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IKA BUANA JANUARTI, S.Farm.

, Apt

SAFETY
SAFE" potential dangers to considering the safety of crude
drug a dangerous unknown.
USDA scientist estimates the dangers of herbal medicine
relative to other dangers in the United States as follows:

Herbs
Supplements
Poisonous Mushrooms
NSAID's
Hospital Surgery
Car Accident
Improper Use of Medication
Angiogram
Alcohol
Cigarettes
Properly Prescribed Medications
Medical Mishap
Iatrogenic Hospital Infection
Bypass Surgery

1 in 1,000,000
1 in 1,000,000
1 in 100,000
1 in 10,000
1 in 10,000
1 in 5,000
1 in 2,000
1 in 1,000
1 in 500
1 in 500
1 in 333
1 in 250
1 in 80
1 in 20

In a 19 year analysis of poison control in the U.S.:

44.6% due to pharmaceuticals


2.4% due to plants (includes exposure to poison ivy,

children eating houseplants and allergic responses).


The vast majority did not involve herbal medicines.
8% of all hospital admissions are due to adverse
reactions to synthetic drugs.
Deaths or hospitalizations due to herbs are so rare that
they're hard to find.
The U.S. National Poison Control Centers does not even
have a category in their database for adverse
reactions to herbs.
Hepatoxicity
where perhaps the strongest case against some herbs
lies
the statistic show that over 80% of cases of fulminant
hepatic failure were due to poisoning by freely
available non-prescription NSAID's.
Not one case was due to ingestion of medicinal herbs.

POISONOUS PLANTS
Which have limited medicinal use are available

only to trained practitioners (Aconite, Arnica,


Belladonna, Bryonia, Datura, Gelsemium,
Henbane, Male Fern, Phytolacca, Podophyllum,
and Veratrum)
Secondly, are herbs with powerful actions,
often causing nausea, sweating vomiting,
Third are plants with specific toxicity like
hepatotoxic pyrrolizidine alkaloids like Comfrey
There are other plant medicines which require
caution or can interact with medications
including St. Johnswort or grapefruit.

HUBUNGAN ANTARA KEAMANAN OT


DAN INTERAKSI OT
Herbal safety show cases that .....

MAY LACK THE APPROPRIATE PHARMACOKINETICS to produce the


adverse results inferred.
A study of herb drug interactions indicated that the vast majority of

drug interactions occurred in four classes of drugs :


1. narrow therapeutic windows
2. the chief class being blood thinners, but also including protease

inhibitors, cardiac glycosides


3. certain antibiotics like cyclosporins
4. Antioxidants interfere with chemotherapy

CONFUSION OF
CONSTITUENTS
WITH
Crude drug constituents may have
an opposite,
moderating or enhancing effect.
WHOLE PRODUCTS
When any constituent is isolated it does not follow

that its actions represent the whole herb.

Ephedra has constituents that increase the heart

rate and constituents that decrease it.


The drug ephedrine only used the constituents that
increased the heart rate and had side effects
absent from the traditional preparation of the herb.

INTERAKSI OBAT KIMIA


DAN OT

OBAT TRADISIONAL
LEBIH AMAN GAK SIH?

HATI-HATI TERHADAP PASIEN DENGAN RESIKO


TINGGI

PASIEN GERIATRI, DIABETES, HIPERTENSI,


DEPRESI, KOLESTEROL TINGGI, GAGAL
JANTUNG

Buletin WHO Drug Information : beberapa

kasus interaksi obat antara Obat Bahan Alam


dan Obat Kimia
Echinacea menyebabkan reaksi alergi
Antidepressan trisiklik dengan Yohimbine

menyebabkan meningkatnya resiko hipertensi


Kortikosteroid oral dan topikal dipotensial

khasiatnya bila bersamaan dengan Liquorice


(Glycyrrhiza glabra)

GINSENG
Dapat meningkatkan TD bila digunakan

pasien Hipertensi
Hati-hati bila digunakan bersama obat

antikoagulan resiko perdarahan >>


Ginseng mrp stimulansia bila digunakan

bersama kafein dapat menyebabkan


insomnia

GARLIC
Bila dikonsumsi penderita DM penurunan kadar

gula yang berbahaya

Pada konsumen yang sensitif dapat terjadi tukak

lambung

Mempunyai efek antikoagulan hati-hati bila

diberikan bersama antikoagulan oral

Mengganggu siklus menstruasi tidak

direkomendasikan utk wanita hamil dan


menyusui

GINKGO BILOBA
Aktivitas farmakologi ginkgo biloba

didasarkan pada kemampuannya sebagai


antioksidan dan inhibitor agregasi platelet
digunakan untuk meningkatkan fungsi kognitif
dan aliran darah

Interaksi antara Glinkgo Biloba dan Tiklopidin

atau Warfarin dan obat lain : perdarahan


saluran cerna (penggunaan 2 tahun)

GINKGO BILOBA
Pasien yang mengonsumsi garlic, vitamin E,

warfarina, asetosal atau obat-obat lain dengan


efek antiplatelet atau antikoagulan hati-hati
terhadap potensi interaksi dengan produk
ginkgo

Pasien yang mengonsumsi produk ginkgo

harus menginformasikan kpd dokter bila terjadi


pendarahan yang tidak biasa, sakit kepala
yang tiba-tiba atau gangguan penglihatan

PENGGUNAAN OBAT
TRADISIONAL
Konsumsi OT yang tidak mengandung BKO
Konsumsi OT yang tidak mengandung BKO

Bila menggunakan OT dan obat kimia agar

tidak bersamaan, terpisah waktunya


dengan selang 2 jam

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