Phyto

• Pharmacognosy


  The science of biogenic or nature-derived pharmaceuticals and poisons
• Medicinal plants used in the form of


  • Crude herbs (comminuted herbal substance)
  • Extracts (phytotherapy)
  • Pure compounds such as morphine
  • Foods having additional health benefits and having preventive effects (nutraceuticals)
• Herbal medicines


  Part of complementary and alternative medicine (CAM)
• Phytotherapy


  The use of plants, either in whole food form or in the form of standardized extracts and supplements, for healing purposes
• The teaching of pharmacognosy has become even more relevant than previously over the last decade, as a result of the increasing use of herbal remedies (phytomedicines)by the public over the world
• When entering a pharmacy today the section of herbs supplement is large enough to occupied the large increased in the number and type of these supplements
• We need a pharmacist with rich knowledge base of traditional use & ethnobotany, combined with modern scientific, chemical, toxicological, pharmacological & clinical research- a position which some might consider under the term rational phytotherapy
• Types of drugs derived from plants


  • Herbal drugs derived from specific parts of a medicinal plant
  • Natural products or compounds isolated from nature
  • Nutraceuticals or 'functional foods'
• Herbal drugs derived from specific parts of a medicinal plant


  • The herb of St John's wort (Hypericum perforatum), used in the treatment of mild to moderate depression
  • The leaves of Ginkgo biloba, used for cognitive deficiencies (often in the elderly), including impairment of memory and affective symptoms such as anxiety
  • The flower heads of chamomile (Chamomilla recutita), used for mild gastrointestinal complaints and as an anti-inflammatory agent
  • The leaves and pods of senna (Cassia spp.), used for constipation
• Natural products or compounds isolated from nature


  • Morphine, from opium poppy (Papaver somniferum), used as an analgesic
  • Digoxin and other digitalis glycosides, from foxglove (Digitalis spp.), used to treat heart failure
  • Taxol, from the Pacific yew (Taxus brevifolia), used as an anticancer treatment
  • Quinine, from Cinchona bark (Cinchona spp.), used in the treatment of malaria
• Nutraceuticals or 'functional foods'


  • Garlic, ginger, turmeric and many other herbs and spices
  • Anthocyanin- or flavonoid-containing plants such as bilberries, cocoa and red wine
  • Carotenoid-containing plants such as tomatoes, carrots and many other vegetables
• Both pure compounds and herbal medicines are included; isolated natural products are used mainly in conventional medicine and are treated in the same way as any other drug
• Many plant drugs are used as extracts, either in crude form, or modified and standardized in some way, and these are normally described as herbal products or phytomedicines
• Many of these herbal drugs have now been incorporated into the European Pharmacopoeia (Eur. Ph.)
• Gastrointestinal (GI) and liver disorders


  Account for minor, everyday complaints as well as major health problems
• Dietary measures can improve symptoms that are caused, for example, by poor eating habits, but, if these are not successful, phytomedicines are also useful
• Natural products are still the most commonly used remedies in cases of constipation, diarrhoea and flatulence
• Plants and their derivatives also offer useful treatment alternatives for other problems such as irritable bowel syndrome, motion sickness and dyspepsia
• In the case of some liver diseases, phytotherapy provides the only effective remedies currently available
• Diarrhoea of sudden onset and short duration

  Very common, especially in children, and normally requires no detailed investigation or treatment, as long as the loss of electrolytes is kept under control
• Chronic serious cases of diarrhoea caused by more virulent pathogens are still a major health threat to the population of poor tropical and subtropical areas
• The World Health Organization (WHO) has estimated that approximately 5 million deaths are due to diarrhoea annually (2.5million in children under 5 years)
• First line treatment for diarrhoea


  1. Oral rehydration therapy using sugar-salt solutions, often with added starch

  2. Use of gruel rich in polysaccharides (e.g. rice or barley 'water')
• Polysaccharides of rice (Oryza sativa) grains


  Hydrolyzed in the GI tract, the resulting sugars are absorbed because the co-transport of sugar and Na from the GI lumen into the cells and mucosa is unaffected. Rice suspensions thus actively shift the balance of Na towards the mucosal side, enhance the absorption of water and provide the body with energy
• The efficacy of rice starch has been demonstrated in several clinical studies
• Treatments for diarrhoea in adults, particularly for travellers


  • Opiates or their derivatives, to reduce gastrointestinal motility
  • Dietary fibre, including that found in bulk-forming laxatives
• Tannins


  Astringent, polymeric polyphenols, found widely in plant drugs
• Tannin-containing drugs used in the treatment of diarrhoea


  • Sangisorba officinalis L.
  • Black catechu
  • Oak bark
  • Tea
  • Coffee
• Tannin-containing drugs are generally safe, but care should be taken with concurrent administration of other drugs since tannins are not compatible with alkalis or alkaloids, and form complexes with proteins and amino acids
• Constipation


  Reduced and difficult bowel movements, with frequency of less than once in 2 or 3 days
• Continuous irregularity in bowel movements should be investigated in case there is a risk of malignant disease
• Constipation is often associated with other forms of discomfort such as abdominal cramps, dyspepsia, bloating and flatulence
• Types of plant-derived laxative


  • Stimulant laxatives (purgatives), which act directly on the mucosa of the GI tract
  • Bulk-forming laxatives, which act mainly via physicochemical effects within the bowel lumen
  • Osmotic laxatives, which act by drawing water into the gut and thus softening the stool
• Patients generally require rapid relief from constipation, and the immediate effect of stimulant and saline purgatives is very well known
• Although there is no problem using them occasionally, or on a short-term basis (less than 2 weeks), or prior to medical intervention such as X-ray (Roentgen) diagnostics, long-term use should be discouraged
• The exception is for patients taking opioids for pain management, who may need to use stimulant laxatives routinely
• Adverse effect of long-term use of stimulant laxatives and saline purgatives


  Electrolyte loss, including hypokalaemia (pathologically reduced levels of potassium), which may even worsen constipation and cause damage to the renal tubules
• The risk of hypokalaemia is increased with administration of some diuretics and hypokalaemia exacerbates the toxicity of the cardiac glycosides (e.g. digoxin), which are often prescribed for elderly patients
• Hyperaldosteronism, an excess of aldosterone production, which leads to sodium (Na)retention, and again to potassium loss and hypertension, is also a risk
• In general, the use of bulk-forming or osmotic laxatives is preferred, unless there are pressing reasons for using a stimulant laxative