alternative medicines

What is the definition of Complementary and Alternative Medicine (CAM)?

Medical and health care therapies outside the territory of conventional medicine, some of which are yet to be validated using scientific methods.

What is the difference between "complementary" and "alternative" medicine?

Complementary = used together with conventional medicine. Alternative = used instead of conventional medicine.

Name four examples of CAM.

Homeopathy, acupuncture, chiropractic therapy, herbal medicines

Name five reasons why people choose to use CAM.

• part of culture/identity;

• personal experience of success

• non-invasive nature

• holistic approach

• perception that natural = safe

criticisms of CAM from the scientific/medical community.

• not evidence-based

• unregulated practice

• potentially unsafe

• all effects attributable to placebo

• based on non-scientific principles.

What is the placebo effect?

The placebo effect is genuine physiological and psychological improvement that occurs because a person believes a treatment will work, not because of the treatment's specific pharmacological activity.

What is statutory professional regulation?

Legal regulation ensuring practitioners are properly qualified and adhere to defined standards and codes of practice.

What are the implications of the lack of statutory regulation for most CAM practitioners?

It is legal for anyone to practise, even with no qualifications or experience. Practitioners are not legally required to adhere to any standards or join any register or association

What are the two core principles of homeopathy?

• "Like cures like" — a substance causing certain symptoms can also remove those symptoms

• The more a substance is diluted, the greater its power to treat symptoms.

Why do scientists reject the scientific basis of homeopathy?

Remedies are diluted to the point where barely any, molecules of the original substance remain to exert pharmacological effects

What is herbal medicine?

The use of plants for medicinal purposes

What is the key chemical difference between a herbal medicine and a conventional medicine derived from a plant?

A herbal medicine contains a complex mixture of chemicals from the plant.

A conventional medicine derived from a plant typically contains one isolated, purified active ingredient/constituent.

Name five key issues associated with herbal medicine use

• Drug interactions with conventional medicines

• adverse reactions/side effects

• variable quality and regulation

• limited evidence of effectiveness

• variability in active ingredient content between preparations.

What type of drug interactions can herbal medicines cause with conventional medicines?

They may make the other medicine less effective OR cause the other medicine to trigger unexpected or increased side effects.

Why is the variable content of active ingredients in herbal preparations clinically important?

It makes consistent dosing unreliable and the pharmacological effect unpredictable.

What condition is St John's Wort (Hypericum perforatum) used for

Mild-to-moderate depression

Despite showing effectiveness, why should St John's Wort NOT be prescribed or recommended?

It is a potent inducer of CYP450 drug-metabolising enzymes. This causes numerous clinically significant drug interactions by reducing the plasma concentrations of co-administered drugs.

How does Vitamin K interact with warfarin?

Vitamin K decreases the anticoagulant activity of warfarin

How does Vitamin E interact with warfarin?

Vitamin E increases the risk of bleeding