Herbal Medicines in Pregnancy discusses herbal medicines used during pregnancy. It defines herbal medicines and introduces their widespread use globally. While some herbal medicines have been shown to help certain conditions, the document notes a lack of standardized testing and potential safety concerns, especially regarding effects on uterine contraction and abortion. It provides an analysis of herbal medicine exposure data from the Korean Motherisk Program and identifies some herbs as slightly or very toxic, like Crotonis Semen and Mylabris, which can cause severe toxicity in high amounts. The document emphasizes the need for more research on herbal medicine safety and effects during pregnancy.
In this ppt the viewer will able to know about Herbal Drug Preparation. An herb is a plant or plant part used for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are sold as tablets, capsules, powders, teas, extracts, and fresh or dried plants. Dosage forms are the means by which drug molecules or plant parts are delivered to sites of action within the body. The routes for which herbal dosage forms may be administered include oral, rectal, topical, parenteral, respiratory, nasal, ophthalmic and otic. Categorization of finished herbal products into dosage forms will help to define specific protocols for quality control and stability testing. Herbal medicinal products may be defined as finished, labelled medicinal products that contain as active ingredients aerial or underground parts of plants, or other plant material, or combinations thereof, whether in the crude state or as plant preparations.
Portion explained:
1. Herbal Drug Preparation
2. Herbal Medicine
3. Dosage forms of Herbal Medicinal Products
4. Decoctions
5. Tinctures
6. Herbal Glycerites
7. Herbal alcoholic beverages (bitters/wines)
8. Oxymels
9. Herbal capsules
10. Herbal tablets
11. Herbal ointments
12. Herbal balms
13. Herbal creams
14. Herbal oils
15. Herbal soaps
16. Herbal pastes
17. Herbal teas
18. Herbal powders
19. Herbal suppositories
20. Herbal liniments
21. Herbal baths
22. Herbal lozenges
In this ppt the viewer will able to know about Herbal Drug Preparation. An herb is a plant or plant part used for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are sold as tablets, capsules, powders, teas, extracts, and fresh or dried plants. Dosage forms are the means by which drug molecules or plant parts are delivered to sites of action within the body. The routes for which herbal dosage forms may be administered include oral, rectal, topical, parenteral, respiratory, nasal, ophthalmic and otic. Categorization of finished herbal products into dosage forms will help to define specific protocols for quality control and stability testing. Herbal medicinal products may be defined as finished, labelled medicinal products that contain as active ingredients aerial or underground parts of plants, or other plant material, or combinations thereof, whether in the crude state or as plant preparations.
Portion explained:
1. Herbal Drug Preparation
2. Herbal Medicine
3. Dosage forms of Herbal Medicinal Products
4. Decoctions
5. Tinctures
6. Herbal Glycerites
7. Herbal alcoholic beverages (bitters/wines)
8. Oxymels
9. Herbal capsules
10. Herbal tablets
11. Herbal ointments
12. Herbal balms
13. Herbal creams
14. Herbal oils
15. Herbal soaps
16. Herbal pastes
17. Herbal teas
18. Herbal powders
19. Herbal suppositories
20. Herbal liniments
21. Herbal baths
22. Herbal lozenges
Cancer is still the second most common cause of death in the major industrial nations.
Some people are particularly sensitive to oncogenic factors.
External factors include;
- Radiation and radioactive substances
- Certain chemical products (food additives, contaminants, certain drugs)
A cell that has undergone change is malignant. Unlike normal cells, cancerous cells multiply ceaselessly, and unless arrested, they will kill the host.
Aromatherapy is the practice of using essential oils for therapeutic benefit.
Aromatherapy has been used for centuries.
When inhaled, the scent molecules in essential oils travel from the olfactory nerves directly to the brain and especially impact the amygdala, the emotional center of the brain.
Aromatherapy derived its name from the word aroma, which means fragrance or smell, and therapy which means treatment. This therapy is a natural way of healing a person’s mind, body, and soul.
Literature survey reveals that this therapy has gained a lot of attention in the late 20th century and is very popular in the 21st century too, and due to its importance, popularity, and widespread use, it is recognized as aroma science therapy.
R1- شرح مفصل عن عشبة الناردين كمستحضرات صيدلية من مدونتي
https://cognosy4all.blogspot.com/2021/06/valerian.html
R1- شرح مفصل عن عشبة الناردين كمستحضرات صيدلية من مدونتي
https://cognosy4all.blogspot.com/2021/06/valerian.html
Crude drugs: A general view of their origin, distributions, cultivation, collection, drying and
storage, commerce and quality control.
a) Classification of drugs.
b) Preparation of drugs for commercial market
c) Evaluation of crude drugs.
d) Drug adulteration.
Cancer is still the second most common cause of death in the major industrial nations.
Some people are particularly sensitive to oncogenic factors.
External factors include;
- Radiation and radioactive substances
- Certain chemical products (food additives, contaminants, certain drugs)
A cell that has undergone change is malignant. Unlike normal cells, cancerous cells multiply ceaselessly, and unless arrested, they will kill the host.
Aromatherapy is the practice of using essential oils for therapeutic benefit.
Aromatherapy has been used for centuries.
When inhaled, the scent molecules in essential oils travel from the olfactory nerves directly to the brain and especially impact the amygdala, the emotional center of the brain.
Aromatherapy derived its name from the word aroma, which means fragrance or smell, and therapy which means treatment. This therapy is a natural way of healing a person’s mind, body, and soul.
Literature survey reveals that this therapy has gained a lot of attention in the late 20th century and is very popular in the 21st century too, and due to its importance, popularity, and widespread use, it is recognized as aroma science therapy.
R1- شرح مفصل عن عشبة الناردين كمستحضرات صيدلية من مدونتي
https://cognosy4all.blogspot.com/2021/06/valerian.html
R1- شرح مفصل عن عشبة الناردين كمستحضرات صيدلية من مدونتي
https://cognosy4all.blogspot.com/2021/06/valerian.html
Crude drugs: A general view of their origin, distributions, cultivation, collection, drying and
storage, commerce and quality control.
a) Classification of drugs.
b) Preparation of drugs for commercial market
c) Evaluation of crude drugs.
d) Drug adulteration.
This is my power point presentation about South Korea for LIT 002 / World Literature.
Contents:
*geography
* brief history
* culture
* traditions
* literature
* landmarks
* economic
* others
It’s easier than ever to create a startup around a new, innovative idea. But most startups fail -- and most innovative products never take off. What differentiates the projects that DO take off? What habits, behaviors and attitudes are shared by the teams who create genre-defining hits? In this talk, you’ll learn the 7 habits of breakthrough innovators - brought to life with front-line stories from the early days of eBay, Ultima Online, The Sims, Rock Band, Covet Fashion, Happify, Lumosity and Pley. You’ll come away with a smarter approach to innovative product design - and practical, actionable design shortcuts you can use right away to turbo-charge your path towards product/market fit.
3 Things Every Sales Team Needs to Be Thinking About in 2017Drift
Thinking about your sales team's goals for 2017? Drift's VP of Sales shares 3 things you can do to improve conversion rates and drive more revenue.
Read the full story on the Drift blog here: http://blog.drift.com/sales-team-tips
Herbal medicine is the use of plants or plant extracts for medicinal purposes (especially plants that are not part of the normal diet).
Phytonutrient or nutraceutical or functional food
Natural substances that aid the body to maintaining health and combating disease such as anthocyanidins, isoflavones and carotenoids.
Natural product : is biosynthetic substances produced by living cells.
Crude Drug: It’s a medically useful drug of plant or animal origin without any further processing or modification.
The human genome project, which has been under way for several years now, represents an attempt to build a complete genetic profile of the human race. Already researchers claim to have identified the gene responsible for a number of abnormalities, from cystic fibrosis to, most recently, aggression. Should this be regarded as an exciting enterprise that deserves the support of therapists of all persuasions? Or is it an extreme expression of hubris, a hazardous undertaking with unforeseeable and possibly disastrous consequences for human health and liberty. The result of this misperception is that, inevitably, genetic mapping will lead to genetic manipulation – indeed that is the avowed aim of geneticists. Whatever the good intentions of researchers, the medical -industrial establishment a tacit alliance of doctors, drug companies ,insurance, and other interested parties, influenced to varying degrees by consideration of money or power –will ensure that the pressures on ‘genetic defectives’ to undergo therapy will be irresistible. This will give rise to a society where the individual will relinquish all control over his or her own health, and where virtually everyone, from gestation onward, will become a “patient” under the control of the medical- industrial complex.
What does all this have to do with Phytotherapy(Herbal Medicine)? The natural therapies-among which the phytotherapy, in global terms, is paramount-in general reflect the philosophical view that nature in totality , is the expression of a universal harmony and equilibrium , the rupture of which gives rise to numerous ill effects, among them environmental devastation in the biosphere and ill-health in the individual.
Phytotherapy, by contrast, aims not to cure disease by a technological fix, but to bring about a restoration of homoeostasis through remedies that assist , but stop short of violence to, the organism’s intrinsic healing powers.
The eminent French doctor J.C Lapaz maintains that 90% of both common and serious illnesses could be treated with phytotherapy.It is therefore the lecturer believe that widening the scope of natural medicine in this way presents as worthy as a challenge to science as the human genome project, and one whose success would be crowned with immeasurably greater benefits to humanity and prevention of diseases.
Therapeutics values of plant derived compoundsSenthil Natesan
Natural products, including plants, animals and minerals have been the basis of treatment of human diseases. History of medicine dates back practically to the existence of human civilization. The current accepted modern medicine or allopathy has gradually developed over the years by scientific and observational efforts of scientists. However, the basis of its development remains rooted in traditional medicine and therapies. The history of medicine includes many ludicrous therapies. Nevertheless, ancient wisdom has been the basis of modern medicine and will remain as one important source of future medicine and therapeutics. The future of natural products drug discovery will be more holistic, personalized and involve wise use of ancient and modern therapeutic skills in a complementary manner so that maximum benefits can be accrued to the patients and the community
Medicinal plants are important and basic drugs sources from ancient times. In this presentation we discussed some of the phytoconstituents of plants which are useful in daily life.
Following file comprises of information about interactions taking place between herbs-drug, herbs-herbs, it also highlights some of the cases of clinical laboratory test interactions taking place due to use of herbal medicines.
The use of herbal drugs for the prevention and treatment of various health ailments has been in practice from time immemorial. Generally it is believed that the risk associated with herbal drugs is very less, but reports on serious reactions are indicating to the need for development of effective marker systems for isolation and identification of the individual components.Standards for herbal drugs are being developed worldwide but as yet there is no common consensus as to how these should be adopted. Standardization, stability and quality control for herbal drugs are feasible, but difficult to accomplish. Further, the regulation of these drugs is not uniform across countries. There are variations in the methods used across medicine systems and countries in achieving stability and quality control. The present study attempts to identify the evolution of technical standards in manufacturing and the regulatory guideline development for commercialization of herbal drugs.
Keywords: survey was conducted to obtain primary data on challenges faced during production, commercialization, and marketing approval for traditional or herbal drugs in India and abroad. Responses were collected from companies by email, telephone, and in-person interviews and were analyzed to draw appropriate conclusions.The use of plants, parts of plants and isolated phytochemicals for the prevention and treatment of various health ailments has been in practice from time immemorial. It is estimated that about 25% of the drugs prescribed worldwide are derived from plants and 121 such active compounds are in use. Of the total 252 drugs in WHO's essential medicine list, 11% is exclusively of plant origin The use of plants, parts of plants and isolated phytochemicals for the prevention and treatment of various health ailments has been in practice from time immemorial. It is estimated that about 25% of the drugs prescribed worldwide are derived from plants and 121 such active compounds are in use. Of the total 252 drugs in WHO's essential medicine list, 11% is exclusively of plant origin .
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
1. Herbal Medicines in Pregnancy
June-Seek Choi, M.D., PhD
Korean Motherisk Program
Div. of Maternal-Fetal Medicine,
Dept. of OB & GYN,
Cheil General Hospital & Women’s Healthcare Center,
School of Medicine, Kwan-dong University, Seoul, Korea
2. Contents
• Definition
• Introduction
• Herbal medicines relate to uterine contraction (in
animal study vs human)
• Herbal medicines relate to spontaneous abortion
(in animal study vs human)
• Data of pregnancy outcomes of herbal medicine
exposure in Korean Motherisk Program
• Summary
3. Definition (1)
• Herbal medicines: include herbs, herbal
materials, herbal preparations and
finished herbal products, that contain as
active ingredients part of plants, or other
plant materials, or combinations.
WHO
4. Definition (2)
• Herbs: crude plant materials such as leaves,
flowers, fruit, seed, stems, wood, bark, roots,
rhizomes or other plant parts, which may be
entire, fragmented or powdered.
• Herbal materials: in addition to herbs, fresh
juices, gums, fixed oils, essential oils, resins and
dry powders of herbs.
WHO
5. Definition (3)
• Herbal preparations: may include
comminuted or powdered herbal materials, or
extracts, tinctures and fatty oils of herbal
materials. They are produced by extraction,
fractionation, purification, concentration, or
other physical or biological processes.
• Finished herbal products: herbal
preparations made from one or more herbs.
WHO
6. Introduction (1)
• It is estimated that about 25% of all modern
medicines are directly or indirectly derived from
higher plants. Farnsworth NR 1976, Shu YZ 1998
• Anticancer and antimicrobial drugs, about 60%
of the medicines currently available on the
Illicii Fructus
market and most of those in the late stages of
clinical trials are derived from natural products,
mainly from higher plants. Gragg GM et al 1997
7. Introduction (2)
• Representing an annual global market of US $60
billion every year, herbal medicines account for
around 20% of the overall drug market.
• Africa- 80% of population
China- 30-50% of total medical consumption
Europe, North America- over 50% of population
have used complementary or alternative medicine at
least once. WHO news 2004
• Fee for herbal medical treatment was increased 57
times in Korea [ US $ 19 million (1990) US $ 1.1 billion (2006)]
A study on the current status and prospect of CAM world market 2007
8. Important factors to growth of this worldwide
Introduction (3) complementary/alternative medicine(CAM)
• Preference of consumers for natural therapies
• Concern regarding undesirable side effects of
modern medicines and the belief that herbal
drugs are free from side effects
• Great interest in alternative medicines
• Herbal medicines might be of effective benefit in
the treatment of certain diseases where
conventional therapies and medicines have
proven to be inadequate
• High cost of synthetic medicines
Grünwald J 1995
9. Compared with well-defined synthetic drugs,
Introduction (4) herbal medicines exhibit some marked difference
• Active principles are frequently unknown.
• Standardization, stability and quality control are
feasible but not easy
• Availability and quality of raw materials are
frequently problematic.
• Well-controlled double-blind clinical and
toxicological studies to prove their efficacy and
safety are rare.
• Wide range of therapeutic use and are suitable for
chronic treatments.
• Usually cost less than synthetic drugs
Calixto J.B. 2000
10. Side effects by Korean herbal medicines-drug interactions
Western Medicine Drug interaction and results
Angelicae Gigantis Radix(Dang gui), Warfarin, Aspirin Decreased International Normalized
Ginseng Radix, Extract of Ginkgonis Ratio and anticoagulant effects
Germen
Glycyrrhizae Radix (Gam cho) Digoxin, Furosemide, Licorice and digoxin may result in
Hydrochlorothiazide increased risk of digoxin toxicity. Licorice
and diuretics may result in increased risk
of hypokalemia and/or reduced
effectiveness of the diuretic.
Ginseng Radix, Ephedrae Herba (Ma Glyburide, Insulin, Metformin Severe Hypoglycemia due to increase
hwang) , Zinberis Rhizoma Recens (Saeng insulin
gang)
Glycyrrhizae Radix (Gam cho) Metoprolol, Verapamil, Diltiazem Decrease drug effect and Hypertension
Allii Bulbus (Ma neul) Isoniazid Decrease serum concentration of isoniazid
Zinberis Rhizoma Recens (Saeng gang) Nifedipine, Verapamil, Diltiazem Severe Hypotension
Extract of Ginkgonis Germen Thiazide Hypertension
Extract of Ginkgonis Germen, Ephedrae Anticonvulsant Increase risk of seizure
Herba (Ma hwang)
Ginseng Radix Azathioprine, Cyclosporine, Decrease effect of immunosuppressant
Corticosteroid
Ephedrae Herba (Ma hwang) Pseudoephedrine, MAO inhibitor Hypertension
Ephedrae Herba (Ma hwang) Amiodaron, Procainamide, Quinidine Prolongation of QT interval
Park YC et al 2011
11. Introduction (5)
• Some Chinese medical (CM) natural herbs listed
in the official Chinese Pharmacopoeia (CP), CP
are considered poisonous or toxic due to the
presence of poisonous or toxic chemical
constituents in the herb.
• Of which about 50 of animal, plant and mineral
natural materials are included in the CP.
• In the CP the words “toxic, non-toxic, very-toxic
or slightly toxic” are often used in describing
Chinese Materia Medica.
Chan K 2003
13. Very Toxic Herbal Medicine
Herbal name Common name Korean common Binominal name Toxicity
name
Crotonis Semen Croton seed Pa doo Croton tiglium L. (Euphorbiaceae) Very toxic
Mylabris Mylabris Ban myo 1. Mylabris cichorii Fabricius Very toxic
(Meloidae)
2. Mylabris phalerata Pall.
(Meloidae)
3. Mylabris sidae Fabricius
(Meloidae)
Aconiti Ciliare Tuber Wild aconite (tuber) Cho o Aconitum ciliare DC. Very toxic
(Ranunculaceae)
Aconiti Kusnezoffii Wild aconite (tuber) Cho o Aconitum kusnezoffii Reichb. Very toxic
Radix (Ranunculaceae)
Aconiti Proliferum Wild aconite (tuber) Cho o Aconitum proliferum Nakai Very toxic
Radix (Ranunculaceae)
Aconiti Radix Wild aconite (tuber) Cho o Aconitum triphyllum Nakai Very toxic
(Ranunculaceae)
Aconiti Radix Aconite main tuber Chun o 1. Aconitum carmichaeli Debx. Very toxic
(Ranunculaceae)
2. Aconitum chinense Paxton
(Ranunculaceae)
Strychni Semen seu nux Nuxvomica Ma jun ja Strychnos nux-vomica L. Very toxic
Vomicae Semen (Loganiaceae)
The Pharmacopoeia Commission of PRC, 2000
14. Crotonis Semen (Pa Doo)
• Indications: Scabies ,Eczema, Abscess
Constituents
4-alpha-Deoxy-5-hydroxy-20-acetoxy-12-O-(2-methyl-amino-benzoyl)phorbol
4-alpha-Deoxy-5-hydroxy-12-O-(N-deca-2,4,6-trienoyl)phorbol
4-alpha-Deoxy-12-O-(2-methylbutyryl)-phorbol-13-acetate
4-alpha-Deoxy-12-O-tiglyl-phorbol-13-acetate
• Pretreatment: Croton seed without husk, Croton seed plaster,
4-alpha-Deoxy-12-O-tiglylphorbol-13-isobutyrate
4-alpha-Deoxy-phorbol-13-acetate
4-alpha-Phorbol
Angelic acid
Croton seed frost-like powder
Cocacinogen A1
Cocacinogen A2
Cocacinogen A3
Cocacinogen A4
Cocacinogen B1
• Pharmacological action: increase GI movement (inhalation,
Cocacinogen B2
Cocacinogen B3
Cocacinogen B4
Cocacinogen B6
Cocacinogen B7
human), increase cell differentiation (in vitro)
Crotin I
Crotin tiglium lectin
Crotonoside
4-Deoxyphorbol tiglate acetate
4-Deoxy-5,13,20-triacetoxy-12-O-(n-deca-2,4,6-trienoyl)phorol
4,20-Dideoxy-5-hydroxy-12-O-(n-deca-2,4,6-trienoyl)-phorbol-13-acetate Hanyak yangnihak 2001
12-O-Acetylphorbol-13-acetate
12-O-(alpha-Methyl-butyryl)-phorbol-13-decanoate
Octyl acetate
12-O-[2-Methyl-amino-benzoyl]-4-alpha-deoxy-5-Hydroxy-phorbol
• Toxicity: Croton oil has the ability to promote radiation
12-O-[2-Methyl-amino-benzoyl]-4-alpha-deoxy-phorbol-5,13,20-triacetate
12-O-[2-Methyl-amino-benzoyl]-4-deoxy-5-hydroxy-phorbol-13-acetate
12-O-[2-Methyl-amino-benzoyl]-4,20-dideoxy-5-hydroxy-phorbol
12-O-[2-Methyl-amino-benzoyl]-4,20-dideoxy-5-hydroxy-phorbol-13-acetate
transformation. It is very toxic and carcinogenic (animal study).
12-O-[2-Methyl-amino-benzoyl]-4,20-dideoxy-phorbol-5,13-diacetate
12-O-(2-Methyl-butyryl)-phorbol-13-acetate
12-O-(2-Methylbutyryl)-phorbol-13-isobutyrate
12-O-[n-Deca-2,4,6-trienoyl]-4-deoxy-5-hydroxy-phorbol-13-acetate
Huang, K.C., The pharmacology of Chinese herbs II, CRC press, 1999.
12-O-[n-Tetradecanoyl]-4,20-dideoxy-5-hydroxy-phorbol-13-acetate
12-O-Tigloylphorbol-13-(2-methyl)-butyrate
12-O-Tiglylphorbol 13-isobutyrate
12-O-Tiglylphorbol-13-acetate
• Caution: Not use in pregnancy
Phorbol
Phorbol 13-butyrate 12-tiglate
Phorbol 13-caprylate 12-acetate
Phorbol 13-caprylate 12-tiglate
Phorbol 13-linoleate 12-acetate
Phorbol 13-myristate 12-acetate
• Formula in Korea: 35/ OTC in Korea:1
Phorbol-13-acetate
Phorbol-12-tiglate
www.tradimed.co.kr
www.tradimed.co.kr/www.kimsonline.co.kr
15. Mylabris (Ban Myo)
• Indications: Rabies, Scabies, Mercury intoxication, Hepatic
Cantharidin
cirrhosis due to Clonorchiasis, Tuberculosis, Tuberculous
lymphadenitis, Eczema, Abscess, Atopic dermatitis, Fever and
• Phytochemical group: Monoterpenoid
chill
• Molecular weight: 196.2
• • Pretreatment: cause symptoms from dermal inflammation to
Cantharidin may parched Mylabris with rice
blisters. If ingested, it may cause irritation and burning of the
• Pharmacological action: intoxication of snake venom,
increase urination, increase abortion GI tract, diarrhea, and
mouth, severe vesication of the upper Dong-Eui-Bo-Gam
kidney and cardiovascular damage.
• Caution: Not use in pregnancy
• Ii is a weak experimental animal carcinogen.
• Formula in Korea: 4 www.tradimed.co.kr
www.thomsonhc.com, www.tradimed.co.kr
16. Aconiti Ciliare Tuber, Aconiti Kusnezoffii Radix, Aconiti
Proliferum Radix, Aconiti Radix (Cho O)
• Indications: Beriberi Aconiti Ciliare Tuber Myalgia, Cold type
Constituents of edema, Cold limbs,
& Aconiti Porliferum Radix
Aconitine Aconitine
dysentery, Epigastric pain, Child epilepsy, Chronic osteomyelitis,
Hypaconitine
Mesaconitine
• Phytochemical group: Alkaloid
Hemiparalysis, Hemiplegia, Migratory arthropathy
• Molecular weight: 645.75
• Pretreatment: processedKusnezoffii Radix tuber
Constituents of Aconiti Wild aconite
• Bioactivity: bind to neurotoxin binding site 2 of α-subunit of
3-Acetylaconitine
Aconitine
• Pharmacological action:Na+ channel ,anti-inflammation,
Acontine
Na+ channel activation of analgesics, increase intracellular
Beiwutine
Bullatine A(structure unknown){formula: C(21)H(31)NO(2)}
vasodilatation, and local anesthetic action in animal study 2010
Ca2+ arrhythmia
Bullatine C Hanbang Yangnihak
Chasmanine; 6-Epimer
Denudatine
• • Toxicity: Toxictoxic if swallowed orbradycardia and irregular
Toxicity: Very symptoms include by skin absorption. Human
Hypaconitine
Lepenine
Mesaconitine
systemic effects by ingestion. LD50 (mus, orl) 1 well LD50 (mus, of
rhythm. Nausea and vomiting may occur, asmg/kg, as spasm ivn)
Neoline
Pendulin
0.175 mg/kg, exp. lethal doses by subcutaneous route reported. LD50 in mice
extremities and cardiac arrhythmias. The intestinal absorption of
Songorine
(mg/kg): 0.166 i.v.; 0.328 i.p.; approx 1 orally (Dybing); also reported as LD50 in
the alkaloids 1.8 relatively s.c.; 0.380 i.p.; 0.12of this, gastric lavage is
mice (mg/kg): is orally, 0.270 fast. Because i.v. (Sato).
Aconiti Ciliare Tuber
www.tradimed.co.kr
recommended in case of overdose.
Huang, K.C., The pharmacology of Chinese herbs II, CRC press, 1999.
Aconiti Kusnezoffii Radix
• Formula in Korea: 16 / OTC in Korea: 10
www.tradimed.co.kr/www.kimsonline.co.kr
17. Aconiti Radix (Chun O)
• Indications: Beriberi edema, Myalgia, Cold type dysentery, Paxton
Constituents of Aconitum carmichaeli Debx. Constituents of Aconitum chinense
14-Acetyltalatizamine Violdelphin
Aconine
Paresthesia, Child epilepsy, Epigastric pain, Chronic
Aconitan A
Aconitan B
Aconitan C
Aconitan D
osteomyelitis, Vomiting and Diarrhea, Testiculitis
Aconitine
Aldohypaconitine
Beiwutine
Benzoylaconine
Benzoylhypaconine
• Pretreatment: processed Aconite main tuber
Benzoylmesaconine
Chuanfumine
Chuan-Wu base A (structure unknown)(Tertiary base with 20H, 20Me and one N-Et groups.)
Chuan-Wu base B(structure unknown){formula: C(32)H(35)NO(4)}
Coryeine
Coryneine
• Pharmacological action: analgesics, anti-inflammation,
Fuzitine
Hokbusine A
Hokbusine B
Hypaconitine
vasodilatation, and local anesthetic action in animal study
Ignavine
Isodelphinine
Isotalatisamine
Isotalatizamine
Karakoline
• Caution: not
Lipoaconitine (R = linoleoyl, palmitoyl, oleoyl, stearoyl, linolenoyl)
use in pregnancy
Lipodeoxyaconitine (R = linoleoyl, palmitoyl, oleoyl, stearoyl, linolenoyl)
Lipohypaconitine (R = linoleoyl, palmitoyl, oleoyl, stearoyl, linolenoyl)
Lipomesaconitine (R = linoleoyl, palmitoyl, oleoyl, stearoyl, linolenoyl)
Mesaconitine
• Toxicity: headache, paralysis of tongue, paraplegia, pain on
Neojiangyouaconitine
Neoline
Salsolinol
upper extremity, nausea, vomiting, respiration difficulty, coma
Senbusine A
Senbusine B
Senbusine C
Songarine Hanyak yangnihak 2001
Songorine
Talatizamine
• Formula in Korea: 1/ OTC in Korea:
www.tradimed.co.kr 5
www.tradimed.co.kr/www.kimsonline.co.kr
19. Korean women have a chance to be exposed to herbal
medicine from marriage to lactation
Increase Decrease Increase
Promote Decreased
pregnancy nausea & breast
Health lochia
chance vomiting milk
35. Demographic characteristics of participants(n=321)
Age (years) 32.0 ± 3.6 Comorbidities [n (%)]
Gravidity (n) 2.2 ± 1.3 a) type 2 diabetes mellitus 1 (0.3)
Parity (n) 1.0 (0, 3.0) b) hypertension 2 (0.6)
Body mass index (kg/m2) 20.8 ± 3.2 c) thyroid disease 2 (0.6)
d) cancer 1 (0.3)
Exposure to X-rays
e) renal disease 1 (0.3)
a) n (%) 54 (16.8)
Education level [n (%)]
b) total dose (mSv) 0.005 (0.0005, 28.8)
a) post-secondary education 130 (40.5)
c) gestational age at exposure (weeks) 4.8 ± 3.2
b) high school 20 (6.2)
Exposure to alcohol (%)
c) not answered 171(53.3)
a) n (%) 128 (39.9)
Occupation
b) total dose (oz) 1.6 ± 1.4
a) professional, technical and related occupatio 54 (16.8)
c) gestational age at exposure (weeks) 4.6 ± 2.3 ns
Smoking (%) b) executive, administrative, managerial and sal 136 (42.4)
a) n (%) 23 (7.2) es
occupations
b) cigarettes/day 5.4 ± 4.4
c) construction workers 124 (38.6)
c) gestational age at exposure (weeks) 6.3 ± 4.6
d) unemployed 7 (2.2)
Korean Motherisk Program, unpublished
36. Indications of herbal exposure (n=321)
INDICATIONS a n (%)
Analgesics 8 (2.5)
Anti-acne preparations 2 (0.6)
Anti-emetics & anti-nauseants 1 (0.3)
Anti-inflammatory enzymes 8 (2.5)
Anti-inflammatory & anti-rheumatic products 7 (2.2)
Anti-obesity preparations 21 (6.5)
Anti-thrombotic agents 2 (0.6)
Cough and cold preparations 129 (40.2)
Dermatological preparations 3 (0.9)
21 cases: Tonic
Drugs for acid related disorder 1 (0.3)
medicine
Functional gastrointestinal disorders 93 (29.0)
Gynecological anti infectives and antiseptics 11 (3.4)
Psycholeptics 2 (0.6)
Sex hormones & modulators the genital system 7 (2.2)
Others 26 (8.1)
aAccording to the pharmacological/therapeutic subgroups of the ATC classification system (World Health Organization Korean Motherisk Program, unpublished
Collaborating Centre for Drug Statistics Methodology 2011)
37. Exposure to herbal medicine in pregnant women (n=321)
Median (range)
Numbers of herbal medicine including 7.0 (1.0 - 40.0)
one prescription
Duration of exposure (days) 3.0 (1.0 – 365.0)
Gestational age at last dose (weeks) 4.7 (0.1 - 25.0)
197 kinds of herbal medicines
Korean Motherisk Program, unpublished
38. Frequencies of Herbal medicine (>10%)
n 188
200
150
100 75 91 81 71 103
50 46 65 71
57 57
48 43 45
0 43 45 41
40 33
Korean Motherisk Program, unpublished
39. Fetal outcomes
Cases (n= 307)
Gestational age at birth (weeks) 38.9 ± 2.4
Birth weight (g) 3,294.2 ± 511.8
Birth length (cm) 49.7 ± 2.2
Head circumference at birth (cm) 34.6 ± 1.4
Apgar score, 1 min 8.3 ± 0.9
Apgar score, 5 min 9.0 ± 0.7
IUFD (%) 6 (2.0)
Malformationsa (%) 7 (2.3)
NICU admission (%) 12 (3.9)
Duration of NICU admission (days) 12.5 ± 9.2
Neonatal jaundice (%) 10 (3.3)
a A baby born with megacisterna magna, second one with dysplastic change of left kidney, left ectopic ureteral
insertion, third one with small pulmonary artery, fourth one with polydactyly of 5th toe of left foot and cleft palate and
patent ductus arteriosus, fifth one with small echogenic foci of anterior papillary muclse of left ventricle heart, sixth
one with borderline left ventriculomegaly of cerebrum, and seventh one with patent ductus arteriosus
Korean Motherisk Program, unpublished
40. Summary (1)
• Although herbal medicines have been used in
clinical practice for thousands of years, basic
research on herbal substances should be focused on
the toxicity and efficacy relationship for those potent
and poisonous herbal substances according to
composite formula.
• Most traditional medical herbs are used in the form
of an aqueous decoction. Therefore research
projects should be centered on development of
analytical and biological procedures for use to give
quality assurance, control, and clinical assessment of
efficacy, and safety of products.
41. Summary (2)
• Herbal medications should be regulated for safety,
quality and for appropriate evidence of efficacy.
• Dosage and indications for treatment should be
standardized. And contraindications should be
clearly identified.
• Language problem is another aspect as herbal
ingredients are supplied with similarly names
substitutes that could be toxic.