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Formulation Development of an Herbal Candy for Altitude Health Problems

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Formulation Development of an Herbal Candy for Altitude Health Problems e-ISSN:2321-6182 p-ISSN:2347-2332 Research & Reviews: Journal of Pharmacognosy and Phytochemistry Formulation development of a Herbal Candy for Altitude Health Problems Reena Hoonda* Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, 124001, India Research Article Received date: 02/09/2015 ABSTRACT Accepted date: 29/10/2015 Published date: 07/11/2015 People, who visit to high altitudes, do experience certain type of health problems as they transits to different altitude ranges. With ascend to high altitude, various *For Correspondence kinds of acute and chronic physiological changes occur which influence all system of human body. These problems although have temporary manifestations, arising due to maladjustment of body to abrupt altitudinal changes in oxygen, atmospheric Reena Hoonda, Department of pressure and gravity but sometimes can be life threatening. Often it has been found Pharmaceutical Sciences, Maharshi that these symptoms are confused with other complications of body. Although various Dayanand University, Rohtak, 124001, formulations are available for the treatment of altitude health problems but they India associated with certain problems in their use such as freezing of liquid formulation, solid dosage forms need water which is again a problem at high altitude, difficulty in E-mail: [email protected] handling, taste problem etc. This work is done to formulate a suitable formulation (candy) for these altitude health diseases and to overcome the problems related to Keywords: Herbal medicines; Plant the dosage forms which are already available as mentioned above. Present work identification; Contamination targeted not only a particular disease but on the main problem i.e. High Altitude Pulmonary Edema which is fatal in most of the cases and on the symptoms of other altitude problems also. INTRODUCTION Altitude High altitude areas can be defined as areas at altitudes equal to or greater than 1500 m above mean sea level[1] . It ranges from 1500 to 5500 m. Each year millions of people ascend to altitudes between 2000 m and 4000 m. Altitude Illness Millions of people travel to high altitudes every year mostly above 1500 m, especially in the Himalayas in Asia, Alps in Europe, Rockies in the United States and Andes in South America. [2] Altitude sickness is a number of symptoms that can occur from ascending to high altitudes more quickly than the body can adjust. Atmospheric pressure is reduced at high altitudes. The reduced atmospheric pressure means that the air is less rich with oxygen and therefore less oxygen is available for body cells to use. The severity of the symptoms depends on the altitude reached, the rate of ascent, the time spent at the high altitude, and the person’s overall health. Why Does Altitude Sickness Occur? The concentration of oxygen at sea level, where the barometric pressure averages 760 mmHg is about 21%. With an increase in altitude, barometric pressure decreases so there are less oxygen molecules taken up per breath. For e.g. at 12,000 feet, the barometric pressure is about 483 mmHg, resulting in about 40% fewer oxygen molecules per breath [3]. Effects of High Altitude on Human Body a. Reduced physical performance: People cannot maintain the same physical performance at altitude as they can sea level, regardless of the fitness level. JPRPC | Volume 3 | Issue 4 | December, 2015 22 e-ISSN:2321-6182 p-ISSN:2347-2332 b. Physiological effects: The physiological effects may result changes in senses (vision and taste), mood and personality. These defects are directly related to altitude and are common at over 3048 m. Various Altitude Health Problems and Their Treatment Altitude health problems are acute mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, frostbite, chilblain, sleep disturbances. Acute mountain sickness (AMS): AMS is a syndrome of non-specific symptoms and is therefore subjective[4] . AMS is defined as the presence of headache in an unacclimatized person who has recently arrived at an altitude above 2500 m. AMS is char- acterized by following symptoms, gastrointestinal problems (anorexia, nausea, vomiting etc), insomnia, dizziness and fatigue [5,6]. High altitude cerebral edema (HACE): HACE is the severe form of acute mountain sickness. It results due to swelling in the brain tissues because of low pressure. In this problem the blood circulation to the brain becomes very low. The mechanism of HACE is when human body is exposes to high, very high altitude, it leads to hypoxia ( a state when low oxygen is present in the body) and low oxygen supply to the brain and hence high altitude cerebral edema. The symptoms of HACE are severe headache, vomiting, ataxia, confusion, localized, paralysis, coma and death. High altitude pulmonary edema (HAPE): HAPE is a life-threatening non-cardiogenic form of pulmonary edema that afflicts vulnerable individuals following rapid ascent to high altitude above 2500 m. With usual ascent rates, the incidence is about 1 to 2% but as many as 10% of people ascending rapidly to 4500 m may develop the conditions [7]. It develops due to oxygen deficiency as well as low atmospheric pressure. Reduced clearance of fluid from the alveoli may also contribute to HAPE. The various symp- toms of HAPE are external dyspnea, cough, and reduced exercise performance, breathlessness at rest, gurgling in the rest, chest pain, and fluid excess in the lungs[8] . Frostbite: Frostbite is a condition caused by the action of cold on the body. Appearance of frostbite not only depends on temperature but also on the duration of exposure to cold, humidity, airflow, pre-existing disorders such as arterial circulatory disorders, chronic alcoholism. The most frequent symptoms along with headache were lightheadedness and vertigo, but sleep disturbance was most common one. Chilblains: It is an inflammatory skin condition presenting after exposure to cold as pruritic and/or painful erythematous to violaceous acral lesions. It may be idiopathic or secondary to an underlying disease [9]. Chilblains are most seen in young and middle aged women and in children, and in terms of sex ratio, women are affected more frequently than men. The direct cause of chilblain is cold exposure, but exposure to both mild non freezing cold and humidity seem to be required. People who exercise or work outdoors in wet and cold rooms, women and people who have acrocyanosis or erythrrocyanosis are prone to develop chil- blain. The various symptoms of chilblain are inflammation, low body weight, hormonal changes, bluish red skin, pain, itchiness, Patients may experience burning sensation, ulcerating blister. Treatment of Altitude Health Problems Various methods and drugs are used in the treatment of acute altitude sickness and are: • Gradual ascent: Controlling the rate of ascent, in terms of the number of meters gained per day [10], is a highly effective means of preventing acute altitude illness. • Acetazolamide: Multiple trials have established a role of acetazolamide in the prevention of AMS. The recommended adult dose for prophylaxis is 250 mg twice a day [11]. It is a carbonic anhydrase inhibitor and its mechanism of action is thought to be to acidify the blood, causing an increase in respiration centrally and an increase in oxygenation. • Gingko biloba: It is also play an important role in AMS prevention; several negative trials have also been published [12]. This discrepancy may result from differences in the source and composition of gingko products. • Natural remedies: Zingiber officinalis, kalium phosphate, ferrum phosphate, cocculum and Pulsatilla vulgaris. If symp- toms don’t go away, descend 300 m. These remedies in combination may help in improvement of breathing rate, disori- entation and speed recovery. • Descent: When HACE is feasible, descent remains the single best treatment for HACE. The symptoms typically resolves following descent of 300 to 4000 m, but the required descent will vary between persons. • Supplemental oxygen: Oxygen delivered by nasal cannula at flow rates sufficient to raise arterial oxygen saturation to greater than 90% provides a suitable alternative to descent [13]. • Portable hyperbaric chamber: These devices are effective for treating HACE and other severe altitude illness, but required constant tending by care providers and are difficult to use with vomiting patients. Symptoms may recur when individuals are removed from the chamber. • Beta 2 receptor agonists: Inhalation of beta-2-receptor agonists might be used in addition to nifedipine is commonly JPRPC | Volume 3 | Issue 4 | December, 2015 23 e-ISSN:2321-6182 p-ISSN:2347-2332 used [14]. It is likely that sildenafil which attenuates hypoxic pulmonary vasoconstriction is effective for the treatment of HAPE but no clinical trials have yet been reported. FORMULATION DEVELOPMENT OF HERBAL CANDY FOR TREATMENT OF ALTITUDE HEALTH PROBLEMS Candy is a delicate, delicious, treat that we all love. The word “candy” comes from Arabic qandi, derived from Persian qand, meaning “sugar”. It comes in many wonderful flavors including milk chocolate, caramel, peppermint, dark chocolate, butter scotch and various other fruit and mint flavors. It also comes in many consistencies such as chewing gum, hard candy, soft candy and all sorts of great delicious configurations and shapes. There are more than 2,000 kinds of candies are available. Candies are divided roughly into two main classes: 1) Creamy or crystalline: These candies contain small crystals in their structure, these are easily chewable and are creamy that melt in the mouth. 2) Amorphous or non-crystalline: These candies include hard candies, caramels and toffees. These are homogeneous and hard. Creamy or amorphous candies are further of various types: • Hard candy: It is a common type of sugar candy which contains water, sugar, color and flavor. • Candy bars: These are the candy which available in the form of bars. • Chocolate candy: These are chocolate containing candies and are of different types white chocolates, dark chocolates, unsweetened chocolates with no sugar and milk chocolates etc.
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