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