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Course # 58392 • Herbal Medications: An Evidence-Based Review

Overview

Patients, and in some cases healthcare providers as well, are not fully aware of the health risks incurred by ingestion of herbal medications, either due to their potential adverse effects or pharmacologic interactions with other medications. This situation is further compounded by the fact that at least 60% of the patients taking herbal medications do not disclose this fact to their healthcare provider. This course provides the knowledge and tools required for clinicians to discuss natural health products with patients and other members of the healthcare team. It also discusses the need for physicians and nurses to actively inquire if the patient is taking herbal medications and take this information into account prior to prescribing new medications. A brief historical background and an overview of regulatory bodies responsible for overseeing herbal medications is provided. Relevant examples of widely used herbal compounds are presented. Clinically relevant information on commonly used herbal medications regarding therapeutic effectiveness, pharmacologic mechanism of action, adverse effects and drug interactions are reviewed based on scientific evidence.

Education Category: Alternative Medicine

Release Date: 07/01/2016

Expiration Date: 06/30/2019

Audience

Considering the widespread availability and increased use of herbal medications, this course is designed for dental professionals who will benefit from the course.

Accreditations/Approvals

NetCE is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by the AGD for Fellowship/Mastership, and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 10/1/2015 to 9/30/2021. Provider ID 217994. AGD Subject Code 016. NetCE is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp. NetCE is approved as a provider of continuing education by the Florida Board of Dentistry, Provider #50-2405. NetCE is a Registered Provider with the Dental Board of California. Provider Number RP3841. Completion of this course does not constitute authorization for the attendee to perform any services that he or she is not legally authorized to perform based on his or her license or permit type.

Designations of Credit

NetCE designates this activity for 10 continuing education credits. This course meets the Dental Board of California's requirements for 10 unit(s) of continuing education. Dental Board of California course #10-3841-19199.

Course Objective

Considering the pharmacologic interactions between herbal medications (HMs) and conventional medications, it is paramount to increase the awareness and knowledge of dental professionals about HMs. The purpose of this course is to increase dental professionals' awareness of the potential risks and benefits of HMs from an evidence-based perspective and promote the planned inclusion of HM use in patients' medical history. This course should allow dental professionals to discuss HMs in a knowledgeable and succinct manner with patients and colleagues.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Discuss the prevalent current and historical use of HMs in North America.
  2. Explain the need to inquire about the use of HMs during preparation of a patient's medical history, including components of a culturally sensitive assessment.
  3. Discuss the pharmacology (i.e., pharmacokinetics, pharmacodynamics, drug interactions, adverse drug reactions, toxicology) of HMs.
  4. Describe the differences between the process of development and approval of HMs versus conventional medications, and the implications of health claims and therapeutic efficacy of HMs.
  5. Outline the merits and limitations associated with the application of contemporary scientific principles and methodologies (i.e., evidence-based medicine) to assess the efficacy and safety of HMs.
  6. Discuss, based on scientific and conventional medical principles, the pharmacologic properties, efficacy, safety, toxicology, therapeutic indications, and recommended dosages of saw palmetto and St. John's wort.
  7. Describe the potential risks and benefits of ginkgo.
  8. Identify key characteristics of ginseng.
  9. Discuss the use of echinacea and kava, including potential adverse effects.
  10. Review the use of garlic and valerian as HMs.
  11. Outline the potential medical uses of andrographis and English ivy leaf.
  12. Analyze the available evidence for the use of peppermint, ginger, soy, and chamomile.

Faculty

A. José Lança, MD, PhD, received his Medical Degree at the University of Coimbra in Coimbra, Portugal, and completed his internship at the University Hospital, Coimbra. He received his PhD in Neurosciences from a joint program between the Faculties of Medicine of the University of Coimbra, Portugal, and the University of Toronto, Toronto, Canada. He was a Gulbenkian Foundation Scholar and received a Young Investigator Award by the American Brain & Behavior Research Foundation.

Dr. Lança participated in international courses and conferences on neurosciences. He has contributed to a better understanding of the mechanisms underlying the ontogenetic development of the brain opiatergic system. As a research scientist at the Addiction Research Foundation (ARF) in Toronto, he initiated research on the functional role played by dopaminergic cell transplants on alcohol consumption, leading to the publication of the first research reports on cell transplantation and modulation of an addictive behavior. Subsequently, he also investigated the role played by other neurotransmitter systems in the limbic system and mechanisms of reward, co-expression of classical neurotransmitters and neuropeptides and potential role in neuropsychiatric disorders.

He is an Assistant Professor in the Department of Pharmacology at the Faculty of Medicine and at the Faculty of Dentistry at the University of Toronto, where he lectures and directs several undergraduate and postgraduate pharmacology and clinical pharmacology courses. He was the Program Director for Undergraduate Studies in the Department of Pharmacology of the University of Toronto. He has developed clinical pharmacology courses for the Medical Radiation Sciences and Chiropody Programs of The Michener Institute for Health Sciences at the University of Toronto.

Dr. Lança’s commitment to medical education started while a medical student, teaching in the Department of Histology and Embryology, where he became cross-appointed after graduation. In Toronto, he has contributed extensively to curriculum development and teaching of pharmacology to undergraduate, graduate, and medical students.

He has authored research and continuing education in peer-reviewed publications and is the author of six chapters in pharmacology textbooks. Dr. Lança has conducted research in various areas including neuropharmacology, pharmacology of alcoholism and drug addiction, and herbal medications.

He has developed and taught courses and seminars in continuing medical education and continuing dental education. His commitment to continuing education emphasizes an interdisciplinary approach to clinical pharmacology.

Faculty Disclosure

Contributing faculty, A. José Lança, MD, PhD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

William E. Frey, DDS, MS, FICD

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

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