Complementary therapy II

Question 1

herbal medicine is a ______ form of medicine

Answer 1

holistic

Question 2

what is holistic medicine

Answer 2

looking at the patient as a whole to restore balance

Question 3

what is the herbalism belief?

Answer 3

ill health arises as a result of imbalance in the body, herbal remedies try to restore this balance

Question 4

herbalists believe that health is when the ______ ______ of the body is achieved

Answer 4

natural state

Question 5

how do herbalist remedies work

Answer 5

stimulate the bodies defences
normalise processes
eliminate toxins

Question 6

what types of plants does herbal medicines use?

Answer 6

use whole plants, whole plant parts or whole plant extracts

Question 7

difference between traditional medicine and herbalism?

Answer 7

traditional western focus is identifying active ingredients, isolating and purifying it to give it as a standardised form to the patient. herbalism give the whole of the herb to the patient

Question 8

how do herbal remedies that make therapeutic claims need to be registered?

Answer 8

medicines
or
traditional herbal registration scheme

Question 9

conditions of THMP?

Answer 9

been in use for 30 years

demonstrate quality and safety

Question 10

what must THMP provide patients information on?

Answer 10

contraindications
side effects
use in pregnancy and children

Question 11

do you have to show that THMP has a benefit?

Answer 11

no

Question 12

where from and what can pharmacists sell herbal remedies?

Answer 12

from any registered premises, any herbal medicines:

containing part I and II substances

Question 13

what can herbal practitioners sell?

Answer 13

remedies with substances from Part II
GSL herbal medicines
any remedies that can be sold by a shop keeper

Question 14

any shopkeeper can sell?

Answer 14

GSL herbal medicines

THRP

Question 15

what does St John Wort contain?

Answer 15

hypericum perforatum

Question 16

what do sjw look like?

Answer 16

yellow flowers with black dots which turn red when rubbed

Question 17

traditional uses of sjw

Answer 17

hand plant in house on st johns day over a religious icon to ward off evil
relief of slightly low mood and mild anxiety

Question 18

what is sjw registered as?

Answer 18

TMP

Question 19

what affects the concentration of the different compounds?

Answer 19

processing of plants and the formulation of the product

Question 20

what’s the main active ingredient in sjw

Answer 20

hyperforin

Question 21

how does hyperforin work?

Answer 21

works like an SSRI
inhibits the reuptake of monoamines e.g. serotonin
upregulate serotonin receptors

Question 22

what are SSRIs

Answer 22

antidepressant drug that inhibits serotonin reabsorption by neurones, so increasing serotonin as a nt- has contributions to feelings of well-being and happiness

Question 23

structure of a hypericin?

Answer 23

blue-black planar solid

Question 24

why can hypericin cause photosensitivity?

Answer 24

can readily form free radicals- blue black absorbs light, electrons are delocalised

Question 25

sjw extraction solvent?

Answer 25

ethanol 60%

Question 26

how much sjw extract does each tablet contain

Answer 26

250mg dry extract

Question 27

dose of sjw?

Answer 27

take 1 tablet daily

Question 28

available formulations of sjw

Answer 28

tablets
capsules
tea bags
tinctures

Question 29

what is a quality consideration with sjw?

Answer 29

equivalence between formulations

Question 30

why can sjw interact with other drugs?

Answer 30

enzyme inducer- DECREASES effect of other drugs

Question 31

what enzymes does sjw interact with

Answer 31

cytochrome P450 isoenzymes

Pgp efflux- increases clearance, lower concentrations

Question 32

sjw effect on antifungals

Answer 32

decreases exposure to the azoles- this is severe so avoid this

Question 33

sjw effect on CCBs

Answer 33

decreases exposure- ipines

adjust dose, moderate interactions

Question 34

don’t take sjw if?

Answer 34

<18 
pregnant or breast feeding 
lactose intolerant 
skins sensitive to sunlight 
on any light treatment
suffering from depression- should be on prescribed medications

Question 35

patients on acute major depression receive either?

Answer 35

hypericum extract 900mg/ day

paroxetine 20mg/day

Question 36

which of hypericum or paroxetine was more effective in the Hamilton depression score experiment?

Answer 36

hypericum extract was at least as effective as paroxetine and is better tolerated

Question 37

does the Cochrane library accept commercial or conflicted funding

Answer 37

no

Question 38

why shouldn’t practitioners prescribe or advise the use of SJW to patients with depression?

Answer 38

due to uncertainty about appropriate doses, persistence of effect, variation in the nature of preparations and potential serious interactions with other drugs

Question 39

sjw has varying amount of active ingredients between…

Answer 39

formulations

between batches of the same formulation