Integrative medicine Flashcards
what is complementary/alternative medicine
- medical and health care systems, practices, and products that aren’t part of conventional/allopathic medicine OR have historic origins outside of mainstream medicine
- Often abbreviated as “CAM”
- Complementary - used together with conventional therapies
- Alternative - used in place of conventional therapies
What is integraive medicine
- evidence based and patient centered
- strong emphasis on foundational health (holistic approach)
- incorporates CAM when clinically indicated in a way that
what is the MC used CAM approach
Herbals (Natural products)
what are the MC conditions in which CAM is used
MSK (neck, back and joint pain)
most use them as complementary practices (in addition to western medicin
who is more likely to use CAM than the general population
healthcare workers
typical pt is middle aged female with multiple medical conditions and a higher education level
what are common forms of MBS medicine
- Biofeedback
- Hypnosis
- Meditation
- Relaxation techniques
- Yoga, Tai Chi, Qi Gong
what is osteopathic medicine
Follow up Questions: what is the training, risks and efficacy
- Manipulation of soft tissue and bone
- Treatment of wide range of diseases (Primarily musculoskeletal)
- Training nearly identical to MDs (Required to have licensure, credentialing, ongoing certification similar to MDs)
- Generally low risk
- Controversial efficacy
what is chiropractic manipulation
Follow up Questions: what is the training and risks
- Emphasis on spinal manipulation
- Treat wide range of diseases (Primarily musculoskeletal)
- 5 yrs of training; board exams (often post grad training and CME)
- generaly low risk (may increase sx, rare serious SE, neck manipulation is highest risk)
What is naturopathy
Follow up Questions: what is the training and risks
- Belief the body has powerful means of self-healing
- 4 yrs ed in basic & clinical sciences
- Conventional & unconventional diagnostic tests and medications
- Emphasis on relatively low doses of drugs, herbal medications, special diets, exercises
- Overall low risk, however…
- Natural does not always equal safe! May conflict with western medicine or lead patients to eschew western medicine
what are the different naturopathic professionals
- naturpathic physicians - 4 yr graduate level program at an accredited school, Need bachelor’s degree and standard premed courses
- Traditional Naturopath - do not prescribe, do xrays or perfrom surgery. no licensing or accredting body.
- other providers (MD, DO, chiropractor, dentists, nurse) - Have pursued additional naturopathic/holistic training after their degree
what is acupunture
Follow up Questions: what is the training and risks
- the belief that a vital energy (chi) circulates in the body through 12 pathways (meridians)
- MOA not well understood but physiologic effects ARE noted
- Thin, solid, stainless steel, sterile and disposable needles at selected points
- requires 4 years of school for non-physicians and a national exam/licensure
- low overall risk but controversial efficacy
what is massage therapy
also: what is education, risk and efficacy
- thousands of years old - used widely today
- variety of health-related purpose - MSK, pain
- generally considered to have at least some efficacy
- few risks if done properly by properly trained person
- requires 500hrs of training, exam and licensing
what is oriental medicine
- Based on belief in opposing energies (“yin and yang”), life force energy (“qi”) and energy pathways in the body (“meridians”)
- Imbalanced energies or blocked flow of qi → illness
- training varies, some have masters/doctoral (43 states require licensure)
- risks vary w modality used
modalities: acupuncture, moxibustion, chinese herbal, nutrition/exercise
what is homeopathy
- compounds extremely diluted that cause the same s/s of the disease being treated
- example: treating rabies with a diluted amount of saliva from a rabies exposed dog
- little to no evidence for support
- accepted less in US than in other countries
- only 3 states with licensure laws
- what is herbal medicine/dietary supplementation
what does it claim, efficacy, and risks
- cannot claim to prevent/treat any disease
- can claim that they “maintain structure and function of body systems”
- potency varies widely
- efficacy is contoversial
- risks - interactions, contamination, questionable potency
what is the use and risks of echinacea
- uses: improve immunity, prevent/fight colds and flu
- risks: worsening of autoimmune disease
What is the use and risk of Ginseng
- use: general improvement in phys/mental state. Decreased stress and increased energy
- risks: agitation, HTN
what is the use/risks of ginkgo biloba
- uses: improve memory and circulation
- Risks: bleeding, seizures
what are the uses and risks for garlic
- uses: heart disease, HLD, Prevent/fight colds
- risks: bleeding, GI, garlic odor
what is the use/risk of saw palmetto
- uses: benign prostatic hypertrophy
- risks: dizziness, HA, hormonal effects
What are the uses and risks of St. Johns Wort
- uses: depression, topical antimicrobial
- risks: numerous DDIs, dizziness, serotonin syndrome
What are the uses/risks for black cohosh
- Uses: menopausal symptoms, PMS
- Risks: stimulating hormone sensitive tissue (CA, endometriosis, fibroids)
what are the uses/risks of Kava Kava
- uses: anxiety, insomnia
- Risks - hepatotoxicity
what are the uses/risks for glucosamine chondroitin
- Uses: joint pain/OA
- Risks: D/C, Drowsiness, warfarin, DDI, Shellfish allergy
What are the uses/risks of fish oil
- uses: CHD, HF, HTN, hypertriglyceridemia
- Risks: GI, Oily stool, burping, bleeding
What are the uses/risks of melatonin
- uses: insomnia, jet lag
- risks: fatigue, drowsiness, irritability
what are the uses/risks of Coenzyme Q10
- uses: HF, HTN, statin-induced myopathy, migraine
- Risks : Mild heartburn, GI
what is CBD? How is it used? who regulates it?
- CBD = cannabidiol (2nd MC ingredient in cannabis, not considered psychoactive)
- usually administered topically or orally
- treats wide variety (good evidence for epilepsy, mild evidence for insomnia, anxiety, chronic pain)
- not regulated by FDA
- generally low-moderate risk
What are the uses of essential oils. Who are they regulated by. what are the risks?
- steam distilled, cold pressued, concentrated extract of herbs
- reported to treat a wide variety of disease including promotion of overall wellness (very little research, mild evidence for insomnia, psych and pain)
- not regulated by the FDA
- risk varies depending on type of oil
what are five unadvised remedies
- urine therapy (drinking or using urine to treat yourself)
- Miracle mineral solution aka pancrea (esentially a bleach solution) targeted at autistic pts, cancer pts. life threatening SE!!!
- Laetrile (vit B 17, Amygalin) - basically cyanide, highly toxic.
- Turpentine - pine tree sap oil, serious toxicity 1tsp fatal in children 3 tsp fatal in adults
- Black Salve - contains bloodroot and/or zinc chloride. highly corosive. touted to draw out cancer and spare normal tissue.
