Clinical pharmacology- CAM

Question 1

What are the main concerns regarding CAM

Answer 1

Implausibility of most therapies
Lack of evidence for benefit
Lack of safety data
Evidence of harm
Adverse Effects / Herb-Drug Interactions
Unqualified practitioners / Missed diagnoses
Stopping conventional medicine
Cost-effectiveness?

Question 2

What is the epidemiology surrounding CAM?

Answer 2

• 80% of the UK population
• 60% of all cancer patients use or have used CAM
• 60% of all pregnant women in the UK use CAM
• 1% of children under 1 year of age are prescribed

Question 3

who do the users of CAM tend to be?

Answer 3

Affluent
Educated
Have family and friends used them

Question 4

List some reasons why patients use CAM

Answer 4

Desire to have personal control over one’s own health.
Dissatisfaction with conventional treatment
Perception that conventional medicine lacks/disregards an holistic approach.
Concerns about the side effects of prescribed medications
-more congruent with their own values, beliefs and philosophical orientations toward health and life
 Side effects
 Lack of effective treatments
 Chronic symptoms
 Hype

Question 5

What are herbal medicines

Answer 5

Herbal medicines include herbs, herbal materials, herbal preparations and finished herbal products, that contain as active ingredients parts of plants, or other plant materials, or combinations.

Question 6

How are herbals classified in the UK/USA

Answer 6

• in the UK sometimes classified as food supplement/ cosmetics
• in the USA come under dietary supplements

Question 7

list some of the safety issues associated with herbals?

Answer 7

• variation in labelled content of products and actual content
• lack of data
• contamination, adulteration, misidentification
• drug-herb interaction

Question 8

List common groups of people that use herbals and what risks they may have?

Answer 8

• Breast Cancer patients

- 2/3rds of women in early and late Pregnant women: fetogenic, teratogenic

Question 9

What is homeopathy?

Answer 9

• Minute concentrations of a particular toxin
• Remedies are produced by the repeated dilution and succussion of the substance
• • A typical homeopathic dilution is 30X, where the X represents 10.

Question 10

How are homeopathic substances produced

Answer 10

• A typical homeopathic dilution is 30X, where the X represents 10.
• One part toxin is mixed with 10 parts water or alcohol.
• The mix is shaken; one part of this mix is added to 10 parts of water or alcohol again; The whole process is repeated 30 times.

Question 11

how does homeopathy work?

Answer 11

Homeopathy’s healing powers are attributed to “water memory” — the concept that water has the ability to remember of shape of the medicine it once contained.

Question 12

what is a

Acupuncture?

Answer 12

Based on traditional Chinese medicine.
Vital force called “Qi” which circulates along channels called meridians.
There are 12 main meridians, and these correspond to 12 major functions or “organs” of the body.

Question 13

how does Acupunture work?

Answer 13

• Trigger points targeted for needling to deal with pain.
• 4 -10 points are needled during a session.
• Needles are left in place for 10-30 minutes, although can be shorter.
• Needles may be stimulated by twirling or an electrical current.
• A typical course of treatment for a chronic condition would be 6 – 12 sessions over 3 months.
• This might be followed by “top up” treatments.

Question 14

safety of acupuncture

Answer 14

Serious problems similar to any harm with needle use.
 	Infection
 	Pneumothorax
 	Pneumopericardium
 	Organ puncture
 	Related to training of therapist.

Question 15

Aromatherapy mechanisms of administration

Answer 15

• inhalation
• massage
• diffusion
• Hot/cold compress
• soaking baths

Question 16

side effects of aromatherapy

Answer 16

Skin irritation with frequent use
Photosensitivity-Avoid prolonged exposure to the sun,
Excessive inhalation can cause headaches and fatigue;
Insomnia -peppermint,
Origanum, sage, savory, thyme, and wintergreen, are not safe for home use.
Bronchial spasms, and people with asthma should not use
Abortifacient- Avoid aromatherapy during pregnancy