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What information should consumers consider when deciding on herbal therapy?
- Natural does not mean safe - What conventional medication the Pt is taking - Quality of herbal drugs caries each year - Unknown herbal drug effects in long term and drug interaction
Nursing Considerations
- Adverse interaction with conventional drugs - BIGGEST ISSUE: Unknown herbal can impact w/ Pt drug interaction
Essential education for Pt
- Herbs are not regulated - Take as instructed - Learns as much as possible - Purchase from reputable company - Inform your health care provider
DSHEA
- Does not regulate the accuracy of labels - All herbs must be labeled as dietary supplements - Labels can not claim the product can be used to diagnose, prevent, or treat disease
Ginger Root use?
Suppress Nausea &Vomiting (motion sickness, morning sickness, sea sickness, postoperative N&G), improve appetite, calm stomach also has some anti-inflammatory and analgesic properties Sore throat, antioxidant
Ginger root action
-Possible blockade of brain chemoreceptor & GI afferent vagal nerves’ serotonin to prevent N&V. -Promotes GI motility and secretion. -Anti-inflammatory from inhibition of prostaglandin & leukotriene synth.
Ginger root adverse effects
Toxicity can cause CNS depression & cardiac dysrhythmias.
Ginger root contraindication
-Use with caution during pregnancy. Can stimulate uterus and cause contraction/abortion. - Antiplatelet drugs (aspirin) or anticoagulants (warfarin, heparin). Can inhibit thromboxane production by platelets & suppress platelet aggregation.
Ma Huang, ephedra, ephedrine use
Reduce appetite, increase energy, overcome tiredness, treat narcolepsy, relieve bronchospasm, enhance athletic performance, suppress nasal congestion in cases of allergy, flu, or colds. Short term weight loss.
Ma Huang, ephedra, ephedrine action
-CNS Stimulant - affects adrenergic receptors by direct activation and stimulating release of norepinephrine. Can activate A1, A2, B1, B2 adrenergics. -activation of adrenergics in brain result in appetite suppression.
Ma Huang adverse effects
Dangerous. CV: tachycardia, palpations, angina, HTN. CNS: irritability, insomnia, psychosis, euphoria
St. John's Wort use
-relieve mild depression. - external use: anti-inflammatory, hemorrhoid relief, treat vitiligo, burns.
St. John's Wort Action
-decrease up take of serotonin, Norepinephrine, dopamine. -binds strongly to GABA receptors, produces mild MAO inhibition.
St. John's Wort adverse effects
dry mouth, dizziness, confusion, constipation, photosensitivity, enzyme inducer accelerates metabolsim of some drugs, thereby decreasingt their effect decreases levels of digixin risk of serotonergic syndrome
St. John's Wort contraindication
Should not be combined with drugs such as amphetamines, cocaine, MAO inhibitors, all SSRIs (Selective Serotonin Reuptake Inhibitors = antidepressants), or drugs that needn’t be rapidly metabolized or excreted.
Saw Palmetto use
-Relieve urinary symptoms associated with BPH.
Saw Palmetto action
- antiandrogenic activity. May inhibit the enzyme that converts testosterone into dihydrotestosterone (DHT).
Saw Palmetto adverse effects
Upset stomach, headache. High doses can cause diarrhea. Monitor for antiandrogenic affects such as gynecomastia. Can cause a false-negative result on a prostate-specific antigen (PSA) test.
Saw Palmetto contraindication
Danger to developing fetus. Pregnant women should not ingest or touch! Finasteride or Proscar are similars that are FDA classified in the Pregnancy Risk Category X.
Two major problems with herbs
Reproducibility Adulteration
Dietary Supplement Health and Education Acts 1994
excempts vitamins minerals and botanicals from FDA regulation must be marked as dietary supplements no requirement to prove safe or effective
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