1ST BHMS HOMOEOPATHIC PHARMACY SYLLABUS: A COMPLETE GUIDE FOR STUDENTS (2022-2023)

C) HOMOEOPATHIC PHARMACEUTICS

1. Mother Tincture and Its Preparation

• Definition: Mother tincture is the primary extract of a drug substance, prepared using a specific solvent (usually alcohol or water). It serves as the base for further potentization.
• Extraction Principles:
  • Maceration: Soaking the drug substance in a solvent to extract its active principles.
  • Percolation: Passing a solvent through the drug substance to extract its active components.
• Old Method (Based on Class I to IX): Hahnemann’s method of preparing mother tinctures, classified into 9 classes based on the nature of the drug substance (e.g., fresh plants, dried plants, minerals, etc.).
• Concept of Uniform Drug Strength: Ensuring consistency in the concentration and potency of the mother tincture.
• Estimation of Moisture Content: Necessity: Moisture content affects the stability and potency of the drug. It is essential to measure and control moisture levels during preparation.
• New Method/Modern Approach: Incorporates advanced techniques like ultrasonic extraction and supercritical fluid extraction for better efficiency and consistency.

2. Various Scales of Potentization

History of Development: Introduced by Dr. Samuel Hahnemann, the concept of potentization involves diluting and succussing (shaking) the drug substance to enhance its medicinal properties.

Scales of Potentization

Centesimal Scale (C Scale)

• Designation: 1C, 2C, 3C, etc.
• Preparation: 1 part of drug substance is diluted with 99 parts of solvent (alcohol/water) and succussed.
• Administration: Used for chronic and deep-seated conditions.

Decimal Scale (X Scale)

• Designation: 1X, 2X, 3X, etc.
• Preparation: 1 part of drug substance is diluted with 9 parts of solvent and succussed.
• Administration: Used for acute conditions and sensitive patients.

50 Millesimal Scale (LM Scale)

• Designation: 0/1, 0/2, 0/3, etc.
• Preparation: 1 part of drug substance is diluted with 50,000 parts of solvent and succussed.
• Administration: Used for gentle and long-term treatment.

3. Drug Dynamisation

• Evolution of Dynamisation Concept: Introduced by Hahnemann to enhance the medicinal properties of substances while reducing toxicity.
• Potentisation and Its Types:
  • Trituration: Grinding the drug substance with lactose to prepare solid potencies.
  • Succussion: Vigorous shaking of the drug substance in liquid form to prepare liquid potencies.
• Merits of Potentisation:
  • Enhances the therapeutic properties of the drug.
  • Reduces toxicity and side effects.
  • Makes the medicine more bioavailable.
• Types of Potency:
  • Fluxion Potency: Prepared by continuous flow of solvent through the drug substance.
  • Jumping Potency: Prepared by skipping intermediate steps in potentization.
  • Back Potency: Prepared by reversing the steps of potentization.
  • Single Vial Potency: Prepared in a single container.
  • Multiple Vial Potency: Prepared using multiple containers.
  • Mixed Vial Potency: Prepared by mixing different potencies in one vial.
• Post-Hahnemannian Potentization Techniques: Includes modern methods like Korsakovian Potency and Skinner’s Method.

4. External Applications

• Scope of Administration: Used for localized conditions like wounds, burns, skin diseases, and musculoskeletal disorders.
• Dr. Hahnemann’s View (Organon 5th & 6th Ed): Hahnemann emphasized the use of external applications only when internal remedies are insufficient.
• Preparation and Uses:

1. Lotion: A liquid preparation applied to the skin for cooling or healing.
2. Glycerol: A semi-liquid preparation used for mucous membranes.
3. Liniment: A liquid or semi-liquid preparation applied with friction for pain relief.
4. Ointment: A semi-solid preparation used for skin conditions.

• Commercial Preparation of Ointment: Involves mixing the active drug with a base like vaseline or beeswax.

5. Posology

• Basic Principles: Posology deals with the dosage and repetition of Homoeopathic medicines.
• Related Aphorisms (Organon of Medicine): Aphorisms 275–287 discuss the selection of potency, dose, and repetition.
• Criteria for Selection of Potency: Based on the patient’s sensitivity, nature of the disease, and depth of pathology.
• Repetition of Dose: Depends on the acuteness or chronicity of the disease.
• Types of Doses:
  • Minimum Dose: The smallest effective dose to avoid aggravation.
  • Single Dose: One dose followed by observation.
  • Split Dose: Dividing the dose into smaller portions.

6. Prescription Writing

Parts of a Prescription:

1. Patient Details: Name, age, gender, and address.
2. Medicine Name: Scientific name of the drug.
3. Potency: The scale and strength of the medicine (e.g., 30C, 200C).
4. Dose: Quantity and frequency of administration.
5. Instructions: Directions for use (e.g., “Take 2 drops in water twice daily”).

Important Abbreviations

• C: Centesimal scale.
• X: Decimal scale.
• LM: 50 Millesimal scale.
• OD: Once daily.
• BD: Twice daily.

Merits of Prescription Writing

• Ensures accurate dispensing and administration.
• Provides a record for future reference.

Demerits of Prescription Writing

• Errors in writing can lead to incorrect medication.
• Lack of clarity can confuse the patient.

7. Dispensing of Homoeopathic Medicines

• Various Dosage Forms:

1. Solid Forms: Globules, tablets, and powders.
2. Liquid Forms: Drops, tinctures, and dilutions.

• Methods of Dispensing:

1. Medicated Globules: Soaking sugar globules in the liquid potency.
2. Liquid Doses: Diluting the medicine in water or alcohol.
3. Powders: Mixing the drug with lactose or sugar of milk.

8. Placebo

• Concept of Homoeopathic Placebo: An inert substance given to satisfy the patient’s psychological need for medicine.
• Philosophy of Administration: Used when no active medicine is required or during follow-up visits.
• Placebo Effect: The psychological benefit derived from taking a placebo, often due to the patient’s belief in the treatment.

9. Pharmaconomy

Routes of Homoeopathic Drug Administration:

1. Oral: Most common route (globules, drops, tablets).
2. Topical: External applications (ointments, lotions).
3. Inhalation: For respiratory conditions.
4. Sublingual: Placing the medicine under the tongue for rapid absorption.
5. Preservation

Preservation Rules

1. Raw Materials: Store in a cool, dry place away from sunlight.
2. Mother Preparations: Store in airtight, amber-colored bottles.
3. Finished Products: Label clearly and store in a controlled environment.
4. Vehicles: Ensure purity and prevent contamination.

D) PHARMACODYNAMICS

1. Doctrine of Signature

Basic Concept

• The Doctrine of Signature is an ancient belief that the physical characteristics of a plant or substance (e.g., shape, color, or habitat) indicate its therapeutic properties.
• For example, Lungwort (with lung-shaped leaves) was traditionally used for respiratory ailments.

Evolution and Application in Ancient Medical Systems

• This doctrine was widely used in Ayurveda, Traditional Chinese Medicine, and European herbalism.
• It was based on the idea that nature provides clues to the medicinal use of plants.

Supporters of the Doctrine

• Paracelsus: A Swiss physician who popularized the concept in the 16th century.
• Jacob Boehme: A German mystic who wrote extensively on the doctrine.

Dr. Hahnemann’s View

• Hahnemann rejected the Doctrine of Signature, emphasizing the importance of drug proving and the Law of Similia as the basis for Homoeopathic medicine.

2. Drug Proving

Homoeopathic Pharmacodynamics

• The study of how Homoeopathic medicines act on the human body.
• Reference to Aphorisms 105–145 (Organon of Medicine, 6th Ed): These aphorisms explain the principles of drug proving, including the selection of provers, administration of drugs, and recording of symptoms.
• Post-Hahnemannian Drug Proving: Modern drug proving methods, including double-blind placebo-controlled trials, to ensure accuracy and reliability.
• Homoeopathic Pathogenetic Trial (HPT): A systematic process of administering a drug to healthy individuals to observe and record its effects.
• CCRH (Central Council for Research in Homoeopathy) Protocols: Standardized guidelines for conducting HPTs, including ethical considerations and data collection methods.

• Other Noted Provers and Their Work:

Dr. Constantine Hering: Known for his extensive provings and contributions to Homoeopathic Materia Medica.

Dr. James Tyler Kent: Conducted provings and emphasized the importance of mental and emotional symptoms.

3. Adverse Drug Reactions (ADRs)

• Basic Idea: ADRs are unintended or harmful effects caused by the use of a drug.
• Reporting of ADEs (Adverse Drug Events): A systematic process of documenting and reporting ADRs to regulatory authorities.
• Drug Safety with Reference to HPI (Homoeopathic Pharmacopoeia of India): HPI provides guidelines for the safe preparation, storage, and administration of Homoeopathic medicines.
• Medication Errors: Mistakes in prescribing, dispensing, or administering medicines.
• Causality Assessment: Determining whether a drug is responsible for an adverse reaction.

4. Incompatible Remedies

• Definition: Remedies that should not be used together due to potential antagonistic effects.
• Examples:
  • Nux vomica and Coffee: Coffee may antidote the effects of Nux vomica.
  • Arsenicum album and Carbo vegetabilis: These remedies may counteract each other.

5. Pharmacovigilance

• Pharmacovigilance in Homoeopathy: Monitoring and ensuring the safety of Homoeopathic medicines.
• Activities of Pharmacovigilance Centres:
  • Collecting and analyzing data on ADRs.
  • Educating healthcare professionals and the public about drug safety.
• Awareness on Medicinal Preparations Against Homoeopathic Principles:
  • Highlighting the risks of using patented medicines and combinations that violate the principles of Homoeopathy (e.g., single remedy, minimum dose).

6. Pharmacological Study of Drugs