FITOTERAPI

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Daftar isi

1. SIMPLISIA :JINTEN HITAM....................................................................................................................1

2. SIMPLISIA :TAPAK DARA......................................................................................................................4

3. SIMPLISIA :KUMIS KUCING...................................................................................................................7

4. SIMPLISIA : BENGLE.............................................................................................................................9

5. SIMPLISIA : SAMBILOTO.....................................................................................................................11

6. SIMPLISIA : KUNYIT............................................................................................................................13

7. SIMPLISIA : MENIRAN........................................................................................................................14

8. SIMPLISIA : LIDAH BUAYA..................................................................................................................16

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1. SIMPLISIA :JINTEN HITAM NAMA ILMIAH : N. sativaKEGUNAAN : ANTI KOLESTEROL

Fitoterapi

No Skenario Kunci ( Pustaka)

1 Tuan Aziz , seorang apoteker sebuah IOTmengeluh sakit kepala dan leher terasa tegang seperti ditarik. Setelah melakukan cek darah di lab klinik ternyata kadar total kolesterolnya 269 mg/dL. Lina, sahabat tuan Azis menyarankan untuk mengkonsumsi kapsul habatussauda.

KANDUNGAN kimia ( Umum) ;

N. sativa seeds contain 36%–38% fixed oils, proteins, alkaloids, saponin and 0.4%–2.5% essential oil (Lautenbucher, 1997). The fixed oil is composed mainly of unsaturated fatty acids, including the unusual C20:2 arachidic and eicosadienoic acids (Houghton et al., 1995). The essential oil was analysed by Burits and Bucar (2000) using GC-MS. Many components were characterized, but the major ones were thymoquinone (Fig. 1.1) (1) (27.8%–57.0%), ρ-cymene (7.1%–15.5%), carvacrol (5.8%–11.6%), t-anethole (0.25%–2.3%), 4-terpineol (2.0%–6.6%) and longifoline (1.0%–8.0%). Thymoquinone readily dimerizes to form dithymoquinone (El-Dakhakhny, 1963). Four alkaloids have been reported as constituents of N. sativa seeds.

(B. H. Ali1 and Gerald Blunden2 *,, Pharmacological and Toxicological Properties of Nigella sativa, review article, Phytother. Res. 17, 299–305 (2003))

Zat aktif yang bertanggung jawab (aktifitas farmakologi, farmakoterapi, struktur :

timoquinone

Mekanisme :

TQRF and TQ effectively improved the plasma and liver antioxidant capacity and enhanced the expression of liver antioxidant genes of

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ypercholesterolemic rats.

via reduction in hepatic HMG-CoA reductase activity as well as antioxidant mechanisms.

(Maznah Ismail; Ghanya Al-Naqeep; Chan KimWei,2010, Nigella sativa thymoquinone-rich fraction greatly improves plasma antioxidant capacity and expression of antioxidant genes in hypercholesterolemic rats., Free Radical Biology & Medicine  Vol. 48 No. 5 pp. 664-672)

Interaksi, ES :

Sinergis dg simvastatin (sama-sama menghambat HMGCoA)

Toksisitas : relatif tdk toksik

To determine their LD50, the aqueous, methanol and chloroform extracts were administered orally, in 4 different doses, 6, 9, 14 and 21 g/kg. Mortality rate and weight changes have also been measured in all groups for 3 and 7 days, respectively. No mortality has been observed in all groups and with all doses.

(N. Vahdati-Mashhadian, H. Rakhshandeh, A. Omidi,, An investigation on LD50 and subacute hepatic toxicity of Nigella sativa seed extracts in mice, Pharmazie 60: 544–547 (2005))

The acute toxicity of Nigella sativa fixed oil was investigated in mice. LD50 values, obtained by single doses, orally and intraperitoneally administered in mice, were 28.8 ml/kg body wt. p.o. [26.2-31.6] and 2.06 ml/kg body wt. i.p. [1.86-2.26], respectively. Chronic toxicity was studied in rats treated daily with an oral dose of 2 ml/kg body wt. for 12 weeks.

(Zaoui A1, Cherrah Y, Mahassini N, Alaoui K, Amarouch H, Hassar M, Acute and chronic toxicity of Nigella sativa fixed oil., Phytomedicine. 2002 Jan;9(1):69-74 )

Dosis : Each N sativa capsule contained 500 +/- 10 mg N. sativa crushed seeds, and patients had to take 2 g N. sativa per day for 4 weeks.

(Sabzghabaee AM1, Dianatkhah M, Sarrafzadegan N, Asgary S, Ghannadi A, Clinical evaluation of Nigella sativa seeds for the treatment of hyperlipidemia: a randomized, placebo

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controlled clinical trial, Med Arch. 2012;66(3):198-200)

Standarisasi :

Hasil uji parameter non spesifik menunjukkan kadar air (21,64% ± 0,02), kadar abu ekstrak (3,97% ± 0,01) dan kadar abu yang tidak larut dalam asam (1,21 % ± 0,012), serta bobot jenis ekstrak (1,315 ± 0,001). Hasil pengujian cemaran mikroba pada angka lempeng total tidak diperoleh adanya mikroba, sedangkan pada kapang dan khamir (9,31 x 102koloni/g), hasil pada pengujian aflatoksin (526 μg/kg) dan pada pengujian logam arsen (4,2034 μg/kg), timbal (0,824 mg/kg), dan kadmium (0,049 mg/kg). Dalam pengujian parameter spesifik menunjukkan organoleptik ekstrak (bentuk ekstrak kental, berwarna coklat, bau aromatis dan memiliki rasa pahit agak pedas), dengan kandungan senyawa larut dalam air (64,16% ± 0,14) dan larut dalam etanol (46,98 % ± 0,03). Hasil profil kandungan timoquinon sebagai senyawa marker sejumlah 0,2775 %

Kandungan Thymoquinone dalam minyak biji jinten hitam adalah 57,78% Anwar dkk, A review of medicinal uses and pharmacological activities of Nigella sativa.

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2. SIMPLISIA :TAPAK DARANAMA ILMIAH : KEGUNAAN : ANTI KANKER

No

Skenario Kunci ( Pustaka)

1 Seorang ibu berumur 69 tahun menderita CML (Chronic myelogenous leukemia) sehingga diberi cytodrox. Secara mandiri Ibu tersebut mengonsumsi seduhan simplisia mahkota bunga tapak dara secara rutin.

KANDUNGAN kimia ( Umum) : ALkaloid

Zat aktif yang bertanggung jawab (aktifitas farmakologi, farmakoterapi, struktur : Vinealeukoblastine (VLB)

Gambar 1. Struktur VLBMekanisme : Mekanisme kerja :

Gambar 2. Bone marrow

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Gambar 3. Ikatan tubulin dengan VLB

Vinblastin berikatan pada tubulin dan menghambat formasi mikrotubula, kemudian menahan sel pada fase metafase dengan cara mengganggu spindel mitotik, spesifik untuk fase M dan S.Interaksi: obat-obat atau makanan dan minuman yang bersifat asam.

ES :1. Mual, muntah biasanya moderat dan terjadi pada 24 jam pertama.2. Neuropati perifer.3. Sembelit dapat terjadi pada 1-3 hari setelah pemberian kadang

disertai kram perut.4. Sistem pencernaan terganggu: sembelit dan diare5. Rambut rontok pada 2-3 minggu setelah pengobatan6. Depresi7. Tekanan darah tinggi

Efek samping dalam leaflet:Leukopenia, gangguan gastrointestinal (saluran cerna), efek neurologi, reaksi kulit, alopesia, kardiotoksik iskemik, sindroma SIADH.Toksisitas : sel darah putih jumlahnya menurun sehingga memperbesar kemungkinan infeksiDosis :Hanya secara suntikan intra vena. Dosis dengan interval mingguan. Untuk dewasa dosis 1: 3,7 mg/m2, dapat ditingkatkan jadi 11,1 mg/m2 pada dosis ke-5. Maksimal 18,5 mg/m2. Anak dosis 1: 2,5 mg/m2 ditingkatkan jadi 7,5 mg/m2 pada dosis ke-5 maksimal 12,5 mg/m2. Dosis jangan ditingkatkan setelah terjadi pengurangan jumlah sel darah putih (3000/mm3). Dosis pemeliharaan: 1 dosis lebih tinggi dari dosis yang menyebabkan leukopeni.Standarisasi :

Extraction of theCatharanthus AlkaloidsAs with any single plant constituent, the extractionof an alkaloid is an individual problem. Whileseveral standard techniques existed for preliminaryextraction of crude plant materials and subsequentseparation and purification of individual alkaloids,none of these were applicable to the specific alkaloids

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of C. roseus. Consequently, a new techniqueof “selective” or “differential” extraction had to bedevised (app. I) (36).This technique differed from the classical approachin that a measure of purification was effectedduring extraction by forming salts of thestronger bases in the crude drug on addition of anaqueous solution of a naturally occurring weak organicacid.Final purification of most of the alkaloids:was accomplished by column chromatographyon Alcoa F-20 alumina which was partly deactivatedwith 10 percent acetic acid. This method- ology was responsible for the isolation of leurosineand VLB sulfate in a single purification step.The major thrust of the Lilly investigation, however,centered around the early observation thatcertain fractions produced an unusually high percentageof laboratory cures. Neither leurosine norVLB, nor any therapeutic combination thereof, wasresponsible for these cures. Eventually a gradientpH technique was devised which yielded leurocristine*and leurosidine, * * the two alkaloids responsiblefor the observed cures (35). Use of selective or differential extraction, coupledwith column chromatography and the gradient pHtechnique, has resulted in the reported isolation of55 new alkaloids in our laboratories and threeothers which were codiscovered by other investigators.To date, 74 alkaloids, three of which wehave never encountered, have been reported as havingbeen isolated from mature plants of C. roseus.In addition, studies related to alkaloid biosynthesisinvolving immature plants have yielded knownmonomeric alkaloids, derivatives thereof, and glycosides.A total of 95 distinct alkaloidal entitieshave been isolated from this plant (app. II-VII).

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3. SIMPLISIA :KUMIS KUCING NAMA ILMIAH :Orthosiphon aristatus (BL) Miq

KEGUNAAN : ANTI HIPERTENSI

FITO TERAPI (Daun Kumis Kucing sebagai Antihipertensi)

SKENARIO KUNCI

Bu Yuni usia 55 tahun sering mengeluh sulit tidur. Setelah periksa ke dokter dan diukur tensinya ternyata tekanan darahnya 180/100 mmHg. Dokter yang memeriksanya memberikan resep yang berisi Nifedipin. Tensi Bu Yuni sering naik terutama apabila kondisi capek, sehingga Bu Yuni ingin mengkonsumsi obat herbal saja. Bu yuni kemudian datang ke apotek untuk berkonsultasi dan disarankan minum produk yang berasal dari olahan daun kumis kucing. Bu Yuni ingin tahu lebih banyak tentang tanaman tersebut.

- Tanaman : Kumis kucing / Orthosiphon aristatus (BL) Miq

- Zat aktif : daun mengandung 0,2% flavonoid lipofil dengan kandungan utama sinensetin, eupatorin, skutellarein, tetrametil eter, salvigenin, rhamnazin; glikosida flavonol, turunan asam kafeat (terutama asam rosmarinat dan asam 2,3-dikaffeoil tartarat), metilripariokromen A 6-(7,8-dimetoksi-2,2-dimetil [2H,1-benzopiran]-il), minyak atsiri 0,02-0,06% terdiri dari 60 macam sesquiterpens dan senyawa fenolik, saponin serta garam kalsium (3%) dan myoinositol

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H3CO O

OCH3

O

Metilripariokromen A

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- Zat aktif sebagai antihipertensi : metilripariokromen A

- Mekanisme : antagonis kalsium menurunkan tonus otot polos arteriola sehingga terjadi vasodilatasi pembuluh arteri perifer yang menyebabakan penurunan tekanan darah

- Dosis :1. Daun disajikan sebagai teh : 6–12 g / hari dalam dosis terbagi2. Ekstrak cair : 2 g, 1–2 kali sehari3. Ekstrak kering (5-7 : 1) : 360 mg, 3–4 kali sehari4. Ekstrak kering (8-12 : 1) : 200–400 mg, 3 kali sehari5. Ekstrak kering (7-8 : 1) : 280 mg, 3 kali sehari

- Interaksi : -

- Efek samping : Efek samping : reaksi hipersensitifitas, fever, dysuria, spasme, blood in the urine occur.

- Kontra indikasi :1. Anak-anak & anak remaja < 18 tahun2. Pasien oedem dengan riwayat penyakit hati dan ginjal- Toksisitas : hasil penelitian toksisitas akut, sub akut & kronik : aman

- Standardisasi Ekstrak

1. Non spesifik : Kadar air, kadar abu total, kadar abu tidak larut asam2. Spesifik : kadar zat aktif

- Literatur :1. Malaysian Herbal Monograph=http://www.globinmed.com/index.php?option=com_content&view=article&id=101972: orthosiphon-stamineus-benth&Itemid=143#OA172. Matsubara, T., Bohgaki, T., Watarai, M., Suzuki, H., Ohashi, K.,

Shibuya, H., 1999, Antihypertensive of Methyllripariocromene A from Orthosiphon aristatus An Indonesian Traditional Medicinal Plant, Biol. Pharm. Bull., 22 (10), 1083–1088.

3. Ohashi, K., Bohgaki, T., Matsubara, T., Shibuya, H., 2000, Indonesian Traditional Medicinal Plant XXIII, Chemical Structure of Two New Migrated Pimarane-Type Diterpenes Neoorthosiphols A and B and Supresive Effects on Rat Thoracic Aortha Chemical Constituents Isolated from Leaves of from Orthosiphon aristatus (Lamiaceae). Chemical and Pharmaceutical Bulletin. (Tokyo), 48 (3), 433–435.

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4. SIMPLISIA : BENGLE NAMA ILMIAH : Z. cassumnar

KEGUNAAN : IMUNOMODULATOR1. Fitoterapi

No Skenario Kunci ( Pustaka)

1 Ibu Amira mengeluhkan anaknya Amirza (5 tahun) yang sering sakit, hamper setiap bulan dibawa ke dokter. Ibu amira dating ke klinik herbal “Mugi Waras” dan disarankan untuk diberikan bangle untuk meningkatkan daya tahan tubuhnya. Ibu Amira berusaha mencari bukti-bulti ilmiahnya.

KANDUNGAN kimia ( Umum) ;

The Chemical constituents isolated from the extract of the rhizome of Z. cassumnar were cassumunarin A, cassumunarin B, cassumunarin C, terpinen-4ol, alpha and beta-pinene, sabinene, myrcene, terpinene, limonene, p-cymene, terpinolene, phenyl Butanoic dimers, (E)-4-(3’,4’-dimethoxyphenyl)-but-3-en-l-ol.

Almost compounds extracted from Z. cassumnar were monoterpenes which exhibits the least volatility among all constituents, containing many known major components, such as a-pinene, ß-pinene, sabinene, a-terpinene and γ-terpinene. Sabinene and terpinen-4-ol have been reported as the main constituents of all the reported oils (Singh et al, 2015)

Several isolated compounds have been found to possess anti-inflammatory activity, for example, two phenylbutanoids, (E)-4-(3, 4 -dimethoxyphenyl) but-3-en-1-ol; compound D (1) and (E)-4-(3,4 dimethoxyphenyl) but-3-en-1-yl acetate; compound B, three cyclohexene derivatives, namely, cis3-(3 ,4 -dimethoxyphenyl)-4-[(E)-3 ,4 -dimethoxystyryl] cyclohex-1-ene; compound B (3), cis-3-(3 ,4-dimethoxyphenyl)-4-[(E)-2,4,5 -trimethoxystyryl] cyclohex-1-ene; (Koontongkaew et al, 2014)

Zat aktif yang bertanggung jawab (aktifitas farmakologi, farmakoterapi, struktur :Golongan phenilbutenoid: three compounds isolated from Z. cassumunar Roxb rhizome which were, [1] (E)-4(3’,4’-dimethoxyphe-nyl)but-3-en-1-ol), [2] ((E)-4(2’,4’,5’-trimethoxyphenyl)but-3-en-1-ol dan [3] (E)-4(3’,4’,1-trimethoxyphenyl)but-3-en-1-ol) showed the activity as immunostimulant through stimulation mouse macrophage cells (Chairul et al, 2009)

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Mekanisme :Meningkatkan aktivitas fagosistosis makrofag (Chairul et ala, 2009; Elya et al, 2009), meningkatkan produksi NO (Nurmasari et al, 2014)’

Interaksi, ES :

Toksisitas : Uji ketoksikan akut dan kronik menunjukkan bahwa bengle ditoleransi sangat bai. Tidak diperoleh efek yg merugikan. The oral no-observed-adverse-effect level (NOAEL) for the extract was 1,125 mg/kg body weight/day for males and females.these observations show an absence of acute toxicity of Z. cassumunar extract granules at 5000 mg/kg bw. ((Koontongkaew et al, 2014)

Dosis :22,6 mg/ 25g mencit

Standarisasi :Parameter spesifikParameter nonspesifikKandungan aktif distandarkan dg kandungan kurkumin.Cara KLT

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5. SIMPLISIA : SAMBILOTO NAMA ILMIAH : Andrographis paniculata

KEGUNAAN : ASAM URAT1. Fitoterapi

No Skenario Kunci ( Pustaka)

1 Samson (40 th) mengalami sakit pada persendian dan dokter memberikan obat allopurinol. Selain itu, disarankan oleh temannya untuk juga mengkonsumsi obat herbal sambiloto.

KANDUNGAN kimia ( Umum) ; fakultasZat aktif yang bertanggung jawab (aktifitas farmakologi, farmakoterapi, struktur :

Kandungan zat aktif utama pada Andrographis paniculata adalah andrographolide 3-[2-[decahydro-6-hydroxy-5-(hydroxymethyl)- 5,8a-dimethyl-2-methylene-1-naphthalenyl] ethylidine] dihydro-4-hydroxy-2(3H)-furanone (Smith et al ., 1982 )., Zat aktif lain adalah neoandrographolide; paniculide A, B, & C; 14-deoxy-11-oxoandrographolide; and 14-deoxy-11-dehydroandrographolide.

Bobot molekul : 350,4492 g/mol, memiliki tiga penyedia (donor) ikatan hidrogen (atom H pada gugus hidroksi yang terletak pada C-3, C-19 dan C-14), lima penerima ikatan hidrogen (atom O pada gugus hidroksi yang terletak pada C-3, C-19 and C-14, karbonil dan lakton) harga log P 2.9. (Daisy et al ., 2009 )

(Daisy et al ., 2009 )(Smith et al ., 1982 )

Mekanisme :Menurunkan kadar asam uratTable 1Parameters Blood Uric acid

(mg/dl)Group I (Normal) 5.08 + 0.21Group II (induced) 8.28 + 0.54*Group III (Standard drug)

5.95 + 0.21**

Group IV 6.12 + 0.33**

IN-VIVO NEPHROPROTECTIVE POTENTIAL FROM LEAVES EXTRACTS OF ANDROGRAPHIS PANICULATAK. Padmalochana1* and M.S. Dhana Rajan21Department of Biochemistry, Sri

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(Aqueous)Group V (Ethanol) 5.21 + 0.12***Group VI (acetone) 6.36 + 0.13***

* p< 0.05,** p < 0.01,***p < 0.001 value are considered statistically significant (BMRT)

Akilandeswari Womens college, Wandiwash – 604408, TN, India.2Department of Biochemistry, Jaya College of Arts and Science, Thiruninravur,Tamil Nadu, India.

Anti oksidan :During ischemia in the heart (in myocyte mitochondria) conversion of ATP to adenosine causes the generation of O2•-, while in the blood vessels (endothelium) the pathway involved is the transition from xanthine to uric acid.5 Antioxidants are substances that neutralize free radicals or their actions.6

Pharmacophore 2013, Vol. 4 (6), 212-229 USA CODEN: PHARM7 ISSN 2229-5402Pharmacophore(An International Research Journal)Available online at http://www.pharmacophorejournal.com/Review ArticleANDROGRAPHIS PANICULATA AND ITS BIOACTIVE PHYTOCHEMICAL CONSTITUENTS FOR OXIDATIVE DAMAGE: A SYSTEMIC REVIEWShirisha K and Mastan M*School of Herbal Studies and Naturo Sciences, Department of Biotechnology,Dravidian University, Kuppam-517426, Andhra Pradesh, India

Interaksi, ES :Interaksi dengan teofilin dan kafein, menurunkan aktivitas sitokrom P450

Toksisitas :Dosis :

30 mg/kg bb (andrographolide total), 300 mg ekstrak

mengandung 15 % andrographolide (45 mg)

Standarisasi :

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6. SIMPLISIA : KUNYIT NAMA ILMIAH : Curcuma longa

KEGUNAAN : OBESITAS

FITOTERAPI

NO SKENARIO JAWABAN1. Seorang wanita umur

45 tahun dengan tinggi badan 156 cm memiliki berat badan 75 kg. Dia berusaha menurunkan berat badan dengan mengkonsumsi rebusan kunyit. Setelah satu bulan berat badannya turun 2 kg.

Kandungan kimia Curcuma longasenyawaturunanfenolikdarihasilisolasirimpangtanamankunyit (Curcuma longa). Zat ini adalah polifenol dengan rumus kimia C21H20O6. Kurkumin dapat memiliki dua bentuk tautomer: keton dan enol. Struktur keton lebih dominan dalam bentuk padat, sedangkan struktur enol ditemukan dalam bentuk cairan. Senyawainimemilikirumusmolekul 2 gugusvinilguaiacol yang salingdihubungkandenganrantaialfa beta diketon. Sejauh ini senyawa yang paling banyak diisolasi dari kunyit adalah kurkumin (1,7-bis (4’- hidroksi- 3’-metoksifenil)-1,6-heptadiena-3,5-dion).Zat aktif yang bertanggung jawabKurkuminoid terutama kurkuminMekanismeMencegah akumulasi lemakInteraksiTidak mempengaruhi farmakokinetik dari amiodarone (obat antiaritmia)Toksisitas8 g/hari tdk memberikan efekDosis10 mg ekstrak kurkuminStandarisasiMenggunakan metode HPTLC dengan menggunakan silika Gel 60GF254 pada panjang gelombang 425 nm

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7. SIMPLISIA : MENIRAN NAMA ILMIAH :

KEGUNAAN : ANTI DIARE

No Skenario Kunci ( Pustaka)

1 Siska (20 tahun) mengeluh BAB sudah 4 kali dalam sehari, feses encer tidak berlendir maupun berdarah. Untuk mempercepat penyembuhan ibunya menyarankan membeli obat X di warung, tetapi Siska menolak, dia menginginkan obat herbal saja. Oleh ibunya dibuatkan rebusan herba meniran yang banyak tumbuh liar di kebun belakang rumah.

KANDUNGAN kimia ( Umum) ; tannin, flavanoid, queisertin (Gunawan et al, 2008 ; Mangunwardoyo, 2009 ;Maiola et al, 2014)Zat aktif yang bertanggung jawab (aktifitas farmakologi, farmakoterapi, struktur :

Mekanisme :

Aktivitas farmakologi dari tanin terhidrolisis:1. antiinflamasi pada membran mukosa2. drying effect on mukosa membran, menurunkan hipersekresi3. mengurangi bengkak4. Mencegah perdarahan pada luka5. menciutkan lapisan permukaan usus (astringensia).6. binding effect in gut-mengurangi diare dan disentri

Quersetin : dapat merelaksasi otot polos usus dan menghambat kontraksi (antispasmodik) dan antibakteri. Flavonoid dan triterpennya berefek antispamodik, tanin (astringen).

Interaksi, ES : makanan

Toksisitas : sampai dosis 50 mg/kgbb tidak

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mempengaruhi makroskopi maupun mikroskopi hati ( Gugum, 2010)

Dosis : ekstrak etanol dosis 14,9 mg/200 g BB tikus (Sumarny et al, 2013)Bahan aktif sebagai antidiare: Flavonoid dan tanin

Faktor konversi tikus 200 g ke manusia 70 Kg = 56

Dosis manusia = 14,9 x 56 = 834,4 mg/70 kg = 715,2 mg/60 KgBB – 800 mg ekstrak kering

Standarisasi :

Standarisasi Simplisia dan ekstrak : mikroskopik dan makroskopis, kadar air, kadar abu, cemaran mikroba, ALT, cemaran logam, residu pestisida, kadar zat terlarut dalam pelarut tertentu, kadar zat aktif, profil kromatogram dll.

Ekstrak : Organoleptis, TLC (profil kromatografi), kadar quersetin atau tanin.

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8. SIMPLISIA : LIDAH BUAYA NAMA ILMIAH : ALOEVERA

KEGUNAAN : INFLAMASI

1. Fitoterapi

No Skenario Kunci ( Pustaka)

1 IBU SITI tidak sengaja menumpahkan minyak goreng panas dan terkena pada bagian kaki saat melarang putranya yang masih balita bermain di dapur. Pada saat bersamaan, putranya terjatuh dan terkena luka memar pada tangan bagian atas. Saat itu, Ibu siti kehabisan obat luka bakar dan obat gosok anti memar. Atas saran tetangga, disuruh mengoleskan bagian dalam daun lidah buaya yang banyak ditanam pada pekarangan pada bagian kaki dan bagian

KANDUNGAN kimia ( Umum) ; Josias. H. H., 2008

Zat aktif yang bertanggung jawab (aktifitas farmakologi, farmakoterapi, struktur) : (Josias. H. H., 2008)

Many compounds with diverse structures have been isolated from both the central parenchyma tissue of A. vera leaves and the exudate arising from the cells adjacent to the vascular bundles. The bitter yellow exudate contains 1,8 dihydroxyanthraquinone derivatives and their glycosides, which are mainly used for their cathartic effects . The aloe parenchyma tissue or pulp has been shown to contain proteins, lipids, amino acids, vitamins, enzymes, inorganic compounds and small organic compounds in addition to the different carbohydrates. Some evidence of chemotaxonomic variation in the polysaccharide composition of aloes existsThe large fluctuations in polysaccharide composition of A. vera fillet as found in the literature has been explained by the fact that the mannosyl residues are contained in a reserve polysaccharide with a significant seasonal influence, as well as large variations between cultivars in terms of the quantities of mannose-containing polysaccharides within the parenchyma cells.

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tangan.

Mekanisme : (Melanie J.C., 2000)

Anti-Inflammatory and Wound Healing ActivityIn one study (Davis, 1986), subcutaneous injections of A. barbadensis inhibited mustard-induced rat paw edema compared to control (p < 0.01). The effectiveness increased with the use of RNA and vitamin C (p < 0.001). Another study (Vazquez et al., 1996) showed that intraperitoneally administered aloe vera extracts decreased carrageenan-induced rat paw edema and peritoneal neutrophil infiltration in response to carrageenan. It was also shown that aloe vera decreased prostaglandin E2 production. Mice receiving subcutaneous injections with colorized aloe vera gel containing anthraquinones at doses of 1, 10, and 100 mg/kg for 7 d had no reduction in their wound diameter (Davis et al., 1987).However, those receiving the same doses of decolorized (i.e., without

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anthraquinones) aloe vera had a decrease in wound diameter. Rats injected with colorized aloe vera for 12 d also had a decrease in wound diameter. These same authors also noted that polymorphonuclear leukocyte (PMN) infiltration and inflammation are decreased by both colorized and decolorized aloe vera. These observations might be explained by the bradykinase activity of A. aborescens (Fujita et al.,1976). Specifically, aloe contains a carboxypeptidase that is responsible for degrading bradykinase (Fujita et al., 1979). A later study on homogenized fetal calf skin showed that both aloe gel and aloe extract in increasing amounts inhibited the oxidation of arachidonic acid, which suggests inhibition of production of inflammatory prostaglandins (Penneys, 1982). As discussed in section 24.4.4, some aloe constituents to salicylic acid (Robson et al., 1982).A case reported in 1935 involved a woman who developed dermatitis 14 month after roentgen treatment for depilatory purposes (Collins and Collins 1935).The affected area was a 4 cm by 8 cm desquamated area that oozed serous fluid. The patient reported severe itching and burning sensations in the area, and had to wear gloves to bed to prevent scratching.The dermatitis had failed treatment with boric acid, phenol in olive oil, ichthyol, a 5% mercurial ointment, and zinc oxide. She was then treated with fresh whole aloe leaf which ceased the burning and itching and resulted in complete skin healing over a period of 5 wk. Two studies published a few years after this case report supported the observations of Collins and Collins. One investigator demonstrated that 1 g of fresh aloe gel applied for 14 d promoted complete healing in 10 of 28 rats that had received 4000 rads. of x-ray radiation in divided doses. Only 5 rats treated with saline showed marked improvement (Rowe, 1940). A later study found that fresh aloe gel applied twice a day for 3–4 wk improved healing in rats that had received 4000 rads. of x-ray radiation in a single dose. Partially decomposed gel was effective as well, but the fresh rind, aqueous extracts of the dried rind, and an ointment made of dried aloe were not effective. Fresh rind was also used to treat apatient with a chronic x-ray reaction of 7 mo duration, also with negative results (Rowe et al., 1941).Another animal study showed that acemannan wound dressing gel applied to mice that had received 30– 47.5 Gy radiation produced a lower peak skin reaction to the radiation than no treatment, K-Y jelly, or Aquaphor ointment (Roberts and Travis, 1995). It was determined that the wound dressing gel was most effective if treatment began immediately after radiation and was continued for at least 2 wk.However, an ointment consisting of 2 drams of powdered aloe, mineral oil, and white petrolatum applied twice daily to irradiated rats for 3 wk did not result in increased rate of healing. In a phase III study, aloe gel from A. barbadensis was no more effective than placebo in preventing radiation-induced dermatitis in women receiving breast or chest wall irradiation (Williams et al., 1996). This result prompted a study of no treatment vs aloe gel, which also showed no benefit. Allergic reactions to aloe were reported in three patients. Results of animal studies might not be reproduced in humans because the experimentally produced reactions are of the acute type, rather than the chronic reactions

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studied in humans (Rowe et al., 1940).A study in mice exposed to ultraviolet radiation found that aloe vera gel does not act to stimulate DNA repair after exposure nor does it act as a sunscreen; however, it was shown to prevent UV-radiationinduced suppression of immune response for 24 h after sun exposure (Strickland et al., 1994).Aloe vera cream was shown to improve tissue survival by 24% in the experimental rabbit-ear frostbite model (Miller and Koltai, 1995). Combination with systemic pentoxifylline showed 30% improvement.Some hospitals use a protocol for frostbite developed by the University of Chicago Hospitals and Clinics that involves the use of Dermaide Aloe Cream® (70% aloe vera) on blisters every 6 h (McCauley et al., 1990).Carrington Dermal Wound Gel®, described by the authors as "aloe vera gel extract," applied to 10 guinea pigs healed a burn covering approx 30% of the body surface area in an average of 30 d (Rodriguez-Bigas et al., 1988). This was compared to sulfadiazine cream (Silvadene®), salicylic acid, and no treatment, which effected healing in an average of 47, 45, and 50 d, respectively. Only the aloe vera gel extract was significantly (p < 0.02) better than no treatment. A study found concentrated aloe gel (98%) to be ineffective against experimental hydrofluoric acid burns on the hind legs of rats (Bracken et al., 1985).Aloe vera extract 0.5% in a hydrophilic cream was shown to be more effective than placebo in treating psoriasis in a study involving 60 patients (Syed et al., 1996). Twenty-five of the thirty aloe patients compared with two of thirty placebo-treated patients were cured after 4 wk and a higher number of healed plaques were shown with aloe. No adverse effects or hypersensitivity reactions were noted. A study found a that post-dermabrasion wounds healed 3 d faster with aloe vera gel polyethylene oxide dressing vs the same dressing without aloe vera (Fulton, 1990). Burning was reported with the aloe dressing. A later study found a delay in wound healing post-cesarean delivery or laparotomy in patients who received Carrington Dermal Wound Gel® in addition to wet-to-dry dressing using saline and Dakin's solution (0.025% sodium hypochlorite) (Schmidt and Greenspoon, 1991).Interaksi, ES : (Melanie J.C., 2000)

Potential Drug InteractionsWith long-term use hypokalemia due to intestinal potassium loss could occur (Blumenthal, 1998). Thiazide diuretics, corticosteroids, and licorice could exacerbate hypokalemia. The effects of digoxincan be potentiated by hypokalemia.Toksisitas : (Melanie J.C., 2000)

Case Reports of Toxicity Due to Commercially Available ProductsA woman who had taken Carter's Little Pills®, which contained aloe and podophyllum, daily for 4 yr presented with unexplained hypokalemic metabolic alkalosis (Ramirez and Marieb, 1970). Carter's Little Pills® have since been reformulated and no longer contain aloe.One retrospective study (Gold, 1980) reviewed cases of acute renal failure in 91 patients who had used herbal remedies. The majority of

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products used by the patients contained phenolphthalein and aloe extract or aloins. Seventy-four of the patients required peritoneal dialysis, 16 had jaundice, eight had neurologic impairment, and four died. One patient who presented with acute interstitial nephritis had ingested an aloe extract.Dermatologic reactions to aloe have also been reported. Two weeks after a perioral chemical peel, a woman applied aloe from a houseplant to the area in an attempt to resolve some remaining pinkness.She immediately experienced a burning sensation, and the area became red, swollen, and crusted. The reaction resolved over 10 wk. (Hunger and Frumkin, 1991). Another patient who used aloe from a houseplant to treat stasis dermatitis developed dermatitis characterized by a scaly, erythematous rash on her neck, arms, and ankle (Hogan, 1988). After 3 yr of ingestion of aloe gel 1 teaspoonful three times daily, a patient developed eczema that persisted for 3 mo (Morrow et al., 1980). This patient had also been applying the gel daily, for the past year, after shaving and for the previous month had noticed urticarial lesions in his beard area that lasted 5 min after each gel application.The FDA has received reports of four deaths as well as other adverse effects associated with the use of herbal laxative "dieters" teas (Kurtzweil, 1997). These teas contain laxatives such as senna, aloe, and buckthorn. Shortterm reactions are nausea, vomiting, cramping, and diarrhea, which may last several days and usually occur in those who exceed the recommended dose. other adverse effects include chronic diarrhea, dependence on laxatives for normal bowel function, and abdominal pain, which occur with long-term use. Severe reactions such as fainting, dehydration, and electrolyte disorders may occur in those with underlying nutritional disorders such as an eating disorder or excessive dieting.Dosis : (Abdul W.K., Sabna. K., etc., 2013)

Aloe vera Gel 75% was applied on wound once daily up to 14 days starting from the first day of wounding .

Standarisasi :

Standarisasi Simplisia dan ekstrak : mikroskopik dan makroskopis, kadar air, kadar abu, cemaran mikroba, ALT, cemaran logam, residu pestisida, kadar zat terlarut dalam pelarut tertentu, kadar zat aktif, profil kromatogram dll.

Ekstrak : Organoleptis, TLC fingerprint (profil kromatografi), kadar quersetin atau tanin.

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