Adverse drug reactions (ADRs) and iatrogenic diseases have been identified as significant factors responsible for patient morbidity and mortality. Significant studies on drug metabolism in humans have been published during the last few years, offering a deeper comprehension of the mechanisms underlying adverse drug reactions and interactions. More understanding of these mechanisms, and of recent advances in laboratory technology, can help to evaluate potential drug interactions when drugs are prescribed concurrently. Increasing knowledge of interindividual variation in drug breakdown capacity and recent findings concerning the influence of environment, diet, nutrients, and herbal products can be used to reduce ADRs and iatrogenic diseases. Reviewed data suggest that drug treatment should be increasingly custom tailored to suit the individual patient and that appropriately co-prescribed diet and herbal remedies, could increase drug efficacy and lessen drug toxicity. This review focuses mainly on recently published research material. The cytochrome p450 enzymes, their role in metabolism, and their mechanisms of action are reviewed, and their role in drug-drug interactions are discussed. Drug-food and drug-herb interactions have garnered attention. Interdisciplinary communication among medical herbalists, medical doctors, and dietetic experts needs to be improved and encouraged. Internet resources for obtaining current information regarding drug-drug, drug-herb, and drug-nutrient interactions are provided.

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Mature and immature fruits of a Cretan Vitex agnus-castus L. population were chosen to investigate different parameters such as comminution, maturity, distillation period and extraction method influencing the essential oil yield and composition. The effect of the comminution and the maturity of the plant material showed highly significant differences in yield and composition of the essential oils obtained, as well as the distillation duration from one to five hours and the method applied (hydrodistillation and simultaneous distillation extraction). The variation of 36 essential oil components due to the parameters applied was studied. The results showed that many different essential oil qualities can be obtained from the same plant material according to the parameters employed in its extraction. Entire fruits hydrodistilled for one hour yielded an oil much richer in monoterpene hydrocarbons and oxygenated compounds whereas the best combination to obtain an oil rich in less volatile compounds is by SDE of comminuted fruits for five hours. For mature fruits the main components varied as follows due to the parameters studied: sabinene 16.4-44.1%, 1,8-cineole 8.4-15.2%, beta-caryophyllene 2.1-5.0%, and trans-beta-farnesene 5.0-11.7%.

The hydrodistilled essential oils of mature fruits from five populations of Vitex agnus castus L. growing wild in Crete, Greece, were analyzed by GC and GUMS.More than 70 components were detected, of which 47, comprising 87% of the total oil were identified. The oil yield and quantitative composition differed significantly between populations. The main constituents of all the oils were sabinene (16.6-31.2%), 1,8-cineole (4.4-14.5%), (E)-P-farnesene (4.8-9.9%), a-pinene (0.4-10.2%) and P-caryophyllene (1.4-6.0%). Yields varied from 0.15% to 1.0%. The effect of the comminution of the fruits prior to distillation was studied, and the results showed a slightly inferior yield and an elevated concentration of monoterpenoids at the expense of sesquiterpenoids in the oil obtained from entire fruits. An oil obtained by a pilot scale distillation for commercial production was also investigated.