CAM Flashcards
integrative and CAM medicine
what is homeopathy
complementary and alternative medicine
- umbrella term for things that arent “mainstream” medicine
Integrative health
- incorporation the complemantay appraoch into “mainstream medicine”
Homeopathy
- the idea that if you give the body the essence of what ypure infected with, it will help get rid of it
- highly diluted substances from plants, minerals or animals
- drugs labeled homeopathic must be listed in the homeopathic pharmacopedia of the US
- these arent regualted like supplements are, but just on the list to take note of the non-active ingredeints
Product Regulations for Homeopathic Remedies
HPUS: monograms made to look at strength, quality and purity
Labeling
- not nutrtion or dosage labeling, just the diluation amount, purpose and directions
no proof of efficacy needed nor is there a safety proof needed to sell these product, thus natural does not mean safe
Vitamins, Minerals and non VM Dietary Supplements
Dietary Supplements
- vitamins, minerals, herbs, etc. which are supplemental to teh normal diet
USFDA: responsible for overseeing and regulation of good manufactuering
- established the good manufacturing practices; just ensure that the way in which products go to market, through the facilities to ensure its clean
- not looking or testing the product itself, its safety or effiacy at all
techniaclly, they do not need to register these products with the FDA prior to creationg, if the “product” is not new
these dietary suppls = not tested through trials to see if theyre efficaious or safe for sue
Current Good Manufaturing PRactices attempt to control what
Dietary Supplemetns “regulated’ via CGMP
looks at
- identity
- purity
- quality
- strength
- composion
of the prodcut: is the amount there, is it actually what they say it is
Dietary Supplement Labeling
Structure Function Claim v Health Claim
Structure Function Claim
for things which have not gone through clincal trials, have no evidence to support treatment of a disease state nor do they ahve informaiton on how well the product works or its safety
specific substances used to maintain normal health structures or functinos of the body
example: calcium to support bone heatlh, fiber to maintain bowel regularity
Health Claim
for things which have been studied and deemed to have health benefit in treating disease/symptoms
a substance and disease or health-related condition can be used in the claim
example: cranberry to help reduce the risk of UTI, or to help symptoms of UTI
USP Verified Products ; Dietary Supplements
Dietary Supplements
USP: US pharmacpedia Dietary Supplement Verification Program
- an additional committee thatn supplements can choose to be evaulated by: to safegaurd the supplement
- rigour testing to ensure what the compant says is in the medication is actaully whats in the medication
Indicates that…
- the product contains the ingredients it says it does
- does not contain harmful ingredients
- is made according to CGMP
- will breakdown/dissolve in accurate time
looks for the USP label!!
Omega-3 Supplements
efficacy
safety considerations
Omega-3 Supplements
- proposed use of these long-chain fatty acids for: heart disease, lipid disorders, alzheimers, etc.
Effiacy
- they have primary benefit for hypertriglyceridemia
- +/- evidence for prevention of stokres and CVD events
Safety
- INCREASED BLEED RISK!! watch if theyre on like warfarin or something
Glucosamine/Chondrotin Supplement
Chondrotin
- found within the cartilage : enzyme which can help to decreased cartilage degradation
Glucosamine
- endogenous compoudn : helps synthesis of cartialge
should always be given in combination form
Efficacy
- the effects are only if taken long term: for osteoarthritis
Safety
- can increased INR: watch with warfarin
- SHELLFISH ALLERGY
Mealtonin Supplementation
Melatonin
- insomnia and prevention of jet lag
take 0.3-5mg before bed 30 minutes
2-5 mg teh evening of arrival an at bedtime for next 2-5 days for jetlag
Efficacy
- help with insomina and jetlag
Safety drowsy and drugs
- GI distress; morning melatonin hangover effect
- LOTS OF DDI with melatonin: need to look into them if someone is using
Coenzyme Q10
what is its proposed use
efficacy
safety
Proposed Use
- normally, its an exnyme in the cells which helps with energy production: mitochondrial functional nergy production
- thought to help with cardiovascualr conditions/support health
- statin intolerance/myopathies
Efficacy
- potential help in CVD and BP lowering
- potentail help with statin intolerance
Safety
- GI side effects
- liver enzymes increased (mildly)
- increased clot risk has a vitamin K like pro-cogaulant effect – could decreased warfarin effectiveness
if using co-enzyme Q with statin, use a lower dose
Echinacea
what is it
when is it used
safety
What is it
- flower derivitive: used to prevent/treat colds and URIs
When to take
- only effective if taken at the first sign of a cold symptom to decrease duration (by like 1/3 a day)
Safety
- tingling of togue
- avoid in asthma pt., those with autoimmune disorders
- potentailly drug interactions at CYP!!!
Vitamins and Minerals
- fat soluables
- water soluables
Fat soluables: ADEK
Water Soluables - Pearls
Thiamine (B1) = used to prevent wernickes encephalopathy (alcoholics)
- found in meat, whole grains, fortified foods
Niacin (B3) = a deficiency = pellagra
- found in meats, beans, enriched grains
- toxicitiy of niacin = N/V/D, hepatoxicity
- used to be used for lipid lowering, less used
Folate (B9) = weak, fatigue, irritability
- deficiency = folic acid deficiency anemia
- need folate to prevent neural tube defects
- FOOD SOURCES: veggies, fruits, nuts, beans, dairy, meta, eggs, grains, chicken
Cobalamins (B12)
- B12 deficiency = pernicous anemia!!
- medications such as PPIs/H2RAs and metformina can decreased B12 absorbtion!!!!
- food: animal products, dairy, cerals and grains taht are fortified
Fat Soluable Vitamins
Vitamin D
Vitamin B
- essentail for bone health skeletal formation
- deficiency = rickett, osteoporosis/penia
- sources: sun expsoure, fish skin, fortified grains/dairy with vit D
- can be in infant supplementations
- too much vit D : kdney sstones, hypercalcemia/calcuria
Supplementation types
best blood test to see levels: 25 (OH)D
supplements
- D2 (ergocalciferol)
- D3 (cholicalciferol)
- musst take calcium if taking vit D
whos at risk of deficiecny
- limited sun expsoure
- older adults
- malabsorbtion.IBS
- gastirc bypass pt.
Fat Soluabe vitamin
Vitamin K
Vitamin K
deficiecny symptoms: bleeding/hemmorrhage (lack vit K = lack proper clotting factors
Uses of Vitamin K
- warfarin reversal agent
sources
- greeny leafy veggies, fruits
calcium
Calcium
three ways to obtain
calcium carbonate: 40% elemental (take with food, needs gastirc pH)
calcium citrate: not dependent on gastric pH
calcium gluconate: least % of calcium
Amount Daily
women 19-50 = 1,000 mg
women 51-70 = 1,200 mg
men 19-70 = 1,000 mg
take 500 mg BID becuase only 500 mg absrbed at one time
take with Vit D
