Complementary and Alternative Medicine

Question 1

Black Cohosh

Answer 1

agent used to stimulate menstrual and uterine flow, tone, activity

concerns- dyspepsia, nausea vomiting, GI disturbances
hepatotoxic!
avoid! major pregnancy risk

Question 2

Capsaicin

Answer 2

temp relief of pain from arthritis or from relief of minor aches
high dose dermal patch for tx of neuropathic pain associated with HIV or herpes simplex

se: transient skin irritation

Question 3

Chondroitin and GLucosamine

Answer 3

used to ease symptoms of osteoarthritis
well tolerated

some trials conclude that products of animal jts superior to placebo

Question 4

Echinacea

Answer 4

dec duration of cold symptoms
temp relief of pain due to cold sores

concerns: fever, LAD< diarrhea, angioedema, hepatitis, nausea vomiting

Question 5

Feverfew, tanacetum parthenium

Answer 5

abortive treatment of migraine and vascular headache
relief of pain due to RA
fever tx

concerns- stimulates premature uterine contractions, impaired platelet aggregation

Question 6

Gingko

Answer 6

treatment of tinnitus, vertigo, improvement of pain free walking, sexual dysfunction due to antidepressants, premenstrual syndrome

concerns- 7 reports of seizures, fatal in excessive ingestion, inhibit platelet aggregation

Question 7

Ginseng

Answer 7

root- adaptogen for mental vitality, asian ginseng is more stimulant

concerns- adulterated, mislabeled products
insomnia

Question 8

Kava Kava

Answer 8

traet anxiety, stress, restlessness

hepatotoxic!

Question 9

milk thistle

Answer 9

relief of ulcers, liver disorders, hep a, tx of acute mushroom poisoning

concerns: GI upset

Question 10

st john’s wort

Answer 10

widely used in europe for treatment of depression, sleep disturbances
relief of inflammation due to minor burns

concerns- no difference from placebo, studies too small, too short, too vague
MAJOR issue- interacts with conventional medicine- inhibit CYP3A4, 2C9, 1A2 in vitro and induce CYP3A4 in vivo– reduces levels/activities of oral contraceptives, warfarin, theophylline,

inhibits drug transporters, induces p-glycoprotein

interacts with SSRIs- serotonin syndrome

adverse rxn- alelrgy, constipation, dizziness, dry mouth, GI distress

Question 11

Ephedra

Answer 11

used as weight loss aid, urinary incontinence, nasal congestion

2003- FDA- significant and unreasonable human health risk of illness