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Chapter 14: Alternative Medications

TERMS TO LEARN

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Beriberi Syndrome associated with thiamine deficiency; symptoms include peripheral neuropathy with CHF (wet beriberi) or without CHF (dry beriberi).
Cheilosis Noninflammatory condition of the lips; symptoms include chapping and fissuring.
Glossitis Inflammation of the tongue.
Megaloblastic Anemia Low blood count with a predominant number of megaloblasts in the bone marrow (enlarged cells); seen in patients with B12 deficiency.
Papilledema Swelling around the optic nerve caused by pressure on the nerve by a tumor or increased intracranial pressure.
Pellagra Syndrome associated with insufficient niacin; symptoms include dermatitis, diarrhea, dementia, and death.
Torticollis Excessive tone in the muscles of the neck.
Xerosis Dryness of the skin, conjunctiva, or mucous membranes.

I. HERBAL PREPARATIONS

HERBAL AND ALTERNATIVE REMEDIES: DRUG FACTS

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Herb Clinical Uses Adverse Effects Drug Interactions and Precautions

Clinical effects of these herbs are not based on evidence in all cases.

Because herbal medications are not regulated by the FDA, their presence on the USMLE is negligible; however, they might be covered in a pharmacology course.
Aloe Vera

  • Topical treatment of burns and other inflammatory conditions of the skin

  • Topical treatment of inflammatory conditions of the skin (ie, psorasis & eczema)

  • Skin rash or irritation

  • Topical use only recommended

  • Oral form associated with renal failure, GI cancer and possibly fatal in high doses

  • Multiple drug interactions with oral form
Capsicum/Cayenne

  • Gastroprotective agent against mucosal injury caused by aspirin

  • Topical treatment of pain associated with neuralgia, RA, and OA

  • Stinging or burning at application site

  • Hypercoagulation

  • Hypersensitivity reactions

  • Avoid contact with eyes or genitalia

  • Decreases bioavailability of aspirin and salicylic acid

  • Limit use to 2 days every 2 weeks
Cascara sagrada

  • Treatment of constipation

  • Arrhythmias

  • Neuropathies

  • Thiazide diuretics, antiarrhythmics, cardiac glycosides, and indomethacin

  • Bowel obstruction, IBD, or abdominal pain of unknown origin
Chondrotin

  • Treatment of OA

  • Intravesicular administration may relieve symptoms of interstital cystitis

  • May worsen asthma symptoms

  • May increase INR in patients on Coumadin
Cranberry

  • Prevention and treatment of UTIs

  • Increases urinary oxalate excretion and the risk of oxalate stones

  • Increases bleeding risks in patients on anticoagulants
Echinacea

  • Decreases duration and intensity of cold symptoms via anti-inflammatory and immunostimulating mechanisms

  • Treatment of UTIs

  • Treatment of wounds and burns

  • Dizziness

  • GI upset

  • Headache

  • Unpleasant taste

  • Immunosuppressant medications

  • Immunodeficiency syndromes, autoimmune disorders, or TB

  • Should not be taken for more than 8 weeks
Feverfew

  • Decreases frequency and severity of migraine headaches

  • Allergic dermatitis

  • GI upset

  • Rebound headaches

  • Anticoagulants and antiplatelet drugs

  • May inhibit platelet aggregation
Garlic

  • Treatment of hyperlipidemia

  • Treatment of arteriosclerosis

  • Treatment of hypertension

  • Allergic reactions

  • Fatigue

  • GI upset

  • Headache

  • Anticoagulants and antiplatelet drugs

  • May inhibit platelet aggregation
Ginger

  • Treatment of nausea and vomiting (eg, pregnancy, motion sickness)

  • Stomach cramps

  • Neurological (HA, irritation, dizziness)

  • Reproductive (decreased sperm count, decreased libido, gynecomastia in men)

  • Increases bleeding risks in patients on anticoagulants

    ...

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