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1 Unit 2:Assignment CAM Paper Lauren Lane Herzing University NU636 Professor Glass May 21st, 2023
2 Introduction Complementary and alternative medicine also known as CAM, is known as a medical practice that is not the normal standard of care. CAM has been more frequently used and tested due to the effectiveness. According to the NHIS Health Interview Survey, about thirty-eight percent of adults are using complementary and alternative medicine. CAM can be combined with normal medicine for increased effectiveness. Complementary medicine can be used with conventional medicine to treat a patient (CDC et al.,2022). Compared to alternative medicine, it is used to treat a patient alone compared to combining it with standard treatment. Examples of CAM include, but not limited to acupuncture, yoga, herbs, and healing practices. Many of these practices are used to treat a wide spread of the human body. Throughout this breakdown the focus will be on the cardiovascular system. CAM can be used to treat a wide spread of cardiovascular diseases with examples CAM including, Ginseng, Hawthorn, L-Arginine, and St-John's worts. These types of CAM can individually affect the cardiovascular system and work in combo with other standards of care to treat the patient effectively. Although, there are many benefits with using these types of CAMs there are risks and adverse effects. As a nurse, education with these types of treatments are very important and will be discussed throughout this breakdown (CDC et al.,2022). Ginseng Ginseng is a well known alternative medicine that started in China. Ginseng started in the Han dynasty era and has continued to be used in today’s century. Ginseng is described as a herb and also named the “man-root due to its shape. This type of herb is used for multiple diseases and treats a variety of patients. Throughout this breakdown will focus on the cardiovascular system. Ginseng is extracted and prepared with water, ginseng can be bought over the counter and a variety of stores. Ginseng can affect patients who are diagnosed with a wide variety of
3 cardiovascular diseases. Cardiovascular diseases can be defined as, a disease that involves the heart and/or the blood vessels. Blood flow to rang part of the body can be disrupted due to these diseases. Thrombosis can occur and atherosclerosis which is hardening of the arteries. Ginseng can affect the cardiovascular system by treating and preventing atherosclerosis and coronary heart disease. Ginseng can affect the gene regulation with atherosclerotic and improve lipid count. Studies have shown that ginseng has improved the lipid count by reducing cholesterol concentrations in the blood (CDC et al., 2022). Also, Ginseng can reduce superoxide dismutase and catalase levels in the blood. Although there are many benefits of using Ginseng there are side effects and risks such as increased heart rate and increased blood pressure. When used on the skin it can cause irritation and inflammation (Liu et al.,2022). When taken orally, can cause trouble sleeping and can cause a rash. Looking at the cardiovascular effects, it can affect the heart rhythm and blood pressure. Patient education with this type of CAM should include, when to take it, the risks and benefits. Also, to discuss with the patient if the benefits outweigh the risks (Liu et al.,2022). Hawthorn Similar to ginseng, hawthorn can affect the body, especially the cardiovascular system. Hawthorn is a plant that deprived from a tree in the rose family. Similarly, to ginseng it helps in cardiovascular diseases such as coronary heart disease, peripheral arterial disease, and aortic disease. Hawthorn the plant can be found in temperate areas such as North American, Asia, North Africa, and parts of Europe( Hawthorn et al.,n.d). Although hawthorn has positive effects in the cardiovascular system it can also be used in the digestive system and assist in patients with anxiety. Hawthorn has shown in studies to assist in treating patients with heart failure. Patients with heart failure are having trouble pumping the adequate amount of blood to the body as it should be (U.S. Department). A study done by Cloud, showed when a patient takes hawthorn
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4 over several weeks, significantly lowered the participants blood pressures. Another study showed, taking 900 mg a day for the span of two months had similar effects to heart failure medication named captopril (Cloud et al.,2020). The anticipated benefits to using hawthorn are shown to be an anti-inflammatory, assist in cardiovascular disease as stated above and in the digestive system. With any of use of CAMs come risks and possible adverse effects. Possible interactions if patient's are taking digoxin include, increased sensitivity to digoxin leading to digoxin toxicity.Similarly to digoxin, when a patient is on a beta blocker and taking hawthorn it will increase the effects of the beta-blocker. Other side effects include nausea, dizziness, and other digestive systems. Patient education for hawthorn includes, to not take when breastfeeding or currently pregnant and to not give to children. Similarly, to always discuss with a physician to see if the negatives outweigh the positives of using hawthorn (Zhang et al.,2022). L-Arginine L-Arginine is a type of amino acid that is associated with proteins. L-Arginine is derived from glutamine, glutamate, and proline. Similarly, two types of CAMs discussed above L-Arginine have been tested to improve a patient's cardiovascular system. Similarly, to other types CAMs it can be treated in many types of cardiovascular diseases. Cardiovascular disease that L-Arginine can treat is hypertension, atherosclerosis, heart failure, and ect. L-arginine is made in multiple ways, the most common is most mammals that can synthesize amino acids from proteins ( Frontiers et al., 2020) . Another way, it can be found in dairy, nuts, soy products, and fish. Looking at dosing of L-arginine, patient's can be dosed anywhere between six grams to thirty grams a day. Looking at a study done by Attila, showed over a four week period of time with patients with chest pain who took L-arginine that it significantly improved their chest pains ( Cziráki et al.,2020) . Another study showed the use of L-Arginine and the reduction of hypertension. The benefits as discussed above include, the reduction of chest pain and
5 hypertension. Risks and adverse effects that patients should be well aware of prior to taking L-Arginine supplements are GI upsets, gout, headache, and possibly make asthma symptoms more aggravated. A provider should educate a patient on possible adverse reactions and interactions with other medications the patient may be on. Possible interaction that should be educated include, if the patient is on any blood thinners L-arginine could increase the chance of bleeding. Another interaction include, is the use of Isuprel, if the patient is already taking this medication combining it with L-arginine could cause the patient's to become hypotensive. As stated, above with all CAMS the provider should educate the patient with the pros and cons of taking this type of CAM ( Mayo et al.,2021) . St.John’s wort St.John’s wort similar to other types of CAMS a derived from a type of flower that was found in European countries. St.John’s wort has been used for decades to treat a variety of diseases. Diseases including, insomnia, wound healing, depression, and the kidneys. In this discussion about this type of CAM will focus on the cardiovascular system. There have been studies shown that St.John's wort increases brain activity releasing serotonin. A study done by Fisher, showed that the use of St.john's wort to treat depression caused supraventricular tachycardia also known as SVT. SVT occurs when the patient has an increased heartbeat that will develop when normal electrical impulses of the heart are obstructed ( Fisher et al.,2021) . Although, as discussed above many of the CAMs have positive impacts on the cardiovascular systems however, some do not. In this study, a thirty-three year old female patient who started St.John's wort to treat patients started to have recurring heart palpitations. Benefits of taking St.Johns wort include, assistance in treating menopausal symptoms, insomnia, wound healing, and depression. With every CAM come with side effects and adverse reactions, this includes increased sensitivity to light, dry mouth, fatigue, and headache. Education for taking St.Johns wort include, having regular blood work down such as serotonin levels. Taking st.john's wort can
6 decrease the effects of some medications including clozapine and benzodiazepines ( U.S. Department et al.,2020) . Conclusion To conclude, complementary and alternative medicine are known as medical practices that are not the normal standard of care. When a patient combines normal standards of practices and complementary and alternative medicines can increase the effectiveness of their treatments. Starting off with a type of CAM called Ginseng, this type of CAM affects gene regulation with patients who have atherosclerosis. Studies have shown that ginseng has improved the patient's lipid count by reducing cholesterol concentrations in the blood. Another positive about Ginseng is it reduces the catalase levels in the blood (Liu et al.,2022) .Another type of CAM discussed above was h awthorn, this type of cam is used in patients with heart failure. A study discussed above, showed patients with heart failure taking this type of CAM had significantly lower blood pressure (Cloud et al.,2020). Another CAM discussed was L-Arginine, patient's who were given between six grams to thirty grams a day had improvement in their chest pains ( Cziráki et al.,2020) . . Lastly, St.John's wort is a type of CAM that was shown to have negative effects on the cardiovascular system. Patient's who were taking this type of CAM to treat depression showed a chance of getting supraventricular tachycardia ( Fisher et al.,2021). As discussed above, all types of CAMS need to be reviewed by each patient's individual physician to make a care plan best suited for a patient.
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7 Work cited Centers for Disease Control and Prevention. (2022, June 9). Complementary and alternative medicine . Centers for Disease Control and Prevention. Liu, L., Hu, J., Mao, Q., Liu, C., He, H., Hui, X., Yang, G., Qu, P., Lian, W., Duan, L., Dong, Y., Pan, J., Liu, Y., He, Q., Li, J., & Wang, J. (2022, November 24). Functional compounds of ginseng and ginseng-containing medicine for treating cardiovascular diseases . Cloud, A., Vilcins, D., & McEwen, B. (2020). The effect of hawthorn (Crataegus spp.) on blood pressure: A systematic review. Advances in Integrative Medicine , 7 (3), 167–175 Hawthorn . Mount Sinai Health System. (n.d.). Zhang, J., Chai, X., Zhao, F., Hou, G., & Meng, Q. (2022). Food Applications and Potential Health Benefits of Hawthorn. Foods (Basel, Switzerland) , 11 (18), 2861. U.S. Department of Health and Human Services. (n.d.). Hawthorn . National Center for Complementary and Integrative Health. Frontiers | L-arginine-nitric oxide-asymmetric dimethylarginine pathway ... (2020, June) Cziráki, A., Lenkey, Z., Sulyok, E., Szokodi, I., & Koller, A. (2020). L-Arginine-Nitric Oxide-Asymmetric Dimethylarginine Pathway and the Coronary Circulation: Translation of Basic Science Results to Clinical Practice. Frontiers in pharmacology , 11 , 569914. Mayo Foundation for Medical Education and Research. (2021, February 4). L-arginine . Mayo Clinic.
8 Fisher, K. A., Patel, P., Abualula, S., & Concepion, L. (2021, April 7). St. John's wort-induced supraventricular tachycardia . Cureus. U.S. Department of Health and Human Services. (2020, October). St. John’s wort . National Center for Complementary and Integrative Health.