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Common Herbs that may be on the NCLEX for both RN's and LPN's

Herbs: Toxicities and Drug Interactions


Medical Author: William C !hiel" M#" $ACP" $ACR Medical Editor: $rederic% Hecht" M#" $AAP" $ACM& Edited and added to by Carin' ( )ou Any con*entional Medication can ha*e side effects +hese side effects are described and re,orted after dru' trials and research studies ha*e been conducted !ide effects are further re,orted and e*aluated after the mar%etin' of the medication -nformation about dru' com,onents" interactions" usa'e in ,re'nancy" nursin' and childhood" and dosin' limits are outlined and made a*ailable in standard references for doctors treatin' ,atients $urthermore" the formulations of the dru's must satisfy strict .uality control standards to ensure conformity +hese medications re'ularly contain *irtually uniform .uantities and ratios of substances -n contrast to con*entional medications" uncon*entional treatments /such as herbs0 ha*e little or no actual scientific basis so doctors can 'uide their ,atients re'ardin' ,ro,er usa'e or ,otential to1icity +here are no standardi2ed references and most of the herbal formulations ha*e not been analy2ed" are not uniform" and ha*e not been .uality controlled 3ne batch can be *ery different from the ne1t Moreo*er" e*en if a 'i*en herb has a %no4n to1icity" the manufacturer may or may not 4arn consumers Manufacturers are not re.uired to alert consumers to %no4n dan'ers +he ,oint is that these 5su,,lements5 are not sanctioned" re'ulated" or su,er*ised by any a'ency +he data are comin'" althou'h slo4ly #r Lucinda Miller of +e1as +ech 6ni*ersity Health !ciences recently re*ie4ed %no4n herb7dru' interactions Her re*ie4 4as ,ublished for doctors in the medical 8ournal Archi*es of -nternal Medicine 9::;<9=;:>>??7 >>?: +he list that follo4s is deri*ed from this article and includes summaries of *arious herbs 4ith ,articular focus on ,otential herb7dru' interactions @ee, in mind that the information in the 56ses5 section is for the most ,art unsu,,orted by *erification of scientific studies -t should be noted that sim,ly because herbs are 5natural5 treatments" they are not necessarily free from side effects [ Heroin ] [ Marijuana ] {updated} [ Cocaine ] [Valarian ] Cha o ile !chinacea "t# $ohn%s &ort 'arlic (e)er*e+ 'in,o -iloba

'inseng 'inger "a+ .al etto -lac, Cohosh Cha o ile 6ses: Chamomile is often used in the form of a tea as a sedati*e Reactions: Aller'ic reactions can occur" ,articularly in ,ersons aller'ic to ra'4eed Re,orted reactions include abdominal cram,s" ton'ue thic%ness" ti'htness in the throat" s4ellin' of the li,s" throat and eyes" itchin' all o*er the body" hi*es" and bloc%a'e of the breathin' ,assa'es Close monitorin' is recommended for ,atients 4ho are ta%in' medications to ,re*ent blood clottin' /anticoa'ulants0 such as 4arfarin !chinacea 6ses: Lar'ely because 4hite blood cells in the laboratory can be stimulated to eat ,articles" Echinacea has been touted to be able to boost the body's ability to fi'ht off infection Reactions: +he most common side effect is an un,leasant taste Echinacea can cause li*er to1icity -t should be a*oided in combination 4ith other medications that can affect the li*er /such as %etacona2ole" leflunomide /Ara*a0" methotre1ate /Rheumatre10" isonia2ide /Ni2oral0 "t# $ohn%s &ort 6ses: !t Aohn's Wort is ,o,ularly used as an herbal treatment for de,ression" an1iety" and slee, disorders -t is technically %no4n as Hy,ericum ,erforatum Chemically" it is com,osed of at least 9? different substances that may ,roduce its effects +he ratios of these different substances *aries from ,lant to ,lant /and manufacturer0 !tudies of its effecti*eness by the National -nstitutes of Health are in ,ro'ress Reactions: +he most common side effect has been sun sensiti*ity 4hich causes burnin' of the s%in -t is recommended that fair7 s%inned ,ersons be ,articularly careful 4hile in the sun !t Aohn's 4ort may also lea*e ner*e chan'es in sunburned areas +his herb should be a*oided in combination 4ith other medications that can affect sun sensiti*ity /such as tetracyclineBAchromycin" sulfa7 containin' medications" ,iro1icam /$eldend0 !t Aohn's 4ort can also cause headaches" di22iness" s4eatin'" and a'itation 4hen used in combination 4ith serotonin reu,ta%e inhibitor medications such as fluo1etine /Pro2ac0 and ,aro1etine /Pa1il0 'arlic 6ses: &arlic has been used to lo4er blood ,ressure and cholesterol /#r Lucinda Miller notes that there is 5 still insufficient e*idence to recommend its routine use in clinical ,ractice 50 Reactions: Aller'ic reactions" s%in inflammation" and stomach u,set ha*e been re,orted Cad breath is a notorious accom,animent !tudies in rats ha*e sho4n decreases in male rats' ability to ma%e s,erm cells &arlic may decrease normal blood clottin' and should be used 4ith caution in ,atients ta%in' medications to ,re*ent blood clottin' /anticoa'ulants0 such as 4arfarin

BCoumadin (e)er*e+ 6ses: Most commonly used for mi'raine headaches Reactions: $e*erfe4 can cause aller'ic reactions" es,ecially in ,ersons 4ho are aller'ic to chamomile" ra'4eed" or yarro4 Nonsteroidal anti7inflammatory dru's /N!A-#s such as ibu,rofen /Ad*il0" na,ro1en /Ale*e0 or Motrin0 can reduce the effect of fe*erfe4 A condition called 5,ostfe*erfe4 syndrome5 features sym,toms includin' headaches" ner*ousness" stiffness" 8oint ,ain" tiredness" and ner*ousness $e*erfe4 can im,air the action of the normal blood clottin' element /,latelets0 -t should be a*oided in ,atients ta%in' medications to ,re*ent blood clottin' /anticoa'ulants0 such as 4arfarin /Coumadin0 'in,o -iloba 6ses: +his herb is *ery ,o,ular as a treatment for dementia /a ,ro'ressi*e brain dysfunction0 and to im,ro*e thin%in' Reactions: Mild stomach u,set and headache ha*e been re,orted &in%o seems to ha*e blood thinnin' ,ro,erties +herefore" it is not recommended to be ta%en 4ith as,irin" nonsteroidal anti7 inflammatory dru's /Ad*il0" na,ro1en /Ale*e0 or Motrin0" or medications to ,re*ent blood clottin' /anticoa'ulants0 such as 4arfarin /Coumadin0 &in%o should be a*oided in ,atients 4ith e,ile,sy ta%in' sei2ure medicines" such as ,henytoin /#ilantin0" carbama2e,ine /+e'retol0" and ,henobarbital 'inseng 6ses: &insen' has been used to stimulate the adrenal 'land" and thereby increase ener'y -t also may ha*e some beneficial effect on reducin' blood su'ar in ,atients 4ith diabetes mellitus /#r Miller em,hasi2ed that there is substantial *ariation in the chemical com,onents of substances branded as 5&insen' 50 Reactions: &insen' can cause ele*ation in blood ,ressure" headache" *omitin'" insomnia" and nose bleedin' &insen' can also cause falsely abnormal blood tests for di'o1in le*el -t is unclear 4hether 'insen' may affect female hormones -ts use in ,re'nancy is not recommended &insen' may affect the action of the normal blood clottin' element /,latelets0 -t should be a*oided in ,atients ta%in' as,irin" nonsteroidal antiinflammatory dru's /such as ibu,rofen /Ad*il0" na,ro1en /Ale*e0 or Motrin0" or medications to ,re*ent blood clottin' /anticoa'ulants0 such as 4arfarin /Coumadin0 &insen' may also cause headaches" tremors" ner*ousness" and slee,lessness -t should be a*oided in ,ersons 4ith manic disorder and ,sychosis 'inger 6ses: &in'er has been used as a treatment for nausea and bo4el s,asms Reactions: &in'er may lead to blood thinnin' -t is not recommended to be ta%en 4ith medications that ,re*ent blood clottin' /anticoa'ulants0 such as 4arfarin /Coumadin0 "a+ .al etto

6ses: !a4 ,almetto has been most commonly used for enlar'ement of the ,rostate 'land /#r Miller em,hasi2ed that studies *erifyin' this assertion are necessary 0 !a4 ,almetto has also been touted as a diuretic and urinary antise,tic to ,re*ent bladder infections Reactions: +his herb may affect the action of the se1 hormone testosterone" thereby reducin' se1ual dri*e or ,erformance #r Miller states that 5While no dru'7herb interactions ha*e been documented to date" it 4ould be ,rudent to a*oid concomitant use 4ith other hormonal thera,ies /e ' " estro'en re,lacement thera,y and oral contrace,ti*es 50 +his listin' re,resents only a small ,ortion of herbal treatments Ne*ertheless" the ,o,ularity of herbal thera,ies is un.uestionable #octors routinely confront the un%no4n 4ith their ,atients 4ho are usin' herbs #octors sim,ly do not ha*e any 4ay of hel,in' you to decide 4hether these herbs are hel,ful or harmful for you" or 4hether they are interactin' 4ith your current medications +here are no data -lac, Cohosh Claims" Cenefits: A natural 4ay to treat meno,ausal sym,toms Cottom Line: Little is %no4n about its benefits and its ris%s -f you try it" tell your ,hysician" since it mi'ht interact 4ith other medications you are ta%in' 9::D7>??( MedicineNet" -nc

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