Complementary And Alternative Medicines (CAM)

Question 1

What are the 3 problems associated with CAM supplements?

Answer 1

1. Contamination: mixed with poisonous chemicals unknowingly
2. Adulteration: change toxic form once mixed with western drugs
3. Misidentification: recognise wrong natural herbal drug, use toxic version instead

Question 2

MOAs of garlic?

Answer 2

1. Blocks cholesterol synthesis by inhibiting HMG-CoA reductase
2. Interferes with platelet aggregation —> inhibits clot formation
3. Dilates blood vessels —> increase arterial elasticity —> lowers blood pressure

Question 3

ADRs of garlic?

Answer 3

1. GIT related: nausea, vomiting, diarrhoea, flatulence
2. Burning sensation in mouth

Question 4

DDIs with garlic?

Answer 4

1. Don’t take with blood thinners (aspirin, warfarin)
2. Increase breakdown in patients with anti-HIV drugs

Question 5

MOA of Gingko biloba?

Answer 5

1. Inhibits platelet aggregation
2. Reduce blood viscosity + dilate blood vessels

Question 6

Uses of Ginkgo biloba?

Answer 6

1. Memory disorders + help younger patients with intact memory improve thinking skills and speed of mental learning
2. Erectile dysfunction
3. Peripheral vascular disease
4. Eye diseases (eg glaucoma, diabetic retinopathy)

Question 7

ADRs of ginkgo biloba?

Answer 7

1. GI: nausea, constipation
2. CNS: headache, dizziness, vertigo

Question 8

DDIs of ginkgo biloba?

Answer 8

1. Interferes with platelet aggregation, don’t take with blood thinners

Question 9

MOA of Ginseng?

Answer 9

1. Blood thinning
2. Lower blood sugar
3. Immunomodulatory
4. Memory enhancing
5. Improve heart function and blood vessels

Question 10

ADRs of ginseng?

Answer 10

1. Abnormal menstruation or breast swelling (due to osteogenic properties)
2. Insomnia due to excessive brain activity
3. Hypertension

Question 11

DDIs of ginseng?

Answer 11

1. Don’t take with blood thinners
2. Don’t take if taking other CNS acting drugs
3. Don’t take if diabetic
4. Don’t take if immunocompromised

Question 12

MOA of St John Wort?

Answer 12

1. Antidepressant: Inhibits MAO and reuptake of serotonin, NE, dopamine —> increase neurotransmitter levels at synapse
2. CYP450 inducer
3. Enhanced serotonin effects

Question 13

DDIs with St Johns Wort?

Answer 13

Don’t take with other CYP450 inducers
Dose adjustment if taking other CYP450 metabolised drugs (increase dose)