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49 Cards in this Set

  • Front
  • Back
use with conventional medicine
complementary
use in place of conventional medicine
alternative
why do people seek alternative therapy
people think safer because natural, they don't require RX, a lot of hear say of what works for them (anecdotal testimony)
what is homeopathic medicine
bases on like cures like, small highly diluted quantities can cure, may be prepared from botanical, zoologic, or pharmacologic agents
what is the regulatory status of homeopathic remedies
they are not regulated under DSHEA, they can be RX or OTC,
what is the homeopathy nomeclature and OTC labeling
are required to have ingredient list, instructions for safe use, instructions for safe use, must be a self limiting conditions
what is not required on labeling
expiration date
how do you determine the dilutions
dilutions of 1/10 = "X" (1X=1/10, 2X=1/100)
dilution of 1/100 would read
C 1C=1/100
what about the clinical evidence
the evidence results are mixed and inconsistent but very likely to be safe
what about bias against homeopathy
english language journals generally show homeopathy to be ineffective so probably won't find in journals. doesn't mean not good study
is a herbal/botanical medicine a drug
in the US herbals are regulated under DSHEA
German Commission E what is it
established by German Federal Health agency evaluates the safety and efficacy of herbs through clinical trials and cases that are published in scientific literature
you want to make sure when using herbs what
what part of the plant was used
Natural medicines comprehensive database rates what
evidence and safety
The natural standards website out of boston also rate
efficacy but not safety
womens health and botanicals:
4 listed in slide
What is another name for black cohosh?
cimicifuga racemosa
what is the MOA of black cohosh
like estrogen and evidence is for menopause. preliminary evdience with 5HT
When would you not recommend black cohosh
pregnancy, safety with breast or uterine cancer should be avoided. avoid tomoxifen
what is the efficacy associated with black cohosh
possibly effective with remifenmin to relief menopausal symptoms similar to estrogen
what are some things to know about chastetree berry
interaction with oral contraceptive, possibly effective with PMDD and PMS
What to know about primrose oil
NOT FOR PMS, potenially helpfuly for atopic dermatitis and eczema, interactions with warfarin or antiplatelet effects, not much good efficacy in trial
What to know about SOY
phytoestrogens, SOY, works as estrogen or antiestrogenic, antioxidant, evidence for hyperlipidemia and menopausal symptoms, don't use with breast cancer or tamoxifen, good source of protein, conflicting evidence as where to get SOY food or sources, know for menopausal symptoms
what are the 3 NT that play a role
5HT, dopamin, NE
what is the latin name for St. johns wort
hypericum perforatum
what is MOA of ST. johns wort
5HT, norepinephrine and dopamine
what about the evidence for St. johns wort
mild to moderate depression, not good evidence for everything else
what to tell patients for St. johns wort
photosensitivity, abrupt D/c get withdrawal symptoms, don't recommend with pregnant/breast feeding or other psych diorder
what is the interaction with St. john worts
INDUCER of cyp3A4, may also induce cyp1a2 and 2c9, OC and warfarin, cyclosporine, digoxin, and statins
what is the dosing and problems
300mg tid, standard mg, depression don't want them self treating need cognitive therapy, drug interactions, less evidence than conventional med, have to take 3 times daily
what is SAMe
used for depression and osteoarthritis
what about the efficacy for SAMe
efficacy similar for tri-cyclic, may take longer to work for arthritis than stardard
what are the problems
cost
what is 5-HTP
uses are depression and tension-type headaches
what about the 5HTP safety
lots of concern about safety and since similar to 5HT interaction
what two NT are associate with imbalance in anxiety
NE and 5HT
what is KAVA used for
anxiety
what about safety
may be unsafe but not officially pulled but really can't find. associated with hepatotoxicity. there is evidence but safety makes it not a good product to recommend
study from slide on page 11
agents for weight loss
what about ephedra
very effective but safety concern. removed from market
what about dextrim
pheylpropanolamine, pulled from market
should you use st john wort or 5HTP for weight loss
no st john for evidence and no for 5HTP for safety
how does HOODIA work
works by appetite suppressant enhancing sensation of satiety
ephedrine
can buy over the counter for asthma but is dangerous for weight loss
what is citrus aurantium
increases HR, AKA green orange, evidence used alone is not good but with other may be some evidence. similar to ephedra, with over dose can cause MI and stroke, interactions with Grapefruit juice
how would you want to advice against citrus aurantium
hypertension and cardio vascular
what about green ten
stimulation has caffeine and polyphenols
what are caffeine like products
guarana, green tea, and mate