Medicinal uses of Rauwolfia

Medicinal uses of Rauwolfia

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Rauvolfia serpentina, or 'snakeroot' or 'sarpagandha' is a species of flowering plant in the family Apocynaceae. It is a evergreen trees and shrubs. The genus is named to honor Leonhard Rauwolf. The approximately 85 species in the genus can mainly be found in tropical regions. Rauvolfia caffra is the South African quinine tree. Rauwolfia serpentina is a small erect glabrous shrub about 1 to 3 feet in height, bearing white or pinkish flowers. It grows fairly wild in the United Provinces, also in Bihar and Eastern and Western Ghats. It is called ‘Sarpa-gandha’ in Sanskrit and ‘Chota Chand’ in Hindi. The roots, the leaves and the juice have been considered of medicinal importance from the very early times and have attracted the attention of the practitioners of the indigenous system of medicine. It has been used as an anthelmintic, as an antidote against snake bite and bites of other poisonous insects, in diarrhoea, dysentery, cholera and also as an ecbolic. In recent years interest has been stimulated in this drug, because of its well marked hypnotic and sedative properties.

Chemical constituents 

Rauvolfia serpentina, commonly known as or Indian Snakeroot or Sarpagandha, contains a number of bioactive chemicals, including ajmaline, aricine, corynanthine, deserpidine
lankanescine rauwolscine,rauwolscine, rauwolscine, reserpine, reserpiline, isoreser-    pine, isoreserpiline,serpentinine,and yohimbine. From the dried roots of Rauwolfia serpentina were isolated five new indole alkaloids, Nb-methylajmaline (1), Nb-methylisoajmaline (2), 3-hydroxysarpagine (3), yohimbinic acid (4), isorauhimbinic acid (5), a new iridoid glucoside, 7-epiloganin (6), and a new sucrose derivative, 6‘-O-(3,4,5-trimethoxybenzoyl) glomeratose A (7), together with 20 known compounds. The structures of the new compounds were determined by spectroscopic and chemical means. The inhibitory activities of the selected alkaloids on topoisomerase I and II and their cytotoxicity against the human promyelocytic leukemia (HL-60) cell lines were assessed.

Medicinal uses

  • Rauwolfia serpentina contains a number of bioactive chemicals, including yohimbine, reserpine,ajmaline, deserpidine,  rescinnamine, serpentinine. Reserpine is an alkaloid first isolated from R. serpentina and was widely used as an antihypertensive drug.
  • The extract of the plant has also been used for millennia in India – Alexander the Great administered this plant to cure his general Ptolemy I Soter of a poisoned arrow. It was reported that Mahatma Gandhi took it as a tranquilizer during his lifetime.It has been used for millennia to treat insect stings and the bites of venomous reptiles. A compound which it contains called reserpine, was used in an attempt to treat high blood pressure and mental disorders including schizophrenia, and had a brief period of popularity for that purpose in the West from 1954 to 1957.
  • According to the American Cancer Society: "Available scientific evidence does not support claims that Indian snakeroot is effective in treating cancer, liver disease, or mental illness. It also has many dangerous side effects and is likely to increase the risk of cancer."
Other plants of this genus are also used medicinally, both in conventional western medicine and in Ayurveda, Unani, and folk medicine.Alkaloids in the plants reduce blood pressure, depress activity of the central nervous system and act as hypnotics.

Pharmacology 

Reserpine has a highly complex pattern of activity. Besides the amine concentration in brain, it is also reported to influence the concentration of glycogen, acetyl choline, g-amino butyric acid, nucleic acids and anti-diuretic hormone. The effects of reserpine include respiratory inhibition, stimulation of peristalsis, myosis, relaxation of nictating membranes, and influence on the temperature regulating centre. It increases the volume and free acidity of gastric secretion. Reserpine reduces glycaemia in some cases but the effect is short-lived. In some patients it has a stimulating effect on prothrombin activity. Reserpine also favors permeation of blood into areas rendered ischemic by burns1. It produces sedation and a lowering of blood pressure. If administered orally, in hypertension, the effects of reserpine are slow, seldom appearing before 3-6 days of administration and continuing for some time after withdrawal of the drug and have a cumulative effect. It is most valuable in young patients with mild labile hypertension associated with tachycardia. In long established hypertension, it is best used in conjunction with more potent hypertensive drugs such as hexamethonium or hydralazine. Combined with polythiazide, it is a useful hypotensive in mild to moderate thiazide, it is a useful hypotensive in mild to moderate conditions. The response to reserpine varies in patients and the dosage must be adjusted to individual requirements. In severe hypertension, it may be given by intravenous or intramuscular injection when the effect begins within a few hours. Parenteral therapy of reserpine is indicated in the treatment of hypertension only when oral administration is impracticable.

Toxicology

In patients with cardiac arrhythmia, myocardial infarction or severe cardiac damage, bronchitis, asthma or gastric ulcer, reserpine has a relatively low toxicity, but even the minimum therapeutic doses may give rise to nasal congestion, lethargy, drowsiness, peculiar dreams, vertigo and gastro-intestinal upsets; sometimes dyspnea and urticarial rash may occur. Higher doses may cause flushing, injection of conjunctivae, insomnia, bradycardia, occasionally parkinsonism, and severe mental depression which may lead to suicide. Cases of asthenia and edema have also been reported. Side effects of reserpine are usually transient and quickly disappear on reducing the dosage or discontinuing treatment. Tolerance to reserpine does not develop and it does not appear to be habit-forming. Prolonged previous use of reserpine may cause disturbances in blood pressure during operation under general anesthesia, while some patients may be highly susceptible to a small parenteral dosage. When give to nursing mothers to increase the secretion of milk, it is excreted with milk but the amount is not therapeutically harmful3. Minimum therapeutic doses may give rise to nasal congestion, lethargy drowsiness, peculiar dreams, vertigo and gastro-intestinal upsets; sometimes dyspnea and urticarial rash may occur. Higher doses may cause flushing, injection of conjunctivae, insomnia, bradycardia, occasionally parkinsonism, and severe mental depression which may lead to suicide. Cases of asthenia and edema have also been reported. Side effects of reserpine are usually transient and quickly disappear on reducing the dosage or discontinuing treatment. Serpentine is more toxic than ajmaline or serpentinine. African quinine tree.

Adverse Reactions

Side effects of rauwolfia include nasal congestion, depression, tiredness and erectile dysfunction. Reserpine can cause severe depression, increase of appetite and weight gain. Drowsiness may occur, too, so the operation of vehicles or heavy machinery must be done with precaution.
Reserpine is known to cause cancer in mice and people who use it increase their cancer risk rates slightly. The U.S. National Toxicology Program classifies it as a "probable cancer-causing substance."

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