PHARMACOGNOSY AND HERBAL PHARMACY WHAT IS PHARMACOGNOSY? Pharmacognosy is the science of naturally occurring substances with medicinal actions. It includes the simultaneous study from various disciplines: Botany Chemistry Biochemistry Physiology Pharmacology AN INTERESTING TIMELINE FOR THE ISOLATION OF CONSTITUENTS 1806 Morphine Extracted from Papaver somniferum (opium poppy). An alkaloid that was found to be a very strong analgesic. The invention of the hypodermic syringe in 1850 by the French doctor CharlesGabriel Pravaz enabled the rapid popularization and spread of the new drug. By the 1870’s many doctors, chemists, nurses and members of France’s elite upper class were addicted as it was hailed as a wonder drug and universal panacea. At the time little was known about the toxic affects and addictive nature of morphine. 1817 Strychnine Extracted from Strychnos nux-vomica. An extremely toxic alkaloid. 1820 Quinine Isolated from Cinchona bark and found to be antimalarial. 1820 Caffeine From Coffea arabica spp. Another alkaloid. 1828 Nicotine From Nicotiana tabacum spp. Very poisonous alkaloid. 10 times as toxic as DDT to the CNS. 1829 Salicin A phenolic glycoside isolated from Salix alba by Leroux 1833 Atropine Isolated from Atropa belladonna amongst others. Was used extensively in orthodox medicine as an anticholinergic to decrease gastric function. 1860 Salicylic acid Isolated from Salix alba but found to be far too corrosive to the stomach and couldn’t be used. 1868 Digitalis Glycosides Cardiac glycosides from Digitalis purpurea. Used widely for congestive heart failure in orthodox medicine. 1899 Acetysalicylic acid Produced under the name of Aspirin. Still corrosive but much better tolerated and more potent. TERMINOLOGY Pharmacognosy Pharma from the Greek word PHARMAKON = drug Gignosco from the Greek = acquire knowledge Cognito from the Latin = to know Therefore, pharmacognosy is the knowledge of drugs. It is the science of naturally occurring substances with medicinal actions. Pharmacology the study of what drugs do in the body, that is, their medicinal effects Pharmacokinetics The quantitative analysis of the Absorption how and where the substance enters the body (Braun & Cohen 2005 pp.28-35) Distribution where the substance goes when it is absorbed Metabolism breakdown or detoxification of a drug Excretion removal of a substance or its breakdown products from the body of a medicine. Pharmacodynamics (Braun & Cohen 2005 p.33) an interaction that results when one substance alters the sensitivity or responsiveness of tissues to another. This type of interaction results in synergistic or antagonistic drug effects. additive, In simplified form this is how drugs elicit a physiological effect. Physicochemical interactions an interaction that occurs when two interacting substances come into physical contact and chemically interact. This type of interaction can occur during the manufacture or administration of medicines and result in the inactivation of one or both medicines. (Braun & Cohen 2005 pp.34-35) Adverse reaction a harmful or seriously unpleasant effect caused by a medicine at doses intended for prophylaxis, diagnosis or therapeutic effect. When two medicines interact in a way that produces an unwanted effect, this is also referred to as an adverse reaction. (Braun & Cohen 2005 pp.28-35) Factors that may be responsible for adverse reactions Discuss why each of these is a risk factor. oHigh risk medicines oSerious disease oOlder patients oSelf-medicators oMultiple healthcare professionals Active constituents can be classified by either Chemical composition e.g. cyanogenic glycosides. To have an effect, a drug must exert some type of chemical influence on one or more constituents of a cell in order to have a physiological effect. Most exert their effect by binding to particular proteins, with the 4 types of regulatory proteins being: oEnzymes oCarrier molecules oIon channels oReceptors o Their actions Some drugs, particularly of herbs, have more of a physical effect that a chemical effect e.g. mucilages act by coating the surface with a slimy substance which soothes and protects the surface in which they come into contact. Pharmacological action how herbs work. The two main types of pharmacological actions are: Agonists oFacilitate a biological action by binding to the particular protein and eliciting the effect of an endogenous substance Antagonists oBlock a biological action by binding reversibly to the binding site and therefore competing with the endogenous substance – competitive inhibitors. If they bind irreversibly, they are known as noncompetitive inhibitors as they are inactivating the protein permanently. There are many herbal substances which act to balance a physiological action e.g. phytoestrogens act as agonists at low levels of oestrogen and as antagonists at high levels of oestrogen. This is because phytoestrogens bind to oestrogen receptors in the body and elicit some activity, but less than that elicited by endogenous oestrogen. Therefore, if there is too much oestrogen around, the phytoestrogen takes up the receptor sites and reduces the effect exerted by the oestrogen. However, if there is not much oestrogen around, the phytoestrogen activates otherwise unused receptors. Therapeutic Index (TI) the ratio between the average minimum effective dose of a drug and the average minimum tolerated dose. This provides a crude measure of the safety of any drug used The higher the therapeutic index the safer the drug and the less likelihood of toxicity problems or accidental overdose. Herbal remedies typically have a very high therapeutic index, with a few very notable exceptions such as digitalis. Digitalis has a TI of 1.5, soluble aspirin has a TI of 10 but herbs often have a TI as high as 100. The main limitation of the therapeutic index is that it is based on animal toxicity data, which cannot always be applied to human, and doesn’t take into account individual variability. Uniform scheduling of Drugs and Poisons (SUSDP) Primary metabolites These are mainly the products of photosynthesis, which provides the food that enables the plant to live, grow and reproduce. These are the substances necessary for the primary functions of life and keep the plant healthy and alive and include proteins, fats, sugars, organic acids etc. They are involved in the assimilation of food, digestion and respiration. Secondary metabolites Not as universal in the plant kingdom, these are usually unique to a plant or group of plant Very diverse and thought to be a secondary function for the plant such as protection. Originally these were believed to be a by-product of metabolic processes. Now it is known that they have evolved to improve the chances of the species’ survival. This is based on the fact that specific enzymes have been discovered which seem to be used in the production of secondary metabolites Most of our medicinal herbs are used because of their secondary metabolites it is the secondary metabolites which provide the pharmacological activity. The purpose of these secondary metabolites is varied and sometimes present in extremely minute concentrations. They exert physiological or pharmacological effects on man and are responsible for the strong flavours and odours of some species, for example: Bitter tastes to repel grazing animals Alkaloids and other compounds to poison predators Bright colours to attract birds and insects for pollination Antimicrobial substances to resist bacterial / fungal or viral attack Compounds which prevent other plants from growing nearby e.g. apricot trees secrete a substance from their roots to prevent other apricots growing too close – to prevent overcrowding Waxes to provide waterproofing The esters of ripe fruit and some flowers attract birds and animals so that the seeds will be dispersed The ‘pink flush’ of lettuces. When growth and photosynthesis is active in the young seedlings, high concentrations of sugars build up increasing the osmotic pressure of the cell sap to dangerously high levels. If allowed to proceed, the cells would explode. At this point, certain enzymes are activated which divert the metabolism to break down these sugars into aromatic compounds with low osmotic pressures called flavonoids, which happen to be red. A pink colour therefore develops in the leaves. After some time, when the plant has grown and can accommodate more sugar, the red substances are removed by reconversion into useful sugars so that the pink hue gradually disappears. Based on the principle ‘structure dictates function’, being able to recognise structure goes a long way to being able to make an educated guess as to what function the compound performs. Many secondary metabolites originate from a similar compound, which is transformed at the last minute by an alternative pathway, e.g. Shikimic acid is the starting point for phenol-based compounds. (Aldred, EM, 2009, ‘Pharmacology: A handbook for Complementary Healthcare Professionals’, Churchill Livingston) Phenol – a benzene with an alcohol group (OH) Crude drugs refers to the fresh or dried plant or plant part e.g. fresh or dried leaves, fresh or dried root Galenical preparation the whole of the crude drug is used in the preparation. The active constituents are not isolated: For example: A tincture of licorice is produced by extracting the powdered root with water and ethanol. Anything soluble in water and ethanol will be extracted. This includes many molecules. If the main active is extracted e.g. glycyrrhizin, the preparation is not a galenical preparation. This is the main difference between allopathic pharmacy and herbal medicine. Modern pharmacologists argue that the use of crude herbs is unpredictable, impure, has dosage variations and cannot be precisely measured. IMPORTANCE OF PHARMACOGNOSY Credibility if we understand why herbs act the way they do, we can communicate more effectively as to how and why individual herbs work. When a particular herbs is unavailable, with knowing what it contains, we can make informed choices about alternatives. If we want to use Hydrastis canadensis for internal parasites and it is unavailable, it can be substituted with Berberis vulgaris or Mahonia aquifolium as they both contain berberine which has a broad range of antimicrobial activity. By understanding which components have the most pharmacological activity, better choices can be made about how to extract the herb. For example Whether to use more or less alcohol – if the main constituents are alkaloids, more alcohol is needed; if they are mucilages, more water is needed. By understanding how a herb acts, informed choices can be made about appropriate herbs to use with conventional drugs. Despite the fact that studying active constituents can give a better understanding of the herbs, never forget that it does not substitute for a holistic approach based on years of empirical evidence. Approximately a quarter of prescription drugs contain at least one chemical that was originally isolated and extracted from plants. (Aldred, EM, 2009, ‘Pharmacology: A handbook for Complementary Healthcare Professionals’, Churchill Livingston) CHEMICAL VARIATIONS WITHIN A SPECIES Even within a particular species there is huge variation of the component chemicals. Tea tree oil is a good example: Some is high in the chemical terpinen-4-ol gives tea tree its antifungal activity Terpinen-4-ol Some is high in cineole irritating to the mucous membranes Cineole (or Eucalyptol) But none are high in both The Australian standard for tea tree oil requires that all tea-tree oil contain less than 15% cineole and more than 30% terpinen 4-ol. A good quality contains 2 – 5% cineole and 40 – 47% terpinen 4-ol. Variation of plant components within a species occurs with most species, and is dependent on a number of different factors: 1. Heredity: Within a species, there is a lot of domestic diversity. This variation causes differences in the chemistry of the plant. Populations within a species with a consistent chemical difference are known as chemical races. Normally chemical races are geographically separated and have evolved separately. Examples are: o Achillea millefolium has a number or substances of which at least one is a distinct chemical race with a high level of chamazulene in its essential oil. chamazulene Chamazulene has an intensely blue colour. o Acorus calamus (sweet flag) is scheduled. Different populations of sweet flag contain different chemicals. Some contain B-asarone which is considered to be a carcinogenic, but it is only found in certain chemical races of the plant. Claviceps purpurea (Ergot) is a fungus that attacks rye and grow on the rye kernel. It was a serious problem in the past in that it contains ergot alkaloids which are hallucinogenic, similar to LSD, and can cause gangrene by their vasoconstriction action. Two of the ergot alkaloids are used widely in allopathic medicine: oErgotamine is a vasoconstrictor used in the treatment of migraine oErgometrine is oxytocic and sometimes is used post partum to reduce the risk of haemorrhage by making the uterus contract quickly It has been possible to separate the chemical races to produce almost entirely the alkaloid required that is ergoramine and ergometrine can be produced by different chemical races. 2. ONTOGENY that is the stage of development, which often equates with age. Plants contain different qualitative and quantitative properties at different stages of development e.g. unripe fruit and ripe fruit tastes different. In Mentha x piperita menthol is the main constituent. Mentha is a constituent which gives an unpleasant smell to inferior peppermint. Young peppermint plants have high menthofuran content and so it is better to harvest the mature plant Symphytum officinale is known to contain pyrrolizidine alkaloids. A small leaf contains about the same amount of PA’s as a large leaf. Consequently, the concentration of PA’s in a small leaf is much greater than in a large leaf. 3. ENVIRONMENT: that is, the effects of soil, pollutants, water, altitude, latitude, competition from other plants and animals Climate: Plants produce more oils if they have a lot of sun. Mentha x piperita should be grown in areas which have very long summer days. In Australia, peppermint is grown in Tasmania for that reason. Thyme, sage, lavender and dill all produce more oil in full sunlight. Soil: Conditions affect the chemistry as many of the constituents required are derived from the soil. Alkaloids will yield higher if grown in nitrogen rich soils. Pollutants: Many plants take up pollutants such as lead. Sunflowers take up cadmium and the seeds of sunflowers grown in high cadmium soils are quite dangerous. Altitude and latitude: latitude affects the amount of sunshine – equatorial regions have smaller variations in day length, therefore those further from the equator have longer summer days and shorter winter days – hence Tasmania is used for growing many of the herbs used for essential oil production. Altitude also affects essential oil content e.g. Artemisia absinthium grown at sea level produces more essential oil than if grown in the mountains. TOXICITY The benefit of such a long history of herbal medicine, is that it has brought to light the adverse effects. This is not the same as quality issues (for example: the method of extraction has resulted in a toxic substance) – that is a separate issue. Pyrrolizidine alkaloids Some of these are toxic, when they are unsaturated at the 1,2 position (remember: unsaturated means a double bond!) There is evidence to suggest that these are hepatotoxic, and thus damaging to the liver. However if the herb goes through a good heating process, it may reduce the number of toxic chemicals present. Comfrey (Symphytum spp.) is a good example. Wormwood This is an example of a herb containing a potentially toxic monoterpene (Thujone), which is also hallucinogenic and famously present in absinthe. Extremely high levels of thujone has been shown to be fatal in mice postconvulsion, the median lethal dose being approx 45mg/kg. Höld KM, Sirisoma NS, Ikeda T, Narahashi T & Casida JE (2000). Alpha-thujone (the active component of absinthe): gammaaminobutyric acid type A receptor modulation and metabolic detoxification. Proc. Natl. Acad. Sci. U.S.A. 97 (8): 3826–31. doi:10.1073/pnas.070042397 Pokeweed This contains agglutinins called ‘pokeweed mitogens’. A mitogen is any chemical substance that causes a cell to start mitosis (division). When taken as a fresh herb it can cause gastric upset, but the mitogens are usually denatured with heat. Pokeweed is generally recommended in small doses only. Gingko Gingkgolic acid is phenolic (contains phenol). They are related to similar chemicals in poison ivy. Gingkgolic acid is found in much higher quantities in the fruit rather than the leaf segment. It only very rarely causes allergic reaction, but it is possible. It is recommended to not use one’s own preparation of Gingko, but rather use a commercially produced product that has had the dangerous chemicals removed; or thoroughly research a good extraction method.