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1. How does the medical community usually define complementary medicine?
A. Medicine used with standard treatment but not considered standard treatment by itself
B. Medicine used instead of standard medical treatment
C. Medicine at no cost –it’s complementary!

2. Which aspect of pharmacokinetics is St. John’s Wort known to alter in patients who are taking imatinib?
A. Absorption–by affecting gastric pH
B. Metabolism–by increasing drug clearance
C. Distribution–by competing with albumin binding sites

3. With respect to the gastrointestinal tract, how do orally administered herbs interact with prescription medication for cancer?
A. They may alter motility, gastric pH, and P-gycoprotein transport
B. They may alter motility, gastric pH, and CYP enzyme activity
C. They may alter the peritoneal space, sodium levels, and P-GP transport

4. Which of the following complementary medications used for hot flashes MAY be a problem in a woman taking tamoxifen?
A. St. John’s wort
B. Echinacea
C. Black cohash

5. Which of the following references contains monographs, an adverse effects checker and a tool to check interactions with hormone sensitive diseases such as breast cancer.?
A. Sloan Kettering Cancer Center’s About Herbs database
B. Natural Medicines Comprehensive Database
C. NIH’s Herbs at a Glance fact sheet

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1. Which of the following is TRUE of ibogaine?
A. It was synthesized by researchers in Japan during the early 1900s
B. It is a naturally occurring alkaloid derived from Tabernanthe iboga
C. It is extracted from the iboga root that is native to South America

2. Which of the following is TRUE regarding the pharmacology of ibogaine?
A. It has a long-acting metabolite called noribogaine
B. Its pharmacokinetic profile is remarkably simple
C. It binds exclusively to the opioid receptor

3. In which condition would ibogaine be contraindicated?
A. Allergic rhinitis
B. Pancreatic cancer
C. Prolonged baseline QTc interval

4. Which of the following is a pharmacologic effect of ibogaine supported by observational research?
A. Detoxification of heroin use disorder
B. Detoxification of alcohol use disorder
C. Detoxification of SSRI overdose

5. Which adverse effect has been reported with ibogaine use?
A. Serotonin toxicity
B. Neuroleptic malignant syndrome
C. Ventricular arrythmias

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1. How do ACE inhibitors work?
A. They convert angiotensin I to angiotensin II
B. They convert renin to angiotensin II
C. They convert Angiotensin II to angiotensin I

2. Before ACE inhibitors were marketed, what drugs were the mainstay of treatment for hypertension?
A. Injectable diuretics, especially furosemide
B. Oral diuretics, and especially chlorthalidone
C. Surgical interventions

3. Which of the following are FDA-approved uses for many ACE inhibitors?
A. Heart failure, hypertensive emergencies, MI and/or stroke prophylaxis
B. Heart Failure, hypertensive emergencies, MI and pancreatic cancer
C. Heart Failure, hypertensive emergencies, MI and sarcopenia

4. Which of the following indications are under investigation for ACE inhibitors?
A. Hepatic necrosis, oligospermia, and sarcopenia
B. Raynaud’s syndrome, sarcopenia, and oligospermia
C. Oligospermia, Raynaud’s syndrome, and sarcopenia.

5. In most conditions in which ACE inhibitors are being investigated but are not yet approved, what is the value of these drugs?
A. We have no treatments for many of these conditions, so ACE inhibitors would be valuable first-line options for people who are suffering
B. Many of these conditions have preferred treatments, ACE inhibitors may be valuable second- or third-line options for refractory cases
C. Many of these conditions have preferred treatments, but ACE inhibitors would replace the first-line treatments with fewer side effect