Aznan Lelo

Dep. Farmakologi & Terapeutik,

Fakultas Kedokteran
UNIBA
7 September 2011, UNIBA, Batam
Relationship between herbal
and modern medicine
Herbal Medicines
................. Not all that is
natural is
harmless
Why do people use herbal
medicines?

Used in developing countries where cost of drugs is

prohibitive, poor accessibility to drugs in rural areas,
shortage of physicians

Perception that natural = safe

More ADRs reported with conventional medicines

than herbal preparations

Provide a sense of control, a mental comfort from

taking action e.g. cancer, AD!

"ultural # religious beliefs

Use differs by ethnic group, income, age & educational

level
$R%&'(M! )A"(D &* +,(
+RAD+%-A' M(D"-(
1. Pharmaceutical assessment crude plant
material, plant preparations, finished products,
stability!.
". #afety assessment to$icological studies,
documentation of safety based on e$perience!.
%. &ssessment of efficacy and intended use
pharmacological activity, evidence re'uired to
support indication!.
(. Product information to consumers.
). *arketing
)ig. / $atient -R 0alues
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1rom2 3am &4, *ohutsky *& and 5lmer 67. Probable herbal,drug interaction
between warfarin and a common 8hinese herb, 3ycium barbarum. &nn Pharmacother
"//19%)21100:1"/1
+he ,erbal +reatment of
Diseases
Phytotherapy ;erbal
medicine!, the natural
therapies, by contrast,
aims not to 1cure2
disease by a
technological fi$.
<he nature in totality, is
the e$pression of a
universal harmony and
e'uilibrium the rupture
of which gives rise to
numerous ill effects.
8
Medicinal Herbs
The Whole better than
part.

Powerul ingredients.

!nl" #$% o estimated

plant species on earth
ha&e been in&estigated or
possible Medicinal uses.

The world Health

organi'ation estimates
that 8(% o the earth
population toda" depends
on plants to treat common
ailments.

Traditional Healers are

good resources or
scienti)c based research.
P!*+!,!-+ P./,T /,D
+/F0 M0D*1*,0
2+traightorward
de)nition o a
3poisonous plant4.
2The ma5or poisonous
principles ound
among plants are
organic compound.
2Herbal medicines are
to be prescribed with
greatest care.
How would "ou ad&ise6

More than 7$ % o the population in the

least de&eloping countries use herbs
or health and other purposes.

More than one third o /mericans and

0uropeans use herbs or health
purposes, spending o&er 8.( billion
annuall".

More than 9$ % o modern

pharmaceutical drugs ha&e botanical
origins.
WH/T : *F6
What i a patient who has the human
immunode)cienc" &irus has an
increasing &iral load and ask "our ad&ise
about a medicinal herb or his case6
What i "ou don;t ha&e access to
/manatadine or pre&ention and
treatment o *n<uen'a /6
What i "ou are located in an area where
medicinal herbs are used intensi&el" b"
public6
Herbal Materia Medica
=>?
+T @!H,;+ W!AT

1onstituentsB
2Aed pigment, Aesin, Colatile oil
1arotenes,Taninnin, Fla&anoideDinc.h"pericinE.

1ommon use B /ntidepressant.

*n&estigational usesB/nticancer , anti&iral

Dincluding human immunode)cienc" &irusE.

+ide eFects B photosensiti&it" Drare,with large

dose.

*t is named ater +t @ohn;s the Gaptist because

it blooms around his east da".
+ources o inormation and
acknowledgments

This lecture draws eHtensi&el" rom

material presented on the 0uropean
@ournal o Herbal Medicine , the Gritish
5ournal o ph"totherap" and the
/merica;s guide to natural Health.

*n particular, the summaries o

inormation on materia medica is
grateull" acknowledged.

+tudents are encouraged to eHplore the

+upercourse site D*.pre&entionE.
Anxet!
complementary and alternative interventions are
currently being used to treat an$iety and an$iety
disorders will be grouped in this article!as follows2

herbal interventions

nutritional supplements and aromatherapy

cognitive interventions, including mindfulness:

based stress reduction *=#>! and meditation

physical interventions such as acupuncture

"erbal Inter#entons,
Nutrtonal Supplements
and Aromat$erap!

7erneke et al. conducted an extensive database search

and identified 2007 studies of herbal remedies and
nutritional supplements in the treatment of psychiatric
disorders.

<he authors found that kava Piper methysticum) was

the most researched remedy for anxiety and that there
was good evidence for its an$iolytic effect.

& 8ochrane review reported by Pittler and 5rnst which

included 11 >8<s involving .() patients, showed that
kava is the only herbal remedy that has been proven to
be effective in reducing an$iety
Depression
8omplementary and alternative treatments for
depression and depressive disorders
discussed in this report are grouped into the
following categories2

herbal interventions

nutritional supplements and aromatherapy

cognitive interventions including

hypnotherapy, 8=< and mindfulness:based
cognitive therapy

physical interventions, including acupuncture

and light therapy.
Herbal *nter&entions,
,utritional +upplements and
/romatherap"

& recent review reported by 5rnst indicated that #t ?ohn@s wort

;ypericum perforatum! is the only herbal remedy found to be
effective as a treatment for mild to moderate depression. <he
author discussed a previous meta:analysis published in
6erman language by >oder et al. An five trials involving ""%1
patients that compared #t ?ohn@s wort with conventional
antidepressants, >oder et al. found both approaches to be
e'ually effective. #t ?ohn@s wort was significantly effective
when compared with placebo in ") trials involving a total of
"1"0 patients.

5rnst cautioned against using #t ?ohn@s wort with other

medications because it can increase the plasma levels of a
range of drugs and there is a possibility that it can occasionally
trigger psychosis in patients who are using selective serotonin
reuptake inhibitors.
1/M
Herbal remedies in cancer
H/* conerence 9((8
Patricia FoH
+chool o ,ursing, Midwier" & Health
+"stems, -1D

1/M pre&alence in haematological
cancers DMolassiotis et al. 9(($E

0uropean stud"B#9 countries DnIJ8E .mts2

B
9J.$% use some orm o 1/M
B
Most common therapies usedB

homeopath" DK8.7%E,

$erbal med%ne D99.9%E

&arious ps"chic therapies, such as use o

mediums, healers, rebirthing D99.9%E

Aeasons or useB
B
*ncrease abilit" o their bod" to )ght cancer and
impro&e ph"sicalLemotional wellMbeing.
Herbal supplementsB
potentiall" dangerous
misconceptions

+ome patients ma" belie&e

B
that i a practice or product has been in use or
hundreds o "ears, it must be eFecti&e

Man" also belie&e

B
that i a product is Nnatural;, it must be sae
D+mith & White 9((#E
Herbal supplements

Herbs and ,atural Products

B
With potential to decrease cancer growth or as
ad5u&ants Dpreliminar" e&idence onl" oten
based on in &itroLanimal studiesE no
recommendations can be made to patients at
this time.
B
With potential to decrease side eFects
B
That ma" increase cancer growth or recurrence
B
That can interact with con&entional treatment
and medications
Patricia 1o$, U8C, "//-
Herbal supplements
+ome Oe" points

@ust because it is labelled Nnatural;

does not mean it is sae or without side

eFects
B
1an act in the same wa" as drugs P

ma" cause medical problems i taken

incorrectl" or in large amounts.
B
Where herbal supplements are used,

it is preerable to do so under guidance o a

medical proessional, properl" trained in
herbal medicine D,11/M 9((>E
Patricia 1o$, U8C, "//-
Herbal supplements
+ome Oe" points

Herbal supplements
B
not sub5ect to the same rigorous standards as
mainstream medications

The acti&e ingredientDsE in man" herbsL herbal

supplements
B
are not known

Published anal"ses ha&e ound diFerences

B
between what is on label and what is in the
bottle

+ome herbal supplements ma" be contaminated

B
with metals, unlabelled prescription drugs,
microMorganisms D,11/M 9((>E
;erbal la$atives

Cecrease blood levels of drugs by shortening

gastrointestinal transit time

Ancrease potassium loss

8ommon herbal la$atives2

B
aloe,
B
cascara sagrada,
B
rhubarb,
B
#enna
&bebe 7, "//%. ? Cental ;ygiene --1!2%-:(.
HERBAL DRUG/NATURAL FOODS
A BIG BUSINESS
Herbal Food Supplements
Herbal Food Supplements
Wat !s te bas!s o" tese Rules#
Wat !s te bas!s o" tese Rules#


Foods sall not be adulterated
Foods sall not be adulterated
&usso A, 'ron%oso N, San%$ez F, (arbarno )A,
*anella A+
,ropols prote%ts $uman spermatozoa
-rom .NA dama/e %aused b!
benzo0a1p!rene and exo/enous
rea%t#e ox!/en spe%es+
.ie +ci. 9((J Feb 9KQ88D#KEB#>(#MJ.
Man" en&ironmental, ph"siological and genetic actors ha&e been
implicated in deecti&e sperm unction, the most common cause
o inertilit".
!ur eHperimental e&idence demonstrated that the natural drug
under in&estigation is able to protect genomic D,/ b" damage
induced b" ben'oRaSp"rene, h"drogen peroHide DH9!9E and
h"drogen peroHide in combination with adenosine $TMdiphosphate
D/DPE and errous sulate DFe+!>E, determining a signi)cant
reduction o the intracellular oHidants.
The propolis eHtract was shown to possess the capacit" to protect
sperm membrane rom the deleterious action o oHidati&e attack,
reducing TG/A+ ormation and .DH release.
*n summar", our results e&idence that the protecti&e eFect
eHhibited b" this natural compound in human spermato'oa is
correlated, at least in part, to the antioHidant capacit" o its
acti&e components, and suggest that propolis ma" ha&e a role in
protection against male inertilit".
Mi"ata T. ,$arma%olo/%al bass o-
tradtonal med%nes and $ealt$
supplements as %urat#es+
@ Pharmacol +ci. 9((8 FebQ#(KD9EB#98MK#.
Traditional !riental medicines and health supplements ha&e been
empiricall" used to treat &arious ailments but most o them ha&e
not been e&aluated ob5ecti&el" to pro&e their eUcacies. /ll o its
actions are based on the restoration o normal molecular and
cellular unctions through D,/ transcriptional regulation.
*n other pre&ious studies, we showed that a health supplement,
ro!al 2ell! 3&)4 has 5eak estro/en% a%t#t!. A@ competes with
#8betaMestradiol or binding to the human estrogen receptors
alpha and beta, although it is much weaker than dieth"lstilbestrol
in binding aUnit".
Furthermore, subcutaneous in5ection o A@ restored the eHpression
o &ascular endothelial growth actor gene in the uteri o
o&ariectomi'ed rats.
We suggest that the di&erse pharmacological unctions o A@ can
be ascribed, in part, to its estrogenic eFects.
"one! Bee
one o Gene)cial *nsects

Vreat Pollinator

Produces hone" & beeswaH

Protects against pests

6ed%al uses -or $one!
/ntibacterial properties o hone" are the result o B
B !smotic eFect,
high concentration o sugar, &er" ew eHtra water molecules
remain a&ailable to microorganisms and so presents a &er"
undesirable en&ironment or their growth.
B H"drogen PeroHide eFect
acti&ated b" dilution, it is present in a concentration o onl"
# mmolLl in hone".
iron in hone" oHidi'e the oH"gen ree radicals released b"
the h"drogen peroHide.
B glucose W H9!W !9 P gluconic acid W H9!9
when used topicall" as, or eHample a wound dressing,
h"drogen peroHide is produced b" dilution with bod" <uids.
as a result, h"drogen peroHide is released slowl" and acts as
an antiseptic.
B High acidit".
The pH o hone" is commonl" between K.9 and >.$
This relati&el" acidic pH le&el pre&ents the growth o man"
bacteria responsible or inection
6adu 3$one!4
0ek Farmakologi B

sumber energi L kalori

antimikroba
o French CM, 1ooper A/, Molan P1. The antibacterial acti&it"
o hone" against coagulaseMnegati&e staph"lococci. @
/ntimicrob 1hemother. $JD#EB998MK#,9(($.

antiseptik

meningkatkan stamina

membantu pencernaan dan pen"embuhan

tukak peptik

membantu pemulihan ungsi s"ara

aman pada penderita DM