Complementary Medicines

Question 1

What are complementary medicines?

Answer 1

= A therapeutic good that consists wholly of 1 or more designated active ingredients, each of which has a clearly established identity and traditional use

- designated active ingredients means an active ingredient mentioned in schedule 14 
- e.g AA, essential oils, plant material, vitamins or probiotics

Question 2

list some complementary medicines:

Answer 2

Herbal medicines
traditional medicines 
Homeopathtic medicines 
Vitamines and minerals 
Nutritional substances 
Essental oils

Question 3

What are complementary medicines used for?

Answer 3

• Dissatisfied with conventional therapy
• Reduced symptoms of conventional
• attraction of holistic care
• Prevention therapy
• Personal beliefs and hopes
• Perception CM are safer
• Sense of control over treatment

Question 4

What are the three outcomes of CM:

Answer 4

1. beneficial effect
2. Neutral effect
3. Harmful effect

Question 5

What are the risks of CM:

Answer 5

• Pts will often not inform dr they are taking CMS
  
  • fear of negative response/judgement
  • Do not consider complementary medicines to be medicine
• HC professionals should always ask if patients are using CMs
• Many pts take together with conventional
• Complementary medicines may produce significant drug reactions to both prescribed and OTC drugs

Question 6

Complementary medicines that interaction with warfarin

Answer 6

• Gingoko Biloba
  
  • St. John’s Wort
  • Co-enzyme q10
  • Ginger
  • Celery
  • Horse chestnut

Question 7

What is St Johns Wort?

Answer 7

• SJW (hypericum perforated) - highest concentrations of active constituent in the flower
• listed product
• advertised to help with: mild anxiety, stress, sadness, mood balance/support

Question 8

What is the MOA of SJW?

Answer 8

• Inhibits noradrenaline uptake
• inhibits 5-HT (serotonin) uptake
• inhibits DA (dopamine) uptake

Question 9

What is the efficacy of SJW with depression?

Answer 9

• superior to placebo in pts with major depression
  
  • similarly effective as antidepressants
  • less side effects than antidepressants

Question 10

What are the drug interactions that SJW may produce?

Answer 10

• Induces CYP3A4 = alter plasma concentrations of other drugs, affect absorption/ excretion
• Serotonin syndrome/toxicity

Question 11

What is the psychological role of Co-enzyme Q10 ?

Answer 11

Psychological role: vital component for energy production within cell - Supports ATP production
- Use claims: HF, HTN, angina, migraine

Question 12

What are the effects of statins on Co-enzyme Q10?

Answer 12

• statin therapy can lower levels of Co-enzyme Q10

- by reducing cholesterol = reduce coEQ10 as carried on LDL

Question 13

What does Ginkgo Biloba claim to be effective for?

Answer 13

Efficacy in treatment and prevention of dementia:

• claims to enhance cognitive function, memory, alertness, mental fatigue
• not enough research it may be effective may not

Question 14

How do Gingo Biloba interact with NSAIDS and warfarin?

Answer 14

• inhibits platelet aggregation - may increase bleeding potential (stop taking prior to surgery
• interacts with NSAIDS - haemorrhage