Phar 460: Homeopathy

Front 1

basic principles of homeopathy (laws)

Back 1

1. law of similars

2. law of infinitesimals

3. law of single remedy

Front 2

Law of Similars

Back 2

"let like cure likes"

a substance that causes a specific symptom or set of symptoms in a healthy person can cure the same symptoms in a patient

rationale: remedy stimulates the body's own homeostatic mechanisms to initiate the healing process and return the system to balance

homeopathy = "similar suffering"

Front 3

Law of Infinitesimals

Back 3

remedies increase in biological activity as they are serially diluted, with agitation or shaking between each dilution

therefore, the smaller the dose, the more potent the remedy

the aggitaion or shaking, known as succussion, of each dilution results in it's potentization through extraction of its 'vital' or 'spirit-like' nature

Front 4

what does 30X mean?

Back 4

serial 1 in 10 dilution of original substance 30 times (or 10^30)

equivalent of one drop in a container 50 times the size of the earth

after a 10^30 dilution, you would need to take ~2 billion pills to get 1 molecule of original substance

Front 5

Law of Single Remedy

Back 5

there is one and only one remedy that will cure a patient:

-one that in provings produces the most similar symptoms to those present in the patient

-only one that will have the necessary sensitivity to 'resonate' with the disorder and bring about a cure

Front 6

Individualization

Back 6

tx of same condition in different patients may be very different based on their mental, emotional and physical pathology

Front 7

information sources used by homeopaths

Back 7

Repertory

Materia Medica

HOmeopathich pharmacopeia

Front 8

Repertory

Back 8

books that list symptoms of illness and their associated remedies

ie. 'the symptom picture'

Front 9

Materia Medica

Back 9

books that list the symptoms produced by homeopathic remedies in a healthy person, as determined by provings

Front 10

Homeopathic pharmacopeia

Back 10

listings of homeopathic medications, describing the preparation of the mother tinctures

canada has no official homeopathic pharmacopeia, so Health Canada accepts the standards set out in the US, French, German, and/or European homeopathic pharmacopeias

Front 11

approaches to homeopathy in practice

Back 11

1. classical homeopathy

2. isopathy

3. clinical homeopathy

4. complex homeopathy

Front 12

classical homeopathy

Back 12

choice of remedy is determined by the specific symptoms experienced by the pt

-involves taking a detailed history

-single remedy used, chosen based on current illness, medical hx, personality, and behaviour

-total patient response is followed

-remedy may be changed as symptoms change

Front 13

isopathy

Back 13

the same substance that is causing the sxs is given, in ultra-high dilution

eg.

-administration of pollen in hayfever

-administration of homeopathic nosodes, where the nosodes may be pus, diseased tissue like cancerous growth, or pathogenic organisms to treat infection or cancer

Front 14

clinical homeopathy

Back 14

the same remedy is used in pts presenting w the same clinical condition or constellation of sxs

the form that has been most widely tested in clincal trials

the basis for self-medication w homeopathic remedies: eg oscilloccinum for flu

Front 15

complex homeopathy

Back 15

more than one homeopathic remedy is used in a fixed combination or concurrently for a specified clinical condition

based on the principle that one of the medications included is likely to be effective

widely available for self-medication

Front 16

mother tincture

Back 16

(base substance)

-the original substance is macerated in 99 parts of an alcohol/water mixture for a set period of time

if not soluble, it is triturated w 99 parts of lactose for a set period of time, then diluted w lactose until the resulting mixture is soluble in a hydroalcoholic soln

Front 17

what does 1C mean?

Back 17

centesimal series:

= 2X (decimal series)

= 1/100 or 10^-2 (dilution ratio)

Front 18

what does 6C mean?

Back 18

12X

10^-12

Front 19

Centisimal dilutions

Back 19

Hahnemannian dilutions

-MT ->

-1 part MT, 99 parts diluent

-succussion (shake)

-transfer to another flask

-1 part 1CH, 99 parts diluent

-shake, etc

Korsakovian dilutions (use 1 flask)

-MT -->

-empty flask and assume 1 part MT remains on wall of flask

-add 99 parts diluent

-succussion, etc

Front 20

Q-dilutions

Back 20

fifty-millesimal dilutions

aka quinquagintamillesimal

indicated by LM or Q

eg 1QM or 1LM is 1:50,000

eg 2Q or 2LM is 1:50,000 x 50,000

more complex to produce, considered exceptionally high potency and not included in retail homeopathic preparations

Front 21

what are homeopathic remedies used for in adults?

Back 21

-functional complaints with little or no tissue damage

-chronic conditions that have not responded to conventional tx

eg: allergies, headache, insomnia, chronic fatigue syndrome, PMS, asthma, arthritis, depression, and other psychological problems, digestive disorders, eczema, and other skin problems

Front 22

what are homeopathic remedies used for in children?

Back 22

-in general, acute self-limiting conditions

eg: teething, colic, cough, bruising, eczema, colds

some naturopaths/homeopaths recommend nosodes as alternative to conventional vaccination

Front 23

problems with homeopathy

Back 23

1. lack of consistency with scientific laws and principles

2. weak evidence for 'provings'

Front 24

problem: lack of consistency w scientific laws and principles

Back 24

no plausable MOA

dilution beyond Avogadro's number, corresponding to 24X or 12C potencies, makes it unlikely that even one molecule of the original substance remains in the finished product

Front 25

"memory of water" theory

Back 25

succussion results in imprinting of solvent water molecules to retain a "memory" of the original material

no evidence for this mechanism has been found

Front 26

some implications of the "memory of water" theory

Back 26

-requires that the structure of water change in inverse proportion to the amount of active ingredient

-that the changed structure has specific therapeutic effects on people who are ill, but no effects on others

-that the changed structure is somehow transmitted to solid dosage forms impregnated with the soln

-that only the remedy and not the other impurities in the water will contribute to its changed structure and any associated effects

Front 27

problem: weak evidence for "provings"

Back 27

-based on imprecise and subjective methods

-most trials of low methodological quality

-in better designed trials, effects of remedies often not distinguishable from placebo

Front 28

studies of effectiveness of homeopathy

Back 28

3 areas of research:

1. comparisons of homeopathy in general with placebo (by systematic reviews or meta-analyses)

2. effectiveness of homeopathy for particular clinical conditions (by review or meta-analysis of clinical trials)

3. laboratory studies of biological effects of ultra-high dilutions

Front 29

studies: comparisons of homeopathy in general with placebo

Back 29

more than 12 SR and MAs combining data from over 150 trials

collectively, no strong evidence in favour of homeopathy

-trials of high quality are more likely to be negative

conclusion: homeopathy cannot be viewed as an evidence-based form of therapy

Front 30

studies: effectiveness of homeopathy in specific conditions

Back 30

reviews and/or MAs of homeopathy in:

-adverse effects of cancer tx, ADHD, soft tissue injury, induction of labour, headache, influenza, asthma, IBS, dementia

better quality trials unable to show that homeopathy is effective in any of these conditions

Front 31

homeopathic oscillococcinum for preventing and treating influenza

Back 31

prepared from wild duck heart and liver, usually diluted 200K

Cochrane review (2015) identified 4 tx trials and 2 prevention trials -quality was low

-no preventative effect

-it might relieve flu sx at 48h, but this could have arisen from bias in the trial methods

conclusion: there is insufficient good evidence to enable robust conclusion to be made about Oscillococcium in the prevention or tx of influenza or influenza-like illness

Front 32

discrepancies between negative trial results and positive observational data?

Back 32

patients may improve for reasons unrelated to specific therapeutic effect of tx

eg:

-self-limiting illness or variable course

-therapist-pt interaction

-concomitant tx

Front 33

risks of homeopathy

Back 33

direct harm

indirect harm

Front 34

risk: direct harm

Back 34

some substances are toxic

-however, homeopathic remedies unlikely to cause direct harm when diluted to at least 4C

adulteration of homeopathic remedies (with corticosteroids, arsenic) have been reported in the past

excipients are commonly alcohol or lactose

-lactose intake/dose considered insufficient to trigger sx in lactose intolerance

Front 35

risk: indirect harm

Back 35

self-administration may delay proper diagnosis and effective tx of disease

missed diagnoses or misdiagnoses by inadequately trained homeopaths

use of these remedies to treat serious conditions that may progress

Front 36

health canada regulation of homeopathic remedies

Back 36

key features:

-all homeopahtic medications sold in canada must have a licence and product # (preceded by DIN-HM)

-all medicinal ingredients must be listed in at least one of the US, French, German, or European Pharmacopeias

-level of dilution or concentration allowed depends on the type of indication for use: whether non-specific or specific

Front 37

requirements for: homeopathic medicines w a non-specific indication for use

Back 37

concentration must be equal to or below the max concentration for OTC use (minimum homeopathic potency) listed in accepted homeopathic pharmacopeias, or 12CH if not listed

there is no maximum dilution level

label must include the statement: 'consult a health care practitioner if sx persist or worsen'

Front 38

requirements for: homeopathic medicines w a specific indication for use

Back 38

concentration must be between the max OTC concentration as above 30 CH. Higher homeopathic potencies may be approved if evidence of safety is provided

must be composed of at least 2 medicinal ingredients

indication for use on the label must be supported by 2 homeopathic references, and should be consistent with principles of self-care

Front 39

use of homeopathy

Back 39

homeopathic txs should be limited to minor, acute, self-limiting illnesses

any current medical tx should not be interrupted, changed, or replaced w homeopathy without consultation with the pt's physician

homeopathic remedies may be safely taken concurrently w conventional medications: no interactions w high dilution remedies are known