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Herb- Drug Interactions: A Review
Anusha S. Thomas,Prakash Varughese,Annie Shirwaikar, Arun Shirwaikar
Hygeia : Journal for Drugs and Medicines , 2012,
Abstract: Herbal drugs are exempt from Food and Drug Administration regulations regarding efficacy and safety. Their potential of interaction with conventional prescription drugs is a matter of great concern. This paper reviews the reported herb- drug interactions among the most commonly used and top selling herbs in the U.S.
HERB-DRUG INTERACTIONS
N. Minaz
International Journal of Pharmaceutical Research and Development , 2011,
Abstract: Throughout history, plants have been used for medicinal purposes and, during the last three decades, we have witnessed a most remarkable revival of herbal medicine. In today’s medicine, as many as one third to approximately half of all drugs available in the market are derived from plants. For example anticancer drugs such as vincristine, vinblastine and paclitaxel (Taxol) are derived from plants and the widely used cardioactive drug digoxin is extracted from the foxglove plant (Digitalis lantana). Herbal therapies are widely used but are not as safe as is being promoted because of lack of safety data. So many of these herbal therapies can interact with other medications, causing either potentially dangerous side effects and / or reduced benefits from the medication. Almost one third of current users of herbal drugs were at risks of herb drug interaction. Since only limited information are available in the literature concerning herb drug interaction.. The clinical importance of herb-drug interactions depends on many factors associated with the particular herb, drug and patient. Herbs should be appropriately labeled to alert consumers to potential interactions when concomitantly used with drugs, and to recommend a consultation with their general practitioners and other medical careers.
Herb-drug interaction: A case study of effect of ginger on the pharmacokinetic of metronidazole in rabbit
Okonta J,Uboh M,Obonga W
Indian Journal of Pharmaceutical Sciences , 2008,
Abstract: The effect of ginger on the pharmacokinectic of metronidazole was studied using rabbits in a crossover study method. The relevance of this study borders on the wide use of ginger for culinary and phytotherapeutic purposes, and metronidazole that is commonly used for every gastrointestinal complain in our communities without prescription. Ginger significantly increased the absorption and plasma half-life, and significantly decreased the elimination rate constant and clearance of metronidazole ( P< 0.05). Thus, in clinical practice, the patients should be advised on the serious implication of using both items together.
Herbal products: a survey of studentsAND#8217; perception and knowledge about their medicinal use
Kavita Sekhri,Sangeeta Bhanwra,Ruchika Nandha
International Journal of Basic & Clinical Pharmacology , 2013, DOI: 10.5455/2319-2003.ijbcp20130114
Abstract: Background: As herbal therapies are increasingly being used around the world because they are perceived to be free of side effects, it is important that prescribers should be made aware of their possible harm or herb-drug interactions. In this context present study was undertaken among dental students to assess their knowledge and attitude towards the use of herbal products as medicines. Methods: A detailed questionnaire having both open and close-ended questions to assess students’ perception, awareness and usage of herbal medication was given to 90 second year students in a teaching dental hospital. Data was expressed as counts and percentages. Results: A total response rate of 93.3% was observed. 60.77% of respondents had used herbal medication for various ailments. Highest frequency of the use was recorded for ginger (37.5%) followed by neem (16.66%), turmeric (15%) and tulsi (13.33%). Elders at home (86%) was cited the most common source of herbal product information. Students were familiar with the use of clove, aloe vera, turmeric and neem but St. John's wort and Gingko biloba are ones that were generally not known to them. 67.64% indicated unawareness about safety concerns and herb-drug interactions. Most (68.65%) agreed that they did not tell their physician about taking herbal products. 58.73% preferred herbal products over allopathic medicine. Conclusions: There is a need to impart knowledge to the students about the usage of herbal products as these are frequently used to treat various health problems. Students should be sensitized about their safety concerns and potential drug interactions. [Int J Basic Clin Pharmacol 2013; 2(1.000): 71-76]
Novel Natural Inhibitors of CYP1A2 Identified by in Silico and in Vitro Screening
Ruixin Zhu,Liwei Hu,Haiyun Li,Juan Su,Zhiwei Cao,Weidong Zhang
International Journal of Molecular Sciences , 2011, DOI: 10.3390/ijms12053250
Abstract: Inhibition of cytochrome P450 (CYP) is a major cause of herb–drug interactions. The CYP1A2 enzyme plays a major role in the metabolism of drugs in humans. Its broad substrate specificity, as well as its inhibition by a vast array of structurally diverse herbal active ingredients, has indicated the possibility of metabolic herb–drug interactions. Therefore nowadays searching inhibitors for CYP1A2 from herbal medicines are drawing much more attention by biological, chemical and pharmological scientists. In our work, a pharmacophore model as well as the docking technology is proposed to screen inhibitors from herbal ingredients data. Firstly different pharmaphore models were constructed and then validated and modified by 202 herbal ingredients. Secondly the best pharmaphore model was chosen to virtually screen the herbal data (a curated database of 989 herbal compounds). Then the hits (147 herbal compounds) were continued to be filtered by a docking process, and were tested in vitro successively. Finally, five of eighteen candidate compounds (272, 284, 300, 616 and 817) were found to have inhibition of CYP1A2 activity. The model developed in our study is efficient for in?silico screening of large herbal databases in the identification of CYP1A2 inhibitors. It will play an important role to prevent the risk of herb–drug interactions at an early stage of the drug development process.
Strong Inhibition of Celastrol Towards UDP-Glucuronosyl Transferase (UGT) 1A6 and 2B7 Indicating Potential Risk of UGT-Based Herb-Drug Interaction
Yong-Sheng Zhang,Yan-Yang Tu,Xing-Chun Gao,Jun Yuan,Gang Li,Liang Wang,Jian-Ping Deng,Qi Wang,Ru-Meng Ma
Molecules , 2012, DOI: 10.3390/molecules17066832
Abstract: Celastrol, a quinone methide triterpene isolated from Tripterygium wilfordii Hook F., has various biochemical and pharmacological activities, and is now being developed as a promising anti-tumor agent. Inhibitory activity of compounds towards UDP-glucuronosyltransferase (UGT) is an important cause of clinical drug-drug interactions and herb-drug interactions. The aim of the present study is to investigate the inhibition of celastrol towards two important UDP-glucuronosyltransferase (UGT) isoforms UGT1A6 and UGT2B7. Recombinant UGT isoforms and non-specific substrate 4-methylumbelliferone (4-MU) were used. The results showed that celastrol strongly inhibited the UGT1A6 and 2B7-mediated 4-MU glucuronidation reaction, with 0.9 ± 0.1% and 1.8 ± 0.2% residual 4-MU glucuronidation activity at 100 μM of celastrol, respectively. Furthermore, inhibition kinetic study (Dixon plot and Lineweaver-Burk plot) demonstrated that celastrol noncompetitively inhibited the UGT1A1-mediated 4-MU glucuronidation, and competitively inhibited UGT2B7-catalyzed 4-MU glucuronidation. The inhibition kinetic parameters (Ki) were calculated to be 0.49 μM and 0.045 μM for UGT1A6 and UGT2B7, respectively. At the therapeutic concentration of celastrol for anti-tumor utilization, the possibility of celastrol-drug interaction and celastrol-containing herbs-drug interaction were strongly indicated. However, given the complicated nature of herbs, these results should be viewed with more caution.
Knowledge, Attitudes and Awareness of Community Pharmacists Towards the Use of Herbal Medicines in Muscat Region
Anas Younis Duraz,Shah Alam Khan
Oman Medical Journal , 2011,
Abstract: Objective: This study aims to investigate the knowledge and attitudes among pharmacists in Oman towards the specific use and knowledge of herbal drugs. Methods: The study was conducted on 100 pharmacists employed in Oman. The data was collected using two self- administered questionnaire containing 7 and 11 closed ended questions in each, respectively. Results: The mean age of pharmacists was 32.6 (SD=5.6) years. The majority of pharmacists were interested in herbal information and their herbal information mainly comes from their previous classes during college. Most of them have belief on the effectiveness of herbal products. Pharmacists were more knowledgeable on specific therapeutic indications of herbal products rather than on other areas such as drug- herb interaction or side effects. Conclusion: In summary, Pharmacists need to be informed on the therapeutic indications, drug interactions, dose, active constituent and precautions of herbal products. Concerned bodies must also provide them with regular continuing education programs apart from putting their effects to incorporate relevant topics in herbal medicine in pharmacy curriculum.
Effects of Vernonia Amygdalina Aqueous Leaf Extract on the Pharmacokinetics of Nifedipine in Rabbits
Owolabi M.A.,Adeniji E.A.,Oribayo O.O.,Akindehin O.E.
Journal of Pharmacognosy and Phytochemistry , 2013,
Abstract: A number of diabetic/hypertensive patients in Nigeria, use a flavonoid containing antidiabetic herb, Vernonia amygdalina; alongside nifedipine which is readily prescribed; and concomitant administration of herbal preparations with conventional drugs can modified the pharmacokinetic profile of a drug. Therefore we investigated possible influence of the aqueous extract of this herb on the pharmacokinetic profile of nifedipine using animal model. The animals were treated with or without V. amydalina extract, blood samples were collected at different time interval and assayed for the concentration of nifedipine. The Cmax, t1/2el, AUC0-∞ and F were significantly higher (P ≤ 0.05) while Cl was lower in the treated group than the control. No significance (P ≥ 0.05) was seen in the Tmax between the two groups. We conclude that concomitant use of V. amygdalina reduced the metabolism of nifedipine evident by decrease in clearance and increased F and AUC thus altering its pharmacokinetic profile
Effects of Ginkgo leaf tablets on the pharmacokinetics of atovastatin in rats
Haifeng Li,Xing Liu,Yan Ren
- , 2019, DOI: 10.1080/13880209.2019.1622569
Abstract: Context: Ginkgo leaf tablets (GLT), an effective traditional Chinese multi-herbal formula, are often combined with atorvastatin calcium (AC) for treating coronary heart disease in clinic
Effects of Danshen tablets on pharmacokinetics of atorvastatin calcium in rats and its potential mechanism
Guoqing Zhang,Hai Zhang,Jie Fan,Rong Wang,Sen Sun
- , 2018, DOI: 10.1080/13880209.2018.1424209
Abstract:
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