Herbal medicine, what physicians need to know. 2009

Joseph A Simaan

Herbal medicine, the most major component of traditional medicine, is as old as recorded history. Beginning in the early 1800s, with the development in the science of chemistry, a new era in pharmacotherapeutics was initiated whereby active chemical ingredients in plants, historically known to produce a favorable therapeutic effect, were extracted, purified and their structure disclosed. This ushered the modern era of therapy with drugs based on exploration of pure chemical products as to chemical identity, physicochemical properties, pharmacodynamic actions, pharmacokinetic behavior in the biological system, toxicological profile and effective and safe application in therapy. This relegated herbal medicine to a secondary role. More recently, a revival in the use of herbal medicine has been witnessed, even in culturally advanced societies, probably enhanced by the false belief that natural products are safe and also by vigorous promotion. Parallel to the increase in the use of herbal preparations as remedies for major diseases, there is currently a growing concern about their efficacy, safety and control. This prompted the World Health Organization to come out with recommendations for control in the document "Research Guidelines for Evaluating the Safety and Efficacy of Herbal Medicines" in 1993. The guidelines are equal in strictness to those applicable for drugs in general. A large number of member states have adopted these guidelines. The dangers in using herbal preparations for treatment include: * unproven therapeutic benefit * undisclosed toxicities * interaction of the chemicals in herbal preparations with each other and with concomitantly taken drugs, at the level of functionally important biological entities such as the plasma proteins, receptors, ion channels, transporters and others * incompatibilities with patient-related factors such as age, sex, genetic background and the function of the organs responsible for eliminating the effects of chemicals in herbal preparations such as the liver or kidney * the difficulty in standardizing treatments and * the inclusion of regular drugs with the herbal preparations without disclosure. In Lebanon, a committee is charged with the control of herbal preparations but a stricter control is required to handle preparations with a therapeutic claim as well as the issue of promotion.

UI MeSH Term Description Entries
D007861 Lebanon A country located in the Middle East, bordering the Mediterranean Sea, between Israel and Syria. The capital is Beirut. Lebanese Republic
D010946 Plants, Medicinal Plants whose roots, leaves, seeds, bark, or other constituent parts possess therapeutic, tonic, purgative, curative or other pharmacologic attributes, when administered to man or animals. Herbs, Medicinal,Medicinal Herbs,Healing Plants,Medicinal Plants,Pharmaceutical Plants,Healing Plant,Herb, Medicinal,Medicinal Herb,Medicinal Plant,Pharmaceutical Plant,Plant, Healing,Plant, Medicinal,Plant, Pharmaceutical,Plants, Healing,Plants, Pharmaceutical
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014943 Global Health A multi- and interdisciplinary field concerned with improving health and achieving equity in health for all people. It transcends national boundaries, promotes cooperation and collaboration within and beyond health science fields, and combines population-based disease prevention with individually-based patient care. International Health Problems,World Health,International Health,Worldwide Health,Health Problem, International,Health Problems, International,Health, Global,Health, International,Health, World,Health, Worldwide,Healths, International,International Health Problem,International Healths,Problem, International Health,Problems, International Health
D014944 World Health Organization A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples. Organization, World Health,WHO
D019317 Evidence-Based Medicine An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006) Medicine, Evidence-Based,Evidence Based Medicine,Medicine, Evidence Based
D029001 Herbal Medicine The study of medicines derived from botanical sources. Herbalism,Medicine, Herbal,Hawaiian Herbal Medicine,La au Lapa au,La'au Lapa'au,Laau Lapaau,Herbal Medicine, Hawaiian,Medicine, Hawaiian Herbal
D064420 Drug-Related Side Effects and Adverse Reactions Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals. Drug-Related Side Effects and Adverse Reaction,Adverse Drug Event,Adverse Drug Reaction,Drug Side Effects,Drug Toxicity,Side Effects of Drugs,Toxicity, Drug,Adverse Drug Events,Adverse Drug Reactions,Drug Event, Adverse,Drug Events, Adverse,Drug Reaction, Adverse,Drug Reactions, Adverse,Drug Related Side Effects and Adverse Reaction,Drug Related Side Effects and Adverse Reactions,Drug Side Effect,Drug Toxicities,Effects, Drug Side,Reactions, Adverse Drug,Side Effect, Drug,Side Effects, Drug,Toxicities, Drug

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