Lecture 1..phytotherapy 7 dec.2021

PHYTOTHERAPY
Is the study of the use of extracts of natural origin as
medicines or health-promoting agents.

• Centre for Drug Discovery Research & Development
• E-mail: dean@pharma.asu.edu.eg
• Office hours:
Contact information
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INTRODUCTION
Medical practice includes diagnosis, prevention
and treatment.
Depends on practical experience and
observations handed down from generation to
generation, whether verbally or in writing.
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Traditional Medicine
&
Conventional
 All modern medicine is derived originally from ancient herbal
traditions.
 Conventional medicine (Western medicine) uses both
synthetic drugs and isolated natural compounds. And now,
plant extracts are rarely used by physicians or in hospitals.
 Improvements in herbal medicine’s formulation have resulted in
a new generation of phytomedicines that are more potent than
before and chemically standardized.
 Herbal remedies are popular with the public
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DEFINITIONS
 Herbal medicine or botanical medicine,
The use of plants or plant substances as medicinal agents, as does the term "herb", "herbal drug“ and "herbal
remedy".
 Crude drugs,
The dried or fresh herbs or the starting material from which chemically pure compounds can be isolated.
 Phytopharmaceutical,
The medicinal preparations made by extracting botanical products with appropriate solvents to yield extracts,
tinctures.
 Nutraceuticals
Are food-derived nutrients which, at doses sometimes exceeding their minimal daily requirement, have beneficial
pharmacological effects. Nutraceuticals support human health or return one to relative health from a disease or
medical disorder.
 Vitamins and minerals, also plant-derived antioxidants such as flavonoids, isoflavones and proanthocyanins, can be
considered common nutraceuticals.
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INTRODUCTION (CONT.)
• Phytotherapy
- The study of the use of extracts of natural origin as medicines or health-promoting agents.
- It describes the efficacy and limitation of herbal medicines in the treatment of human diseases (science-
based medical practice). it covers everything, from herbal medicines with powerful actions (foxglove,
belladonna, etc.) to those with mild action (chamomile, mint, etc.).
- Is the bridge between herbal folklore (traditional) and allopathic (conventional) medicine.
- Phytochemistry studies the chemicals in the plants
 Phytopharmacy dealing with the preparation of vegetable medicines.
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STANDARDIZATION
 One of the main problems of phytotherapy is the standardization of herbal preparations.
 The standardization of any herbal drug is not simply an analytical evaluation, e.g., the identification and assay of
active principles or of a marker.
 Standardization of herbal medicines comprises all the experiments undertaken to guarantee the consistency of
composition, and consequently the constancy of activity, of a herbal medicine.
 Herbal material has a complex and inconstant chemical composition, depending plant age, geographical origin,
harvesting period, the specific parts of the plant to be processed, the extraction methods used, the drying and
storage.
 The use of cultivated rather than wild plants may reduce some causes of inconsistency of chemical composition.
 The process of production of botanical preparations must be kept constant; only in this way it is possible to obtain
a standardized herbal preparation.
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TOXICITY
 Toxicity Studies
 Ideally, therapeutic dosages of a herbal product should not provoke problematic effects such as gastro-
intestinal disturbances, blood pressure changes or allergic reactions, nor alter enzymatic reactions.
 Safety of a drug is more important than its effectiveness.
 Prolonged toxicity is based on data supplied by daily observation of some parameters: weight, food
consumption, appearance, behavior, muscular tone, appearance and consistency of urine and feces),
blood analysis, and macro and microscopic examination of the main organs at the end of the treatment
period.
 Toxicity tests also include teratogenic and carcinogenic potential.
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EFFICACY
 Efficacy Studies
 The effectiveness & therapeutic should be taken into consideration.
 This requires specific biological tests for every pharmacological action on laboratory animals.
 Evaluation of pharmacological action is complicated by the presence of multiple components in addition to
the active principle(s). Therefore, it is difficult to extend the experimental results in animals to humans as
with conventional drugs.
 The chemical complexity of herbal medicines causes multiple effects in humans which must be tested only
by extensive clinical trials.
 When evaluating human studies, it is essential to rule out a placebo effect.
 This can be accomplished through rigorous experimental design, specifically using a double-blind methods.
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 Traditional Chinese Medicine (TCM).
 Traditional Egyptian medicine (TEM)
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SYSTEMS OF TRADITIONAL SYSTEM WORLDWIDE

TRADITIONAL CHINESE MEDICINE (TCM)
 Is a mixture of myth and fact, stretching back well over 5000 years.
 Chinese medicine is philosophically based, and as a holistic therapy
the concept of balance and harmony is supremely important.
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Qi (or chi) permeates everything.
 It is transferable.
Human Qi ?
 Digestion extracts qi from food and drink and transfers it to
the body;
 Breathing extracts qi from the air and transfers it to the
lungs.
 These two forms of qi meet in the blood and form 'human
qi', which circulates through the body
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QI , THE ESSENTIAL LIFE FORCE

DETERMINATION OF HEALTH STATE
 It is the quality, quantity and balance of qi that determine your state of health and lifespan.
 Obviously, therefore, food and air affect health, so diet and breathing exercises are very important.
 These aspects of treatment will be considered first, before herbs are introduced.
 It is considered that the original vital energy qi, is gradually dissipated throughout life,
 So, it is important to conserve it using diet, kung fu, breathing exercise and herbal medicine.
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 Yin: negative/passive/dark/female/water.
 Yang: positive/active/bright/male/fire.
 Yin is the stronger: fire is extinguished by water, and water is
'indestructible'.
 So, Yin is always mentioned before Yang; however, they are
always in balance.
 Consider the well-known symbol, where yin becomes weak, yang is
strong and vice versa.
 Both contain the seed of each other: their opposites within
themselves.
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YIN & YANG

CONCEPTS IN TCM
 The five elements
 It is divided into wood, fire, earth, metal and water. They dominate
everything on earth, and each is associated with a vital organ of the body
The vital organs
 Heart : fire.
 Liver: wood.
 Spleen: earth.
 Lungs: metal.
 Kidneys: water.
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 Coupled organs are connected by meridians, or energy channels,
through which qi flows. Meridians are not associated with the
nervous system and cannot be seen physically.
 They are stimulated with herbs and by acupuncture and will
have a direct effect on a particular organ as well as a toning effect
on the system.
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 Causes of disease
External forces (6 excesses) Internal emotional factors(7 emotions)
Wind
Cold
Summer heat
Dampness
Dryness
Fire
Joy
Anger
Anxiety ‫القلق‬
Pensiveness ‫التركيز‬ ‫و‬ ‫الفكر‬
Grief ‫الحزن‬
Fear ‫الخوف‬
Fright ‫الرعب‬
Joy. . Anger. . Anxiety. . Concentration. . Grief. . Fear.
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CAUSES OF DISEASE
Excessive emotional activity
 Causes a severe yin/yang imbalance, blockage of qi in the meridians and
impairment of vital organ’s function. This leads to damage of the organs and
allows disease to enter from outside, or a minor weakness from inside to
develop.
 There are a few other causes, which are not emotional or external excesses.
These are the exception not the rule, and include epidemics, insect and
animal bites, worm infestation and hereditary diseases.
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1. Examination of the tongue: a very important aspect.
2. Pulse diagnosis: more than one pulse will be taken, depending on the pressure
exerted.
3. Palpation of internal organs: carried out to determine consistency and tone.
4. Massage: used to detect temperature and knotted muscles or nerves.
5. Interviewing: vital; questions are asked about sleep patterns, tastes in food.
6. Drink, stool and urine quality, fever, perspiration and sexual activity.
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Diagnosis

 The purpose is to rectify harmony, restore qi and the yin/yang
balance.
 For example, 'cold' diseases, such as cold in the lungs, coughs,
vomiting and nausea are considered to be a deficiency of yang
and treatment would be with a warming herb such as ginger.
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Treatment

TRADITIONAL EGYPTIAN MEDICINE (TEM)
 "In Egypt, the men are more skilled in medicine than
any of humankind” The words of Homer in the
Odyssey.
 Egyptians excelled not only as great architects but
also as physicians, surgeons and dentists. Many
important drugs date back to ancient Egypt, and its
legacy ‫االرث‬lives on.
 Medical knowledge in ancient Egypt had an excellent
reputation, and rulers of other empires would ask the
Egyptian pharaoh to send them their best physician to
treat their loved ones.
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CONCEPTS IN TEM
 Egyptian physicians were aware of the existence of the pulse and
of a connection between pulse and heart.
 They developed their theory of "channels" that carried air, water
and blood to the body by analogies with the River Nile; if it
became blocked, crops became unhealthy, and they applied this
principle to the body:
 If a person was unwell, they would use laxatives to unblock the
"channels". 4/6/2022 23
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CONCEPTS IN TEM
 Egyptians had knowledge of human anatomy.
 For example, in the classic mummification process, mummifiers knew how to insert a
long-hooked implement through a nostril, breaking the thin bone of the brain case and
remove the brain.
 They also must have had a general idea of the location in the body cavity of the inner
organs, which they removed through a small incision in the left groin. ‫الفخذ‬
‫األيسر‬
.
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CONCEPTS IN TEM
 Mostly, the physicians' advice for staying healthy was to wash and shave the
body and this may have prevented infections.
 They also advised patients to look after their diet, and avoid foods such as
raw fish or other animals considered to be unclean.
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CONCEPTS IN TEM
 Egyptian treatments
Surgical:
 Egyptians did little major surgeries because they believed that the body must be kept intact for the journey
into the afterlife.
 However, they did perform numerous minor surgeries, including lancing boils, ‫المعركة‬ ‫جروح‬ ‫خياطة‬, and
circumcision ‫الختان‬ .
Dental:
 In Egypt where sand blew easily into foods easily, people suffered from horrible tooth aches and abscess
because a mixture of sand and food could easily ‫بها‬ ‫ارتدى‬the hard coating of enamel off the teeth and could
expose the inner nerves and blood vessels.
 Dentists applied medicines to the teeth and even tried magic spells.
 They also relieved pain by drilling holes into the gum surrounding the tooth to drain pus.
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DIGESTIVE
SYSTEM
1. Stomatitis, gingivitis and
glossitis
2. Constipation
3. Diarrhea
4. Dyspepsia
5. Flatulence
6. IBS
7. Gastric and peptic ulcer
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Introduction
 Digestion takes place in the alimentary canal
by means of enzymes secreted mostly by the
stomach, pancreas and small intestine.
 Mechanical movements such as chewing
initially break down food before mixing it in
the stomach and intestine.
 Digestion is facilitated by peristalsis.
 In the small intestine most drugs, sugars and
minerals are absorbed, while in the large
intestine mostly water and mineral salts are
absorbed.
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1. Stomatitis, gingivitis and glossitis
Stomatitis is inflammation in the
mouth.
Gingivitis is the inflammation of
the gum tissue.
Glossitis is the inflammation of
the tongue
Essential oils: antimicrobial effects
Tannins: anti-inflammatory, antimicrobial, astringent effects.
Mucilage: soothing effects
I. GIT - 1. Stomatitis, gingivitis and glossitis
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Marigold (Calendula sp.)
• Calendula contains essential oils,
triterpenoid saponins, triterpene
alcohols and their esters,
flavonoids, sterols, carotenes
• Triterpenoid saponins inhibit
multiplication of vesicular
stomatitis
Bee Propolis
• Resinous material, collected by
honeybees from the buds of living
plants mixed with bee wax and
salivary secretions.
• Anti inflammatory, antifungal,
antiviral, antibacterial and tissue
regenerative.
• Caffeic acid methyl ester (CAME) and
flavonoids (galangin) are the main
active ingredients.
• CAME is nuclear factor kB inhibitors
Myrhh (Commiphora species)
• Oleogum resin: volatile oil, resin,
gum (about 60%), sesquiterpenes.
• Topical application of tincture (or
extract) is quite resinous, the resin
fixes the active compounds so that
they are not readily washed away by
saliva.
Aloe vera (Aloe gel)
• Mucilage (30%(, anthraquinone
derivatives, polysaccharides,
glycoproteins, enzymes, salicylic
acid and fatty acids
• Aloe gel act as a protective barrier.
• Anti-inflammatory and antibacterial
activities.
‫الطبية‬ ‫البكورية‬
Apply a few drops of
myrrh tincture 1 : 5 to
the affected sites, 2 to 3
times a day.
Matricaria chamomilla
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Chamomile extract
Myrrh tincture
Clove oil
Sage oil
Peppermint oil
Myrrh oil
Clove oil
Sage oil
Peppermint oil
Myrrh oil
Panthenol
Bee propolis
Tea tree oil
Aloe vera
Calendula
vitamin C/E
Myrrh
Honey
Benzocaine
clove oil
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2. Constipation
 Constipation may be defined as the delayed transit or less than usual volume feces.
 Laxatives improve the abnormal motility patterns and/or reduce fluid absorption in the intestines and
promotes the elimination of a soft stool.
I. GIT – 2. Constipation
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Laxatives
Stimulant Laxatives
Anthraquinones
(senna, cascara, frangula,
aloe)
Castor oil
Bulk-forming Laxatives
Fibers
Mucilage
Polysaccharides
Ricinoleic acid
Anthraquinones combined with fiber are also effective and well
tolerated for chronic constipation in elderly patients.
X pregnancy
X Children
X L. Time.
X Diuretics
X GIT inflammation.
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Occurrence: Present in senna, cascara, frangula, aloe
Mechanism of action:
• Glycosides - pro-drug, liberating the aglycone that acts as the laxative.
• The metabolism takes place in the colon, where bacterial glycosidase
remove sugars. The products obtained are poorly absorbed and act by
evoking secretory and motility changes in the colon.
• These compounds act on enteric nerves or mucosal cells to stimulate the
release of neurotransmitter which increase intestinal motility and stimulate
fluid accumulation in the intestine.
glycosidase
Anthraquinones
1) Stimulant Laxatives
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 Leaves and fruit of Senna species. F. Fabaceae
 Anthraquinones are dianthrone glycosides,
primarily sennosides A and B
 Sennosides A and B are pro-drugs: hydrolyzed by
the bacterial flora to form the main active
metabolites, rhein and rhein anthrone.
 Although senna is not as mild in its action as cascara
and frangula, it is nevertheless, for its low cost, more
widely recommended in atonic constipation.
Anthraquinones
Senna (Cassia sp.)
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Preparations/Dosage
 Senna is taken in the form of tea (prepared from 0.5 -2 g leaves or fruit) produce a single
bowel evacuation within 6 h.
 A beverage prepared by soaking senna in cold water for 10-12 h is more active than hot tea
as it contains more sennosides.?????????????
 Crystalline senna glycosides (sennosides) are also available (usual dose 20-60 mg); they
are more stable, more reliable and safer than the preparations of crude drug.
Side effects:
 Long term uses of doses of senna is associated with flatulence, cramping, abdominal pain,
discoloration of the urine.
 Long-term use may lead to melanosis of the colon, electrolyte imbalance, dehydration and
changes in muscular function (chronic constipation).
Anthraquinones
Senna (Cassia sp.)
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Occurrence: The bulk- forming agent’s includes dietary fiber, mucilage, polysaccharides
and cellulose derivatives.
Mechanism of action: Dietary fiber and bulk-forming agents increase the mass of stool,
its water content.
 Most appropriate method for prevention and treatment of functional constipation.
 They are useful as a supplement when a constipating, fiber-poor diet cannot be
corrected.
Side effects: The bulk forming agents potentially absorb other drugs administered
concurrently, thereby interfering with their intestinal absorption.
2) Bulk forming Laxatives
37

 Psyllium husk contains 10-30% of a hydrophilic water absorbing fibers that produces a
mucilaginous mucoid-like substance, thus giving bulk and lubrication.
 Useful in treating atonic and spastic constipation and when excessive straining must be
avoided following anorectal surgery.
 Take 1- 2 teaspoons, 3 times a day for 1 to 3 days in a considerable amount of water.
Note: After taking psyllium seed, the patient should wait for 30 to 60 minutes before taking
other medications.
Genus Plantago (Psyllium / Ispaghula ) seed husk
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 The addition of bran to the diet softens the fecal
consistency
 Bran must be taken with a sufficient quantity of
fluids to avoid any risk of obstruction of the
intestine.
 Some patients will experience bloating due to
increased production of intestinal gas related to
bacterial degradation of the components of bran.
This symptom will usually disappear with time.
Bran
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1 tbsp whole or crushed
flaxseed taken in 150 mL
water 2–3 times/day
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Cichorium Intybus Herb
Cassia Angustifolia Leaves
Foeniculum Vulgare Fruits
Sennosides
Aloe, Belladonna, Colocynth and
Scammony Resin
Rhubarb extract, senna leaf,
Sulphur purified, wood charcoal,
peppermint oil, fennel oil
Ispaghula Husk, Plantago
Seed and Senna
Senna glycoside
Peppermint oil
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Senna + Frangula+ boldo +
Scammony+ anise
Natural fibers 500mg. Bran +
Cellulose +Mineral
Chitosan 50mg. +Psyllium
400mg.+ C 10mg.Karaya Gum
25mg.+ Pectin 10mg
Psyllium Husk
Gum sterculia
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3. Diarrhea
 Diarrhea can be defined as a frequent liquid or semi-liquid stool for more than 3 times
a day.
I. GIT – 3. Diarrhea
Intestinal infections
Pathogenic bacteria release
toxins into the intestinal
lumen
• Increase intra luminal
secretion
• Reduce absorption.
Swallowing toxic
substances or foods which
are not well tolerated
Milk, eggs, strawberries,
that stimulate the release of
secretagogues by mast cells
located along the intestinal
lining.
Medications
which can induce an
excessive motor reaction or
reduce water and ion
absorption if taken regularly
and over a long period of
time.
Causes of diarrhea
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Antidiarrheal drugs
Tannins Essential oils Pectin
 Antiseptic.
 Antispasmodic.
Green banana (amylase
resistant starch)
Pectin not digested in the small
intestine. On reaching the colon,
pectin are fermented by bacteria
into short-chain fatty acids which
stimulate salt and water
absorption
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Antidiarrheal drugs
Occurrence: Agrimony, oak bark, blackberry leaf, catechu, and
tea.
Mechanism of action:
• Local effect: Poorly absorbed through the GIT, produce a
temporary protective layer of coagulated protein on the
mucosal membrane of the gut, possibly desensitizing sensory
nerve endings and reducing inflammatory peristaltic
stimuli.
• Antibacterial activity against enteric pathogens.
• Bind and inactivate the hyper-secretory activity of some
toxins.
Tannins
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Antidiarrheal drugs
Tannins
Precaution:
• High doses of tannins cause an irritating effect
• They inhibit digestive enzymes, which bind to the small intestinal mucosa.
• They complex metal ions thus inhibiting their absorption.(tea –green tea milk –
meat).
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Pectin +Chamomile Light Kaolin + pectin
Diiodohydroxyquinoline, Kaolin, Nicotinamide,
Pectin, Streptomycin, Succinyl sulphathiazole and
Sulphadiazine
Achillea leaves, Verbascum flowers, Hibiscus
flowers, Chamomile flowers, Chicory leaves, Basil
leaves, Vine leaves
Tr. Catec + tr. BL+ Ca
carbonate
GIT – 3. Diarrhea
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4. Dyspepsia (indigestion)
 Functional dyspepsia (i.e. disturbed digestion) is a syndrome featuring nausea, epigastric
pressure, bloating, flatulence and cramps abdominal pain.
 Traditional herbal remedies used in the treatment of
dyspepsia include:
Carminatives – VO (e.g., caraway, fennel and anise).
Digestive enzymes (Bromelain – Papain)
Bitter drugs (e.g., artichoke, Quassia, gentian, capsicum,
bitter-orange peel) stimulate the production of gastrointestinal
secretions (especially saliva and gastric juices) via lingual
taste buds.
Cholagogues/choleretics (e.g., Ginger, artichoke, turmeric,
dandelion)
GIT – 4. Dyspepsia
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For indigestion (dyspepsia): 320-
640 mg of artichoke leaf three
daily for up to 8 weeks.
0.5–1 g of the dried or fresh, sliced or coarsely
powdered rhizome in a covered pot for 10
minutes 2 times daily
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Papin 80mg + Sanzyme12mg
+Pepsin 40mg/5ml.
Papin 50mg.+ Pepsin 150
mg.+ Anise25mg +
Pancreatin + Bromelin
+Glutamic aci+Fennel
Powder of (Chamomile
120mg.+ Ginger
60mg.+Peppermint 20mg.+
Fennel 40mg.)+ Anise flavour
20mg.+Bromelain 50mg.
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5. Flatulence
 Flatulence is defined as the presence of excessive amount of
gas in the stomach or in the intestine.
 Most common symptoms of gas are abdominal bloating and
pain.
 The most common ways to reduce the discomfort of gas are:
 Changing diet.
 Reducing the amount of air swallowed
 Taking digestive enzymes (lactase supplements help to
digest carbohydrates and may allow people to eat foods
that would normally cause gas).
GIT – 5. Flatulence
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 Caraway contain carvone, limonene.
 Anise contains 2-6% volatile oil (94% anethole)
 Fennel contains 2-7% volatile oil (50-70% anethole, 15-30% fenchone and 2-5% estragole)
 Antispasmodic
 Stimulate bile flow.
 Antimicrobial activity.
 The intake of larger dosages of the volatile oil for long periods can lead to kidney and liver
damage.
5. Flatulence
Typical herbal carminatives include caraway, fennel, chamomile, peppermint, lemon balm
and anise.
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1- 2 teaspoons of the fruit in 150 mL of boiling water for 5
minutes.
1 tablespoon (3–6 g) of the
herb in 150 mL of boiled
water for 10 minutes.
Dosage: One cup, between
meals, 3 to 4 times a day.
1 cup of hot water onto 1
tablespoon (3 g) of the herb,
cover, and steep for 5 to 10
minutes.
Dosage: One cup between
meals, 3 to 4 times a day.
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Peppermint oil 75 mg + anise
oil 75mg + Ginger 50g+ Thyme
50mg
Caraway + Chamomile +Cellulase
+ Glutamic acid + Lecithin
Oils of (Chammomile
30mg+Fennel 50mg +
Caraway25mg + Peppermint 50mg
+Olive oil 250mg)
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6. Irritable bowel syndrome IBS
 Irritable bowel syndrome (IBS) is a disturbed state of
intestinal motility for which no anatomic cause can be
found.
 It has many manifestations including bloating,
constipation, and diarrhea.
 Because its etiology is unknown, an evidence-based
treatment for IBS is difficult to develop. Treatment is
symptomatic.
 Peppermint oil is the only botanical remedy which has
been shown to have a promising efficacy in the treatment
of IBS.
GIT – 6. Irritable bowel syndrome
55

6. Irritable bowel syndrome IBS
 The active principle of peppermint oil is menthol, a cyclic monoterpene with a Ca2+
channel blocking properties.
 Antispasmodic property of peppermint allows these muscles to return to their proper
tone.
 Peppermint oil also inhibits the excitability of enteric nerves by reducing calcium uptake
into enteric nerves.
Peppermint Oil
Daily dose: 6 to 12 drops. Daily dose for irritable
colon: 0.6 mL.
Peppermint oil is standardized to contain not less
than 44% free menthol.
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Oil of (Caraway+ fennel+
peppermint+ chamomile)+ curcumin
57

7. Gastric and peptic ulcer
 Gastritis is an inflammation of the mucosa lining of the stomach often caused may be caused by
alcohol, tobacco, spices, toxins, bacteria and drugs (e.g. aspirin).
 Peptic ulcer disease refers to mucosal damage of the stomach and/or duodenum.
Decrease gastric acidity and the rate of emptying
of gastric content because of their effect on
viscosity and neutralization of gastric activity.
E:g Myrrh
Covering and protecting gastric mucosa.
E:g: Althaea officinalis (marshmallow) and
Cetraria islandica (Iceland moss).
Gums Mucilage
GIT – 7. Gastric ulcer and peptic ulcer
Anti-inflammatory
58

7. Gastric ulcer and peptic ulcer
Liquorice roots of Glycyrrhiza glabra F. Fabaceae
Mechanism of action
 Liquorice contains a saponin-like glycoside glycyrrhizin (glycyrrhizic acid) (anti-
inflammatory properties) 50 times sweeter than that of saccharose.
 Antiulcer effects of liquorice are due to inhibition of 15-hydroxyprostaglandin
dehydrogenase, an enzyme that metabolizes prostaglandin E2 and F2 to 15-keto
prostaglandins, an inactive compound.
 The block of prostaglandin metabolism causes an increase of protective prostaglandins in the
stomach and consequently a secretion of protective mucous and a cell proliferation of the
gastric mucosa leading to the healing of ulcers.
59

Adverse effects
 Glycyrrhetinic acid is a potent inhibitor of 11ß-hydroxysteroid
dehydrogenase (11ß-HSD), which converts cortisol to
cortisone.
 Cortisol, in contrast to cortisone, has the same binding affinity
for mineral corticoid receptors as aldosterone promoting sodium
reabsorption leading to:
 Sodium and water retention
 Hypertension and hypokalaemia (potassium depletion).
Contraindications: Patients with cardiac, liver and kidney
problems, hypertension or potassium deficiency should avoid
consumption of significant quantities of glycyrrhetinic acid.
Herb–drug interactions: Thiazide and loop diuretics can increase
the mineralocorticoid effects of licorice/ laxatives/ cortisone
7. Gastric ulcer and peptic ulcer
Liquorice roots of Glycyrrhiza glabra F. Fabaceae
60

150 mL boiled water onto 1.5-3 g of the finely chopped
powdered herb or place the herb in cold water and bring
to a boil. Steep for 10 to 15 minutes
3 times daily after meals not more than 4 - 6 weeks
Daily dose: 5–15 g
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Lecture 1..phytotherapy 7 dec.2021

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Lecture 1..phytotherapy 7 dec.2021