5 CAM Revised

8/2/2019 5 CAM Revised

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Complimentary and

Alternative Medicine


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Complementary and AlternativeMedicine

Is a group of diverse medical and health

care systems, practices, and products thatare not presently considered to be a part of conventional medicine

Ex. acupuncture, chiropractic, massage, andhomeopathy


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Complementary and AlternativeMedicine

People use CAM therapies in a variety of ways. CAM therapies used alone are often referred

to as alternative. When used in addition to conventional

medicine, they are often referred to ascomplementary.


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Complementary and

Alternative therapies arenot the same

-NCCAM


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Complementary therapy

Used to supplement/ augment conventionaltherapy

(guided imagery, music, relaxation techniques)


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Alternative therapy

Generally used instead of conventionaltreatment

Acupuncture instead of analgesic


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Conventional Medicine

- Medicine practiced by holders of M.D. and D.O. (doctor of osteopathy) degrees and by alliedprofessionals.( Registered nurse, Physical

therapist & Psychologist)

- Some conventional practitioners are alsopractitioners of CAMex.

Using Aroma therapy to help lessen clientsdiscomfort following surgery.


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Integrative medicine

- Combines mainstream medical therapies and CAMtherapies for which there is some high-qualityevidence of safety and effectiveness.

Ex.Nurses use combination of therapies when they

use massage, touch, distraction and relaxationtechniques in addition to use of analgesics for pain.


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Why do people choose AlternativeTherapies?

2 main reasons:

High personal involvement in decision making.

Hope for gaining therapeutic benefits( Lazar and O Connor)


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Factors affecting the use of AlternativeMedicine

Desire for control over decision-making Hope to gain therapeutic benefit. Desire to avoid toxicities, invasiveness or

other qualities of conventional treatments.

Need to control undesirable side effects of conventional therapies.

Preference of natural over syntheticmedications.


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Factors affecting the use of AlternativeMedicine (cont)

Dissatisfaction with attitudes andpractitioners conventional medicine

Failure to determine diagnosis Failure of conventional therapy Chronic illness with poor prognosis

Acute or chronic conditions for whichconventional treatments are lacking ordisappointing

Reduced insurance coverage


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Factors affecting the use of AlternativeMedicine (cont)

Healing system that is part of a clients culturalor identity group heritage.

Restraints on access to health care Increased costs of prescriptions and services. Increased interest in preventive strategies and

holistic approaches to health such as eating amore nutritionally sound diet, maintainingfitness and reducing stress.


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Issues Related to Herbal Remedies andDietary Supplements

Current laws do not give a strict definition of the term supplement

Manufacturers of supplements may only makegeneral claims about their products

Herb manufacturers are not required todemonstrate the safety, efficacy, or quality of their products

Supplement manufacturers are not held tostrict standards


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Issues Related to Herbal Remedies andDietary Supplements (cont)

Food companies can make health claims if most of the scientific evidence supports the

claim The placebo effect plays a significant role in

the use of herbal remedies and supplements

Most medicinal plants are untested At least 30% of all modern drugs are actually

derived from plants


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Risks Posed by Complementary andAlternative Medicine (CAM)

Most herbal remedies and supplements areuntested and therefore might have unknown

adverse effects on the body CAM could interfere with prescribed

medication, anesthesia or surgery


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Dietary Supplement as Defined Under the DietarySupplement Health and Education Act of 1994

It contains one or more of the following ingredients: a vitamin, a mineral, an herb or other botanical (excluding tobacco), an amino acid,

a dietary substance for use by man to supplement the diet by increasing thetotal daily intake (e.g., enzymes or tissues from organs or glands), a concentrate, such as a meal replacement or energy bar, or a metabolite, constituent, or extract.

It is intended for ingestion in pill, capsule, tablet, or liquid form. It is not represented for use as a conventional food or as the sole item

of a meal or diet.


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Benefits from Using Complementaryand Alternative Medicine

Individuals might be more conscious andcooperative with their health management

when CAM therapies are used

Individuals generally report marked

improvement in their well-being aftersubscribing to CAM therapies


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Role Of The Nurse

Obtains a health history from the client Initiates the discussion about the use of

CAM modalities.

Educates clients about possible adversereactions, provide information from theNCCAM, and to teach lifestyle-modificationbehavior that could prevent thedevelopment of acute or chronic problems.


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Methods to Facilitate Discussion of CAM therapies

Give permission for clients to raise the topicand ask questions.

Ask, in every history and physical examination What else are you doing to care for your health?

Listen for nondisclosing cues or referencesthat may represent a clients effort to test thewaters without making full disclosure.


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Methods to Facilitate Discussion of CAM therapies (cont.)

Become familiar with local patterns of use Be frank with what you do not know Seek more information from clients. When asking clients about medications, ask

specifically about any supplements orherbs.


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I. Alternative Medical Systems


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Alternative Medical System

Involve complete systems of theory andpractice

Independent or parallel to conventionalmedicine

Many are traditional systems of medicine thatare practiced by individual culturesthroughout the world


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1. Alternative Medical Systems Alternative medical systems are built upon complete

systems of theory and practice

TRADITIONAL CHINESE MEDICINE ACCUPUNCTURE

ACCUPRESSURE

AYUVEDIC MEDICINE HOMEOPATHY NATUROPATHIC MEDICINE NATIVE AMERICAN HEALING PRACTICES TIBETAN MEDICINE


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Alternative Medical System

Major Eastern Whole Medical Systems Traditional Chinese medicine

Acupuncture and Moxibustion

Chinese Materia Medica Massage and Manipulation

Ayurvedic Medicine

Major Western Whole Medical Systems Curanderismo Homeopathy

Naturopathy


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a. Traditional Chinese Medicine

The superior physician helps before

the early budding of the disease; Theinferior physician begins to helpwhen the disease has already set in...-Yellow Emperors Classic of Medicine

A. EASTERN WHOLE MEDICAL SYSTEM:


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Traditional Chinese Medicine

complete system of healing that dates back to200 B.C. in written form

Korea, Japan, and Vietnam based theirmedical system from practices originatingChina

Principle: the body is a delicate balance Yin represents cold, slow, or passive principle Yang represents hot, excited, or active principle


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Qi, the Vital Energy

Invisible flow of energy that circulates theuniverse

Qi flows throughout the body along a networkof energy circuits called meridians

Obstruction in the normal flow of Qi can causeillness


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Five Phases and Seasons

Five Phases Theory Dynamic connection between forces of nature and

the body Fire, earth, metal, water, and wood

Five Seasons Four cardinal directions are connected with the

Five elements Earth, the fifth element, is the center

South is the most important direction


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Diagnostic Methods Inspection Auscultation/Olfaction

Sounds and odors of the body may signify imbalance

Inquiry Comprehensive history taking

Palpation Pulse diagnosis


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Treatments and Interventions Acupuncture

Stimulation of anatomic points called hsueh where

meridian passes close to the skin Moxibustion

Application of heat from burning substances atacupuncture points

Chinese Materia Medica standard reference book of information on medicinal

substances that are used in Chinese herbal medicine


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Acupressure


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Acupressure

Method of maintaining health,treating disease and alleviating painby applying pressure or massagingcertain points on the body surfaces


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Acupuncture


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Acupuncture involves the insertion of stainless

steel needles into various body areas A low-frequency current may be

applied to the needles to producegreater stimulation

claims to restore balance


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Tui Na Massage


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Tui Na Massage Chinese therapeutic massage Pushing and grasping combination of all massage styles

including relaxation, deep tissues,acupressure, joint, or bonemanipulations

deals almost exclusively withphysical/structural imbalance only


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b. Ayurvedic MedicineThe relationship between the bodyand the mind is so intimate that, if either of them get out of order, the

whole system would suffer- Ghandi

EASTERN WHOLE MEDICAL SYSTEM


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Ayurvedic Medicine

Ayurveda is one of the oldest medical systemsin the world

Practiced for 4000 years in India Sanskrit word:

ayur means life veda means knowledge

Principle: Connection and balance betweenmicrocosm and macrocosm


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Microcosm and Macrocosm

Microcosm the people Macrocosm the universe Understand the world to understand people Understand the people to understand the world Because of this assertion it is believed that

human health is influenced by his environment


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Ayurvedic Medicine

Diagnostic Methods Pulse diagnosis

pulses are related to prana

Tongue diagnosis Color of tongue indicates functional status of internal

organs

Urine diagnosis Body observation

Cool, hot, rough, or dry skin indicates imbalance Nails that have longitudinal striations, bumps, or a

parrot beak also indicates imbalance


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Ayurvedic Medicine

Specific lifestyle interventions are a majorpreventive and therapeutic approach

Individualized care and treatment Treatments and Interventions includes

Nutrition balanced diet means balance of six tastes - sweet, sour,

salty, pungent, bitter, and astringent Yoga

Combination of exercise, meditation, breathing, andrelaxation techniques


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Ayurvedic Medicine

Treatments and Intervention (cont.) Herbs Exercise

Breathing Meditation Massage

Marma theraphy is similar to acupuncture andacupressure

Aromatheraphy Music

Purification


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CAM Alternative Medical Systems

B. Western Alternative Medical Systems Curanderismo Homeopathic Medicine Naturopathic Medicine


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Curanderismo


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a. Curanderismo

Spanish verb curar or to heal Latin America Hispanic Americans Most characteristic of Mexican Americans Survives by growing, changing, and

incorporating Western biomedical beliefs


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Curanderismo

Various techniques Prayer Herbal medicine Healing rituals Spiritualism Massage

Psychic healing


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Curanderismo

Healers call themselves curanderos andcuranderas

The only healer in the culture who can treatmal puesto - illnesses caused by witchcraft(brujos and brujas)

Supernatural illness el don de Dios gift of healing from God


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Don Martin performing a cure in front of his altar in Ojinga,Chihuahua, Mexico


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Curanderismo

Three levels of healing Material level

Use of physical or supernatural objects to heal

Spiritual level Similar to shamanic healing rituals

Mental level

Transmits mental vibrations in a way that directlyaffects a persons condition


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b. Homeopathy

Complete system of medical theory andpractice

Samuel Christian Hahnemann (1755-1843) German physicist

Proving or human pathogenic trial Considers all the aspects of a persons health

status - individualized

Practitioners are called homeopaths


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Homeopathy

Aims to stimulate the bodys own healingresponses

Administered in minute or potentiallynonexistent material dosages

Concepts Law of Similars (like cures like) Law of Infinitesimals


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Naturopathy


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c. Naturopathy

System of healing Originated from Europe Body naturally heals itself Emphasizes health restoration and disease

treatment

Literally translates as nature disease


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Naturopathy

Six principles Healing power of nature Identification and treatment of the cause of

disease The concept of "first do no harm" The doctor as teacher

Treatment of the whole person Prevention


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Naturopathy

Core modalities Diet modification and nutritional supplements Herbal medicine Acupuncture and Chinese medicine Hydrotherapy Massage and Joint manipulation

Lifestyle counseling


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Naturopathy

No research study has regarded naturopathyas a complete system of medicine

Examples Propolis (a resinous product collected from

beehives) and vitamin C for ear pain

Cranberrry juice or tablet acts as prophylaxis

against urinary tract infection


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II. MIND-BODY TECHNIQUES

Drag your thought away from your troubles bythe ears, by the heel, or any other way you can

manage it. Its the healthiest thing a body can do Mark Twain


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Mind-body interventions

Uses a variety of techniques designed toenhance the minds capacity to affect bodilyfunction and manifestations

Ex: client support groups and cognitive-behavioral therapy Other ex: aromatherapy; art, music, or dance

therapy; biofeedback; hypnosis; imagery;meditation; shamanism; spiritual healing; TaiChi; yoga


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a. AROMATHERAPY


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Aromatherapy


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AROMATHERAPY

Use of fragrant compounds or essential(volatile) oils extracted from plants

Used to improve mood and overall health Can be inhaled or applied during massage Popular compounds: CHAMOMILE,

EUCALYPTUS, JASMINE, LAVANDER,PEPPERMINT, ROSEMARY


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Application of AROMATHERAPY

Inhalation (directly or diffused into the air) Absorption through the skin (baths,

massages, compresses)

Absorption through the mucous membranes(oral rinses and gargles)

Ingestion (occasionally prescribed, withcaveats)

b ART


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b. ARTc. MUSICd. DANCE THERAPY
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ART, MUSIC OR DANCE THERAPY

Use drawing or art, music, or dance to help

individuals cope or express emotions


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BIOFEEDBACKIf you believe you can or if youbelieve you cant, youre right.

Henry Ford


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e. BIOFEEDBACK

Utilizes monitoring devices to assistindividuals to make them more aware of theirphysiology and allow them better self-controlover such things as blood pressure, muscletension, temperature, and bladder control


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Biofeedback is a method of bringingunconscious biologic processes underconscious control.

Biofeedback involves the use of electronicdevices to measure and report back to theconscious mind information such as heartrate, blood pressure, muscle tension, andbrain surface electrical activity


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Types of BIOFEEDBACK

THERMAL FEEDBACK Primary tool for general relaxation training

and treatment of specific vascular disease

Sensors attached to your fingers or feetmeasure your skin temperature

Blood flow in the hands responds to stress andrelaxation, & clients learn to relax by watchingthe rise and fall of finger temp.


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ELECTRODERMAL RESPONSE (EDR) or GALVANICSKIN RESPONSE

Sensors measure the activity of your sweat

glands and the amount of perspiration on yourskin, alerting you to anxiety Highly sensitive to emotions and thoughts Method most commonly used by a lie

detector machine


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ELECTRODERMAL RESPONSE (EDR) orGALVANIC SKIN RESPONSE

Used in general relaxation training to helppeople reduce the impact of significantstressors and anxiety, and to treat excessivesweating


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ELECTROMYOGRAPHY (EMG) most common form of biofeedback

measurement

uses electrodes or other types of sensors tomeasure muscle tension

mainly used as a relaxation technique to help

ease tension in those muscles involved inbackaches, headaches, neck pain and bruxism


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ELECTROMYOGRAPHY (EMG) Used for general relaxation training and

insomnia that is due to over activation of theautonomic nervous system


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RESPIRATORY RESISTANCE Measures the rate, volume, and rhythm of

respiration

Useful in treating both asthma and thehyperventilation of anxiety and panic attacks


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GASTROINTESTINAL FEEDBACK Helpful in treating irritable bowel syndrome,

colitis, heartburn, functional dyspepsia, andCrohns disease

CARDIOVASCULAR (EKG) FEEDBACK Available through portable heart rate

monitors to augment a persons ability tocontrol heart rate


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Biofeedback


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PELVIC MUSCLE DYSFUNCTION FEEDBACK Used for people with chronic constipation

related to pelvic dysfunction

Sensors measure the activity of internal andexternal renal sphincter for treatment of fecalincontinence and the activity of the detrusormucle for the treatment of urinaryincontinence


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ELECTROENCEPHALOGRAPH (EEG) Also called NEUROTHERAPY Records information about brain wave activity

from sensors placed on the scalp

Used for mind quieting, attention control,short-term memory improvement, moodswings, posttraumatic stress disorder, andalcohol and drug addiction


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f. HYPNOTHERAPY

The greatest discovery of anygeneration is that human beings can

alter their lives by altering theattitude of their minds.

Albert Schweitzer


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HYPNOTHERAPY

application of hypnosis as a form of treatment, usually for relieving pain orconditions related to one's state of mind

HYPNOSIS State of restful alertness during which

individual become more aware of his or hersurroundings to change behavior or promotehealthful practices

h


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Techniques

Age Regression - by returning to an earlier ego-statethe patient can regain qualities they once had, buthave lost. Remembering an earlier, healthier, ego-state can increase the patients strength and

confidence. Revivification - remembering past experiences can

contribute to therapy. For example; the hypnotistmay ask "have you ever been in trance?" and then

find it easier to revive the previous experience thanattempt inducing a new state.

h


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Techniques

Guided Imagery - a method by which thesubject is given a new relaxing and beneficialexperience.

Parts Therapy - a method to identifyconflicting parts that are damaging the wellbeing of clients, then helps those parts

negotiate with each other through thetherapist to bring about a resolution.


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T h i


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Techniques

Indirect Suggestion - using "interspersal"technique and other means to cause effect.

Mental State - people are more receptive

while relaxed, sleeping, or in a trance. Hypnoanalysis - the client recalls moments

from his past, confronting them and releasingassociated emotions, similar topsychoanalysis.

T h i


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Techniques

Post Hypnotic Suggestion - a suggestion that will becarried out after the trance has ended. "When youre-awaken you will feel refreshed."

Visualization - being told to imagine or visualize adesired outcome seems to make it more likely toactually occur.

Techniques specific to medical disorders, such as gut-directed hypnotherapy protocols for Irritable BowelSyndrome

HYPNOTHERAPY M th d R liti


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HYPNOTHERAPY: Myths and Realities

MYTH REALITYPeople are asleep duringhypnosis.

People are awake and awarethroughout the entire process andare highly selective about where

they focus their attention.Hypnotized people have lostcontrol and are under someonespower

All hypnosis is self-hypnosis sincepeople cannot be hypnotizedagainst their will

People can be influenced to tell

secrets

People cannot be forced to reveal

any secrets they would notdisclose in a fully alert state

People might get stuck in ahypnotic trance

Because individuals control thesituation, they can end thehypnotic trance any time


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f. IMAGERY

The power which a mansimagination has over his body to heal

it or make it sick is a force whichnone of us is born without

Mark Twain


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Guided imagery involves the use of mentalimages to promote relaxation and wellness,

reduce pain facilitate healing of a particular ailment, such as

cancer or psychologic trauma.

IMAGERY


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IMAGERY

Two way communication between theconscious and unconscious mind and involvesthe whole body and all of its senses.

Mental exercise where the clients mind andthoughts are supposed to impact or assist a

certain outcome

Ki d f IMAGERY


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Kinds of IMAGERY

Feeling-state imagery End-state imagery Energetic imagery Cellular imagery Physiologic imagery

Psychological imagery Spiritual imagery

Eight Characteristics to make IMAGERY


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geffective as a HEALING TOOL

1. Images must be personal2. Images must feel right to the person and be

congruent with who they are and theirvalues

3. Imagery works best in a permissive, unforcedatmosphere

4. Images must be energetic and physical

Eight Characteristics to make IMAGERY


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geffective as a HEALING TOOL

5. Images must be anatomically correct andaccurate

6. Skill at using imagery increases with practice7. Imagery should have an end-stage component8. If people are receiving medical treatment

concurrently, they should include it in theimagery


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g. MEDITATION

In prayer we talk with God, in meditation welisten.

Edgar Cayce


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MEDITATION
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MEDITATION

meditari , means to consider or to payattention to something

General term for a wide range of practicesthat involve relaxing the body and stilling themind

Uses reflection or mental concentration to

create a higher sense of well-being andrelaxation


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In meditation , people regulate their attentionor systematically focus on particular aspects of inner or outer experience.

Meditation involves sitting or resting quietly,often with the eyes closed.

Sometimes it involves the repetitive sounding

of a phrase ( a mantra ) meant to help theperson focus


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SHAMANISM


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SHAMANS


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SHAMANS

he who knows originally referred to the

traditional healers of Turkic-Mongol areas such as

Northern Asia and Mongolia experts employed by animists

or animist communities

are not often organized into

full-time ritual or spiritualassociations, as are priests


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Shaman are spiritual beings with the ability toheal, work with energies and 'see' visions.

The essential characteristics of shaman aremastery of energy and fire as a medium of transformation.

Shamanistic practices are thought to predate

all organized religions, and certainly date backto the neolithic period


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i. Spiritual Healing

SPIRITUAL HEALING


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SPIRITUAL HEALING

direct interaction between the healer and aclient with the intention of improving theclients overall or specific condition or

potentially curing the disease

Variations: Reiki, intercessory prayer, faith

healing, therapeutic touch


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FAITH and PRAYERAnd if you would know God be not therefore a

solver of riddles.Rather look about you and you shall see Him

playing with your children.And look into space; you shall see Him

walking in the cloud, outstretching His arms inthe lightning and descending in the rain.You shall see Him smiling in flowers, then

rising and waving His hands in trees

*FAITH and PRAYER


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FAITH and PRAYER

active effort to communicate with a deity orspirit, including a monotheist God, Saints,gods within a pantheon, or others; either tooffer praise, to make a request, or simply toexpress one's thoughts and emotions

People meditate and say prayers that elicitphysiologic calm and a sense of peacefulness,

both of which contribute to loner survival


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TAI CHI


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TAI CHI

great ultimate fist supreme boxing or root of all motion system originally taught by the Chen family to the

Yang family starting in 1820 promoted and practiced as a martial arts therapy for

the purposes of health and longevity

considered a soft style martial art, an art appliedwith as complete a relaxation or "softness" in themusculature as possible

TAI CHI: Three primary subjects


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Health - an unhealthy or otherwiseuncomfortable person will find it difficult tomeditate to a state of calmness or to use T'ai

Chi as a martial art. T'ai Chi's health trainingtherefore concentrates on relieving thephysical effects of stress on the body andmind.



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Meditation - the focus meditation andsubsequent calmness cultivated by themeditative aspect of T'ai Chi is seen as

necessary to maintain optimum health (in thesense of effectively maintaining stress relief orhomeostasis) and in order to use it as a softstyle martial art



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Martial art - the ability to competently use T'aiChi as a martial art is said to be proof that thehealth and meditation aspects are working

according to the dictates of the theory of T'aiChi Ch'an

The T'ai Chi Symbol or


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T'ai Chi T'u

to physically andenergetically balanceyin (receptive) and yang (active) principles

"From ultimate softnesscomes ultimatehardness."


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YOGA

Mindful yoga invites us to observethe arising and passing of sensations,

thoughts, and emotions like cloudswithin the all-embracing sky of

awarenessJon Kabat-Sin


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YOGA


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YOGA

Form of therapy hasimproved quality of lifefor some clients byleading to relaxationand reduced stresslevels

Yoga


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Yoga

Physical and Psychological Benefits of


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YOGA

Increases flexibility of muscles and joints Tones and strengthen muscles Improves endurance Increases circulation Lowers blood pressure Increases lymphatic circulation Improves digestion and elimination

Physical and Psychological Benefits of


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YOGA

Promotes deeper breathing Increases brain endophins, enkephalins,

serotonin

Increases mental acuity Augments alpha and theta brain wave activity Promotes relaxation Manages stress


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Biological Based Therapies

Use substances found in nature suchas herbs, foods, and vitamins.

Biological Based Therapies


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g p

Includes, but is not limited to, botanicals, animal-derived extracts, vitamins, minerals, fatty acids,amino acids, proteins, prebiotics and probiotics,whole diets, and functional foods

Includes natural and biologically-based practices,interventions, and products, many of which overlapwith conventional medicine's use of dietarysupplements

Herbal, special dietary, orthomolecular and biologicaltherapies

Biological Therapy


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g py

Use of natural but scientifically unproved therapies

Use of laetrile and shark cartilage to treat cancer

Use of bee pollen to treat autoimmune and inflammatorydiseases

Herbal Therapy


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py

Herbal medicine or herbalism , the oldestknown form of health care, uses plants andplant extracts to treat disease and promote

wellness. A single herb or a mixture of different herbs

can be used.

Herbal TherapyE l i di id l i f h b f h i l


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Employs individual or mixtures of herbs for therapeutic value Herb - a plant or plant part that produces and contains

chemical substances that act upon the bodyEXAMPLES:

Valerian tea for improved sleep Echinacea to treat or prevent colds Garlic Peppermint Chamomile

St. John's wort Ginkgo biloba Ginseng

Orthomolecular Medicine


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Uses combinations of vitamins, minerals, and amino acidsnormally found in the body to treat specific conditions and tomaintain health.

Referred to as nutritional medicine Emphasizes supplementing the diet with high-dose

combinations of vitamins, minerals, enzymes, hormones (suchas melatonin), and amino acids.

Dosages often far exceed the amounts normally consumed inthe diet.

A common form of orthomolecular medicine is megavitamintherapy , often with doses well above the recommended dailyallowances (RDAs).


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Dietary Supplements


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y pp

A product taken by mouth that contains a "dietary ingredient"intended to supplement the diet ( Congress, DSHEA 1994 )

Dietary ingredients include vitamins, minerals, herbs orother botanicals, amino acids, and substances such as

enzymes, organ tissues, glandulars, and metabolites

Extracts or concentrates (in tablet, capsule, softgel, gelcap,liquid, or powder form)

Regulated differently by FDA than drug products (prescriptionor OTC)

Drug vs. Dietary Supplement


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g y pp

The difference between a dietary supplement and a drug liesin the use of the agent, not in the nature of the agent itself.

Dietary supplement used to resolve a nutritional deficiency

or to improve or sustain the structure or function of the body

Drug used to diagnose, prevent, treat, or cure a disease

FDA RegulationDr gs s Dietar S pplements


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Drugs vs. Dietary Supplements

Drugs Dietary SupplementsFollow defined good

manufacturing practices(GMPs)

Follow existingmanufacturingrequirements for foods

Drugs Dietary Supplements


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Drugs Dietary SupplementsApproved by the FDA as

safe and efficacious priorto marketing

Marketed dietary

supplements monitoredfor adverse effects afterthey are on the market

Newly marketed dietary

supplements not subjectto premarket approval or aspecific postmarketsurveillance period

* manufacturers of dietarysupplements areresponsible for ensuringthat their products aresafe


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Drugs Dietary SupplementsRequire claims of benefit,

and citation of existingliterature to validate such

claims

Do not require substantiationdata

*the Federal Trade

Commission has primaryresponsibility formonitoring dietarysupplements for truth in

advertising


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Drug Dietary SupplementSubject to investigational

new drug (IND)requirements

Not subject to INDrequirements

History


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Italian Alps (1991) Ice Man s personal effects includedmedicinal herbs

Middle Ages medicinal herbs inventoried for their medicinal

effects

Formed the basis of modern drugs

Interactions with Drugs


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Because of widespread use and because they arenatural, people assume that dietary supplementsare inert or harmless.

Studies show that interactions between drugs anddietary supplements do occur.

EXAMPLE: Gingko extract antioxidant and inhibits platelet aggregation

bleeding reported with the combined use of gingko anddrugs with anticoagulant or antiplatelet effects



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Garlic, glucosamine, ginseng ( Panax ), sawpalmetto, soy, valerian, and yohimbe are alsothought to potentiate or interfere with

prescription drugs


Toxicity


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May be due to misidentification, contamination, andadulteration

May result from the products themselves

Ex. Kava - fulminant liver failure, ephedra

Common Plant-Derived Conventional Medicines


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Drug Plant Name Drug Classification

Atropine Atropa belladonna Anticholinergic,antispasmodic,antidysrhythmic

Capsaicin Capsicumfrutescens

Topical analgesic

Cocaine Erythroxylon coca Topical anesthetic

Codeine Papaversomniferum

Analgesic

Colchicine Colchicumautumnale

Antigout



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Drug Plant Name Drug Classification

Digoxin Digitalispurpurea

Antidysrhythmic

Ephedrine Ephedra sinica Appetite suppressant

Ipecac Caphaelisipecacuanha

Antidote, emetic

Physostigmine

Physostigmavenenosum

Cholinergic

Quinine Cinchonaofficinales

Antimalarial,antimyotonic



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Drug Plant Name Drug ClassificationSalicylin Salix purpurea Analgesic, Antipyretic

Scopolamine Datura fastuosa Antiemetic,

anticholinergicSenna Cassia

acutifoliaLaxative

Taxol Taxus brevifolia Antineoplastic

Vincristine Catharanthusroseus

Antineoplastic


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Manipulative and Body-Based

Methods

Chiropractic manipulation


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Osteopathic manipulation Massage therapy

Tui Na Reflexology

Rolfing Bowen technique Trager bodywork

Alexander technique Feldenkrais method

Manipulative and body-based practices


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Manipulative and body-based practices

focuses on: structures of the body bones and joints the soft tissues the circulatory system

lymphatic systems.


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Practices were derived from traditionalsystems of medicine from:

China

India Egypt

DEFINITIONS Alexander technique :


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Alexander technique : Patient education/guidance in ways to improve

posture and movement, and to use musclesefficiently.

Bowen technique : Gentle massage of muscles andtendons over acupuncture and reflex points.

Chiropractic manipulation : Adjustments of the jointsof the spine, as well as other joints and muscles.

Craniosacral therapy : Form of massage using gentlepressure on the plates of the patient's skull.

.

Feldenkrais method : Group classes andhands-on lessons designed to improve thecoordination of the whole person in


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coordination of the whole person incomfortable, effective, and intelligentmovement

Massage therapy : Assortment of techniques

involving manipulation of the soft tissues of the body through pressure and movement.

Osteopathic manipulation: Manipulation of the joints combined with physical therapy andinstruction in proper posture.

Reflexology: Method of foot (and sometimes hand)massage in which pressure is applied to "reflex"

f


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zones mapped out on the feet (or hands).

Rolfing: Deep tissue massage (also called structuralintegration).

Trager bodywork: Slight rocking and shaking of the patient's trunk and limbs in a rhythmic fashion.

Tui Na: Application of pressure with the fingers andthumb, and manipulation of specific points on thebody (acupoints).


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What is Chiropractic


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form of health care that focuses on therelationship between the body's structure,primarily of the spine, and function

use a type of hands-on therapy called

manipulation (or adjustment) as their core

clinical procedure

Key Points


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Chiropractic is most often used to treatmusculoskeletal conditions--problems withthe muscles, joints, bones, and connectivetissue such as cartilage, ligaments, andtendons.


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Basic Concepts


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The body has a powerful self-healing ability The body's structure (primarily that of the

spine) and its function are closely related, andthis relationship affects health

Chiropractic therapy is given with the goals of normalizing this relationship betweenstructure and function and assisting the body

as it heals

What kind of training do chiropractorsreceive?


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receive?

Chiropractic training is a 4-year academic programconsisting of both classroom and clinical instruction

At least 3 years of preparatory college work arerequired for admission to chiropractic schools

Students who graduate receive the degree of Doctorof Chiropractic (D.C.) and are eligible to take statelicensure board examinations in order to practice

What do chiropractors do in treatingti t ?


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patients?

health history

physical examination, with special emphasison the spine

What do chiropractors do in treatingpatients?


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p

Chiropractors perform adjustments Given mainly to the spine, chiropractic

adjustments involve applying a controlled,

sudden force to a joint To increase the range and quality of motion in

the area being treated

What do chiropractors do in treatingpatients?


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p

Most chiropractors useother treatments inaddition to adjustment,such as mobilization,massage, andnonmanual treatments

Examples of NonmanualChiropracticTreatments 1

Heat and ice Ultrasound Electrical stimulation Rehabilitative exercise Magnetic therapy Counseling about diet,

weight loss, and otherlifestyle factors

Dietary supplements Homeopathy Acupuncture
http://nccam.nih.gov/health/chiropractic/http://nccam.nih.gov/health/chiropractic/


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MASSAGE THERAPY

MASSAGE THERAPY


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It is an assortment of techniques involvingmanipulation of the soft tissues of the bodythrough pressure and movement.

BENEFITS OF MASSAGE THERAPY


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increases blood supply, oxygen, and nutritionto muscles, tissue, joints, and the vital organs improves circulation throughout the body,

which helps muscles to recover more quicklyfrom exertion and fatigue

helps to relieve the pain and discomfortassociated with muscle tension, fractures,

sprains, sciatica, and stiff joints

BENEFITS OF MASSAGE THERAPY


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aids in the relief of muscle spasms and cramping helps in the prevention of muscular atrophy. helps break up scar tissue

especially useful in the breakup of post surgicaladhesions and edema

promotes a greater range of motion in joints keeps ligaments and tendons supple lowers blood pressure and heart rate reduces stress, anxiety, and depression.

MASSAGE TYPES


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Craniosacral Therapy - Via a gentle, noninvasivemanipulative technique This encourages own natural mechanisms to

improve the functioning of your brain and spinalcord to dissipate the negative effects of stress,promote good health, and enhance resistance todisease.

MASSAGE TYPES


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Deep Tissue Massage - is used to releasechronic muscle tension through slower strokesand more direct pressure or friction appliedacross the grain of the muscles. is a process of detection of stiff or painful areas by

determining the quality and texture of the deeperlayers of musculature, and slowly working into thedeep layers of muscle tissue.

MASSAGE TYPES Shiatsu - traditional hands-on Japanese healing therapy.


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can help in a wide range of conditions - from specific

injuries to more general symptoms of poor health. help to prevent the build up of stress in our daily lives.Relives:

back pain menstrual problems headaches, migraines digestive problems whiplash injuries asthmatic symptoms

neck stiffness sports injuries joint pain and reduced mobility

MASSAGE TYPES


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Swedish massage - collection of techniques designedprimarily to relax muscles by applying pressure. uses oil or baby powder to reduce friction. can relax muscles, increase circulation, remove metabolic waste products speed venous return from the extremities. shortens recovery time from muscular strain by flushing

the tissue of lactic acid, uric acid and other metabolic

wastes. improves circulation without increasing heart load. It

stretches the ligaments and tendons, keeping them supple.


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Energy Therapies

May the force be with you...

ENERGY THERAPIES


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Energy medicine is a domain in CAM that deals withenergy fields

Two types :

Biofield therapies (putative)

Bioelectromagnetic (veritable)

ENERGY THERAPIES


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Biofield therapies intended to affect energy fields that supposedly

surround and penetrate the human body.

Examples:qi gong,Reiki, and

Therapeutic Touch

ENERGY THERAPIES


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Bioelectromagnetic

involve the unconventional use of electromagnetic fields

employ mechanical vibrations and electromagnetic

forces

involve the use of specific, measurable wavelengths andfrequencies to treat patients


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Biofield Therapies

BIOFIELD THERAPIES


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Background based on the concept that human beings are infused

with a subtle form of energy

Asian practitioners postulated that the flow and balanceof life energies are necessary for maintaining health anddescribed tools to restore them

Practitioners of energy medicine believe that illnessresults from disturbances of these subtle energies

BIOFIELD THERAPIES


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Examples: Acupuncture

Reiki

Qi Gong

Therapeutic Touch

BIOFIELD THERAPIES


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Acupuncture

BIOFIELD THERAPIES


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Acupuncture a family of procedures involving stimulation of

anatomical points on the body by a variety of techniques

method of healing developed in China at least 2,000years ago

involves penetrating the skin with thin, solid, metallicneedles that are manipulated by the hands or byelectrical stimulation.

BIOFIELD THERAPIES


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Acupuncture more than 2,000 acupuncture points in the body

12 main and eight secondary pathways called meridians

Meridians: conduct energy or gi throughout the body

BIOFIELD THERAPIES


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Acupuncture for pain Acupuncture points are believed to stimulate the

central nervous system to release chemicals intothe muscles, spinal cord and brain

three main mechanisms: Conduction of electromagnetic signals Activation of opioid systems

Changes in brain chemistry, sensation andinvoluntary body functions

BIOFIELD THERAPIES


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Reiki

BIOFIELD THERAPIES


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Reiki means "universal life energy.

originated in Japan

practitioner places his hands on or near the personreceiving treatment, with the intent to transmit ki

Ki : life-force energy

BIOFIELD THERAPIES


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Reiki Ki:

Is spiritual in origin.

Makes up and moves through all living things.Is available in infinite quantities, positive in nature,and important to all aspects of health.Is present both inside the body and on its surface.

Flows throughout the body in specific channels.Has its flow disturbed by negative thoughts or

feelings.

BIOFIELD THERAPIES


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Reiki if ki's flow is disrupted, the body's functioning becomes

disrupted, and health problems can occur

Health related purposes:

Effects of stress. Chronic pain. Improving immunity. Mental clarity. Sense of well-being and/or spirituality. Enhancing sense of peace in dying people

BIOFIELD THERAPIES


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Reiki Procedure practitioner places her hands on or slightly above the

client's body

uses 12 to 15 different hand positions

Each hand position is held until the practitioner feelsthat the flow of energy has slowed or stopped (typically2-5 mins)

BIOFIELD THERAPIES


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Qi Gong

BIOFIELD THERAPIES


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Qi Gong ancient form of exercise therapy, often translated as

'energy work' or 'breath discipline,

Combining breathing, mental focus, stretching, andmovement

promotes enhancement of the flow of qi in the body,improve blood circulation, and enhance immunefunction.


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BIOFIELD THERAPIES


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Therapeutic Touch

BIOFIELD THERAPIES


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Therapeutic Touch derived from an ancient technique called laying-on of hands

based on the belief that living beings have an energyfield or aura which extends beyond the surface of thebody that can be manipulated by the therapist

healing is promoted when the body's energies are inbalance

BIOFIELD THERAPIES


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Therapeutic touch works with the interaction between the energy fields

(auras) of healer and patient

the healer must have an active intent for healing tooccur

the patient must desire (even unconsciously) a return tohealth


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Bioelectromagnetic Therapy

Energy is not obtained from the gross molecularaspects of food and air, but rather from what can

be called its vibrational essence or itselectromagnetism

BIOELECTROMAGNETIC THERAPY


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Magnetic Therapy Use of static magnets to relieve pain or to obtain other

alleged benefits

based on belief that magnetic fields from permanentmagnets placed close to the body can cause bones toheal faster, relieve pain, and perform other forms of healing

It has recently been shown that static magnetic fields

affect the microvasculature of skeletal muscle



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Millimeter Wave Therapy Low-power millimeter wave (MW) irradiation elicitsbiological effects, and is used to treat a variety of conditions

the nature of MW action is not well understood

unclear whether MW yields clinical effects beyond a

placebo response.



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Sound Energy Therapy referred to as vibrational or frequency therapy includes music therapy

presumptive basis of its effect is that specificsound frequencies resonate with specific organsof the body to heal and support the body

used to entrain mood states and reduce acute orchronic pain



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Light Therapy Use of natural or artificial light to treat various ailments

High-intensity light therapy has been documented to beuseful for seasonal affective disorder

Low-level laser therapy is claimed to be useful forrelieving pain, reducing inflammation, and helping toheal wounds

MAGNETIC THERAPY
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Magnets produce energy fieldsof different strengths, whichproponents believe canpenetrate the human body,correcting disturbances andrestoring health to the afflictedsystems, organs, and cells.

Magnetic therapyinvolves the use of magnets of varying sizesand strengths that are

placed on the body torelieve pain and treatdisease.

Homeopathy is based on the belief that likecures like. Miniscule amounts. In other words, a
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small amount of the substance that would causethe illness is administered to the person with theillness

Homeopathy - is a gently and effective naturalmedical science that recognizes disease as anenergy imbalance, a disturbance of the bodysvital force.

Q: Are there any side effects of homeopathicmedicines? It is a very friendly system of treatment and it


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y y y

is well known that homeopathic medicineshave no harmful side effects.

Q: How long does it take to cure

The treatment time depends on the natureand severity of the case. Usually acute casesrespond earlier whereas chronic cases take

time

Q: Can homeopathy be used alongsideanother treatment system?


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It is generally recommended that only onemedical system be used at a time to avoidany disagreement between the action of

medicines. If medicines from two differentsystems are used simultaneously, they mightneutralize the effects of each other leavingthe patient in disappointment.

Q: Are there specialists for various diseases inhomeopathy? The human body always works as one integrated unit


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while performing any function. None of the majororgans can survive without the active support of other organs. Heart, liver, kidneys, spleen, stomach,brain and all other organs must function as an

integrated whole. If one part (organ) does notfunction properly, other organs will be affected oneway or the other, less or more. Therefore, all of thephysical, emotional and mental symptoms must be

considered together, in totality. This is whathomeopathy does.

Q: What precautions should be taken duringhomeopathic treatment?


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Homeopathic medicines are quite effectivebut there are some precautions that should betaken for better results. It is very importantthat correct diet be taken at least during thetreatment otherwise the medicines might notgive the desired results.


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Generally, any thing that contains Caffeine,Coca (e.g. Coca-Cola), Menthol, Camphor,Peppermint, excessive Salt etc. should beavoided because these may antidote (but notalways) the effects of some homeopathicmedicines. Coffee is one item that needs to beavoided in most of the cases.


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Documents

5 CAM Revised