Cures for Sale: reality/distortion Flashcards
What is alternative medicine?
Alternative remedies are those for which there is no reliable evidence to document their value and/or they have been accurately tested and found to be ineffective
How are alternative medicines marketed?
marketed with appeal to tradition, personal stories, and/or anti-science, testimonials, folklore, tradition, belief systems
What is conventional medicine?
Conventional drugs have been proven effective through clinical trials that compare them to a placebo and document their effectiveness, side effects and pharmacokinetics
Can Alternative medicines become conventional medicine?
If evidence of effectiveness were to exist, they would be included in conventional medicine.
What are the 3 questions evidence based medicines have to answer before going on the market?
Does it work?
What are the side effect?
How does it compare to what’s already on the market?
The positives need to out weight the negatives to get the drug on the market
Who can sell alternative medicines? Where are they sold mainly?
There are >1,500 products, on many internet sites: anyone can sell these with no education needed
Is there a lot of money made on these alternative medicines?
Yes, They are starting to rival pharmaceutical companies with the amount of money made by selling their products
Side effect labeling on bottles, alternative vs conventional?
They do not put the side effect on the bottle (conventional medicines need to say the side effects)
The 3 questions clinical trials need to answer?
- Is it safe?
- Does it work?
- How does it compare to what’s already on the market?
What is a double blind study?
- Double blind: neither person nor the care giver knows which group is given the placebo
What is a randomized study?
- Randomized: equivalent groups in terms of age, sex, and lifestyle
What is a placebo response?
Placebo response: most people respond in a positive way if we believe we are doing something helpful or if we think someone is trying to help us
Placebo = I will please
How many people get a placebo response?
Around 1/3 of people get a placebo
What might effect the amount of placebo? (4)
- The time course of the disorder
- The relationship to the caregiver
- The ritual of taking the medicine
- Strength of belief
What is the nocebo effect?
Some people get a negative response (nocebo effect) 15%
What is homeopathy?
A belief system invented in the late 1700s
What is the basis for homeopathic treatments (how do they work)?
Whatever produces a symptom in a normal person will cure the same symptom in disease if you dilute it until nothing is left while following a ritual that will allow water to spiritually retain a memory of the original ingredient.
(If a plant makes you vomit, then you can use it to treat a disease that makes you vomit by diluting it 100-fold and banging it 30 times)
How to prepare a homeopathic remedy?
Dilute the original compound 100 times, bang it, then dilute it 100-fold again and repeat this 30 times
The final concentration is so low that it is basically water (106)
Why are homeopathic remedies bad for the consumer?
Consumer will lose a lot of money and for serious illness like infectious disease they will not get effective treatment and possibly death.
Spending on homeopathy in the US, Canada, Global?
US 2022 - $3 billion on homeopathy
Canada: 3-5 million adults and 1 million children using these products
Global spending on homeopathy in 2022 was greater than $11 billion
What are nosodes?
Nosodes: homeopathic vaccine pills – claim to immunize against many diseases, and people will not get vaccinated, and can die from these diseases, kids are “immunized” only using this
What effect do nosodes have?
Nosodes have the same effect as placebo
Are homeopathic remedies only for humans?
No, there are some for dogs, cats, horses
What are herbal remedies?
Many contain plant chemicals that have toxic side effects, some secretly contain powerful drugs
They claim that substances from plants are better than conventional drugs, but conventional drugs are actually tested and have evidence, plants could have toxic materials
What are the prime targets for herbal remedies? (5)
- Conditions that resolve themselves (colds)
- Conditions with high psychological components
- Chronic condition that naturally cycle (think the herbal remedy is causing the decrease in pain but it is just the down part of the pain cycle)
- Attempts to improve appearance
- Cure terminal diseases (will prevent people from seeking out real treatments)
Herbal remedies often try to show their use by claiming to cure things that go away quickly and on their own like cold sores
Viagra in plant based remedies?
Viagra: needs to be prescribed, could kill some people, sometimes slipped into plant-based remedies
What is Yohimbine?
- sold for body building, male impotence
- contains a blocker of the alpha-2-adrenergic receptor in the periphery and CNS
- risk of seizures, paralysis
What is Saw Palmetto?
Saw palmetto – ineffective remedy for prostate problems
What is Echinacea?
Echinacea – ineffective for colds, skin disorders
What is Ephedra?
- Contains an amphetamine-like chemical
- Strong stimulant
- Ineffective for asthma, obesity, athletic improvement,
- Risk of sudden death, now banned in many countries but still marketed on the internet
- Sold with caffeine or with ginger
What famous person died from taking Ephedra?
- Not banned in the US, has killed many people
- Steve Bechler (Baltimore Orioles pitcher) died in the locker room from a stroke or heart attack, due to taking ephedra
What does ephedra claim to do?
Claims to be helpful for asthma, obesity, athletic improvement,
What is Kava?
Kava – marketed for stress and anxiety, but causes a risk of hallucinations and liver toxicity
Green tea concentrates?
- > 60 cases of liver failure
- Very concentrated
- Sold for weight loss, risk of liver failure
What is Leri Tone junior?
Leri tone Junior: to increase memories, made of cerebral phospholipids (cow brains mashed up)
What is Chinese herb medicine?
- 20-25 components of plants and animal products combined in a recipe for certain situations
- Some are useful but most don’t work
- No quality controls/ineffective
- Some can contain toxic materials, lead
Can Chinese herb medicine become conventional medicine?
- Since Chinese remedies have some active ingredients there can be some drug interactions with conventional medicine
- If some evidence is found can be turned into conventional medicine
What is St. John’s Wort used to treat?
St. John’s Wort = anti-depressant
What does St. John’s Wort induce that causes many drug interactions?
- Induces a specific P450 (CYP3A4) causes drug interactions
What are some drug interactions using St. John’s Wort? (4)
- People taking AIDS medication and St. John’s Wort causes more drug to be broken down due to the upregulation of CYP3A4
- Interacts with oral contraceptives, causes photosensitivity
- Causes the rejection of newly transplanted organs
- Causes the breakdown of warfarin (anticoagulant)
What is oregano oil claiming to treat?
- The new snake oils
- Marketed for a cure to any type of infection, inflammation
- Claims to cure whooping cough (use 1-3 drops 3 times a day to supercharge to immune system)
What is bad about claiming oregano oil can treat anything?
- Side effects: syphilis
- Child died from strep throat because his mother treated him only with oregano oil
Over the counter drugs?
45 new OTC drugs in the last 20 years
Have been tested, shown to be effective, side effects are documented and listed on the product
OTC drugs examples?
NSAIDs
Acetaminophen
Nasal Sprays?
Nasal spray: for colds, allergies – alpha 1 stimulant = vasoconstriction, decreasing secretions
Antihistamines for seasonal allergies, mechanism of action?
- Allergen – mast cell – release histamine – histamine causes allergy symptoms
- If block histamine-2-receptor, block histamine, no allergic reaction
- Blockers of H2 receptors and proton pump inhibitors for gastric distress and ulcers
What is a topical antibiotic for minor wounds?
Neosporin
What is loperamide used for?
Loperamide for diarrhea – action on intestinal opioid receptors, does not cross the blood brain barrier
Calcium supplements for?
Calcium supplements for bone strength, help with osteoporosis
Salicylic acid used for?
local removal or warts, duofilm
OTC drugs must have (4)?
- Quality control
- Evidence of efficacy
- List of potential side effects
- Continuous monitoring for rare reactions/interactions (aspirin)
