The Official Patient's Sourcebook on Lupus (22 page)

Contraindications and Interactions (Hidden Dangers)

Some of the medications mentioned in the previous discussions can be

problematic for patients with lupus nephritis--not because they are used in

the treatment process, but because of contraindications, or side effects.

Medications with contraindications are those that could react with drugs

44 Adapted from
A to Z Drug Facts
by Facts and Comparisons.

Researching Your Medications 121

used to treat lupus nephritis or potentially create deleterious side effects in patients with lupus nephritis. You should ask your physician about any

contraindications, especially as these might apply to other medications that

you may be taking for common ailments.

Drug-drug interactions occur when two or more drugs react with each other.

This drug-drug interaction may cause you to experience an unexpected side

effect. Drug interactions may make your medications less effective, cause

unexpected side effects, or increase the action of a particular drug. Some

drug interactions can even be harmful to you.

Be sure to read the label every time you use a nonprescription or

prescription drug, and take the time to learn about drug interactions. These

precautions may be critical to your health. You can reduce the risk of

potentially harmful drug interactions and side effects with a little bit of

knowledge and common sense.

Drug labels contain important information about ingredients, uses,

warnings, and directions which you should take the time to read and

understand. Labels also include warnings about possible drug interactions.

Further, drug labels may change as new information becomes available. This

is why it’s especially important to read the label every time you use a

medication. When your doctor prescribes a new drug, discuss all over-the-

counter and prescription medications, dietary supplements, vitamins,

botanicals, minerals and herbals you take as well as the foods you eat. Ask

your pharmacist for the package insert for each prescription drug you take.

The package insert provides more information about potential drug

interactions.

A Final Warning

At some point, you may hear of alternative medications from friends,

relatives, or in the news media. Advertisements may suggest that certain

alternative drugs can produce positive results for patients with lupus

nephritis. Exercise caution--some of these drugs may have fraudulent claims,

and others may actually hurt you. The Food and Drug Administration (FDA)

is the official U.S. agency charged with discovering which medications are

likely to improve the health of patients with lupus nephritis. The FDA warns

patients to watch out fo
r45:

· Secret formulas (real scientists share what they know)

45 This section has been adapted from
http://www.fda.gov/opacom/lowlit/medfraud.html
.

122 Lupus Nephritis

· Amazing breakthroughs or miracle cures (real breakthroughs don’t

happen very often; when they do, real scientists do not call them amazing

or miracles)

· Quick, painless, or guaranteed cures

· If it sounds too good to be true, it probably isn’t true.

If you have any questions about any kind of medical treatment, the FDA

may have an office near you. Look for their number in the blue pages of the

phone book. You can also contact the FDA through its toll-free number, 1-

888-INFO-FDA (1-888-463-6332), or on the World Wide Web at

www.fda.gov
.

General References

In addition to the resources provided earlier in this chapter, the following

general references describe medications (sorted alphabetically by title;

hyperlinks provide rankings, information and reviews at Amazon.com):

·
Complete Guide to Prescription and Nonprescription Drugs 2001

(Complete Guide to Prescription and Nonprescription Drugs, 2001)
by H.

Winter Griffith, Paperback 16th edition (2001), Medical Surveillance; ISBN:

0942447417;

http://www.amazon.com/exec/obidos/ASIN/039952634X/icongroupinterna

·
The Essential Guide to Prescription Drugs, 2001
by James J. Rybacki, James W. Long; Paperback - 1274 pages (2001), Harper Resource; ISBN:

0060958162;

http://www.amazon.com/exec/obidos/ASIN/0060958162/icongroupinterna

·
Handbook of Commonly Prescribed Drugs
by G. John Digregorio, Edward J. Barbieri; Paperback 16th edition (2001), Medical Surveillance;

ISBN: 0942447417;

http://www.amazon.com/exec/obidos/ASIN/0942447417/icongroupinterna

·
Johns Hopkins Complete Home Encyclopedia of Drugs 2nd ed.
by Simeon Margolis (Ed.), Johns Hopkins; Hardcover - 835 pages (2000),

Rebus; ISBN: 0929661583;

http://www.amazon.com/exec/obidos/ASIN/0929661583/icongroupinterna

·
Medical Pocket Reference: Drugs 2002
by Springhouse Paperback 1st edition (2001), Lippincott Williams & Wilkins Publishers; ISBN:

1582550964;

http://www.amazon.com/exec/obidos/ASIN/1582550964/icongroupinterna

Researching Your Medications 123

·
PDR
by Medical Economics Staff, Medical Economics Staff Hardcover -

3506 pages 55th edition (2000), Medical Economics Company; ISBN:

1563633752;

http://www.amazon.com/exec/obidos/ASIN/1563633752/icongroupinterna

·
Pharmacy Simplified: A Glossary of Terms
by James Grogan; Paperback -

432 pages, 1st edition (2001), Delmar Publishers; ISBN: 0766828581;

http://www.amazon.com/exec/obidos/ASIN/0766828581/icongroupinterna

·
Physician Federal Desk Reference
by Christine B. Fraizer; Paperback 2nd edition (2001), Medicode Inc; ISBN: 1563373971;

http://www.amazon.com/exec/obidos/ASIN/1563373971/icongroupinterna

·
Physician’s Desk Reference Supplements
Paperback - 300 pages, 53

edition (1999), ISBN: 1563632950;

http://www.amazon.com/exec/obidos/ASIN/1563632950/icongroupinterna

Vocabulary Builder

The following vocabulary builder gives definitions of words used in this

chapter that have not been defined in previous chapters:

Inhalation:
The drawing of air or other substances into the lungs. [EU]

Liquifilm:
A thin liquid layer of coating. [EU]

Quinidine:
An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the

excitability of cardiac and skeletal muscles by blocking sodium and

potassium currents across cellular membranes. It prolongs cellular action

potential, and decreases automaticity. Quinidine also blocks muscarinic and

alpha-adrenergic neurotransmission. [NIH]

Researching Alternative Medicine 125

APPENDIX B. RESEARCHING ALTERNATIVE MEDICINE

Overview

Complementary and alternative medicine (CAM) is one of the most

contentious aspects of modern medical practice. You may have heard of

these treatments on the radio or on television. Maybe you have seen articles

written about these treatments in magazines, newspapers, or books. Perhaps

your friends or doctor have mentioned alternatives.

In this chapter, we will begin by giving you a broad perspective on

complementary and alternative therapies. Next, we will introduce you to

official information sources on CAM relating to lupus nephritis. Finally, at

the conclusion of this chapter, we will provide a list of readings on lupus

nephritis from various authors. We will begin, however, with the National

Center for Complementary and Alternative Medicine’s (NCCAM) overview

of complementary and alternative medicine.

What Is CAM?46

Complementary and alternative medicine (CAM) covers a broad range of

healing philosophies, approaches, and therapies. Generally, it is defined as

those treatments and healthcare practices which are not taught in medical

schools, used in hospitals, or reimbursed by medical insurance companies.

Many CAM therapies are termed “holistic,” which generally means that the

healthcare practitioner considers the whole person, including physical,

mental, emotional, and spiritual health. Some of these therapies are also

known as “preventive,” which means that the practitioner educates and

46 Adapted from the NCCAM:
http://nccam.nih.gov/nccam/fcp/faq/index.html#what-is
.

126 Lupus Nephritis

treats the person to prevent health problems from arising, rather than

treating symptoms after problems have occurred.

People use CAM treatments and therapies in a variety of ways. Therapies are

used alone (often referred to as alternative), in combination with other

alternative therapies, or in addition to conventional treatment (sometimes

referred to as complementary). Complementary and alternative medicine, or

“integrative medicine,” includes a broad range of healing philosophies,

approaches, and therapies. Some approaches are consistent with

physiological principles of Western medicine, while others constitute healing

systems with non-Western origins. While some therapies are far outside the

realm of accepted Western medical theory and practice, others are becoming

established in mainstream medicine.

Complementary and alternative therapies are used in an effort to prevent

illness, reduce stress, prevent or reduce side effects and symptoms, or

control or cure disease. Some commonly used methods of complementary or

alternative therapy include mind/body control interventions such as

visualization and relaxation, manual healing including acupressure and

massage, homeopathy, vitamins or herbal products, and acupuncture.

What Are the Domains of
Alternative Medicine?47

The list of CAM practices changes continually. The reason being is that these

new practices and therapies are often proved to be safe and effective, and

therefore become generally accepted as “mainstream” healthcare practices.

Today, CAM practices may be grouped within five major domains: (1)

alternative medical systems, (2) mind-body interventions, (3) biologically-

based treatments, (4) manipulative and body-based methods, and (5) energy

therapies. The individual systems and treatments comprising these

categories are too numerous to list in this sourcebook. Thus, only limited

examples are provided within each.

Alternative Medical Systems

Alternative medical systems involve complete systems of theory and practice

that have evolved independent of, and often prior to, conventional

biomedical approaches. Many are traditional systems of medicine that are

47 Adapted from the NCCAM:
http://nccam.nih.gov/nccam/fcp/classify/index.html
.

Researching Alternative Medicine 127

practiced by individual cultures throughout the world, including a number

of venerable Asian approaches.

Traditional oriental medicine emphasizes the balance or disturbances of qi

(pronounced chi) or vital energy in health and disease, respectively.

Traditional oriental medicine consists of a group of techniques and methods

including acupuncture, herbal medicine, oriental massage, and qi gong (a

form of energy therapy). Acupuncture involves stimulating specific

anatomic points in the body for therapeutic purposes, usually by puncturing

the skin with a thin needle.

Ayurveda is India’s traditional system of medicine. Ayurvedic medicine

(meaning “science of life”) is a comprehensive system of medicine that

places equal emphasis on body, mind, and spirit. Ayurveda strives to restore

the innate harmony of the individual. Some of the primary Ayurvedic

treatments include diet, exercise, meditation, herbs, massage, exposure to

sunlight, and controlled breathing.

Other traditional healing systems have been developed by the world’s

indigenous populations. These populations include Native American,

Aboriginal, African, Middle Eastern, Tibetan, and Central and South

American cultures. Homeopathy and naturopathy are also examples of

complete alternative medicine systems.

Homeopathic medicine is an unconventional Western system that is based

on the principle that “like cures like,” i.e., that the same substance that in large doses produces the symptoms of an illness, in very minute doses cures

it. Homeopathic health practitioners believe that the more dilute the remedy,

the greater its potency. Therefore, they use small doses of specially prepared plant extracts and minerals to stimulate the body’s defense mechanisms and

healing processes in order to treat illness.

Naturopathic medicine is based on the theory that disease is a manifestation

of alterations in the processes by which the body naturally heals itself and

emphasizes health restoration rather than disease treatment. Naturopathic

physicians employ an array of healing practices, including the following:

diet and clinical nutrition, homeopathy, acupuncture, herbal medicine,

hydrotherapy (the use of water in a range of temperatures and methods of

applications), spinal and soft-tissue manipulation, physical therapies (such

as those involving electrical currents, ultrasound, and light), therapeutic