k - 42 traditional medicine (farmakologi)
TRANSCRIPT
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Traditional MedicineTri Widyawati
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New drug(release process)
Screening
Mechanism
Component efficacy
System effectiveness
Safety
Utilisation
Safety
System effectiveness
Component efficacy
Mechanism
Traditional drug(in widespread use)
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Herbal medicines are naturalmedicines which made fromplantor
plants part
Most of traditional medicines are
herbal, although some of it are
animal-origin
The knowledge of traditional
medicines are handed down
from generation to generation
over centuries in differentcommunities
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Good examples: vincristine and vinblastine for
cancer, morphin for pain, digitalisfor heart failure,
colchicine for acute attacks of gout, and artemisinin
for drug-resistant malaria.
Good prospects: finding some herbal formulations
forlife-threatening diseases such as cancer and
HIV.
Herbal Medicine: therapeutic agents
Digitalis, the heart stimulant, is found in the leaves of the European foxgloves (Digitalis purpurea)
http://rds.yahoo.com/_ylt=A0Je5xUI0KNEK_MAwIWJzbkF;_ylu=X3oDMTBjb3ZrYjNkBHBvcwM0BHNlYwNzcg--/SIG=1fb4ovi4b/EXP=1151672712/**http:/images.search.yahoo.com/search/images/view?back=http%3A%2F%2Fimages.search.yahoo.com%2Fsearch%2Fimages%3Fp%3Dfoxglove%252C%2Bdigitalis%2B%26ei%3DUTF-8%26fr%3Dsfp%26x%3Dwrt&w=1050&h=1191&imgurl=www.genrichs.com%2Fimages%2FDIGITALIS%2520FOXGLOVE.jpg&rurl=http%3A%2F%2Fwww.genrichs.com%2Ftoc.htm&size=1.4MB&name=DIGITALIS+FOXGLOVE.jpg&p=foxglove%2C+digitalis&type=jpeg&no=4&tt=2,363&ei=UTF-8 -
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Why people use traditional medicine ?
Health care
Esthetic
Alternatif
Economi
Easy to obtained, prescription (-)
Pegagan
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1.Jamu
(Empirical based herbal medicine)
seluruh bahan tanaman
5-10 plants
Empiric.
Handed down from generation togeneration : safety and efficacy
Indonesian Schemes of Herbal Medicines
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2.Obat Herbal Terstandar
(Scientific based herbal medicine)
extract formulation
complex tools, skills
pre klinik
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Ex.
Extract Conc. Indication
Arvensis Curcuma (temulawak)
(Curcuma xanthorrhiza)
> 17.50% Curcumin Hepatoprotector
Appetice Enhancer
Arvensis Turmeric (kunyit)
(Curcuma domestica)
> 30% Curcumin Antioxidant
Anti Dyspepsia
Immunomodulator
Arvensis Green Tea (teh)
(Camellia sinensis)
> 70% Polyphenols Anti-inflamatory
Anti Oxidant
Arvensis Retropiper (cabe jawa)
(Piper retrofractum)
> 40% Piperin Aphrodisiac
Tonicum
Arvensis Orthosiphon (kumis
kucing) (Orthosiphon stamineus)
> 0.20% Sinensetin Diuretic
Anti Hypertension
Arvensis ginger (jahe)
(Zingiber purpureum Roxb.)
> 0.05% Essential Oil Analgesic
Cardiotonic
Arvensis galanga (kencur)
(Kaempferia galanga)
> 5.60% Essential Oil Anti Dyspepsia
Appetite Stimulant
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3. Phytopharmaca
(Clinical based herbal medicine)
= modern medicine
Standard
Clinical study
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Jamu to Phytopharmaca
Plant
Kurkuminoid
Kurkuminoid Minyak Atsiri
Extracum Curcuma
Curcuma Rhizoma
Curcuma Xanthorriza Roxb
Allo-AromandenrenAr-CurcumenXanthorizol
KurkuminSenyawa Murni
Kelompok Senyawa Bioaktif
Campuran Senyawa Bioaktif
Extract
Part of plant
Minyak Atsiri
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How do herbs work ?
For most herbs, the specific ingredientthat cause a therapeutic effect is notknown
Whole herbs contain many ingredients(alkaloids, terpenoid, saponin, flavonoids, phenols, volatile oils, etc)
that work together to produce the
desired medicinal effect
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Modernpharmacology
Herbalism
Isolated One active ingredients
One effect that measurable & repeatable
Holistic Whole plants
Synergistic effect of itscomponents
Table 1. Comparism of modern pharmacologyand herbalism
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Pharmacology characteristics ofmedicinal plants
Have a broadtherapeutics range
Onset of actionoccurred after alatent period (weeks or months)
The action have usually been observed
empiricallyin human patient treatedwith the herbs
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Pharmacology characteristic(continued)
Accuratepharmacokinetic datafor extractsthat have a complex composition is difficultto obtain
Subjective assessmentsby the patients orphysician used to evaluate efficacy
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Phytomedicines that have undergone pharmacology testing
Herb extract Pharmacological action uses
Ginkgo bilobaLeaf extracts
Anti ischemic Anti hemorrheologic
anti PAF
Cerebralinsufficiency
Peripheral vascular
disease
Garlic cloves
(Allum sativum)
hypolipidemic
Antithrombotic
fibrinolytic
Hypotensive
Dyslipidemia
CV-disorders
Hawthorn extract
(Cratageus monogyna)
positive inotropic
anti arrythmic coronary vasodilatation
mild heart failure
(St. II NYHA)
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Potential Interactionbetween Herbal and Conventional Drugs
Herb Conventional drugs problem echinacea > 8 week anabolic steroids,
methotrexate, amiodarone,ketoconazole
immunosuppresants
hepatotoxicity
antagonist effect
garlic, ginger, ginkgo warfarin altered bleeding
time
ginseng warfarin
estrogens, corticosteroids
altered bleeding
time additive effects
valerian barbiturates additive effects(exessive sedation)
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Many things must take into account
when prescribing herbs, i.e :
Varietyof plantThe plants habitat
How it was stored & processed
Whether or not there are contaminants
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Traditional Medicine Development
Active constituents : Stabil
Market ???
Malaria and filariasis not profitable
Benefit Risk Ratio :Tapak dara (Catharanthus roseus)
antidiabetic & antileukemia
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Morphology ?- Curcuma zedoaria ( kunyit putih, kunir putih)
Vs Curcuma mangga ( temu mangga)
Dosage?
- Kunyit (Curcuma domestica) :
low dose : maag, high dose induce maag
- Mentimun (Cucumis sativus) BP
The Rasionalitation
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When ?- Jamu Kunir asem abortivum
- Jamu cabe puyeng uterus contraction
How?
- Kecubung (Datura metel)
oral: mabuk kecubung midriasis
The Rasionalitation
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Safety ?- Daun tapak dara ( Catharanthus ro seus)leukosit - Keji beling (Sericocalyx crispus) diuretik renal
damage
Biji kapas (Gossypium sp.) gossypol spermicidebut libido
Avoid misuse:
- Jamu masuk angin : asetosal
bleeding
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SOPin Formal health servicesHISTORY
TREATMENT
EXAMINATION
with
drugs
without
drugs
Standard diagnostic Standard treatment
EBM ?
DIAGNOSE
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Evaluating Web Sites
Accuracy
Authority
BiasCurrency
Coverage
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