13.1 Complementary and Alternative Therapies

Question 1

Herbal Medicines

Answer 1

• Most common form of alternative/complementary medicine

- Used because people think natural is healthier than conventional drugs

Question 2

Dietary Supplement Health & Education Act

Answer 2

• Products not sold as drugs can be sold as dietary supplements
• FDA cannot get involved unless product proves to be harmful and does not advertise benefits

Question 3

Supplement Labels

Answer 3

• Cannot say they diagnose, treat, cure, or prevent disease
• They can say it has the ability to favorably influence body structure or function
• “Helps Promote or Helps Maintain”
• Safe until proven hazardous

Question 4

Good Manufacturing Practices (June 2007)

Answer 4

• More quality control
• Use of hygienic processes
• Labeling needs to be accurate on purity, quality, strength and all ingredients
• Does not require safety or efficacy

Question 5

Dietary Supplement and Nonprescription Drug Act

Answer 5

• Mandates reporting of adverse effects

Question 6

Germany E Commission

Answer 6

• Therapeutic Guide to Herbal Medicine

Question 7

Aloe Vera

Answer 7

• Oral version used as laxative
• Topical used for burns and bites, cuts, skin wrinkles, sunburn
  Adverse Effects
• Allergic Reaction (topical)
• Diarrhea (oral)

Question 8

Black Cohosh

Answer 8

• Used for menopause, dysmenorrhea, PMS
• Blue Cohosh is toxic
• Possible replacement for estrogen therapy
• Not intended for use longer than 6 months
  Adverse Effects
• Stomach upset, Headache Dizziness,
• Can affect antihypertensives
• Do not take with low blood pressure
• May potentiate insulin and oral hypoglycemics

Question 9

Chamomile Tea

Answer 9

• Used for GI Spasms, Inflammatory Disease of GI Tract, Cough, Bronchitis, Cold Symptoms.
• Sedative and Sleep Aid (no evidence)
  Adverse Effects
• Allergies to ragweed, asters, mums, other plants

Question 10

Co-Enzyme Q10

Answer 10

• Found in production of ATP
• Treatment of heart failure, muscle injury caused by statin drugs that lower cholesterol.
• Antioxidant properties
  Adverse Effects
• Antagonize Warfarin
• Shares biosynthesis pathway with cholesterol
• Statis decrease natural effects of Q10

Question 11

Cranberry

Answer 11

• Used for UTI’s
• Cranberry pills are better alternative (less sugar)
• Not as effective in elderly (45-50)
  Adverse Effects
• Possibly impact INR with warfarin

Question 12

Echinacea

Answer 12

• Supportive therapy for colds and chronic upper respiratory infections and poorly healing wounds
• No Side Effects

Question 13

Feverfew

Answer 13

• Useful for fever, migraines, arthritis, arteriosclerosis
• Benefits to migraines used prophylactically
  Adverse Reactions
• Abdominal pain
• Diarrhea
• Chewing leaves causes burning/swelling on lips and tongue
• Contraindicated in patients on antiplatelet/anticoagulant drugs.

Question 14

Flaxseed

Answer 14

• Treats dyslipidemia (elevated cholesterol) and constipation.
  Adverse Effects
• GI Related

Question 15

Garlic (Raw)

Answer 15

• Decrease triglycerides and LDL cholesterol
• Increases HDL and lower blood pressure
• Benefits go away if cooked
  Adverse Effects
• Decreases platelet aggregation
• Formation of atherosclerosis plaque

Question 16

Ginger Root

Answer 16

• Treats vertigo and suppresses nausea/vomiting caused by morning sickness in pregnant women.
• Treats motion sickness
• Post-op nausea and vomiting in chemotherapy
  Adverse Effects
• Can suppress platelet aggregation

Question 17

Ginseng

Answer 17

• Energy boost and concentration
  Contraindications
• Patients with hypertension

Question 18

Probiotics

Answer 18

• Helps irritable bowel syndrome, ulcerative colitis, antibiotic associated diarrhea
• Useful in rotavirus.
  Precautions
• Notify PCP if taking with antibiotics

Question 19

Saw Palmetto

Answer 19

• Used for UTI problems with enlarged prostate
• Antiandrogen activity
• Category X drug
• Affects prostate-specific antigen levels

Question 20

St John’s Ward

Answer 20

- Depression, Anxiety, Nervousness 
Adverse Effects
- Competes for metabolism sites in P450 system in liver
- May intensify some drug effects
- Lots of interactions

Question 21

Ginkgo Glucosamine

Answer 21

• Used for arthritic pain

- Caution in people with shellfish allergy

Question 22

Green Tea

Answer 22

• Can cause caffeine overdose

Question 23

Soy

Answer 23

• Do not use with antiestrogenic medications (tamoxifen)

Question 24

Valerian

Answer 24

• Used as tranquilizer in WW2
• May potentiate alcohol CNS depressant
• Generally well tolerated

Question 25

Comfrey (DANGER)

Answer 25

- Can cause hepatic vessel occlusive disease and liver damage - Used to be used to treat broken bones, sprains, fractures

Question 26

Kava (DANGER)

Answer 26

- Alternative to benzodiazepine - Sedative anti-anxiety muscle relaxant - Relax muscles and anxiety ADVERSE EFFECTS - Hepatoxicity

Question 27

Ma Huang - Ephreda (DANGER)

Answer 27

- CNS stimulant - Can cause euphoria and lead to abuse ADVERSE EFFECTS - Stroke, MI, Death

Question 28

Ginkgo and Anticoagulants (DANGER)

Answer 28

- Accelerates effects of aspirin and other antiplatelets | - Dangerous to use with antiplatelet and coumadin

Question 29

Ephedrine (DANGER)

Answer 29

- Used for weight loss medications | - Large doses people were dying with stimulants

Question 30

DANGER

Answer 30

Echinacea and anabolic steroids Saint Johns Wort with amphetamines, cocaine, MAO inhibitors Kava with anesthesia and Parkinson's drug