Kuliah Farmakoogi Kedokteran Blok Herbal di FK-UMP Disampaikan tahun 2020

1. M Fadhol Romdhoni
Laboratorium Farmakologi
Fakultas Kedokteran
Univ. Muhammadiyah Purwokerto

3.  Informasi ilmiah tentang Obat Herbal dapat dilihat di beberapa
literatur, salah satunya:
www.naturalstandard.com
↓
naturalmedicines.therapeuticresearch.com

4. Suplemen Makanan ≠ “obat resep” dari tanaman
(morfin, digitalis,dll)
Perbedaan ini menghilangkan keharusan untuk
membuktikan kemanjuran dan keamanannya
sebelum dipasarkan
Sehingga menjadi tantangan bagi FDA / BPOM utk
membuktikan obat tsb bahaya kemudian ditarik
dari pasaran

5.  DSHEA ( Dietary Supplement Health and Education Act )
• Suplemen makanan sbg Vitamin, mineral, bahan herbal
atau tanaman lain, asam amino atau suplemen
makanan yang digunakan untuk menambah diet
dengan meningkatkan asupan makanan, atau
konsentrat, metabolit, ekstrak, atau kombinasi apapun
dari bahan – bahan tersebut

6.  Bahan tanaman
 Suplemen nutrisi yang telah dimurnikan

7. 1. Ekinase (Echinachea purpurea)
2. Bawang putih (Allium sativum)
3. Ginkgo (Ginkgo biloba)
4. Ginseng (Panax sp.)
Suplemen Nutrisi Yang Telah Dimurnikan
1. Koenzim Q10
2. Glukosamin
3. Melatonin

8. Kandungan Kimia
 Flavonoid
 Bahan lipofilik (alkamid, poliasetilen)
 Polisakarida larut air
 Konjugat kafeoil larut air (ekinakosida, asam cikorat, asam
kafeat)
Bahan Tanaman

9. Modulasi imun
 Studi in vivo pada manusia
 Fagositosis ↑
 Sel darah putih ↑
 Monosit ↑
 Neutrofil ↑
 NK Cell ↑
 Imunostimulasi ≠
Bahan Tanaman-Ekinase

10.  Studi in vivo
 Il-1, Il-6, Il-10 ↑
 Faktor nekrosis tumor-α oleh makofag ↑
 Biakan sel sehat dan pasien ggn imunitas
 NK cell ↑
 Terdapat toksisitas selular dependen-antibodi
Bahan Tanaman-Ekinase

11. Mekanisme
 Menghambat siklooksigenase, 5-lipoksigenase, dan
hialuronidase
Efek antibakteri, antijamur, antivirus, dan
antioksodan
Hasil in vitro
• MIC100 < 1 μg/mL thd virus influenza dan herpes
simpleks
• Bakterisida  S. pyogenes, H. influenzae, Legionella
pneumophila sel bronkus
• Sitokin proinflamasi ditekan
Bahan Tanaman-Ekinase

12.  IV  demam, menggigil, nyeri kepala, muntah
 Oral  ggn pengecapan, ggn pencernaan, ruam
Interaksi obat & Peringatan
• Hindarkan  HIV/AIDS, kanker, autoimun, TBC,
pasien imunosupresan
• Alkohol  timbul reaksi mirip disulfiram
Bahan Tanaman-Ekinase

13. Kandungan Kimia
 Alisin  bau khas bawang putih
 Aliin  prekursor kimiawi
 Organosulfur larut air  komponen utama
Bahan Tanaman

14. Efek kardiovaskular
 Menghambat HMG-KoA reduktase
 Efek antitrombosit  hambat Tromboxan A2
 Stimulasi sintesis NO
 Aktivitas fibrinolitik ↑
Efek endokrin
 Organosulfur  efek hipoglikemik pada hewan coba non-
diabetes
Bahan Tanaman-Bawang Putih

15. Efek Antimikroba
 Mekanisme: inhibisi enzim yg mengandung tiol yg
dibutuhkan oleh berbagai mikroba
 Alisin berefek pada bakteri gram + dan - ; jamur,
protozoa, virus tertentu
Efek Antineoplastik
 Hewan coba  hambat prokarsinogen utk Ca kolon,
esofagus, paru, payudara, lambung melalui detoksifikasi
karsinogen dan penurunan aktivitas karsinogen.
 Case control pada manusia  penurunan insiden Ca
lambung, esofagus, dan kolorektal
Bahan Tanaman-Bawang Putih

16. Kandungan aktif
 Glikosida flavon
 Terpenoid (ginkgolida A,B,C,J, dan bilobalida)
Bahan Tanaman

17. Efek kardiovaskular
 Aliran darah ↑
 Viskositas darah ↓
 Vasodilatasi  perfusi jaringan ↑
 Pada HT dan stroke  tdk bermakna
Efek metabolik
 Memiliki aktivitas mirip superoksida dismutase
 Sifat membersihkan radikal hidroksil dan anion
superoksida
Bahan Tanaman-Ginkgo

18. Efek pada SSP
 Menyebabkan modifikasi reseptor dan neurotransmitter
 Kepadatan reseptor meningkat  muskarinik, alfa-2, 5-HT1a
 Kepadatan reseptor menurun  adrenoseptor beta
Efek lain
 Bronkokontriksi alergik dan asmatik
Bahan Tanaman-Ginkgo

19. Bahan aktif
 Glikosida saponin triterpenoid atau ginsenosida atau
panaksosida
 Ada 30 jenis berbeda
 Pada P. ginseng komersil distandarisasi  4-10% ginsenosida
Bahan Tanaman

20.  Modulasi fungsi imun
 Pada SSP:
 Proliferasi progenitor neuron ↑
 Meningkatkan asetilkolin, serotonin, NE, dopamin sentral di
korteks serebrum
 Antioksidan
 Antiinflamasi antistres
 Analgesia vasoregulator  NO ↑
 Kardioprotektif
 Antitrombosit
 Homeostasis glukosa ↑
 antikanker
Bahan Tanaman-Ginseng

21.  200 mg ekstrak P. ginseng ≈ 1 g akar mentah
Interaksi obat dan Peringatan
• Obat psikiatrik
• Obat estrogenik
• Obat hipoglikemik
• Warfarin
• Penyakit autoimun
Bahan Tanaman-Ginseng

22. Suplemen nutrisi yang telah
dimurnikan

23.  Nama lain: KoQ, KoQ10, dan ubikuinon
 Ditemukan di mitokondria organ: jantung, ginjal, hati, otot
rangka
  merupakan suatu antioksidan kuat dan mungkin berperan
dalam mempertahankan fungsi otot, meskipun makna klinis
efek ini belum diketahui
Suplemen

24.  Hipertensi
 TD ↓  pemakaian 8-10 minggu
 Mekanisme: mungkin berkaitan dg sifat antioksidan dan vasodilator
KoQ10
 Gagal Jantung
 Pada gagal jantung  KoQ10 endogen↓
 KoQ10 memperbaiki ejeksi 3,7%
Suplemen-KoQ10

25.  Penyakit jantung iskemik
 Pada penyakit arteri koronaria dan angina stabil kronik ringan 
hasilnya baik
 Dasar teori: proteksi metabolik dari iskemik miokardium
 Pencegahan miopati akibat statin
 Statin menurunkan KoQ10 endogen  produksi energi otot ↓  miopati
Suplemen-KoQ10

26.  Toleransi baik hingga 3000mg/hari
 Ggn cerna  < 1%
Interaksi obat
• Warfarin  krn struktur mirip vitamin K
Dosis
• 30mg  sbg suplemen makanan
• 60-100mg/hari  ada efek ke jantung
Suplemen-KoQ10

27.  Ditemukan pada jaringan manusia
 Suatu substrat utk membentuk tulang sendi dan berfungsi sbg
nutrien tulang rawan
 Berasal dari kepiting dan krustasea lainnya
Suplemen

28.  Glukosamin endogen  utk memproduksi
glikosaminoglikan dan proteoglikan lain di tulang
rawan sendi
 Osteoartritis  pembentukan < degradasi
↑
Glukosamin
Dosis
• 500 mg  3x sehari, atau 1500 mg sekali sehari
• Tidak memiliki efek analgesik scr langsung
Suplemen-Glukosamin

29.  Turunan serotonin  diproduksi kelenjar pinealis dan bbrp
jaringan lain
 Dipercaya berperan mengatur tidur-terjaga
 Sekresi bersamaan dgn gelap (21.00 – 04.00)
 Tertekan oleh sinar matahari
Suplemen

30.  Jet lag  0,5 – 5 mg
 Insomnia  0,3 – 10 mg
 Fungsi reproduksi perempuan
 Fungsi reproduksi laki-laki
Suplemen-melatonin

31. Presentation Title
Presentation Subtitle
Lampiran…

32. Jamu is regulation minister of health republic Indonesia
Traditional medicines are ingredients or ingredients in the form of plant
materials, animal materials, mineral materials, “sari” (galenic) preparations,
or mixtures of such substances which have been hereditary for treatment,
and may be applied in accordance with prevailing norms in the community.
Jamu saintification is a scientific verification of jamu through
health-based research.
The scope of Jamu Saintification is preferred for
preventive, promotive, rehabilitative and palliative.
Regulation minister of health republic Indonesia
No. 003 / 2010 about Jamu Saintification

33. Through the decree of the head of the drug and food
regulatory agency (BPOM), we have three symbols
Based empirical, traditional, hereditary
based on the test pharmacology and
test toxicity in animals
based on the test pharmacology toxicity
test in animals and clinical trials human

34. JAMU BODY
Pharmacodynamic
Pharmacokinetic
(ADME)
Jamu is also undergoing a process…

35. Jamu has pharmacokinetics like conventional medicine
Jamu consists of many chemical compounds
All compounds present together produce an effect
So that pharmacokinetic of Jamu is difficult to measure
Pharmacokinetic of Jamu

36. Medicinal Herbs Compiler Of
Jamu Scientific
1. Adas (Foeniculum vulgare)
2. Daun Ungu (Graptophyllum pictum)
3. Daun Duduk (Desmodium triquetrum)
4. Iler (Plectranthus scutellarioides)
5. Ginger (Zingiber officinale)
6. Jati belanda (Guazuma ulmifolia)
7. Jati cina (Senna alexandrina)
8. Black seed (Nigella sativa)
9. Jombang (Taraxacum officinale)
10. Kepel (Stelechocarpus burahol)
11. Kumis kucing (Orthosiphon aristatus)
12. Kunyit (Curcuma longa)
13. Meniran (Phyllanthus niruri)
14. Pegagan (Centella asiatica)
15. Rumput bolong (Equisetum debile)
16. Secang (Caesalpinia sappan)
17. Seledri (Apium graveolens)
18. Sembung (Blumea balsamifera)
19. Tea (Camelia sinensis)
20. Tempuyung (Sonchus arvensis)
21. Temulawak (Curcuma xanthorriza)

37. Fennel/ Adas (Foeniculum vulgare)
the most commonly used part is seed
Nutrition
A 100-gram portion of fennel seeds provides 1,440
kilojoules (345 kilocalories) of food energy, and it is a
rich source (more than 19% of the Daily Value, DV) of
protein, dietary fiber, B vitamins and several dietary
minerals, especially calcium, iron, magnesium and
manganese, all of which exceed 100% DV (table). Fennel
seeds are 52% carbohydrates, 15% fat, 40% dietary fiber,
16% protein and 9% water

39. Daun ungu (Graptophyllum pictum)
Effective for hemorrhoids

40. Daun duduk (Desmodium triquetrum)
Main benefit:
Diuretic

42. Coleus/ Iler (Plectranthus scutellarioides)
Main benefit:
hemorrhoide

43. Ginger/ Jahe (Zingiber officinale)
the most commonly used part is rood/tuber

44. Zingiber officinale and
Type 2 Diabetes Mellitus

45. Jati belanda/ Dutch teak
(Guazuma ulmifolia)
Efficacy:
Slimming/ weight loss
Reducing body fat

46. Jati cina/ Chinese teak (Senna alexandrina)
Historically, Senna alexandrina was
used in the form of senna pods, or as
herbal tea made from the leaves, as a
laxative. It also serves as a fungicide.
Modern medicine has used extracts
since at least the 1950s as a laxative.
The active ingredients are several
senna glycosides which interact with
immune cells in the colon

47. Jinten hitam/ Black cumin (Nigella sativa)

48. Nigella sativa (N. sativa) (Family Ranunculaceae) is a widely used medicinal plant throughout
the world. It is very popular in various traditional systems of medicine like Unani and Tibb,
Ayurveda and Siddha. Seeds and oil have a long history of folklore usage in various systems of
medicines and food. The seeds of N. sativa have been widely used in the treatment of
different diseases and ailments. In Islamic literature, it is considered as one of the greatest
forms of healing medicine. It has been recommended for using on regular basis in Tibb-e-
Nabwi (Prophetic Medicine). It has been widely used as antihypertensive, liver tonics,
diuretics, digestive, anti-diarrheal, appetite stimulant, analgesics, anti-bacterial and in skin
disorders. Extensive studies on N. sativa have been carried out by various researchers and a
wide spectrum of its pharmacological actions have been explored which may include
antidiabetic, anticancer, immunomodulator, analgesic, antimicrobial, anti-inflammatory,
spasmolytic, bronchodilator, hepato-protective, renal protective, gastro-protective,
antioxidant properties, etc. Due to its miraculous power of healing, N. sativa has got the place
among the top ranked evidence based herbal medicines. This is also revealed that most of the
therapeutic properties of this plant are due to the presence of thymoquinone which is major
bioactive component of the essential oil. The present review is an effort to provide a detailed
survey of the literature on scientific researches of pharmacognostical characteristics, chemical
composition and pharmacological activities of the seeds of this plant.

49. Jombang/ Dandelion (Taraxacum officinale)

50. Historically dandelion was prized for a variety of medicinal properties. It
contains a wide number of pharmacologically active compounds. Dandelion
contains flavonoids including
Dandelion has been used as an
herbal remedy in Europe, North America, and China. "Empiric traditional
application in humans of dandelion, in particular to treat digestive disorders, is
supported by pharmacological investigations. Some results, e.g. concerning
possible diuretic activity, are even contradictory and require a thorough
reinvestigation."
Dandelion has been used in herbal medicine in an attempt
. Dandelion is used in herbal medicine
as a mild laxative, for increasing appetite, and as a plant bitter for improving
digestion. The milky latex has been used as a mosquito repellent and as a folk
remedy to treat warts.

51. Kepel/ Keppel/ Burahol (Stelechocarpus burahol)
The fruit of this species has traditionally been known in Java to have value as an oral
deodorant. Out of the pulp, seed and peel, the peel has the best adsorbent ability. A 2012
study showed that it reduced the odor of feces by activating the probiotic bacterium
Bifidobacter. Stelechocarpus burahol is also an antihyperuricemic, and has traditionally
been used to treat gout.
This fruit is an identity flora of Daerah Istimewa Jogjakarta. Stelechocarpus
burahol was loved by Javanese princesses because it was a symbol of unity and
mental and physical integrity. Because it functioned as a deodorant, many
common people did not have this tree planted because they believed they
would get cursed. That made this tree rare.
This fruit was also believed to be used by Javanese Princesses as
contraception. The fruit is believed to have the function of preventing
kidney inflammation. The wood can be made into house tools, the leaves
used to lower cholesterol.
This rare fruit can be found at Keraton Jogjakarta Area, Taman Mini
Indonesia Indah, Taman Kiai Langgeng Magelang and Kebun Raya Bogor.

52. Kumis kucing/ “Cat whisker” (Orthosiphon aristatus)
Used in:
Nephrolithiasis / kidney stones

54. Kunyit/ Turmeric (Curcuma longa)
turmeric has been used as an attempted treatment for a
variety of internal disorders, such as indigestion, throat
infections, common colds, or liver ailments, as well as
topically, to cleanse wounds or treat skin sores

55. Meniran (Phyllanthus niruri)
Phyllanthus niruri has been used
in Ayurveda for problems of the
stomach, genitourinary system,
liver, kidney and spleen

57. Pegagan/ Centella (Centella asiatica)
C. asiatica has been used in an
attempt to treat varicose veins,
chronic venous insufficiency,
psoriasis, minor wounds, strangury,
and to encourage lactation

58. Rumput bolong (Equisetum debile)
Has been used in haemorrhoid, acute conjunctivitis, etc

59. Secang (Caesalpinia sappan)

61. Seledri/ Celery (Apium graveolens)
Celery (Apium graveolens) is a marshland plant
in the family Apiaceae that has been cultivated
as a vegetable since antiquity. Celery has a
long fibrous stalk tapering into leaves.
Depending on location and cultivar, either its
stalks, leaves, or hypocotyl are eaten and used
in cooking.

62. Pharmacodinamic Study of Ethanol Extract of Celery Root
(Appium graveolens) to Lipid Profil And APO A1 Of White Rat
Strain Wistar (Rattus novergicus Strain Wistar) Dyslipedemia
by: Romdhoni, 2014
Result & Discussion: In controller group showed increase LDL, TG and
decrease HDL and Apo A1. In treatment group showed decrease LDL, TG and
increase HDL, Apo A1 following increase doses of extract ethanol of celery
root. The mentioned happened cause of extract ethanol of celery root have
d-limonene. D-limonene can decrese LDL, TG and increase HDL, Apo A1 by
activated peroxisome proliferator-activated receptor (PPAR)-α signaling, and
inhibited liverX receptor (LXR)-β signaling mechanism.
Conclution: The study concluded that effect of ethanol extract of celery root
can decrease LDL cholesterol, triglycerida and increase HDL cholesterol, Apo-
A1. In the future the ethanol extract of celery root can be solution of
dyslipidemia cases.

63. Sembung (Blumea balsamifera)
Its primary uses are as a diuretic (or "water
pill") and to treat symptoms of the common
cold. As a diuretic, sambong is an herb used to
treat urolithiasis (urinary tract or kidney
stones) and urinary tract infections, and thus
reduces high blood pressure. Sambong works
as an expectorant, an anti-diarrheal and an
anti-spasmotic, all of which treat some
symptoms of the common cold. It is also
sometimes used as an astringent for wounds.

64. Tea (Camelia sinensis)
The leaves have been used in traditional Chinese
medicine and other medical systems to treat
asthma (functioning as a bronchodilator), angina
pectoris, peripheral vascular disease, and coronary
artery disease.
Among other bioactivities, (-)-catechin from C.
sinensis acts as an agonist of the nuclear receptor
protein peroxisome proliferator-activated receptor
gamma, that is a current pharmacological target
for the treatment of diabetes type 2.
Tea may have some negative impacts on health,
such as over-consumption of caffeine, and the
presence of oxalates in tea

65. Tempuyung (Sonchus arvensis)
Main health effect:
Urolithiasis/ urinary track stone

66. Temulawak (Curcuma xanthorrhiza)
This plant originated from Indonesia, more
specifically from Java island
The rhizome contains an ethereal oil (5ml per kg), it
primarily consists of Sesquiterpenes. There is also a
content of Curcumin (at least 1%, Ph. Eur.) and starch
Curcuma zanthorrhiza is used for dyspepsia

67. 11 mixture of substance Jamu Scientific
1. For hiperuricemia
2. For hipertention
3. For haemorrhoid
4. For arthritis
5. For high cholesterol
6. For liver
7. For gastritis
8. For nephrolithiasis
9. For diabetes mellitus
10. For physical fitness
11. For obesity

68. For hiperuricemia
Ingredients:
Sonchus arvensis 6 gram
Caesalpinia sappan 15 gram
Stelechocarpus burahol 9 gram
Curcuma xanthorrhiza 9 gram
Curcuma longa 9 gram
Phyllantus niruri 9 gram

69. For hipertention
Ingredients:
Apium graveolens 15 gram
Centella asiatica 9 gram
Orthosiphon aristatus 9 gram
Curcuma xanthorrhiza 9 gram
Curcuma longa 9 gram
Phyllantus niruri 9 gram

70. For hemorrhoid
Ingredients:
Graptophyllum pictum 15 gram
Desmodium triquetrum 12 gram
Plectranthus scutellarioides 9 gram
Curcuma xanthorrhiza 3 gram
Curcuma longa 3 gram
Phyllantus niruri 3 gram

71. For arthritis
Ingredients:
Foeniculum vulgare 3 gram
Orthosiphon aristatus 5 gram
Equisetrum debile 5 gram
Curcuma xanthorrhiza 15 gram
Curcuma longa 15 gram
Phyllantus niruri 7 gram

72. For hiper-cholesterol/ dyslipidemia
Ingredients:
Senna alexandrina 1 gram
Guazuma ulmifolia 6 gram
Sonchus arvensis 6 gram
Camellia sinensis 6 gram
Curcuma xanthorrhiza 5 gram
Curcuma longa 4 gram
Phyllantus niruri 3 gram

73. For liver
Ingredients:
Taraxacum officinale 12 gram
Curcuma xanthorrhiza 28 gram
Curcuma longa 6 gram

74. For gastritis
Ingredients:
Zingiber officinale 15 gram
Blumea balsamifera 15 gram
Nigella sativa 2 gram
Curcuma longa 15 gram

75. For nephrolithiasis
Ingredients:
Orthosiphon aristatus 6 gram
Strobilanthes crispa 4 gram
Sonchus arvensis 10 gram
Imperata cylindrica 5 gram
Phyllanthus urinaria 5 gram
Curcuma longa 4 gram
Curcuma zanthorrhiza 3 gram

76. For Diabetes Mellitus
Ingredients:
Syzygium polyanthum 5 gram
Andrographis paniculata 5 gram
Cinnamomum verum 7 gram
Curcuma zanthorrhiza 10 gram

77. For Physical Fitness
Ingredients:
Curcuma zanthorrhiza 5 gram
Curcuma longa 4 gram
Phyllanthus urinaria 3 gram

78. For Obesity
Ingredients:
Guazuma ulmifolia 10 gram
Murraya paniculata 10 gram
Rheum officinale 4 gram
Sonchus arvensis 10 gram

79. How to set up and how to use ?
boil 1 liter of water in a
stainless pot or a clay
pot until boiling
after boiling, enter the Jamu,
then boiling for 15 minutes
using a small fire
lift the pan and allowed to cool
(room temperature), then filter
using a tea strainer

81. TERIMA KASIH
THANK YOU
AYO MINUM JAMU….!!!