Science-based Pharmacy

Abstract

The word “pharmakon” translated as ‘drug’ and meaning both ‘remedy’ and ‘poison’. Pharmacopoeia is an official book published by the government containing list of medicines with information about sources, description, identification, preparation and standardisation. Pharma-co-logy is a branch of medicine that encompasses drug interaction, toxicology, pharma-co-dynamics and pharma-co-kinetics. Pharmacodynamics is the study of drug action (biochemical) on living organism. Homeopathic medicines are prepared through a specific nanopharmacological process of potentisation. Pharmacy is the art and science of preparation and standardisation of drugs for use and dispensing them as medicines. Pharma-co-gnosy is the study of physical,chemical,biological and biochemical properties of drugs of natural origin. A pharmacist/chemist dispenses medicines in a pharmacy shop.

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Pharmakon

The word “pharmakon” meant both the disease and its cure to the ancient Greeks. The word is paradoxical, translated as ‘drug’ and meaning both ‘remedy’ and ‘poison’. This is still the same today – we refer to both effective medicines and to toxic substances as ‘drugs’ [1].

The words ‘pharmacopoeia’, ‘pharmacology’, ‘pharmacy’ and ‘pharmaceutical’ and are all derived from ‘pharmakon’.

Pharmacopoeia

The name Pharmacopoeia originates from the two greek words: Pharmakon, means a drug; and poieo, means to make. Pharmacopoeia is an official book published by government containing list of drugs and medicines, with information about the sources, habitats, description, identification, collection, preparation, combining, compounding and standardisation.

It is officially published by authority i.e by the government in charge of medical and welfare department, any Medical or pharmaceutical Society, either constituted or authorised by the government; and revised at times. A pharmacopoeia published by such an authority is termed as “official” [2]. Homoeopathic Pharmacopoeia of India(9 volumes, 1oth in progress) has documented 944 drugs. India also recognises British Homoeopathic Pharmacopoeia, Homoeopathic Pharmacopoeia of United States and German Homoeopathic Pharmacopoeia.

Homoeopathic Pharmacopoeia Laboratory, Govt. of India

List of homeopathic medicinesAnother List

Homeopathic medicines having more than one name

Pharmacology

It is a branch of medicine that encompasses drug interaction, toxicology, pharma-co-dynamics and pharma-co-kinetics. Pharmacodynamics is the study of drug action (biochemical) on living organism. In homeopathy, pathogenetic trials (provings) are conducted on healthy human beings, not on animals. Pharmacokinetics is the study of how the drug is absorbed in the body, the rate at which a drug action begins and the duration of the effect, and routes of excretion.

Arndt-Schultz law

This pharmacological law is about non-linearity between dose and response. It states that, “weak stimuli slightly accelerate the vital activity, medium-strong stimuli raise it, strong ones suppress it and very strong ones halt it”.

In simple words, ‘Minimal (minute: below its toxicity threshold) doses (weak stimuli) of a drug stimulate (increases physiological activity), medium doses inhibit or suppress and large doses (strong stimuli) abolish/destroy cellular activity’ [8].

In other words, substances vary in action depending on whether the concentration is high, medium, or low. The opposite action of large and small doses of medicine is known as ‘bi-phase response’, also known as ‘reverse action of drugs’ i.e. every medicine has two action phases that depend upon dosage.

Fig. 1: dose-response curve according to arndt-schultz law for laser therapy

On x-axis, we have response (effect/efficacy) of drug on body,,,,,,Response is stimulatory (therapeutic) above x-axis and inhibitory (toxicity) below x-axis,,,,,,On y-axis, we have dose (amount/concentration) of drug,,,,,,, A to B: no reaction because drug concentration is too small,,,,,, B to C: biostimulation (sharp rise in bioeffect),,,,,, C to D: sharp fall in bioeffect,,,,,, Below D: toxicity

Southam and Ehrlich coined the term ‘hormesis’ in 1943 to describe arndt-schultz law. Nanoparticles have biological activity. Nanoparticles can cause hormesis [10]. Hormesis ensures homeostasis is maintained.

Nanopharmacology

Homeopathy is “nanopharmacology” [3]. Medicines are prepared through a specific pharmacological process of potentisation which results in nanograms of fine nanoparticles of the original starting material in the final product (upto 200c potency) administered in treatment of any disease. Hahnemann in his paper “Cure and prevention of scarlet fever”, published in Journal of Practical Medicine in 1801, mentioned the prophylactic properties of Belladonna in scarlet fever and the method to prepare potentised Belladonna to 1/24,000,000 dilution. He recommended one drop which is equivalent to 0.0416 nanograms of belladonna (1 grain = 0.06479891 grams) and to repeat the dose every 72 hours. This is the first recorded nanodose of medicine used in treatment of any disease. Hahnemann can be attributed asThe Father of NanoMedicine[4].

Pharmacy

Image Credit: Wikipedia

Pharmacy is the art and science of preparation and standardisation of drugs for use and dispensing them as medicines

Pharmacist/chemist: Dispenses medicines in a pharmacy shop and advices, inform and answers frequently asked questions from patients.

Education for Pharmacist in UK

LFHom (Pharma): Licensed Associates of the Faculty of Homeopathy (1st qualification)

DFHom (Pharma) (Diploma)

MFHom (Pharma) (post-graduate)

Sources of homeopathic medicine [6]

Plant Kingdom: Herbs and plants are from plant kingdom such as Belladonna atropa (Deadly Nightshade) ,Calendula Off (Marigold), Arnica Montana (Leopards bane),Crocus Sativa (Meadow saffron),Drosera,Rumex, Opium (poppy), Carbo Veg (charcoal). Plants constitute more than 60% of homeopathic remedies.

Mineral Kingdom: Most of the elements and compounds like metals, salts, alkali, and acids are from mineral kingdom such as Sulfur, Calcarea Carb (Calcium Carbonate), Nitric-Acid, Natrum-Muriaticum (Common Salt).

Animal Kingdom: Lac Defloratum,Lac Caninum, Oleum Jecrosis,Lachesis, Aranea diadema, Apis Mellificia (honey bee), Sepia (cuttle fish), Lachesis (Snake), Tarentula (Spider), etc. Animal products constitute 20% of homeopathic remedies.

Farrington was the first one to arrange the remedies in three grand divisions: Vegetable, Mineral and Animal Kingdom in his book, “Lectures on Clinical Materia Medica in Family Order”.

Diseased Products: Medicines prepared from causative agent (agent which causes the pathology) i.e. identical disease products are known as Nosode such as Psorinum, Tuberculinum, Carcinosinum (breast cancer tumour),Pyrogenium, etc.

Medicines prepared from disease products of patient’s own body are known as auto-nosodes.

Healthy Specimen: Medicine prepared from healthy spicemen such as extracts of fresh tissue, organ or glands are called Sarcodes ex.Thyroidinum, Cortisone, Cholesterninum, Lecithin.

Energy Sources: Medicine prepared from energy sources are called Imponderabilia such as X-Rays, Sol (sun rays). Imponderables are potentised water (1l) or sugar or milk (1kg) which have been exposed to X-rays (1000 rad), and then diluted to 1/100 and the product is equivalent to 2X, etc. The electrical energy of the X-rays brings a change in orientation of dipoles of water molecules present in the water/sugar of milk.

Allersodes: Potentised antigens such as potentised histamine.

Remedies of plant and animal sources are named according to the binomial nomenclature introduced by Linnaeus (1753).

What do Homeopathic Medicines contain?

Homeopathic medicines are colloidal solutions containing biologically active ingredients heterogeneously dispersed in water-ethanol solution and are prepared by a pharmacological process mentioned below.

a. Biologically active ingredients: bulk concentration of remedy source material (below Avogadro limit) and nanoparticles of remedy source material (both below and above Avogadro limit upto 200C) (5-100 nanometer sized particles with a concentration of 1-4000 picograms/ml).

b. Carrier/solvent/drug-delivery vehicle: silica (glass-derived, 6 ppm), aqueous ethanol, lactose.

Water: purified (de-mineralised) by combination of double distillation and reverse osmosis

Ethanol: 95% triple distilled extra-neutral (treatment by activated carbon)

c. Adjuvant: Silica (glass-derived)

How Homeopathic Medicines are prepared?

Hahnemann, in Chronic Diseases, 2nd edition (1835-1839) and Organon Aph 269 – 275 (6th edition) recommends that all medicines should be prepared by trituration upto 3rd attenuation (3C/3X) and then by potentisation for higher potencies.

Trituration is repeated grinding (pulverization) of medical substance with sugar of milk (lactose) powder (9 or 99 parts by weight in X and C scale respectively) in a grinding machine for minimum of 1 hour. This results in breaking down of cellular walls of medicinal substance into nanoparticles.

1. Preparation of Mother Tincture/Mother Solution [ethanol-based extract prepared by adding the original drug substance in ethanol or a 10% water-90% (v/v) ethanol solution (phytochemical extraction methods, Maceration/Percolation for 15-21 days, hydraulic press]. The ethanol content in mother tincture varies from 45% to 65%

2. Potentisation: It is carried out in type-2 borosilicate (96.4%) glass vial. It involves two steps:

a. Systematic dilution of MT or third attenuation in water-ethanol solution: successive reduction in the concentration of the basic medicinal substance to make the drug chemically non-toxic.

b. Succussion of the solution

Effects of Potentisation [5,7]

1. It activates (brings out) the qualitative change (formative intelligence) in dynamic properties of the physical/remedy substance (solute) which is potentised by eliminating the chemical toxicity (by dilution) and enhancing its efficacy by activates its latent healing properties (by succussion) which were otherwise inert. The properties are transferred/imprinted on the carrier/solvent/diluent/vehicle (water-ethanol mixture, expiry: 5 years).

Other liquid vehicles: water (expiry: 1 day), ethanol, glycerin

Other vehicles: Lactose

Possible vehicles: honey, ascorbic acid

2. It increases the range (intensification) and depth (more readily absorbed into the body (tissues) of curative action of a drug.

3. Potentisation creates Molecular Clusters(micro-domains) in water.

4. Potentisation alters the physical and chemical properties of Water.

5. Potentisation alters the structure of water

6. Potentisation creates nanostructures in aqueous solutions.

Scales of Potencies [5]

1.Decimal (X or D): used in

2.Centesimal (C)

3. Millesimal (LM or Q): LM potency is derived from 3C trituration of the original drug substance. LM dose is given in water, succussed and diluted before administering each dose so as to alter the potency each time.

Each dilution step in three scales divides the original quantity by 10, 100 and and 50,0000 respectively. A potency 6x means it is diluted 1:9 6 times with succussion at each dilution level. A potency 7x is 10 times more diluted and many times more succussed than 6x.

Relationship between various scales dilution wise

2X = C (C is succussed more than X at same potency)

LM1 = 5.35 C (LM1 succussed considerably more than 6C)

Each step of LM dilution is a rise of 2.5C

Preparing potency: Korsakoff method [6]

Each potency is prepared in the same sterilised vial (20 ml), and the earlier step is simply poured out, so the remedy carried on is that which sticks to the inner surface of the vial. Benoit Mur built the first potentisation machine based on karsakoff method. Automatic potentizer ensures that each succussion is performed with the same number of strokes and with the same force on each stroke. Quinn potentiser is a variation of Karsakoff machine. The most popular Karsakoff machine used now-a-days is Labotic’s K-TRONIC. Mathematically, the final solution of a Korsakovian potentization using single-vial-method is identical to that of the Hahnemann’s multi-vial-method, provided that one hundredth (for C scale) of the remedy solution keeps adhering to the glass wall.

Machine-Made Potencies

Standardisation of drugs

In february 2010, World Health Organisation initiates steps towards standardisation in preparation of homeopathic medicines.

Homeopathic Pharmacopeia of United States Guidelines for Manufacturing Homeopathic Medicines 2013 http://www.hpus.com/Draft-Guidelines-for-Manufacturing-Homeopathic-Medicines.pdf

European Pharmacopeia of Homeopathic Preparation 2013 http://www.pharmalogica.pl/pharmalogica/news/2013.09/2013-09-26%20EDQM%20Elaboration%20of%20monographs%20on%20homoeopathic%20preparations.pdf

Pharmacognosy: Quality Testing

Spectral methods: Infrared spectroscopy, Atomic Absorption spectroscopy

Chromatography: HP Thin Layer Chromatography, Gas chromatography

Electrochemical: Potentiometry, Conductometry,Polarimetry

Lovibond Tintometer, Titometery, Refractometry

Drug Constituents: Alkaloids, Glycosides, Saponins, Tannins,Flavonoids, etc.

Identification of homeopathic medicines (4 techniques) [9]

A. Spectroscopy: It is the study of interaction between matter and radiated energy i.e. how a substance absorbs, emits or scatters electromagnetic radiation.

1. Raman Laser Spectroscopy (1976)

In 1976, Boiron and Vinh used Raman Laser Spectroscopy, showing that for the 1C potency of Kali bichromicum the spectrum of alcohol disappears completely, while that for potassium bichromate appears. In Kali bich 1C the ratio of the number of potassium bichromate molecules is 1 to 500. In such a case the light meets 500 more alcohol molecules as those of bichromate, yet the alcohol spectrum does not appear.

2. New Magnetic Resonance method by K. Lenger (2006)

Homeopathic Potencies Identified By a New Magnetic Resonance Methodpublished in journal ‘Subtle Energies and Energy Medicine’

Delayed luminescence of high homeopathic potencies on sugar globuli (2008) FULL TEXT

3. Ultra-Violet–Visible (UV–VIS) spectroscopy (2007)

The defining role of structure including epitaxy in theplausibilityof homeopathy(2007) FULL TEXT

4. Nuclear Magnetic Resonance (NMR) spectroscopy (2008)

NMR spectroscopy on Kalium Bichromium (2008) FULL TEXT

High dilutions of histamine distinguishable using NMR (2009) FULL TEXT

5. Electromagnetic Signatures (2009)

Nanostructures in highly diluted biological samples of bacteria and virus DNA sequence produces electro-magnetic signals (2009) FULL TEXT

B. Thermo-luminescence: The amount of light produced by a sample when it is heated (due to the release of stored energy) can be measured.

Low temperature thermo-luminescence of ultra-high dilutions of lithium chloride & sodium chloride (2003) FULL TEXT

C. Dielectric Dispersion

Homeopathic medicines when subjected to variable frequency electric field shows dielectric dispersion (2010)

D. Physiological variability in human body: homeopathic medicines produce change in body temperature by its action on hypothalamus.

Software for measuring physiological variability (2008) FULL TEXT

Dispensing homeopathic medicines

1. Wet Dose (orally administered and is absorbed from gastro-intestinal tract)

a. Mother tincture: Preserved at 15.6’C (Lawrence Ashwell)

b. Liquid (aqueous-ethanol) Potency: In X, C and LM scale of potencies. In C-scale readily available potencies are 3c, 6c, 12c, 30c, 200c, 1M, 10M. Solutions with minimum of 10 ml packaging size available.Drinkable ampoules (single-dose liquid potency) are also available. Liquid potencies are supplied in amber-coloured glass bottles

2. Dry Dose (administered sub-lingually by placing under tongue and is absorbed by mucous membranes)

a. Sugar of milk (lactose) powder: whey powder prepared from skimmed goat milk

b. Granule/Pillules/Globules(cane sugar): globule size varies from 8 to 80 , example, size 20 (or 30) means 10 gloubules in close contact with each other in a line whose length is 20 (or 30) millimeter.

c. Tablets/Diskets/Pellets e.g. Biochemical salts: readily available in 1X,3X,6X and 12X potency. For tabletting permitted excipients are starch (permitted upto 10%) and magnesium stearate (upto 2%). Currently used is Carboxy-methyl celulose

3. Ointments: Cream, Gel

4. Drops:Homogenous liquid preparations

Cost-Effectiveness of homeopathic medicines

Homeopathic medicine has a price of up to 70% lower than patent medicines, and is 15% cheaper than generics

Treatment by homeopathy costs 50% less compared to conventional therapy in respiratory diseases (2009) FULL TEXT

The homeopathic approach was 14% cheaper compared to conventional treatment in case of acute otitis media (2001) FULL TEXT

Homeopathic pharmacies worldwide

http://hpathy.com/homeopathy-pharmacies/

http://homeoking.blogspot.in/p/homeopathy-pharmaceuticals.html

Homeopathic pharmacies in UK

Manufacturers: Helios,,,,,Ainsworths,,,,,Nelsons,,,,,,FreeMans,,,,,Weleda

Retailers:Boots,, Neals Yard,, Manor,, HSC ,,,,Sanjivini

Homeopathic pharmacies in India

http://www.freewebs.com/homeopathy249/pharmaciesindia.htm

There are 199 Good Manufacturing Practices-compliant homeopathic pharmaceutical companies in India with West Bengal state having the highest numbers (2010)

Healthcare services in Homoeopathy are provided by 215 hospitals and 6812 dispensaries run by state governments and municipal bodies, 35 dispensaries of Central Government Health Scheme, 39 of the labour ministry and 129 of the railway ministry.

According to AYUSH 2010 report, Rs. 5.58 crores of homoeopathic medicines and Rs. 2.83 crores of biochemic medicines have been exported in 2009-10.

FACT: No individualised homeopathic medicine has ever been subject to a product recall in the entire history of medicine

DOWNLOAD BOOK: Homeopathic Pharmacy

Last Modified: This article was last updated on 10th Feb 2014.

References

• Why Pharmakon?
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• A textbook of Homoeopathic Pharmacy, D.D. Banerjee, 2007, pp.12
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• The Emerging Science of Homeopathy.Complexity, Biodynamics and Nanopharmacology. Paolo Bellavite, Andread Signorini. North Atlantic Books. Berkeley, California. 1995. ISBN 1-55643-384-0.
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• Homeopathy as Nano Medicine, Nancy Malik, Research Updates-Homeopathy (ISSN 2278-4500), Vol. 1, issue 8, 13 July 2012
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• Principles of Homeopathy Explained, Nancy Malik
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• FAQ&A on Homeopathy, Nancy Malik
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• How super-Avogadro Dilutions in Homeopathy work?, Nancy Malik
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• Homoeopathy in the Light of Modern Science, A.C.Dutta, 4th ed., B. Jain Publishers, 200?
• Scientific Research in Homeopathy, Nancy Malik
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• Iavicoli I, Calabrese EJ, Nascarella MA: Exposure to nanoparticles and hormesis. Dose Response 2010, 8(4):501–517.
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