Chapter 15.1

Question 1

1. Provide a definition of complementary medications

Answer 1

drugs used in addition to conventional treatment

Question 2

alternative medications

Answer 2

Drugs used as a substitute for more conventional treatment

Question 3

2. List the various agents and treatments that are considered under the broad category of complementary and alternative medications (CAMs).

Answer 3

herbs, natural supplements, nutraceutical, vitamins, minerals,

Question 4

3. Provide a definition of nutraceutical.

Answer 4

A nutritional supplement that can have pharmaceutical properties

Question 5

4. List reasons that patients may use complementary and alternative medications and treatments.

Answer 5

Patients may feel that natural products are fundamentally(intrinsically) better
May hypothesis that nutrition is the foundation for good health
May have distrust in conventional medication

Question 6

5. List the misconceptions that patients may have about CAM safety.

Answer 6

Consumer may think NATURAL products are safer & less toxic
May think MORE IS BETTER & exceed recommended dose
May fail to recognize impact on other (conventional) meds

Question 7

6. List some of the issues with CAM use that may impact on patient safety.

Answer 7

CAMs can produce similar/additive effects to conventional meds
CAMs can produce effects opposite to that of conventional meds
CAMs can increase metabolism of conventional meds via enzyme induction

Question 8

7. Define the concept of enzyme induction.

Answer 8

CAMs stimulates(induce) liver to synthesize more drug metabolizing enzymes resulting in a increased enzymes in liver that break down conventional meds faster than usual. So conventional meds never reach therapeutic levels

Question 9

8. State how enzyme induction by CAM use may impact effectiveness of conventional medication therapy (e.g. the anticoagulant warfarin).

Answer 9

IF CAM drugs are causing enzyme induction in the liver, the liver will break down anticoagulant warfarin faster therefore it cannot reach its therapeutic effects. As a result, anticoagulant warfarin is an inadequate anticoagulant & cannot break down DVT which can lead to a pulmonary embolism.

Question 10

9. State how a patient’s failing to report CAM use to other practitioners may have a negative impact on that patient’s overall therapy.

Answer 10

Negative impact can result in bad drug combination & interactions
Adverse effects may not be reported by the patients

Question 11

10. State the patient safety issues involved because of the lack of standards in testing CAMs.

Answer 11

CAMs are not subject to same testing standards as conventional meds which can lead to safety issue
CAMs may have a poor-quality control which can lead to safety issues

Question 12

11. State the patient safety issues involved because a patient delays conventional therapy because of the use of CAMs.

Answer 12

Safety issue is that the patient may tend to stick with CAM too long/forego use of conventional meds. If the CAMs are not effective, condition/disease may have worsened until conventional meds are no longer effective

Question 13

12. Provide a definition of the following terms: homeopathy

Answer 13

Very small dose of a substance cause symptoms that mimic a disease & stimulate the body’s self-healing response

Question 14

naturopathy

Answer 14

Healing is encouraged by various practices such as massage, acupunctures, herbal remedies, exercise, & lifestyles counseling

Question 15

mind-body medicine

Answer 15

Techniques such as medication, prayers, relaxation, & art therapies are used to enhance & strengthen the mind/body connection

Question 16

energy medicine

Answer 16

Techniques such as a therapeutic touch, reiki, and magnet therapies are used to maintain or restore an invisible flow of energy throughout the body

Question 17

biology-based practices

Answer 17

Ingredients found in nature such as herbal remedies & dietary supplements are used to restore/maintain health.

Question 18

13. List the primary uses and potential problems of the following CAMs: echinacea

Answer 18

Uses 
Promote wound healing(topical) 
Prophylaxis against colds, flu, etc. 
Potential problems 
Skin rash

Question 19

gingko biloba

Answer 19

Uses 
Improve memory, cognitive function
Enhance peripheral circulation
Potential problems 
CNS (headache, anxiety) – GI (nauseas, vomiting) – skin rash

Question 20

ephedra

Answer 20

Uses
Improve asthma, bronchitis, joint pain, inflammation, promote weight loss
Potential problems
Cardiac (sever increase HR & BP) & CNS stimulation (sympathomimetic effect)

Question 21

St. John’s wort (on test)

Answer 21

Uses 
Depression & anxiety
Potential problems 
CNS (dizziness & insomnia), GI cramps, constipation
Skins: rashes & photosensitivity

Question 22

kava

Answer 22

Uses
Sedative effects used for depression, anxiety, psychosis & seizures
Used as muscle relaxants & promote wound healing
Potential problems
Liver damage, blood disorders (decrease platelets), Gi distress

Question 23

bee venom

Answer 23

Uses
Have anti-inflammatory & immunosuppressive effects
Rheumatoid arthritis, & chronic inflammatory diseases, MS
Potential problems
Acute pain, arthropathy with long term use, immune disturbance

Question 24

glucosamine and chondroitin

Answer 24

Uses
For joint pain (osteoarthritis)
Potential problems
GI (nauseas, vomiting, heartburn) & CNS (drowsiness, headaches)

Question 25

14. List the primary use of the following CAMs: garlic

Answer 25

antilipidemic

Question 26

ginger

Answer 26

used for headaches & sore throats

Question 27

ginseng

Answer 27

used for general health & well being

Question 28

saw palmetto

Answer 28

used for benign prostate hypertrophy (BPH) & cystitis

Question 29

valerian

Answer 29

used for anxiety & insomnia

Question 30

15. State the role of vitamins in maintaining health

Answer 30

Vitamins - body needs them to facilitate specific metabolic and biosynthetic process

Question 31

minerals

Answer 31

small chemical substances that play key roles in various physiological processes like sodium, potassium, chloride, and calcium & how they influence the function and homeostasis of virtually every cell in the bod

Question 32

16. List appropriate indications for vitamin and mineral supplementation.

Answer 32

Appropriate if the diet is inadequate (not enough V&M)

Appropriate if there is a problem with V&M absorption or metabolism of specific V&M

Question 33

17. State general concerns when vitamins and minerals are used regularly without a clear indication.

Answer 33

High doses could potentially have harm, especially with the fat-soluble vitamin A, D, E, K
Can lead to toxicity

Question 34

18. State the considerations of a physical therapist working with patients who are using complementary and alternative medications and treatments

Answer 34

Education patients on myths and appropriate uses
Pt should query patients about CAM use
Looks for signs of excessive use of CAMs such as muscle weakness, incoordination, excessive fatigue, balance problems, skin rashes or bruising, neuropathic changes, & CV impairments (increased BP, arrhythmias)