Winter Lectures 2013

A series of six lectures - Charms and harms of natural medicines

The natural health products industry is said to exceed NZ$1 billion in revenue (including exports). This Winter Lecture series 2013 speaks to popular interest in ‘natural’ medicines, and real concerns over their quality, safety and efficacy.

Topics include nature’s molecular creativity and modern drug discovery from natural resources, and evidence for efficacy and safety of herbal and other ‘natural’/complementary medicines, including those with ‘lifestyle’ uses such as smoking cessation. Monitoring safety of these types of products, and future strategies, including regulation is also covered.

Speakers are internationally known in their respective fields, and come from four Schools (Chemical Sciences; Medicine; Pharmacy; Population Health) representing two faculties (Science; Medical and Health Sciences) within The University of Auckland.

 

• Lecture 1, Nature’s medicine chest: opportunities for drug discovery
Distinguished Professor Margaret A. Brimble PhD CNZM FRSNZ
Tuesday 23 July

Natural products have long been regarded as “nature’s medicine chest” providing invaluable platforms for developing front-line drugs. In total, 63% of all new drugs approved by the USA Food and Drug Administration from 1981 to 2006 were natural products or were “inspired” by natural products. The chemical structures of natural products have evolved over several millennia for a specific biochemical purpose and their molecular frameworks can be considered “privileged scaffolds” that inspire the synthesis of focused natural-product–based libraries to advance biomedical research. This lecture will showcase research on the synthesis of bioactive natural products (especially molecules derived from extreme environments and shellfish toxins) as novel anticancer, antibacterial and antiviral agents.

• Lecture 2, Can alternative medicines help you quit smoking?
Dr Natalie Walker PhD
Tuesday 30 July

Smoking is the most significant cause of lost healthy life in New Zealand, and contributes substantially to the 10-year life expectancy difference between Maori and non-Maori. Smoking cessation dramatically reduces the risk of smoking–related diseases, such as heart disease and cancer, and is thus a key strategy for reducing health inequalities. In New Zealand, there is a variety of proven services (such as Quitline) and medications, including nicotine replacement therapy (NRT), bupropion, nortriptyline and varenicline (Champix®) to help people stop smoking. Despite easy access to most of these medicines, some people who smoke prefer to use complementary/alternative medicines and therapies to help them quit. This presentation will discuss the various complementary/alternative medicines used by New Zealand smokers trying to quit, and will summarise the evidence around each method regarding their safety and efficacy. Methods discussed will include acupuncture, the Allen Carr’s Easyway programme, hypnosis, Nicobrevin, St John’s wort, bioresonance therapy and cytisine.

• Lecture 3, Hype or hope? Complementary and ‘natural’ remedies in the treatment of couples with subfertility
Professor Cindy Farquhar MD FRANZCOG MPH MNZM
Tuesday 6 August

Subfertility is defined as more than a 12-month delay in conceiving, and affects one in six couples in New Zealand. Many of the established treatments for subfertility are both expensive and not predictably reliable. As a consequence, many couples seek complementary or natural remedies. However, the evidence that these remedies will be effective is often based on poorly designed studies. The Cochrane Collaboration seeks to summarise the evidence on the effects of health care interventions. These reviews are published on the Cochrane Library. The Cochrane Menstrual Disorders and Subfertility Group has undertaken several reviews focused on the impact of complementary and natural remedies on subfertility. This presentation will summarise the evidence for complementary and natural remedies in couples seeking fertility treatments.

• Lecture 4, Herbal highs and lows: the recreational use of psychoactive plants (this lecture was not recorded)
Associate Professor Janie Sheridan PhD FRPharmS
Tuesday 13 August

The use of plants and herbs for their psychoactive effects has a long history. Much of this use historically may have been for cultural and ritual purposes. More recently, we have seen the emergence of their use in a similar manner to that of contemporary alcohol use. Apart from tobacco, the most commonly used psychoactive plant in New Zealand is cannabis, but internationally many other plant-based substances are also used. Furthermore, New Zealand has seen an emergence of a new phenomenon of the use of less commonly known psychoactive plants, such as Salvia divinorum. This presentation will explore what is known about the contemporary use of such plants in New Zealand, in terms of context, their effects and harms.

• Lecture 5, Interactions between medicines and food supplements
Professor Gil Hardy PhD FRSC
Tuesday 20 August

Interactions between medicines, foods and nutrients include pharmacokinetic interactions, i.e. those affecting the absorption, distribution, metabolism and/or elimination of the medicine or nutrient. The clinical consequences of such interactions can include nutritional deficiencies, drug toxicity, and/or loss of therapeutic efficacy.

Providing optimal nutrition therapy is as vital to patient outcome as prescribing the correct drug, but as our knowledge of clinical nutrition and pharmaconutrition has expanded, so too have the complexities of the nutrition and drug therapies that patients are prescribed. The two extremes of nutritional status (i.e. malnutrition and obesity), food and food supplements, fruit juice interactions with medicines, enteral and parenteral nutrition regimens, all influence drug disposition and drug absorption.

• Lecture 6, Safety of herbal medicines: from patient to population
Associate Professor Jo Barnes PhD MRPharmS RegPharmNZ FLS
Tuesday 27 August

Herbal and other ‘natural’ medicines are chemically rich complex mixtures, and many have toxic constituents, and/or contain compounds that can interact with conventional drugs. Recent safety concerns with herbal medicines include adverse liver reactions associated with black cohosh (Cimicifuga racemosa) and interactions between St John’s wort (Hypericum perforatum) and certain prescription medicines. Problems can also arise because of the use of poor-quality herbal products.

It is important to monitor the safety of herbal medicines to identify safety concerns as early as possible. Methods used for safety surveillance (pharmacovigilance) of conventional pharmaceutical medicines are used for pharmacovigilance of herbal medicines, but have important limitations for this class of product. Current and future approaches to safety monitoring for herbal medicines will be discussed.