Yellow Oleander Trumpet Flower

Thevetia peruviana flower and fruit Thevetia peruviana shrub

Description: Thevetia peruviana (Pers.) K. Schum. is a shrub, up to 6 m tall. All parts contain highly poisonous milky latex. Leaves are simple, few, exstipulate and spirally arranged. Blade is linear, 7-13 cm by 0.5-1 cm and glossy. Flowers are large, yellow, 5 cm across, gathered in few flowered terminal cymes. Fruits are green, shiny, globose, 4-5.5 cm across with 4 or less poisonous seeds.[1]

Origin: Native to Central and South America.[2]

Phytoconstituents: Thevetins A and B, thevetosides, acetylperuvoside, epiperuviol, perusitin, theveneriin, thevebioside, thevefolin, pervianoside I—III and others.[3-6]

Traditional Medicinal Uses: Used as an abortifacient, to treat congestive heart failure, malaria, leprosy, indigestion, ringworm, venereal disease and even as a suicide instrument.[7] Used in India as an astringent to the bowel, useful in urethral discharge, worms, skin diseases, wounds, piles, eye problems and itch. Used in continental Europe and is considered particularly useful in mild myocardial insufficiency and digitalis intolerance.™ Its bark is used as an emetic, febrifuge, insecticidal, poison and for reviving patients with heart failure.[4]

Pharmacological Activities: Antiarrhythmic,™ Antifungal,™ Hepatotoxicity and Nephrotoxicity,™ Larvicidal, [9] Molluscicidal,[10] and Cardiotonic.™

Dosage: No information as yet.

Adverse Reactions: Vomiting, dizziness, and cardiac dysrhythmias such as conduction block affecting the sinus and AV nodes may occur.[11]

Toxicity: Toxic to humans,[31116] fishes[1719] and animals.[520] Ingestion of half to fifteen seeds may cause a varying degree of vomiting, palpitation, arrhythmia including sinus bradycardia and could also lead to death.[21] The kernels of about 10 fruits may be fatal to adults while the kernel of one fruit may be fatal to children.[22]

Contraindications: No information as yet.

Drug-Herb Interactions: No information as yet.

[Authors' Note: The purified glucoside thevetin, extracted from the seeds, is prescribed as a cardiotonic drug in a 0.1% solution orally, in a dose of 1 to 2 ml daily, or in 1 mg/2 ml ampoules parenterally. 1 to 2 ampoules have been given daily for its cardiotonic property.[23] A dose of 2.4 mg followed by average maintenance dose of 600 /g has been shown to be effective in 22 patients with congestive heart failure.™ The herb has been administered as a thevetin tablet of 0.25 mg/tablet. A maintenance dose consists of 0.25 mg/day. For injection administration, an injection ampoule is prepared from 0.25 mg/ml diluted in a 5% glucose solution.[24] However, note that thevetin is not conventionally used in clinical practice and its dosage is not found in pharmacopoeial monographs.]

73. Tinospora crispa (L.) Diels (Menispermaceae)

Akar Putarwali, Batang Wali

Tinospora crispa shrub Flowers of Tinospora crispa

Description: Tinospora crispa (L.) Diels is a woody climber with numerous protrusions on the stem. Leaves are oblong-ovate, cordate, 8-9 cm by 7-8 cm and tapering to a pointed end. Flowers are small, with 6 petals, 2 mm in length and 8-27 cm racemes. Male flowers have yellow sepals whereas female flowers have green sepals. Drupelets are red, juicy and 7-8 mm long.[1,2]

Origin: Native to Malesia, Indochina, Indian subcontinent and China.[3]

Phytoconstituents: Boropetol B, borapetoside B, C & F, jatrorhizine, mag-noflorine, palmatine, protoberberine, tembolarine, diosmetin, cycloeucalenol, cycloeucalenone and others.[4-8]

Traditional Medicinal Uses: It is used for hypertension, diabetes mellitus,[9] to treat malaria, remedy for diarrhoea and as vermifuge.[6] In Malaysia, T. crispa extract is taken orally by Type 2 (non-insulin-dependent) diabetic patients to treat hyperglycaemia.[10]

Pharmacological Activities: Anti-inflammatory,[11] Antioxidant,[7] Antimalarial,[12,13] Antiprotozoal[14] and Hypoglycaemic.[10,15,16]

Dosage: No information as yet.

Adverse Reactions: The plant may result in an increased risk of hepatic dysfunction due to marked elevation of liver enzymes but is reversible upon discontinuation of T. crispa.[11]

Toxicity: No information as yet.

Contraindications: No information as yet.

Drug-Herb Interactions: T. crispa extract showed 61.3% increase of cytochrome P450 3A4 (CYP3A4) enzyme inhibition after 20 min of preincubation with human liver microsomes.[18]

[Authors' Note: In a randomised double blind placebo controlled trial[17] to determine the efficacy of T. crispa as an additional treatment in patients with Type 2 diabetes mellitus who did not respond to oral hypoglycaemic drugs and refused insulin injection, 20 patients received T. crispa powder in capsule form at a dose of 1 gram three times daily for six months. Twenty patients received a placebo. The results showed no evidence to support the use of T. crispa for additional therapy in such patients. Two patients had elevated levels of liver enzymes, which was reversible on discontinuing T. crispa. Patients receiving T. crispa had significant weight reduction and cholesterol elevation. Note that the study only included patients that did not respond to oral hypoglycaemic therapy.]

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