CMN E2 -REVIEW

What is complementary medicine?

conventional (mainstream, Western, allopathic) medicine along with non-traditional medicine

What is integrative medicine?

use of alternative medicine as adjunct to conventional medical care; healing occurs within the body/mind and requires active participation from the pt

What are the two major groups of complementary health approaches?

Natural products & Mind/Body practices

What is the MC reason for complementary alternative medicine use?

Prevent illness/For general wellness

What is the best predictor of complementary medicine use?

higher education = more disposable income, inc knowledge & self-awareness, different attitudes

Pts w/ what condition utilize complementary medicine the most?

Back pain

What is the most common complementary health approach among adults?

Natural products

What is the most common natural product used among adults?

Fish oil/Omega 3

Why has complementary medicine gained increased attention?

use for prevention of chronic disease

What is used to match a patient's presentation with a corresponding homeopathic remedy?

Materia medica

What is the MC limb of Yoga?

Raja

What are the physiologic effects of yoga?

inc: blood flow, CO2 output, relaxation, focus, mental clarity, energy enhancement, lactate elimination

dec: metabolism, need for O2, BP, HR, SNS activity -adrenaline

What is meditation?

complementary practice that realigns the mind-body connection, the conscious with the physical body

What is the overall benefit of meditation?

Stress management

What is the objective of meditation?

Still the mind & direct the focus inward

What is Om (“aum”)?

“essential sound of the universe”, “voice of God”, “originating sound of creating”, "unhitted sound”

What are the 3 parts of Om?

Holy Trinity

A = Creation (Brahma)

U = Preservation (Vishnu)

M = Dissolution (Shiva)

What is magnet therapy?

use of low-level magnetic field to treat illness and disease states

What does newer research show that magnetic strength must be for magnet therapy?

> 800 gauss/80 mili tesla

**MRI is 15,000+ Guass

What is the principle of magnet therapy?

all living organisms have bio-magnetic fields around them

What can electrical fields in the body be measured by?

condition of salty plasma

Where are magnets placed?

over arteries to carry the magnetic field farther (they are attracted to the iron in blood)

What are the effects of magnet therapy?

inc blood flow, dec inflammation, helps transport endorphins & decrease prostaglandins → decreases pain

What does the NCCIH classify magnetic therapy as?

form of energy medicine

Transcranial magnetic stimulation has been approved by the FDA for what?

use in individuals with depression unresponsive to drug therapy

MDD in adolescents >15 yo

In what patients should you AVOID magnet therapy?

Implanted cardiac & other medical devices (pacemakers, defibrillators, E-stimulators, insulin pumps, etc)

What is “Healing touch”?

form of energy healing where the practitioner's hands are thought to manipulate the flow of energy around the patient's body WITHOUT physically touching the patient

What is Reiki?

transfer of energy from the giver to the receiver by the practitioner placing their hands lightly on or just above the patient

What is ozonotherapy?

use of medical grade ozone, a highly reactive form of pure oxygen, to create a curative response to the body

What are the uses for ozonotherapy?

- Immune system stimulation

- Stimulates release of growth factors (help damaged joints & degenerative discs regenerate)

- Reduction in pain receptor activity

What MUST you check for before initiating high dose vitamin C therapy?

check for G6PD deficiency because it can induce an acute hemolysis

What has been shown to be selectively cytotoxic against cancer cells?

high dose vitamin C

What are SEs of high dose vitamin C therapy?

hypoglycemia, interferes with anticoagulants, renal impairment

What are the 3 means of use of essential oils?

topical, inhalation (diffuser), ingestion

What needs to be done to most essential oils prior to apply them to the skin?

must be diluted

What are the tenets of manual therapy?

- The body is a unit

- Structure & function are interrelated

- Body has an inherent ability to heal itself

- Disease may ensue when normal adaptations are interrupted

What is Manual therapy?

use of physical force applied to the body to correct abnormal or inefficient motion seeking to optimize the interplay between the nervous and MSK systems to improve physical functioning

What is the most common SE of manual therapy?

Local discomfort

Spinal manipulation is a type of what therapy?

Manual therapy

What are contraindications to spinal manipulation?

osteoporosis, sx of nerve damage, hx of spinal surgery, CVA due to carotid vascular disease

What type of therapy focuses attention on the intention to heal through the "laying on of hands"?

Osteopathy

What is osteopathy?

concept of "vital energy" and belief in "drugless healing"

*many medicines at this time were toxic

Andrew Still developed an emphasis on what kind of osteopathy?

Spine mobilization

What is osteopathy today?

combo of allopathic medicine w/ spinal manipulation, proper posture, & body positioning

What are trigger points?

tender taut areas (knots) in muscle that produce local and referred pain

Trigger points result from what 3 mechanisms?

- Neuro: proprioceptive-movement, response to acute muscle strain/injury

- Neuro: nociceptive-sensory, response to visceral disease or persistent injury from lack of tx

- Reflex response from anxiety or pain

What osteopathic technique produces a hallmark "pop" sound?

High velocity low amplitude

What osteopathic technique moves a muscle spasm into a position that shortens the muscle (counter-strain) and holds it for 90-120 seconds, then slowly returns to original position?

Strain counter strain

What osteopathic technique gently stretches the muscle to interrupt the reflex spasm loop?

Strain (direct)

What osteopathic technique causes muscle relaxation, breaking of fascial adhesions or fascial realignment?

Myofascial release

What osteopathic technique is used primarily on kids and relieves tension by gentle pressure on scalp?

Cranial osteopathy

What osteopathic technique uses passive ROM?

Articulatory technique

What is the theory of chiropractic therapy?

"One cause, one cure" which postulates all disease is due to vertebral subluxations

What is one of the MCC of nervous system disruptions?

subluxation -joints are lock up, fixated, not moving properly

What does chiropractic care include?

gentle massage, manipulation of spine & extremities to restore proper function and strengthen supporting muscles and soft tissue

What is the goal of chiropractic therapy?

restore spinal movement thereby improving function, dec back pain

According to the NCCIH, what was the most common complementary therapy used to treat low back pain?

chiropractic therapy

What is the ultimate goal of physical therapy?

restore maximal functional independence to each individual patient

What is occupational therapy?

use of treatments to develop, recover, or maintain the daily living and work skills of patients with a physical, mental, or developmental condition

What type of perspective do OT practitioners have?

Holistic -focus is on adapting the environment to fit the person, and the person is an integral part of the therapy team

What is the MC alternative therapy used today?

dietary supplements

What dietary supplement may inc risk of bleeding?

Omega 3 or fish oil

What dietary supplements might reduce the effectiveness of some types of cancer chemotherapy?

Antioxidants- Vitamins C & E

What conditions are approved for medical marijuana use?

CA, epilepsy, glaucoma, HIV/AIDS, PTSD, ALS, MS, chronic pain, terminal conditions

What is the tx for cannabis hyperemesis syndrome?

Benzos, antiemetics, IV fluids, capsaicin cream on the abdomen

What pts should extreme care be used when dosing herbs?

children

*doses are wt based

What type of herbal preparations are rapidly absorbed?

Teas & Tincture

What is the role of the Dietary Supplement Health & Education Act (DSHEA)?

regulates herbs as dietary supplements, regulated AFTER they are on market

Does the FDA regulate dietary supplements?

NO- No standardized purity, bioavailability guarantees. No requirement for reporting SEs

Who handles complaints of false or misleading advertising or SEs of dietary supplements?

Federal trade commission

Pts should try to buy what kind of supplements?

3rd party tested

What are the most widely used dietary supplements?

Multivitamins & minerals

What are the actions of Fish oil, Omega-3 fatty acids, & DHA?

dec: BP, TG levels, clotting time, inflammation, mild dilation of blood vessels

What are the SEs of Fish oil/Omega-3 fatty acids/DHA?

Mercury levels in fish

Interact w/ NSAIDs and blood thinners

What is Glucosamine used for?

treat OA, joint problems

What herbal med should be AVOIDED in patients with shellfish allergies?

Glucosamine

What herbal supplement should you use cautiously in those taking K+ supplements or anticoagulants?

Glucosamine

*also interacts with: NSAIDs, Diabetic agents (including insulin)

What is Flaxseed used for?

Hypercholesterolemia, cardioprotective, immune function

What effect does Flaxseed have on medications?

can slow absorption of all meds

Interacts w/: Anticoagulants, Diabetes meds, Contraceptives, Hormones, Antihyperlipidemic agents

What is Ginseng used for?

fatigue, sexual dysfunction, stomach disorders, asthma

What herbal med should be AVOIDED with products containing caffeine?

Ginseng

*interacts w/ diabetes meds, psych meds, opiate pain meds, anticoagulants, CCBs, NSAIDs

What is Chamomile used for?

*typically not useful on its own, but in combo

sleeplessness, anxiety, GI upset, gas, diarrhea, used topically for skin conditions and mouth sores from cancer tx

What medications does Chamomile interact with?

Cyclosporin, Coumadin

What is Echinacea used for?

tx for common cold & other infections based on the idea that it might stimulate the immune system

topical use for wounds & skin problems, vaginal yeast infections, increasing exercise performance

**LOW medication interaction risk

In what situations should Echinacea NOT be used?

Autoimmune disorders, Anxiety/depression, Asthma, Cancer, Migraines, Seizures

What herbal oil should NOT be applied to the face of infants or young children as serious side effects may occur if they inhale the menthol?

Peppermint oil

What herbs are used for liver disease?

Milk thistle, Burdock, Chicory, Dandelion

What is a SE of milk thistle?

Hypoglycemia

What is Glutathione a combination of?

Cysteine, glycine, and glutamine

What does glutathione deficiency cause?

inc susceptibility to oxidative stress

-found in nearly every chronic illness pt

What boosts your glutathione levels?

Exercise & Milk thistle

*B6, B12, folate help sustain levels

What is the cancer chemopreventative polyphenol found in green tea?

Epigallocatechin gallate (EGCG)

Green tea contains small amounts of what vitamin?

Vitamin K → makes anticoagulants less effective

What is the likely active compound within turmeric credited with the benefits of the herb?

Curcumin

What are Turmeric and Curcumin used for?

relief of arthritis pain & inflammation, anticancer, antioxidant

What are adaptogens?

natural substances that help the body adapt to stress, support metabolic functions, and help restore balance

What is an essential component of healthy mitochondrial function?

CoQ10

In what tissue is CoQ10 most densely populated?

*production decline w/ advancing age

Cardiac

What meds cause a decrease in CoQ10 levels?

Statins & Diabetic meds

What is the reduced form of CoQ10?

*absorbs 8x greater

Ubiquinol