Drugs
Some years ago a report appeared of a patient presenting at a hospital in
Birmingham with powders from the Punjab that he was using to self-treat
psoriasis and were individually wrapped in newspaper.^23 High-performance
liquid chromatography analysis of the powders revealed the presence of
prednisolone, a prescription medicine that is potentially dangerous.
Identification of medicines
A number of problems that pharmacists and other healthcare providers may
experience in identifying ingredients and assessing their potential toxicity in
Asian remedies have been identified:^24
- Typographical errors on the label
- Inaccurate phonetic transliteration
- Changes in nomenclature
- Absence of generic names on the label
- Undeclared ingredients and adulterants
- Assessing the literature and finding information.
Trease and Evans’ Pharmacognosy,^13 to which frequent references are
made in this chapter, provides an excellent and readily available source of
information for traditional medicine practices.
Potential interactions
There is a substantial risk that patients will receive simultaneous western
and traditional treatments. Patients seldom volunteer information
concerning any traditional medicines being taken. A case has been reported
in which a woman receiving chemotherapy for Hodgkin’s disease supple-
mented her treatment with at least nine different ayurvedic medicines.^25 She
suffered a thrombosis thought to result from an interaction between the
orthodox and traditional medicines. Pharmacists can provide an extremely
valuable function in this respect by intervening with advice whenever they
consider it to be appropriate.
An interaction between the fruit karela (Momordica charantia), an
ingredient of curries, and chlorpropamide has been reported.^26 Although
this particular drug has been superseded by other hypoglcaemics, it serves
to flag up a possible difficulty with concurrent treatment. Karela improves
glucose tolerance and is therefore hypoglycaemic. There are a number of
other close relatives of this plant that are also used by hakims to treat
diabetes, including crushed seed kernels of the marrow (Curcubita pepo) and
the honeydew melon (Cucumis melo). There is a danger that some patients
may be treating their diabetes with both allopathic and traditional remedies
without realising the risk of interaction.
212 | Traditional medicine