Ayurveda

Ayu + Veda (Sanskrit)

Ayu: Life; Veda: Knowledge/Science

The literal meaning of Ayurveda is the knowledge or science of life. It is the most ancient medical science of the world which was evolved before 5000 years ago. It is an integral part of the Vedic philosophy and evolved in the culture of Nepal and India (Indian subcontinent). Ayurveda is the holistic science of health which covers the physical, psychological and spiritual well being of all living beings. It focuses on achieving optimal health through the integration of mind and body with nature. It treats human being as a complex whole and strives for harmony between human being and the entire surroundings around. In order to achieve this harmony, Ayurveda guides an individual to live perfect quality live through the management of lifestyle and physical, mental or spiritual ailments. It adopts different medicine therapies, exercises and dietary regimens. So, Ayurveda is not only a system of medicine but also a dynamic philosophy of life which enables one to lead a simple, productive and healthy life.

Likewise, apart from human body, Ayurveda deals with the welfare of all living beings including plants and animals. According to the Vedic philosophy, animal and plants also have mind and a soul along with physique. Besides, Ayurvedic texts for human beings, there are certain books for animals and plants as well.

a. Gavaayurveda: Dealing with the health of cattle

b. Aswayurveda: Dealing with the health of horse

c. Gajaayurveda: Dealing with the health of elephants

d. Vriksayurveda: Dealing with the health of vegetable kingdom.

Ayurveda doesn’t accept health as a condition of freedom from disease and possession of robust body. To be healthy, there should be perfect harmony of Doshas (Bioregulating principles or physical entities governing body physiology/ somewhere referred as humors), Dhatus (Tissues elements composing anatomical structures) along with the soundness of the Senses, Mind and Soul. Thus Ayurveda deals signs and symptoms of happy and unhappy life, drugs, diets, drinks and other regimens which are useful and harmful for good health. In other words, Ayurveda prescribed DOs and DON’Ts, the prevention and promotion of positive health as well as prevention and cure of the diseases. Hence, Ayurveda is a holistic science of life, which teaches us the art of living.

The scope of Ayurveda is quite vast. On one hand, it gives detailed information regarding treatment of rare and complex diseases. On the other hand, it teaches a healthy person to remain fit and disease free. Ayurvedic principles and philosophy are real and universal. They are eternal and everlasting which guides us to universal well being and joy.

AYU (LIFE)

Ayu is the combination of physical body containing five each of the sensory and executive organs, mind (Satwa) and Soul/Spirit (Aatma). Hence body, mind and spirit are the constituents of Ayu.

VEDA (KNOWLEDGE)

Veda literally means knowledge in Sanskrit. They are the collection of the supreme knowledge achieved by the ancient seers in the stage of the contemplation. They are:

• Oldest scriptures in the library of human beings.

• Most well organized scriptural knowledge (books of wisdom) of the whole world.

• Knowledge of Veda used to be handed down from generation to generation for several thousand years by oral tradition by Vedics before being recorded in written form.

• Roots and basis of our culture (Indian subcontinent) and civilization.

According to Hindu philosophy there are four different Vedas. i.e Rigveda, Yajurveda, Samveda and Atharvaveda

1. Rigveda: The book of Mantra:

The Rig Veda is a collection of inspired songs or hymns and is a main source of information on the Rig Vedic civilization. It is the oldest book in any Indo-European language and contains the earliest form of all Sanskrit mantras that date back to 1500 B.C. - 1000 B.C. The Rig-Vedic ‘samhita’ or collection of mantras consists of 1,017 hymns or ‘suktas’, covering about 10,600 stanzas, divided into eight ‘astakas’ each having eight ‘adhayayas’ or chapters .

2. Samveda: The book of Songs:

The Sama Veda is purely a collection of melodies (‘saman’). The hymns in the Sama Veda, used as musical notes, were almost completely drawn from the Rig Veda and have no distinctive lessons of their own. If the Rig Veda is the word, Sama Veda is the song or the meaning, if Rig Veda is the knowledge, Sama Veda is its realization, if Rig Veda is the wife, the Sama Veda is her husband.

3. Yajurveda: The book of Rituals:

Yajurveda was made to meet the demands of a ceremonial religion. It practically served as a guidebook for the priests who execute sacrificial acts muttering simultaneously the prayers and the sacrificial formulae (yajus).

4. Atharvaveda: The book of Spells:

This is completely different from the other three Vedas and is next in importance to Rig-Veda with regard to history and sociology. The Atharva Veda consists of spells and charms prevalent at its time, and portrays a clearer picture of the Vedic society.

From the Ayurvedic point of view, Atharvaveda is the most important Veda. Primarily Ayurveda was developed from this Veda nd Ayurveda is considered as the Upaveda (branch) of the Veda. It is the most recent of all Vedas which contains the concept of three bioregulating principles/ humors (Vata, Pitta and Kapha), anatomy, physiology, diseases and medicinal plants. Some scholars (Kashyapa) took Ayurveda as a fifth Veda because of its great importance, put in topmost position amongst them.

Definition of Ayurveda

Ayurveda is that science which describes

• Advantageous(Wholesome) and disadvantageous(unwholesome) life: Social aspect

• Happy and unhappy states of life: Individual aspect

• What is good and bad for life: Dietary aspect

• Life and its measurement: Healthy life must be of 100 yrs duration!

So, Ayurveda is the knowledge of life which makes human life healthy, happy and optimum. In conclusion, Ayurveda is not merely the science of treatment through herbal medicines and shrubs or some bodily exercises but an instruction and view of living a complete human life.

Traditional System of Medicine: Concept and Overview

 

Search of absolute emancipation from all types of miseries is as old as the beginning of human civilizations. The evolution of different healing systems in different parts of world is the result of this fact. Asian countries were ahead from the west in the philosophical field. Ayurveda: Evolved in the indian sub-continent as most authentic and well documented system before 5000 years ago. Likewise, Chinese system of traditional medicine, Kampo (Japanese), Tibetan (Himalayan region), Naturopathy, Homeopathy, Aromatherapy etc are the other major traditional system of medicine which have their own speciality and practice history.

Complementary/ alternative medicine (CAM)

The terms "complementary medicine" or "alternative medicine" are used inter-changeably with traditional medicine in some countries. They refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.

 

Characteristics features and major concepts associated with Traditional Medicine (TM).

Ø  Guided by different ancient philosophies

Ø  Focuses not only in medicine but in the whole process of life.

Ø  Holistic system rather than analytical.

Ø  Patient oriented rather than disease oriented.

Ø  Remain almost unchanged over a long period of time

Ø  Natural products, mostly herbs are used as the source of medication.

Ø  Different breathing techniques, postures, exercises, spiritual practices (Shamanism) are also the part of TM therapy.

Ø  TM practitioners ethically do not accept any reward of the therapy.

Traditional Medicine: Evidence of efficacy

Ø  Symptomatological improvements such as relief from pain, fever and discomfort.

Ø  Behavioral changes in case of psychological disorders.

Ø  Modern laboratory and analytical tools also prove the efficacy.

Ø  (Bilirubin level in jaundice, absence of stones)

Ø  Improvement in the quality of life.

Ø  Reverse Pharmacology.

 

Safety, Quality Control and Legal Aspects of TM/Herbal drugs

After the famous St. John’s Wort case and the progressive use of herbal remedies, the issues of safety, quality control and the regulation of traditional medicine was immensely felt and different national and international authorities are these days concerned with the aspects and developing different strategies and implementing them.

 

Ø  WHO has announced the strategy to increase the number of nations having national policy and legal framework to deal with CAM and TM.

Ø  WHO Traditional Medicine Strategy 2014-2023.

·         Key needs identified by the WHO are:

·         National regulation and registration of herbal medicines.

·         Post marketing surveillance of herbal products to monitor safety.

·         Support of clinical research in the use of CAM for common health problems.

·         National monographs preparation for medicinal plants.

Ø  In 1991, WHO published guidelines for the assessment of herbal medicines.

Ø  In 1999, WHO published a volume of herbal monographs to establish guidelines for identity, quality, safety and effective use.

Ø  In 2005, WHO published WHO Global Atlas of Traditional, Complementary and Alternative Medicine which explains such practices of 23 countries.

Ø  The WHO launched WHO Herbal Dictionary (published twice a year, March and September) with the aim to regulate the practice by helping in the following matters.

·         Find the trade names of herbal products and code them in the clinical data.

·         Translate the trade name into active ingredients-plants, parts of plants and extraction types.

·         Analyze the coded data by using the new unique Herbal ATC classification.

In Nepalese National Drug Policy, there is provision which states that ‘Define, Promote and Regulate the Ayurvedic, Homeopathic and other Traditional System of Medicines with Scientific Approach’.

 

Assessment of Quality:

Pharmaceutical assessment

This should cover all important aspects of the quality assessment of herbal medicines. It should be sufficient to make reference to a pharmacopoeia monograph if one exists. If no such monograph is available, a monograph must be supplied and should be set out as in an official pharmacopoeia.

Crude plant material

The botanical definition, including genus, species and authority, should be given to ensure correct identification of a plant. The active and characteristic constituents should be specified and, if possible, content limits should be defined. Foreign matter, impurities and microbial content should be defined or limited.

Finished product

The manufacturing procedure and formula, including the amount of excipients, should be described in detail. A finished product specification should be defined. A method of identification and, where possible, quantification of the plant material in the finished product should be defined. If the identification of an active principle is not possible, it should be sufficient to identify a characteristic substance or mixture of substances (e.g. “chromatographic fingerprint”) to ensure consistent quality of the product. The finished product should comply with general requirements for particular dosage forms.

Stability

The physical and chemical stability of the product in the container in which it is to be marketed should be tested under defined storage conditions and the shelf life should be established.

Toxicological studies

Toxicological studies, if available, should be part of the assessment. Literature should be indicated.

 

Documentation of safety based on experience

As a basic rule, documentation of a long period of use should be taken into consideration when assessing safety. This means that, when there are no detailed toxicological studies, documented experience of long-term use without evidence of safety problems should form the basis of the risk assessment. The assessment of risk, whether independent of dose or related to dose, should be documented. In the latter case, the dosage specification must be an important part of the risk assessment. An explanation of the risks should be given, if possible. Potential for misuse, abuse or dependence must be documented. If long-term traditional use cannot be documented or there are doubts on safety, toxicity data should be submitted.

 

Assessment of Efficacy

Activity

The pharmacological and clinical effects of the active ingredients and, if known, their constituents with therapeutic activity should be specified or described.

 

Evidence required to support indications

The indication(s) for the use of the medicine should be specified. In the case of traditional medicines, the requirements for proof of efficacy should depend on the kind of indication.

Combination products

As many herbal remedies consist of a combination of several active ingredients, and as experience of the use of traditional remedies is often based on combination products, assessment should differentiate between old and new combination products.

Medicinal Chemistry (I) Question Paper : B.Pharmacy

Medicinal Chemistry I: B.Pharmacy

Unit 1: Introduction to Medicinal Chemistry

1. What is meant by drugs? Explain the role of hydrogen bonding and Ionization and chelation in the biological activity of drugs with suitable examples. 

2. List the various physicochemical properties that modulate biological activity and discuss the importance of partition coefficient in relation to biological activity.

3. Define drug metabolism. Why metabolism is also called detoxification reaction? Explain role of bio-isosterism in biological action. 

4. What is meant by bioactivation? What are the main processes of drug absorption? Describe about simple diffusion and active transport.

5. List the main molecular targets of drugs. Discuss the specific role of ADME to enable a drug to reach the active site.

6. What is the difference between classical drug discover and rational drug discovery? Draw the chemical reaction of drug receptor interaction.

7. Write short notes on: Phase I and Phase II reactions.

Pharmacotherapeutics Question paper- set 2/ B.pharmacy

 
 
1.      Elaborate the general principle of Chemotherapy of cancer. What are the approaches to Minimize the chemotherapy induced toxicities. (5+5)
2.      Explain IBD. Write the clinical features of GI ulcer and its management. (10)
3.      Explain the general guidelines for the rational use of antibiotics.  Write a note on choice of antimicrobials for surgical prophylaxis. (5+5)
4.      Explain the pathophysiology and clinical manifestations of tuberculosis. Add a note on DOTS therapy. (7+3)
5.      What is enteric fever? Explain management of enteric fever, and syphilis. (10)
6.      What are the complications that may arise in the patients with CKD. How it can be managed? (5+5)
7.      Write the pharmacotherapeutics approaches in the management of Spondylitis and Psoriasis. (5+5)
8.      Write short notes on (5*2)
-         Evidence-based Medicine
-         National Immunization Programme and its implications

Pharmacotherapeutics question paper/ B.pharmacy

 
1.      Describe the SOAP notes of Pharmacotherapy plan. Write shortly about CORE, PRIME, FARM note. (7+3)
2.      Explain in detail about the etiology, pharmacotherapy and various triggering factors responsible to produce asthma. (10)
3.      Describe the etiology, clinical features and investigations of diabetes. Explain the treatment protocol of the same. (5+5)
4.      Write the Pharmacotherapeutic management of Glaucoma. What are the clinical manifestations of conjunctivitis? (5+5)
5.      Explain the Electrophysiology of Arrhythmias. Differentiate Angina pectoris and myocardial infarction. (5+5)
6.      Describe the clinical manifestation of Parkinsons diseases and pharmacology of drug use in Parkinson disease. (10)
7.      Describe about general approaches of treatment of depression. Classify different types of pain. (5+5)
8.       A 40-year-old Mr Shrestha, is overweight and has a blood pressure of 178/114 mmHg. He smokes 25 cigarettes daily and drinks 28 units of alcohol per week. He has a sedentary occupation. He eats excessive quantities of saturated fat and salt. (10)
Questions:
a. How should this patient be managed?
b. Briefly state the regulation of blood pressure in body.
c. what do you suggest for the non-pharmacological measure?
d. what pharmacological treatment for BP would be appropriate if non pharmacological treatment was unsuccessful?
 
As per suggestion, he subsequently stopped smoking and lost a little weight but remain hypertensive. He was treated with atenolol 50mg daily. His blood pressure fell to 136/84 mg but he developed tiredness and brady cardia & complained with erectile impotence
 
e. What are the treatment options for this patient?

 

Biopharmaceutics and Pharmacokinetics Question paper/ B.pharmacy/ Tribhuvan University/ Pokhara university

 

1.      Describe the various parameter of plasma concentration time profile obtain after a single dose of a drug administered by extra vascular route.   [10]

2.      Discuss Indications and Protocol for TDM. Discuss application of biopharmaceutics and pharmacokinetics in controlled release drug delivery system. [10]

3.      Differentiate between linear and nonlinear kinetics. Discuss the different methods to determine k_m and V_max.  [10]

4.      Discuss theories of dissolution. Discuss the concepts on various mathematical modeling of drug release. [10]

5.      Explain in-vitro in-vivo correlation. Discuss the curve fitting and regression procedures.  [10]

6.      Procainamide is to be administered to a 65kg arrhythmic patient at 500mg tablet every 4 hours. The drug has half-life 3 hr, Vd of 2L/kg and oral availability 0.85.   

a) Calculate the steady state conc. of drug.

b) What change would you recommended in the dose regimen if the therapeutic range of drug is 4-12 mcg/ml?    [10]

7.      A new antibiotic drug was given a single intravenous bolus of 4mg/kg to a 35-year-old healthy male adult (body weight 75kg). The pharmacokinetics of the plasma drug *concentration-time curve for this drug fits a one-compartment model. The equation of the curve that best fits the data is Ct=78e-0.46t. Determine the following (assume units of mcg/ml for Ct and hr for time);

i) What is the t_1/2?

i) What is the Vd?

iii) What is the plasma level of the drug after 4 hours?

iv) How much drug is left in the body after 4 hours?

v) Assuming the drug is no longer effective when levels decline to less than 2mcg/mg, when should you administer the next dose?  [10]

8.      Drug X is to be administered to a 70 kg patient at a rate of 2 mg/kg every 12 hour by multiple IM injection. The drug has a half-life of 2.2 hours and Vd, of 0.2 L/kg.

a) Determine Css,_Max, Css,_min and Css_avg.

b) If the half-life increases to five hours in renal insufficiency, what should be the new dose or the new dosing interval?  [10]

Pharmaceutical Analysis Question Paper/ B.Pharmacy/ Tribhuvan University/ Kathmandu University- Set II

 
1.   How can the moisture content be analyzed by using Karl Fisher method? Discuss the basic principle, methods and application of diazotization. (4+6)
2.      Write the principle of kjeldahl method. Explain its different step with neat and clean diagram. (10)
3.      Why non-aqueous titration is used in pharmaceutical industry? Explain about the solvent used in non-aqueous titration, with its indicator. (3+7)
4.      Which titration method use ammonium thiocyanate as titrating agent. Explain the types of titrations of this method.  (10)
5.      Explain the various theory of indicator. Write about the indicator used in neutralization, complexometric and redox titration. (5+5)
6.      Classify ligands. What are the advantages of EDTA titration. How do you prepare and standardize 0.05 M EDTA solution. (10)
7.      Write the principle of gravimetry. Explain the steps involved in gravimetry analysis. What are the impurities that may arises during gravimetry and how do you overcome those impurities? (10)
8.      Define the following terms; (2*5)
a.       Iodimetry               b. Iodometry                c. Masking agent and Demasking agent        
d. Oxidizing and reducing agent                     e. Solubility product