INTRODUCTION
Knowledge about plants and their medicinal properties, as well as their
use for the purpose of treating and curing diseases, is one of the
oldest forms of medicinal practice in world¹. Since antiquity, myths,
legends, and traditions perpetuate the use of medicinal plants and
reflect their vast employment in medicine over time².
Although the global market for pharmaceuticals has been predominantly
dominated by synthetically derived products³, in recent years, there has
been an increased investment in the search for alternative medicines and
in the therapeutic use of naturally sourced products, particularly plant
derivatives4. The use of herbal medicines in developed
countries constitutes an alternative therapy², however many users
believe that because they are naturally sourced, medicinal plants pose
no threat to the user’s health and are unfortunately unaware that herbal
medicines can induce serious adverse effects5. In this
study, we highlight a plant with significant medical potential,Hypericum perforatum L., an herbaceous, perennial commonly found
in Europe, Asia, Brazil, and the USA6, where it is
commonly known as St. John’s wort7. Although,H.perforatum is composed of more than 150 compounds with
additive, synergistic, and partially antagonistic
properties8, with the most characteristic of the
plant’s constituents being naftodiantrones (hypericin and
pseudohypercicine), floroglucinols (hyperforin), flavonoids,
bioflavonoids, and xanthones9. This diversity of
medicinally active components and potential utilization e in the
treatment of diverse pathologies has sparked significant interest in the
medicinal potential of H. perforatum.
The action mechanisms of H. perforatum have yet to be fully
described due to the large abundance and diversity of compounds
contained within the plant. Traditional schools of thought have
suggested that hypericin was the main active ingredient in H.
perforatum extracts. However, studies have shown that hyperforin is
found in concentrations higher than that of hypericin within the
plant8 and that hyperforin may be primarily
responsible for the antidepressant properties attributed to the
plant9.
Therefore the use of H. perforatum extracts have become popular
due to the plants’ beneficial effects on the nervous
system7. H. perforatum has been used for
decades in clinical practice specifically in the treatment of a range of
mood disorders, presenting significant efficacy in the treatment of
acute, mild to moderate depression9,10,11,12. However,
although it has a higher safety profile when compared to conventional
antidepressants, H. perfuratum is not exempt from adverse
reactions and drug interactions9,13,14. Some adverse
side effects attributed to H. perfuratum are gastrointestinal
symptoms, allergies, dizziness, mental confusion, fatigue, dry mouth and
sedation, however these side effects from the use of H.
perforatum considered to be mild, moderate or transient in
nature15. Additionally, important interactions are
reported with conventional synthetic drugs such as diazepam and
paracetamol6, antihistamines (fexofenadine),
cardiovascular drugs (warfarin), hypolipidemic like simvastatin,
gastrointestinal drugs (omeprazole and loperamide), in addition to oral
contraceptives, corticosteroids, opioids, antineoplastics, and
immunosuppressants8.
Considering these aspects, it is important for the health professionals
to have in-depth the appropriate knowledge of phytotherapeutics,
specifically their interactions and adverse effects, before
administering such medicine or conducting a study on the use of these
treatments. Among the health professional, pharmacists have a key role
in the process of the use of medicine once he is the last link between
the prescription and the use of medicine by patients. According to the
American Society of Health-System Pharmacists (ASHP), the mission of a
pharmacist is to provide pharmaceutical care, which is defined as the
direct, responsible provision of medication-related care for the purpose
of achieving definite outcomes that improve a patient’s quality of
life16. Therefore, it is of worth importance to
develop a study of the use of medicine focused on the knowledge aboutH. perfuratum of pharmacists from public and private pharmacy
services-dispensing this herbal medicine