1. Anti-hyperlipidemia

2. What is Hyperlipidemia
What is Hyperlipidemia ? Hyperlipidemia is an excess of fatty substances called lipids, largely cholesterol and triglycerides, in the blood.

3. Cholesterol is required to build and maintain cell membranes
It is the major precursor for the synthesis of vitamin D and of the various steroid hormones
Cholesterol is primarily synthesized from acetyl CoA through the HMG-CoA reductase pathway in many cells and tissues.

4. Alfalfa Family :fabaceae/leguminosae Species: medicago sativa
Part used: herb
Herbal use :
treatment arthritis ,high cholesterol ,diabetes and peptic ulcer
It has bactericidal ,cardiotonic ,diuretic &emetic
It is source of vitamins A,C,E,K &mineral ca ,k,phosphorus and iron

5. Constituent Acids: lauric acid, malic acid, malonic acid …
Alkaloids: pyrrolidine type ,pyridine type in the seeds only
Amino acids :arginine ,asparagines, cystine ….
the non protein toxic Amino acids canavanine is present in leaves ,stem and seeds
Coumarins: medicagol
Isoflavonoid:coumestrol,biochaninA,daidzein….
Saponins: 2-3%hydrolsis yield aglycone ,medicagenic acid ,soyasapogenolsA-F and hedragenin .
sugar chain component include arabinose galactose …
Steroids
Other consisteunts:
Carbohydrates ,vitamin ,pectin methylestrase pigments, protein and trace element

6. Pharmacological action
Saponins is decrease plasma cholesterol concentration without change in (HDL)
decrease intestinal absorption of cholesterol and increase excretion of neutral steroids and bile acids .
stimulate lipolytic activity of a mixture of porcine pancreatic enzymes including lipase ,amylase and proteases
Clinical study
reduced plasma cholesterol concentration by less than 5% in (LDL)

7. Side effect /toxicity :
It induce asystemic lupus erthematosus like syndrome because there is canavanine which is toxic due to it is structure analogue of arginine and may interfere with the binding of this amino acid to enzymes and its incorporation into protein
Contra indication &warning
should be avoided it with (SLE) .
Not take with oral contraceptive &hormonal replacement therapy because the potential oestrogenic &anticoagulant activity
Pregnancy and lactation:
The safety not established .

8. Preparation& dosage: Tablet ,capsule and teas Dried herbs
Liquidextract

9. Artichoke Family asteraceae /compositae Species cynara scolymus L
Part used leaves
Herbal use :
treatment hyperlipidemia , hyperlipoprotinaemia condition require an increase in choleresis and non-ulcer dyspepsia
It has choleretic,hypocholesterlamic,hypolipidaemic ,diuretic and hepatostimulating properties

10. Pharmacological action
Inhibition of cholesterol biosynthesis by 65% .
The hypolipidemic effect well document for globe aritichoke leaf extract and the Constituent: cynarin
Luteolin the most important constituent for this effect by indirect inhibition of hydroxymethylglutrayl-COA reductase(HMG-COA)
Clinical study :
It is reported cynarin tobe effective in lowering serum concentration of cholesterol and triglyceride when taken daily dose ranging from 60mg to 1500mg

11. Side effect /toxicity :
1- No series adverse effect were reported
2- Non- specific gastrointestinal complaints: dyspepsia& constipation gastric irritation
3- Allergic contact dermatitis
Contra indication &warning
globe aritichoke yields cynaropicirin potentially allergenic
Pregnancy and lactation:
The safety not established .

12. Preparation& dosage Leaf extract Liquid extract
A teabag containing artichoke tea

13. Fenugreek Family: Leguminosae Species: Trigonella foenum –graecum
Part used : seed
Herbal use :It possess as mucilaginous demulcent,laxative,nutritive ,expectorant .
Traditionally ,use for treatment of anorexia ,dyspepsia ,gastritis
topically for myalgia,lymphadenitis ,gout wounds and leg ulcers .

14. Constituent Alkaloids: pyridine type. Protein :23%-25%
Flavonoids: flavone glycosides including orintin and vitexin,quercetin(flavonol)
Saponins: %.glycosides yeilding steroidal sapogenins diosgenin and yamogenin (major)
Other constituent:
coumarin,lipid,mucilaginous,fibre,vitamins and minerals

15. Pharmacological action
Hypocholesterolaemic activity due to fibre and saponin fraction
It has Hypocholesterolaemic activity and lowering triglyceride concentration but without change (LDL)& (HDL)
Clinical study :
A significant reduction in serum cholesterol concentration in diabetic patients was also noted

16. Side effect /toxicity :
No reported
Contra indication &warning:
It has hypoglycemic activity so it is interfere hypoglycemic therapy
Cation is advisable in patients receiving monoamine oxidase inhibitor ,hormonal or anticoagulant therapies
Pregnancy and lactation:
It is reputed to be uterine stimulant activity .

17. Preparation& dosage
Seed 1-6g or equivalent three times daily

18. Garlic Family :Amaryllidaceae /liliaceae Species :Allium sativum L .
Part :used bulb
Herbal use :
expectorant ,antispasmodic, antiseptic ,bacteriostatic ,antiviral,hypotensive and anthelmintic properties
Traditionally :it used to treat chronic bronchitis ,recurrent colds ,bronchitic asthma and influenza .
Modern use :
antihypertensive ,antiartherogenic ,antithrombotic,antimicrobial ,cancer preventive and lipid lowering effects .

19. Constituent Enzyme :allinase ,peroxidases,myrosinase and others
Volatile oils: % .sulfur containing compound including alliin , compound produced enzymetically from alliin including allicin,S-allylmercaptocysteine and S-methylmercaptocysteine ;terpenes
Other constituents :
Protein ,amino acids ,minerals, vitamins, trace element ,lipid and prostaglandins

20. Pharmacological action
Sulfur-containing constituent inhibit cholesterol biosynthesis including :
Inhibition (HMG-COA)reductase
Reduction in triacylglycerol biosynthesis
Increase in hydrolysis of triacylglycerols via increased lipase activity and inctivation of enzymes ivolved in lipid synthesis
inhibit triglyceride biosynthesis in part by decreasing de novo fatty acid synthesis via inhibition of fatty acid synthase.
garlic significantly reduced total serum cholesterol concentration by about 9%

21. Side effect :
Non toxic
Burning sensation in the mouth and gastrointestinal tract
Garlic breath &body odour
The allergenic potential due to allergen as:diallyl disulfide ,allylpropyl sulifide and allicin
Contra indication &warning:
Interfere with hypoglycemic and anticoagulant therapies
It potentiate the antithrombotic effects of anti-inflammatory drugs such as aspirin
Gastrointestinal irritation may occur
Pregnancy and lactation:
There is no experimental or clinical reports

22. Preparation& dosage Dried bulb Tincture Oil Juice of garlic
Syrup of garlic
Garlic powder tablets

23. Milk Thistle Species: silybum marianum Synonym: carduus marianus
Part used: fruits, herb.
Legal category: milk thistle is not included in the GSL.
Constituents:
Fruit: flavolignans,flavonoids,lipids,sterols.
Leaves: flavonoids

24. Food use: it is not used in foods.
Herbal use:
✭Milk thistle fruits have been used for disorder of liver,spleen and gall bladder.
✭Also used for nursing mothers for stimulating milk production,as abitter tonic for haemorrhoids.
✭The leaves have also been used for the treatment of liver, spleen and gall bladder disorders and as an antimalarial and for uterine complaints.

25. Pharmacological actions:
As well as inhibition of lipid peroxidation, stimulation of protein biosynthesis and acceleration of liver regeneration.
Mechanism of Action?
*Found a dose dependent decrease in HMG-CoA reductase in the liver with increasing silymarin concentration .
*A decrease in HMG-CoA reductase leads to a decrease in synthesis of cholesterol.

26. Sid-effects, toxicity:
Sever sweating, abdominal cramping, nausea,vomiting, diarrhoea,anaphylactic shock in a 54-year-old man with immediate type allergy to kiwi fruit.
Contra-indications, warning s:
✭It is conta-indication for individuals with hypersensitivity to species of asteraceae.
✭Pregnancy and lactation should be avoided.

27. Pharmaceutical prepration:
Extract milk thistle capsules

28. Hawthorn Species: crataegus laevigata (rosaceae) Synonym: whitethorn
Part used: fruit
Legal category: it is not included in the GSL.
Constituents:
Amine,flavonoids(flavonol,flavones), tannins.
Food used:
It is not common used in food.
Herbal use:
✭It is stated to possess cardiotoinc,coronary vasodilator and hypotensiveproperties,hypertension

29. Pharmacological action:
An inhibition of lipid peroxidation which can be caused by highly reactive free radicals was also documented.
Mechanism of Action:
The mechanism of action of hawthorn remains unknown.

30. Side-effect,toxicity:
Nausea,fatigue,sweating,rash on the hand.
Contra-indications,warnings:
✭Cardiovascular disorder such as hypertention, hypotention and cardiac disorders. ✭pregnancy and lactation should be avoided.

31. Pharmaceutical prepration:
Capsule liquid

32. ✰Ginger
Species: Z. officinale
Synonym: zoingiber
Part used: rhizome
Legal category: GSL
Constituents:
Carbohydarates starch, lipids, oleo-resin gingerol homologues, volatile oils.
Food used:
It is the natural source of food flavouring,and used widely in foods as a spice.

33. Herbal use:
✭Ginger is stated to possess carminative, diaphoretic and antispasmodic properties.
✭Also used for colic, flatulent dyspepsia and used to prevention of nausea and vomiting.
Pharmacological actions:
✭Anti-atherosclerotic
Ginger (dried ginger)oleo-resin by intragastric administration has been reported to inhibit elevation in serum and hepatic cholesterol concentration in rats by impairing cholesterol absorption and those with existing hypercholesterolamai.
✭Fresh ginger not effect on serum cholesterol.

34. Side-effect,toxicity:
Non toxic
Contr0indication,warnings:
✭Effect to blood pressure
✭Pregnancy and lactation should be avoided.
Pharmaceutical prepration:
Oleo-resin cream

35. Ispaghula Family: Plantaginaceae
Species: Plantago ovata Forsk.
Family: Plantaginaceae
Synonym: Blond psyllium Indian plantago,Ispagol, Pale psyllium,Spogel
Part used: seed, husk

36. Herbal use:
Ispaghula is started to posses demulcent and laxative properties.
Traditional use:
in the treatment of the:
chronic constipation.
dysentery diarrhea.
cystitis.
The German commission A approved use for chronic constipation and disorder in which bowel movement with loose stool are desirable.

37. Active constituent:
1- Alkaloids Monoterpene-type. Plantagonin and indicainin.
2- Mucilages 10-30% mucopolysaccharide consisiting mainly of ahighly branched arabinoxylan with a xylan backbone and branches of arabinose, xylose and 2-O-galacturonic-rhamnose moites.
3- Other constituents:
Aucubin
sugars (fructose, glucose, sucrose).
protein.
steroils .
triterpenes .
fatty acid .
tnnins.

38. Pharmacological action
In clinical studies:
Hypocholesterolaemic effects:
26 men with mild to moderate hypercholesterolemia
(serum cholesterol concentration: mmol/L) received
isphagula 3.4 g for eight weeks , and the end of study ,
serum cholesterol concentration were reduced by 14.8 % and
LDL cholesterol by 20.2% and ratio of LDL to HDL
cholesterol by 14.8 %.
Laxative effect.
Antidiarrhoeal effect.
Hypoglycemic effect.

39. Mechanism of actin:
IN CHOLESTEROL CONTROL : The content has cellulose fiber, which is responsible for decreasing the absorption of cholesterol into the blood stream.

40. Dosage: Seeds/ 5-10g (3g in children ) three times daily, seed should be soaked in worm water for several hr before taking. Liquid extract/ 2-4 ml (1:1 in 25% alcohol) three times daily. . Ispaghula Husk 225 Capsules Ispaghula Husk (300g

41. Side effects, toxicity:
Increase flatulence and abdominal distention, and may be cause intestinal obstruction
If swllowed dry ,may cause oesphageal obstruction.
Contra-indictions, warnings:
Not given to patints with intestinal obstruction.
Should be taken fluid to avoid oesphageal obstruction.

42. Interaction with other medicinal products and other form of interaction:
Absorption of minerals ( calcium, iron, lithium, zinc), vitamins (B12), cardiac glycoside and coumarine derivatives may be delayed .for this reason the product should not be taken hr before or after intake of other drugs.
If the product is taken together with meals in the case of insulin-dependent diabetics it may be necessary to reduce the insulin dose .

43. Pregnancy and lactation:
Ispaghula may be used during pregnancy and lactation

44. Gugulipid (Gum Guggul, Guggulu )
Species : Commiphora mukul
Local Name : Bdellium Gum,
Guggulipid, Gum Gugal, Salaitree
Gugulipid, gum guggulu.
Parts Used : Gum resin extract.
Origin: The mukul myrrh (Commiphora mukul) tree is a small, thorny plant distributed throughout India.

45. Traditional use:
guggul lipid has been used to treat arthritis, rheumatism, haemorrhids, urinary disorder, obesity, skin diseases and high cholesterol. It has been claimed to be widely used for over 2,000 years.

46. active constituents:
Ketone fraction that is extracted from the resin contains
the most potent cholesterol lowering components.
This is composed of C21 or C27 steroids, with the major
components being Z- and E-guggulsterone.
Guggul contains resin, volatile oils, and gum.
The extract isolates ketonic steroid compounds known
as guggulsterones. These compounds have been
shown to provide the lipid-lowering actions noted
for guggul.

48. Dosage:
A common intake of guggulsterones is 25 mg three times per day. Most extracts contain 5-10% guggulsterones. For a 5 percent guggulsterone extract, this translates to an effective dose of 500 milligrams three times per day.

49. Pharmacology:
lowers serum triglycerides and cholesterol as well as LDL and VLDL cholesterols (the "bad" cholesterols). At the same time, it raises levels of HDL cholesterol (the "good" cholesterol).
inhibits platelet aggregation,
stimulation of the thyroid, potentially resulting in weight loss.,
deposits of waste or toxic material in the body
A direct anti-inflammatory effect
reduce the stickiness of platelets.thate
lowers the risk of coronary artery disease.

50. mechanism of action:
Guggul works on the liver by increasing the metabolism (or break down) of the bad cholesterol known as LDL Cholesterol.
After taking the product for 4 to 12 weeks, total cholesterol levels can drop, triglyceride levels can drop and an increase in HDL (the good cholesterol) of approximately 16% can occur.
Guggul can lower blood cholesterol by 14-27% and can lower triglycerides by 22-30%

51. Advers effect:
Gugulipid is a fairly nontoxic product
there may be mild skin rashes or GI upset/diarrhea.
It is safe to use during pregnancy and does not adversely affect liver or kidney function,

52. Pharmaceutical prepration: Guggul - Pure extract (250 mg capsule)

53. Thank You