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Functional Medicine: Conventional Medications

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Functional Medicine: Conventional Medications 7/27/2021 2 Goal for this presentation This webinar is designed for hospice providers who are accepting patients on “natural” products who have a different mindset concerning Functional Medicine: conventional medications. This program will provide an overview of functional medicine which Benefits for the Hospice addresses the underlying causes of diseases or symptoms using a patient- Patient centered approach and what hospice also has in common with this approach. Jenna Head BS, RPH, BCGP We will also explore alternative agents used to palliate common symptoms at end of life, as well as manage side effects of commercially available medications. 1 2 3 4 Webinar Objectives Disclosures The presenter has no relevant financial relationships with • Define Functional Medicine and compare with manufactures of any commercial products discussed in this presentation. conventional, alternative, and integrative medicine. • Discuss the nutritional costs of commercially Supplement manufacturers are not allowed to make available medications which can cause a health claims: prescribing cascade. “These statements have not been evaluated by the • Identify commonly used hospice medications with Food and Drug Administration. This product is not natural origins and common drug/natural product intended to diagnose, treat, cure, or prevent any disease.” interactions. • Explore specific examples of remedies for common There are a vast number of studies on natural products that have been done to study efficacy and drug symptoms that are palliated in hospice. interactions. 3 4 5 6 Different approaches • Conventional Medicine – making diagnosis is endpoint of therapy. Treat symptoms and send patient home. Specialized not holistic. • Alternative Medicine – any of a range of medical therapies that are not regarded as orthodox by the medical profession, such as herbalism, homeopathy, and acupuncture. Holistic. FUNCTIONAL MEDICINE • Integrative Medicine – a type of medical care that combines conventional medical treatment with complementary and alternative medicine (CAM). CAM therapies treat the mind, body, and spirit. Holistic. • Functional Medicine – looks deeper to find the root cause. FM looks to see if you are missing something you may need- vitamins, minerals, probiotics or amino acids. It also looks to see if you have something you don’t need such as environmental contaminants, heavy metals, bacteria, fungus, and/or parasites. Holistic. http://www.ibsgroup.org/other/articles/Understanding_functional_medicine.pdf 5 6 1 7/27/2021 7 8 Definition of Functional Medicine 4 R’s of Functional Medicine Remove refers to the elimination of anything that may be in our body or diet • Functional Medicine is a systems-biology-based model that empowers which contributes to poor health. This can include foods, pesticides, food patients and practitioners to work together to achieve the highest additives, unwanted bacteria, fungi, and parasites. expression of health by addressing the underlying causes of disease. Reinnoculation involves the use of probiotic supplements containing lactobacillus acidophilus, bifidobacteria, and other friendly flora. These • Functional Medicine uses a unique operating system and personalized bacteria manufacture vitamins, repel. harmful microbes, and have anti-tumor therapeutic interventions to support individuals in achieving optimal effects. They are easily disrupted by use of antibiotics and the stress of wellness. contemporary living. Replace refers to the addition of supplements to support digestive function and may include: digestive enzymes, bile salts, and/or HCl. Repair refers to the nutritional support that helps quickly regenerate and heal the body. Jones, DS. Textbook of Functional Medicine. Institute for Functional Medicine. Federal Way, WA: Institute for Functional Medicine; 2010. http://www.ibsgroup.org/other/articles/Understanding_functional_medicine.pdf 7 8 Recognize Interconnectedness 9 10 of conditions and causes All Functional Medicine is Integrative, but not all Integrative Medicine is Functional Integrative Medicine: healing-oriented, body/mind/spirit, lifestyle approach that combined Conventional and CAM therapies X Functional Medicine: emphasizes underlying cause of dysfunction, organizes assessment & treatment using FM tools Jones, DS, Quinn, S.Introduction to Functional Medicine. Gig Harbor, WA: The Institute for Functional Medicine; 2016. Castle, L Riera-Gilley V, PharmD, ASCP Power point presentation Functional Medicine: The impact on the Senior Patient. August 2019. 9 10 12 Functional vs. Conventional http://www.ibsgroup.org/other/articles/Understanding_functional_medicine.pdf Jones, DS, Quinn, S.Introduction to Functional Medicine. Gig Harbor, WA: The Institute for Functional Medicine; 2016. 11 12 2 7/27/2021 13 14 Functional vs. Hospice Functional Medicine Hospice Nutritional Cost of Holistic Holistic Medication and Common Patient Centered Patient Centered Prescribing Cascades Deprescribe medications Deprescribe medications High Touch High Touch Focuses on quality of life Focuses on quality of life 13 14 15 16 Resource for Identifying Nutrient Depletion Drug Muggers Definitions Drug Mugger: noun An Over-the-Counter or prescribed medication, food, Suzy Cohen, RPH has devoted her career herb, medical condition, or lifestyle choice that is capable of robbing your to identifying nutrient depletions from body’s natural stores of an important vitamin, mineral or hormone. commercially available medications and offers safer ways to use medications to Usage: Acid blockers are drug muggers of zinc. prevent side effects by effectively Smoking is a drug mugger of Vitamin C. replacing the lost vitamin, mineral or hormone. Drug Mugging: adjective Of or relating to a drug mugger. Usage: My legs are cramping; I could be suffering from the drug mugging effects of my cholesterol medication. S Cohen, RPH, Drug Muggers Rodale Publishers 2011 15 16 17 18 Nutrient Depletion Effect of Drugs Nutrient Depletion Effect of Drugs Diseases related to drug mugging Diseases related to drug mugging Depression, osteoporosis, and irregular heartbeat: These can all be caused by a deficiency Cataracts, macular degeneration, liver problems, and high levels of the heart-attack- of the mineral magnesium. Common drug muggers of magnesium include female promoting substance homocysteine: Any of these conditions could be tied to low hormones, diuretics, raloxifene (Evista), anti-inflammatories (NSAIDS), and aspirin. glutathione, a powerful antioxidant needed to get rid of poisons in your body. Acetaminophen is a possible drug mugger of glutathione. Bald patches, loss of taste or smell, erectile dysfunction, and chronic diarrhea: All these conditions may result from zinc deficiency. Common drug muggers for zinc include anti- Weight gain, depression, fatigue, anemia, nerve pain, and a sensation of pins and needles: inflammatories (NSAIDS), antibiotics, antacids, ulcer and heartburn medications, diuretics, Any of these could be related to a deficiency of one or more B vitamins. Your stash gets and estrogen drugs used for birth control and menopause. depleted by female hormones (used for birth control and menopause), alcohol, antacids, ulcer medications, diuretics, raloxifene (Evista), cholestyramine, and diabetes drugs. Leg cramps, muscle spasms, memory loss, and fatigue: Any of these conditions may develop from a deficiency of CoQ10 (ubiquinone). This life sustaining antioxidant gets demolished by hundreds of medications, including statin cholesterol drugs, metformin, antidepressants, beta blockers and diuretics. S Cohen, RPH, Drug Muggers Rodale Publishers 2011 S Cohen, RPH, Drug Muggers Rodale Publishers 2011 17 18 3 7/27/2021 19 20 Prescribing Cascade For example, there was a man who went to see a cardiologist because he experienced heart palpitations. The cardiologist put him on heart medication. He saw his internist because he had a tremendous amount of leg cramping, and was put on a muscle relaxant. And his psychiatrist put him on an anti-depressant for anxiety. Natural Remedies for The same man saw a functional medicine physician who immediately noticed that all of these symptoms could be due to a lack of magnesium. Magnesium and other Common Symptoms supportive nutrients were given and the man was able to discontinue all other medications. Palliated in Hospice Another example is patients on Amlodipine and diuretics such as furosemide. A common side of amlodipine is peripheral edema. Review to DC amlodipine and the edema may subside and relieve the need for the diuretic. The diuretics can always cause potassium loss. http://www.ibsgroup.org/other/articles/Understanding_functional_medicine.pdf 19 20 21 22 Dyspepsia, Nausea, Constipation & Diarrhea Chronic Pain, Leg Cramps, Muscle Spasms Constipation can cause nausea so look at treating both Dyspepsia (Heartburn): Calcium Carbonate (Tums), Restless Leg Syndrome: Chelated Iron (prevents constipation) Mylanta/Maalox(magnesium), Peppermint. Muscle/Leg Cramps: Check hydration, Chelated magnesium (lessens chance of Gastroesophageal spasms: Altoids Peppermint/Spearmint lozenges diarrhea), Check potassium if on diuretic, CoQ10 (ubiquinone), Epsom salt baths (magnesium) Gas/Bloating/Flatulence: Activated charcoal (CharcoCaps) Chronic Pain: Vitamin D, Tumeric, Bosweillia, Chlorophyll, Nausea: Ginger Ale, Ginger chews, Sprite Glucosamine/Chrondrotin, Apple Cider Vinegar, Bilberry, Smoking cessation Constipation: Warm prune juice, Aloe Vera juice, Magnesium Citrate, Milk of Magnesia, Senna, Bisacodyl
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