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EFICACY, SAFETY AND TOXICITY OF THE TRADITIONAL MEDICINES

By: Prof. Dr. ARMENIA, MS. Apt.

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Most people in non-industrialised countries (6080%) receive traditional health care (THC) for their everyday health care needs. (own or in conjunction with modern medical care) (WHO Demand for traditional medicine in many countries (Bannerman, 1993). Since 1977, traditional healers should be part of the primary health care team (WHO, 1978a). The needs for improvement quality and safety standards THC as a complementary therapy.

LATAR BELAKANG

OBAT TRADISIONAL PUNYA KERJA FARMAKOLOGI DAN MEMPENGARUHI PASIEN TIDAK SEMUANYA AMAN DPT BERINTERAKSI DNG OBAT MODERN PERLU DICARI TAHU SEJARAH PENGOBATAN PASIEN

TRADITIONAL MEDICINE
REASONS FOR RENEWED PUBLIC INTEREST IN COMPLEMENTARY AND ALTERNATIVE (TRADITIONAL) MEDICINES:
1. increased side effects 2. lack of curative treatment for several chronic diseases, 3. high cost of new drugs 4. microbial resistance 5. emerging diseases

OF MODERN MEDICINES

characteristics
CHEAP EASY TO OBTAIN LOW RISK OF SIDE EFFECT (SAFE) FULFILL MONOSUBSTANCE MULTYSUBSTANCES (COMBINATION) THERAPY PARADIGM

disadvantages
(1) Language difficulty it is difficult to translate into modern terminology (2) imprecision and lack of consistency in describing the uses of herbs; (3) lack of information on chemical constitution, (4) difficulties over identification and taxonomic status

SUMBER OBAT TRADISIONAL

TANAMAN (LAUT/DARAT) HEWAN (DARAT/LAUT) MINERAL

KATEGORI

PRODUK HERBAL TERDAFTAR HERBAL KERING BELUM TERDAFTAR PRODUK HERBAL YG DIJUAL SEBAGAI SUPLEMEN, TAK ADA KHASIAT KHUSUS

SAFE TOXIC EFFECTIVE

PERSPECTIVE

EFEKTIVE CHEMICAL CONTENTS TOXIC YES OR NO

CONTAMINATION (OTHER CHEMICAL/MICROBES) DOSE AND DURATION OF USING TIME OF HARVESTING METHODS OF PREPARATION PART OF PLANT USED ETC.

SAVETY RESTORE THE BALANCE OF HEALTH (HOMEOPATHIC >< ALLOPATHIC

adverse events
may be difficult to identify. First, one often does not have adequate information about the potential for a specific adverse event. Second,patients who are using complementary therapies and their providers often fail to report abnormal events or symptoms as an adverse event (Blendon, DesRoches, Benson, Brodie, & Altman, 2001).

adverse events (Cont.)

Third, many experts disagree on whether an adverse event has actually occurred. Fourth, there is currently no organized state or national system for reporting adverse effects of complementary and alternative therapy

NOTES FOR BOTANICAL MED.

SPECIES MATERIALS (PART OF PLANTS) DOSE TIME OF USING DISEASE PREPARATION INTERACTION WITH OTHER DRUGS!

MEDICAL TREATMENT
Evidence-based medicine (EBM) /Information-based medicine (IBM)

TM
experiential basis >< experimental basis

OBJECTIVES: The need to achieve optimal efficacy while avoiding adverse drug reactions and medical errors.

TM requirements

Consistency AND Quality in composition and biological activity FOR safe and effective use of therapeutic agents (botanical medicine). Government Policies and regulatory frameworks safety, efficacy and quality access rational use.

WHO
Traditional medicine is based on the needs of individuals. Different people may receive different treatments even if, according to modern medicine, they suffer from the same disease. Traditional medicine is based on a belief that each individual has his or her own constitution and social circumstances which result in different reactions to causes of disease and treatment.

national policy
to promote public awareness of and access to traditional medicine; to evaluate the economic potential of traditional medicine; to establish appropriate standards for traditional medicine;

national policy
to encourage and strengthen research into evidence-based practice of traditional medicine; to foster respect for the cultural integrity of traditional medicine; and to formulate policies on the protection and conservation of health resources.

Beberapa obat dari tanaman


Obat Aspirin Atropin Dikumarol Digoksin Digitoksin Ipratropium Quinidin Reserpin Emetin Efedrin Hiosiamin Ipecac Vinkristin

Kegunaan klinik Analgetik, antiinflamsi Dilator pupil Antitrombosit Gagaljantung Gagaljantung Bronkodilator Antiaritmia Antihipertensi Antiamuba Bronkodilator Antikolinergik Emetik Leukaemia

Spesies Filipendula ulmaria Atropa belladonna Melilotus officinalis Digitalis purpurea D. purpurea H. niger C. pubescens Rauvolfia canescens Psychotria pecacuantha Ephedra sinica Hyoscyamus niger P. ipecacuantha Catharanthus roseus

Formulation

Means of Preparation

Infusion Near-boiling water poured on herb for 510 minutes Tea (tisane) Infusion of aromatic herbs Decoction Simmer herb for 15 minutes, then strain Maceration Steep herb in room-temperature water Tincture Steep herb in ethyl alcohol and water Fluid extract 1 part herb to 1 part ethyl alcohol Glycerin extract Steep herb in glycerinwater mix Juice Juice expressed by crushing herb Inhalation Breathe in vapor from heated herb mix Oil Steep herb in olive or other plant oil

Formulation

Means of Preparation
Herb salve made with lanolin or beeswax Herb preparation that dissolves in the mouth Dried powdered herb Compressed herb material in pill form Encapsulated herbal material Concentrated sugar solution to preserve infusion Cloth soaked in herbal solution Application of moist herbal paste

Ointment Lozenge Powder Tablet Capsule Syrup

Compress Poultice

Herbal Preparation

Type of Toxicity
Nephrotoxicity General toxicity Liver toxicity Possible carcinogen, liver toxicity Liver toxicity Arrhythmias, stroke, elevated blood pressure Nervous system toxicity, respiratory paralysis CNS stimulation Carcinogen CNS stimulation, psychosis

Aristolochia Bloodroot Chaparral tea Coltsfoot tea Comfrey tea Ephedra (ma huang) Lobelia Pennyroyal Sassafras (safrole) tea Yohimbe

Plants That Can Be Used for Common Ailments


Analgesics sativa,
Sedatives

Action

Datura suaveolen, Albizia sp., Cannabis Papaver somniferum


Rauwolfia vomitoria, Datura stramonium

Botanical Name

Opportunistic Allium sativa (Garlic), Cannabis sativa infections/symptoms Immunomodulators Withania somnifera, Aloe sp., Loranthus (Mistletoe) Antibiotics Leonotis nepetifolia, Albizia sp.,Erythrina abyssinica, Aristolochia elegans Antivirals Withania somnifera, Aspilia africana /pluriseta Antipyretics (fevers) Entanda abyssinica, Boerhavia repens, Albizia sp.

Plants That Can Be Used for Common Ailments


Antipyretics (fevers)
Neuralgia Enteritis Anti-diarrhoea Anti-emetics Anti-fungal Pruritus Appetite

Action

Botanical Name

Entanda abyssinica, Boerhavia repens, Albizia sp. Securinega virosa, Cucurbita maxima Abrus precatorious Paullinia pinnata, Priva cordifolia
Ambrosia maritime, Erythrina abyssinica Cassia alata, Bridelia ferruginea, Dracaena manni Clerodendrum rotundifolia Cannabis sativa

WHO Expected outcomes


Increased government support for TM/ CAM, through comprehensive national policies on TM/CAM. Relevant TM/CAM integrated into national health care system services. Increased recording and preservation of indigenous knowledge of TM, including development of digital TM libraries

Safety, efficacy and quality


Evidence-base for TM/CAM. (emphasis on priority health problems such as malaria and HIV/AIDS). Regulation of herbal medicines. ( for registration and quality assurance of herbal medicines). Guidelines on safety, efficacy and quality. Develop and support implementation of technical guidelines for ensuring the safety, efficacy and quality control of herbal medicines and other TM/CAM products and therapies.

Tradisional medication

VIRGIN COCONUT OIL, Obat mujarap segala penyakit ?.


1. Batuk pilek, 3 kali sehari satu sendok makan, paling cepat 3 hari hari sembuh. 2. Luka luka kecil/ baret2/ luka jahitan, di olesi dan di kompres dengan kapas, ganti pagi-sore. Barengi juga dengan diminum satu sendok makan 3 kali sehari. 3. Bisul, jerawat, biang keringat, boleh di olesi sampai di kompress dengan kapas. Barengi juga dengan diminum 2 kali sehari satu sendol makan. 4. Berat badan saya yang overweight juga jadi berkurang meskipun tanpa diet makan dan kurang olahraga. 5. Stamina saya juga stabil, tidak lekas capai. Dari bangun pagi sampai mau tidur. Dan tidur pun lebih pulas.

Resep Tradisional untuk Radang Usus.


Bahan -7 -3 -1 : lembar daun kumis kucing lembar daun imbau ruas dlingo bengkle / lengkuas Cara Mengolah : bahan2 tersebut dikeringkan diatas api ( tidak boleh dikeringkan di sinar matahari), setelah itu di tumbuk jadi satu. Tumbukkan dari bahan-bahan ini berwarna hitam seperti serbuk arang. campur bahan yg telah di tumbuk dgn sebutir telor ayam kampung dan beri madu. Aduk rata dan jika pengadukan benar maka bau amisnya akan berkurang. Dosis : 1 x sehari selama 3 hari berturut-turut. Kemudian tunggu dan jangan di minum lagi. Proses penyembuhannya memang agak lambat tapi manjur dan alami. Jika terasa masih sakit. Ramuan ini bisa di ulang setelah 2 minggu. dan untuk waktu penggunaan 3 hari saja. Biasanya orang tuaku membuat ramuan bubuk itu sekaligus dan bisa di simpan untuk waktu yang lama asalkan di bungkus dalam bungkus kertas bersih dan dimasukkan dalam toples. Sehingga sewaktu-waktu memerlukan dapat langsung digunakan.

CONCLUSIONS ?

PLEASE WRITE DOWN YOUR CONCLUSIONS !

THANK YOU

EBM><IBM (CONT.)
EBM: evidence gained from the scientific method conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. IBM: A model of individualized healthcare whereby patients receive personalized, targeted treatment solutions specific for their individual disease states as well as their individual genetic and metabolic parameters Information Based Medicine is about providing the right information in the right format to the right individual at the right time