صفحه 1:
9 طبایع
صفحه 2:
Herbal Medicine
صفحه 3:
outcom
= Discuss the significance of
Complementary and alternative
medicine for conventional prescribing
" Highlight the difficulties involved in
obtaining reliable information on this
topic
= Discuss significant drug interactions
and cautions that relate to different
patient groups
صفحه 4:
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History
eae and alternative medicine ی 2
" Herbal medicine at least 5,000 years old
= 5 ا
ا
= اك eee
صفحه 5:
0۳۳۳ بطح
What is CAM?
= Complement and alternative
medicine. coe of disease
= Use of 9 Mogae
aromatherapy and over the counter
vitamin supplements to treat conditions
= Often not adequately clinically trialled
= Might not have a product licence
صفحه 6:
صفحه 7:
= Little evidence with regards to drug
interactions
صفحه 8:
a
Herbalism
" National Institute of Medical
Herbalists 1864 (professional body)
= Phytotherapy-the science of
herbalism
صفحه 9:
SSS _
Herbal medicines
= Plant derived medicines at
pharmacological doses where effects
can be measured
= Symptom based approach to
diagnosis
صفحه 10:
= Glucosamine (not strictly herbal)-
For relief of joint pain (side
effects:mild GI symptoms, rash,
drowsiness, headache and insomnia
= May alter glucose sensitivity
= Caution if pregnant or breastfeeding
or if allergic to shell fish
صفحه 11:
SSS.
= Urogenital conditions - Benign prostatic
ا
" Side effects: - dizziness, and GI disturbance
™ Rare,- mild puritis, headache and
hypertension
= ? Erectile dysfuntion (similar to placebo)
= Drug interactions ? Hormonal therapies
0 الات كت
= Cautions: Pregnancy and breastfeeding, sex
hormone dependent cancers
صفحه 12:
SSS _
22
am aa
= Side effects: headache, drowsiness,
500 GI symptoms, rarely nervousness
and excitability
= ? Cardiac disturbances rarely on sudden
withdrawal (not confirmed)
= Precautions: Pregnancy and breastfeeding,
before driving or operating heavy machinery,
= Not to be taken if known hypersensitivity
= Can cause dependency
صفحه 13:
0
aN Cornea 1701
= Mild depression -
= Caution (Liver enzyme inducer (anti-
epileptics)( theophylline )(the Pill)
(SSRI’s), ( wafarin)
صفحه 14:
ببببببجججججججبببجبجببب-
Echinacea
= Prevention of upper respiratory tract infections
= Cautions: asthma, at و 2
i te ین ی 92
a Ao eee ta eae
= Do not take continuously for more than eight weeks
صفحه 15:
= Licensed: Marketing authorisation
ی و license) issued by Medicines
ee Care products Regulatory
= Have to meet it acl eae, and
efficacy standards
conventional ope
= Unlicensed: Exempt from licensing
requirements (Section 12 of Medicines
act 1968)
صفحه 16:
2108
es sell and supply
ی
oa ae 3 eee
ولاه لطم مولا Poet 5300"
ی 2
صفحه 17:
ببببببجججججججبببجبجببب-
ل لاست
Moves afoot to regulate industry =
صفحه 18:
Committee 2000
= Tougher regulation
" More rigorous testing
= Greater supervision of practice
" Only those with a statutory
regulation or powerful self
regulation should be available on
NHS
= Only by referral from GP.
سس ؟ش "* * ۳" "سس "اس" ۳
صفحه 19:
Safety and
Regulation.
= “We are concerned about the safety
implications of an unregulated
herbal sector and we urge that all
legislative avenues be explored to
ensure better control of this
unregulated sector in the interests
of public health.”
صفحه 20:
بببججججججبجببببببببببب 0
1
= Lack of data
= ‘Natural’ does not always mean safe
e.g digitalis
" Kava Kava hepatotoxicity
صفحه 21:
SSS _
ا تاك
= Remember herbal remedies are
medicines
= Report adverse reactions to doctor
or pharmacist
= May interact with other medicines
= Natural does not mean safe
صفحه 22:
y of Care when
prescribing
= To facilitate full and informed
consent
= To do no harm
= Negligence - Proven breach of duty
of care and harm to patient
صفحه 23:
ببببببجججججججبببجبجببب-
When prescribing
= Always ask the patient what else
they are taking
= Including Over the Counter
medication and herbal medicines
= Consider potential drug interactions
= BNF (2005) and Stockley (2002)
صفحه 24:
0۳۳۳ بطح
Alert
= Patients taking drugs with a narrow
theraputic index e.g wafarin or a
drug therapy which is considered
critical ( e.g insulin) should avoid
using complementary medicines
= Women who are pregnant or
breastfeeding should avoid
complementary medicines
صفحه 25:
SSS _
Problems
= Poor manufacturing process
= Adulteration to include toxic
substances and conventional drugs
= Misidentification of herbs
= Substitution of herbs
= Varying strengths of preparations
= Incomplete labelling
= Incorrect dosage and instructions
صفحه 26:
a
Reporting
= To the MHRA using yellow card
porting
16
= Important for all drugs especially
0156 لكين دكا
صفحه 27:
medicine: what is
BMJ 1999; 319: 693-6!
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December