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For example, on the decimal dilution scale, a 1X (or

D1) remedy is prepared by taking one part mother

tincture and adding it to nine parts diluent (dilute

alcohol) and succussing the resulting 1 in 10

dilution. A 2X remedy is prepared by taking one part

1X remedy and adding it to nine parts diluent and

succussing the resulting dilution, which is now a

dilution of 1 in 100, and so on. The centesimal scale

uses the same procedure except that each step

involves adding one part mother tincture to 99 parts

diluent so that the first step produces a 1 in 100

dilution (1C or 1cH), the second step a 1 in 10,000

dilution (2C) and so on.

There are also LM potencies which involve serial

dilutions of 1 in 50,000 at each step.


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Dosage forms and potentization

Homeopathic remedies come in pellets,tablets, and dilutions (liquids).

The potentizing (mixing) affects the way a

homeopathic medicine works. Generallyspeaking, the lower potencies, such as 3x or

6x, have a greater effect on the organs and

are suited to acute illness. Medium

potencies, such as 12x and 30x, affect the

senses and nervous system. High potencies,

60x and above, affect mental condition.

Th f ll i i h id h i


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The following is a rough guide to the various

potencies, their effects, and uses:

Frequency ofDosage

What It AffectsPotency

One dose every hour to every 4

hours

Body organs. Usedfor symptoms of

acute conditions

6x, 12x, 6c, 12c

One a day to 3times a day

Body organs plusthe senses and

nervous system.Used for symptoms

of chronicconditions

30x, 30c

Once a month toonce a year

Body organs,senses, nervous

system, mind, and

emotions

200x, 1m, 10m, LM


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A typical dose of a homeopathic remedy is

3 tablets or 10 pellets for adults, 2 tabletsor 5 pellets for children.

Remedies should be taken on an empty

stomach.

The tablets should be placed under the

tongue and held there for as long as

possible while they dissolve. If possible,

you should not swallow the tablets.


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Essential oils

Typically, essential oils contain around 100 or

more chemical constituents, mostly present at

concentrations below 1%, although some

constituents are present at much lower

concentrations. Some essential oils contain one ortwo major constituents, and the therapeutic and

toxicological properties of the oil can largely be

attributed to those constituent(s).

The composition of an essential oil will varyaccording to the plant's environment and growing

conditions, the plant part used and on methods of

harvesting, extraction and storage.


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Aspects of aromatherapy

1. Aromatherapists believe that essential oils can be

used not only for the treatment and prevention ofdisease, but also for their effects on mood andemotion.

2. Aromatherapy is claimed to be an holistictherapy.

3. Aromatherapists believe that the constituents ofessential oils work synergistically.

4. Essential oils are described not only withreference to reputed pharmacological properties(e.g. antibacterial), but also by terms that are notrecognized in conventional medicine (e.g.

balancing, energizing).


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Conditions treated

Aromatherapy is widely used as an approach

to relieving stress, and many essential oilsare claimed to be relaxing.

Many aromatherapists also claim thatessential oils can be used in the treatment of

a wide range of conditions. For example:digestive problems, eczema, headaches,insomnia.

Aromatherapy is also used in a variety ofconventional healthcare settings, such asmental health units and in specialized unitscaring for patients with HIV/AIDS, physicaldisabilities and severe learning disabilities.


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Ways of Using Essential Oils

1. Inhaling through vaporization

2. Bathing3. Compress

4. Massage


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Special considerations

Some oils should be avoided by peoplewith certain conditions, such as:

1. High blood pressure

2. Epilepsy

3. pregnancy


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Pharmacognosy-I (Part-3)

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