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Paeonia lactiflora
Panax ginseng
Plantago afra
Platycodon grandiflorum
Piper methysticum
Polygala senega
Prunus africana
Prunus armeniaca
Plantago ovata
Pimpinella anisum
Passiflora incarnata
Psidium guajava
Punica granatum


 

 

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Plantago ovata Forsk. (Plantaginaceae)

Synonyms
Plantago brunnea Morris, P. decumbens Forsk., P. fastigiata Morris, P. gooddingii Nelson et Kennedy, P. insularis Eastw., P. ispaghula Roxb. ex Flem., P. lanata Willd. ex Spreng., P. leiocephala Wallr., P. microcephala Poir., P. minima Cunn., P. trichophylla Nab., P. villosa Moench.

Local names
Ashwagolam, aspaghol, aspagol, bazarqutuna, blond psyllium, Blondes Psyllium, Ch’-Ch’ientzu, esfarzeh, esopgol, esparzeh, fi syllium, ghoda, grappicol, Indian plantago, Indische Psyllium, isabakolu, isabgol, isabgul, isabgul gola, isapagala-vittulu, ishppukol-virai, ispaghula, isphagol, vithai, issufgul, jiru, kabbéche, lokmet an naâja, obako, psyllium, plantain, spogel seed plantain

Description
An annual, acaulescent herb. Stem highly ramifi ed bearing linear leaves, which are lanceolate, dentate and pubescent. Flowers white and grouped into cylindrical spikes; sepals characterized by a distinct midrib extending from the base to the summit; petal lobes oval with a mucronate summit. Seeds oval, clearly carinate, 2–3 mm long, light grey-pink, with a brown line running along their convex side

Plant material used
dried seed coats (epidermis)

Chemical assays
To be established in accordance with national requirements. Plantago products can be assayed for their fibre content by the Association of Official Analytical Chemists method

Major chemical constituents
The major constituent is a mucilaginous hydrocolloid (20–30%), which is soluble polysaccharide fraction composed primarily of an arabinoxylan (up to 85%). The polymer backbone is a xylan with 1- 3 and 1- 4 linkages with no apparent regularity in their distribution. The monosaccharides in this main chain are substituted on C-2 or C-3 by L-arabinose, D-xylose, and α-D-galacturonyl-(1-2)-L-rhamnose. Fixed oil (5–10%) is another major constituent

Medicinal uses
Uses supported by clinical data
A bulk-forming laxative used therapeutically for restoring and maintaining bowel regularity. Treatment of chronic constipation, temporary constipation due to illness or pregnancy, irritable bowel syndrome and constipation related to duodenal ulcer or diverticulitis. Also indicated for stool softening in the case of haemorrhoids, or after anorectal surgery. As a dietary supplement in the management of hypercholesterolaemia, to reduce the risk of coronary heart disease, and reduce the increase in blood sugar levels after eating.

Uses described in pharmacopoeias and well established documents
Short-term use for the symptomatic treatment of diarrhoea of various etiologies.

Uses described in traditional medicine
As an expectorant, antitussive and diuretic. Treatment of rheumatism, gout, glandular swelling and bronchitis

Proven pharmacological activity
Animal studies
Antidiarrhoeal, Antihypercholesterolaemic, Antihyperglycaemic, Anticholesterol gallstones

Human studies
Antidiarrhoeal, Antihypercholesterolaemic, Laxative

Adverse reactions
Sudden increases in dietary fi bre may cause temporary gas and bloating. These side-effects may be reduced by a gradual increase of fi bre intake, starting at one dose per day and gradually increasing to three doses per day. Occasional flatulence and bloating can be reduced by decreasing the amount of the seed coats taken for a few days. Allergic reactions to ingestion or inhalation of Plantago products have been reported, especially after previous occupational exposure to these products. These reactions range from urticarial rashes to anaphylactic reactions (rare). One rare case of fatal bronchospasm has been reported in a Testa Plantaginis-sensitive patient with asthma

Contraindications
Testa Plantaginis should not be used by patients with faecal impaction, undiagnosed abdominal symptoms, abdominal pain, nausea or vomiting unless advised by their health-care provider. Testa Plantaginis is also contraindicated following any sudden change in bowel habits that persists for more than 2 weeks, in rectal bleeding or failure to defecate following use of a laxative, and in patients with constrictions of the gastrointestinal tract, potential or existing intestinal blockage, megacolon, diabetes mellitus that is diffi cult to regulate, or known hypersensitivity to the seed coats

Warnings
To minimize the potential for allergic reaction, health professionals who frequently dispense powdered products prepared from Testa Plantaginis should avoid inhaling airborne dust while handling these products. To prevent generating airborne dust, the product should be spooned from the packet directly into a container and then the liquid should be added. Testa Plantaginis products should always be taken with suffi cient amounts of liquid, e.g. 5.0 g of the seed coats with 150 ml of liquid. Failure to do so may result in swelling of the seed coats and blockage of the oesophagus, which may cause choking. Intestinal obstruction may occur if an adequate fluid intake is not maintained. The seed coats should not be
used by those with diffi culty in swallowing or throat problems. Anyone experiencing chest pain, vomiting or diffi culty in swallowing or breathing after taking Testa Plantaginis should seek immediate medical attention. Treatment of the elderly and the debilitated requires medical supervision. Testa Plantaginis should be taken at least 2 h before or after other medications to prevent delayed absorption of other drugs. If bleeding, or no response and abdominal pain occur 48 h after ingesting the seed coats, treatment should be discontinued and medical advice sought

Precautions
General
Testa Plantaginis should be taken with adequate volumes of fluid. Products should never be taken orally in dried powder form owing to possibility of causing bowel or oesophageal obstruction. In patients confined to bed or undertaking little physical exercise, a medical examination may be necessary prior to treatment with the seed coats.

Drug interactions
Bulking agents may diminish the absorption of some minerals (calcium, magnesium, copper and zinc), vitamins (B12), cardiac glycosides and coumarin derivatives. However, more recent studies suggest that since seed coats do not contain phytates, they will not bind to vitamins and minerals and are therefore no cause for concern. The co-administration of the seed coats with lithium salts may reduce plasma concentrations of the latter and inhibit their absorption from the gastrointestinal tract. The seed coats may also decrease the rate and extent of carbamazepine absorption, and induce subclinical levels of the drug. Ingestion of lithium salts or carbamazepine and the seed coats should therefore be separated by as long an interval as possible . Ingestion of the seed coats 2 hours before or after the administration of other drugs is suggested. Individual monitoring of the plasma levels of these drugs, especially in patients also taking products containing Testa Plantaginis is aalso recommended. Insulin-dependent diabetics may require less insulin.

Other precautions
No information available on precautions concerning drug and laboratory test interactions; carcinogenesis, mutagenesis, impairment of fertility; teratogenic and non-teratogenic effects in pregnancy; nursing mothers; or paediatric use.

Dosage forms
Dried seed coats available commercially as chewable tablets, granules, wafers and powder. Store in a well closed container, in a cool dry place, protected from light.

Posology
No information available.

 

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