Herbal Medicines: Can We Do without Pharmacologist?

The increase of herbal medicine use led many scientists to contribute to the research in this field. Also a few pharmacologists, after an initial phase of correct criticisms, today recognize the possibility of investigating the scientific value of medicinal products composed essentially of vegetable extracts. However, it is logical to pose the questions: (i) is there a role for the pharmacologist in herbal medicine (or phytotherapy)? (ii) can we do without pharmacologists’? First, two worlds—drug researchers (pharmacologists) and herbal medicines—yesterday appearing in opposition, are today closer and it is not unusual to read scientific works describing herbal extracts in journals traditionally dedicated to the study of synthetic drugs. Second, clinical application of herbal medicines is evaluable through the methods of modern clinical pharmacology. Efficacy and safety of medicinal plants represent naturally the object of interest for the pharmacologist and it is surely this aspect which gives the most important information on herbal medicine use. Many plants have been studied and results published showing, one time good or another poor, efficacy. Safety aspects of some of the most frequently used plants are now well known. For example, today we learn to usehypericumand we do not give it to patients taking other drugs because the interactions ofhypericumwith them. Contraindications of other plants, often represented by interactions with drugs, are finally known (Ginkgo bilobaand drugs acting on blood coagulation). In conclusion, antagonistic behavior of pharmacologists versus herbal medicines is not useful. On the contrary, modern phytotherapy needs the contribution of researchers usually trained to evaluate efficacy and safety of medicinals.

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Widespread use of herbal medicines by people living with human immunodeficiency virus and contamination of herbal medicines with antiretrovirals in Nigeria

International Journal of STD & AIDS ◽

10.1177/0956462418809749 ◽

2018 ◽

Vol 30 (4) ◽

pp. 371-377

Author(s):

J Gini ◽

A Amara ◽

Sujan D Penchala ◽

David J Back ◽

L Else ◽

...

Keyword(s):

Mass Spectrometry ◽

Human Immunodeficiency Virus ◽

Herbal Medicine ◽

Herbal Medicines ◽

Immune Deficiency Syndrome ◽

Deficiency Syndrome ◽

Medicine Use ◽

Street Vendors ◽

Hiv Therapy ◽

Immunodeficiency Virus

Herbal medication use amongst people living with human immunodeficiency virus (PLWH) is widespread and understudied. This study aimed to evaluate the prevalence of herbal medicine use amongst PLWH and possible contamination with antiretrovirals (ARVs). Countrywide collection of herbal samples sold by street vendors in Nigeria for the following indications: human immunodeficiency virus (HIV), acquired immune deficiency syndrome, fever and general weakness. Samples were screened using a validated liquid chromatography-mass spectrometry/mass spectrometry method for the presence of the following ARVs: efavirenz, nevirapine, lopinavir, darunavir, ritonavir, atazanavir, emtricitabine, tenofovir and lamivudine. A survey was conducted among 742 PLWH attending four HIV clinics in Nigeria. Data were collected using a structured questionnaire and analysed using IBM SPSS statistics version 22.0 (IBM Corp., 2013, Armond, NY). Of the 138 herbal medicines sampled, three (2%) contained detectable levels of tenofovir, emtricitabine and/or lamivudine. Additionally, of the 742 PLWH surveyed, 310 (41.8%) reported herbal medicine use. Among the users, 191 (61.6%) started taking herbals after commencing HIV therapy while herbal medicine use preceded ARVs treatment in 119 (38.4%) PLWH. We found herbal use to be widespread among PLWH in Nigeria, with increasing use after commencing ARV. Three herbal preparations were also found to contain detectable levels of ARVs. This is a concern and should be studied widely across the region and countries where herbal medicine use is prevalent and poorly regulated.

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Factors Associated With Herbal Medicine Use in Pregnancy Among Postnatal Mothers in Mbarara Regional Referral Hospital in Western Uganda

10.21203/rs.3.rs-141153/v1 ◽

2021 ◽

Author(s):

Laban Muteebwa ◽

Ali Ssetaala ◽

Dan Muramuzi ◽

Annet Nanvubya ◽

Yunia Mayanja

Keyword(s):

Herbal Medicine ◽

Pregnant Women ◽

Herbal Medicines ◽

Referral Hospital ◽

Sub Saharan Africa ◽

Medicine Use ◽

Regional Referral Hospital ◽

Factors Associated ◽

Western Uganda ◽

In Pregnancy

Abstract BackgroundThere is widespread use of herbal medicines among populations in sub-Saharan Africa. However, pregnant women should be conscious about medication taken during pregnancy including herbal medicines because their safety profiles are not known and some of them might affect the mother, fetus and pregnancy outcomes. Knowledge about use and safety of herbs in pregnant women is limited. This study aimed to assess the extent of use and the factors associated with use of herbal medicine in pregnancy.MethodsA cross-sectional study involving 385 women 6 weeks post-partum and below, receiving post-natal services at Mbarara Regional Referral Hospital in Western Uganda was conducted during May to August 2016. Simple random sampling was used to select participants. A structured pretested questionnaire was administered after written informed consent. Data was analyzed using logistic regression (STATA- 14).ResultsOf 385 respondents, 70.4% reported to have used herbal medicine during their most recent pregnancy. Associated factors were perception that herbal medicines are safe (aOR 9.8, 95% CI (4.2-23.0), perception that herbal medicines are important (aOR 12.4, 95% CI (5.2-29.5), staying more than 10KM from the heath facility (aOR 3.1, 95%CI (1.4-6.9), being a first time mother (aOR 2.6, 95%CI (1.1-6.2) and dissatisfaction with ANC services at health facility (aOR 2.6, 95%CI (1.1-6.3)ConclusionHerbal medicine use in pregnancy is common in the study area. Community Sensitization drives about the dangers of herbal medicine use in pregnancy is recommended. Healthcare workers should routinely screen for herbal medicine use during antenatal care visits and labor.

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Nephrotoxicity and Chinese Herbal Medicine

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.11571017 ◽

2018 ◽

Vol 13 (10) ◽

pp. 1605-1611 ◽

Cited By ~ 23

Author(s):

Bo Yang ◽

Yun Xie ◽

Maojuan Guo ◽

Mitchell H. Rosner ◽

Hongtao Yang ◽

...

Keyword(s):

Herbal Medicine ◽

Chinese Herbal Medicine ◽

Aristolochic Acid ◽

Herbal Medicines ◽

Kidney Injury ◽

Medicine Use ◽

Chinese Herbal ◽

Aristolochic Acids ◽

Increase Risk ◽

Plant Alkaloids

Chinese herbal medicine has been practiced for the prevention, treatment, and cure of diseases for thousands of years. Herbal medicine involves the use of natural compounds, which have relatively complex active ingredients with varying degrees of side effects. Some of these herbal medicines are known to cause nephrotoxicity, which can be overlooked by physicians and patients due to the belief that herbal medications are innocuous. Some of the nephrotoxic components from herbs are aristolochic acids and other plant alkaloids. In addition, anthraquinones, flavonoids, and glycosides from herbs also are known to cause kidney toxicity. The kidney manifestations of nephrotoxicity associated with herbal medicine include acute kidney injury, CKD, nephrolithiasis, rhabdomyolysis, Fanconi syndrome, and urothelial carcinoma. Several factors contribute to the nephrotoxicity of herbal medicines, including the intrinsic toxicity of herbs, incorrect processing or storage, adulteration, contamination by heavy metals, incorrect dosing, and interactions between herbal medicines and medications. The exact incidence of kidney injury due to nephrotoxic herbal medicine is not known. However, clinicians should consider herbal medicine use in patients with unexplained AKI or progressive CKD. In addition, exposure to herbal medicine containing aristolochic acid may increase risk for future uroepithelial cancers, and patients require appropriate postexposure screening.

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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9963038 ◽

2021 ◽

Vol 2021 ◽

pp. 1-18

Author(s):

John Baptist Asiimwe ◽

Prakash B. Nagendrappa ◽

Esther C. Atukunda ◽

Mauda M. Kamatenesi ◽

Grace Nambozi ◽

...

Keyword(s):

Herbal Medicine ◽

Meta Analysis ◽

Herbal Medicines ◽

Patient Characteristics ◽

Medicine Use ◽

Middle Income ◽

Patients With Cancer ◽

Pooled Prevalence ◽

Prevalence Estimates ◽

Meta Analyses

Background. Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods. Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results. In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion. Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.

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Pharmacists’ Knowledge, Perceptions, and Practices Regarding Herbal Medicine

INNOVATIONS in pharmacy ◽

10.24926/iip.v10i3.2059 ◽

2019 ◽

Vol 10 (3) ◽

pp. 15

Author(s):

Catherine Santanello ◽

Ashlyn Carr

Keyword(s):

Side Effects ◽

Herbal Medicine ◽

Drug Interactions ◽

Herbal Medicines ◽

Community Pharmacists ◽

Reliable Information ◽

Medicine Use ◽

Article Type ◽

Knowledge Survey ◽

The Impact

Introduction: With the increase of herbal medicine sales and a lack of reliable information available to consumers, it is important for pharmacists to be knowledgeable about these products and have the ability to effectively counsel on their uses and risks. The purpose of this study was to: 1) assess community pharmacists’ knowledge, perceptions, and practices regarding herbal medicines, 2) understand the impact pharmacists may have on their patients’ herbal medicine use, and 3) gauge what practices could be improved. Methods: An anonymous survey was distributed to community pharmacists through email, social media, and in-person at local pharmacies. The survey consisted of general background questions, questions assessing perceptions and practices regarding herbal medicine, and a ten-question true/false quiz to assess knowledge. Survey data was collected and assessed using Qualtrics and Excel. Results: Of the 127 community pharmacists who completed the survey, only 34% were confident in their ability to effectively counsel patients on herbal medicines. Approximately 50% of pharmacists reported never or rarely asking patients about herbal medicine use and 80% reported never or rarely documenting herbal medicine use. Only 25% of pharmacists reported that they always discuss side effects and 19% reported that they always discuss herb-drug interactions when patients are using herbal medicines. The average quiz score assessing knowledge of herbal medicines was 6.06 out of 10. Conclusions: It is important for community pharmacists to be knowledgeable about herbal medicines and prepared to educate patients to ensure safe medication use. Pharmacists need to acknowledge the use of herbal medicine in their patients and always discuss potential side effects and herb-drug interactions. It is also important that pharmacists know where they can find reliable information on herbal medicines and use evidence-based resources when possible. Article Type: Student Project

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A Qualitative Study of Herbal Medicine Use in the Ukraine

Journal of Pharmacy Practice ◽

10.1177/0897190011431633 ◽

2012 ◽

Vol 25 (1) ◽

pp. 96-100 ◽

Cited By ~ 1

Author(s):

Duska M. Franic ◽

Konstantin Kleyman

Keyword(s):

Health Care ◽

Herbal Medicine ◽

Health Care Provider ◽

Health Care Providers ◽

Care Provider ◽

The United States ◽

Care Providers ◽

Medicine Use ◽

Herbal Medication ◽

Synthetic Drugs

Introduction: Half of nearly all new immigrants in the United States come from only 10 countries, including the Ukraine. Immigrants bring facets of their culture to their new country; therefore, it is important for health care providers to have an appreciation and understanding of cultural differences in regard to the use of herbal medicine. Objectives: To determine health care provider and patient preferences for herbal versus synthetic medications, health care provider didactic training in pharmacognosy and trends in herbal medication use in the Ukraine. Methods: Ten health care providers, pharmacists and physicians, were interviewed to determine their views on herbal medicine use in Ukraine using semistructured in-depth face-to-face interviews. Results: Ukrainian practitioners and patients viewed herbal medicines as safer than synthetic drugs, appropriate and preferable for use in chronic and preventative programs. Synthetic drugs were viewed as more desirable for use in the acute setting. Preference for synthetic versus herbal medication was not price driven. Conclusions: The inclusion of pharmacognosy training in the US pharmacy curricula is recommended to facilitate US health care professional’s ability to provide pharmaceutical care both to new US immigrants and to the increasing number of US citizens utilizing herbal medications.

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Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/9493807 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 11

Author(s):

Peter Bai James ◽

Lexina Taidy-Leigh ◽

Abdulai Jawo Bah ◽

Joseph Sam Kanu ◽

Jia Bainga Kangbai ◽

...

Keyword(s):

Herbal Medicine ◽

Traditional Medicine ◽

Sierra Leone ◽

Healthcare Providers ◽

Herbal Medicines ◽

Cross Sectional Study ◽

Herbal Remedies ◽

Medicine Use ◽

Chi Square ◽

Cross Sectional

In resource-poor countries where access to infertility care is limited, women may turn to traditional medicine to achieve motherhood. It is unknown whether Sierra Leonean women with such condition use herbal medicine. This study investigates the prevalence and factors associated with herbal medicine use among women seeking care for infertility. This was a questionnaire-based cross-sectional study conducted among women seeking care for infertility at various clinics within Freetown, Sierra Leone. Data analysis included Chi-square tests and logistic regression. Out of the 167 women that participated, 36.5% used herbal medicine for infertility treatment. Women with no formal (AOR 4.03, CL: 1.38–11.76, p=0.011), primary education (AOR: 6.23, CL: 2.02–19.23, p=0.001) and those that visited a traditional medicine practitioner (AOR: 20.05, CL: 2.10–192.28, p=0.009) as well as women suffering from other reproductive health problems (AOR: 2.57, CL: 1.13–5.83, p=0.024) were more likely to use herbal medicines. Friends and family (n=57, 96.7%) were the main influencers of herbal medicine use. Only (n=12) 19.7% of users disclosed their status to their healthcare provider. Over half (n=32, 52.5%) could not remember the name of the herb they used. Luffa acutangula (n=29, 100%) was the herbal medicinal plant users could recall. Herbal medicine use among women seeking care for infertility in Freetown is common. Healthcare providers should be aware of the potential dyadic use of herbal and allopathic medicines by their patients and be knowledgeable about commonly used herbal remedies as well as being proactive in communicating the potential risks and benefits associated with their use.

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The potential of herbal extracts to inhibit SARS-CoV-2: a pilot study

Clinical Phytoscience ◽

10.1186/s40816-021-00264-6 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Michela Luisa De Pellegrin ◽

Anette Rohrhofer ◽

Philipp Schuster ◽

Barbara Schmidt ◽

Philipp Peterburs ◽

...

Keyword(s):

Respiratory Infections ◽

Quantitative Polymerase Chain Reaction ◽

Herbal Medicines ◽

Vero Cells ◽

Cell Culture Supernatant ◽

Herbal Extracts ◽

Medicinal Products ◽

Herbal Medicinal Products ◽

Herbal Medicinal

Abstract Background Herbal medicinal products have a long-standing history of use in the therapy of common respiratory infections. We sought to assess the potential of five validated herbal extracts regarding their ability to restrict SARS-CoV-2 replication in vitro: Bronchipret thyme-ivy (BRO TI), Bronchipret thyme-primrose (BRO TP), Imupret (IMU), Sinupret extract (SINx) and Tonsipret (TOP). Methods Vero cells were incubated with different concentrations of herbal extracts and infected with SARS-CoV-2 for 48 hours. The inhibition of viral replication was assessed by determination of the viral RNA load in the cell culture supernatant using quantitative polymerase chain reaction (qPCR). Results SARS-CoV-2 RNA load was reduced by non-cytotoxic concentrations of BRO-TP (up to approximately 1,000-fold) and, to a lesser extent, IMU and TOP (approximately 10-fold). Conclusions Some herbal extracts showed a promising in vitro effectiveness against SARS-CoV-2, suggesting an antiviral potential of herbal medicinal products. The potential of herbal medicines to restrict SARS-CoV-2 and to treat COVID-19 should be investigated further in a clinical setting.

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Understanding forgotten exposures towards achieving Sustainable Development Goal 3: a cross‐sectional study on herbal medicine use during pregnancy or delivery in Tanzania

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03741-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anna Tengia-Kessy ◽

George Chombe Msalale

Keyword(s):

Sustainable Development ◽

Herbal Medicine ◽

Confidence Interval ◽

Health Care Providers ◽

Herbal Medicines ◽

Prevalence Ratio ◽

Care Providers ◽

Medicine Use ◽

Sustainable Development Goal ◽

Development Goal

Abstract Background In most of the sub-Sahara African countries, use of herbal medications is widely practiced during pregnancy or delivery for various reasons despite uncertainties on their pharmacological profiles. Use of unregistered herbal medicines has the potential of causing adverse health effects to the mother and the newborn, thus deterring achievement of Sustainable Development Goal 3, which aims to “ensure healthy lives and promote well-being for all at all ages”. One of the targets is on reduction of morbidity and mortality among mothers and newborns. This study investigated use of herbal medicines and predictors of usage during pregnancy or delivery as a forgotten exposure towards understanding some of the challenges in achieving Sustainable Development Goal 3. Methods This cross-sectional quantitative study gathered information from women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, women attending reproductive, maternal and child health clinics in Tabora were selected and interviewed. Proportions were compared using chi-square test and Poisson regression analysis was performed to determine independent correlates of herbal medicine use. Results Of 340 recruited women, 208 [61.2 %; 95 % confidence interval: 55.4, 66.3 %] used herbal medicines during pregnancy or delivery. Major reasons for use included accelerating labour, 81 (38.9 %) and reducing labour pains, 58 (27.9 %). Women who made less than four antenatal visits had a 24 % higher adjusted prevalence ratio of using herbal medicines as compared to those who had at least four visits [adjusted prevalence ratio:1.24; 95 % confidence interval: 1.02, 1.50, p = 0.03]. Furthermore, the adjusted prevalence ratio of using herbal medicines was 35 % higher among women who were not discouraged by health care providers against their use as compared to those who were discouraged (adjusted prevalence ratio: 1.35; 95 % confidence interval: 1.13, 1.60, p = 0.01). Conclusions Use of herbal medicines during pregnancy or delivery among women in Tanzania is common. Independent predictors of herbal medicine use were number of antenatal visits and stance of maternity health care providers on their use. Comprehensive investigations on the magnitude, patterns and predictors of use of herbal medicines during pregnancy or delivery are warranted.

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Lysis Test of Ascaris lumbricoides Eggs After Giving Ethanol Extract of Chinese Ketepeng Leaves (Cassia alata L.)

JURNAL PROTEKSI KESEHATAN ◽

10.36929/jpk.v9i2.236 ◽

2021 ◽

Vol 9 (2) ◽

pp. 9-15

Author(s):

Sri Kartini ◽

Ira Oktaviani Rz

Keyword(s):

Herbal Medicine ◽

Morphological Change ◽

Ascaris Lumbricoides ◽

Laboratory Experiments ◽

Morphological Changes ◽

Herbal Medicines ◽

Ethanol Extract ◽

Cassia Alata ◽

Synthetic Drugs ◽

Intestinal Worms

soil or known as soil transmitted helminth (STH). Infection caused by these parasites can be eradicated by giving synthetic drugs and herbal medicines. One of the plants that can be used as herbal medicine is ketepeng cina (Cassia alata L.). chinese ketepeng leaves (Cassia alata L.) have one benefit, namely to treat intestinal worms. This study aims to determine the morphological changes of eggs Ascaris lumbricoides after the administration of ethanol extract of chinese ketepeng leaves (Cassia alata L.) with concentration 1%, 2%, 3%, 4%, 5%. The method used in this study is laboratory experiments. The results of this study indicate that the ethanol extract of chinese ketepeng leaves (Cassia alata L.) in concentrated 4% and 5% changes color in the eggs but there is no morphological change in eggs. From this study it can be concluded that the ethanol extract of chinese ketepeng leaves (Cassia alata L.) is not able to damage the morphologi of Ascaris lumbricoides worm eggs.

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