Practice of Herbal Medicine

Question 1

The practice of herbal medicine is based on …..

Answer 1

1. Holistic approach- Treating the person as a whole
2. Individualises therapy
3. Diagnosis based on underlying theory of the medical
   system
4. can be part of range of interventions
5. used to treat of range of conditions

Question 2

what are the areas of concern in quality control in herbal medicine?

Answer 2

Consistencies in the levels of active compounds.

Identification of active compounds - mechanisms of action.

Correct/validation of speciation - counterfeit herbs

Adulteration of herbs

Question 3

Differences in the levels of active compounds
E.g Ginseng

main species: Panax ginseng (Asian ginseng) and Panax quinquefolius (N American ginseng).

________ of both plants look similar - distinguish visually by botanical experts.

Different effects in traditional medicine. P. ginseng is a ___________and ___________ is more calming.
Different levels of the______________

Levels vary according to age of the plant and part of the plant (_______,__________,________).
Whole herb extracts can improve consistency.

Answer 3

roots

stimulating tonic

P. quinquefolius

7 ginsenosides.

leaves, stem, root.

Question 4

Identification of active compounds - mechanisms of action.
• An understanding of which compounds lead to activity is important in ____________
• An understanding of the ratios of active compounds in different species is important in _____________
A knowledge of the active compounds is important in _________________

Answer 4

ensuring accuracy of the pharmacopeia.

validation of species.

ensuring that extracts have the desired activity

Question 5

St John ‘s Wort (Hypericum perforatum)

SJW used for the _____________
Efficacy demonstrated in clinical studies and meta analyses.

Range of products available of varying quality (__________ & ___________)

Antidepressant activity has been reported for a number of active compounds in SJW: ______________

Precise _____________ still under debate.

One plant -> one compound -> one mechanisms of action does not hold for ______________.

Answer 5

treatment of mild to moderate depression.

herb & extracts

hyperforin, hypericin, pseudohypericin and several flavonoids.

mechanisms of action

St John ‘s Wort (Hypericum perforatum)

Question 6

Validation of Species/Counterfeit Herbs

Through identification of active compounds in extracts (need good understanding)
E.g. Ginseng
Difficult to distinguish __________ and Asian ginseng visually.
Different ___________ composition Different medicinal properties
In China, Asian ginseng was sold as N American ginseng due to ________________ for the latter.

Answer 6

N. American

ginsenoside

high demands

Question 7

Counterfeit herbs are abundant
Many are not intentionally sold as counterfeit - ___________ are genuinely believed to be the true medicinal plant.
Others are knowingly counterfeit e.g. ____________(Counterfeit wild ginseng), Cordyceps sinensis.
Cultivated forms of the wild plants (medicinal properties not known) or fakes (made from flour).
Ineffective but not considered dangerous

Answer 7

regional substitutes

Gong Yi Shen

Question 8

Adulteration of Herbs
Presence of contaminants e.g. ___________
Environmental e.g. _______________
Added contaminants e.g. __________________

No reports of intoxication from heavy metals in TCM herbs has been reported by patients to the RCHM in the last 1O years .

MHRA confirmed no cases of_____________ in last 10 years (1 case of As and one of Hg over 10 years ago)

Answer 8

heavy metals, other active compounds.

heavy metals and pesticides in TCM herbs

Heavy Metals (Pb, Hg, As) in Ayurvedic and TCM formulae.

Pb toxicity

Question 9

Contamination with synthetic drugs reported.
Most common contaminants - ____________________
Incidence varies according to country.

MHRA issued warning related to Chinese products (mostly for slimming and erectile dysfunction).

Answer 9

steroids, NSAIDs, anti­ convulsants, benzodiazepines, hypoglycaemic agents, caffeine, diazepam, diclophenac.