Complementary and alternative medicines

Acupuncture, herbal medicines, homeopathy

What are the most common groups of complementary and alternative medicines (CAM)?

Herbal medicines, homeopathy, acupuncture

What are the 4 classifications of CAM?

Medicine based, traditional medicine, manipulative therapies and mind-body therapies

What are some examples of medicine based therapies in CAM?

Herbalism, naturopathy, homeopathy, aromatherapy

What are examples of traditional based therapies in CAM?

Traditional chinese medicine, Ayurveda

What are examples of manipulative therapies in CAM?

Alexander technique, reflexology, massage

What are examples of mind-body therapies?

Yoga, Reiki

What is a reason for scepticism associated with CAM?

Perceived lack of evidence for efficacy

What is the name of the technique involving the insertion of fine needles into the skin at specific points on the body?

Acupuncture

What are the 2 forms of acupuncture?

Traditional Chinese medicine and Western acupuncture

What is involved in TCM?

Physical/emotional ill health disrupts the meridian system - use acupoints on the meridians using fine needles, apply pressure on the 365 meridians, points used often not in same area of body as targeted symptoms and other points can be another 1000 on hands, ear and scalp

What is involved in Western acupuncture?

Minimal acupuncture - involves very brief needling with very few needles, ignores meridians and acupoints, trigger points (hyperirritable areas in injured skeletal muscle) used instead

What is involved in Sham acupuncture?

Needles inserted outside of the acupuncture/trigger points with a minimal amount of interaction between patient and practitioner, used as control in RCTs in acupuncture

What is involved in Acupressure?

Instead of inserting needles, pressure applied using fingers, thumbs and elbows - claimed to relieve muscular tension and blood flow, can be in travel band form for motion sickness

What is the term to describe a holistic complementary and alternative therapy based on the concept of like to treat like, involves administration of dilute and ultra-dilute products prepared according to pharmacopoeias?

Homeopathy

What are the 3 basic principles homeopathy is based on?

• Like cures like - substance that causes a set of symptoms can help relieve those symptoms

• Minimum dose - succession process of diluting/shaking used to give substance in small dose - greater dilution, greater its power to treat symptoms

• Single medicine - only a single medication required to treat condition

What conditions may homeopathy be used for?

Asthma, ear infections, hayfever, mental health e.g., depression, stress, anxiety, allergies, dermatitis, arthritis, high BP

Does homeopathy prevent diseases?

No evidence - not recommended for any health conditions

What is the regulatory body for homeopathic practitioners?

No legal regulation

What are herbal remedies derived from?

Plants, parts of plants or extracts of plants

What are pharmacists advised to do about herbal products?

NOT recommend if they doubt quality/safety of product, only advise if they have appropriate product and only licensed products should be offered for sale

What can be safety issues with herbal medicines, despite people thinking they are safe because they are natural?

Herb itself or combination with adulterants e.g., pesticides, toxic metals, conventional medicines can be dangerous

What can be an issue with dosing in herbal medicines?

Standardisation of amount of API - regulating dosage is difficult

What tool should pharmacists use to report ADRs to the MHRA with?

Yellow card scheme

What conditions are herbal medicines recommended to avoided in?

Women of childbearing potential

What are some examples of drug-herb interactions?

• Ginseng + warfarin - reduced anticoagulation

• St John’s wort and SSRI - Serotonin syndrome

• St john’s wort and MAOI antidepressants - increase risk of hypertensive crisis

• St Johns wort and hormonal contraception - reduced contraception

What legislation affects the regulation of herbal medicines?

MHRA - medicines (traditional herbal medicinal products for human use) regulations 2005 and human medicines regulations 2012

What are herbal medicines required to have in the UK before human use from consumers, retailers, wholesalers etc?

Marketing authorisation or certificate of registration under traditional herbal products registration scheme - THR

What is key for herbal products sold as food supplements or cosmetics?

NO medicinal claims permitted to be made