PHARMACOLOGY AND TOXICOLOGY OF HERBS AND NUTRACEUTICALS

The aim of the course is to provide general principles of pharmacokinetics and pharmacodynamics as well as a specific knowledge of the clinical efficacy and tolerability profile and the indications and contraindications of medicinal plants in the treatments of main affections affecting our body. Knowledge of both the different classes of active ingredients present in medicinal plants and nutraceutical products, and of the main interactions between drugs and plants medicines therefore represents an essential step for a better professional training of the future herbalist.

Good knowledge of General and Organic Chemistry. Good knowledge of Anatomy and Physiology Good knowledge of General Biochemistry and Nutrition Good knowledge of Phytochemistry Good knowledge of Pharmacognosy and Pharmaceutical Botany

Mandatory as required by the educational system
http://www.dsf.unict.it/corsi/l-29_sfa/regolazione-didattico

Introduction to the course: definition of medicinal plant, medicinal plant and outline of current regulatory references

Pharmacokinetics:

Passage of drugs across biological membranes. Barriers. Drug absorption. Factors affecting absorption. Routes of drug administration. Binding of drugs to plasma proteins. Distribution and redistribution of medicines. Evaluation of pharmacokinetic parameters (plasma clearance; half-life, repeated doses, 1st pass effect, bioavailability and bioequivalence). Drug metabolism. Elimination of drugs; absorption-elimination ratio. Factors of variability of drug response.

Pharmacodynamics:

Mechanisms and site of action of drugs. Classification of receptors. Receptor function and variability of drug response. Agonism, competitive and non-competitive antagonism, affinity, intrinsic activity, efficacy. Dose-response curves, effective dose, lethal dose, therapeutic index, safety. Pharmacological effects and therapeutic effects. Drug side effects, adverse reactions, side effects, overdose, drug intolerances, fetal toxicity; teratogenesis and carcinogenesis.

Drug discovery and Preclinical drug development

Clinical trials: the different phases, drug safety, phytovigilance.

Anti-inflammatory drugs.

Vitamins. Poisons.

Drugs active on the Central Nervous System (CNS): Stimulating, anorectic, antidepressant (with particular attention to hypericum), anxiolytics, cholinesterase inhibitors in the treatment of Alzheimer's disease, cannabis, cocaine, opiates, hallucinogens, caffeine active ingredients.

 Drugs active on the cardiovascular system: digitalis glycosides, hawthorn, drug treatment of chronic venous insufficiency (horse chestnut, maritime pine, centella),

Medicinal plants and reproductive system: black cohosh, chaste tree, phytoestrogens (classification, mechanism of action and possible use in menopause). Herbal medicine for benign prostatic hypertrophy: Serenoa repens, Pygeum africanum.

Drugs that affect the respiratory system: expectorants, anti-asthmatics (with particular attention to theophylline).

Adaptogenic and immunostimulating medicinal plants: ginseng and echinacea

 Gastrointestinal drugs: purgatives (with particular attention to anthraquinone laxatives), antidiarrheal.

Dermatological drugs for the treatment of psoriasis: aloe Antineoplastics (in particular vinca alkaloids and taxol) and notes on carcinogens

Potential clinically relevant herb–drug interactions for commonly used herbs: the role of CYP450.

General Pharmacology
1. Absorption of the drug.
2. Factors affecting the absorption and routes of administration of drugs.
3. Binding of drugs to plasma proteins.
4. Distribution and redistribution of drugs.
5. Evaluation of pharmacokinetic parameters (plasma clearance; half-life, repeated doses, 1st pass effect, bioavailability and bioequivalence).
6. Drug metabolism. Elimination of drugs; absorption-elimination ratio. Factors of variability of drug response.
7.Classification of receptors.
8. Receptor function and drug response variability.
9. Agonism, competitive and non-competitive antagonism, affinity, intrinsic activity, effectiveness.
10. Dose-response curves, effective dose, lethal dose, therapeutic index, safety margin.
11. Pharmacological effects and therapeutic effects.
12. Drug side effects, adverse reactions, side effects, overdose, drug intolerances,
13. Fetal toxicity; hints of teratogenesis and carcinogenesis.
14. Preclinical drug development
15. Clinical trial
16. Safety of medicines and phytovigilance.
17. Anti-inflammatory drugs
18. Vitamins
19. Poisons.



Pharmacology of medicinal plants

1. Valeriana officinalis
2. Melissa officinalis
3. Passiflora incarnata
4. Hypericum perforatum in the treatment of major depression
5. Alzheimer's disease: cholinesterase inhibitors and Hyperzia serrata
6. Alzheimer's disease: active ingredients with neuro-protective action, Gingko Biloba, Salvia officinalis,
Melissa officinalis
7. Medicinal plants and nutraceuticals used in the treatment of system diseases
cardiovascular: digitalis glycosides
8. Hawthorn
9. Herbal medicine for chronic venous insufficiency (horse chestnut, maritime pine, centella, blueberry)
10. Medicinal plants that affect glycidic and lipid metabolism: phytosterols, garlic, artichoke
11. Guggul gum
12. Fenugreek
13. Fermented red rice
14. Herbal medicine for overweight and obesity: gommaguar, garcinia
15. Phytotherapy of diabetes mellitus with notes on medicinal plants that cause hypoglycemia
16. Medicinal plants and urinary system: Antiseptics: bearberry, American blueberry
17. Medicinal plants and urinary system: Diuretics: juniper, horsetail, European goldenrod, orthosiphon,
parsley, lovage and weeds
18. Phytotherapy of bronchial asthma: ephedra, ginkgo, ligustic, plants of the genus Solanum,
boswellia and ivy.
19. Indirect expectorants: polygala, licorice, primila, mullein.
20. Direct expectorants: thyme, eucalyptus, pine essence, fir essence, niaouli essence.
21. Ginseng
22. Echinacea
23. Black cohosh, chaste tree,
24. Phytoestrogens (classification, mechanism of action and possible use in menopause).
25. Phytotherapy of constipation: anthraquinone laxatives (senna, cascara, buckthorn, rhubarb)
26. Bulking plant laxatives (dietary fiber, bran, psyllium, agar, guar gum)
27. Phytotherapy of diarrhea: medicinal plants containing tannins, plants of the genus Potentilla.
28. Mint oil and irritable colon treatment
29. Medicinal plants and the skin system: the role of aloe vera in the treatment of psoriasis and in
phytotherapy of wounds and burns.
30. Arnica and bromelain.
31. Medicinal plants used in the prevention of tumors: plants of the genus allium, green tea,
ginseng, soy, tomato, turmeric.
32. Drug interactions in phytotherapy: cytochrome P450 and interactions between plants
medicines and drugs: enzyme inhibition and induction (with particular attention to interactions
which have relevance in clinical practice).