پاورپوینت کامل Adulteration/Contamination of Herbal Products Ayurvedic & Chinese Medicines with Drugs and Heavy Metals: An Under- Recognized Threat 52 اسلاید در PowerPoint

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پاورپوینت کامل Adulteration/Contamination of Herbal Products Ayurvedic & Chinese Medicines with Drugs and Heavy Metals: An Under- Recognized Threat 52 اسلاید در PowerPoint

اسلاید ۴: Potential Contaminants that Should be Taken Into account in the Quality Control of Herbal RemediesDe Smet, P.A.G.M. (1999): Drug Information J. 33, 717-724

اسلاید ۵: Potential Contaminants that should be taken into account in the Quality Control of Herbal RemediesDe Smet, P.A.G.M. (1999): Drug Information J. 33, 717-724

اسلاید ۶: Adulteration of phytomedicines and traditional Chinese medicines with pharmaceuticalsPart IHealth SantéCanada Canada

اسلاید ۷: PC-SPES ProductsPC-SPES* is a complex mixture of extracts obtained from eight Chinese and American herbs (7 medicinal herbs plus saw palmetto)It was recommended by naturopathic healers for the treatment of prostate cancer, and was touted to induce castrate serum levels of testosterone and a reduction in prostate specific antigen (PSA).In 1996, PC-SPES gained tremendous popularity in USA as a herbal medicine for the treatment of prostate cancer. Clinical trials of the product were initiated at several health centres, some with federal funding from the NIH. Saw palmetto*PC-SPES: PC = prostate cancer; SPES = Latin for hopeCont’d…

اسلاید ۸: Adulteration of PC-SPES with Prescription and Non-Prescription DrugsChemical analyses of PC-SPES and its related preparation SPES showed adulteration with pharmacological dosages of:Diethylstilbestrol (DES, synthetic estrogen-like compound)Warfarin (anticoagulant)Indomethacin (analgesic)Serious adverse effects were experienced by PC-SPES users taking 6 to 9 x 320 mg capsules daily. ADRs included breast tenderness and/or enlargement, loss of libido and/or erectile dysfunction, deep vein thrombosis, pulmonary embolus, myocardial infraction, and ischemic heart disease. There were 2 case reports of severe bleeding. Cont’d…

اسلاید ۹: In January 2002, PC-SPES was withdrawn from the market due to serious ADRs and alleged adulteration with warfarin, DES, or indomethacin.Blumenthal M. (2002): Integrative Cancer Ther., 1, 266-70Guns et al. (2002): Can. J. Urol., 9, 1684-88Oh and Small (2002): Semi. Oncol., 29, 575-84Sovak et al. (2002): J. Natl. Cancer Inst., 94, 1275-81

اسلاید ۱۰: Adulteration of Herbal ED Products with PDE-5 InhibitorsBiovigoraHerbal EroticaHerbal ViaphrodisiacStamina-Rx*Super-X*Vip ViGaVuka VukaOf the 7 tested herbal products marketed via the internet or at health food stores for the treatment of male ED, 2 products were found adulterated with PDE-5 inhibitors. Stamina-Rx contained pharmacological amounts of tadalafil (19.8 mg/tablet), and Super-X contained sildenafil (30.2 mg/capsule). Adulteration with vardenafil was not identified.Although herbal products are marketed as devoid of adverse effects, their adulteration with PDE-5 inhibitors can cause potentially fatal drug interactions in patients taking nitrates.Fleshner et al. (2005): J. Urology, 174, 636-641

اسلاید ۱۱: Pharmaceuticals in Asian Patent MedicinesAsian patent medicines comprise multiple products, including herbs, plants, animal parts, and minerals, which are formulated into tablets, pills, or liquids for ease of use.Of 260 Asian patent medicines collected from California retail herbal stores, 14 had labels that declared pharmaceutical ingredients, and 3 had insufficient sample amounts. At least 83 (32%) contained undeclared pharmaceuticals or heavy metals, and 23 had more than one adulterant.Of the remaining 243 products, 17 (7.0%) contained undeclared pharmaceuticals. The most common undeclared ingredients were ephedrine, chlorpheniramine, methyltestosterone, and phenacetin.Ko, RJ. (1998): New Eng. J. Med. 339, 847

اسلاید ۱۲: How Natural Are Natural Herbal Remedies A Saudi Perspective In Saudi Arabia, 247 herbal remedies and related preparations were analysed for heavy metals, synthetic drugs, bacterial contamination or the presence of toxic natural substances. Of 123 samples examined, the indication for use was not specified. Other preparations were indicated for the treatment of: – Leukemia and other cancers (n=22); obesity (n=18); diabetes mellitus (n=14); rheumatic disorders (n=14); skin pigmentation problems (n= 11); or to enhance male sexual activity (n=9). Eight preparations contained undeclared synthetic drugs: – benzodiazepines; tricyclic antidepressants; cyproheptadine, ibuprofen; and dipyrone.Cont’d…

اسلاید ۱۳: How Natural Are Natural Herbal Remedies A Saudi Perspective Micro-organisms (E. coli, S. aureus and other pathogens) contamination was noted in 18 samples, while dangerous and toxic natural compounds were present in 14 preparations used for the treatment of skin conditions or indigestion . Strikingly high amounts of heavy metals were identified in 39 samples. The levels of arsenic ranged from 522 to 161, 600 ppm in remedies used for treating leukemia, and the content of mercury ranged from 5,700 to 126,000 ppm in creams used for skin whitening. High lead concentration (> 1.5%) was also found in few samples. The authors concluded that an urgent action is required to control the production, importing and selling of herbal preparations in the Kingdom of Saudi Arabia.Bogusz et al. (2002): Adv. Drug React. Toxicol. Rev. 2 (4), 219 – 29.

اسلاید ۱۴: Undeclared pharmaceuticals found in traditional Chinese medicinesCaffeineChlorzoxazoneDexamethasoneDiclofenacFenfluramineGlibenclamideAminopyrineCarbamazepineClobetasol propionateDiazepamEthoxybenzamideFluocinolone acetonideCont’d…

اسلاید ۱۵: HydrochlorothiazideIndometacinMethylsalicylatePhenacetinPhyenytoinHydrocortisoneMefenamic acidParacetamolPhenylbutazoneValproateErnst E. (2005): The Pharmaceutical Journal, 275, 167-168

اسلاید ۱۶: Two cases of severe adverse effects were reported from South Africa after the ingestion of herbal remedies adulterated with an anti-epileptic drug (trimethadione), an anti-inflammatory agent (diclofenac), and an anesthetic (propofol).Snyman et al. (2005): Ther Drug Monit. 27, 86-89

اسلاید ۱۷: Adulterants found in Chinese Herbal Products The following six undeclared adulterants were found in herbal weight-reducing dietary supplements marketed in China and exported abroad.Wang J. et al. (2008): Food Additives & Contaminants, 25 ; 822-30.N-di-desmethyl sibutramineN-mono-desmethyl sibutramineSibutramineOrlistatPhenolphthaleinFenfluramineCont’d…

اسلاید ۱۸: Fenfluramine was removed from the market in 1997 by the US FDA because of its serious side effects.Phenolphthalein has been used as a laxative for over a century, but now its use is discouraged due to carcinogenicity risk. N-mono-desmethyl sibutramine and N-di-desmethyl sibutramine are metabolites of sibutramine.In 2004, USFDA sent warning letters to 16 Chinese manufacturers asking them to stop making false claims for weight loss, and requested 23 companies to stop distributing dietary supplements containing androstenedione.Wang J. et al. (2008): Food Additives & Contaminants, 25 ; 822-30.

اسلاید ۱۹: A baby was hospitalized in 2008 after consuming melamine-tainted milk

اسلاید ۲۰: In 2010, 20 children’s jewelry items were recalled a