Abstract:
Introduction: Phytotherapy is increasingly evident in the complex treatment of diseases due
to the elucidation of the active compounds from plants with beneficial pharmacological effects. The
creation of a scientific base on rational use of medicinal herbs opens new prospects for the
pharmacotherapy improving. Therefore, the issue of interactions between drugs and plant drugs in
terms of synergism and antagonism becomes current for arguing security and safety of their
association. Data on such interactions are minor and dispersed, as they are more difficult due to the
varied and rich content of active ingredients from plants. Interactions between herbs and drugs can
be detected in pharmacotherapeutic and toxicological aspect.
Purpose and objectives: is the bibliographic study of the pharmacodynamic interactions
between medical herbs and drugs, their reflection in the training process.
The results and discussion: Pharmacodynamic studies of herbal drugs and of their active
principles have demonstrated the presence of a variety of pharmacological effects (anti-inflammatory,
immunostimulant, antioxidant, antimicrobial, sedative, anxiolytic, antispasmodic, etc.). It was
determined that the association with drugs can have unpredictable consequences, both therapeutic and
toxicologic. Thus, pharmacodynamic interactions can be achieved by: drug interaction with receptors,
allosteric modulation of receptor sites; influencing mediator systems (release, uptake, synthesis,
metabolism), modifying the activity of enzymes, changing the activity of organs and systems, the
development of liver, kidney disturbances etc. Thus, St. John's wort drugs manifest antidepressant
action by inhibiting the norepinephrine, serotonin, dopamine reuptake. However, they also induce
adverse effects in combination with antidepressants as selective inhibitor of the reuptake of these
neurotransmitters. Valerian benzodiazepines shows the same effect by modulating the GABA - ergic
system. Echinacea, ginseng, by their phenolic triterpenes, flavonoids, saponins, polysaccharides
determine the immunomodulatory effect which can produce contradictory effects in patients under
immunosuppressive organ transplantation. Garlic drugs develop multiple metabolic effects, including
the inhibition of lipid-lowering hydroxy-methyl-glutaryl - CoA - reductase for stimulation of the
efficiency of statins. The associated use of these compounds may increase the incidence of
rhabdomyolysis due to increased concentration of statins as a result of pharmacokinetic interactions. It is
necessary to mention that the result of pharmacokinetic interactions, particularly produced by the
induction and/or inhibition of cytochrome P-450 and transport systems will be characterized by the
amplification and/or decrease of the pharmacological effects and adverse reactions.
Conclusion. The associated use of drugs with medicinal herbs for the treatment of diseases requires
strict monitoring of the efficiency and safety through the possible pharmacokinetic and pharmacodynamic
interactions. The information about the consequences of these interactions must be brought to the attention
of physicians, pharmacists and patients in order to ensure a rational pharmacotherapy.
Description:
Department of
Pharmacology and Clinical Pharmacy, State Medical and Pharmaceutical University „Nicolae
Testemiţanu”, Republic of Moldova
