Complementary Alternative Medicines Flashcards
Define CAM as WHO
a broad set of health care practices that are not part of that country’s own traditions and are not integrated into the dominant health care system
Define CAM as National Centre for Complementary and Integrative Health
a diverse group of medical and health care systems, practices and products that are not presently considered to be part of conventional medicine
What makes the interpretation of what constitutes CAM complex?
National, cultural and ethnic differences
What are the key underlying dogmas of CAM? (7)
treatments have a long hx of use and stood the test of time
treatments enjoy a lot of support
treatments are natural and therefore safe
treatments are holistic
treatments tackle the root causes of the problem
treatments are being suppressed by the establishment
treatments are inexpensive and so value for money
Name some CAM modalities
herbal and homeopathic therapies acupuncture aromatherapy Reiki Shiatsu Yoga Anthroposophic medicine Ayurveda chiropractic hypnosis mediation naturopathy osteopathy reflexology Chinese medicine vitamins and minerals massage nutraceutical acupressure spiritual healing Alexander technique Applied kinesiology autogenic training
Are males or females the highest users of CAM?
Females
Who are high risk patient groups?
children
pregnancy
those on prescribed medications
polypharmacy
60% of Scottish GP practices prescribe homeopathy or herbal medicines. what are the concerns with this?
implausibility of most lack of evidence of benefit lack of safety data evidence of harm adverse effects herb-drug interactions missed diagnoses stopping conventional medicines cost effectiveness?
What is a sterotypical CAM user?
Affluent
Educated
Family and friends also use
Why do people use CAM?
desire to have control over one health dissatisfaction with conventional treatment perception that conventional medicine lacks a holistic approach concerns over SE of prescribed think its safe, natural and harmless don't see any distinction promote health relatives use
why do HCWs recommend CAM?
patient demand placebo genuine belief experience feel good factor in terminal illness use CAM themselves
what are herbal medicines?
include herbs, herbal materials, herbal preparations and finished herbal products that contain as active ingredients parts of plants or other plant material or combinations
What are the differences in herbal classification in UK and USA?
UK - food supplements, cosmetics, medicines
USA - dietary supplements
do herbal medicines contain active ingredients?
yes
name common adulterants in herbal medicines
heavy metals
bacteria
medicines
How many breast cancer patients use CAM? What is the issue with this?
70% - many use substances with oestrogenic activity
Name the most common herbal supplements used by breast cancer patients
soya cranberry echinacea glucosamine grapefruit garlic
what proportion of women use herbals during pregnancy?
2/3
most common herbals in early pregnancy
ginger
cranberry
chamomile
raspberry
what are the issues with taking herbals during pregnancy?
teratogenic
interactions
no safety or efficacy data
fetogenesis
what herbals are there trials on and for what?
St John’s wart - depression
Saw palmetto - BPH
Ginkgo leaf - cognitive deficiency and dementia
what are the safety issues with herbal products?
contamination and misidentification variation between stated and actual content serious toxic effects lack of data drug-herb interactions
Why is Juniper oil only sold in small quantities?
can be used for abortion
what is homeopathy?
Principle of like cures like
similar - therapeutic substances are selected on the basis of symptoms produced by ingesting the undiluted substance and matched to the symptoms of an illness
how are homeopathic solutions made?
repeated dilution and succussions - potency increased with the number.
what are homeopathy’s healing powers attributed to?
water memory
what potential harms could be produced with accupuncture?
infection
pneumothorax
pneumopericardium
organ function
what is aromatherapy?
use of concentrated essential oils extracted from herbs, flowers and other plants to treat disease. it is commonly administered by massaging into the skin.
how can aromatherapy be done?
inhaled massage diffusion hot or cold compress baths
what harm could result from aromatherapy?
skin irritation photosensitivity headache and fatigue with excessive inhalation insomnia bronchial spasms abortifacient
describe the UK regulation of CAM
homeopathy can be registered under Simplified Scheme 1992 or National Rules Scheme 2006. demonstrate quality and safety
herbals are exempt if no claims of efficacy
New European Traditional Medicinal Products Directive - traditional use registration, does not cover preparations made of a specific patient
Osteopaths and chiropractors are state registered and regulated
