1.

VISION
We will be the global leader in pharmacy education, research and service,
committed to providing a transformative learning experience in a
collaborative and diverse environment focused on improving the health and
well-being of the communities we serve.

The overall objectives of the study:-

 To enable the students to implement the knowledge acquired in a practical

or realistic way.
 Cooperative learning.
 Real time problem solving
 Refine the skills.
 Improve the attitude and discipline in the students.
 Increase the students employability.
 To assess the benefits and risks of phytomedicines in people with
sickle cell disease of all types, of any age, in any setting.

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 2. INTRODUCTION
What are Phytomedicines?
Phytomedicines also called Botanical/Plant Medicines, differ from Chinese Herbalism.
Phytomedicines use medicinal plants,which grow mainly in the western hemisphere
and do not combine their therapy with acupuncture.
The word ‘phyto’ derived from the Greek word plant: hence it menas plant based
medicines. Phytomedicines is rooted in scientific research and therefore not to be
confused with homeopathy.
It takes it name from the word used in other parts of Europe. Where plant based
medicines continue to be provided by doctors and pharmacists as ‘phytomedicines’.
Herbal medicine or phytomedicine refers to the use of plants and herbs for
the purpose of cure and mitigation of human ailments. Plants have been
used for medicinal purposes by humans since long before recorded history.
Phytomedicine publishes innovative studies on efficacy, safety, quality and
mechanisms of action of specified plant extracts, phytopharmaceuticals and
their isolated constituents.
This includes clinical, pharmacological, pharmacokinetic, and toxicological
studies of specified herbal medicinal products, herbal preparations and purified
compounds which have a defined and consistent quality assuring reproducible
pharmacological activity.
How does Phytomedicine work?
In Phytomedicine, plant medicines are selected to stimulate or strengthen the body’s
own function and immune system, hence support the body to restore itself to health.
The Phylotherapist approaches each patient as a unique individual in making a
diagnosis and assessing his or her needs. Any herbal medicine prescribed may be a
combination of plants chosen for the therapeutic actions required to treat that individual.
This gives phytomedicines an edge over antibiotics, as bacteria cannot develop
resistance against these drugs because they strengthen the immune system instead of
destroying the pathogens.

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Examples of Phytomedicine:
A few very well known examples are-
S.No. Compound Structure Figure
1. Shikimic acid from
Anis Seed

2. Taxus bravifolia is
the active
constituent of Taxol

3. Morphine form
Opium poppy

4. Quinine form
Chinchina bark

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5. Salicin from
Willow bark known
as Aspirin

6. Atropine from
Belladona

7. Strychine from
Strychhnos

8. Digoxin from
Foxglove

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 3. HISTORY OF PHYTOMEDICINES
Phytomedicine was founded in 1994 to focus and stimulate research in this
particular field and to set internationally accepted scientific standards for
pharmacological studies, proof of clinical efficacy and safety of
phytomedicines. The main aims of Phytomedicine are associated with the
integration of phytopreparations into conventional/official medicine.
The directions of Phytomedicine are known to provide profound scientific
background in Herbal Medicinal Products, their reproducible Quality and
evidence based therapeutic efficacy. Since then quality criteria and
standardization methods were defined and the European Medical Agency has
elaborated numerous guidelines for the conduction of clinical studies and
preparation of Herbal Medicinal Products.
In total 107 ESCOP monographs have been produced and submitted to EMA.
Many new analytical methods and instruments were implemented both for
analysis and standardization of herbal Substances, herbal preparations and their
bioassays and tremendous work has been carried out to remain aligned with
these intentions during the last 18 years.
By definition, ‘traditional’ use of herbal medicines implies substantial historical
use, and this is certainly true for many products that are available as ‘traditional
herbal medicines’.
In many developing countries, a large proportion of the population relies on
traditional practitioners and their armamentarium of medicinal plants in order to
meet health care needs. Although modern medicine may exist side-by-side with
such traditional practice, herbal medicines have often maintained their
popularity for historical and cultural reasons. Such products have become more
widely available commercially, especially in developed countries. In this
modern setting, ingredients are sometimes marketed for uses that were never
contemplated in the traditional healing systems from which they emerged.

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An example is the use of ephedra (= Ma huang) for weight loss or athletic
performance enhancement (Shaw, 1998). While in some countries, herbal
medicines are subject to rigorous manufacturing standards, this is not so
everywhere.
In Germany, for example, where herbal products are sold as ‘phytomedicines’,
they are subject to the same criteria for efficacy, safety and quality as are other
drug products. In the USA, by contrast, most herbal products in the marketplace
are marketed and regulated as dietary supplements, a product category that does
not require pre-approval of products on the basis of any of these criteria
The role of herbal medicines in traditional healing:-
The pharmacological treatment of disease began long ago with the use of herbs
(Schulz et al., 2001). Methods of folk healing throughout the world commonly
used herbs as part of their tradition. Some of these traditions are briefly
described below, providing some examples of the array of important healing
practices around the world that used herbs for this purpose.
Indian traditional medicine:-
Ayurveda is a medical system primarily practised in India that has been known
for nearly 5000 years. It includes diet and herbal remedies, while emphasizing
the body, mind and spirit in disease prevention and treatment (Morgan, 2002).
Use of Traditional Herbal Medicines in Developed Countries:
1) Origin, type and botanical data:
Plants and their secondary metabolite constituents have a long history of use in
modern ‘western’ medicine and in certain systems of traditional medicine, and
are the sources of important drugs such as atropine, codeine, digoxin, morphine,
quinine and vincristine.
2) Medicinal applications, beneficial effects and active components:
In some cases, the active principles of plant-derived products have been isolated
and characterized, and their mechanisms of action are understood (e.g.,
ephedrine alkaloids in some species of Ephedra). For many, however, including

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virtually all of the most common products in the marketplace, such information
is incomplete or unavailable. This is in large part due to the complexity of
herbal and botanical preparations; they are not pure compounds. It is also a
function of the traditionally-held belief that the synergistic combination of
several active principles in some herbal preparations is responsible for their
beneficial effects.
3) Trends in use:
Data on the global nutrition products industry, in which herbal and botanical
products are often included, are given in Tables.
The global nutrition products industry in 1999, including herbal and botanical
products (in millionsof US $)
Country Vtamins/ Herbs/ Sports, meal Natural Total
Minerals botanicals replacement, foods
homeopathy,
speciality
USA 7070 4070 4320 9470 24930
Europe 5670 6690 2510 8280 23150
Japan 3200 2340 1280 2410 9230
Asia 1490 3170 970 710 6340
Total 17430 16270 9080 20870 63650
Global

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 4. ROLE OF PHYTOMEDICINES
1) Phytomedicines and Cardiovascular disease:
Several epidemiological studies show that intake of more plant foods reduce the
incidence of diseases like cancer and arthrosclerosis. When normal foods are
fortified or enriched with some nutrients it shows some health benefits.
Phenolics are derivatives of benzene (cyclic derivatives in the case of
polyphenols) with one or more hydroxyl groups associated with ring structure.
They are classified into ten different groups depending on their chemical
structure.
The two main types of polyphenols are flavonoids and phenolic acids.
Flavonoids are distributed as flavones, flavonols, flavanols, flavanones,
isoflavones, proanthocyanidins, and anthocyanins.
Some of the most common flavonoids are quercetin, a flavonol found in onion,
tea, and apple; catechin, a flavanol found in tea and several fruits; hesperetin, a
flavanone present in citrus fruits, pigment anthocyanin in red fruits (tomatoes,
blackcurrant, watermelon, raspberry, pomegranate, strawberry, etc.); daidzein,
the main isoflavone in soybean; proanthocyanidins, common in many fruits,
such as apple, grape, or cocoa and are responsible for their characteristic
astringency or bitterness.
Phenolics play a vital role in plant physiology, providing to resistance to
microbes, insects, pigments, odor and flavor. Polyphenolic compounds mainly
flavonoids have potential therapeutic value as antioxidant and antiinflammatory
agents for prevention of cardio vascular disease. Polyphenols helps in
decreasing the oxidation of Low Density Lipoproteins (LDL), induce Nitric
Oxide (NO) production, inhibit aggregation of platelets and down regulate
expression of pro inflammatory mediators.
A meta-analysis study including seven case-control and 10 cohort studies
suggested a reduction of the risk of myocardial infarction of 11% upon
consumption of three cups of tea per day 9. When the source of polyphenols

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were consumed for three months, an increase in the plasma antioxidant capacity
or in the concentration of antioxidants such as vitamin E, vitamin C, b-carotene
and uric acid was observed in some studies, whereas no change were observed
in other studies.
Phytosterols are typical constituents of plants' cell walls. The plant kingdom
contains a number of sterols that differ from cholesterol by having ethyl or
methyl groups or unsaturation in the side chain. The major ones sitosterol,
stigmasterol and campesterol can be present in Western diets in amounts almost
equal to dietary cholesterol. When ingested with plant foods, phytosterols
reduce cholesterol absorption from the stomach, due to its structural similarity
with cholesterol. In the last decades, purified plant sterols/stanols have been
added to foods items to obtain functional foods with remarkable hypo
cholesterolemic activity. A daily intake of 1.6-2g/day of plant sterols or stanols
incorporated in foods helps to reduce cholesterol absorption from the stomach
by about 30%, and plasma LDL cholesterol levels by 8-10%.
2) Role of Phytochemicals and Nutraceuticals against cancer:
Phytochemicals plays a vital role in preventing oxidative damage. Antioxidants
defuse free radicals leading to limited risk of oxygen species and associated
disorders. At cellular and molecular levels they inactivate ROS and under
specific low concentration inhibit or delay oxidative processes by interrupting
the radical chain reaction of lipid peroxidation.
Phytochemicals with antioxidant capacity naturally present in food are of great
interest due to their beneficial effects on human health as they offer protection
against oxidative deterioration.
The occurrence of cancer is a slow process and the risk of developing cancer
increases with age. Consumption diet which consists of beneficial
phytochemicals can influence the balance and availability of dietary chemo
preventive agents. Supplementation of foods that contain anti-cancer properties
helps in preventing the deadly cancer.

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3) Phytomedicines in prevention of Diabetes:
Diabetes mellitus is a complex metabolic disorder resulting from either insulin
insufficiency or insulin dysfunction. Type I diabetes (insulin dependent) is
caused due to insulin insufficiency. Type II diabetes (insulin independent) is
due to immunological destruction of pancreatic β-cells leading to insulin
deficiency. Type II diabetes is characterized with insulin resistance. It is the
more common form of diabetes constituting 90% of the diabetic population.
Traditional herbal medicine has been used since ancient time in many parts of
the world. The many side effects of insulin therapy and other oral hypoglycemic
agents necessitate the use of more effective and safer antidiabetic drugs. Many
medicinal plants have shown experimental or clinical antidiabetic activity and
that have been used in traditional systems of medicine. Plants such as M.
charantia, Eugenia jambolana, Mucuna pruriens, Murraya koeingii and Brassica
juncea have found to have anti diabetic property.
All plants have shown varying degree of hypoglycemic and antihyperglycemic
activity. In the recent years more than 500 herbal medicines have been reported
to possess antidiabetic property 25. The principal antidiabetic plants included
Vernonia amygdalina, Morinda lucida, Carica papaya, Citrus aurantiifolia,
Bidens pilosa, Ocimum gratissimum, and Momordica charantia.
The positive effects of aloe are due to the presence of compounds such as
polysaccharides, mannans, lectins and anthra –quinones 26. Consumption of
Aloe vera helps to improve blood glucose levels in diabetics 27 and lowered
blood lipids in hyperlipidaemic patients.
Azadirachta indica is commonly known as neem, margosa or Indian lilac. Three
bitter compounds were extracted from neem oil, which were named nimbin,
nimbinin, and nimbidin. The neem tree offers an opportunity to reduce insulin
requirements with a safe and proven herb.
Momordica charantia, called bitter melon or bitter gourd in English belongs to
family Cucurbitaceae, widely grown in Asia and Africa. The plants contain also

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bioactive glycosides (including momordin, charantin, charantosides, and
momordicosides) and other terpenoid compounds (including momordicin-28,
momordicin, momordenol and momordol). Effect of Momordica charantia fruit
powder on serum glucose level and body weight in Alloxan induced diabetic
rats has been studied.
Anti-diabetic activity of Holosstemma ada-kodien Schults in alloxan induced
diabetic rats was studied. Extracts of this plant possess antidiabetic properties
such as reducing insulin requirements by enhancing endogenous insulin
availability, improving blood glucose homeostasis, controlling of
hyperlipidemia associated with diabetes, and reducing serum anaylase activity.
4) Green tea and Kidney disease:
Consumption of green tea helps kidneys to process toxins and waste products
more efficiently. In the rats study, extracts of green tea increased antioxidant
activity and improved antioxidant levels in the cells of kidneys. It also reduced
signs of kidney damage and restored levels of creatinine and urea to normal.
The researchs concluded that green tea could provide inexpensive and safe way
to prevent kidney disease and further research on humans to confirm the results
of the preliminary animal study on green tea extracts. Inclusion of green tea
helps to prevent kidney cancer. In the study done by Mowafy et al. on
laboratory animals, supplementation of 50 mg per kg body weight of
epigallocatechin-gallate, an extract of green tea, reduced tumors by 92 percent.
Green tea extract also helped in reduction of white blood cells levels,
inflammatory C-reactive protein (CRP) and lipid peroxidation. An animal study
showed that extracts of green tea protects the kidneys from toxicity that can
lead to tumor formation.

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 4. EXTRACTION METHODS
Standard procedures of separating the therapeutically active portions from
medicinal plants via selective solvents are called as extraction with the purpose
of separating soluble metabolites leaving behind cellular residue
Solvent of Extractions:
The solvent used for the extraction of medicinal plants is also known as the
menstruum. The choice of solvent depends on the type of plant, part of plant to
be extracted, nature of the bioactive compounds, and the availability of solvent.
In general, polar solvents such as water, methanol, and ethanol are used in
extraction of polar compound, whereas nonpolar solvents such as hexane and
dichloromethane are used in extraction of nonpolar compounds
Commonly used methods in the extraction of medicinal plants.
 Maceration
 Infusion
 Digestion
 Decoction
 Percolation
 Soxhlet extraction
 Microwve-assisted extraction
 Ultrasound-assisted extraction

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 5. CONCLUSION
This review highlights the importance of medicinal plant to in human health.
The number of studies in this area is quite high although most of the studies
have been done on the extract level but yet to be practiced in humans.
Enormous numbers of studies are to be done in isolated antioxidant
compounds on various diabetic models for better understanding of its
mechanism of action.

Several works have been done on medicinal plant either to investigate and
prove a reported claim of biological activity or to mimic its traditional
medicinal use based on ethnomedicinal survey. Large numbers of medicinal
plants have been extracted, fractionated, and compounds isolated
successfully. In addition, compounds obtained were tested for biological or
pharmacological activity, and in most cases, they were found to be active.
Nonetheless, the rate of success and the authenticity of these findings
depends on the accuracy in selection of solvents, selection and proper
execution of extraction methods, phytochemical screening, fractionation, and
identification techniques. Lastly, proper understanding and implementation
of these techniques are indispensable. Advancement and modification of
these methods periodically will ease research processes and improve the
outcome.

Amit Kumar

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http://www.who.int/mediacentre/factsheets/fs355/en/.

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bioefficacy of polyphenols in humans: I- A review of 97 bioavailability
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5. Halliwell B, Whiteman M. Measuring reactive species and oxidative

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bioefficacy of polyphenols in humans: I- A review of 97 bioavailability
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Food Funct 2012; 3: 575- 591.

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