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Interações entre plantas medicinais e medicamentos cardiovasculares
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Orientador(es)
Resumo(s)
Segundo a Organização Mundial de Saúde, as doenças cardiovasculares são a principal causa de morte em todo o mundo. O aumento da prevalência de doenças crónicas leva ao aumento do consumo de medicamentos utilizados para o tratamento de doenças do aparelho cardiovascular (MCV).
O crescente consumo de produtos de saúde à base de plantas medicinais, que são frequentemente administrados em combinação com medicamentos convencionais pode tornar os tratamentos ineficazes ou mesmo prejudiciais para a saúde.
Existem na literatura vários estudos de revisão relativos a interações entre medicamentos, mas são poucos os que estudaram especificamente as interações entre MCV e as plantas medicinais.
Pretendeu-se com esta monografia investigar a possibilidade de plantas medicinais e respetivos produtos interagirem com os MCV e, se sim, saber quais são os principais mecanismos e intervenientes destas interações, realizando-se, para o efeito uma revisão da literatura existente, por recurso a bases de dados eletrónicas disponíveis na Faculdade de Farmácia da Universidade de Lisboa.
Os resultados obtidos permitiram verificar a existência de interações entre plantas medicinais ou metabolitos secundários isolados a partir destas e os MCV, sendo estas fundamentalemente farmacocinéticas. Os medicamentos com maior número de estudos de interações foram a digoxina, a amiodarona, o losartan, o propranolol, a atorvastatina, a rosuvastatina e a sinvastatina. As espécies vegetais com maior número de estudos foram Ginkgo biloba, Camellia sinensis e Hibiscus sabdariffa e Allium sativum, Carica papaya e Citrus aurantium. Os metabolitos secundários com maior número de estudos foram a quercetina (flavonóide) e a curcumina (fenilpropanóide). Foram encontrados vários estudos de interações que não se referiam ao medicamento em concreto, mas à interação de plantas medicinais e metabolitos secundários com os principais alvos onde ocorrem essas interações. A espécie com maior número de estudos foi Panax ginseng, seguida de Allium sativum, Camellia sinensis, Echinacea purpúrea e Ginkgo biloba e os principais alvos de interação foram as enzimas metabolizadoras do citocromo P450 (CYPs) e os polipeptídeos transportadores de aniões orgânicos (OATPs) e glicoproteína-P (P-gp).
O presente trabalho mostrou a existência de interações entre plantas medicinais e MCV, sendo abordados os possíveis mecanismos desta interação. Realça-se também a importância do conhecimento destas interações pelos profissionais de saúde, para que estas se possam de alguma forma prevenir.
According to the World Health Organization, cardiovascular disease is the leading cause of death worldwide. The increased prevalence of chronic diseases leads to increased consumption of medicines used for the treatment of cardiovascular diseases (MCV). The increasing consumption of herbal health products, which are often administered in combination with conventional medicines, can make treatments ineffective or even harmful to health. There are several review studies in the literature on interactions between medications, but there are few who have specifically studied the interactions between MCV and medicinal plants. The aim of this monograph was to investigate the possibility of medicinal plants and their products interacting with MCV and, if so, to know what the main mechanisms and actors of these interactions are. For this purpose, a bibliographical research was carried out, on electronic databases available at the Faculty of Pharmacy of the Universidade de Lisboa. The results obtained allowed to verify the existence of interactions between medicinal plants or secondary metabolites isolated from these and the MCV, which are fundamentally pharmacokinetic. The drugs with the most interaction studies were digoxin, amiodarone, losartan, propranolol, atorvastatin, rosvastatin and syvastatin. The most studied plant species and corresponding medicinal plants and preparations were Ginkgo biloba, Camellia sinensis, Hibiscus sabdariffa, Allium sativum, Carica papaya and Citrus aurantium. The most studied secondary metabolites were quercetin (flavonoid) and curcumin (phenylpropanoid). Several studies of interactions were not related to a specific drug, but to the interaction of plants and secondary metabolites with the main targets where these interactions occur. The most studied species was Panax ginseng, followed by Allium sativum, Camellia sinensis, Echinacea purpurea and Ginkgo biloba and the main targets of interaction were cytochrome P450 (CYPs) metaboliser enzymes and anion organic transporting polypeptides (OATPs) and P-glycoprotein (P-gp) transporters. The present work showed the existence of interactions between medicinal plants and MCV, being addressed the possible mechanisms of this interaction. It also highlights the importance of knowing these interactions by health professionals, so that they can somehow prevent.
According to the World Health Organization, cardiovascular disease is the leading cause of death worldwide. The increased prevalence of chronic diseases leads to increased consumption of medicines used for the treatment of cardiovascular diseases (MCV). The increasing consumption of herbal health products, which are often administered in combination with conventional medicines, can make treatments ineffective or even harmful to health. There are several review studies in the literature on interactions between medications, but there are few who have specifically studied the interactions between MCV and medicinal plants. The aim of this monograph was to investigate the possibility of medicinal plants and their products interacting with MCV and, if so, to know what the main mechanisms and actors of these interactions are. For this purpose, a bibliographical research was carried out, on electronic databases available at the Faculty of Pharmacy of the Universidade de Lisboa. The results obtained allowed to verify the existence of interactions between medicinal plants or secondary metabolites isolated from these and the MCV, which are fundamentally pharmacokinetic. The drugs with the most interaction studies were digoxin, amiodarone, losartan, propranolol, atorvastatin, rosvastatin and syvastatin. The most studied plant species and corresponding medicinal plants and preparations were Ginkgo biloba, Camellia sinensis, Hibiscus sabdariffa, Allium sativum, Carica papaya and Citrus aurantium. The most studied secondary metabolites were quercetin (flavonoid) and curcumin (phenylpropanoid). Several studies of interactions were not related to a specific drug, but to the interaction of plants and secondary metabolites with the main targets where these interactions occur. The most studied species was Panax ginseng, followed by Allium sativum, Camellia sinensis, Echinacea purpurea and Ginkgo biloba and the main targets of interaction were cytochrome P450 (CYPs) metaboliser enzymes and anion organic transporting polypeptides (OATPs) and P-glycoprotein (P-gp) transporters. The present work showed the existence of interactions between medicinal plants and MCV, being addressed the possible mechanisms of this interaction. It also highlights the importance of knowing these interactions by health professionals, so that they can somehow prevent.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2020, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Citocromo P450 (CYP) Interação farmacocinética Interação farmacodinâmica Medicamento cardiovascular Plantas medicinais Mestrado integrado - 2020