Course program
PROGRAM
The course includes a general part, a special part and a specific in-depth part. In the general part (point 1 and 2) introduction of concepts related to pharmacognosy will be developed, including: a "glossary" of specific terminologies relating to important definitions (botanicals, phytotherapeutics, nutraceuticals, etc. - point 1.), and a part relating to classification phytochemistry of plant drugs (point 2.), which will be further developed in the part referring to the treatment of specific pathologies.
In the special part (point 3) phytotherapy of specific mild/moderate pathologies will be discussed.
In the part relating to in-depth analysis (point 4), current issues will be addressed, case reports will be evaluated, compositions of commercially available products will be analysed, etc.
The articulation into the various thematic cores of the teaching is profoundly interconnected, as the plants that are described from a phytochemical point of view (point 2) are also contextualized in their possible application in phytotherapy (point 3) and evaluated in case of specific in-depth analysis (point 4). However, the various themes can be divided into the following number of indicative hours: point 1 = 21 hours; point 2 = 35 hours; point 3-4= 40 hours.
1. General part
Definition of Pharmacognosy. "Drug" in Pharmacognosy. Plant and animal drugs: origins, evolution and their use. Whole drugs and purified principles: differences in terms of bioavailability, pharmacodynamic activity, routes of administration and dosages.
Variability factors of medicinal plants. Collection, preparation and storage. Quality control according to the Official Pharmacopoeia. Use of the principles of plant origin as starting material for hemisynthesis and as molecular models of new drugs. Phytotherapy principles: therapeutic value; safe use of medinal plants; definition and marketing of herbal products, dietary supplements, nutraceuticals, cosmetics, herbal medicinal products of consolidated and traditional use and related examples. EMA monographs (aloe, echinacea, calendula, lemon balm, guarana, ginger, eleutherococcus, horse chestnut, etc.).
2. Classes of herbal substances of pharmacognostic interest.
Carbohydrates and plants containing carbohydrates.
Natural sources, methods of production, therapeutic, herbal, technical and industrial uses of carbohydrates, carbohydrate drugs and their total preparations. Monosaccharides: glucose, fructose, sorbitol. Oligosaccharides: sucrose, lactose, cyclodextrins. Polysaccharides: starch, cellulose, dextrans, inulin, pectins, gums and mucilages. Main drugs containing carbohydrates.
Lipids and plants containing lipids.
Natural sources, methods of obtaining, therapeutic, herbal and technical uses of lipids, drugs containing lipids and their total preparations. Saturated and unsaturated fatty acids with particular regard to essential fatty acids, glycerides, waxes. Main drugs containing lipids.
Glycosides and plants containing glycosides.
Anthraquinone glycosides. Mechanism of action, indications for use, undesired effects and risks in case of abuse or misuse. Anthraquinone drugs: aloe, cascara, buckthorn, rhubarb, senna.
Cardiocinetic glycosides. Natural sources, biological activity, therapeutic uses of cardiac glycosides. Drugs containing cardiokinetic glycosides.
Flavonoid glycosides and plants containing flavonoids. Natural sources, biological activities, mechanisms of action, therapeutic uses of flavonoids and their semisynthetic derivatives; herbal uses of flavonoid drugs. Main drugs used for their flavonoid content (Silybum marianum, Cynara scolymus, Crataegus oxyacanta, Matricaria recutita, Passiflora incarnata, etc.).
Saponins and plants containg saponins. Natural sources, herbal, technical and industrial uses of saponins, drugs containing saponins and their preparations. Drugs containing saponins: ivy, ginseng, polygala, licorice, horse chestnut, centella, fenugreek, butcher's broom
Tannins and plants containg tannin.
Hydrolysable tannins, condensed tannins and tannoids. Natural sources, biological activity and uses of tannins, tannic drugs and their preparations. Possible side effects of tannin preparations. Drugs containing tannins: Camellia sinensis, Hamamelis virginiana, Krameria triandra.
Terpenes and plants containg terpenes.
Essential oils: chemical composition, natural sources, methods of production, biological effects and related mechanisms of action, practical uses of essential oils and drugs containing essential oils. Undesirable and toxic effects of essential oils. Main drugs containing essences and resins: mint, camphor, eucalyptus, lavender, lemon balm, bitter orange, wormwood, chamomile, balsam from Peru, balsam from Tolu. Other drugs containing terpenes: ginkgo, etc.
Alkaloids and plants containing alkaloids (this part of the program requires the knowledge of the physiology of the central and autonomic nervous system).
Drugs with action on the SNA. Sympathomimetic drugs: coca, ephedra; sympatholytic: rauwolfia; parasympathomimetics: Amanita muscaria, Calabar bean, jaborandi; parasympatholytic: belladonna, giusquiamo, stramonio.
Drugs with ganglionic action: tobacco.
Drugs acting on neuromuscular plaque: curare.
Drugs acting on the CNS. Exciting drugs: caffeic drugs, coca, ephedra; depressive: opium, rauwolfia. Other drugs used for voluptuous or ritual purposes.
3. SPECIAL SECTION: Phytotherapy
Basic concepts.
Problems related to the use of medicinal plant preparations: variability of the composition and problem of bioequivalence. Preparations obtainable from plant drugs: differences in terms of qualitative and quantitative composition. Standardization of plant preparations. Fingerprint. Use of markers. Preparations based on plant drugs and their derivatives: use based on scientific evidence. Methods of evaluation of the clinical efficacy of the preparations: systematic reviews and meta-analyzes. Safety of use of plant preparations: causes of adverse events to natural products. Drug interactions between plant drugs and drugs.
Surveillance of adverse events from medicinal plant products: causality assessment methods, algorithms. The Italian system of suspected adverse reactions to products of natural origin.
Medicinal plants and their preparations used as sedatives.
Medicinal plants and their preparations used in depression.
Medicinal plants and their preparations used as adaptogens and immunostimulants
Medicinal plants and their derivatives used in disorders of the upper airways.
Medicinal plants and their preparations used as eupeptic, choleretic and hepatoprotectors.
Medicinal plants and their preparations used as hypolipidemic agents.
Medicinal plants and their preparations used in hypertension.
Medicinal plants and their preparations used as vasoprotectors.
Medicinal plants and their preparations used as laxatives and purgatives.
Medicinal plants and their preparations used for the control of body weight: drugs stimulating lipolysis and/or thermogenesis, drugs inducing satiety; drugs reducing lipogenesis; purifying drugs.
Medicinal plants and their preparations used as aquaretic diuretics and as disinfectants of the lower urinary tract.
Medicinal plants and their preparations used in disorders related to benign prostatic hyperplasia.
Medicinal plants and their preparations used in menopause disorders, premenstrual syndrome and dysmenorrhea.
Medicinal plants used in the treatment of skin inflammations, wounds, burns, bruises.
Medicinal plants and their preparations used antirheumatic.
Notes on principal unconventional medicines.
Homeopathy: historical background and general principles. Homeopathic product: composition and methods of preparation.
4. MISCELLANEOUS INSIGHTS: according to the academic year, the details, more explanatory of the topics (current issues, case reports, etc.), will be given also in class.
Prerequisites
The student must not have to absolve particular prerequisites. However, in order to better understand some specific concepts (e.g., drugs containing alkaloids, mechanism of action of medicinal plants, phytotherapy of specific diseases) and to more easily achieve the learning objectives, it would be important to know subjects such as: human anatomy, general physiology, biochemistry and general pathology. It could also be useful to study (at least at the same time) general and molecular pharmacology. Where the student cannot attend the lessons, he/she must absolutely inform himself of what was made available and/or reported by the teacher, as material useful for learning purposes. The above mentioned must not be considered as an indispensable obligation, but as a prerequisite recommended to optimize the successful passing of the exam, to be taken at the end of the course.
Books
- Farmacognosia e Fitoterapia. Basi farmacologiche e aspetti applicativi. Mazzanti G., Dell'Agli M., Izzo A.A. Ed. Piccin (2020).
- Farmacognosia – Botanica, chimica e farmacologia della piante medicinali. Capasso F. II° Ed. Springer-Verlag (2011).
- Fitoterapia – Impiego razionale delle droghe vegetali. Capasso F., Grandolini G., Izzo A.A. Ed. Springer (2006).
In order to help the student in terms of method and continuity in the study, the distribution of the recommended texts along the duration of the course could be hypothesized as follows:
Text 1 is useful for carrying out the entire program of the course and can be effectively integrated with the notes taken in class and with the sitography and / or other specific bibliography, recommended by the teacher (see sites and references reported in the "Reference Bibliography" section)
The texts 2 and 3 are useful if they are integrated with each other. Text 2 for the general part of the program (see points 1 and 2 of the same, in the appropriate section "teaching program"). Text 3 is more useful for the special part (see point 3 of the program) relating to the phytotherapy of specific mild / moderate diseases.
Teaching mode
The adopted teaching method provides (for the greater number of hours), in accordance with any measures relating to the management of emergencies, lectures. However, exercises, related to the analysis of case reports of Phytovigilance and the simulations of bibliographic research in the drafting of papers, through the use of telematic supports (specific to the field of pharmacognosy and phytotherapy) are also foreseen. The course will in any case depend on the teaching method, allowed by the COVID19 emergency.
The teaching methods, chosen by the teacher, contribute not only to the achievement of the planned training objectives, but are also methods easily usable in the real working life, as they provide quick and free access to databases and websites of the medicinal plants sector and its uses and warnings.
Frequency
Course attendance is mandatory. The teacher will check the presence in the way it deems most appropriate. The frequency is useful as it allows to obtain updated information, not necessarily available in textbooks and, above all, helps to achieve a valid method of approach to the study of the subject.
Exam mode
The actual achievement of the expected learning outcomes by the student, in accordance with the training objectives, is evaluated through an oral exam. Among the aspects that contribute to the formation of the final judgment, beyond the specific preparation of the student on exam topics, is also evaluated the reasoning ability and the study that has conducted in an autonomous way, not based only on the mnemonic abilities.
The duration of the test, as an oral one, is difficult to define and depends essentially on the degree of preparation and the student's exhibition skills. An average duration of about 20 minutes is conceivable.
The teaching, as established by Manifesto, does not provide intermediate tests but only tests at the end of the teaching course. These tests have pre-established dates and are communicated annually to the Secretariats and published via e-learning and via Infostud.
To pass the exam it is necessary to achieve a grade of not less than 18/30. The student must demonstrate that he has acquired sufficient knowledge of the general and special topics and that he is able to provide useful application advice concerning the use modalities, warnings, undesired effects, interactions of the products containing medicinal plants. To achieve a score of 30/30 cum laude, the student must instead demonstrate that he has acquired excellent knowledge of all the topics covered during the course (including the most recent ones covered during the course), being able to link them in a way logical and consistent.
Bibliography
The reference bibliography reported below can be used in the part related to the in-depth analysis (point 4) and/or more current topics. It should however be specified that the preparation of the student should not be sectorialized, but must provide the reasoned capacity for the integration between the different parts of the program, in the different sources of information.
Website list
hhttp://www.salute.gov.it/
http://www.epicentro.iss.it/focus/erbe/sorv_reaz-avv.asp
https://www.ncbi.nlm.nih.gov/pubmed/
http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/landing/herbal_search.jsp&mid=WC0b01ac058001fa1d
https://www.farmacovigilanzasif.org/topics/aggiornamenti/
Photocopies delivered in class and/or included on the course website (http://elearning2.uniroma1.it/).
Lesson mode
The adopted teaching method provides (for the greater number of hours), in accordance with any measures relating to the management of emergencies, lectures. However, exercises, related to the analysis of case reports of Phytovigilance and the simulations of bibliographic research in the drafting of papers, through the use of telematic supports (specific to the field of pharmacognosy and phytotherapy) are also foreseen. The course will in any case depend on the teaching method, allowed by the COVID19 emergency.
The teaching methods, chosen by the teacher, contribute not only to the achievement of the planned training objectives, but are also methods easily usable in the real working life, as they provide quick and free access to databases and websites of the medicinal plants sector and its uses and warnings.