clinical pharmacology: complimentary medicine

Question 1

what is CAM?

Answer 1

complimentary and alternative medicine

‘broad set of health care practices that are not part of the country’s own tradition and not integrated into the dominant health care system’

Question 2

what % of population worldwide use CAM?

Answer 2

80%

Question 3

what are some issues with CAM?

Answer 3

lack of evidence for benefit and safety

evidence of harm

adverse drug reactions

Question 4

what are some examples of CAM?

Answer 4

• herbal medicine
• homeopathy
• chinese medicines
• vitamins and minerals
• acupuncture
• hypnosis
• meditation
• osteopathy
• yoga

Question 5

why do people use CAM?

Answer 5

personal control over own health

dissatisfied with conventional treatment - lacks holistic approach or side effects

Question 6

what is the most popular CAM in the UK?

Answer 6

herbal medicine

Question 7

what does herbal medicine contain?

Answer 7

active ingredients of plants

Question 8

what is homeopathy?

Answer 8

toxin diluted and ingested

remedies being produced by repeated dilution and succession of the substance:

• potency increases with number of dilutions and successions
• typical homeopathic dilution is 30X, where X represents 10
• one part toxin mixed with 10 part water or alcohol, repeated 30x

Question 9

what is acupuncture?

Answer 9

based on traditional Chinese medicine:

• vital force called “Qi” which circulates along channels called meridians
• balance of yin and yang

Question 10

what happens during an acupuncture session?

Answer 10

• 4-10 needles inserted in session
• left in place for 10-30 minutes
• needles can be stimulated by twirling or an electric current

Question 11

explain the efficacy and safety of acupuncture?

Answer 11

efficacy:

• stimulates pain fibres entering dorsal horn of spinal cord, causing inhibition of pain impulses
• stimulates release of endogenous opioids and other neurotransmitters such as serotonin

safety:

• incidence of adverse effects is thought to be 10%

Question 12

what is aromatherapy?

Answer 12

concentrated essential oils extracted from herbs, flowers and other plants to treat disease:

• commonly administered into skin
• inhaled
• in diffuser
• hot or cold compresses
• soaking baths

Question 13

possible side effects of aromatherapy?

Answer 13

• skin irritation
• photosensitivity
• headache and fatigues
• bronchospasm

Question 14

Is there any evidence for the efficacy of aromatherapy?

Answer 14

• Massage is pleasant but no evidence of clinical indication of prescription, no lasting benefit

Question 15

describe the UK regulation of CAM?

Answer 15

homeopathy: registered under National Rules Scheme 2006, demonstrates quality and safety but no efficacy
herbals: regulated by European Traditional Herbal Medicinal Products Directive (THMPD)

Question 16

summarise what doctors need to know about CAM?

Answer 16

• be aware of what is available via complementary practitioners, on-line and OTC
• ask patients about CAM use
• be aware of potential for harm with CAM use
• how to evaluate evidence of safety and efficacy
• appropriate use in NHS