NMT150 wk2

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Questions and Answers

What is the recommended amount of essential oil to add to the boiling water for a steam inhalation?

5 drops (correct)

1 drop

20 drops

10 drops

What is the duration of the steam inhalation process?

5 minutes

10 minutes (correct)

20 minutes

15 minutes

What is the purpose of adding garlic, onion, and ginger to soups or stews?

For herbal support through food (correct)

To provide hydration

To relieve cough and congestion

To add flavor

What is the role of astragalus in the Immune Support Soup?

To support immune modulation Signup and view all the answers

What is the purpose of using medicinal mushrooms like Reishi and Chaga?

To strengthen the immune system Signup and view all the answers

What is the importance of considering the patient's cultural background when choosing herbal pharmacy?

To ensure compliance Signup and view all the answers

What is the benefit of adding miso to the Immune Support Soup?

To provide alkalinity and rehydration Signup and view all the answers

What is the role of Schisandra chinensis in preventing recurrence?

To act as an adaptogen Signup and view all the answers

What is the purpose of using Panax ginseng in preventing recurrence?

To act as an adaptogen and support the HPA axis Signup and view all the answers

What is the benefit of using Eucalyptus, Thyme, and/or Peppermint essential oils in steam inhalations?

To relieve cough and congestion Signup and view all the answers

What is a possible way to experience different relational patterns in life?

By leaning into different relational patterns in different ages/stages of life and/or different roles in life Signup and view all the answers

What is the dominant relational style that most people have?

A wired-in default style from early childhood Signup and view all the answers

What is the good news about our relational patterns?

We can consciously change these patterns if they no longer suit us Signup and view all the answers

What is an important skill to cultivate in ourselves and bring to our patients?

Tracking autonomic states Signup and view all the answers

What is the title of the video featuring Gabor Maté, MD?

Authenticity Can Heal Trauma Signup and view all the answers

What is the main topic discussed by Gabor Maté, MD, in the video?

The underlying causes of malaise in modern-day living Signup and view all the answers

What is the characteristic of a person's default relational style?

It is wired in as our first perceptual system in early childhood Signup and view all the answers

What can we experience in different areas of life?

Different relational patterns Signup and view all the answers

What is the adaptation of our nervous system?

Fight-flight-freeze expressions Signup and view all the answers

What is the result of tracking autonomic states?

Improved emotional regulation Signup and view all the answers

What is the main precaution when needling on the posterior neck?

Avoiding the brain stem Signup and view all the answers

What is a normal sensation during De Qi?

Soreness Signup and view all the answers

What is the correct management of a stuck needle?

Rotate the needle in the opposite direction and shake left and right gently Signup and view all the answers

What is a cause of a bent needle?

All of the above Signup and view all the answers

What is the recommended action when a patient is experiencing fainting during needling?

Remove all needles and lie the patient down with their feet higher than their head Signup and view all the answers

What is the correct management of an arterial puncture?

Apply direct pressure with ice for 5 minutes for small arteries Signup and view all the answers

What is a symptom of fainting during needling?

All of the above Signup and view all the answers

Why is it important to use thicker gauge needles for tough, thick areas?

To avoid breaking the needle Signup and view all the answers

What is a consequence of poor management of a stuck or bent needle?

Broken needle Signup and view all the answers

Why is it important to consider the needle length and gauge when needling?

To avoid inserting the needle too deeply Signup and view all the answers

What is the main function of Blood in Traditional Chinese Medicine?

To nourish and moisten the body Signup and view all the answers

What is a characteristics of Qi Deficiency?

Insomnia and frequent infections Signup and view all the answers

What is a symptom of Blood Deficiency?

Slow recovery and pale complexion Signup and view all the answers

What is a characteristic of Excess Yang?

Feeling hot all day and thirst for cold drinks Signup and view all the answers

What is the process by which Food Qi is converted to Blood?

Food Qi is acted upon by Yuan Qi in the chest Signup and view all the answers

What is characterized by emptiness of the Upright Qi and the absence of a pathogenic factor?

Deficiency Signup and view all the answers

What is the result of a decrease in Yin?

Heat symptoms Signup and view all the answers

What is the function of Qi in the body?

All of the above Signup and view all the answers

What is a characteristic of Empty Yang?

Cold limbs and absence of thirst Signup and view all the answers

What is a symptom of Yang Excess?

Red face and thirst for cold drinks Signup and view all the answers

What is one of the basic hygiene practices for healing and prevention?

Washing your hands with soap and water Signup and view all the answers

What is the recommended type of water to use for nasal saline irrigation?

Distilled water or recently boiled water that's cooled Signup and view all the answers

What is a potential benefit of nasal saline irrigation?

Relieving symptoms of URTI Signup and view all the answers

What is the origin of nasal saline irrigation?

Ayurvedic practice Signup and view all the answers

What is a consideration when using nasal saline irrigation as part of an Ayurvedic practice?

Considering the practice holistically Signup and view all the answers

What is the primary purpose of obtaining informed consent from patients?

To ensure compliance with regulatory requirements Signup and view all the answers

What is a key component of a comprehensive Naturopathic treatment plan?

All of the above Signup and view all the answers

Which regulatory requirement is relevant to record keeping in Naturopathic practice?

All of the above Signup and view all the answers

What is the primary focus of the active learning session in Week 2?

Collaborating with colleagues and learning from each other's perspectives Signup and view all the answers

What is the relationship between informed consent and treatment recommendations in Naturopathic practice?

Informed consent is necessary for all interventions, including treatment recommendations Signup and view all the answers

What is a potential side effect of taking Vitamin C?

Osmotic diarrhea & GI upset Signup and view all the answers

What is the recommended daily dose of Zinc for adults?

30-50 mg Signup and view all the answers

What should be considered when advising patients on Vitamin C supplementation?

Bowel tolerance and potential for osmotic diarrhea & GI upset Signup and view all the answers

Why should Zinc not be taken at the same time as antibiotics?

To avoid interference with absorption Signup and view all the answers

What is a potential risk of taking Vitamin C supplements for those susceptible to kidney stones?

40% increase in kidney stone risk Signup and view all the answers

What is an important consideration when advising patients on Zinc supplementation?

Taking with food to avoid GI upset Signup and view all the answers

What is a potential side effect of taking Zinc supplements?

GI upset and N&V Signup and view all the answers

What is the purpose of screening for allergies and potential interactions when advising patients on supplements?

To ensure safe and effective use Signup and view all the answers

What is the role of a Naturopathic doctor in advising patients on supplements?

To advise on safe and effective use, including product selection and dosing Signup and view all the answers

What is the primary goal of treatment in this case presentation?

All of the above Signup and view all the answers

What is the family of the ginseng plant?

Araliaceae Signup and view all the answers

What is the main indication of ginseng?

Stress, fatigue, low immunity, and cold and flu treatment and prevention Signup and view all the answers

What is the action of ginseng as approved by the German Commission E?

Tonification and fortification in times of fatigue and debility Signup and view all the answers

What is the photo courtesy of?

Matt Gowan Signup and view all the answers

What is ginseng useful for according to King's American Dispensatory?

All of the above Signup and view all the answers

What are the phytochemicals found in ginseng?

Triterpenoid glycosides and poly-furanosyl-pyranosyl-saccharide Signup and view all the answers

What is the caution for using ginseng?

High blood pressure Signup and view all the answers

What is the result of various clinical trials of ginseng?

Reduction in repeated colds and flu Signup and view all the answers

What is the Latin name of the Korean ginseng?

Panax ginseng Signup and view all the answers

What is the drug derived from the root of ginseng?

Ginseng radix Signup and view all the answers

Which remedy is characterized by persistent nausea and vomiting?

Ipecacuanha Signup and view all the answers

What is a common anxiety feature of Spongia tosta?

All of the above Signup and view all the answers

What is a key feature of Ipecacuanha's cough?

Spasmodic and suffocating Signup and view all the answers

What is a general characteristic of Ipecacuanha?

Sensitive to cold and warm winds Signup and view all the answers

What is a key mental characteristic of Ipecacuanha?

Irritable and anxious Signup and view all the answers

What is a characteristic of Ipecacuanha's fever?

Fever with anxiety and suffocation Signup and view all the answers

What is a key feature of Spongia tosta's cough?

Hoarse and raw Signup and view all the answers

What is a comparison remedy to Ipecacuanha?

Antimonium tartaricum Signup and view all the answers

What is a general aggravation factor for Ipecacuanha?

All of the above Signup and view all the answers

What is a key feature of Ipecacuanha's female issues?

All of the above Signup and view all the answers

What is the primary reason for using a combination of amoxicillin and clavulanate?

Treatment failure or recurrence Signup and view all the answers

Which of the following antibiotics is effective against H.influenzae and M.catarrhalis?

Cefuroxime axetil and Cefprozil Signup and view all the answers

What is the recommended treatment for patients with type 1 hypersensitivity reactions to beta-lactam antibiotics?

Azithromycin and Clarithromycin Signup and view all the answers

What is the purpose of using analgesics in AOM treatment?

To support watchful waiting and antibiotic therapy Signup and view all the answers

What is the recommended dosage of acetaminophen for children?

10 – 15 mg/kg every 4 – 6 hours Signup and view all the answers

Why should aspirin not be given to children or teenagers?

It has been linked to Reye syndrome Signup and view all the answers

What is the mechanism of resistance produced by H.influenzae?

Production of beta-lactamases Signup and view all the answers

What is the primary role of antibiotics in AOM treatment?

To treat bacterial infections Signup and view all the answers

What is the effect of antibiotics on pain within the first 24 hours of therapy?

They do not reduce pain within the first 24 hours of therapy Signup and view all the answers

Why is clindamycin not effective against H.influenzae or M.catarrhalis?

It is not effective against H.influenzae or M.catarrhalis Signup and view all the answers

Study Notes

Upper Respiratory Tract Infection (URTI)

Involves an infection of the nose, sinuses, pharynx, larynx, and large airways
Viral causes: rhinovirus (most common), adenovirus, parainfluenza virus, enterovirus, and respiratory syncytial virus (RSV)
Diagnosis: typically a clinical diagnosis, but nasal and nasopharyngeal swabs/aspirates can be used
Complications: pneumonia, sinusitis, otitis media, coinfection with bacterial agents, and exacerbation of preexisting medical conditions (asthma & COPD)

Common Cold

Typically mild and self-limited
Symptoms: nasal mucosal erythema and edema, rhinorrhea, and nasal congestion, sore throat, cough, and sneezing, headache, and low-grade fever
Onset of symptoms usually begins one to three days after exposure and can last 7-10 days or persist up to 3 weeks

Botanical Treatment Strategies

Enhance the immune system's first and second lines of defense
Choose herbs with tissue and microbial specificity
Relieve common symptoms such as sore throat, congestion, and rhinorrhea
Prevent recurrence

Herbal Actions

Antivirals / antimicrobials
Immune stimulants
Deep immune tonics
Adaptogens
Anti-catarrhals / mucolytics
Expectorants
Diaphoretics
Demulcents
Lymphatics
Anti-inflammatories

Baptisia Tinctoria

Pharmacy: decoction, tincture, and dried herb
Actions: anti-microbial, immune stimulant, anti-inflammatory, diaphoretic, and lymphatic
Safety: can cause nausea, vomiting, anorexia, hypersalivation, tachypnea, tachycardia, and respiratory paralysis with toxic doses internally; contra-indicated in long-term use or high doses, pregnancy, and lactation

Echinacea Angustifolia / Purpurea

Pharmacy: decoction, tincture, and powdered extract
Actions: anti-microbial, immunomodulator, immune stimulant, anti-inflammatory, diaphoretic, lymphatic, vulnerary, and anti-catarrhal
Pharmacology: activates immune response via enhanced granulocyte chemotaxis, macrophage phagocytosis, and increased levels of TNF, IL-1, Ig binding, and neutrophils
Safety: high doses may cause nausea, throat irritation, and skin irritation; caution in Asteraceae allergy; selectively modulates CYP 3A4 substrates – potential for interactions

Zingiber Officinale (Ginger)

Pharmacy: infusion, tincture, dry herb, and fresh herb
Actions: anti-oxidant, anti-inflammatory, anti-microbial, diaphoretic, carminative, and anti-spasmodic
Pharmacology: sesquiterpenes in ginger have specific anti-viral effects against rhinoviruses and RSV; fresh ginger may stimulate mucosal cells to secrete IFN-β to counter viral infection
Safety: caution with ulcers, GERD, gallstones, kidney disease, bleeding disorders, and those with sensitive stomachs; additive effect with anticoagulant medication

Herbal Pharmacy

Herbal selection: Echinacea angustifolia, Baptisia tinctoria, and Zingiber officinale
Pharmacy and posology: tincture, ratio, and dosage
How to make an herbal lozenge: using demulcent herbs like Althea officinalis, Glycyrrhiza glabra, Verbascum thapsus, and/or Ulmus fulvus
Steam inhalations: using Eucalyptus, Thyme, and/or Peppermint essential oils to relieve cough and congestion

Other Considerations

Rest, hydration, and nutrition
Food as Medicine: adding garlic, onion, ginger, thyme, oregano, sage, or mushrooms to soups or stews for immune support
Immune Support Soup recipe
Preventing recurrence: using adaptogens and deep immune tonics long-term to support HPA axis and strengthen immune system

Adverse Childhood Experiences (ACEs)

ACEs are strongly associated with 9 of the 10 leading causes of death in the US:
- Heart disease
- Cancer
- Accidents/unintentional injuries
- Chronic lower respiratory disease
- Stroke
- Alzheimer's disease or dementia
- Diabetes
- Kidney disease
- Suicide

Relationship Matters

Human beings are social creatures, neurologically designed to be in relationships with others
Social engagement, active listening, and compassionate presence can create a safe space for patients
The relational experience we can provide to patients can have a significant impact on their health and well-being

Bruce Perry's Reflections

Human beings are designed to be in relationships with others, which affects our brain and body physiology
Consistent, predictable, nurturing caregiving can shape our worldview and create a sense of safety and trust
Inconsistent, unpredictable, chaotic interactions can lead to maladaptive behaviors and a view of the world as unsafe

Attachment and Adaptations of Self

Secure attachment is the foundation of subconscious perceptual systems
Secure attachment is associated with:
- Meeting discomfort and distress with reliable, loving care
- Soothing the baby/young child and establishing CNS patterns of trust, security, and comfort
- Predicting lifelong health outcomes (biological, social, psychological)
Insecure attachment styles include:
- Anxious style: preoccupied with relationships, seeking safety in the presence of others
- Avoidant style: equating intimacy with loss of independence, seeking safety in disconnection
- Disorganized style: no template for safety, resulting in chronic tension between connection and disconnection

The Common Denominator

Insecure attachment styles are rooted in shame, a belief that one is flawed and unlovable

Your Attachment Style Can Influence

Your adult relationships and behaviors in relationships
Your beliefs about yourself
The way you explain the events of your life
Your physical health
Your subconscious triggers
How you perceive stress, adversity, and challenge
How you react to and recover from adversity

Relational Tensions vs Relational Security

Relational security is associated with trust and security in self and others
Relational tensions can be shifted through conscious awareness and intention

Attending

Attending is an important skill for cultivating relational security and bringing to our patients
Tracking autonomic states involves noticing and describing physical/sensory experiences of different states

Authenticity Can Heal Trauma

Authenticity and connection can be a powerful tool for healing trauma
Gabor Maté, MD, discusses the underlying causes of physical and emotional suffering and connects them to the pressures of modern-day living

Clean Needle Technique

Definition: "Use of techniques designed to reduce the risk of infection of patients, practitioners, and office personnel by killing or reducing the strength of pathogens, thereby reducing the chances for contact between the pathogens"
Includes: Clean Field, Sterile Needles, Universal Precautions, Contraindications, Needle Insertion, Needle Manipulation, and Management of Problems

Anatomy of a Needle

Consists of: Handle, Root, and Body/Shaft

Clean Field

Definition: "The area that has been prepared to contain the equipment necessary for acupuncture, in such a way as to protect the sterility of the needles"
Setup: Use a paper towel or folded gauze pad, place packaged needles, cotton, and alcohol-soaked cotton on the clean field
Important: The clean field is 3-dimensional, and non-sterile items must not be passed over it

Sterile Needles

All pre-packaged needles come sterilized from the manufacturer
Each needle has an expiry date and method of sterilization indicated on the box
The inside of the bubble package is considered sterile
Handle the needle shaft carefully to maintain sterility

Universal Precautions

Assume all patients are infected with HBV or HIV and take non-discriminatory precautions to protect yourself
Pertains to: Blood, body fluid containing visible blood, semen, vaginal secretions, tissues, CSF, synovial fluid, pleural fluid, peritoneal fluid, and amniotic fluid

Contraindications

Absolute: alcohol intoxication, exhaustion, severe fear
Relative: sexual intercourse, overeating, hunger, excessively thirsty, strenuous exercise

Needle Insertion

Steps:
1. Wash hands
2. Prepare clean field
3. Locate and mark points to be needled
4. Cleanse each point with alcohol
5. Inspect needle
6. Place tube over cleansed area and allow needle tip to fall to the surface of the skin
7. Tap the top of the needle handle to penetrate the skin
8. Remove tube and ensure needle doesn't fall over
9. Gently yet firmly insert the needle to the desired depth

Needle Manipulation

Techniques: leaving needles in for 15 minutes, tapping and flicking, tonifying methods, holding Channel Qi, and moving Qi

Problems with Needling

Needle-stick Injury: inform instructor, encourage bleeding from the site, and follow testing protocol
Stuck Needle: gentle traction, relaxation, or oppositely rotating the needle
Bent Needle: gentle removal, correcting patient position, and avoiding strong manipulation
Broken Needle: remain calm, remove broken portion with forceps or locking hemostats, and seek medical attention if necessary
Fainting: stop needling, lie the patient down, keep them warm, and consider needling GV 26, St 36, Pc 6, and Kd 1 or moxa GV 20, CV 4 or 6
Arterial Puncture: apply direct pressure with ice, contact emergency services immediately, and allow blood to flow back toward the heart

Types of Needles

Filiform needle: standard solid needle, comes in different materials (Chinese, Japanese, Korean)
Ear Tacks: small needles with adhesive backing, used for auricular acupuncture
Grain Type needles: small needles for sub-cutaneous insertion and covered with tape

Deficiency

Characterized by emptiness of the Upright Qi and the absence of a pathogenic factor
Types of deficiencies:
- Qi deficiency: pale face, weak voice, slight sweating, slight shortness of breath, fatigue, loose stools, poor appetite
- Yang deficiency: bright pale face, cold limbs, absence of thirst, desire for hot drinks, frequent pale urination
- Yin deficiency: heat in the afternoon, dry throat at night, night sweats
- Blood deficiency: dull-pale face, pale lips, dry hair, blurred vision, tiredness, poor memory, insomnia, scanty periods

Yin Deficiency

Decrease in Yin produces heat symptoms
Symptoms: red cheeks, dry stools, anxiety at night, night sweats, hot flushes, 5 Centre Heat, thirst for cold drinks in sips

Yin Excess

Excess Yin produces cold symptoms
Symptoms: abdominal pain better with warmth, dysmenorrhea better with warmth, local pain better with heat, chills

Yang Deficiency

Decrease of Yang produces cold symptoms
Symptoms: tired after bowel movement, low libido, edema, fatigue

Yang Excess

Excess Yang produces heat symptoms
Symptoms: feeling hot all day, red face, thirst for cold drinks (gulps)

Qi

Qi is the root of the human body
Qi functions: promoting, warming, defending, checking, nourishing
Qi deficiency: fatigue, insomnia, poor digestion, cold hands and feet, shortness of breath, little to no appetite, frequent infections, weak immune system

Stagnation

If Qi stagnates in the meridians, symptoms include: stiffness, heaviness, numbness or tingling of the limbs, migrating pain in the limbs

Blood

Formed from Food Qi, which is acted upon by Yuan Qi
Blood is not complete until it is sent to the Heart, where it is turned red
Blood functions: nourishment, moisture, circulation with Ying Qi, determining menstruation
Blood deficiency: long cycles, short luteal phase, scanty menstrual blood, amenorrhea, fatigue, anxiety, insomnia, poor memory, cold hands and feet, abdomen, low back, floaters in eyes, slow recovery, pale
Blood stasis: oppression or pain in the chest, coughing up dark, clotted blood, purple, deep, stabbing pain

Excess

Characterized by the presence of a pathogenic factor while Upright Qi is relatively intact and actively fighting against the pathogenic factor
Symptoms: pain worse with pressure, pain that is acute in onset, irritability, restlessness, strong voice

Naturopathic Therapeutics - Putting it Together

Learning objectives for this week's session include active learning, collaboration, and applying preventative care and lifestyle advice to the case study.
Considerations for a comprehensive Naturopathic treatment plan include 3 treatment recommendations, nutritional guidance, lifestyle guidance, collaborative care, medical guidance, and follow-up considerations, all requiring informed consent.

Informed consent must be obtained and documented for every intervention, including obtaining case history, performing physical exams/testing, treatments, and collecting health information.
This is in accordance with regional privacy acts and the CONO Standard on Consent.

Record Keeping

Accurate record keeping is essential to meet regulatory requirements, as outlined in the CONO Standard for Record Keeping.
Records must be communicated to the patient and noted in their chart.

Lifestyle, Prevention, and Health Promotion

Basic hygiene practices for healing and prevention include rest, staying home when sick, washing hands, avoiding touching face and eyes, coughing into elbows, and keeping up-to-date with vaccinations.
Nasal saline irrigation (Neti pot) can help relieve symptoms of URTI, reduce viral load, and reduce reliance on medications, but requires proper technique and equipment.
Traditional Ayurvedic practice recognizes the importance of Jala Neti as a holistic practice.

Scenario: Treatment Plan Design

Work in groups to design a treatment plan for this week's case, considering 3 EBM treatment suggestions that are appropriate for the patient.
Considerations include treatment recommendations, nutritional guidance, lifestyle guidance, collaborative care, and follow-up considerations, all within the framework of informed consent.

Nutrition for Immune Support and Healthy Function

Learning objectives for nutritional guidance include considering Vitamin C, Zinc, and Probiotics in relation to case presentation.

Treatment Goals

Address presenting symptoms and improve patient comfort
Support full and speedy recovery to return to regular activities
Patient education
Monitor and prevent sequelae

Natural Medicines Database

Vitamin C:
- Data supports use of Vitamin C in treatment of common cold
- Consider bowel tolerance with dosing and potential for osmotic diarrhea and GI upset
- May precipitate kidney stones for those susceptible (40% increased risk with 1 gram/day supplement)
Zinc:
- 30-50 mg/day for adults (75 mg in study) for specific, limited time period to avoid copper deficiency
- Take with food to avoid GI upset
- GI upset and N&V are most likely side-effects
- Avoid taking at same time as antibiotics to avoid interference with absorption

Our Role/Advice

Provide appropriate and specific product and formula
Recommend safe and appropriate therapeutic dose
Screen for allergies and potential interactions
Advise on cautions, concerns, and possible side-effects

Colds and Coughs

Colds and coughs can be treated with herbal medicine, which involves the use of herbal actions to combat the infection.

Herbal Actions

Immunostimulant: activates the immune system to fight infections
Diaphoretic: induces sweating to help remove toxins
Antitussive: soothes and relieves coughs
Antispasmodic: relaxes smooth muscles to reduce inflammation
Expectorant: liquefies respiratory secretions to facilitate the expulsion of phlegm and mucous
Mucolytic: breaks down mucous and loosens thick bronchial secretions
Demulcent: soothes irritated mucous membranes
Antimicrobial: destroys or inhibits the growth of microorganisms
Antiadherence: prevents microorganisms from attaching to and infecting mucous membranes
Antipyretic: reduces fever
Lymphatic: promotes the proper functioning of the lymphatic system

Phytochemicals

Polysaccharides: immunostimulants found in Echinacea, Asian ginseng, Canadian ginseng, and Siberian ginseng
Alkylamides: immunostimulants found in Echinacea
Saponins: expectorants found in Ivy, Licorice
Steroidal saponins: adaptogens, immunomodulators found in Asian ginseng, Canadian ginseng, and Siberian ginseng
Mucilage: demulcent found in Marshmallow
Essential oils: antispasmodics found in Thyme, Oregano, and Eucalyptus
Diterpene lactones: immunomodulators, antispasmodics found in Andrographis

Echinacea

Main indications: prevents and treats the common cold, flu, and upper respiratory tract infections (URIs), vaginal candidiasis, and urinary tract infections
Actions: immunostimulant, antimicrobial
Phytochemicals: alkylamides, phenolics, polysaccharides, glycoproteins, ketoalkenes
Safety: caution in autoimmune disease, safe in pregnancy and lactation

Ginseng

Main indications: stress, fatigue, cold and flu treatment and prevention, low immunity
Actions: adaptogen, immunostimulant, immunomodulator, antiviral, aphrodisiac
Phytochemicals: steroidal saponins, polysaccharides
Safety: caution in high blood pressure, Korean ginseng is considered safe in pregnancy and lactation

Homeopathic Remedies for Upper Respiratory Tract Infections

Dros era: #1 remedy for whooping cough; respiratory illnesses such as laryngitis, bronchitis, and tuberculosis
Dros era Cough: Tormenting cough with short paroxysms, ringing cough, must hold the chest to cough, inability to cough due to pain
Dros era Characteristics: < evening, after midnight, after drinking, exertion, singing, smoking; cough after measles; > walking

Rumex Crispus

Rumex Characteristics: Nervous, restless, sad, and depressed; aversion to mental work
Rumex Symptoms: Dry tickling cough, copious discharge from mucosa of nose, eyes, and whole respiratory tract
Rumex Modalities: < cold air, touch or pressure on throat/larynx, temperature changes, morning, and before 11 pm; > drinking, sucking on candy

Spongia

Spongia Characteristics: Sensitive, anxious, and fearful; "sssh" or "sshh" sound when inhaling
Spongia Symptoms: Dry, raw, or sore throat, hoarseness, asthmatic cough, and blood circulation problems
Spongia Modalities: < before midnight, dry cold wind, cold drinks, warm room, and heat; > eating, drinking, warm things, and resting
Spongia Use in Croup: Bönninghausen used Aconitum, Spongia, and Hepar sulphuris calcareum to cure croup; can be used in alternating order with Aconitum and Hepar

Ipecacuanha

Ipecacuanha Characteristics: Persistent nausea and vomiting; spasmodic irritation in the chest and stomach
Ipecacuanha Symptoms: Shortness of breath, gastric disturbances, bright red hemorrhage, and convulsions
Ipecacuanha Modalities: < warmth, damp warmth, warm room, overeating, and motion; > open air, rest, pressure, and closing the eyes
Ipecacuanha Mentals: Irritable, contemptuous, anxious during fever and coughing; intolerant to noise, and tranquil after anger

Acute Otitis Media (AOM)

AOM is typically a pediatric condition, but can also affect adults.
It can be caused by both bacteria and viruses, and co-infection is common.
The most common bacterial pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

Preventative Factors

Vaccination (influenza and S.pneumoniae) can reduce the risk of AOM.
Public health measures may reduce virus transmission, leading to a decrease in AOM cases.
Avoiding exposure to tobacco smoke and breastfeeding can also help prevent AOM.

Watchful Waiting

Spontaneous resolution is seen in a number of cases caused by the top 3 bacterial pathogens:
- S.pneumoniae: 20%
- H.influenzae: 50%
- M.catarrhalis: 75%
Withhold antibiotic prescriptions for 48 hours in children over 6 months of age if they have:
- Nonsevere illness (mild pain and fever < 39°C)
- Uncomplicated AOM (no episode in the preceding month, no acute facial nerve palsy, mastoiditis, meningitis, or labyrinthitis)
No craniofacial abnormalities, immunodeficiencies, cardiac or pulmonary disease, Down syndrome, or history of complicated AOM.

Exceptions

Infants under 6 weeks of age should be immediately referred to the nearest emergency department.
Patients aged 6 weeks to 6 months should begin antibiotic therapy immediately.
Patients with 3 or more episodes in 6 months or 4 or more within a year should begin antibiotic therapy immediately.

Antibiotic Therapy

Antibiotic resistance is common among the three pathogens.
S.pneumoniae resistance is due to the alteration of penicillin-binding cell wall proteins, leading to decreased drug affinity.
This is overcome by doubling the dose of amoxicillin.
H.influenzae and M.catarrhalis produce beta-lactamases, which confer resistance.
This is overcome by using a beta-lactamase inhibitor called clavulanate.
When antibiotics are used, treatment failure should be considered if symptoms do not improve after 72 hours of treatment.

Antibiotic Options

Amoxicillin is considered first-line therapy in the treatment of AOM.
The combination of amoxicillin and clavulanate is typically used for treatment failure or recurrence.
Cefuroxime axetil and Cefprozil are second-generation cephalosporins and have reasonable activity against H.influenzae and M.catarrhalis.
Azithromycin and Clarithromycin are macrolides and should be reserved for patients with type 1 hypersensitivity reactions to beta-lactam antibiotics.
Clindamycin is a lincosamide and can be used for patients with type 1 hypersensitivity reactions to beta-lactam antibiotics.

Supportive Therapy

Antibiotics do not reduce pain within the first 24 hours of therapy and do little in the following days compared to placebo.
Analgesics are recommended during watchful waiting and with antibiotic therapy.

Analgesics

Acetaminophen: 10-15 mg/kg every 4-6 hours to a maximum of 75 mg/kg/day and not to exceed 4000 mg/day.
Ibuprofen: 10 mg/kg every 6-8 hours to a maximum of 40 mg/kg/day and not to exceed 2400 mg/day.
Aspirin should never be given to children or teenagers recovering from chickenpox or with flu-like symptoms due to the risk of Reye syndrome.

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Description

Learn about the botanical treatment strategy, herbal actions, and safety concerns for treating the common cold. This quiz covers the selection process of anti-microbial herbs and lists herbs indicated for treatment.