NHP for RTI

Question 1

Echinacea bottom line

Answer 1

Accept, maybe recommend for prevention or use at onset of URTI

-possibly effective

Question 2

echinacea counciling

Answer 2

• any benefit modest at best
• cold coming on, use
• good safety profile

Question 3

echinacea cautions (5)

Answer 3

good safety profile

• GI side effects most common
• allergic reactions can occur (asteraceae/compositae family)
• theoretical exacerbation of AI disorders
• rash common in children

Question 4

American Ginseng mechanism of action

Answer 4

• most effects caused by ginsenosides (triterpene saponins)

- immune enhancement due to plysaccharides and oligosaccharides

Question 5

American Ginseng cautions (3)

Answer 5

• gastrointestinal, nervous, CV system AEs (rates sim to placebo)
• interaction with warfarin (dec effectiveness of therapy

other species insomnia etc.

Question 6

American Ginseng bottom line

Answer 6

• accept maybe recommend for prophyactic use
• accept for use at cold onset

natural medicines: possibly effective

Question 7

American Ginseng patient counseling

Answer 7

take daily during winter months for 3-4 months

Question 8

Vitamin C cautions

Answer 8

doses above 2g/day

• diarrhea
• GI upset
• PPT of urate, oxalate, or cysteine stones or drugs in urinary tract
• hyperozaluria
• hyperuricosuria
• hematuria
• crystalluria

Question 9

Vitamin C bottom line

Answer 9

accept, maybe recommend

natural medicines: possibly effective

Question 10

Vitamin C patient counciling

Answer 10

benefits may not outweigh risks fro high doses of vitamin C

Question 11

Zinc cautions (3)

Answer 11

• lozenges lead to unpleasant taste, taste distortion, abdominal cramping may occur
• nausea common
• do not use intranasal zinc (hundreds cases anosmia (loss smell))

Question 12

Zinc bottom line

Answer 12

(dec incidence and duration in adults)

• accept, maybe recommend
• nautral medicines: possibly effective

Question 13

Zinc patient counselling (4)

Answer 13

• take every 2 hours while awake starting within 24 hours of symptom onset
• lozenge dissolved in mouth
• do not take at same time as tetracyclines, quinolones, etc (chelating dec drug abs)
• do not take at same time as foods containing cirtric acid, mannitol, sorbitol (chelation dec ionization

Question 14

oil of oregano bottom line/ safety, recommend

Answer 14

Accept

not concerned with safety

DO NOT RECOMMEND, no data

Question 15

Honey bottom line

Answer 15

accept, maybe recommend

natural medicines: possibly effective

Question 16

honey counselling

Answer 16

• children over 12 months (younger risk botulism)

- usually night time

Question 17

honey evidence

Answer 17

reduce cough in children, possibly good/better than DM or diphenhydramine

Question 18

Oscillococcinum cautions

Answer 18

HOMEOPATHIC

-no safety concerns

Question 19

Oscillococcinum bottom line

Answer 19

Accept

natural medicines: insufficient reliable evidence

Question 20

Stodal what marketed for

Answer 20

marketed for cough

Question 21

stodal evidence

Answer 21

no studies

Question 22

stodal safety

Answer 22

homeopathic so nothing in it

Question 23

honey

Answer 23

few small studies suggest benefit for cough

Question 24

oil of oregano

Answer 24

no human studies

Question 25

echinacea

Answer 25

conflicting results for treating or preventing colds - trend twd benefit prevention - some studies show benefit treat - better designed studies show no effect

Question 26

cold-FX

Answer 26

few small studies | -some benefit in prevention

Question 27

zinc

Answer 27

reasonably good evidence | -use at onset, moslty lozenges

Question 28

Vitamin C

Answer 28

only use to prevent colds when under extreme physical stress | -may very slightly reduce duration of colds when taken at onset