complementary medicines Flashcards

1
Q

What is a therapeutic good

A
  • Preventing diagnosing curing or alleviating a disease ailment defect or injury
  • Influencing inhibiting or modifying a physiological process
  • Testing the susceptibility of persons to a disease or ailment
  • Influencing, controlling or preventing conception
  • Testing for pregnancy
  • Used as an ingredient or component in the manufacture of therapeutic goods
  • Used to replace or modify parts of the anatomy
  • Must be entered in ARTG
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2
Q

Examples of therapeutic goods

A
•	Medicines 
o	OTC complementary medicines vitamins sunscreens
•	Medical devices 
o	Pacemakers x ray bandages 
•	Biologicals
o	Derives from human or animal cells 
•	Blood and and blood components 
•	Some disfectants and tampons
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3
Q

Herbal medicines

A
  • Herbal substances as the major active ingredients
  • Preparation of plants and other organisms that are treated as plants in the international code of botanical nomenclature fungi/algae/yeast
  • St johns wort, valerian, echinacea ginseng
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4
Q

Traditional medicines

A
  • Health practices approaches knowledge and beliefs incorporating medicines of plant animal and or mineral origin
  • Eg ATSI medicine
  • Traditional of use with 3 generations of use 75 years
  • Ethnopharmacology
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5
Q

Homeopathic medicines

A

• Capable of producing in a healthy persons symptoms similar to those which it is administered to alleviate
o Onion used to treat hay fever
o Let like cure like
• Prepared via serial dilution of a mother tincture in water aqueous ethanol
• Mainly derived from plants
• Highly diluted rendered non toxic
• Manufactured to different strengths /potencies

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6
Q

Vitamins and minerals

A
  • Some listed on the poison standard
  • Must not imply that vitamins and minerals are a good substitute for a balanced good diet/good nutrition
  • Appropriate in cases of documented diefneciy eg vitamin D
  • Some preparation contain doses far in excess of RDI
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7
Q

Nutritional substances

A

• Some regulated as foods others as TG

o Fish oil krill oil shark cartilage

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8
Q

Essential oils

A
  • Cosmetic claim

* Regulated by national industrial chemical notification and assessment scheme

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9
Q

Regulation of commentary medicines

A

• Registered medicines
o are considered to be of higher risk and evaluated for safety quality and efficacy
• Listed medicines are lower risk and are evaluated for safety and quality only not efficacy
o AUST L

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10
Q

Listed meds

A

• Lower risk
• Assessed for quality and safety not efficacy
• Product manufactured in TGA approved facilitis
o Lincesed manufacturer
• TGA does not perform direct toxcitiy testing
• Lack of reported or documented toxcitiy
o Published literature
o History of use
• Dossier of safety data evaulted
• Evidence from scientific literature and based on history of use
• Provide evidence to TGA if requested

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11
Q

Post marketing surveillance of CM

A
  • Community adverse reporting
  • Sponsor adverse event reporting
  • Inspection of manufacturers
  • Sampling and lab testing
  • Compliance reviews
  • Cancellation
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12
Q

What did COIVD19 do

A
•	Handsantisr hand wash PPE 
•	Consumer drop in demand for cold and flu 
•	Consumer increase in demand for immunity and well being 
o	Pre and probiotic 
	Echminame 
o	Vit c and d 
o	Vitamins
•	Online purchasing
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13
Q

The following may interact with warfarin

A
  • Gingko biolab
  • St johns wort
  • Ginger
  • Co enzyme Q 10
  • Glucosamine
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14
Q

Patients often do not inform their doctor that they are taking CM

A
  • Fear of negative response/judgment
  • Do not consider CM medicines
  • HC professionals should always ask if patients are using CM
  • Many patients take conventional and complementary medicines together
  • CM may produce significant risk
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15
Q

Why do people use CM

A
  • Dissatisfied with conventional therapy
  • Reduce symptoms side effects from convential therapy
  • Attraction to a holistic method of HC
  • Preventative therapy or an adjunct to conventional therapy
  • Personal beliefs and hope
  • Perception that complemtary medicines are safe
  • Sense of control over treatment
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16
Q

St johns wort

A
•	Relieve nervousness
•	Healthy mood balance
•	Mood support 
•	Relief of sleeplessness 
•	How it is advertised 
•	Cannot cure or prevent 
•	Efficacy in depression 
o	Superior to placebo in patients with major depression
o	Similarly effective as standard antidepressants
o	Less side effects than standard antidepressant 
•	Hypericin 
•	Pseudihypercin 
•	Hyperforin 
•	Aldyherperforin 

• Uptake inhibition of serotonin, NA etc with hyperforin

17
Q

st johns wort risk

A
Risks 
•	Induces CYP3A4 
•	Induces p-glycoprotein
•	Serotonin syndrome/toxicity 
•	Can affect absorption and elimination
  • Can be good in treating depression
  • Potential drug interactions
  • Pharmacokinetic CYP induction
  • Pharmacodynamic serotonin syndrome
18
Q

COQ10

A
•	Vital component for energy production within the cell
o	Ubiquitous 
o	Supports ATP production in the mitochondria
•	Use with statins 
•	HF 
•	Angina 
•	Hypertension 
•	Migraine 
•	Improve circulation 
•	Better aborded orally when 
o	Taken with fatty meal 
o	Mixed with oil in capsule 
o	Bioequliance?
•	Generally, well tolerated
19
Q

CoQ10 and statins

A

Taking CoQ10 supplements can help increase your CoQ10 levels and may reduce statin side effects.

•	Muscle symptoms 
•	Eg pain 
•	Important that any muscle symptoms are investigated
o	Muscle damage 
•	Measure CK levels 
•	Benign statin induces myalgia treatment
o	Reduce dose 
o	Switch to another statin 
o	Switch alternative therapy
20
Q

CoQ10 and warfarin

A
  • Reports decrease in INR following co-admin warfarin and CoQ10
  • Structure similar to vitamin K procoagulant effect
  • Can use warfarin and CoQ10 together
21
Q

Coq10 and HF

A
  • Statins lower serum Coq10
  • Heart contains high concentrations of Coq10
  • Statin therapy may precipate HF
  • Sno increase in HF
22
Q

Ginkgo biloba

A
•	Extract prepared from leaves of ginkgo tree 
•	Claimed action 
o	Inhibit platelet aggregation 
o	Vasodilation 
o	Anti-oxidant free radical scavenger 
o	Anti-inflammatory 
o	Enhance cognitive function 
o	Improve and enhance memory dementia
o	Fatigue 
o	Learning 
•	Listed
•	Well tolerance 
•	Might see
o	Gi disturbance 
o	Headache 
o	Dizziness
o	May increase bleeding – interaction with warfarin