McKenna's Pharmacology for Nursing, 2e

Appendix F these substances. The power of believing that some- thing will work and that there is some control over the problem is often beneficial in achieving relief from pain or suffering. Some of these substances may contain yet-unidentified ingredients that eventually may prove useful in the modern field of pharmacology. Because these products are not regulated or monitored, there is always a possibility of toxic effects. Some of these products may contain ingredients that interact with prescription drugs. A history of the use of these alter- native therapies may explain unexpected reactions to some drugs.

Complementary and alternative (CAM) therapies

M any dietary supplements and “natural” remedies are used by the public for self-treatment. These substances, many derived from the folklore of various cultures, commonly contain ingredients that have been identified and that have known therapeutic activities. Some of these substances have unknown mecha- nisms of action but over the years have been reliably used to relieve specific symptoms. There is an element of the placebo effect in using some of

■■ TABLE F Complementary and alternative therapies (continued) Substance Reported uses and possible risks

acidophilus

Oral: prevention or treatment of uncomplicated diarrhoea Decreased effectiveness of warfarin

(probiotics)

alfalfa

Topical: healing ointment, relief of arthritis pain Oral: treatment of arthritis, hot flushes; strength giving; reduction of cholesterol level Increased risk of bleeding with warfarin ; increased photosensitivity with chlorpromazine ; increased risk of hypoglycaemia with oral hypoglycaemic agents ; loss of effectiveness with hormonal contraceptives or hormone replacement

allspice

Topical: anaesthetic for teeth and gums; soothes sore joints and muscles Oral: treatment of indigestion, flatulence, diarrhoea, fatigue Risk of seizures with excessive use; decreased iron absorption

aloe leaves

Topical: treatment of burns, healing of wounds Oral: treatment of chronic constipation Caution: oral use may cause serious hypokalaemia; risk of spontaneous abortion if used in third trimester

androstenedione

Oral, spray: anabolic steroid to increase muscle mass and strength Caution: may increase risk of cardiovascular disease and certain cancers

angelica

Oral: “cure all” for gynaecological problems, headaches, backaches, loss of appetite and gastrointestinal spasms; increases circulation in the periphery Risk of bleeding if combined with anticoagulants

anise

Oral: relief of dry cough, treatment of flatulence May increase iron absorption and cause toxicity Oral: control of blood glucose, constipation May interfere with oral hypoglycaemic agents

apple

arnica

Topical: relief of pain from muscle or soft-tissue injury Oral: immune system stimulant May decrease effects of antihypertensives and increase effects of anticoagulants and platelet drugs ; very toxic to children Oral: to improve mental and physical functioning; general tonic; to protect cells during cancer chemotherapy and radiation therapy May increase bleeding with anticoagulants ; may interfere with thyroid replacement therapy; discourage use during pregnancy and breastfeeding Oral: to increase stamina, energy; to improve immune function, resistance to disease; to treat upper respiratory tract infection, common cold May increase effects of antihypertensives ; caution against use during fever or acute infection

ashwagandha

astragalus