Complementary Medicines Answers 2007

1. A 28 year old female customer asks for your advice about using cranberry for a urinary tract infection. She explains she has a urinary tract infection, the third one she has experienced this year.

a) Would cranberry be suitable as a treatment for the urinary tract infection?

b) What advice would you give the customer about the suitability of using cranberry for treatment and prevention of urinary tract infections?

c) What kinds of cranberry products are available?

2. A number of reports of drug interactions involving the herb St John’s wort have appeared in the medical literature.

a) When taken orally, preparations containing St John’s wort have been found to reduce the plasma concentrations of a range of conventional drugs including digoxin, indinavir and cyclosporin. What are the two mechanisms by which St John’s Wort may reduce the plasma concentration of these other drugs?

b) There have also been reports of St John’s wort causing “serotonin syndrome” when it has been used in conjunction with selective serotonin reuptake inhibitors (SSRIs). Explain the mechanism by which this is thought to occur.

c) Why might a change from one brand of St John’s Wort to another affect the extent of the interaction with another drug?

3. Different types of ginseng including Korean ginseng (Panax ginseng) and Siberian ginseng (Eleutherococcus senticosus) are sometimes used as “adaptogens”. What do you understand by the term “adaptogen”?

4a. What do you understand by the term “phytoestrogen”?

4b. Why are products containing isoflavones promoted for the relief of menopausal symptoms?