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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
KATEGORI
PRODUK HERBAL TERDAFTAR HERBAL KERING BELUM TERDAFTAR PRODUK HERBAL YG DIJUAL SEBAGAI SUPLEMEN, TAK ADA KHASIAT KHUSUS
PERSPECTIVE
CONTAMINATION (OTHER CHEMICAL/MICROBES) DOSE AND DURATION OF USING TIME OF HARVESTING METHODS OF PREPARATION PART OF PLANT USED ETC.
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).
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
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.
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
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
Action
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.
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
Tradisional medication
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