CAM

Ginger for __________

Ginger: portion of plant used ___________

Origin of Ginger

Ginger MOA

Ginger Efficacy

Ginger Dosage and Standardization

How long before a trip should you take ginger before a trip?

Should you continue to take ginger throughout the trip?

What is the standardization of ginger?

Ginger: AEs

Can ginger be used in pregnancy?

Ginger: Precautions

Contraindications with Ginger

What is the mechanism of action of ginger?

            a.  inhibits GABA receptors

            b.  inhibits serotonin receptors

            c.  inhibits dopamine receptors

            d.  inhibits H2 receptors

Ginger has been shown to:

            a.  prolong the onset of motion-induced nausea

            b.  shorten the recovery time of motion sickness

            c.  be as effective as conventional treatments

            d.  all of the above

Which of the following is not a side effect
of ginger?

            a.  heartburn

            b.  diarrhea

            c.  fatigue

            d.  mouth irritation

Which of the following is a contraindication
for the use of ginger?

            a.  gallbladder disease

            b.  renal insufficiency

            c.  hepatic insufficiency

            d.  pancreatic disease

Phytosterols: History

Phytosterols: Naturally available in

Phytosterols: MOA

Phytosterols: Efficacy

Phytosterols: Dosaged and Standardization

Phytosterols: ADR

Phytosterol: Contraindications

Phytosterol drug interactions

Phytosterol food and supplement interactions

Sitosterolemia and phytosterols

Phytosterols and Beta Carotene

1.     Why are phytosterols not recommended first line for reduction in LDL?

a.     They cause too many side effects

b.     They are a potent CYP P450 inhibitor and therefore interact with many drugs

c.  They do not demonstrate the same capacity to lower lipids as statins

d. They are not manufactured by a large drug
company

1.     Which of the following is false pertaining to phytosterols

A.      They are effective in lowering cholesterol
B.       They are added to many foods
C.     They are not naturally found in many foods
D.      They are recommended by ATP III

1.     At a dose of ­­­_  g/day, phytosterols have been shown to lower LDL concentration by ­_ %.

a.     15 g/day; 10-11%

b.     1.5 g/day; 21-67%

c.    2g/day; 10-11%

d.     10-11 g/day; 2%

1.     Although phytosterols are generally well tolerated, an adverse effect commonly noted in patients is

A. Transient loss of arm
B. Rhabdomyolysis
C. Elevated LFTs
D.  GI upset (nausea, dyspepsia, constipation, flatulence)

1.     Phytosterols supplementation may reduce the absorption and transportation of which of the
following

a.     LDL

b.     HDL

c.     Hydrocarbon carotenes

d.    Both a and c

1.     Phystosteral supplementation should be avoided in which disease states

a.     Diabetes mellitus

b.     Acid reflux

c.     Morbid obesity

d.    sitosterloemia

Curcumin Indication

First use of curcumin

Curcumin MOA

Curcumin efficacy profile

Curcumin AE

Curcumin Contraindications

Curcumin Drug Interactions

Curcumin Food interactions

Curcumin disease interactions

Curcmin Dosing

When should you D/C curcumin? (s/sx)

1.     What is the basic mechanism of action for how curcumin is suspected to reduce the progression of
Parkinson’s Disease?

A.  Decreases oxidative stress to prevent degradation of
dopaminergic neurons

B. Increases oxidative stress to stimulate glutathione conjugates in the liver

C.  Increases intracranial blood flow to increase oxygen supply to the brain

D.  Stabilizes the myelin sheath around neurons to enhance signal transduction 

Which of the following is NOT a contraindication to curcumin?

A. Pregnancy
B. Surgery
C. Hypertension
D. Gastric Ulcers

Which of the following medications would result in a drug-interaction with curcumin?

A. Propranolol
B. Warfarin
C. Amoxicillin
D. Simvastatin

Which of the following clinical trials support the use of curcumin in
Parkinson’s Disease?

A. CIPD (Curcumin in Parkinson’s Disease)
B. TTND (Turmeric Treatment in Neurodegenerative Disorders)
C. CMPHS (Curcumin: Managing Parkinson’s with Herbal Supplementation)
D. None of the above: there are NO clinical trials supporting the use of curcumin in Parkinson’s Disease

Maca Indication

Part of Maca used in medicine

Maca MOA

Maca efficacy profile

Maca compared to conventional medicine

Maca dosage and standardization

Maca AE

Maca’s mechanism of action is which of the following:
a.  unknown
b. stimulates GABA receptors in the brain
c. increases adrenal stimulation of alpha and beta receptors
d. Increases levels of nitrous oxide systemically

Maca’s commonly reported side effects are?
A. hypertension
B.  There are no commonly reported side effects
C. hypotension
D. gastroparesis

Where does Maca originate from?
a. Peru
b. United States
c. Russia
d. China

Maca is used to treat which of the following?
a. Menopause
b. Diabetes
c. Pain
d. Muscle wasting

Saw Palmetto Indication

Saw Palmetto: Part of the plant used

Saw Palmetto MOA

Saw Palmetto Efficacy Profile

Saw Palmetto Dosage and Standardization

Saw Palmetto AE

Saw Palmetto precautions

Saw Palmetto Drug Interactions

Saw Palmetto Lab Test Interactions

Saw Palmetto Interactions with Other CAM

1.   What is the most common use of Saw Palmetto?

a.   pruritus caused from an allergic reaction

b.  memory loss

c.lower urinary tract symptoms associated with benign
prostatic hyperplasia

d. wart caused by tinea pedis

e.   appetite suppressant

1. Which of the following medications is most
likely to interact with Saw Palmetto?

a. metoprolol tartrate
b.carbamazepine
c. fluconazole
d. warfarin
e.none of the above

1.      
What is the most commonly proposed mechanism
of Saw Palmetto?

a.      inhibitor of HMG-CoA reductase

b.     inhibitor of 5-alpha reductase

c.      alpha-2 agonist

d.     inhibition of prostaglandin synthesis

e.     both a & b

Did the systematic review favor Saw Palmetto
for the treatment of BPH?

a.      Yes, because Saw Palmetto proved to be
effective in the treatment of BPH

b.     No, because there are too many risks involved
in using Saw Palmetto

c.     No, the studies in the systematic review did not
favor Saw Palmetto

d.     Yes, but only favored one dosage form of Saw
Palmetto over another

Cranberry Indication

Cranberry Portion Used

Cranberry MOA

Cranberry Juice Efficacy Profile

Dosage and Standardization

Cranberry AE

Cranberry Precautions

Cranberry contraindications

Cranberry Drug Interactions

Cranberry Lab Interactions

Cranberry Disease Interactions

What are possible adverse effects of using cranberry?
A)  Tachycardia
B) Dyspnea
C)  Headache
D) GI side effects

Cranberry is contraindicated in all of the following EXCEPT

a)   Diabetes

b)   Aspirin allergy

c)    History of kidney stones

d)   Penicillin allergy

Which of the following about the effectiveness of cranberry is FALSE?

a)   It is unclear whether cranberry juice and capsule form are equal in effectiveness.

b)   To prevent UTIs an exact dose of cranberry has been recommended.

c)    Some studies have shown a decrease in recurrent UTIs as a result of taking cranberry.  

d)   The Natural Medicines Comprehensive Database has listed Cranberry as “possibly effective” for UTIs.

What is the active ingredient responsible for the MOA of Cranberry against bacterial pathogens?

a)   Anthocyanidins

b)   Fructose

c)    Flavonoids

d)   Water

Fenugreek Indication

Fenugreek MOA

Fenugree Efficacy

Fenugreek Dosage and Standardization

Fenugreek AE

Should Fenugreek be used in pregnant women? nursing women? children?

Fenugreek Drug Interactions

a.     In which of these patients would you most likely recommend the use of fenugreek?
                                                  
i.  Diabetic patient                                            
ii. Pregnant patient                                            
iii. Nursing mother
iv. Pediatric patient

a.     What part of the plant has therapeutic effects?
                       
i.    The leaf                              
ii.    The root                                              
iii.    The stem                                               
iv.    The seed

Which of the following is a common adverse effect of fenugreek?
                                                
i.    Somnolence
                                  
ii.    Muscle cramps
                             
iii.    Tinnitus
                       
iv.    GI upset

In making an argument ‘For’ the use of fenugreek, which of the following is true?
                                          
i.    Fenugreek should always be used in combination
with other diabetic agents.
                                       
ii.    Fenugreek may be used as an oral supplement to lower blood glucose and HgbA1c and to increase insulin sensitivity.
                                           
iii.    Fenugreek will have no effect on PPG if mixed
with food and consumed.
       
iv.    Fenugreek may be used as an oral supplement to lower blood glucose and HgbA1c, but it will decrease insulin
sensitivity.

Cat's Claw for _________

Part of Cat's Claw used for medicinal purposes

Cat's Claw MOA

Cat's Claw Efficacy

Cat's Claw Dosage and Standardization

Cat's Claw AE

Cat's Claw in Pregnancy?

Cat's Claw Contraindications

Cat's Claw Precaution

Cat's Claw Drug Interactions

In what formulations is Cat’s Claw Prepared
                             
i.    Liquid extracts
                          
ii.    Capsules
  
iii.    Teas

iv. All of the above

Cat’s claw should be discontinued _________ before medical or dental procedure.
                      
i.    3 days
                
ii.    1 week
               
iii.    14 days
                
iv.    1 month

Which medications interact with Cat’s Claw?

i.    Antibiotics

ii.    Antipsychotics
  
iii.    Oral contraceptive
    
iv.    Anticoagulants

Cat’s Claw was proposed for the use in what ailment?
                 
i.    Acne
                       
ii.    Osteoarthritis
                  
iii.    Hepatitis
                
iv.    ADHD

Chasteberry for ___________

Portion of chasteberry used

Chasteberry MOA

Chasteberry Active Ingredients

Chasteberry Efficacy Profile

Chasteberry Standardization

Chasteberry Dosage

Chasteberry in pregnancy?

Chasteberry AE

Chasteberry Drug Interactions

Chasteberry Disease Interactions

Vitex agnus-castus (chasteberry) affects all of the
following hormones and neurotransmitters except:

1. Dopamine

2. Serotonin

3. Prolactin

4. Acetylcholine

What is the most common indication for chasteberry?

1. Benign prostatic hyperplasia (BPH)

2. Insect repellant

3. Menopause

4. Premenstrual syndrome (PMS)

Chasteberry should be avoided during in-vitro fertilization because:

1. Chasteberry causes the death of sperm cells

2. Chasteberry causes potential hyperstimulation syndrome that terminates viable embryos

3. Chasteberry has potential effects on estrogen levels

4. Chasteberry’s dopaminergic effects cause spontaneous abortion

All of the following medications interact with chasteberry except:

1. Metoclopramide

2. Antipsychotics

3. Birth controls

4. Antihypertensives

Zinc for ________

Zinc MOA

Zinc Efficacy