Unit VI – Herbal / Pharmacological

• Readings for Unit V: Systems II: Text 8 (166-176) & 11

Links on Easing Cancer Pain & Reflex

• Unit VI: Herbal / Pharmacological & ‘Unconventional’ (drugs, vaccines) Approaches

Readings for Unit VI

• Links re Pharmacological/Herbal: Herbal Minefield by Barrett

Herbal Remedies: Adverse Effects and Drug Interactions

Herbal 'Health' Products: What Family Physicians Need to Know

• Text: 5 – Botanical Medicine 6 – Safety of Herbs & Phytochemicals 7 – Integrative Approach to Nutrition

Text chapters 8 & 11

• Straightforward ?

• 8 re Osteopathy fits nicely with Taylor session [ all of his slides are posted ]

• 11 is re body centered therapies – focus on the use, evidence, practice for therapies discussed

Easing Cancer Pain & Anxiety

• What does dealing with pain demand?• Pain prevalence with cancer?• How good is the empirical evidence

for pain relief with holistic therapies ?• What does Reflexology do for pain &

anxiety ?• For pain / anxiety from lung and/or

breast cancer, what does the study by N.C. research team show ?

Reflexology

• Any different theories behind Reflexology mentioned here ?

• Instruments used ?• Techniques can be learned and self

administered, any flag here ?• What evidence is offered re

“scientists” studying health problems like IBS or MS?

• Do you believe the findings of this article, why or why not ?

Drugs are THE answer

• What drugs do you (your “friends”?) use, OCD’s, herbal, legal, illegal ? ~ make a list

• Why do you / they use them ?

• What do you know about them ?

Herbal Gardens

At Issue…

• $3.8 billion self-care health products industry in Canada

                                           

Too available ?

Chemicals in plants ?

• chemical constituents of plants vary depending on: ~ species; variety; part of the plant

~ conditions of growth (soil, water, & temp)

~ age of the plant• These complexities and variations of

chemical content make standardization essential

• some cases standardization is attempted, but it is difficult and seldom accomplished [ compare to Barrett, Herbal Minefield reading re drug companies going for potency, predictability, & few side effects ]

Herbal / Pharmacological

• Are they safe just because they come from plants ?

• Fully 1/3 of North American population uses herbs for health purposes

• Chamomile, Flavonoids, Garlic, Gingko biloba …

Usage Patterns in Canada

• Largest user group: women 36 – 55 ( almost 40% )

• Women use more than men• B.C. region clearly has the most users• Longevity of users -- 5 years or less• 41.5% (2003) of users said they take

herbal or homeopathic remedies on a daily basis

Usage Patterns in Canada

• Most frequent reasons for use : to alleviate symptoms of a specific illness or disease, and / or to prevent illness or disease

• Family / friend main influence on decision to use

• Drugstores are main point of sale

Grow, Grow… Stall

0

5

10

15

20

25

30

35

Use of "Herbal" Remedies

1996199719981999

Taken from: Waiting for the Sheriff: From growth to uncertainty in the NHP market, NDMAC Issue Seminar -- March 22, 2000

Between 1996 and 1998, usage of “herbal” remedies more than doubled, but

there has been a levelling-off.

Herbal / Pharmacological

• High blood pressure

• Diabetes • Thyroid problems • Heart disease • Psychiatric

problems • Epilepsy

• Parkinson's disease • Glaucoma • Enlarged prostate

gland • Stroke at some

time in the past • Blood clotting

problems

Are they safe just because they come from Are they safe just because they come from plants ? Maybe no, IF you haveplants ? Maybe no, IF you have

ephedra

ephedra

Ephedra

• º Clinical Summary º Scientific Name º Also Known As º Brand Name º Purported Uses º Constituents º Mechanism of Action 

• ºPharmacokinetics  º Warnings  ºContraindications  º Adverse Reactions  º Drug Interactions  º Lab Interactions  º Literature Summary and Critique  

Effectiveness of Herbal Medicines

• To establish the effectiveness of herbs as medicines, they must be tested in prospective, double blind, randomized, placebo-controlled clinical trials (RCTs)

• Relatively few herbs have been tested in this manner

Non-prescription drug makers association of Canada

Natural Health Products -Mission Statement

Natural Health Products DirectorateHealth Products and Food Branch, Health Canada

To ensure that all Canadians have ready access to Natural Health Products that are safe, effective, and of high quality, while respecting freedom of choice and philosophical and cultural diversity

Your job for 1 Week Today

• Text p 116 has 10 clinically researched botanicals

• Using web sites, our text, what you know about nature of evidence, data bases, NHP data, & any other original sources of evidence, find out everything you can about the botanical assigned to you

• Groups

Botanical Groups

• Cohosh: Abu-Romeh to Blanchette – 1

• Chamomile: Blommers to Connor – 2

• Chaste tree: Crowther to Eastwood – 3

• Echinacea: Fabian to Geddis – 4

• Garlic: Girvan to Hudders – 5

• Ginkgo: Jagielnik to Korczynski – 6

• Ginseng: Kusmider to Mazur – 7

• Saw Palmetto: McDonagh to Persico – 8

• Milk Thistle: Pone to Sklazeski – 9

• St John’s Wort: Snider to Zettler – 10

What are you to find out ?

• What is it ?• Where is it found ?• How prevalent ?• What is it used for and by

whom ?• What does Barrett (Quackwatch)

say about it ?• Evidence – what kinds, be critical• Would you take it ?