Catalogo dei Corsi di studio

The general objective of the course of Pharmacognosy and Phytotherapy is to provide the student, at the completion of the course, the concepts concerning the composition and effects of “drugs” (biologically active substances of natural origin), their preparations and the active ingredients contained in them. The student, based on the acquired skills, will thus be able to correctly use natural products in the therapeutic field, as well as dietary supplements or in the pharmaceutical industry. These objectives will be achieved through the co-ordinated integration of lectures and practical activity of comparison and analysis, in which particular attention is devoted to the effectiveness and safety of use of herbal preparations.
Specific objectives of the course of Pharmacognosy and Phytotherapy are the acquisition, by the student, of transversal skills, related to detailed knowledge of different aspects of herbal drugs. In particular: their morphological characters, identification methods, possible sophistication, chemical composition, the pharmacological activity, the practical uses, the possible pharmacokinetic and / or pharmacodynamic interactions with drugs, foods, etc. and any undesired or toxic effects.
The skills that will be acquired, also through classroom exercises dedicated to specific insights, concern the exercise of critical skills and judgment on the real effectiveness and safety of use of commercial products containing medicinal plants. These skills will contribute to the preparation by the student, not only to communicate what has been learned, but also to continue the study and the related in-depth analysis of the subject. The communication skills and the applicative autonomy (in the real life) of the concepts learned and the related objectives achieved, will also be made possible by the tools that will be provided to the student during the course, including: scientific documentation to refer to, institutional and non-profit scientific associations websites, industry databases, etc., in addition to reference teaching texts.

Programme

The syllabus is divided into the three major sections. In the first section (20 h), the general aspects of Pharmacognosy and the problems of natural products will be examined, with particular interest in the variability factors of natural products, preparation methods of herbal drugs, and quality control (points 1-3). In the second part (28 h), the characteristics of the phytochemicals of herbal drugs and their biological properties and mechanisms of action will be studied, with representative examples of medicinal plants (points 4). In the third part (48 h), the phytotherapy for specific mild/moderate pathologies will be treated; in this part, general problems relating to safety of herbal drugs and possible adverse reactions will be also dealt with (point 5-7).

General Pharmacognosy (point 1)

Basic concepts and terminology of Pharmacognosy (medicinal plant, drud, herbal drug, principle active, phytocomplex, balsamic time, herbal medicine, botanicals). Herbal drugs and its pure chemical components (biavailability, pharmacodynamic activity, administration routes and dosages). Elements of animal and mineral pharmacognosy. Enzymes. Principles of alternative medicines. Homeopathy.

Herbal drug production and preparation (point 2)
Spontaneous and cultivated medicinal plants. Collection of medicinal plants. Methods of post-harvest storage (drying, freeze-drying). Extractive methods (maceration, percolation, infusion, decontamination).

Quality control (point 3)
Definition and aim of quality control. Herbal drug quality: variability factors and causes of quality loss: adulteration, sophistication, deterioration, substitution.
Phases of the quality control: identification of herbal drugs (macro- and microscopic analysis), organoleptic examination, purity assays and physico-chemical analysis.

Phytochemicals (point 4)
Chemical aspects, biosynthesis, occurrence in nature, properties and mechanisms of action.

Carbohydrates and carbohydrate-based herbal drugs. Natural sources, methods of obtaining, therapeutic, herbal, technical and industrial uses of carbohydrates, carbohydrate drugs and their preparations. Monosaccharides: glucose, fructose, sorbitol. Oligosaccharides: sucrose, lactose, cyclodextrins. Polysaccharides: starch, cellulose, dextrans, inulin, pectins, gum arabic, tragacanth, guar gum, agar, carrageenans, alginates. Main medicinal plants containing carbohydrate.

Lipids and lipid-based herbal drugs. Natural sources, methods of obtaining, therapeutic, herbal and technical uses of lipids, lipid-containing drugs and their preparations. Saturated and unsaturated fatty acids with particular regard to essential fatty acids, glycerides, waxes. Main medicinal plants containing lipids.

Glycosides and herbal drugs containing glycosides.

Anthraquinone glycosides. Mechanism of action, indications for use, adverse effects and risks due to abuse or misuse. Main medicinal plants containing anthraquinones: aloe, cascara, buckthorn, rhubarb, senna.

Cardiac glycosides. Natural sources, biological activity, therapeutic uses. Main medicinal plants containing cardiac glycosides.

Flavonoid glycosides and flavonoid-based herbal drugs. Natural sources, biological activities, mechanisms of action, therapeutic uses of flavonoids and their semisynthetic derivatives; uses of flavonoid-based herbal drugs.

Other glycosides. Iridoids and herbal drugs containing iridoids: gentian, valerian, devil's claw. Glucosinolates and sulfur compounds.

Polyphenols and tannins. Natural sources, biological activity and uses. Hydrolyzable tannins, condensed tannins and tannoids. Main medicinal plants containing polyphenols: Camelia sinensis, Hamamelis virginiana, etc.

Saponins and saponin-based herbal drugs. Natural sources, herbal, technical and industrial uses of saponins, herbal drugs containing saponins and their preparations. Main medicinal plants containing saponins: sarsaparilla, ginseng, polygala, licorice, horse chestnut.

Terpenes and terpene drugs. Essential oils: chemical composition, natural sources, methods of obtaining, biological effects and related mechanisms of action, uses of essential oils and herbal drugs containing essential oils. Adverse effects of essential oils. Main medicinal plants containing essential oils and resins: mint, camphor, eucalyptus, lavender, lemon balm, bitter orange, wormwood, chamomile, balsam of Peru, balsam of Tolu. Other medicinal plants containing terpenes: ginkgo, badger.

Alkaloids and medicinal plants containing alkaloids: this part requires, in particular, knowledge on physiology of central (CNS) and autonomic nervous system (ANS).

Herbal drugs acting on ANS. Sympathomimetic herbal drugs: coca, ephedra; sympatholytics: rauwolfia; parasympathomimetics: Amanita muscaria, Calabar bean, jaborandi; parasympatholytics: belladonna, henbane, thorn tree.

Ganglionic herbal drugs: tobacco.

Herbal drugs acting on neuromuscular plaque: curaries.

Herbal drugs acting on CNS. Exciting herbal drugs: caffeic drugs, coca, ephedra; depressants: opium, rauwolfia. Other herbal drugs used for pleasure or ritual purposes: Amanita muscaria, Indian hemp, khat, peyote, psilocybe. Derivatives of lysergic acid. Oxytocic drugs: ergot.

Phytotherapy (point 5)

Problems related to the use of medicinal plant-based preparations: variability of the composition and problem of bioequivalence. Standardization of herbal preparations. Fingerprint. Use of markers for titration.

Definition and marketing of herbal products, food supplements, nutraceuticals, cosmetics, herbal medicines of consolidated and traditional use and related examples. EMA Monographs.

Preparations containing herbal drugs and derivatives: evidence-based use.

Methods for clinical efficacy evaluating: systematic reviews and meta-analyzes.

Safety of herbal drugs (point 6)

Basics principles of Phytovigilance. Causes of adverse reactions to natural products. Herbal drugs and drugs interactions. Surveillance of adverse reactions to medicinal plant-based products: case reports and causality assessment methods.

Application part (point 7)

Herbal drugs and their preparations used as mild sedatives.

Herbal drugs and their preparations used in mild and moderate depression.

Herbal drugs and their preparations used as adaptogens and immunostimulants.

Herbal drugs and their preparations used in upper respiratory tract disorders.

Herbal drugs and their preparations used as eupeptics, choleretics and hepatoprotectors.

Herbal drugs and their preparations used as fat-lowering agents.

Herbal drugs and their preparations used in mild or border-line hypertension.

Herbal drugs and their preparations used as vasoprotectors.

Herbal drugs and their preparations used as laxatives and purgatives.

Herbal drugs and their preparations used for weight control: lipolysis and/or thermogenesis stimulating drugs; satiety inducing drugs; drugs that reduce lipogenesis; cleansing drugs.

Herbal drugs and their preparations used as aquaretic/diuretics and against lower urinary tract infections.

Herbal drugs and their preparations used in disorders related to benign prostatic hyperplasia.

Herbal drugs and their preparations used in menopausal disorders, premenstrual syndrome and dysmenorrhea.

Herbal drugs for dermatological use in the treatment of skin inflammations, wounds, burns, bruises.

Adopted texts

- Mazzanti G., Dell'Agli M., Izzo A.A. (2020) - Farmacognosia e Fitoterapia - Basi farmacologiche e aspetti applicativi - Piccin Nuova Libraria S.p.A., Padova

- Capasso F. (2011). FARMACOGNOSIA Botanica, chimica e farmacologia delle piante medicinali. Springer, Milano.

- Capasso F. (2006). Fitoterapia – Impiego razionale delle droghe vegetali. Capasso F., Grandolini G., Izzo A.A. Ed. Springer

Bibliography

- Ragazzi E., Dorigo P. (1999). Droghe Animali ed Enzimi. Casa Editrice CEDAM, Padova. - Paolo Colombo, Franco Alhaique, Carla Caramella, Bice Conti, Andrea Gazzaniga, Elena Vidale (seconda edizione 2015). Principi di tecnologia farmaceutica (CHAPTER 39 - Preparati di droghe vegetali). Zanichelli Ed. - Heinrich M., Barnes J., Gibbons S., Williamson E.M. – Edizione italiana a cura di Galeotti N., Mazzanti G., Serafini M. (2015). FONDAMENTI DI FARMACOGNOSIA E FITOTERAPIA. Edra S.p.a., Milano. - European Pharmacopoeia 10th Edition

Prerequisites

To effectively follow and understand the topics covered in the course and to achieve the learning objectives, or to begin the study of the topics provided by the module of Pharmacognostic biotechnology, the students should possess key competences of general biology, plant biology, in particular with regard to the structure and physiology of vegetable cell and plant, inorganic and organic chemistry, biochemistry and physiology. Knowledge of the principles of general pharmacology is recommended.

Frequency modes

Class attendance is recommended. In fact, the lectures will allow the student not only to acquire specific knowledge but also to develop communication skills and technical language through the interaction in the classroom with the lecturer on topics related to the course. The student will also be stimulated to formulate judgments and to critically evaluate the challenges and problems about the topic under study, particularly the herbal drug quality, the rational use and the possible adverse reactions.

Exam modes

Learning achievements will be evaluated through an oral exam, during which the student will be asked to describe and critically discuss the topics covered by the syllabus and covered during classroom.
The exam can be passed if the score is greater than or equal to 18/30. To achieve the minimum score, the student must demonstrate to that sufficient knowledge of the general problems of Pharmacognosy and plant drugs, and of natural compound characteristics and on the use of medicinal plants in phytotherapy, with particular reference to rational use and safety problems of use, have been acquired. To achieve a score of 30/30 cum laude, the student must instead demonstrate that excellent knowledge of all the topics covered during the course and logical abilities have been acquired.

Programme

PROGRAM
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.

Adopted texts

- 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.

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/).

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.

Frequency modes

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 modes

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.