Week 5 - Homeopathy and Herbal Medicines Flashcards
What is homeopathy
Complementary therapy
- alternative medicine based on the theory of treating ‘like with like’
- stimulate healing responses to diseases by administering substances that mimic the symptoms of those diseases
When making homepathic medicine:
- Dilute = to get medicine to required potency
- Shake (sucession) between each dilution = ensures molecules mix
- Store away from sunlight, in glass container
What are the limitations of homeopathy
- Has no fixed shelf life
- Lack of evidence supporting its efficacy
What is the homeopathic potency scale
Potencies depends on dilutions
- e.g. 1 in 10
- e.g. 1 in 100 = 1c
- e.g. 1 in 100 followed by 1 in 100 = 2c
Quantity is expressed in grams
- e.g. 1g = 10 tablets
Patient counselling related to homeopathy
- Homeopathic medicines are available on NHS and on FP10 prescriptions
- but not widely prescribed due to lack of evidence supporting homeopathy use
What is herbal medicines
Use whole plants or plant extracts that act together to produce a therapeutic effect in pt
- Takes a holistic approach (i.e. look after whole body not just area of complaint)
- Herbalist beleive ill health is due to imbalance
- Herbal remedies need to have Traditonal Herbal Registration (THR) to be licensed as a medicine
What is the MoA for St John’s wort
A Herbal Medicine
The whole (or fragmented) dried flower is used
- active ingredient = HYPERFORIN and HYPERICIN
MoA:
- Hyperforin inhibits reuptake of monoamines (5HT and NA)
- Upregulates 5HT receptors
= why it treats anxiety + depression
USES:
Topical:
- wound healing
- bruising
Orally:
- anxiety
- depression
- menopausal symptoms
Why do patients using St John’s wort experience photosensitivity
Due to HYPERICIN
- Hypericin forms free radicals
- benzene ring + delocalised e- absorb energy = formation
Patient counselling related to herbal medicines
specifically St John’s Wort
- Quality assurance
- may have variations in the amounts of active ingredient
- variations in conc. of the active ingredient impacts the pharmaceutical quality of formulations - Side effects
other limitations to the wider use of herbal medicines
Evaluate the evidence for the therapeutic benefit and safety for St John’s wort
Short term studies showed its use was as effective as antidepressants in depression treatment
- BUT was a short term study, don’t know how it will perform in long term use or the potential SE
- antidepressants are required for long term use
What are the BNF and NICE guidelines for using St John’s Wort
NICE:
- Useful in mild-moderate depression
- Prescribers should NOT PRECRIBE or ADVISE its use
- Avoid due to uncertainity about DOSE, preparation variations, INTERACTIONS
BNF:
- Useful in mild depression
- Should NOT be PRESCRIBED or RECOMMENDED
- Due to INDUCING metabolisng ENZYMES, INTERACTIONS, variation in active ingredient
- inducing enzymes = if stop drug the conc. of the affected drug will be too high = toxic
Explain potential interactions between St John’s wort and other medicines
inc. outcome if St John’s wort taken in combination with other medicines
St John’s wort induces:
1. CYP3A4 and CYP2C10
- drugs metbaolised by these enzymes will be at a lower conc. = reduced efficacy
2. P-gp (AET)
- drugs that are substrate for these pumps will have increased clearance, reduced conc. = reduced efficacy
SHOULDN’T TAKE St John’s Wort with…
- Hormone contraception, HRT
- ALL depression medicines
- Immunosupressants
- Anticoagulants
- Antihypertensives
- AEDs
- Lithium, thyroxine
- Statins
- Antifungals
- CCB
CONTRAINDICATIONS:
- Under 18
- Pregnant / breastfeeding
- Allergic to any ingredients
- Skin is very sensitive to sunlight
- Having light treatment for a condition
- Suffer from depression
- Excessive use of sunbeds / sunbathing
