LBM 4 Herbal

7/25/2019 LBM 4 Herbal

1/24

LBM 4 FARMAKOTERAPI

Mengatasi Tekanan Darah Tinggi dengan Herbal

STEP 1

STEP

1! "elaskan #engenai standar $ela%anan #edi& herbal '! A$a kand(ngan ki#ia dari seledri) k(#is k(&ing)dan #eniran'

bagai#ana #ekanis#e terhada$ hi$ertensi'*! A$a sa+a khasiat dari k(#is k(&ing) seledri) #eniran'4! Seb(tkan taks,n,#i dari k(#is k(&ing) seledri) #eniran'-! A$a sa+a tana#an %ang da$at #en(r(nkan tekanan darah

tinggi selain k(#is k(&ing) seledri) #eniran'.! Hal/hal a$a sa+a %ang har(s di$erhatikan d,kter (nt(k

#e#berian tera$i k,#binasi herbal'

0! A$a s%arat #en+adi d,kter herbal tera$is #edi&'! Bagai#ana langkah dala# tindakan $ela%anan #edi& herbal'2! A$a sa+a tana#an %ang b,leh direse$kan dala# $eng,batan

herbal'

STEP *

1! Seb(tkan taks,n,#i dari k(#is k(&ing) seledri) #eniran'Jawab :

A! Seledri (Apium graviolans)Kingdom : plantae

Sub kingdom : tracheobrontaDivisi : spermatophytaSubdivis : magnophytaKelas :magnolipsidaOrdo : apialesFamily : apraceaeGenus : apiumSpecies :Apium graviolens

B. Meniran (Pylanthus niruri)

Kingdom : plantae

Subkingdom: traceobronta

Divisi : spermatophyte

Kelas : rocidae

Kelas: rocidae


2/24

Family : euphurbraceae

Genus: phylanthus

Species : phylantus ninuri

C. Kumis kucing (Ortoshypon st)LE3KAPI55

! A$a sa+a khasiat dari k(#is k(&ing) seledri) #eniran'"A6AB7

A Seledri 7di daun ada:Apium graveolens

(Family: Apiaceae; Common name: Celery). According to Chinese theory,

Celery is effective for HTN eca!se it acts !pon the liver; one type of HTN is

associated "ith liver. #n $ainland China, celery "as !sef!l in red!cing HTN

in %& of %' patients. The !ice "as mied "ith e*!al amo!nt of honey and

ao!t + o!nces "ere taen orally three times each day for !p to one "ee.-/0

#t has also een reported to red!ce systolic and diastolic 12. The difference of

12 in h!man eings efore and after treatment has een fo!nd to e

significant (P3/./4), indicating that seeds ofA. graveolenscan e !sed as a

safe and effective treatment of high 12.-%0 Fresh celery !ice can e mied

"ith vinegar to relieve di55iness and headache and sho!lder pain associated

"ith HTN. #t is also administered in HTN associated "ith pregnancy and

climacteric.-640

2hytochemical analysis of the A. graveolensdemonstrated the presence of flavonoids

apigenin, l!teolin and *!ercentin (%67%4). The

compo!nd of celery apigenin have een st!died

for their effect on lood vessels, "here "ere

fo!nd to prod!ce vasodilatatory effect (%'7%+).

Flavonoids from other plants may ehiit

hypotensive, cariodepressant and vasodilatatory

activities. #n an eperiment in isolated rat

vasc!lar smooth m!scle, 8!arte et al. (%9) fo!ndthat the contractile responses ind!ced y high

Cl and Ca6 "ere inhiited y *!ercetin in a

concentration7dependent manner. The presence

of s!ch compo!nds in A. graveolens might

possily contri!te to hypotensive, negative

inotropic and chronotropic effects of the celery
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref30http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref31http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref31http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref30


3/24

etracts.

ana iti=, $irana ?adenovi=,

)enghambat pengeluaran aldosteronvolume darah berkurang


4/24

Flavonoidseperti A$%*

+oli,enolantioksidan' mencegah aterosklerosis

)ethylripariocromen &)-$( menyebabkan vasodilatasi

penurunan denyut !antung' e,ek diuretic

.ntuk hipertensi dera!at ringan/moderat

8! Meniran0ipophylantin dan phylantin sebagai

hepatoprotector&melindungi hepar dari 1at toksisk'

memperbaiki !aringan hepar(' menghambat D2A

polymerase&en1im yg dibutuhkan virus hepatitis 3 untuk

berkembang( )engatasi penyakit kuning' kencing batu' *SK4

diuretic' sakit perut' batuk' sakit gigi' gonorhe3agian yang digunakan : daun dan akar

Bagai#ana e9ek dan kand(ngan #eniran %ang ber#an9aatsebagai $en(r(n tekanan darah' A$akah han%a bersi9at

di(reti& sa+a' bagai#ana #ekanis#en%a 'E9ek sinergis#e' Interaksi ,bat' Bent(k sediaan'&ara

$engg(naan'd,sis'e9ek sa#$ing'k,ntraindikasi'

*! A$a s%arat #en+adi d,kter herbal tera$is #edi&'"a:ab 7

S5+5 ' dikeluarkan oleh dinkes kabupaten

S*+5 &surat i!in pengobatan tradisional(

6ang bisa pengobatan herbal : dokter' dokter gigi' dokterspesialis

Kursusnya dilaksanakan di -Skelas A' 3' $' D dan puskesmas

Dalam pelaksanaan' bila meracik obat sendiri harus didampingi

asisten apoteker

+engetahuan mengani tanaman obat' ketrampilan meracik'

perilaku' mendapat kewenangan dari organisasi himpunan

kedokteran *ndonesia untuk pengobatan herbal

4! "elaskan #engenai standar $ela%anan #edi& herbal '

Ke$#enkes RI n, 11 Tah(n ;;


5/24

-! Hal/hal a$a sa+a %ang har(s di$erhatikan d,kter (nt(k

#e#berian tera$i k,#binasi herbal'2?AT?AN 2$?#NTAH ?21# #N8BN


6/24

2asal 6'

(%) 2enyehat tradisional dan tenaga esehatan tradisional hanya dapat memerian

lienJpasien er!pa:

a. Bat Tradisional yang diprod!si oleh ind!striJ!saha Bat Tradisional yang s!dah eri5inserta memilii nomor i5in edar ses!ai dengan etent!an perat!ran per!ndang!ndangan;

danJata!

. Bat Tradisional racian sendiri ses!ai dengan etent!an perat!ran per!ndang7!ndangan.

(6)


7/24

0! A$a sa+a tana#an %ang da$at #en(r(nkan tekanan darah

tinggi selain k(#is k(&ing) seledri) #eniran'

Pharmacogn Rev. 2011 Jan-Jun; 5(9): 3040.

doi: 10.410309!3-!"4!.!909!

P#$%&: P#$321000'

Role of natural herbs in the treatment of hypertension

ahida a*a++umand ,ero hmad

u/hor inorma/ion r/ice no/e+ $origh/ and icen+e inorma/ion

hi+ ar/ice ha+ *eenci/ed *o/her ar/ice+ in P#$.

Abstract

6o /o:

INTRODUCTION

Hypertension (HTN) or high lood press!re (12) is a chronic medical condition in "hich the 12

in the arteries is elevated. #t is classified as eitherprimary(essential) or secondary. Ao!t 9/ to

94K of cases are termed primary HTN, "hich refers to high 12 for "hich no medical ca!se can

e fo!nd.-%0 The remaining 4 to %/K of cases, calledsecondaryHTN, are ca!sed y other

conditions that affect the idneys, arteries, heart, or endocrine system.-60

2ersistent HTN is one of the ris factors for stroes, heart attacs, heart fail!re, and arterial

ane!rysm, and is a leading ca!se of chronic idney fail!re.- 0 $oderate elevation of arterial 12

leads to shortened life epectancy. 1oth dietary and lifestyle changes as "ell as medicines can

improve 12 control and decrease the ris of associated health complications.

6o /o:

CLASSIICATION

HTN is !s!ally classified ased on the systolic and diastolic 12s.


8/24

HTN has several s!classifications incl!ding, HTN stage #, HTN stage ##, and isolated systolic

HTN. #solated systolic HTN refers to elevated systolic press!re "ith normal diastolic press!re

and is common in the elderly. These classifications are made after averaging a patientDs resting

12 readings taen on t"o or more office visits. #ndivid!als older than 4/ years are classified as

having HTN if their 12 is consistently at least %&/ mmHg systolic or 9/ mmHg diastolic.2atients "ith 12 s higher than %/J+/ mmHg "ith concomitant presence of diaetes or idney

disease re*!ire f!rther treatment. HTN is also classified as resistant if medications do not red!ce

12 to normal levels.-&0 ercise HTN is an ecessively high elevation in 12 d!ring eercise.-40

The range considered normal for systolic val!es d!ring eercise is et"een 6// and 6/ mmHg.

-'0 ercise HTN may indicate that an individ!al is at ris for developing HTN at rest.-L0

6o /o:

CAUS!S

!ssential "ypertension

ssential HTN is the most prevalent type of HTN, affecting 9/ to 94K of hypertensive patients.

-%0 Altho!gh no direct ca!se has identified itself, there are many factors s!ch as sedentary

lifestyle, stress, visceral oesity, potassi!m deficiency (hypoalemia),-+0 oesity,-90 (more than

+4K of cases occ!r in those "ith a ody mass inde greater than 64),- %/0 salt (sodi!m)

sensitivity,-%%0 alcohol intae,-%60 and vitamin 8 deficiency that increase the ris of developing

HTN.-%0 ?is also increases "ith aging,-%&0 some inherited genetic m!tations,-%40 and having

a family history of HTN.-%'0 An elevation of renin, an en5yme secreted y the idney, is another

ris factor,-%L0 as is sympathetic nervo!s system over activity.-%+0 #ns!lin resistance, "hich is a

component of syndrome M, or the metaolic syndrome, is also tho!ght to contri!te to HTN.

Cons!ming foods that contain high fr!ctose corn syr!p may increase oneDs ris of developing

HTN.-%90

Secon#ary hypertension


9/24

d!ring pregnancy, the congenital defect no"n as coarctation of the aorta, and certain

prescription and illegal dr!gs.

6o /o:

$AT"O$"%SIOLO&%

$ost of the mechanisms associated "ith secondary HTN are generally f!lly !nderstood.

Ho"ever, those associated "ith essential (primary) HTN are far less !nderstood. hat is no"n

is that cardiac o!tp!t is raised early in the disease co!rse, "ith normal total peripheral resistance

(T2?). Bver time, cardiac o!tp!t drops to normal levels, !t T2? is increased. The follo"ing

three theories have een proposed to eplain this:

*nability o, the kidneys to e8crete sodium' resulting in natriuretic ,actors such

as atrial natriuretic ,actor being secreted to promote salt e8cretion with theside e9ect o, raising 5+-

An overactive renin/angiotensin system leads to vasoconstriction and

retention o, sodium and water 5he increase in blood volume leads to 052

#";

An overactive sympathetic nervous system' leading to increased stress

responses##;

*t is also known that 052 is highly heritable and polygenic &caused by more

than one gene( and a ,ew candidate genes have been postulated in the

etiology o, this condition#


10/24

5able "

$onventional medicines used in the treatment o, hypertension

#n the last three decades, a lot of concerted efforts have een channeled into researching into

local plants "ith hypotensive and antihypertensive therape!tic val!es. The hypotensive and

antihypertensive effects of some of these medicinal plants have een validated and others

disproved.

Attempts y the lo"7income gro!p, partic!larly the r!ral d"ellers in the developing co!ntries, to

control HTN and its attendant complications in the face of the scarce socioeconomic reso!rces,

have led more people opting for heral remedy.-6&0 Ho"ever, more scientific research needs to

e done to verify the effectiveness and el!cidate the safety profile of s!ch heral remedies. Thisrevie" provides an introd!ction of the nat!rally occ!rring medicinal plants that have so far een

scientifically st!died and reported to have hypotensive or antihypertensive effects.

Naturally occurring me#icinal plants' herbs having hypotensive(antihypertensive potential

ga/ho+ma *e/uina

(Family: ?!taceae; Common name: 1!ch!). #t is a


11/24

red!ction of +7hydroy767deoyg!anosin, level of nitric oide, and lipid peroidation, and an

increased level of antioidative vitamins (C and ). This st!dy points to the eneficial

cardioprotective action of garlic in essential HTN.-6+0

nnona murica/a

(Family: Annonaceae; Common name: 2ricly C!stard apple).A. muricatais a memer of the

family of c!stard apple trees called Annonaceae and a species of the gen!sAnnona, no"n

mostly for its edile fr!its Annona. The tree gro"s natively in the Cariean and Central

America. The leaf etract of the plant has een reported to lo"er an elevated 12 y decreasing

the peripheral vasc!lar resistance.-690

ium graveoen+

(Family: Apiaceae; Common name: Celery). According to Chinese theory, Celery is effective for

HTN eca!se it acts !pon the liver; one type of HTN is associated "ith liver. #n $ainland China,

celery "as !sef!l in red!cing HTN in %& of %' patients. The !ice "as mied "ith e*!al amo!nt

of honey and ao!t + o!nces "ere taen orally three times each day for !p to one "ee.- /0 #t

has also een reported to red!ce systolic and diastolic 12. The difference of 12 in h!man eings

efore and after treatment has een fo!nd to e significant (P3/./4), indicating that seeds ofA.

graveolenscan e !sed as a safe and effective treatment of high 12.-%0 Fresh celery !ice can e

mied "ith vinegar to relieve di55iness and headache and sho!lder pain associated "ith HTN. #t

is also administered in HTN associated "ith pregnancy and climacteric.-640

ri+/oochia man+hurien+i+

(Family: Aristolochiaceae; Common name: !an $! Tong). This Chinese plant is eing !sed as

a di!retic and antiphlogistic for the treatment of edema and rhe!matic pain. The etract of this

plant has een reported to contain aristolochic acid, aristoloside, magnoflorine, oleanolic acid,

hederagenin, and tannins. $agnoflorine has een fo!nd to possess hypotensive properties.-60

r/ocaru+ a/ii+

(Family: $oraceae; Common name: 1readfr!it). The plant is native to the $alay 2enins!la and

"estern 2acific islands. A st!dy has sho"n that the leaf etract of the plant decreased the tension

of phenylephrine7stim!lated isolated g!inea pig aorta rings y %4 to 4K.-690

vena +a/iva

(Family: 2oaceaeJramineae; Common names: 8ietary Fier, reen Bat). A diet containing

sol!le fier7rich "hole oats can significantly red!ce the need for antihypertensive medication
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref28http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref29http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref30http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref31http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref32http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref29http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref28http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref29http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref30http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref31http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref32http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref29


12/24

and improve 12 control. Considering the lipid and gl!cose improvements as "ell, increased

cons!mption of "hole oats may significantly red!ce cardiovasc!lar disease ris.-0 The

addition of oat cereals to the normal diet of patients "ith HTN has een fo!nd to significantly

red!ce oth systolic and diastolic 12.


13/24

decrease in H? at the higher doses (%/ and / mgJg). ?epeated inections of the same dose of

the cr!de etract have een seen to prod!ce tachyphylais. A s!stained fall in 12 of anestheti5ed

animals and "ea antiacetylcholine effect has een reported.-+0

$a++ia occiden/ai+

(Family: Caesalpiniaceae; Common name: Coffee "eed). #t is a small tree gro"ing 4 to + m in

height. The leaf of this plant is !sed in local fol medicine as an antihypertensive agent. In

vitro st!dies of the leaf etract have sho"n a relaant effect on the aortic rings. The st!dies

revealed that cassia etract may e relaing smooth m!scle and red!cing 12 y inhiiting

Ca6infl! thro!gh receptor7operated channel and voltage7sensitive channel, sho"ing its

nonselectivity on these Ca6channels.-90

$a+/ano+ermum au+/rae

(Family: Faaceae; Common name: 1lac ean). Cr!de etract of C. australehas een reported

to ca!se a fall in systolic as "ell as diastolic 12 in a dose7dependent manner (%7%// mgJg). This

fall in 12 has een attri!ted to the saponin fraction and medicogenic acid gl!coside present in

the cr!de etract.-&/0

$oeu+ or+8ohii

(Family: amiaceae; Common name: arp!rvali). The pharmacological properties of coleonol, a

diterpene, isolated from C. forskohlii, have een investigated. #ts predominant effect has een to

lo"er the 12 of anestheti5ed cat and rat as "ell as of the spontaneo!sly hypertensive rat d!e torelaation of the vasc!lar smooth m!scle. #n small doses, it has a positive inotropic effect on

isolated rait heart as "ell as on cat heart in vivo. Coleonol also ehiits nonspecific

spasmolytic activity on smooth m!scle of the gastrointestinal tract in vario!s species, !t not on

ronchial m!sc!lat!re of g!inea pig. arge doses of coleonol have a depressant action on the

central nervo!s system.-&%0

$ommeina virginica

(Family: Commelinaceae; Common name: @irginia dayflo"er). #t is a perennial heraceo!s plant

in the dayflo"er family. #t is native to the mideastern and so!theastern nited


14/24

(Family: ?osaceae; Common name: Chinese Ha"thorn). #t has een !sed in China as a decoction

for treatment of HTN for tho!sands of years. 2harmacological and clinical trials have sho"n that

it lo"ers 12. The t"o main s!stances that contri!te to ha"thornDs eneficial effects on heart

are flavonoids and oligomeric procyanidins, "hich are potent antioidant agents.

?hynchophylline, an alaloid in catDs cla", has demonstrated an aility to inhiit plateletaggregation and thromosis, "hich s!ggests that it may e !sef!l in preventing stroes and

red!cing the ris of heart attac y lo"ering 12, increasing circ!lation, and inhiiting oth the

formation of pla*!e on arterial "alls and formation of lood clots in the rain, heart, and arteries.

-&60 #n eperiments "ith anestheti5ed raits, intraveno!s administration of the etract

preparation lo"ered the 12 for !p to ho!rs.-&0 rataegic acid "as identified as the

hypotensive principle. $echanisms of action of Crataeguspost!lated to date reveal a remedy

"ith potentially road7ased infl!ence on the cardiovasc!lar system. These effects incl!de a

hypotensive activity thro!gh vasorelaation res!lting from nitro!s oide stim!lation,-&&0

significant antioidant activity, and a tonic action on cardiac myocytes.-&40

$rinum gaucum

(Family: Amaryllidaceae; Common name: ?iver ily,


15/24

locade of calci!m channels, and this effect may e responsile for the 127lo"ering effect of

the compo!nds oserved in the in vivost!dies.-&+0 T"o ne" g!aiane7type ses*!iterpene

terpenoids containing an interesting epoy !nit, da!c!side and da!c!sol, have een isolated from

fr!its ofD. carota.-&90

&e+modium +/racioium

(Family: eg!minosae; Common name: Bsec). 2reparations from the dry leaves and stem of

the plant inected intraveno!sly into anestheti5ed dogs increased coronary circ!lation, lo"ered

arterial 12, slo"ed H?, and decreased the oygen cons!mption of the heart.-&0 The

cardiovasc!lar pharmacology of a*!eo!s etracts ofD. styracifolium(8


16/24

delayedJirreg!lar menstr!ation.-690

i*i+cu+ +a*daria

(Family: $alvaceae; Common name: ?oselle). This happens to e one of the most etensively

st!died plants for antihypertensive properties. The leaves, caly, and corolla of this plant are

!sed traditionally in many est African co!ntries for vario!s medicinal p!rposes and as ediles.

The antihypertensive effect of this plant etract has een vario!sly st!died. Bne st!dy reported

the antihypertensive effect of caly of H


17/24

The standard daily dose for. latifoliumin man "as to 4 gJday in the form of tea, "hich is

e*!ivalent to & to L% mgJg ody "eight in a L/ g s!ect.-'/0

inum u+i/a/i++imum

(Family: inaceae; Common name: inseed, Flaseed). #t is an ann!al her elieved to have

originated in gypt. inseed and its oil are rich in Q7linolenic acid, an essential fatty acid that

appears to e eneficial for the heart diseases, inflammatory o"el disease, arthritis, and other

health prolems. Q7linolenic acid elongs to a gro!p of s!stances called omega7 fatty acids.


18/24

(Family: $oringaceae; Common name: $!r!ngai). #n anestheti5ed rats, the cr!de etract of the

leaves of!. oleifera ca!sed a fall in systolic, diastolic, and mean 12 in a dose7dependent

manner. The antihypertensive effect "as rief, ret!rning to normal "ithin t"o min!tes. H? "as

not affected significantly, ecept at high doses ( and %/ mgJg), "hich prod!ced a small degree

of radycardia. #t "as also estalished that thiocaramate and isothiocyanate fractions of thecr!de etract "ere responsile for the antihypertensive activity.-'40

#u+anga cecroiode+

(Family: Cecropiaceae; Common name: mrella tree, Cor ood). #t is a rapidly gro"ing plant

!i*!ito!s to the tropical rain forests, partic!larly of est Africa. The ethanol etract of the plant

stem ar has een reported to have antidiarrheal activity.-''0


19/24

in mean diastolic, systolic, and mean arterial press!re of &9.L R L.9, &4.4 R 9.4, and &+.// R '.4

mmHg, respectively. The etract prod!ced greater depressant effect on the diastolic 12 than the

systolic 12.-L%0

Pinu+ ina+/er

(Family: 2inaceae; Common name: $aritime 2ine).Pycnogenolis an etract from French

maritime pine ar. #t is most commonly no"n as a treatment for veno!s ins!fficiency and

other vasc!lar conditions. 1!t it is eing st!died for a long list of other conditions, incl!ding

HTN. 2reliminary clinical research sho"s that pycnogenol 6// mgJday can modestly lo"er 12

in people "ith mild HTN. #t has een reported to act y inhiiting angiotensin7converting

en5ymes.-L60

Pueraria o*a/a

(Family: Faaceae; Common name: !d5!). The dry root of this plant is officially listed and

!sed in China as a m!scle relaant, antipyretic, and for the treatment of dysentery and HTN.- L0

The total isoflavones, from the ethanol etract of roots, have sho"n hypotensive effect on

anestheti5ed dogs and !nanestheti5ed hypertensive dogs.-L&0 The isoflavone7p!erarin, "hen

administered intraveno!sly at a dose range of %// to 6// mg, in clinical trials to patients

s!ffering from HTN or angina pectoris, sho"ed a decrease in lood catecholamine levels, 12,

and H?.-L40

Punica grana/um

(Family: ythraceae; Common name: 2omegranate). 2omegranate !ice is ecoming a more

pop!lar fr!it drin. ?esearch sho"s that pomegranate red!ces the activity of angiotensin

converting en5ymes (AC) y ao!t 'K. Clinical research reveals contradictory res!lts. Bne

st!dy sho"s modest red!ction in systolic 12 after drining 4/ mlJday of pomegranate !ice for a

year. Another st!dy sho"s no enefit after drining 6&/ mlJday of the !ice for months.-L'0

Rahanu+ +a/ivu+

(Family: Cr!ciferae; Common name: ?adish): The plant has een fo!nd to have antihypertensive

activity. #solated tiss!e preparations "ere s!spended in tiss!e aths containing res sol!tion,

"hile ac!te toicity st!dy "as performed in mice for 6& ho!rs. The etract ca!sed a dose7

dependent (/.%7 mgJg) fall in 12 and H? of rats that "as mediated thro!gh an atropine7

sensitive path"ay. #n isolated g!inea7pig atria, it sho"ed dose7dependent (/./7./ mgJml)

inhiition of force and rate of contractions. #n the atropine7treated tiss!es, the inhiitory effect

"as aolished and a cardiac stim!lant effect "as !nmased, "hich "as resistant to adrenergic
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref71http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref72http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref73http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref74http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref75http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref76http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref71http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref72http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref73http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref74http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref75http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/#ref76


20/24

and serotonergic receptor locade. #n the endotheli!m7intact rat aorta, it inhiited

phenylephrine7ind!ced contractions, "hich "as loced y atropine. The etract "as safe in

mice !p to the dose of %/ gJg. The st!dy sho"ed that the cardiovasc!lar inhiitory effects of the

plant are mediated thro!gh activation of m!scarinic receptors, th!s possily !stifying its !se in

HTN.-LL0

Rau


21/24

peroidase, s!peroidase dism!tase, and catalase activities. These res!lts s!pport the hypothesis

that sesame oil cons!mption may help to enhance antioidant defense system in h!man eings.

The investigators s!ggested that sesamin is a !sef!l prophylactic treatment in HTN and

cardiovasc!lar hypertrophy.-+/0

=oanum +i+m*riioium

(Family:


22/24

>ncaria rhnchoha

(Family: ?!iaceae; Common name: CatDs Cla" her). #n traditional oriental medicine, &.

rhynchophyllahas een !sed to lo"er 12 and to relieve vario!s ne!rological symptoms. The

hypotensive activity has een attri!ted to an indole alaloid called hirsutine, "hich has een

fo!nd to act at the Ca6channels.-L%0 The effects of hirs!tine on cytosolic Ca6level (-Ca60cyt)

"ere st!died y !sing f!ra767 Ca6fl!orescence in smooth m!scle of the isolated rat aorta.

Noradrenaline and high sol!tion prod!ced a s!stained increase in -Ca60cyt. Application of

hirs!tine after the increases in -Ca60cyt ind!ced y noradrenaline and high notaly

decreased -Ca60cyt, s!ggesting that hirs!tine inhiits Ca6 infl! mainly thro!gh a voltage7

dependent Ca6channel. F!rthermore, the effect of hirs!tine on intracell!lar Ca6store "as

st!died y !sing contractile responses to caffeine !nder the Ca67free n!trient condition in the rat

aorta. hen hirs!tine "as added at / P$ efore caffeine treatment, the agent slightly !t

significantly red!ced the caffeine7ind!ced contraction. hen added d!ring Ca6loading,

hirs!tine definitely a!gmented the contractile response to caffeine. These res!lts s!ggest that

hirs!tine inhiits Ca6release from the Ca6store and increases Ca6!ptae into the Ca6store,

leading to a red!ction of intracell!lar Ca6level. #t is concl!ded that hirs!tine red!ces

intracell!lar Ca6level thro!gh its effect on the Ca6store as "ell as thro!gh its effect on the

voltage7dependent Ca6channel.-+40

A methanol etract of the hoos of an &ncariaspecies "as fo!nd to have a potent and long7

lasting hypotensive effect in rats and the activity "as different from that of &. rhynchophyllaand

its analog!e. F!rther st!dies of the etract res!lted in the isolation of 7indole alaloid,

glycoside, cadamine, dihydrocadamine, and isodihydrocadamine. The latter t"o "ere fo!ndto e the hypotensive principles, "hereas cadamine "as inactive.-+'0

?i+cum a*um

(Family:


23/24

increase in 12 in the N$T. The res!lts s!ggested that the mistletoe etract prod!ces

antihypertensive effect "itho!t alteration in H?, possily involving sympathetic mechanism.-++0

?i/e doniana

(Family: @erenaceae; Common name: 1lac pl!m). adei et al. investigated the effect of oral

administration of the etract of this plant on 12 of rats. The etract "as fo!nd to eert

hypotensive effect. 1oth the systolic and diastolic 12s "ere significantly red!ced "ithin &4 min

after oral administration of the etract. The 12 egan to ret!rn to normal after 6 ho!rs.-+90

@ingi*er oicinae

(Family: Uingieraceae; Common name: inger). inger root is commonly !sed in Asian

cooing. #t acts to improve lood circ!lation and relaes m!scles s!rro!nding lood vessels. The

cr!de etract of ginger (Uo.Cr) ind!ced a dose7dependent (/.7 mgJg) fall in the arterial 12 of

anestheti5ed rats. #n g!inea pig paired atria, Uo.Cr ehiited a cardiodepressant activity on the

rate and force of spontaneo!s contractions. #n rait thoracic aorta preparation, Uo.Cr relaed the

phenyl ephrine7ind!ced vasc!lar contraction at a dose ten times higher than that re*!ired against

(+/ m$)7ind!ced contraction. Ca6channel7locing activity "as confirmed "hen Uo.Cr

shifted the Ca6dose7response c!rves to the right, similar to the effect of verapamil. These data

indicate that the 127lo"ering effect of ginger is mediated thro!gh locade of voltage7dependent

calci!m channels.-9/0 Chronic administration of 2et ether etract (2) (4/ mgJgJday; po),

tol!ene fraction (%/ mgJgJday; po) of ginger rhi5ome, and orean ginseng etract () (/

mgJgJday; po) significantly red!ced the 12 in deoycorticosterone acetate salt7ind!ced

hypertensive rats, "hereas 2 (4/ mgJgJday; po) and (/ mgJgJday; po) red!ced the 12

in fr!ctose7ind!ced hypertensive rats. The mechanism of action may partly involve the

serotonergic antagonistic property.-9%0 H!man trials for hypotensive effect of ginger have een

fe" and generally !sed a lo" dose "ith inconcl!sive res!lts.-960

Nahida Taass!mand Fero5 Ahmad, ?ole of nat!ral hers in the treatment of hypertension,6/%%,pharmacognosy revie(.

! A$a sa+a tana#an %ang b,leh direse$kan dala# $eng,batan

herbal'

Jawab : menurut kepmenkes no "#"' terdapat


24/24

/ *ler/ Jahe/ Ke!i beling/ Kumis kucing/ Kunyit

/ Jombang/ >engkuas/ >idah buaya/ mahkota dewa/ )engkudu/ )eniran/ )imba/ +are/ +egagan/ +icisan/ rumput mutiara

/ daun saga/ sambiloto/ sambung nyawa/ sidaguri/ tempuyung/ temulawak

STEP 4

Documents

LBM 4 Herbal