Chapter 15.1 Flashcards
- Provide a definition of complementary medications
drugs used in addition to conventional treatment
alternative medications
Drugs used as a substitute for more conventional treatment
- List the various agents and treatments that are considered under the broad category of complementary and alternative medications (CAMs).
herbs, natural supplements, nutraceutical, vitamins, minerals,
- Provide a definition of nutraceutical.
A nutritional supplement that can have pharmaceutical properties
- List reasons that patients may use complementary and alternative medications and treatments.
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
- List the misconceptions that patients may have about CAM safety.
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
- List some of the issues with CAM use that may impact on patient safety.
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
- Define the concept of enzyme induction.
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
- State how enzyme induction by CAM use may impact effectiveness of conventional medication therapy (e.g. the anticoagulant warfarin).
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.
- State how a patient’s failing to report CAM use to other practitioners may have a negative impact on that patient’s overall therapy.
Negative impact can result in bad drug combination & interactions
Adverse effects may not be reported by the patients
- State the patient safety issues involved because of the lack of standards in testing CAMs.
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
- State the patient safety issues involved because a patient delays conventional therapy because of the use of CAMs.
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
- Provide a definition of the following terms: homeopathy
Very small dose of a substance cause symptoms that mimic a disease & stimulate the body’s self-healing response
naturopathy
Healing is encouraged by various practices such as massage, acupunctures, herbal remedies, exercise, & lifestyles counseling
mind-body medicine
Techniques such as medication, prayers, relaxation, & art therapies are used to enhance & strengthen the mind/body connection
energy medicine
Techniques such as a therapeutic touch, reiki, and magnet therapies are used to maintain or restore an invisible flow of energy throughout the body
biology-based practices
Ingredients found in nature such as herbal remedies & dietary supplements are used to restore/maintain health.
- List the primary uses and potential problems of the following CAMs: echinacea
Uses Promote wound healing(topical) Prophylaxis against colds, flu, etc. Potential problems Skin rash
gingko biloba
Uses Improve memory, cognitive function Enhance peripheral circulation Potential problems CNS (headache, anxiety) – GI (nauseas, vomiting) – skin rash
ephedra
Uses
Improve asthma, bronchitis, joint pain, inflammation, promote weight loss
Potential problems
Cardiac (sever increase HR & BP) & CNS stimulation (sympathomimetic effect)
St. John’s wort (on test)
Uses Depression & anxiety Potential problems CNS (dizziness & insomnia), GI cramps, constipation Skins: rashes & photosensitivity
kava
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
bee venom
Uses
Have anti-inflammatory & immunosuppressive effects
Rheumatoid arthritis, & chronic inflammatory diseases, MS
Potential problems
Acute pain, arthropathy with long term use, immune disturbance
glucosamine and chondroitin
Uses
For joint pain (osteoarthritis)
Potential problems
GI (nauseas, vomiting, heartburn) & CNS (drowsiness, headaches)
- List the primary use of the following CAMs: garlic
antilipidemic
ginger
used for headaches & sore throats
ginseng
used for general health & well being
saw palmetto
used for benign prostate hypertrophy (BPH) & cystitis
valerian
used for anxiety & insomnia
- State the role of vitamins in maintaining health
Vitamins - body needs them to facilitate specific metabolic and biosynthetic process
minerals
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
- List appropriate indications for vitamin and mineral supplementation.
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
- State general concerns when vitamins and minerals are used regularly without a clear indication.
High doses could potentially have harm, especially with the fat-soluble vitamin A, D, E, K
Can lead to toxicity
- State the considerations of a physical therapist working with patients who are using complementary and alternative medications and treatments
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)
