| Term 
 
        | What is complementary medicine? |  | Definition 
 
        | used together with conventional medicine |  | 
        |  | 
        
        | Term 
 
        | What is alternative medicine? |  | Definition 
 
        | used in place of conventional medicine |  | 
        |  | 
        
        | Term 
 
        | What is integrative medicine? |  | Definition 
 
        | combines treatments from conventional medicine and CAM; high-quality evidence of safety and efficacy |  | 
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        | Term 
 
        | What percent of out-of-pocket health care dollars are spent on alternative medicine? |  | Definition 
 | 
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        | Term 
 
        | How are dietary supplements regulated? |  | Definition 
 
        | as foods not as drugs (no FDA oversight); as long as they don't claim to treat a disease and haven't been proven to cause harm, they don't need FDA oversight |  | 
        |  | 
        
        | Term 
 
        | What organization does most of the legitimate research on complementery medicine? |  | Definition 
 
        | National Center for Complementary adn Alternative Medicine; a compoenent of the National Institutes of Health |  | 
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        | Term 
 
        | What percent of U.S. adults have ever used CAM? |  | Definition 
 | 
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        | Term 
 
        | What is the most commonly used natural product? |  | Definition 
 | 
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        | Term 
 
        | What is the disease for which CAM is most frequently used among adults? |  | Definition 
 | 
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        | Term 
 
        | Where in your diet do omega-3 fatty acids come from? |  | Definition 
 
        | fish oil and certain plants or nut oils |  | 
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        | Term 
 
        | Why are fish oils so important to have in your diet? |  | Definition 
 
        | humans do not produce omega-3 FA |  | 
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        | Term 
 
        | Name the omega 3s in fish oils. |  | Definition 
 
        | Docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) |  | 
        |  | 
        
        | Term 
 
        | What is the omega 3 fatty acid in english walnuts and vegetable oils (canola, soybeen, flaxseed/linseed, olive)? |  | Definition 
 
        | alpha-linolenic acid (ALA) |  | 
        |  | 
        
        | Term 
 
        | Whey should omega 6 fatty acids be avoided? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the positive effects of taking fish oils/omega 3s? |  | Definition 
 
        | effective for high triglycerides (may reduce levels by 20-50%); may reduce death due to heart disease |  | 
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        | Term 
 
        | Fish oils/omega 3 fatty acids are possibly effective for what kinds of diseases? |  | Definition 
 
        | elevated cholesterol, atherosclerosis, high blood pressure, stroke, rheumatoid arthritis, osteoporosis, Raynaud's syndrome ADHD, endometrial cancer, ADHD, IgA nephropathy, reducing renal injury by cyclosporine, bipolar disease, age-related macular degeneration |  | 
        |  | 
        
        | Term 
 
        | How often should you eat fish? |  | Definition 
 | 
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        | Term 
 
        | What is the minimal effective dose of EPA + DHA for TG reduction? |  | Definition 
 | 
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        | Term 
 
        | 2-4 grams of omega 3/day decreases TGs by ____%. |  | Definition 
 | 
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        | Term 
 
        | How much is in each pill of omega 3s? |  | Definition 
 
        | usually 120 DHA and 180 EPA/1 gm caps; would need 7-13 caps/day for 2-4 gms per day |  | 
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        | Term 
 
        | Should Cod liver oil be recommended to help patients reduce their TGs? |  | Definition 
 
        | not really; need a large amount to achieve effective doses and this could lead to toxic levels of vitamin A |  | 
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        | Term 
 
        | What are the side effects of taking omega 3s? |  | Definition 
 
        | allergies to fish or fish products (nuts), increases in blood sugar, bleeding potential, increasing levels of low-density lipoproteins, potentially harmful contaminants (dioxins, mercury, polychlorinated biphenyls [PCBs]), GI upset (common), diarrhea, reflux, burping, small reductions in BP, vitamin E deficiency potential with long-term use |  | 
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        | Term 
 | Definition 
 
        | substrate for glycoaminoglycans and hyaluronic acid backbone for proteoglycans |  | 
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        | Term 
 
        | What is chondroitin sulfate? |  | Definition 
 
        | a glycoaminoglycan that has a role in cartialge formation through stimulation of chondrocyte metabolism and synthesis of collagen and proteoglycan; inhibits destructive synovial enzymes |  | 
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        | Term 
 
        | What is glucosamine and condroitin used for? |  | Definition 
 
        | osteoarthritis (knee and hip), chronic venous insufficiency, inflammatory, bowel disease, leg pain, rheumatoid arthritis, temporomandibular joint disorders |  | 
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        | Term 
 
        | Is glucosamine and chondroitin effective for treating osteoarthritis of the knee? |  | Definition 
 
        | no but combination may be effective in some patients with moderate to severe knee pain |  | 
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        | Term 
 
        | Patient should not take glucosamine if they have allergies to... |  | Definition 
 
        | shellfish or iodine because glucosamine may be made from shells of shrimp, crabs, and other shellfish |  | 
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        | Term 
 
        | What are the side effects/cautions of glucosamine/chondroitin? |  | Definition 
 
        | dyspepsia, nausea, H/A, drowsiness, insomnia, skin reactions, sun sensitivity, temporary increases in BP and heart rate (palpitations), increased risk of cateract formation in animals, may increase risk of bleeding, may cause proteinuria |  | 
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        | Term 
 
        | Which patients should be monitored if they are on glucosamine/chondroitin? |  | Definition 
 
        | type 2 diabetics because it can increase their blood sugar |  | 
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        | Term 
 
        | What drug interactions occur with glucosamine/chondroitin? |  | Definition 
 
        | may decrease effectiveness of all hypoglycemics, NSAIDS bleeding risk, diuretics may increase side effects |  | 
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        | Term 
 
        | What's another common name for echinacea? |  | Definition 
 
        | purple or american coneflower |  | 
        |  | 
        
        | Term 
 
        | What is the most commonly used species of echinacea? |  | Definition 
 
        | echinacea purpurea (not angustifolia or pallida) |  | 
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        | Term 
 
        | What is echinacea used for? |  | Definition 
 
        | stimulate the immune system to fight infections; traditionally used to treat or prevent colds, flu or other infections; less commonly used for treating wounds and skin problesm like acne and superficial skin abscesses |  | 
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        | Term 
 
        | What part of the purple coneflower are used? |  | Definition 
 
        | above ground parts and roots |  | 
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        | Term 
 
        | Does echinacea work to prevent or shorten the course of URIs? |  | Definition 
 | 
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        | Term 
 
        | What are the side effects of taking echinacea? |  | Definition 
 
        | GI side effects; some experience alelrgic reactions such as rashes, increased asthma, and anaphylaxis |  | 
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        | Term 
 
        | Why should you not use echinacea for more than 8 weeks at a time? |  | Definition 
 
        | can possibly supress the immune system |  | 
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        | Term 
 
        | What's another name for flaxseed? |  | Definition 
 | 
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        | Term 
 
        | What is 5-50 mg flaxseed oil used for? |  | Definition 
 
        | laxative; tx of hot flashes and mastalgia; hyperlipidemia |  | 
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        | Term 
 
        | Wat is 3-10 grams of flaxseed oil per day used for? |  | Definition 
 
        | topical demulcent and emollient, coughs, colds, arthritis and hyperlipidemia |  | 
        |  | 
        
        | Term 
 
        | What's the difference between flaxseed oil and flaxseed posder? |  | Definition 
 
        | flaxseed oil does NOT contain lignans which are phytoestrogens |  | 
        |  | 
        
        | Term 
 
        | How does flaxseed act as a laxative? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Does flaxseed oil lower cholesterol? |  | Definition 
 
        | mixed results; it contains alpha linolenic acid which may benefit heart disease but there is not enough reliable data |  | 
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        | Term 
 
        | T/F Flaxseed oil/pills helps treat hotflashes. |  | Definition 
 
        | we don't know; there have been mixed results |  | 
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        | Term 
 
        | What are the side effects of flaxseed oil/pills? |  | Definition 
 
        | should be taken with plenty of water otherwise will worsen constipation and there have been rare cases of intestinal obstruction; fiber may also reduce medication absorption |  | 
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        | Term 
 
        | Which ginseng is not a true ginseng? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is Ginseng used for? |  | Definition 
 
        | supporting overall health, boosting immune system, increasing sense of well-being and stamina, improving mental and physical eprformance, treating erectile dysfunction, menopausal symptoms, hep C, lower blood glucose and controlling hypertension |  | 
        |  | 
        
        | Term 
 
        | Which part of the ginseng plant is used? |  | Definition 
 
        | the root is dried and used in various products such as tablets or capsules; extracts and teas and creams |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | it may lower blood glucose or help immunity; most research is inconclusive |  | 
        |  | 
        
        | Term 
 
        | What should you tell patients to avoid side effects of ginseng? |  | Definition 
 
        | limit use to 3 months because of development of side effects |  | 
        |  | 
        
        | Term 
 
        | What are the most common side effects of taking ginseng? |  | Definition 
 
        | headaches, sleep and GI problems, allergic reactions, breast tenderness, menstrual irregularities, HBP, low blood sugar |  | 
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        | Term 
 
        | Diabetics on ginseng should use extra caution when taking Ginseng with other herbs that lower blood sugar such as... |  | Definition 
 
        | bitter melon and fenogreek |  | 
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        | Term 
 
        | What is ginkgo biloba used to treat? |  | Definition 
 
        | asthma, bronchitis, fatigue, tinnitus, improve memory, Alzheimers (treatment and prevention), other dimentia, decrease intermittent claudication, sexual dysfunction, multiple sclerosis |  | 
        |  | 
        
        | Term 
 
        | Ginkgo biloba has shown promising results in treating... |  | Definition 
 
        | Alzheimer's, dementia, claudication, tinnitus, memory enhancement |  | 
        |  | 
        
        | Term 
 
        | What are the side effects and cautions to take when using ginkgo biloba? |  | Definition 
 
        | headache, nausea, GI upset, diarrhea, dizziness, allergic skin reactions, may increase bleeding risk |  | 
        |  | 
        
        | Term 
 
        | Ginkgo biloba should be used with caution with what other drugs/medical situations? |  | Definition 
 
        | caution with anticoagulants, bleeding disorder, surgery or dental procedures |  | 
        |  | 
        
        | Term 
 
        | Why must care be taken in the preparation of ginkgo biloba? |  | Definition 
 
        | uncooked seeds cotain ginkgotoxin which can cause seizures (roasted seeds can be dangerous); leaf and leaf extracts contain little ginkgotoxin |  | 
        |  | 
        
        | Term 
 
        | What is the latin name for garlic? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are garlic supplements used to treat? |  | Definition 
 
        | hypercholesterolemia, heart disease (CAD), hypertenion, prevention of stomach and colon cancer |  | 
        |  | 
        
        | Term 
 
        | Is garlic useful in treating high cholesterol, high blood pressure, and cancers? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | In what form does garlic have the worse side effects? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the side effects of garlic supplements? |  | Definition 
 
        | breath and body odor, dyspepsia, GI upset, allergic reactions, similar effects as aspirin in platelet function |  | 
        |  | 
        
        | Term 
 
        | In what clinical situations does it matter if a patient is taking garlic? |  | Definition 
 
        | during surgery, post-operative, dental procedure or if they have a bleeding disorder; discontinue at least one week prior to surgery; interferes with efficacy of saquinavir |  | 
        |  | 
        
        | Term 
 
        | What is the funciton of coenzyme Q-10? |  | Definition 
 
        | involved in mitochondrial electron transport and oxidative phosphorylation (endogenous antioxidant) |  | 
        |  | 
        
        | Term 
 
        | Where are concentrations of coenzyme Q-10 highest and lowest in the body? |  | Definition 
 
        | highest in the heart, liver, kidney and pancreas; lowest in the lung |  | 
        |  | 
        
        | Term 
 
        | What is the scientific name for coenzyme Q-10? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is coenzyme Q-10 used for? |  | Definition 
 
        | ischemic heart disease including intra-operative cardiac ischemia, congestive heart failure, toxin induced cardiomyopathy, hypertension and to stimulate the immune system |  | 
        |  | 
        
        | Term 
 
        | What are the benefits of taking coenzyme Q-10? |  | Definition 
 
        | improves symptoms and status of patients with CHF; improved symptomatic mitral valve prolapse, some benefit in patients with drug-induced cardiotoxicity, some improvement in immune function |  | 
        |  | 
        
        | Term 
 
        | What supplement is thought to be helpful in preventing/reversing statin-associated myopathy? |  | Definition 
 
        | coenzyme Q-10 but studies are not conclusive |  | 
        |  | 
        
        | Term 
 
        | What are the side effects of coenzyme Q-10? |  | Definition 
 
        | insomnia, nausea, upper abdominal pain, elevated liver enzymes |  | 
        |  | 
        
        | Term 
 
        | Which patients should not take coenzyme Q-10? |  | Definition 
 
        | those that are pregnnat or nursing because it has not been studied in those situations |  | 
        |  | 
        
        | Term 
 
        | What are the drug interactions of coenzyme Q-10? |  | Definition 
 
        | may decreasethe effects of warfarin |  | 
        |  | 
        
        | Term 
 
        | What are some other names for St. John's wort? |  | Definition 
 
        | hypericum, klamath weed, goat weed, hypericum perforatum |  | 
        |  | 
        
        | Term 
 
        | What is St. Johns wort used to treat? |  | Definition 
 
        | ancient times= sedative, malaria, balm for wounds, burns, and insect bites now= depression, anxiety, sleep disorders
 |  | 
        |  | 
        
        | Term 
 
        | Is St. Johns wort effective in treating depression? |  | Definition 
 
        | may treat mild to moderate depession but no more effective than placebo in treating major depression of moderate severity |  | 
        |  | 
        
        | Term 
 
        | What are the side effects of St. John's wort? |  | Definition 
 
        | increased sensitivity to sunlight, anxiety, dry mouth, dizziness, GI symptoms fatigue, headache, sexual dysfunction, |  | 
        |  | 
        
        | Term 
 
        | By what mechanism does St. John's wort intefere with other drugs? |  | Definition 
 
        | may speed or slow other drugs metabolism through the induction of cytochrome P450 3A4 and drug pump P-glycoprotein |  | 
        |  | 
        
        | Term 
 
        | What drugs interact with St. John's wort? |  | Definition 
 
        | combined with SSRIs may increase side effects, indanavir and other HIV drugs, trinotecan and other anti-cancer drugs, cyclosporin for preventing transplant rejection, digoxin, warfarin and related anticoagulants, oral contraceptives |  | 
        |  | 
        
        | Term 
 
        | What are other names for saw palmetto? |  | Definition 
 
        | american dwarf palm tree, cabbage palm, serenoa repens, sabal serrulata |  | 
        |  | 
        
        | Term 
 
        | What is saw palmetto used for? |  | Definition 
 
        | mainly for urinary symptoms associated with BPH, chronic eplvic pain, prostate cancer, bladder disorders, decreased libido, hair loss, hormone imbalances |  | 
        |  | 
        
        | Term 
 
        | Is saw palmetto effective? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the side effects of saw palmetto? |  | Definition 
 
        | mild stomach discomfort, tender breasts and decline in sexual desire |  | 
        |  | 
        
        | Term 
 
        | What is the MOA of red yeast rice? |  | Definition 
 
        | contain monacolins with inhibits cholesterol synthesis |  | 
        |  | 
        
        | Term 
 
        | How effective is red yeast rice? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the side effects of red yeast rice? |  | Definition 
 
        | dyspepsia, muscle pain injury |  | 
        |  |