NURS Exam Prep - Complementary and Alternative Therapies in Pharmacology and Emergnecy Preparedness and Poisonings

What is complementary medicine?

the use of a nonmainstream practice with conventional medicine

What is alternative medicine?

the use of a nonmainstream practice instead of conventional medicine

What is integrative medicine (multimodal therapy)?

traditional and complementary approaches to treatment used in a coordinates, patient centered manner

A patient with cancer is recieving chemotherapy and using an herbal remedy for nausea which was not recomended by a health care provider. What is this approach?

complementary medicine

What are natural products?

include the use of herbs, nutritional supplements, probiotics, and special diets

What are mind-body practices?

pet therapy, biofeeback, acupuncture, chirpractic, prayer, guided iamgery, hypnotherapy, massage, meditation, yoga

Mind/body practices include all the following except…

probiotics

What is not considered a natural product?

homeopathy

What is homeopathy?

a german medical system, the notion that a disease can be cured by a substance that produces similar symptoms in healthy people

What is the “law of minimum doses”?

the notion that the lower the dose of the medication, the greater its effectiveness.

What is naturopathy (naturopathic medicine)?

includes diet/lifestyle changes, stress reduction, herbs/dietary supplements, manipulations (chiropractic) therapies, exercise therapy, practitioner guided detox, and psychotherapy/counseling

What are state governments responsible for?

deciding what credentials practitioners must have to work in that state

What does the Food, Drug, and Cosmetic Act (1936) govern?

all medications, including prescription and OTC drugs

How are medications passed by the food, drug, and cosmetic act?

testing to ensure safety, effectiveness, and that the benefits claimed by the manufacturer are substantiated

What does the Dietary Supplement Health and Education Act (1994) govern?

supplements and herbal products

What are the standards of the Dietary Supplement Health and Education Act?

less rigorous, manufacturerers of supplements do not have to verify effectiveness or test the safety of their products

What is required of manufacturers to state by the Dietary Supplement Health and Education Act?

the product is not intended to diagnose, treat, cure, or prevent any disease

What is the first stipulation of the Dietary Supplement and Nonprescription Drug Consumer Protection Act (2007)?

manufacturers must include contact information on labeling for consumers to report adverse effects

What is the second stipulation of the Dietary Supplement and Nonprescription Drug Consumer Protection Act (2007)?

manufactureres must notify the FDA of any serious adverse events reported

What is the third stipulation of the Dietary Supplement and Nonprescription Drug Consumer Protection Act (2007)?

manufacturers must maintain records of adverse events and keep these records for at least 6 years

What is the fourth stipulation of the Dietary Supplement and Nonprescription Drug Consumer Protection Act (2007)?

manufacturers must evaluate the identity, purity, potency, and composition of their products. Labels must accurately reflect the contents of the product

What do patients’ perception on supplements include?

prefer an herbal to a prescirption medication, see no harm in use, feel herbal medications are safer, have fewer side effects, cost less than prescription medications, and are effective

What are motivations for patients using supplements?

recommendation of health care providers, family/friends, or CAM provider.

What is the first problem with herbal supplements?

can contain multiple chemicals which have not necessarily been identified, measures, isolated, or studied at all

What is the second problem with herbal supplements?

has the potential to interact with many medications which may result in a wide variety of effects

What may herbal supplements reduce the effectiveness of?

OCPs, anticoagulants, immunosuppressants, diuretics, and HAART

Who is most likely to experience problems with herbal supplements?

adults, people with liver/kidney disease, and people taking medications with a narrow therapeutic index

What are commonly used herbal preparations?

black cohosh, cascara, echinacea, evening primrose, feverfew, garlic, ginger, ginkgo, ginseng, milk thistle, palmetto, St. John’s wort, and valerian

What are speciality supplements?

have a basis for their uses, non-herbal supplements; amino acids, carnitine, coenzyme Q10, DHEA, and fish oil

What is considered a specialty supplement?

coenzyme Q10

What is an epidemic?

a disease that affects large numbers of people within a community, population, or religion

What is a pandemic?

an epidemic which has spread to multiple countries or continents around the world

What is bioterrorism?

the intentional use of infectious biological agents agents, chemicals, or radiation to cuase widespread harm

What is an example of a pandemic?

COVID-19

What is an example of an epidemic?

opioid overdoses

What is an example of bioterrorism?

anthrax spread

What must be maintained for infection control?

strict control and records of who comes into contact with infected aptients

What must be used for infection control?

personal protective equipment (PPE) and universal precautions

What must be limited for infection control?

use of needles and sharps

What must be avoided for infection control?

aerosol-generating procedures

What must be practiced for infection control?

proper hand hygiene

What is the strategic national stockpile?

program within the CDC. Materials in this program inlcude antibiotics, vaccines, and medical/surgical support supplies

What are universal precautions CDC (1985)?

require all blood and certain body fluids to be treated as potentially infectious, regardless of patient history or percieved risk

What is the number one method of infectious control?

Handwashing

What are the four bioterrorism agents?

anthrax, polio, ebola, smallpox

What is anthrax?

a bacterial infection which may be ingested, inhaled, or enter through an open wound. Bacteria forms spores

What is polio?

a viral illness (fecal-oral) spread, for which we have a very effective vaccine

What is ebola?

a viral illness (blood and body fluids) with a 21 day incubation period and a fatality rate of 90%.

What is smallpox?

a viral illness (aerosol/droplet spread) with a mortality rate of up to 30%

What toxic chemicals are used in bioterrorism?

nerve agents, bloods agents, choking/vomiting agents, and blister/vesicant agents

What is used to treat nerve agents (sarin)?

atropine

What is used to treat blood agents (cyanide)?

amyl nitrate

What is used to treat choking/vomiting agents (phosgene)?

treated symptomatically

What is used to treat blister/vesicant agents (nitrogen mustard)?

treated symptomatically; a 5% bleach solution may be used on skin

What is important in regards to toxic chemical exposures?

time is of the essence, agents work very quickly which is why exposures are often fatal

What is ionizing radiation?

mass exposures may result from a nuclear accident or a nuclear bomb

What is radiation sickness?

can be acute, late symptoms include weight loss, fatigue, bone marrow depression, and cancers

Who is most likely to be poisoned?

children

How are poisoning emergencies managed?

with supportive care

What isn’t used to treat poisoning events?

antidotes, not available for many poisons

What are the principles of supportive care?

ABCs, glucose levels, stabilizing ABGs, manage seizure acitivty, surface decontamination, facilitate toxin removal

What are the ABCs of life support?

airway, breathing, and circulation

What is syrup of ipecac?

an agent used to induce vomiting

When should ipecac not be used?

after ingestion of caustic agents, side effects can be confused with symptoms related to the poisoning, can cause an overdose

What is gastric lavage and aspiration?

must be perfomed within 60 minutes of ingestion. perfomed via a gastric tube/NG tube

When is gastric lavage and aspiration contraindicated?

when reflexes are lost/absent

What is activated charcoal?

may be administered and is useful for large, carbon-based substances, cyanide etc.

What are the 4 medical managements of poisonings?

syrup of ipecac, gastric lavage and aspiration, whole-bowel irrigation, and antidotes

What is whole bowel-irrigation?

administration of large amounts of a substance like polyethylene glycol via NG tube.

What are antidotes?

used for specific poisonings

What is the antidote for warfarin?

vitamin K

What is the antidote for opioids?

naloxone

What is the antidote for cholinergic agonists and acetylcholinesterase inhibitors?

atropine

What is the antidote for acetaminophen?

acetylcysteine

What is the antidote for digoxin?

digibind

What is the antidote for benzodiazepine?

flumazenil

What is the antidote for iron?

deferoxamine

What is the antidote for lead?

calcium EDTA

What is the priority in any poisoning event?

assessing the patient’s level of consciousness and vital signs