1. PTP 546 Complementary & Alternative Medicine Jayne Hansche Lobert, MS, RN, ACNS-BC, NP 1Lobert

2. Complementary and Alternative Medicines Complementary and Alternative Therapies – NIH: National Center for Complementary & Alternative Medicines  www.nih.nccam.govwww.nih.nccam.gov – Categories of CAM Mind-body medicine – Relaxation therapy, meditation, prayer, imagery, art therapy, music therapy, dance, imagery Biologically based practices – Biofeedback, herbals, dietary supplementations, nutritional therapy, aromatherapy Manipulative and body-based practices – Massage, chiropractic therapy, yoga Energy Therapies – Therapeutic touch, healing touch, reiki, 2Lobert

3. Complementary and Alternative Medicines NCCAM – Whole Medicine Systems Traditional Chinese Medicine – Balancing of vital energy (Qi); uses acupuncture Homeopathy – Based on like cures like; remedies work through energy transfer Naturopathy – Promotion of health through nutrition, herbology, homeopathy, physical therapies and counseling 3Lobert

4. Complementary and Alternative Medicines Complementary & Alternative Therapies – Scope: NIH Study 38% of adults used CAM within the past 12 months Most commonly used therapies: herbs, supplements, and deep breathing exercises Most frequently used natural product : fish oil/omega 3 Greatest use of CAM is noted in Native American Indians, Alaska Natives and Caucasians 25% of patient who utilized alternative therapies did so based upon the recommendation of a health care provider – Challenges 4Lobert

5. Complementary and Alternative Medicines – Glucosamine & Chondroitin Osteoarthritis – Echinacea Immune stimulant for uri and colds Cold symptom reduction if taken immediately – Garlic Reduction of lipid profile Avoid if taking anti platelet agents – Ginger Antiemetic, anti-inflammatory; antioxidant 5Lobert

6. Complementary and Alternative Medicines – Ginkgo Improve memory and cognition Increased risk of hemorrhage – Ginseng Increase well being, reduce fatigue Reduces effect of Warfarin – Kava Sedative hypnotic with antianxiety properties Liver toxicity – Melatonin Sedative hypnotic, regulates sleep wake cycles – Saw Palmetto Benign prostatic hypertrophy by reduction of prostate swelling – St. John’s Wort Antidepressant Accelerates metabolism  interactions with warfarin, cyclosporine, etc. 6Lobert

7. Complementary and Alternative Medicines Vitamins – A: normal vision – B: metabolism; red cell production – C: antioxidant – D: maintains serum calcium – E: antioxidant – K: blood clotting 7Lobert

8. Complementary and Alternative Medicines Minerals – Calcium: bone & teeth formation, blood clotting, muscle contraction – Chloride: maintains fluid and electrolytes – Magnesium: muscle contraction, enzyme cofactor – Phosphate: energy storage; maintains acid base – Potassium: muscle contractions, nerve conduction – Sodium: fluid balance; muscle and nerve conduction 8Lobert

9. Complementary and Alternative Medicines Minerals/Trace Elements – Chromium: maintains normal blood glucose – Iodine: component of thyroid hormones – Iron: component of hemoglobin – Manganese: bone formation, metabolism – Selenium: defense against oxidative stress – Zinc: component of enzymes and proteins 9Lobert