History of Pharmacy Exam I

Jan 20: Why Study the History of Pharmacy and Medicine?

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Early evidence of medical and pharmaceutical activities

Pharmacy and medicine in the early civilizations of the Middle East
Diseases and lifestyles of ancient populations

PHARMACY BEFORE, NOW, AND FUTURE

Just one example of the dramatic changes that have occurred in the profession of
pharmacy over the course of history has to do with the minimal educational
requirements for the pharmacists. These requirements vary from country to
country, but in the United States, up to the start of the __20th__ century ,
apprentice training was the only requirement. Apprentice training meant
working for a period of _1 or more__ years under the supervision of an
experienced pharmacist (today we use the term preceptor) __ for __minimal or
no__ pay.
The educational requirements for American pharmacists were gradually, but
continuously expanded throughout the 20th century, so that by the start of the
_21st__ century, the minimal requirement had become: minimum 6 years leading
to PharmD degree
o Two additional requirements are being discussed by U.S. pharmacy
schools as potential and emerging trends for the future?
1. Before you can get into PharmD degree, have to have Bachelor of
Science (BS) degree (4 year degree, similar prereq to get into med
school)
2. Minimum of 1 year of residency (post-pharmD) for any clinically
oriented career in pharmacy
Mail order became commonly available in the 1970s, a major change in the
profession. The effect this had on pharmacy is it posing additional competition to
retail pharmacy in general.

PRE-HISTORIC EVIDENCE OF MEDICINE

When did humans first get the idea to use medications to treat diseases?:
Humans have used drugs/medicines as far back as we can note, in prehistoric
times. Its an innate (inborn) characteristic of humans, to use substances to treat
various illnesses and disease and conditions.
ICE MAN: case of spontaneous mummification in central Europe in 1991, dating
to 3000 B.C., based on a tree fungus using tree fungus as an antibiotic to
treat infection
o Spontaneous vs. Anthropogenic mummification (indefinite preservation of a
corpse):
Anthropogenic: the intentional act of preserving a body
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Spontaneous: body is mummified due to natural causes

o 1991 in Alps Mountains in Northernmost Italy near Austrian border
spontaneous mummy found by skiers buried in ice. Thought the man had
suffered an accident recently
o 3300 B.C.
o Actual cause of death shot by an arrow and bled to death
o Amulet, Tools, Tree Fungus amulet for protection; tree fungus: we have a
lot of antibiotics from various fungal sources, he was using the tree fungus as
an antibiotic ointment to treat scratches and bruises he might have had,
proof medicinal use dates back to prehistoric times
SHAMAN: in Native American Sand Painting ceremonies (community involvement)
o Tribal healer who would administer mind-altering drugs
o A characteristic of cultures that did not rely on written language is that their
recent practices extend to very ancient times.
o Most Native American tribes did not have a written language.
TREPHINATION: Craniotomy
o the surgical removal of an area of bone from the skull., exposing the brain.
o Craniotomy is used to perform brain surgery or to resolve intracranial
neurological problems such as dealing with sub-arachnoid hemorrhage
(falls, faints, and hits the back of their head, bleeding in the brain,
undetected bleeding will clot and form sub-arachnoid hematoma, leads to
serious problems in which they have to do brain surgery to clean out).
o Prevalence in pre-historic times in mummy, hole in head; many skulls found
that have these holes drilled in skull; areas of hole had become smooth and
not jagged, meaning they had healed and survived this practice
o Believed in evil spirits, treating things like migraine headaches or seizures
like epileptic seizures; thought by drilling a hole, would relieve pressure and
get rid of whatever was causing the problem
MEDICINAL AGENTS: Tells us that in order to have done these procedures in such
a widespread basis, they must have had ways of treating these people so that they
would survive
o Hemostatic agent: stops bleeding
o Antiseptics: antimicrobial substances applied to skin to reduce infection,
commonly alcohols
o Analgesics: pain killers
o Hypnotics: puts you to sleep, like opium
CLAY TABLETS: extensive list of drugs found in earliest written record in clay
tablets of the Middle East dating to 2100 BC

DISEASES: subject of major relevant to anyone studying/working in health care

specialties like Pharmacy or Medicine; have tremendous impact on history; historical
advances in the biomedical sciences reveal great power of scientific discovering in
treating or curing diseases; serious limitations and challenges faced in dealing with
disease
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DISEASES DOCUMENTED IN PRE-HISTORIC AND ANCIENT CIVILIZATIONS

CANCER(s) the emperor of all maladies, most challenging and pervasive in a
sense; evidence from soft-tissue specimen (mummies) and skeletal remains (more
prevalent because they dont decay as much) that cancer does date back to the
earliest times and earliest civilizations. However, the prevalence of cancer in
ancient times and early civilizations was LESS because they pretty much
eliminated the greatest risk factor of cancer: age. The longer you live, the greater
the chance you have of getting cancer.
CIRRHOSIS the fatty degeneration of the liver; prevalent in ancient times,
caused mostly by a parasite infestation of the liver (very common then); would
lead to death; the cause of cirrhosis today is alcohol abuse
CORONARY ARTERY DISEASE (atherosclerosis): The build-up of fatty
deposits--related to cholesterol--on the inner walls of the coronary arteries.
Sclerosis = hardening; plaque = fatty deposits especially in the lumen (the
inside walls) of the blood vessels, especially the coronary arteries, which leads to
strokes and heart attacks; heart attacks are MI = myocardial infarction
o evidence found in mummies, still not as prevalent as today
o today people are at risk because of their diets and they live longer
FUNGAL INFECTIONS: common both in ancient times and today. If invasive, (gets
into the system) very serious and life-threatening but we do have antibiotics and
antifungals to treat today
PNEUMONIA bacterial or viral, lung infection. Still common today, present in
ancient times. Today, especially a danger post-flu; develops in elderly people and
the very young
TUBERCULOSIS (TB) A bacterial disease caused by the organism
Mycobacterium tuberculosis. For a long time it was believed that this major
killer was not indigenous to the American continents, but was imported by
Europeans from the Old World. It was believed that TB did not exist in the New
World prior to the arrival of Christopher Columbus in 1492. However, in 1994, DNA
fragments of Mycobacterium tuberculosis were discovered in a mummy in Peru
dating to the year 1000.
o first antibiotic: penicillin
o second antibiotic: streptomycin discovered 1951 in Rutgers
antibiotics eventually developed resistance; bacteria and viruses no
longer affected by antibiotics;
did not have HIV or AID in ancient times; didnt come up till 1980s;
AIDS greatly reduces the immune system, makes them more
susceptible to TB, TB had a resurgence
TRAUMA A physical injury or wound caused by external force or violence. Very
common in ancient civilizations because a lot of fights, had to go out and hunt and
animals would attack. Still common today but for different causes
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OBSTETRICAL (childbirth and delivery) MORBIDITY (illness, sickness) and

MORTALITY (death): even more problematic before the introduction of
midwives, non-physician females who specialize in helping with delivery of babies

DISEASES OF TODAY: not documented in ancient times but are major causes of
morbidity/mortality today
HYPERTENSION (HTN): high blood pressure; dont have proof it existed in ancient
times but we believe it did; we are certain its much more prevalent today because
its an age-related disease, but we have drugs to treat hypertension today
PARKINSONS DISEASE: neurodegenerative disease, first described in 1817, age
related
ALZHEIMERS DISEASE: neurodegenerative disease, age related
INFECTIOUS DISEASES (IDs): prevalence in ancient/prehistoric times vs. modern
times
o In early times, there was lower population density so you were less likely to
get the flu from somebody close to you who sneezed or something
o They didnt know anything about the germ theory of disease and lacked
modern sanitation in early times
THEORITICAL BASIS FOR DISEASE CAUSATION (ETIOLOGY) OR TREATMENT IN
THE EARLIEST CIVILIZATONS OF THE MIDDLE EAST

Why has it been important in all periods of history to have a theoretical

basis for the etiology of disease?
o Etiology: the root cause of the disease
o Todays basis is biochemistry
o Important because you need a theoretical basis to be able to figure out how
you want to design treatment options and how to cure and prevent the
disease
Why did the therapeutic interventions employed in the earliest
civilizations emphasize cleansing and purging?
o Their idea of what the etiology of the disease was an evil influence in the
body (today: chemical imbalances, bacteria, virusesthen, a demon
possession)
o Cleansing and purging to get rid of evil influences (laxatives and cathartics
today), they used bleeding (get rid of blood, get rid of evil influence); used
exorcisms to exorcise the demon
PURGING MEDICINES:
o PURGATIVES (purging agents) modern examples: Golytely - [PEGs,
NaHCO3, Na2SO4 , NaCl, KCl] preparative when people hit about 50 years of
age, have to get a colonoscopy, examines in your colon, the large intestine look
for cancerous ___; take purgative that purges the patient, NuLytely - [PEGs,

NaHCO3 , NaCl, KCl] surfactant cathartic, NaHCO3 is a saline cathartic,

MiraLAX - [PEG ] (polyethyleneglycol) - otc
o CATHARTICS AND LAXATIVES both terms are less powerful or harsh than a
purgative (purgative implies harsher effect)
o ENEMAS (clysters) a rectally administered instead of orally administered
saline cathartic or some sort of purging agent
o VENEPUNCTURE/VENESECTION/PHLEBOTOMY [bloodletting] Bloodletting
was widely practiced as a form of therapy at least up to the19th century. This
practice was originally related to the theory of purging of evil spirits and
supernatural influences, and it
persisted, almost into the 20th century,
although there was never any scientific proof of its therapeutic efficacy.
George Washington died more from purging, bleeding in 1799 than he did
from the infection
Polycythemia vera the only valid use of bleeding today, a condition in
which the patient has an excess of erythrocytes (erythro = redcytes =
cells red blood cells)
Medicinal Leeches (Hirudo Medicinalis): suck blood out of the skin,
wormlike creatures
RITUALS AND INCANTATIONS: accompanied the administration of certain
medications
o SOIL/CLAY SAMPLES many of our antibiotics were originally derived from
clay samples; clay samples had some healing properties within them that
people used. Clay materials from certain parts of the ground could either be
taken orally or applied externally to the body
o FUNGI tree fungus and ice man; had antibiotic properties and some fungi
have psychoactive properties; used PO or topically as well
o SCARIFICATIONS AND TATTOOS tattoos, put into the skin by processes
similar to intradermal injection; would inject tattoo-like dyes or snake venom
or even smallpox pestuleswas a way of inducing immunity to smallpox and
immunity to things like snakebites and so forth
o OPIUM- drug that was widely used at that time, the opium poppy plant,
analgesics, addictive
o ALCOHOL addictive, a CNS depressant
MESOPOTAMIA: modern day Iraq, Kuwait, and parts of Syria, Turkey, and Iran; the
first definitive written records of drugs used as medicines on clay tablets; drugs
mostly botanical in origin, some were mineral (like clay), or even from animal
sources, in addition to things like opium, alcohol, and marijuana
o Mesopotamia, Babylonia, Sumaria, Chaldea, Assyria [ modern-day Iraq,
Jordan, Israel, Syria, Lebanon, Iran, etc.]
o Dates associated with the Clay Tablets Cuneiform (wedge-shaped)
writing 3000 B.C.
HAMMURABIS CODE: Hannurabi was a military ruler of this region around
Baghdad, reined as King of Babylon (present day Iraq) from 1792 BC 1750 BC, 42
years
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o Hammurabis well-documented Code and its influence on the history of

medicine and subsequent health professions when we think about how
western medical practices have evolved we know that our practices have
adopted a caring attitude to the patient, an ethical caring attitude. This came
from Hippocrates. But before the ethical aspect of caring for patients, had
LEGALISTIC aspect. Hammurabis code had many rules, laws, and
regulations in it related to medical practice. If a patient claimed that a
physician was mistreating the patient, and the cure didnt go well
(malpractice), the physician would be punished and depending on how
influential the patient was, the harsher the punishment for the physician,
their idea of justice. Today in pharmacy we have regulations and laws, that
all began with Hammurabis code that medical practice would be regulated
by governmental laws and regulations.
Jan 23: The Chinese and Eastern Systems of Pharmacy and Medicine
THE BASIS FOR EASTERN MEDICINE & PHARMACY
China is one of the major early civilizations:
o Dates 4000-2000 BC
o Extended regional influence: extends through far east today, cultures like
Korea and Vietnam and much of the Far East were greatly influenced by the
early development of Chinese civilization
Traditional Chinese Medicine (TCM) and Ayurvedic medicine
o Emperor Shen Nung: the Father of Ancient TCM
Pent Sao; Pent Sao Kang Muin 200 BC, updated in 16th century
These 2 publications are the basis for Traditional Chinese Medicine.
Include over 2000 drugs in these publications; most of them botanical
Shen Nung proclaimed Green Tea (the most consumed beverage
globally) to be Heaven-sent. We know that green tea contains EGCG
(Epi-Gallo-Catechin Gallate), one of the most powerful antioxidants
occurring in nature
Complementary and Alternative Medicine (CAM): based on Eastern medicine;
its alternative or complementary to traditional western medical practices
o Emphasizes use of herbals
o Herbals ancient origins, modern resurgence used for centuries in China
and India
o CAM also known as Integrative Medicine because integrating eastern with
western medical practices, a popular idea today
How modern TCM (in China) differs from our use of herbal dietary
supplements as a form of CAM in the United States:
o Traditional Chinese pharmacies stock a large variety of crude (unrefined)
botanical drugs, including herbals in the form of roots, stems, or leaves, not
in the form of tablets or capsules or other finished dosage forms as found in
the Dietary Supplement sections of modern American pharmacies.
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Prescriptions in TCM combine several crude herbals to treat specific

conditions
o Decoction like brewing tea, how they prepare these medicines by and
large
POPULAR HERBALS IN US PHARMACIES (DEFINITELY) DERIVED FROM
TRADITIONAL CHINESE MEDICINE
GINSENG increases energy and stamina, overcomes fatigue, dietary
supplements
o May cause DDIs (drug-drug interactions) such as an increased risk of clot
formation for patients who are on warfarin (anticoagulant drug) therapy. May
also increase post-prandial (post-meal) blood glucose levels in diabetic
patients.
GINKGO BILOBA improves memory, inc. mental alertness, helps patients
coming down with Alzheimers or dementia
o May cause DDIs such as enhancing the anticoagulant effect of warfarin,
increasing the risk of a bleeding episode.
o Opposite effect from ginseng
GREEN TEA (Camellia sinensis) promotes wellness, some lab experiments have
shown that green tea can suppress tumor formation (chemopreventive)
MA HUANG (Ephedra) = Ephedrine and Pseudoephedrine (both alkaloids) as its
active ingredients)
o stereoisomers both ephedrine and pseudoephedrine are stereoisomers of
one another; both pharmacologically active.
o alkaloids Nitrogen-containing organic free bases derived from plant
sources with potent pharmacologic effects.
o amphetamine-like properties CNS stimulants: (increase heart rate),
Vasoconstriction (constrict blood vessels), increased blood pressure, nasal
decongestant (blood vessels in nasal passage areas swell up;
vasoconstriction constricts them, appetite suppression (weight reduction)
RED YEAST RICE (Monascus purpureus) Used for centuries in Traditional
Chinese Medicine to promote CV cardiovascular health. It contains, among
other ingredients, lovastatin (first statin drug in the treatment of cholesterol)
o The active ingredient in Mevacor, the original STATIN
antihypercholesteremic (gets rid of excessively high cholesterol in the
blood). Available as dietary supplements
DONG QUAI (Angelica sinensis) to treat dysmenorrheal (difficult, abnormal
menstruation)
ARTEMISININ - This drug has been used in Traditional Chinese Medicine for at
least 2000 years. It is now the standard therapy worldwide for the treatment of
malaria, the major cause of which is infection with Plasmodium falciparum.
o The active ingredient, artemisinin, is a multi-ring structure containing an
unusual peroxide bridge, which is involved in the mechanism of action.
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Monotherapy with artemisinin is not recommended. Combination therapy is

preferred as a means of preventing
o the development of resistance develops very quickly in malaria and
infectious diseases in general. Combination therapy usually involves
melofquin or other quinine derivatives, or lumefantrine in the product
Coartem, marketed by Novartis Pharmaceutical Corporation.
CURRENTLY POPULAR HERBALS THAT ALSO COME UNDER DSHEA (Dietary
Supplement Health and Education Act) PROVISIONS BUT ARE NOT PRIMARILY
ASSOCIATED WITH TCM

ECHINACEA (Echinacea purpurea) stimulates the immne system, promotes

immune system health; prevents cold, flu, ameliorating the symptoms of cold or
flu, although the doses are uncertain so sometimes that has to be dealt with as to
whether itll be effective or not
GARLIC- cardio protectant; promotes good maintenance of blood pressure and
heart health, not exactly a CV drug but cant hurt
GLUCOSAMINE WITH CHONDROITIN SULFATE promoting joint health, people
use it to treat arthritis (osteoarthritis)
SAW PALMETTO (Serenoa repens) NOT urinary tract infections (fix on term
sheet) but does promote prostate health, used in cases of BPH (benign (not
cancerous) prostate hyperplasia)
SAINT JOHNS WORT (Hypericum perforatum) Wort distinguished from wart;
wort means a plant; clearly has antidepressant effects; caution: if the patient is on
prescription medications for depression, you cannot also be taking this; would
interfere with the effects of those Rx drugs
KAVA KAVA (Piper methysticum)- tranquilizing properties
CRANBERRY (Vaccinium macrocarpon)- promotes urinary health, can help to
prevent urinary tract infections, or at least lessen the severity of UTIs, but have to
take a lot of itdoes not replace UTI antibiotic, but can have some benefits
MILK THISTLE (Silybum marianum)- a liver protectant; if people are taking a lot
of acetaminophen (Tylenol), generates liver toxicity
BLACK COHOSH (Actaea racemosa)- treats menstrual problems
VALERIAN (Valeriana officinalis)- clearly has effects of anxiolytic; term means
that it gets rid of anxiety, a mild tranquilizing effect; some use this product as a
sleep aid
GRAPESEED EXTRACT promotes cardiovascular health, similar to garlic
ELDERBERRY (Sambuccus)- similar to echinacia, immune system stimulant
FISH OIL compare the dietary supplement with the Rx-only product: Lovaza -excellent means of controlling and lowering triglycerides (a kind of fat in the blood,
can be dangerous if builds up too high)
o Dietary supplement vs. Rx: dont need Rx, less expensive.
o Benefit of Rx: dose is more standardized
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ACUPUNCTURE: The selected insertion, with rotation, of very thin needles into selected
pressure points on the body

goes back to at least 500 BC documented in China; introduced to West

Analgesic effect to relieve pain, is effective; has become mainstream in US
Relationship to TCM and to Moxabustion (the use of burning embers of specific
types of wood in place of needles)
Popularity of acupuncture in Western medicine:
o Has become mainstream
o Insurance providers are willing to pay for visits to the acupuncturist
o Associated with agencies that provide physical therapy
If PT doesnt work, acupuncture supplement to it will usually work to
relieve pain
o Estimated 3 million patients per year that utilize this treatment in the US
o FDA has practitioners licensed and is concerned about insuring that the
needles used are sterile
Possible mechanism of action (endogenous endorphins): stimulation of
acupoints by fine needles
o Insertion of needles causes the release of endogenous substances called
endorphins
o Endorphins are naturally occurring in the body, are the bodys natural pain
relievers

Jan 27: Indias System of Ayurvedic Pharmacy and Medicine

INTRODUCTION

Ayurvedic Medicine & Pharmacy, together with Traditional Chinese Medicine &
Pharmacy, represent the eastern system of Medicine & Pharmacy, which is
contrasted with the western system of Medicine and Pharmacy, also referred to as
the allopathic system.
Eastern medical and pharmaceutical practices have been incorporated to some
degree into Western Medicine in the form of CAM, the acronym for
complementary and alternative medicine
India as an ancient civilization:
o Date of origin 3000 BC, one of the ancient civilizations
o Extended Regional Influence Pakistan, Napal, Sri Lanka
o Religions that originated in the Indian Civilization as related to the origin of
the practice of Ayurvedic Medicine :
Hinduism The origins or Ayurvedic Medicine are in the ancient
Hindu writing in the Sanskrit, one of the traditional languages of India,
and still the dominant religion of modern India.
Buddhism a religious tradition that originated in India, but became
more widely adopted in China.
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Ayurveda The traditional form of Indian Medicine. As with Traditional Chinese

Medicine, Ayurvedic Medicine is still widely practiced today, but commonly
integrated with Western-style Medicine. Ayurvedic pharmacies differ from
Western-style pharmacies.
o Prevalence of Ayurveda as the basis for pharmacy and medicine in
India: still widely practiced today, particularly in India
o The popularity of Ayurvedic Medical and Pharmaceutical Practices in
the United States at present As people from India emigrated to US in
large populations, many of those people who have come here continue to
practice ayurvedic medicine in the US
o Integrated with western style medicine

COMPARISONS OF TCM AND AYURVEDIC MEDICINE AND PHARMACY

Holistic both TCM and Ayurvedic Medicine are holistic, a long-standing

characteristic of Eastern Medicine.
o Since 1970s, holistic practices have been recognized as very valuable, have
been incorporated into western medicine
o Involves emphasis on natural products
Herbal (natural) medicines associated with holistic ideals
Preventive Medicine [concept of wellness] Meditation and Yoga
are also Ayurvedic treatments
Treating the Whole patient wholism; dont just treat a bad kidney
or heart, look at the needs of the whole patient, including
psychological needs
Popularity of Spices as one form of emphasis on Herbals: spices related to drugs
o Ex: Early voyagers like Columbus and Vasco de Gama what they were really
looking for was a way to get these spices (very valuable, associated with
drugs)
o CURRY contains Turmeric, the active ingredients of which are curcumin
and piperine.
Turmeric is a bright yellow spice best known as an ingredient of Curry.
Turmeric use for osteoarthritis pain reduction has shown similar safety
and efficacy results as low-dose ibuprofen
studies have shown that curcumin in turmeric or curry can have some
tumor reduction properties in animals, and possibly breast cancer in
humans
Surgery
o Chinese did not utilize surgery to any great extent because cultural aversion
to bloodshed
o Used in Ayurvedic medicine
o Susruta and Charaka (approx. 900 B.C.) beginnings of Plastic or
Reconstructive Surgery
Invented the idea of plastic/reconstructive surgery
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Did not have general anesthetics, would have to hold the patient down
because of the pain
Also had a system of preventing infection: applied materials to prevent
excessive blood flow, stopping the buildup of infection
Ex: Otoplasty (repairing ear) and Rhinoplasty (nose job)

Rasa Shastra vs. Herbal only Ayurvedic pharmaceutical products and

toxicity concerns:

Definition:
Metals used: heavy metal salts like Pb, Hg, As either as sulfides or oxides; felt that
it made the medications more powerful; US has concerns about the toxicity
Prevalence of metals in Ayurvedic products sold in the United States:
Arguments pro and (mostly) con regarding the toxicity potential of Ayurvedic
products used in the U.S.

INDIAN PHARMACEUTICAL COMPANIES: a dominant force in production of APIs,

Generics, and some innovator pharmaceuticals:

RANBAXY Laboratories as emblematic of the status of Indias global

pharmaceutical industry: [
o Daiichi-Sankyo, a Japanese pharmaceutical company, purchased a major
share of Ranbaxy
o North American HQ in FL, a manufacturing facility in central NJ
o QC problems with laboratories in India that have caused the FDA to put a
hold on some of Ranbaxys products
o Evidence of the truly global nature of the modern pharmaceutical
industry emergency of generic pharmaceutical industry is indicative of
nature; Ranbaxy has facilities in US and other places, but is headquartered in
India
DR. REDDYS laboratories: North American Branch headquartered in the Princeton
area of NJ
o Significant supplier worldwide of generics, not as big as Ranbaxy
CIPLA Ltd.- Headquartered in Mumbai, India
o Focus on providing low-cost drugs for the world as a whole, particularly poor
third world countries that cant afford expensive western medicine; as a
result, sometimes have to become adversarial to the patent laws of the US
based products; fought with US based companies over patents because they
dont want the patents to hold back the ability to produce these medicines
generically to distribute in poor countries
Reasons for great success of the Indian generic pharmaceutical industry:
o Labor costs in India are less than they are in the US and Europe, etc (the
same is true for China)
Safety concerns:
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o FDA caught Ranbaxy people faking the quality control data that they submit
to the FDA
o Reluctance to get involved in India,but on the other hand, the large
population (that could soon overtake China) just cant ignore that kind of
market but will be cautious of patent issues and quality control
Concerns over Indias failure to recognize international patents of
pharmaceutical companies:
o In India, less restricted patent laws, easier to take brand name product and
make it a generic
Concerns about widespread counterfeiting of pharmaceuticals: India and
China

THREE EXAMPLES OF DRUGS THAT AROSE FROM ANCIENT AYURVEDIC

MEDICINE

GINGER (Zingiber officinalis) A typical spice in India. Used in CAM (in U.S.) to
promote GI health; to treat N&V, and to prevent motion sickness. Possibly other
uses; e.g., arthritis.
INDIAN HEMP Cannabis Sativa or Marijuana [several varieties of the
marijuana plant are indigenous to India.]
o Hemp is a botanical cousin of marijuana, both the same species of
cannabis plant. However, hemp has a much lower content of THC
(tetrahydrocannabinol) the pharmacologically active compound in
marijuana. Hemp has important industrial applications in cosmetic
production. Its production in the U.S. is currently restricted, but the
restrictions are being challenged.
o Cannabis (marijuana): traditionally used in India, goes back to ancient times,
for making rope and clothing and carpets, cosmetics, etc; Hemp has low
conc. of cannabis in the product
o Marijuana written in ancient Ayurvedic and Chinese writings
o HASHISH: A resin expressed (extracted) from the marijuana plant. The resin
is then dried and used as a more potent form of marijuana with greater
psychoactive properties.
INDIAN SNAKEROOT or Rauwolfia Serpentina (active ingredient: Reserpine)
the root, which contains the pharmacologically active ingredient reserpine,
resembles a serpent.
o Its use in Ancient Ayurvedic Medicine extensively used from ancient
times to promote cardiovascular health.
o Its introduction into the U.S. pharmaceutical market in the 1950s
first as standardized root; then as the pharmacologically active ingredient,
Reserpine, marketed in the U.S. as Serpasil; first effective drug for
hypertension in capsule form, effective in controlling blood pressure
o Its historic place in the annals of cardiovascular
pharmacotherapeutics
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o Its action in the depletion of catecholamines (serotonin, dopamine, norepinephrine) causes reduction in vascular resistance, relaxes the blood
vessels, reduces resistance, reduces blood pressure
o Current role in pharmacotherapy not widely used today because (used
somewhat) weve come out with many more effective modern drugs to treat
hypertension
In treating hypertension, run into resistant hypertension (hard to
control the blood pressure even with a drug, so have to add another
drug, and sometimes a third); sometimes reserpine is added in as one
of the drugs to treat this resistant hypertension

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