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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5698_Библиотеки_им_академика_М_И_Перельмана
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all over the globe, employs phytochemicals produced by alkaloids as active pharmaceutical
ingredients as they are known over the world as a dependable source of high-quality
phyto-products. Alkaloids Corporation also creates custom-made items. They currently
have four cutting-edge production facilities that all follow stringent cGMP criteria. In addition,
they have established a factory in Australia to process a critical biomass for captive use. To
maintain the regular and sustainable supplies of biomass for successful manufacturing of
botanical extract and phytochemicals, the corporation cultivates their medicinal plants, by a
contractual basis with farmers following Good Agricultural and Collection Practices
(GACP). Alkaloids Corporation marketed their products in four different parts, i.e., active
pharmaceutical ingredients (APIs) derived from plant sources, phytochemicals other than
APIs, standardized botanical extract, and synthetic APIs and intermediates. APIs derived
from plant sources and phytochemicals other than APIs have various therapeutical applica-
tions such as Ajmaline (antiarrhythmic), Artemether (antimalarial), Cabergoline (Parkinson),
Colchicine (antigout), Hyoscine butylbromide (antispasmodic), etc.; each sample synthesis
in Alkaloid corporation has Chemical Abstracts Service (CAS) for numerical identification
of chemicals, i.e., Ajmaline (4360-12-7) and Artemether Int. Ph./IP (71963-77-4) [35].
25. Kothari phytochemicals international
Established in 1974, KPI is a prominent manufacturer and supplier of bulk medicines and
phytochemicals. Herbal extracts, phytochemicals, natural pharmaceutical ingredients, and
APIs are all manufactured by KPI. They are specialized in the preparation of natural plant
products. This company has a dedicated analytical R&D team, which includes students
with extensive experience in specific product developments such as Calcium Sennoside
10%, 20%, 45%, 55%, 65%, 70%, 90%, and 110%; Curcumin 95%; Forskolin 10%, 20%, 40%,
TABLE 12.2 Indian market of phytochemicals.dcont’d
National
companies Product name Phytochemicals Application References
Ashwagandha dry
Extract 1.5%, 2.5%,
5.0%, 10%
Withania somnifera Nerve tonic
Potency enhancer
Bahera dry extract
40%
Terminalia bellirica Laxative and astringent
Colchicine Colchicinum Antigout agent
Guggul dry extract
1.0%, 2.5%
Commiphora mukul Antiinflammatory
Antihypertensive
Hathjor dry extract
3.0%
Martynia annua Tuberculosis
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95%, and 98%; Colchicine; Thiocolchicoside; and others, as well as herbal extracts, phyto-
chemicals, and lists of phytochemicals as per customer specifications. Metformin HCL, Tolbu-
tamide, and Chlorpropamide are their APIs. With a continuous research work they are
involved in the separation of no vel active components from natural sources. Their initiatives
involve extracting herbal extracts and isolating active principle chemicals from natural plant
resources, as well as providing healthcare applications for the mentioned product. KPI is also
interested in collaborating or developing new items as a turn-key project. By combining best
practices with core principles, KPI will become a leading worldwide player in its diverse
business interests. Take advantage of opportunities for growth and development, while being
socially responsible. KPI produces wealth, increases the value of customers, and optimizes
shareholder profits. They also inspire business partners to grow and profit by adapting to
changing environments and technology advancements with a focus on human resource
development [34].
26. Conclusion
In conclusion, there has been an immense commercial potential of phytopharmaceuticals
due to its range of therapeutic response making it popular among consumers. But there is
an urgent need to continue research support to develop more phytopharmaceutical botani-
cals to counter various disorders as well as regulatory reforms of clinical development pro-
grams. Not only these, phytomedicines also render the medicinal values that have been
implicated in the treatment of chronic disorder such as cancer, rheumatoid arthritis, athero-
sclerosis, cardiac and cerebral ischemia, and neurological disorder. There has been an
immense surge toward the use of botanical medicines to embellish the channel of drug devel-
opment. This has increased the marketed demand of phytoactive compounds and attracted
many of the international and national companies. Thus the utilization of unique traditional
knowledge of herbal medicine has great potential to generate biocompatible, cost-effective so-
lutions and will continue to boost the commercial benefits in the field of phytomedicines.
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Application aspects of
phytopharmaceuticals
SECTION IV
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13
Interactions between
radiopharmaceutical products and
herbal medicines
Ezgi Kayan Eluz
1
and Asuman Yekta Özer
2
1
Turkish Medicines and Devices Agency, Ankara, Turkey;
2
Hacettepe University, Faculty of
Pharmacy, Department of Radiopharmacy, Ankara, Turkey
List of symbols and abbreviations
The abbreviations used in this study are listed below along with their explanations.
ALT Alanine Amino Transferase
AST Aspartate Amino Transferase
CYP Cytochrome
DISIDA Di Isopropyl Imino DiAcetic Acid
DMSA Di Mercapto Succinic Acid
DNA Deoxyribo Nucleic Acid
DTPA Diethylene Triamine Penta Acetate
FDG Fluoro DeoxyGlucose
HPLC High Pressure Liquid Chromatography
MAA Macro Aggregated Albumin
MDP Methylene Di Phosphonate
SPECT Single Photon Emission Computed Tomography
TLC Thin Layer Chromatography
1. Introduction
Radiopharmaceutical products are pharmaceuticals containing radionuclide, which are
generally used for diagnostic purposes in nuclear medicine and can also be used for treat-
ment. The most commonly used radionuclide is known as
99m
Tc. Radiopharmaceuticals
CHAPTER
305
Phytopharmaceuticals and Herbal Drugs
https://doi.org/10.1016/B978-0-323-99125-4.00010-X © 2023 Elsevier Inc. All rights reserved.
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are used in a variety of procedures for diagnostic purposes, including lung perfusion, venti-
lation, cerebral blood flow, thyroid scan, bone-liver-pancreas-kidney or cardiac imaging pro-
cedures, gastrointestinal bleeding localization, tumor localization studies, iron metabolism,
and they have a wide range of uses in nuclear medicine.
Herbal medications, on the other hand, are pharmaceuticals including a medicinal plant as
part of their formula. These products are widely used because they are considered inexpen-
sive, effective, and safe. However, because there are not enough clinical data for these prod-
ucts and their structures have not been fully elucidated, this approach is not very precise.
Since herbal medications are not monitored by doctors or pharmacists, the probability of
encountering a negative result when these products are used is higher than other medicines.
On the interaction of radiopharmaceuticals with other medications, there are many litera-
ture and data. They are known to interact with herbal medications in the same way as they
interact with other medications, causing biodistribution and radiolabeling alterations. These
changes are very critical because they can lead to misleading imaging and, as a result, misdi-
agnosis in nuclear medicine. Or it may result in the patient being exposed to radiation again
unnecessarily, as well as the employees wasting time. However, such scenarios can be
avoided by being educated about these interactions and having the doctor and pharmacist
counsel the patient on these issues. For this, the number of studies on the interaction of radio-
pharmaceutical products and herbal remedies should be increased.
In the present book chapter, critical evaluative survey has been done to assess the interac-
tion of radiopharmaceuticals with herbal medicines. Following a brief overview of radiophar-
maceuticals and drug interactions, this specific topic was reviewed, and a brief description of
the usage of several herbal remedies for radiation protecti on was provided.
2. Radiopharmaceuticals
2.1 Radiopharmaceuticals and general properties
Radiopharmaceuticals are drugs containing a radionuclide in their molecule andare used for
the diagnosis and/or treatment of human diseases. In nuclear medicine, around 80%e85% of
radiopharmaceuticals are used for diagnostic purposes, while the rest are used for therapeutic
purposes. Radiopharmaceuticals usually have no effect (inert) or minimal pharmacological ef-
fect. The rays emitted by the radionuclide linked to the parent molecule provide diagnosis or
treatment in radiopharmaceuticals, which do not have an expected pharmacological effect.
Therapeutic radiopharmaceuticals can cause tissue damage from radiation. For radiopharma-
ceuticals, the same quality control tests that are necessary for conventional products are also
required. They must also be sterile and pyrogen-free. Radiopharmaceuticals can be a radioac-
tive elemen t such as
133
Xe, or a labeled compound such as
99m
Tc.
Radiopharmaceuticals consist of two components, a radionuclide and a pharmaceutical
part. A pharmaceutical is first selected for a radiopharmaceutical based on its primary local-
ization in the administered organ or role in the organ’s physiological function. The radionu-
clide then binds to the selected pharmaceutical. The pharmaceutical selected must be both
safe and nontoxic. The selected radionuclide should easily be detectable, and the patient’s
exposed radiation dose should be minimal [1,2].
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2.2 Radioactive labeling and some radionuclide examples
In medicine, biochemistry, and other fields, the use of radiolabeled components has grown
tremendously. Radionuclides that emit g, especially in the field of medicine, have a lot of use.
In a radiolabeled component, atoms or groups of atoms of a molecule have been replaced by
similar or different radioactive atoms or groups of atoms. When it comes to radiolabeling,
there are three sorts of chemical bonds to consider. Ionic bonds (weak bonds) are formed
by joining oppositely charged ions, covalent bonds (stronger than ionic bonds) are
formed by each atom transferring an electron to the bond, coordinated covalent bonds are
formed by an atom giving two electrons to the bond, and chelation is formed when more
than one atom donates electrons. The type of chemical bond affects the stability of the labeled
component. Despite the need for high labeling efficiency and specific activity, the effect of the
labeling reaction on the component to be labeled must also be considered. For example, pro-
teins at low pH, can be denatured by heating and oxidation [1,2].
2.2.1 Radionuclide examples
In nuclear medicine,
99m
Tc is the most often used radionuclide.
99m
Tc-labeled components
constitute more than 80% of the radiopharmaceuticals used in nuclear medicine. In studies of
herbal medicine interactions,
99m
Tc-labeled components were also used. Therefore, properties
of this radionuclide will be discussed. Technetium, with the atomic number 43, is a transition
metal of group 7B. It was discovered by Perrier and Segre in 1937. In nature, there is no stable
isotope of technetium.
99m
Tc, is widely used due to its ideal physical and radiation properties.
It has a physical half-life of 6 h. It can be used in millicurie amounts without exposing the
patient to a high radiation dose because of the low amount of electron emission. Also, it
can be obtained from
99
Mo-
99m
Tc generators as sterile and pyrogen-free.
99m
Tc-sodium per-
technetate,
99m
Tc-human serum albumin,
99m
Tc- macroaggregated albumin can be given as
examples of
99m
Tc-labeled components [1].
2.3 Drug interactions
A drug-drug interaction is described as when one drug alters the effect of another drug in
a qualitative or quantitative way. Both drugs must be present in the body at the same time for
an interaction to occur. However, the interaction may occur after the drug has been excreted
from the body in some cases. Since both radiopharmaceuticals and herbal medicines are
drugs, it is important to know how medications interact in order to understand the interac-
tions between them.
Drug interactions are classified into three groups based on their mechanisms [3].
2.3.1 Pharmacodynamic interactions
Pharmacodynamic interaction occurs when a medicine alters the effect of another drug by
producing the opposite or the same effect, or, in rare cases, by interacting chemically. When
two drugs are used together, there is a synergistic interaction if the response is greater than
when they are used separately, and an antagonistic interaction if the response is less. An ad-
ditive effect occurs when the combined effect of two medications equals the sum of the effects
they produce independently. Additive effect is also a kind of synergism. So there are two
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