Herbal Medicine

Dr. Deny Susanti

Course Outline

Credit hours : 2 lecture hours per week

1 laboratory hour per week

Contact hours :

• Lectures = 25 hours,

• Seminar/Debate = 3x1 hours,

• Practical = 5 x 3 hours

• Visit = 6 hours

Instructional strategy:

Lectures

Seminar/Debate

Practical

Visit

Course Assessment

Method %

Seminar & Debate 10

Fieldwork report 10

Practical 10

Mid-Semester Examination 30

End-of-Semester Examination 40

Total 100

Course Objective

• The objective of this course are to:

– introduce the basic concept of Herbal Medicine practices.

– show the pharmacology involved in Herbal Medicine.

– illustrate usage of medicinal herbs for various therapeutic application such as for the: cardiovascular, genito-urinary and nervous system, for diabetes mellitus, arthritis and pain, endurance and energy, liver, metabolic and endocrine disease

– instill awareness of the usage of local herbs for various therapeutic applications.

– also elaborate for each herb, the scientist basis of the usage, its chemical constituents, pharmacological aspects, clinical efficacy, safety, toxicity and potential drug interaction

– make students aware of the bounty of Allah in His creation of ‘Alam

Learning Outcomes

At the end of the course, student should be able to:

1. Describe the concept and principle of Herbal Medicine and botanical therapy

2. Describe of mode of action of common medicinal plants based on the pharmacological effects on their active phytochemical, clinical efficacy, safety, toxicity and potential herbal drug interaction

4. Critically evaluate various therapeutic problems within the range of Herbal Medicine and adopt a professional perceptive in practice.

5. Demonstrate knowledge and understanding of the legislation and dispensing of Herbal Medicine

Topics

1. Introduction to Herbal Medicine

2. Principle of herbal pharmacology and treatment

3. Dosage and dosage forms in herbal medicine

4. Herbs for Cardiovascular disorder

a. Congestive Heart Failure

b. Atherosclerosis

c. Venous Disorder

d. Hypertention/Hypotention

5. Herbs for Respiratory Disorder

a. Bronchial Asthma

b. Colds and Flu

c. Sore Throat

d. Cough Expectorant

6. Herbs for Digestive System Disorder

a. Nausea and Vomiting

b. Flatulence

c. Gastritis and Ulcer

d. Diarrhea

e. Constipation

f. Liver Disease

8. Herbs for Nervous System Disorder

a. Anxiety and Sleep Disorder

b. Depression

c. Pain (General)

d. Headache

e. Memory enhancer/loss

9.Herbs for Kidney, Urinary Tract and Prostate Disorder

a. Urinary Tract Infections

b. Benign Prostatic Hyperplasia

c. Urinary stone

10. Herbs for Endocrine and Metabolic Disorder

a. Hormone and Endocrine Disorder

b. Gynecological Disorder

c. Diabetes mellitus

11. Herbs for Arthritis and

Musculoskeletal Pain Disorder

a. Arthritis

b. Muscle Pain

c. Gout

12. Herbs for Performance and Immune

Deficiency Disorder

a. Adaptogens

b. Immune Stimulants

c. Cancer

d. Sexual Stimulant

13. Common Malaysian Herbs

14. Monograph of Common Herbs

Fieldwork study:

Visit to Herbal Farm/Medicinal plant research institute.

Identification of common local herbal plants, botanical description, plant part used, local name, traditional usage, and biological screening, formulation of herbal medicine

Seminar/Debate

1. Herbal Medicine vs Drug

2. Can Traditional Medicine Coexist with Modern Medicine in the Same Health Care System?

3. Herbal Medicinal Products: Doing More Good Than Harm?

4. Herbal Medicine: Curative or Preventive?

References:

Required:

1. Awang, D. V.C. (2009). Tyler’s Herbs of Choice: The Therapeutic Use of Phytomedicinals (3rd ed.). Boca Raton: CRC Press.

Recommended:1. Fetrow, C.W. and Avila, J.R.(1999). Professional’s Handbook of

Complementary and Alternative Medicine. Springhouse Corporation, Springhouse, Pennsylvania.

2. Philip, R.B.(2004). Herbal-drug Interaction and Adverse effects. An Evidence-based Quick Reference Guide. Mc. Graw-Hill. New York.

3. Lewis, H.L. and Lewis, P.F.L. (2003). Medical Botany: Plant Affecting Human Health (2nd ed.). John Wiley & Son, Inc. Hoboken. New Jersey.

4. Schulz, Hansel, Tyler. (2001). Rational Phytotherapy: A Physician Guide to Herbal Medicine (4th ed.). Springer.

5. Blumenthal, M., Busse, W.R., Goldberg, A., Gruenwald, J., Hall, T., Riggins, C.W. and Rister, R.S. (1998). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicine (1st ed.). The American Botanical Council, Texas.

6. Anderson, N. (1998). Herbal Medicine: A guide for Healthcare Professionals. The Pharmaceutical Press.

7. Muhammad, Z. and Mustafa, A.M. (1994). Traditional Malay Medicinal Plants. Penerbit Fajar Bakti Sdn. Bhd., Kuala Lumpur

• What is Herbal Medicine ?

• Is it safe?

• What are the differences of herbal medicine and drugs?

• Herbal medicine

is the use of plants as medicines. Herbal medicine is also known as phytotherapy(especially in Europe; from Greek phytonmeaning plant)

botanical medicine, medical herbalismand herbology (USA).

Origin of Herbal Medicine

• 60 000 BCE, was the discovery that the dead huminidae (great apes) seemingly had been laid to rest with bunches of flowers that would have grown in the area at the time

• The African great apes, which appear to use several plants for strictly therapeutic purposes (Huffman et al. 1998)

Western Herbal Medicine

• The oldest written reference to medicinal plants and their use is the Chinese Pen Ts’ao, written about 4800 years ago and listing more than 360 species of herbs

• Another ancient manuscript, the EbersPapyrus from Egypt, dates from about 1500 BCE and mentions a large number of plant and animal remedies

• Hippocrates (c.460–377 BCE) of Greece is often referred to as ‘the father of medicine’. He could equally be regarded as one of the founders of holistic herbal medicine.

He prescribed individualised treatments for his patients, recommende exercise and dietary regimens and selected his herbal treatments from more than 400 species of plants.

• Diocles, a student of Aristotle, wrote the oldest Greek herbal, the Rhizotomika, in the fourth century BCE

• Galen (c. 129–199 CE), like Hippocrates, practised humoral medicine but his approach to therapy was rigid, quite unlike the flexible and individualisedapproach of Hippocrates.

• In England, John Gerard’s famous Herbal or General Historie of Plantes was published in 1597, and in 1649 the apothecary Nicholas Culpeper (1616–54) translated the London Pharmacopoeia from Latin into English, much to the consternation of the medical establishment, who saw this as a threat to their exclusive medical knowledge

• Twentieth-century western herbal medicine arose from the physiomedicaland eclectic traditions but was also influenced by European folk medicine, especially from Germany.

Major

influences on western herbal medicine pre- and post-1900

Biogeographical origin of 259 species used in western herbal medicine

Europe/Europe and parts of Asia

37.4%

Asia 19.3%

Africa 3.0%

North America 21.6%

South America 3.5%

Pacific (incld Autralia) 1.2%

Native to several continents 14.0%

Morphological plant part used for medicine

Aerial parts 37.8% 37.8%

Underground parts 27.8%

Fruit/seed 13.9%

Bark 8.5%

Flower 4.6%

Is it safe?

• There are numerous quality issues pertinent to herbal medicines.

• These range from basic issues of correct botanical identification, harvest, drying and storage methods, to issues of good manufacturing practice and stability

Parameters that impact on the quality of herbal medicines and measures taken to control them

Parameter Measures

Botanical identity of raw material

Correct botanical identification

Correct medicinal part(s) of plant

Correct morphological identification

Quality of raw material Good agricultural practice; correct harvest and post-harvest handling; tests for marker compounds, contaminants (heavy metals,micro-organisms, pesticide residues)

Extraction and manufacturing Good manufacturing practice; use of appropriate methodology; test for marker compounds

Stability Stability testing on extract/product

Quality Use Appropriate packaging and labelling(indications, dosage, warnings)

Types of evidence relevant to the therapeutic use of medicinal plants

Clinical evidence Non-clinical evidence

Empirical data from traditional use Data from in vitro (test tube) studies (e.g. pharmacopoeialmonograph)

Data from in vitro (test tube) studies

Published case studies Data from animal studies

Uncontrolled trials

Randomised controlled trials

Systematic reviews of randomisedcontrolledtrials

Herbal-Drug Interaction

• Herbal medicines have the potential to interact with pharmaceutical drugs and modify their pharmacological effects in the body.

• Recent years have seen a marked increase in our understanding of herb–drug interactions, and clinical trials are now being conducted with the specific purpose of investigating potential interactions between herbal medicines and drugs.

Differences between herbal medicines and pharmaceutical drugs

Herbal medicines Pharmaceutical drugs

Relatively crude plant extracts Synthetic or highly purified

Multiple active compounds Single active compound

Potentially multiple targets of action Single target of action

The scope of Herbal Medicine

• Acute illnesses, such as the common cold, influenza, sinusitis, digestive upsets, insomnia, urinary tract infections and menstrual pain, to mention but a few, can be treated successfully by herbal therapy

• Herbal medicines are generally well tolerated and associated with only minor side effects. This makes them suitable for use in chronic conditions, where long-term treatment is required

• The role of herbal medicine in serious or life-threatening conditions is supportive and complementary to conventional medicine