Pharmacology of Black Pepper

Many spices used in food seasoning have broad spectrum of antimicrobial activity. Their antioxidant activity against lipid peroxidation enhances the keeping quality of food. Apart from the use as a popular spice and flavouring substance, black pepper as drug in the Indian and Chinese systems of medicine is well documented. In the Ayurvedic descriptions, pepper is described as katu (pungent), tikta (bitter), usbnaveerya (potency, leading to storing up of energy, easy digestion, diaphoresis, thirst and fatigue), to subdue vatta (all the biological phenomena controlled by CNS and autonomic nervous system) and kapha (implies the function of heat regulation, and also formation of various preservative fluids like mucus, synovia etc. The main functions of kapha is to provide co-ordination of the body system and regularization of all biological activities). Pepper is described as a drug which increases digestive power, improves appetite, cures cold, cough, dyspnoea, diseases of the throat, intermittent fever, colic, dysentery, worms and piles; also useful in tooth ache, pain in liver and muscle, inflammation, leucoderma and epileptic fits. Black pepper is called maricha or marica in Sanskrit, indicating its property to dispel Read more […]

Specific Medicinal Uses of Cannabis: Anticonvulsant Activity

As early as 1890, the use of cannabis was advocated for the suppression of convulsions in man. While there are some reports of the effects of smoking cannabis in this area, most effort has focused on synthetic cannabinoid derivatives. Cannabis Two reports indicate that regular cannabis smoking contributes to better control of seizures in epileptic patients whose disease is refractory to conventional therapy. These studies were not controlled and contained few patients. THC There have been no reports of the use of THC in epileptics; this compound has induced or exacerbated seizure activity in animal studies. Cannabidiol (CBD) Carlini and Cunha added CBD, 200–300 mg daily, to the anticonvulsant regime of eight patients with generalised secondary seizures, refractory to antiepileptic drugs. Over the 5-month observation period, improvement was noted in seven. Very similar results were reported in an earlier trial by Karler and Turkanis. In a placebo controlled study in patients with grand mal seizures, CBD produced improvement in seizure control in 7 patients, three of these showing great improvement. One patient showed some improvement on placebo however. Summarising, there seems to be little to recommend the Read more […]

Milk Thistle (Silybum marianum)

Milk Thistle: Medical Uses Milk thistle improves liver function tests and helps to counteract mushroom (Amanita phalloides) poisoning if taken within 24 hours after ingestion of the mushroom. It can also be used for chemical-induced liver damage, cirrhosis, and viral hepatitis. Historical Uses Milk thistle has been used traditionally for liver complaints. Growth A member of the aster family, milk thistle is native to southern and western Europe and some parts of the U.S. Part Used • Fruits, known as achenes () Major Chemical Compounds • Silymarin • Silibinin Milk Thistle: Clinical Uses Milk thistle improves liver function tests and reverses mushroom (Amanita phalloides) poisoning if given within 24 hours after ingestion of the mushroom. It can also be used for chemical-induced liver damage, cirrhosis, and viral hepatitis. Silibinin may be useful in prostate cancer. It is approved by the German Commission E for dyspepsia, liver damage, and liver disease. Mechanism of Action This herb has antioxidant, hepatoprotective, and hepatorestorative properties. It also increases the gluthione content of liver, inhibits leukotrienes, and stimulates protein synthesis. Silibinin, an antioxidant in milk thistle, Read more […]

Paeony: Convulsions And Nightmares

Following its general ‘cleansing’ role and its specific use in menstruation, paeony has a more extraordinary application in the literature for nightmares and potential use in epilepsy. The name comes from a powerful god and suggests a deeper meaning to the herb. Paeon, an ancient god of healing, is famous for healing the wounds of the gods themselves when they foolishly become embroiled in the world of humans. When the gods took to the field in the Trojan war, he healed Ares, god of war, wounded fighting on the side of the Trojans. He gave Ares ‘such sovereign medicines that as soon the pain was qualified … as fast as rennet curdles milk’ and the sides of the wound were reunited. Paeon used herbs to heal. In fact Macurdy (1912) argues that the word is associated with the Paioniae tribal group of northern Greece, who were designated herb-gatherers as they were from the north. Both Dioscorides and Pliny refer to the familiar 15 black seeds. Dioscorides says simply for ‘those who gasp from nightmares,’ expressed by Turner as ‘against the strangling of the nightmare’. Pliny, for the seeds taken in wine, has a more fanciful expression ‘this plant also prevents the mocking delusions that the Fauns bring on us in our Read more […]

Herb-Drug Interactions: Cannabis

Cannabis sativa L. (Cannabaceae) Synonym(s) and related species Bhang, Dagga, Ganja, Hashish, Indian hemp, Marihuana, Marijuana. Cannabis indica Lam. Constituents Cannabis herb contains a wide range of cannabinoids, which are the major active compounds. The main psychoactive constituent is delta9-tetrahydrocannabinol (THC; dronabinol), and it is the cause of many of the pharmacological effects elicited by the consumption of cannabis. However, other cannabinoids, which do not possess psychoactive properties, such as cannabidiol, cannabinol (a decomposition product of delta9-tetrahydrocannabinol), cannabigerol and cannabichromene, are increasingly being investigated for their pharmacological and therapeutic properties. Cannabinoids are often found in the plant as their acid metabolites, e.g. ll-nor-9-carboxy-delta9-tetrahydrocannabinol, cannabidiol acid and others, especially if the plant has been grown in a cooler climate. These decarboxylate to the parent cannabinoid at high temperatures, such as during smoking. Most medicinal cannabis products have been heat treated to ensure that the cannabinoids are present only in the non-acid form. Use and indications Cannabis has no current established use in herbal Read more […]

Herb-Drug Interactions: St John’s wort

Hypericum perforatum L. (Clusiaceae) Synonym(s) and related species Hypericum, Millepertuis. Hypericum noeanum Boiss., Hypericum veronense Schrank. Pharmacopoeias St John’s Wort (British Ph 2009, European Ph 2008, US Ph 32); St John’s Wort Dry Extract, Quantified (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The main groups of active constituents of St John’s wort are thought to be the anthraquinones, including hypericin, isohypericin, pseudohypericin, protohypericin, protopseudohypericin and cyclopseudohypericin, and the prenylated phloroglucinols, including hyperforin and adhyperforin. Flavonoids, which include kaempferol, quercetin, luteolin, hyperoside, isoquercitrin, quercitrin and rutin; biflavonoids, which include biapigenin and amentoflavone, and catechins are also present. Other polyphenolic constituents include caffeic and chlorogenic acids, and a volatile oil containing methyl-2-octane. Most St John’s wort products are standardised at least for their hypericin content (British Pharmacopoeia 2009), even though hyperforin is known to be a more relevant therapeutic constituent, and some preparations are now standardised for both (The United Read more […]

Herb-Drug Interactions: Resveratrol

Types, sources and related compounds Resveratrol is a polyphenol present in most grape and wine products and is the compound largely credited with providing the health benefits of red wine. However, the concentration is very variable between foods and supplements, so it is difficult to evaluate the clinical relevance of the available information. Use and indications Resveratrol is used for its reputed anti-ageing effects. It is said to have antioxidant properties and antiplatelet effects, and is therefore promoted as having benefits in a variety of cardiovascular diseases, including atherosclerosis. It also has some oestrogenic and anti-inflammatory activity, and is under investigation in the prevention and treatment of cancer, because it appears to reduce cell proliferation. Pharmacokinetics An in vitro study reported that resveratrol inhibited the cytochrome P450 isoenzyme CYP3A4, but was much less potent than erythromycin, a known, clinically relevant, moderate CYP3A4 inhibitor. Similar results were found in other studies. Interestingly, red wine also inhibited CYP3A4, but this effect did not correlate with the resveratrol content. In other studies resveratrol had only very weak inhibitory effects on CYP1A2, Read more […]

Herb-Drug Interactions: Pepper

Piper nigrum L. (Piperaceae) Synonym(s) and related species Black and white pepper are derived from the fruits of the same species, Piper nigrum L. Black pepper is the unripe fruit which has been immersed in hot water and dried in the sun, during which the outer pericarp shrinks and darkens into a thin, wrinkled black layer. White pepper consists of the seed only, prepared by soaking the fully ripe berries, removing the pericarp and drying the naked seed. Long pepper, Piper longum L., is a closely related species where the fruits are smaller and occur embedded in flower ‘spikes’, which form the seed heads. Constituents Alkaloids and alkylamides, the most important being piperine, with piperanine, piperettine, piperlongumine, pipernonaline, lignans and minor constituents such as the piperoleins, have been isolated from the fruits of both species of pepper. Black pepper and long pepper also contain a volatile oil which may differ in constitution, but is composed of bisabolene, sabinene and many others; white pepper contains very little. The pungent taste of pepper is principally due to piperine, which acts at the vanilloid receptor. Use and indications Pepper is one of the most popular spices in the world, Read more […]

Herb-Drug Interactions: Ginkgo

Ginkgo biloba L. (Ginkgoaceae) Synonym(s) and related species Fossil tree, Kew tree, Maidenhair tree. Salisburia adiantifolia Sm., Salisburia biloba Hoffmanns. Pharmacopoeias Ginkgo (US Ph 32); Ginkgo capsules (US Ph 32); Ginkgo dry extract, refined and quantified (British Ph 2009, European Ph 2008); Ginkgo leaf (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4); Ginkgo tablets (US Ph 32); Powdered ginkgo extract (The United States Ph 32). Constituents Ginkgo leaves contain numerous flavonoids including the biflavone glycosides such as ginkgetin, isoginkgetin, bilobetin, sciadopitysin, and also some quercetin and kaempferol derivatives. Terpene lactones are the other major component, and these include ginkgolides A, B and C, and bilobalide, Ginkgo extracts may be standardised to contain between 22 and 27% flavonoids (flavone glycosides) and between 5 and 12% terpene lactones, both on the dried basis. The leaves contain only minor amounts of ginkgolic acids, and some pharmacopoeias specify a limit for these. The seeds contain ginkgotoxin (4-O-methylpyridoxine) and ginkgolic acids. Use and indications The leaves of ginkgo are the part usually used. Ginkgo is often used Read more […]

ANTICONVULSANTS

ANTICONVULSANTS are drugs used to treat convulsions of various types, for instance, in drug or chemical poisoning, e.g. chlorpromazine, diazepam. However, these anticonvulsants are not necessarily effective or suitable for epilepsy. In practice, the antiepileptic drugs are the more used, especially for prolonged treatment, and these agents have extensive usage in preventing the occurrence of epileptic seizures. The drug of choice depends on the type and severity of the epilepsy. For tonic-clonic seizures (Grand Mai) as part of a syndrome of primary generalized epilepsy the drugs of choice are carbamazepine and phenytoin. For absence seizures (Petit Mai), sodium valproate and ethosuximide. For myoclonic seizures, sodium valproate, clonazepam and ethosuximide. For other types of seizure, such as atypical absence, atonic and tonic seizures (often in childhood), phenytoin, sodium valproate, clonazepam, phenobarbitone, or ethosuximide are valuable. These all appear to work by stabilizing membranes and decreasing excitability, though with differing profiles of activity and mechanisms of action. Phenobarbitone, though a barbiturate, is more of an anticonvulsant than expected from its sedative actions, and it resembles Read more […]