Unani By Dr. Shabistan Fatma Taiyabi
Abdaal-e-Advia (Drugs substitution)
Drug substitution/ therapeutic interchange (Abdal-e-Advia) is an important concept of Unani medicine pharmacotherapy. It deals with principles, requirements, and related aspects of drug substitution or interchange of drugs for therapeutic purposes.
Zakariya Razi (865–925 AD) authored a treatise Kitab-al-Abdal on the subject of Drug substitution/ therapeutic interchange. he has mentioned substitutes for 122 drugs in this treatise. He also described the concept of Abdaal-e- Advia (Drug substitution/ therapeutic interchange) in detail.
Ibn-e-Sina (980–1037 AD) also discussed the topic of drug substitution/ therapeutic interchange in his famous treatise the Al Qanoon fil Tib. He has described substitutes for a total of 61 drugs out of the 781 drugs described by him. He also discusses the concept of drug substitution and framed guidelines for alternate drug preions at the time of unavailability of the drugs of choice.
Drug substitution/ therapeutic interchange (Abdaal-e-Advia), of a rare or unavailable medicine, is substituted by more readily available medicine. Drug substitution is the replacement of an unavailable drug of therapeutic choice with an available alternate drug. Hence it is an alternate drug preion at the time of unavailability of the drugs of choice. In other words, drug substitution is the replacement of one plant species by another in special circumstances. The new species is often of a completely different genus, but with similar therapeutic properties and effects/ actions. The concept of substitution of drugs (Abdaal-e- Advia) is an established practice in the Unani system of medicine. The concept of drug substitution (Abdaal-e-Advia) is based on the similarity in action, temperament, and physical properties of drugs mainly botanicals, which are already established and have no need for further evaluation. Recently, scientific studies have proved the efficacy of several botanicals on a phytochemical basis indicating that drugs having similar active constituents may exert similar pharmacological actions.
Need for Substitution
Unani Concept of drug substitution (Abdal-e-Advia)
Drugs are substituted when they are endangered, costly, rare, banned or the procurement is cumbersome. A drug is prescribed as a substitute only for a particular action, as the substitute could differ from the main drug in other actions. In classical Unani text, there are frequent examples of substitutes between drugs of different origins, e.g. a botanical-origin drug can be a substitute for an animal or geological-origin drug. Similarly in the unavailability of a fresh drug, inferior quality of the same may be used in increased doses to maintain efficacy. Similarly, if a particular desired part of a botanical drug is unavailable then other parts of the same botanicals may be used if both of these have the same action.
Criteria for Substitution: In case of non-availability of the intended drug, another drug having similar action or temperament or physical properties or any two or all is substantial for selection of a substitute. The criteria for drug substitution/ therapeutic interchange are as follows.
Types of substitution of the drug (Abdaal-e- Advia): It is mainly classified into three types
However, preference is given to similarity in action followed by origin and lastly type of drugs.
Classification of substitution of the drug (Abdaal-e-Advia) based on therapeutic actions: Other classification of Substitution of the drug (Abdaal-e- Advia) is as follows.