Pharm D Program: Herbal and Alternative Medicine Lecture 7

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Questions and Answers

Where does digestion take place in the body?

Alimentary canal (correct)

Lymphatic system

Nervous system

Bloodstream

What is the function of ptyalin in the mouth?

To digest proteins

To digest cellulose

To digest starch (correct)

To digest fats

What is the role of parietal cells in the stomach?

To secrete pepsin

To secrete hydrochloric acid (correct)

To secrete bile

To secrete mucus

What is the function of the stomach lining's mucus layer?

To protect the stomach from corrosion Signup and view all the answers

What is the primary site of absorption for most drugs, sugars, and minerals?

Small intestine Signup and view all the answers

What is the movement that helps to facilitate digestion?

Peristalsis Signup and view all the answers

What is the function of the chief cells in the stomach?

To secrete pepsin Signup and view all the answers

What is the primary function of the small intestine?

To complete digestion of most foods Signup and view all the answers

What is one of the causes of functional dyspepsia?

Deficiency in gastric secretion Signup and view all the answers

What type of remedies are used in the treatment of dyspepsia?

Herbal remedies Signup and view all the answers

What is the action of bitter drugs on the oral taste receptors?

They sensitize the taste receptors Signup and view all the answers

What is the benefit of using bitter drugs in elderly patients?

They treat loss of appetite Signup and view all the answers

What type of drugs promotes gastric juice secretion and facilitates digestion?

Eupeptics Signup and view all the answers

What is the mode of action of gentian?

It stimulates the taste buds and increases saliva secretion Signup and view all the answers

What is the composition of gentian?

Iridoid glycosides Signup and view all the answers

Why must bitter eupeptics be followed by a meal within 20 minutes of administration?

Because their effect lasts for 20-30 minutes Signup and view all the answers

What is likely to be the cause of the effect mentioned in the text?

The transient desensitization of sensory fibers by capsaicin Signup and view all the answers

What is the recommended daily dosage of chili powder?

0.5 g administered in a gelatin capsule Signup and view all the answers

What are the two sources of gas in the digestive tract?

Swallowed air and normal breakdown of certain undigested foods Signup and view all the answers

What are the common symptoms of gas?

Abdominal bloating, abdominal pain, and belching Signup and view all the answers

What is the role of herbal medicines in the treatment of flatulence?

They relieve the discomfort of flatulence Signup and view all the answers

What do carminative agents do in the alimentary tract?

They prevent the formation or cause the expulsion of gas Signup and view all the answers

What are the typical herbal carminatives mentioned in the text?

Caraway, fennel, and anise Signup and view all the answers

What is a possible adverse effect of consuming large dosages of caraway volatile oil?

Kidney and liver damage Signup and view all the answers

What is gastritis?

An inflammation of the mucosa lining of the stomach Signup and view all the answers

What is the leading cause of peptic ulcer disease?

Infection by Helicobacter pylori Signup and view all the answers

What is the main mechanism of mucosal injury in gastritis and peptic ulcer disease?

An imbalance of aggressive and defensive factors Signup and view all the answers

What is the purpose of antacids in the treatment of gastritis and peptic ulcer disease?

To neutralize excess stomach acid Signup and view all the answers

What is the mode of action of glycyrrhizin and glycyrrhetinic acid?

Anti-inflammatory properties Signup and view all the answers

What is the effect of glycyrrhizin on prostaglandin E2 and F2?

Inhibition of their metabolism to 15-keto prostaglandins Signup and view all the answers

What is the purpose of eradication of H. pylori infection in the treatment of gastritis and peptic ulcer disease?

To prevent recurrence of disease Signup and view all the answers

What is the first-line agent in the treatment of gastritis and peptic ulcer disease?

Histamine H2-receptor antagonist Signup and view all the answers

What is a possible adverse event of gentian?

Headache Signup and view all the answers

Why is gentian contraindicated in individuals with gastro-duodenal ulcers?

Due to its stimulation of gastric juice secretion Signup and view all the answers

What is the main component of bitter orange?

Volatile oil with up to 90% terpene limonene Signup and view all the answers

What is the effect of bitter orange on the gastrointestinal tract?

It has a mild spasmolytic effect Signup and view all the answers

What is the mode of action of capsaicin?

It acts on gastric sensory fibers of visceral nociceptive neurones Signup and view all the answers

What is the effect of capsaicin on gastric sensory fibers?

It has a biphasic effect Signup and view all the answers

What is a possible adverse event of chili?

All of the above Signup and view all the answers

What happens to the sensory fibers after prolonged activation of capsaicin?

They become unresponsive to nociceptive stimuli Signup and view all the answers

Study Notes

Introduction to the Digestive System

The digestive system is a complex process that involves the breakdown of food into smaller molecules for absorption and utilization by the body.
The digestion process takes place in the alimentary canal, involving enzymes secreted by the stomach, pancreas, and small intestine, as well as mechanical movements like chewing and peristalsis.
The digestive tract is protected by a layer of mucus, which can interact with and reduce the absorption of herbal medicines.

Oral Cavity and Stomach

In the mouth, chewing initiates digestion through the action of ptyalin, which breaks down starch.
The stomach stores ingested food and subjects it to further digestion through the action of hydrochloric acid and pepsin.
The stomach lining is protected by a layer of mucus against the corrosive action of gastric juice.

Small Intestine and Large Intestine

In the small intestine, proteases, lipases, and amylases complete the digestion of most foods.
Most drugs, sugars, and minerals are absorbed in the small intestine, while in the large intestine, mostly water and mineral salts are absorbed.

Dyspepsia

Dyspepsia is a functional disorder characterized by symptoms such as bloating, discomfort, and pain in the upper abdomen.
Causes of dyspepsia include:
- Deficiency in gastric secretion
- Motility gastric disorders
- Deficient bile production
- Diet, alcohol, tobacco, and aspirin-like drugs abuse
- Psychosocial factors
- Helicobacter pylori infection

Phytotherapy of Dyspepsia

Traditional herbal remedies used in the treatment of dyspepsia include:
- Bitter drugs (e.g. quassia, gentian, bitter orange peel)
- Cholagogues/choleretics (e.g. artichoke, boldo, celandine, turmeric, dandelion, wormwood)
- Carminatives (e.g. caraway, fennel, and anise)
These medicines promote gastric juice secretion and facilitate digestion, and are useful in cases of loss of appetite, anorexia, dyspepsia, and gastric ailments.

Bitter Drugs (Eupeptics)

Bitter drugs sensitize oral taste receptors, facilitating saliva secretion, which lasts for 20-30 minutes.
Examples of bitter drugs include:
- Gentian, which contains iridoid glycosides (bitter principles)
- Bitter orange, which contains a volatile oil with up to 90% of the terpene limonene
Bitter drugs combined with an essential oil have a direct stimulus on taste and olfactory receptors and gastric secretion, and tend to have antibacterial action on intestinal flora and stimulate bile secretion.

Flatulence

Flatulence is defined as the presence of excessive amounts of gas in the stomach or intestine.
Gas in the digestive tract comes from two sources: swallowed air and normal breakdown of certain undigested foods by colon bacteria.
Symptoms of flatulence include abdominal bloating, abdominal pain, and belching.
Herbal medicines play a special role in the treatment of flatulence, particularly carminatives, which prevent the formation or cause the expulsion of gas in the alimentary tract.

Carminatives

Typical herbal carminatives include caraway, fennel, and anise.
Other herbal medicines considered to have carminative actions are chamomile, peppermint, and lemon balm.
Carminatives inhibit gastric smooth muscle contractions and possess antimicrobial activity.

Gastritis and Peptic Ulcer Disease

Gastritis is an inflammation of the mucosa lining of the stomach, often caused by factors such as alcohol, tobacco, spices, toxins, bacteria, and drugs.
Peptic ulcer disease refers to a distinct mucosal damage of the stomach and/or duodenum.
The mechanisms of mucosal injury in gastritis and peptic ulcer disease involve an imbalance of aggressive factors, including gastric juice, and defensive factors, such as mucus production, bicarbonate, and blood flow.
Helicobacter pylori infection is a leading cause of peptic ulcer disease due to hypersecretion of gastric acid.

Treatment of Gastritis and Peptic Ulcer Disease

Treatment goals include relief of discomfort and protection of the gastric mucosal barrier to promote healing, and eradication of H. pylori infection.
Antacids may be sufficient in mild cases, while most patients require a histamine H2-receptor antagonist, anticholinergic drugs, or a proton pump inhibitor.
Liquorice contains a saponin-like glycoside glycyrrhizin and flavonoids, which possess anti-inflammatory properties and inhibit 15-hydroxyprostaglandin dehydrogenase, an enzyme that metabolizes prostaglandin E2 and F2 to 15-keto prostaglandins, an inactive compound.

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Description

This quiz covers the concepts of herbal and alternative medicine related to the digestive system, including diseases and disorders of the oral cavity, stomach, and intestines.