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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5958_Библиотеки_им_академика_М_И_Перельмана
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lead identification and optimization followed by in vivo preclinical studies
(phase-I) and human clinical trials (phase-II and phase-III), this reverse
direction could work best for the Ayurvedic drug discovery process and a
schematic diagram for this process was depicted in our earlier publication.
31
This concept of reverse pharmacology in Ayurvedic Sciences was founded by
eminent vaidyas Mahamahopadhyaya Gananath Sen
32
and evolved as a
powerful scientific approach for newer drug discovery from ayurvedic
medicine. Ashok DB Vaidya
33
described reverse pharmacology as a newer
discipline in science that integrates well established clinical and experiential
evidences, providing leads to trans-disciplinary exploratory studies. These
leads could be further developed into potential drugs of interest triggered by
Figure 13.1 The Ayurvedic drug discovery-suggested sequence of steps.
Table 13.1 The problems and solutions in the pure compound isolation process.
30
Steps in bioactivity
guided fractionation Problems Solutions
Plant collection Not possible to grow them out
of the natural habitat
New tissue culture
methods to grow these
plants
Desired active compounds are
not available when taken out
of natural habitat
New methods for
synthesis induction
Crude extract
preparation
Presence of compounds that
do have drug activities or
bioactive present in
insufficient quantities
New methods for
extraction and
pre-fractionation
Isolated compounds Unknown molecular targets
identified with phenotypic
assays
New methods for
molecular mode of
action elucidation
332 Chapter 13
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experimental and clinical research. Thus, Ayurvedic drug discovery follows a
retrogressive path based on clinical observations noted with herbal prod-
ucts. Several research institutions in India with the financial support from
the CSIR (Council of Scientific and Industrial Research) and ICMR (The
Indian Council for Medical Research), have successfully conducted many
clinical trials based on ‘reverse-pharmacology’ and the Director Generals
from these Institutes have detailed the prospects of this approach in na-
tional and international forums for future drug discoveries. Some of the
plants that have been successfully analyzed by this approach include Mucuna
pruriens for Parkinson’s disease, Zingiber officinale for nausea/vomiting,
Picrorhiza kurroa for hepatitis, Curcuma longa for oral cancer, Panchavalkal
species for burns and wounds, and Azadirachta indica for malaria,
31
and the
list continues.
Since the clinical implication of the herbs or their formulations have
already been described in ayurvedic medicine, there could be a significant
reduction of failure rates during the drug development process. This is one
of the biggest advantages of this reverse pharmacology approach. In add-
ition, this approach gives an opportunity to seek more effective synergistic
formulations with increased bioavailability and these innovative strategies
that could play a significant role in drug development. For e.g., piperine
studies reported earlier revealed that it improves the bioavailability of syn-
thetic drugs such as propranolol, theop hylline, and rifampicin, when used in
combination.
34
13.4.5 Essential Considerations in the Ayurveda-based Drug
Development Process
Fundamental basic research in physiology, pathology, pharmacology, and
pharmacokinetics is required to replace the faith and suppositions of
Ayurvedic medicines with scientific reasoning and this data should be
complemented with facts and figures. The objectives of the investigation in
the fundamental research are categorized into the human body (Purusha),
the disease (Vyadhi), the medicine (Aushadha), and the right time for action
(Kriyakala).
35
To develop drugs based on Ayurvedic knowledge and principles, it is ne-
cessary to consider several factors. First, it demands the incorporation of
alternate and additional steps to the current drug development process to
perform a more versatile Ayurvedic library screen not just a chemical com-
pound library screen. The prospects of this elaborate, extensive-screening
approach could be numerous, but essentially allows chemical and biological
characterization of chemical compounds belonging to different classes to
successfully hit ‘druggable’ Ayurvedic leads with defined biochemical spe-
cificities.
36
Also, it is well-known that natural products-based extract-lib-
raries as opposed to existing chemical libraries harbor predominantly
(490%) compound structures that follow Lipinski’s ‘Rule-Of-Five’
37
Ayurvedic Knowledge Inspired Approach to Modern Drug Discovery 333
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properties that are ideal for oral administrations. Such a cohort of com-
pounds are those drug molecules already developed and commercialized.
36
In addition, Ayurvedic drug discovery mandates the inclusion of Ayurvedic
medicines based on existing knowledge and blends its concept and prin-
ciples with modern drug development technologies for more successful
pipeline drugs. To fulfill these requirements and face challenges, Ayurvedic
practitioners and researchers are currently focusing on many effective, yet
feasible methods that could document detailed experimentation on Ayur-
vedic herbs and products for the eventual implementation of standardized
Ayurvedic drug discovery methodologies.
33,38,39
We reviewed th e scientific
basis and resource availability of Ayurvedic medicines and discussed its
relevance to current and potential future drug development strategies, along
with the major scientific challenges to be faced.
31
Most of the research methodology of Ayurveda is based on examination/
diagnostic tools called Pareeksha, that are inspired from the philosophical
term Pramaana, which means evidence.
40
These diagnostic tools include
(i) the direct observation (Pratyaksha), (ii) the inference (Anumana), and
(iii) the authoritative testimonies or literature (Aptopadesha). Modern-day
disease diagnosis also depends on these three basic tools to some extent, but
efficiencyand accuracy have been largely boosted by the utility of the innovative
technologies and the use of modern devices. These advanced diagnostic
methodsare essentialto modernizeAyurvedapractices from principle-basedto
scientific-based medicine. If high quality research merges with modern
scientific techniques, it would expand Ayurvedic knowledge worldwide and
Ayurveda could show its presence in the path of current medical science.
41
13.5 Development of New Drugs
13.5.1 From Natural Resources
Despite several challenges and hindrances, natural products continue to
play a highly significant role in the drug discovery and development process.
During the last four decades (1981 to 2019), 71 drugs were developed from
natural products in an unaltered form, 14 were botanical drugs (including
defined mixtures), 356 drugs were derivatives of natural products, 207 drugs
were natural product pharmacophores, and 217 drugs were the mimics of
natural products. These 865 drugs are listed in Table 13.2 along with their
target diseases and year of approval.
42
13.5.2 From Ayurvedic Medicinal Plants
Since most Ayurvedic drugs have been in practice since ancient times, the
drug development process from Ayurveda is unique and based on either
reverse pharmacology (starts with clinical and goes to mechanistic studies)
or ‘‘drug rediscovery’’ (research to understand their mechanism or identi-
fying new molecular target). These processes involve several stages and
334 Chapter 13
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Table 13.2 New drugs developed from natural sources. Reproduced from ref. 42 with permission from the American Chemical Society,
Copyright 2020.
No. Generic name Trade name Disease Year Source
1 Aclarubicin Aclacin Anticancer 1981 Natural product Unaltered
2 Netilimicin sulfate Netromicine Antibacterial 1981 Natural product Unaltered
3 Peplomycin Pepleo Anticancer 1981 Natural product Unaltered
4 Isotrentoin Accutane Antiacne 1982 Natural product Unaltered
5 Micronomicin sulfate Sagamicin Antibacterial 1982 Natural product Unaltered
6 Chenodiol Chenix Hypocholesterolemic 1983 Natural product Unaltered
7 Cyclosporine Sandimmun Immunosuppressant 1983 Natural product Unaltered
8 Meglutol Lipoglutaren Hypolipidemic 1983 Natural product Unaltered
9 Sodium cellulose PO4 Calcibind Hypocalciuric 1983 Natural product Unaltered
10 Mizoribine Bredinin Immunosuppressant 1984 Natural product Unaltered
11 Miokamycin Miocamycin Antibacterial 1985 Natural product Unaltered
12 Mupirocin Bactroban Antibacterial 1985 Natural product Unaltered
13 Podophyllotoxin Condyline Genital warts 1985 Natural product Unaltered
14 Dronabinol Marinol Antinauseant 1986 Natural product Unaltered
15 Lentinan Lentinan Immunostimulant 1986 Natural product Unaltered
16 Schizophyllan Sonifilan Immunostimulant 1986 Natural product Unaltered
17 Artemisinin Artemisin Antiparasitic 1987 Natural product Unaltered
18 Bucillamine Rimatil Immunomodulator 1987 Natural product Unaltered
19 Ganglioside GM1 Sygen Antithrombotic 1987 Natural product Unaltered
20 Guglipid Guglip Lipoprotein disorders 1987 Natural product Unaltered
21 Ivermectin Mectizan Antiparasitic 1987 Natural product Unaltered
22 Lovastatin Mevacor Hypocholesterolemic 1987 Natural product Unaltered
23 Plaunotol Kelnac Antiulcer 1987 Natural product Unaltered
24 Ubenimex Bestatin Immunostimulant 1987 Natural product Unaltered
25 Carumonam Amasulin Antibacterial 1988 Natural product Unaltered
26 Fosfomycin trometamol Monuril Antibacterial 1988 Natural product Unaltered
27 Gamolenic acid Epogam Antiallergic 1988 Natural product Unaltered
28 Isepamicin Isepacin Antibacterial 1988 Natural product Unaltered
29 Simvastatin Zocor Hypocholesterolemic 1988 Natural product Unaltered
Ayurvedic Knowledge Inspired Approach to Modern Drug Discovery 335
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Table 13.2 (Continued)
No. Generic name Trade name Disease Year Source
30 Teicoplanin Targocid Antibacterial 1988 Natural product Unaltered
31 Adenosine Adenocord Antiarrhythmic 1989 Natural product Unaltered
32 Azelaic acid Skinoren Antiacne 1989 Natural product Unaltered
33 Pravastatin Mevalotin Hypocholesterolemic 1989 Natural product Unaltered
34 RV-11 Zalig Antibacterial 1989 Natural product Unaltered
35 Pumactant Alec Respiratory distress syndrome 1990 Natural product Unaltered
36 Masoprocol Actinex Anticancer 1992 Natural product Unaltered
37 Pentostatin Nipent Anticancer 1992 Natural product Unaltered
38 Paclitaxel Taxol Anticancer 1993 Natural product Unaltered
39 Tacrolimus Prograf Immunosuppressant 1993 Natural product Unaltered
40 Angiotensin II Delivert Anticancer 1994 Natural product Unaltered
41 Voglibose Basen Antidiabetic 1994 Natural product Unaltered
42 Carperitide Hanp Congestive heart failure 1995 Natural product Unaltered
43 Galanthamine HBr Nivalin Alzheimer’s disease 1995 Natural product Unaltered
44 Betain anhydrous Cystadane Homocystinuria 1996 Natural product Unaltered
45 Arglabin ? Anticancer 1999 Natural product Unaltered
46 Sirolimus Rapamune Immunosuppressant 1999 Natural product Unaltered
47 Aminolevulinic acid HCl Levulan Anticancer 2000 Natural product Unaltered
48 Daptomycin Cubicin Antibacterial 2003 Natural product Unaltered
49 Mycophenolate sodium Myfortic Immunosuppressant 2003 Natural product Unaltered
50 Paclitaxel liposomal Lipusu Anticancer 2003 Natural product Unaltered
51 Ach-02 Acheflan Analgesic 2005 Natural product Unaltered
52 Paclitaxel nanoparticles Abraxane Anticancer 2005 Natural product Unaltered
53 Ziconotide Prialt Neuropathic pain 2005 Natural product Unaltered
54 Citrofen Antiarthritic 2007 Natural product Unaltered
55 Paclitaxel nanoparticles Nanoxel Anticancer 2007 Natural product Unaltered
56 Paclitaxel nanoparticles Genexol-PM Anticancer 2007 Natural product Unaltered
57 Trabectedin Yondelis Anticancer 2007 Natural product Unaltered
58 Romidepsin Istodax Anticancer 2010 Natural product Unaltered
59 Fidaxomicin Dificid Antibacterial 2011 Natural product Unaltered
60 Spinosad Natroba Insecticide 2011 Natural product Unaltered
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61 Cysteamine hydrochloride Cystaran Cystinosis 2012 Natural product Unaltered
62 Homoharringtonine Ceflatonin Anticancer 2012 Natural product Unaltered
63 Ingenol mebutate Picato Anticancer 2012 Natural product Unaltered
64 Cholic acid Orphacol Inborn errors of bile synthesis 2013 Natural product Unaltered
65 PICN Anticancer 2014 Natural product Unaltered
66 Omega-3-carboxylic acids Epanova Hypertriglyceridemia 2014 Natural product Unaltered
67 Deoxycholic acid sodium salt Kybella Dermatological disorders 2015 Natural product Unaltered
68 Prasterone Intrarosa Dyspareunia 2016 Natural product Unaltered
69 Angiotensin II acetate Giapreza Antihypertensive 2017 Natural product Unaltered
70 Aplidine Aplidin Anticancer 2018 Natural product Unaltered
71 Cannabidiol Epidiolex Antiepileptic 2018 Natural product Unaltered
72 Extract of serenoa repens Permixon Benign prostatic hypertrophy 1982 Botanical drug
73 Solamargines Curaderm Anticancer 1989 Botanical drug
74 Cannabis sativa L extract Sativex Neuropathic pain 2005 Botanical drug
75 Kunecatechins Veregen Genital warts 2006 Botanical drug
76 NIX-0699 Hemoxin Anemia, sickle cell 2006 Botanical drug
77 Curemisinin Antiallergic 2007 Botanical drug
78 XP-828L Dermylex Antipsoriatic 2007 Botanical drug
79 Oralair Grasses Allergic rhinitis 2008 Botanical drug
80 Crofelemer Fulyzaq Antidiarrheal 2012 Botanical drug
81 PG-201 Layla Antiarthritic 2012 Botanical drug
82 Jap cedar pollen Cedartolen Immediate allergy 2014 Botanical drug
83 Ragweed pollen extract Ragwitek Immediate allergy 2014 Botanical drug
84 Extract from birch bark Episalvan Vulnerary 2016 Botanical drug
85 IZN-6D4 Curasite Topical ulcers 2017 Botanical drug
86 Budesonide Pulmicort Antiasthmatic 1981 Natural product derivative
87 Cefoperazone sodium Cefobis Antibacterial 1981 Natural product derivative
88 Cefotiam HCl Pansporin Antibacterial 1981 Natural product derivative
89 Cefsoludin sodium Takesulin Antibacterial 1981 Natural product derivative
90 Desogestrel/ethinylestradiol Marvelon Contraception 1981 Natural product derivative
91 Sulprostone Nalador Abortifacient 1981 Natural product derivative
92 Testosterone undecanoate Restandol Hypogonadism 1981 Natural product derivative
93 Apalcillin sodium Lumota Antibacterial 1982 Natural product derivative
Ayurvedic Knowledge Inspired Approach to Modern Drug Discovery 337
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Table 13.2 (Continued)
No. Generic name Trade name Disease Year Source
94 Atracurium besilate Nimbex Muscle relaxant 1982 Natural product derivative
95 Ceftizoxime sodium Epocelin Antibacterial 1982 Natural product derivative
96 Ceftriaxone sodium Rocephin Antibacterial 1982 Natural product derivative
97 Lisuride maleate Dopergin Antihyperprolactinemia 1982 Natural product derivative
98 Moxalactam disodium Shiomarin Antibacterial 1982 Natural product derivative
99 Vecuronium bromide Norcuron Muscle relaxant 1982 Natural product derivative
100 Cefmenoxime HCl Tacef Antibacterial 1983 Natural product derivative
101 Ceftazidime Fortam Antibacterial 1983 Natural product derivative
102 Elliptinium acetate Celiptium Anticancer 1983 Natural product derivative
103 Epoprostenol sodium Flolan Platelet aggreg. inhib. 1983 Natural product derivative
104 Gemeprost Cervagem Abortifacient 1983 Natural product derivative
105 Halometasone Sicorten Antiinflammatory 1983 Natural product derivative
106 Hydrocortisone butyrate Pandel Antiinflammatory 1983 Natural product derivative
107 Oxitropium bromide Oxivent Bronchodilator 1983 Natural product derivative
108 Promegestrone Surgestone Progestogen 1983 Natural product derivative
109 Aztreonam Azactam Antibacterial 1984 Natural product derivative
110 Buserelin acetate Suprefact Hormone 1984 Natural product derivative
111 Cefonicid sodium Monocid Antibacterial 1984 Natural product derivative
112 Ceforanide Precef Antibacterial 1984 Natural product derivative
113 Cefotetan disodium Yamatetan Antibacterial 1984 Natural product derivative
114 Epirubicin HCI Farmorubicin Anticancer 1984 Natural product derivative
115 Ibopamine HCI Inopamil /Scandine Cardiotonic 1984 Natural product derivative
116 Leuprolide acetate Enantone Hormone 1984 Natural product derivative
117 Melinamide Artes Oil Hypocholesterolemic 1984 Natural product derivative
118 Naltrexone HCI ReVia Antinarcotic 1984 Natural product derivative
119 Nicorandil Sigmart Vasodilator; coronary 1984 Natural product derivative
120 Sofalcone Solon Antiulcer 1984 Natural product derivative
121 Temocillin disodium Temopen Antibacterial 1984 Natural product derivative
122 Teprenone Selbex Antiulcer 1984 Natural product derivative
123 Alclometasone dipropionate Vaderm Antiinflammatory 1985 Natural product derivative
124 Astromycin sulfate Fortimicin Antibacterial 1985 Natural product derivative
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125 Cefbuperazone sodium Tomiporan Antibacterial 1985 Natural product derivative
126 Cefpiramide sodium Sepatren Antibacterial 1985 Natural product derivative
127 Cimetropium bromide Alginor Antispasmodic 1985 Natural product derivative
128 Dalteparin sodium Fragmin Anticoagulant 1985 Natural product derivative
129 Doxofylline Ansimar Bronchodilator 1985 Natural product derivative
130 Elcatonin Diatin Calcium metabolism 1985 Natural product derivative
131 Enprostil Gardrin Antiulcer 1985 Natural product derivative
132 Heme arginate Normosang Porphyria 1985 Natural product derivative
133 Imipenem/cilastatin Zienam Antibacterial 1985 Natural product derivative
134 Mefloquine HCI Fansimef Antiparasitic 1985 Natural product derivative
135 Misoprostol Cytotec Antiulcer 1985 Natural product derivative
136 Nabumetone Relifex Antiinflammatory 1985 Natural product derivative
137 Nadroparin calcium Fraxiparine Anticoagulant 1985 Natural product derivative
138 Rifaximin Rifacol Antibacterial 1985 Natural product derivative
139 Rosaprostol Rosal Antiulcer 1985 Natural product derivative
140 Thymopentin Sintomodulina Immunomodulator 1985 Natural product derivative
141 Brovincamine fumarate Sabromin Vasodilator; cerebral 1986 Natural product derivative
142 Deflazacort Deflan Antiinflammatory 1986 Natural product derivative
143 Gestrinone Dimetrose Antiprogestogenic 1986 Natural product derivative
144 Gonadoreline-6-
D-trp acetate Decapeptyl Hormone 1986 Natural product derivative
145 Idebenone Avan Nootropic 1986 Natural product derivative
146 Levacecarnine HCI Nicetile Nootropic 1986 Natural product derivative
147 Nedocromil sodium Tildade Antiallergic 1986 Natural product derivative
148 Nomegestrol acetate Lutenyl Progestogen 1986 Natural product derivative
149 Norgestimate Cilest Progestogen 1986 Natural product derivative
150 Prednicarbate Dermatop Antiinflammatory 1986 Natural product derivative
151 Rokitamycin Ricamycin Antibacterial 1986 Natural product derivative
152 Sulbactam sodium Sulperazone Beta-lactamase inhibitor 1986 Natural product derivative
153 Triptorelin Decapeptyl Anticancer 1986 Natural product derivative
154 Amlexanox Solfa Antiasthmatic 1987 Natural product derivative
155 Artemether Artemetheri Antiparasitic 1987 Natural product derivative
156 Artenusate Arinate Antiparasitic 1987 Natural product derivative
157 Aspoxicillin Doyle Antibacterial 1987 Natural product derivative
Ayurvedic Knowledge Inspired Approach to Modern Drug Discovery 339
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Table 13.2 (Continued)
No. Generic name Trade name Disease Year Source
158 Cefixime Cefspan Antibacterial 1987 Natural product derivative
159 Cefminox sodium Meicelin Antibacterial 1987 Natural product derivative
160 Cefpimizole Ajicef Antibacterial 1987 Natural product derivative
161 Cefteram pivoxil Tomiron Antibacterial 1987 Natural product derivative
162 Cefuroxime axetil Zinnat Antibacterial 1987 Natural product derivative
163 Cefuzonam sodium Cosmosin Antibacterial 1987 Natural product derivative
164 Enoxaparin Lovenox Anticoagulant 1987 Natural product derivative
165 Gestodene/ethinylestradiol Femodene Contraception 1987 Natural product derivative
166 Goserelin Zoladex Hormone 1987 Natural product derivative
167 Hidrosmin Venosmil Cardiovascular disease 1987 Natural product derivative
168 Lenampicillin HCI Varacillin Antibacterial 1987 Natural product derivative
169 Metergolin Liserdol Antihyperprolactinemia 1987 Natural product derivative
170 Micinicate Micivas Cardiovascular disease 1987 Natural product derivative
171 Midoriamin Midoriamine Antiulcer 1987 Natural product derivative
172 Mometasone furoate Elocon Antiinflammatory 1987 Natural product derivative
173 Ornoprostil Alloca Antiulcer 1987 Natural product derivative
174 Rifamixin Normix Antibacterial 1987 Natural product derivative
175 Roxithromycin Rulid Antibacterial 1987 Natural product derivative
176 Sultamycillin tosylate Unasyn Antibacterial 1987 Natural product derivative
177 Teriparatide acetate Parathar Calcium metabolism 1987 Natural product derivative
178 Azithromycin Sunamed Antibacterial 1988 Natural product derivative
179 Choline alfoscerate Delecit Nootropic 1988 Natural product derivative
180 Erythromycin acistrate Erasis Antibacterial 1988 Natural product derivative
181 Flomoxef sodium Flumarin Antibacterial 1988 Natural product derivative
182 Flutropium bromide Flubron Antitussive 1988 Natural product derivative
183 Halopredone acetate Haloart Antiarthritic 1988 Natural product derivative
184 Hydrocortisone aceponate Retef Antiinflammatory 1988 Natural product derivative
185 Limaprost Opalmon Antithrombotic 1988 Natural product derivative
186 Mifepristone Mifegyne Abortifacient 1988 Natural product derivative
187 Octreotide Sandostatin Antisecretory 1988 Natural product derivative
188 Pergolide mesylate Permax Alzheimer’s disease 1988 Natural product derivative
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189 Pirarubicin Pinorubicin Anticancer 1988 Natural product derivative
190 Propentofylline propionate Hextol Vasodilator; cerebral 1988 Natural product derivative
191 Rifapentine Rifampin Antibacterial 1988 Natural product derivative
192 Secalciferol Osteo D Calcium metabolism 1988 Natural product derivative
193 Tibolone Livial Anabolic metabolism 1988 Natural product derivative
194 Acitretin Neotigason Antipsoriatic 1989 Natural product derivative
195 Cefpodoxime proxetil Banan Antibacterial 1989 Natural product derivative
196 Deslorelin Somagard Hormone 1989 Natural product derivative
197 Ipriflavone Osten Calcium metabolism 1989 Natural product derivative
198 LMW heparin Sandoparin Anticoagulant 1989 Natural product derivative
199 Tiopronin Thiota Urolithiasis 1989 Natural product derivative
200 Vigabatrin Sabril Antiepileptic 1989 Natural product derivative
201 Vinorelbine Navelbine Anticancer 1989 Natural product derivative
202 Acarbose Glucobay Antidiabetic 1990 Natural product derivative
203 Arbekacin Habekacin Antibacterial 1990 Natural product derivative
204 Cefodizime sodium Neucef Antibacterial 1990 Natural product derivative
205 Clarithromycin Klaricid Antibacterial 1990 Natural product derivative
206 Eflornithine HCl Ornidyl Antiparasitic 1990 Natural product derivative
207 Ethyl icosapentate Epadel Antithrombotic 1990 Natural product derivative
208 Fluticasone propionate Flixonase Antiinflammatory 1990 Natural product derivative
209 Idarubicin hydrochloride Zavedos Anticancer 1990 Natural product derivative
210 Nafarelin acetate Synarel Hormone 1990 Natural product derivative
211 Rebamipide Mucosta Antiulcer 1990 Natural product derivative
212 Calcipotriol Daivonex Antipsoriatic 1991 Natural product derivative
213 Cefdinir Cefzon Antibacterial 1991 Natural product derivative
214 Cloricromen Proendotal Antithrombotic 1991 Natural product derivative
215 Halobetasol propionate Ultravate Antiinflammatory 1991 Natural product derivative
216 LMW heparin Logiparin Anticoagulant 1991 Natural product derivative
217 Romurtide Nopla Immunostimulant 1991 Natural product derivative
218 Beraprost sodium Dorner Platelet aggreg. inhib. 1992 Natural product derivative
219 Cefetamet pivoxil HCl Globocef Antibacterial 1992 Natural product derivative
220 Cefpirome sulfate Cefrom Antibacterial 1992 Natural product derivative
221 Cefprozil Cefzil Antibacterial 1992 Natural product derivative
Ayurvedic Knowledge Inspired Approach to Modern Drug Discovery 341
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