Subacute toxicology studies on the aqueous fraction of the ethanol extract of the leaves of Cissampelos sympodialis Eichl. (Menispermaceae) in dogs

Cissampelos sympodialis Eichl. (Menispermaceae) has been investigated about its botanical, chemical, pharmacological and toxicological aspects in our laboratory. Previous acute toxicology studies demonstrated that in dogs as well as in Wistar rats, 5 g/kg, p.o., and 2 g/kg, i.p. of the aqueous fraction of the ethanol extract of the leaves of Cissampelos sympodialis (AFL), induced a significant increase in the phosphatase alkaline and gama glutamil tranferase (GGT) levels, that were completely reversed in 15 days after interruption of AFL treatment. The aim of the present work was to investigate the subacute toxicology effects induced by AFL in dogs. We used the methods proposed by Portaria 116/96 of the Secretaria Nacional de Vigilância Sanitária, which regulates studies of toxicity for phytomedicines in Brazil. Daily administration (p.o.) of AFL, 45 mg/kg/day (5 times the dose used by human beings), during 4 weeks, was devoid of any effect on haematological (haemogram and platelets) and on blood biochemical parametes. In conclusion, the present study, using dogs, demonstrated that AFL, in a popularly used dose, by human beings, was devoid of any toxicological effect

Uso da terapia não farmacológica, medicina alternativa e complementar na fibromialgia Non-pharmacological therapy and complementary and alternative medicine in fibromyalgia

A fibromialgia é uma síndrome dolorosa crônica que afeta até 5% da população mundial. Pode associar-se com distúrbios do sono, do humor e fadiga, e cursar com incapacidade funcional. Sua patogênese envolve distúrbio de modulação central da dor, comprometimento do sistema inibitório descendente e hiperatividade da substância P. Em função da vasta sintomatologia apresentada pelos pacientes e da natureza multifatorial da sua patogênese, seu tratamento ideal requer uma abordagem multidisciplinar incluindo a associação de terapia farmacológica e não farmacológica. A terapia farmacológica atualmente preconizada nessa síndrome inclui, entre outros compostos, antidepressivos, moduladores dos canais de cálcio, relaxantes musculares e analgésicos. O tratamento não farmacológico é realizado, na maioria dos casos, por meio de educação do paciente, atividade física aeróbica supervisionada e terapia cognitivo-comportamental. No entanto, muitos pacientes não apresentam respostas satisfatórias ou apresentam efeitos colaterais associados ao uso dos fármacos a longo prazo, além de referirem dificuldades em permanecer em uma terapia baseada em exercícios e medicina física. Há, portanto, um crescente interesse por parte dos médicos e pacientes por uma terapia alternativa e complementar na fibromialgia. Nesta revisão, os autores discorrem sobre as diversas modalidades terapêuticas empregadas nessa doença, enfatizando as evidências da terapia não farmacológica e do uso de medicina alternativa e complementar nesses pacientes.<br>Fibromyalgia is a chronic painful syndrome that affects up to 5% of the world population. It is associated with sleep and mood disorders, fatigue, and functional disability. Its pathogenesis involves a disorder of the central modulation of pain, impairment of the descending inhibitory system, and hyperactivity of substance P. Because of the extensive symptomatology of patients with fibromyalgia and its multifactorial pathogenesis, its ideal treatment requires a multidisciplinary approach including the association of pharmacological and non-pharmacological therapies. The pharmacological therapy currently recommended for the syndrome includes antidepressants, calcium-channel modulators, muscle relaxants, and analgesics. In most cases, the non-pharmacological treatment consists of patient education, supervised aerobic physical activity, and cognitive-behavioral therapy. However, many patients do not respond satisfactorily, or have side effects associated with the long-term use of drugs, in addition to reporting difficulties in adhering to a therapy based on exercises and physical medicine. Thus, physicians and patients are increasingly interested in an alternative and complementary therapy for fibromyalgia. This review approaches the different therapeutic modalities used in fibromyalgia, emphasizing the evidence of non-pharmacological therapy and use of alternative and complementary medicine for these patients