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Introduction
Whether synthetic or natural (herbal), drugs are intended to act on the body. There always is a chance that they will produce effects that we do not want. Also, if two or more drugs are taken at the same time, there is a chance that one drug will interact with another drug in either a positive or negative way. This does not imply that the drugs are bad, but rather that they should be used carefully in order to reap the greatest benefit while minimizing unwanted side effects.
Side effects: Problems that occur when treatment goes beyond the desired effect. Or problems that occur in addition to the desired therapeutic effect. Example -- A hemorrhage from the use of too much anticoagulant (such as heparin) is a side effect caused by treatment going beyond the desired effect. Example -- The common side effects of cancer treatment including fatigue, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores are instances of side effects that occur in addition to the desired therapeutic effect.
Unlike conventional drugs, herbal products are not regulated for purity and potency.2 Thus, some of the adverse effects and drug interactions reported for herbal products could be caused by impurities (e.g., allergens, pollen and spores)
Ginko biloba
Ginkgo biloba has potential interactions with garlic, vitamin E and medications with antiplatelet or anticoagulant properties.
Side effects Bleeding Gastrointestinal disturbances, allergic reactions, fatigue, dizziness, confusion, dry mouth, photosensitivity
Kava
Sedation, oral and lingual dyskinesia, torticollis, oculogyric crisis, exacerbation of Parkinson's disease, painful twisting movements of the trunk, rash
Interacting drugs Aspirin, warfarin (Coumadin), ticlopidine (Ticlid), clopidogrel (Plavix), dipyridamole (Persantine)
Antidepressants Caffeine, decongestants, stimulants Warfarin Sedatives, sleeping pills, antipsychotics, alcohol
Ephedra
Ephedrine and related alkaloids are the pharmacologically active moieties of the extract of Ephedra (a genus of shrubs).19 Ephedrine constitutes 30 to 90 percent of the alkaloids of Ephedra species. The extract of some species also contains pseudoephedrine. Patients should be advised not to use ephedrinecontaining supplements if they have cardiovascular disease, hyperthyroidism, diabetes mellitus, benign prostatic hypertrophy or glaucoma.
Ginseng
Little scientific evidence shows that ginseng is effective for any purpose to strengthen normal body functions, increase resistance to stress and improve sexual function
The timing of drug administration should be considered as possible influence on drug efficacy, adverse effects, and interactions with other drugs and food. A medication regimen should be simplified as much as possible to enhance patient adherence. A patients perception of illness or the risks and benefits of therapy may affect adherence and treatment outcomes. Careful observation of a patients response to treatment is necessary to confirm efficacy, prevent, detect, or manage adverse effects, assess compliance, and determine the need for dosage adjustment or discontinuation of drug therapy. A medication should not be given by injection when giving it by mouth would be just as effective and safe.
Before medications are used, lifestyle modifications should be made, when indicated, to obviate the need for drug therapy or to enhance pharmacotherapy outcomes. Initiation of a drug regimen should be done with full recognition that a medication may cause a disease, sign, symptom, syndrome, or abnormal laboratory test. When a variety of drugs are equally efficacious and equally safe, the drug that results in the lowest health care cost or is most convenient for the patient should be chosen. When making a decision about drug therapy for individual patients, society effects should be considered. The possible reasons for failure of medication regimens include inappropriate drug selection, poor adherence, improper drug dose or interval, misdiagnosis, concurrent illness, interactions with foods or drugs, environmental factors, or genetic factors.