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Chapter 47
Herbal and dietary Supplement Therapy
| Term | Definition |
|---|---|
| • “All natural” is NOT synonymous with “better” | • Some herbal medicines/supplements are harmful |
| * | Almost all herbal medicines, vitamins, minerals, amino acids for health reclassified as “dietary supplements,” a food category |
| * | Must state that product is not evaluated by FDA |
| • Herbal medications, vitamins, minerals, amino acids, other chemicals used for health reclassified | –No safety, effectiveness requirements –Vast majority of claims unproven –No standardized manufacturing requirements |
| Role of Health Care Professional • Moral, ethical responsibility to recommend only medicines proven safe and effective • Factors to consider | –Most supplements not scientifically tested –Consumers may be misinformed –Supplements cannot cure serious conditions –Quality control is deficient –Exercise caution for pregnant or pediatric patients –Watch for adverse effects –Examine label carefully |
| Assessment | • 40% to 70% don't tell of use • Discuss pt reasons for use • Obtain list of patient symptoms and information about changes in symptoms since supplement use • Obtain complete list of all med • Determine cultural/ethical beliefs contributing to use |
| • Aloe | –Topically for pain, inflammation, itching |
| Black cohosh | –Reduces symptoms of PMS, dysmenorrhea, menopause |
| Chamomile | –Antiinflammatory and antispasmodic effects |
| Echinacea | –Nonspecific immunostimulant • Not recommended in patients with autoimmune disorders or diseases affecting immunity (AIDS) |
| Ephedra | –Bronchodilator, nasal decongestant, CNS stimulant • Touted as weight-loss product, energy booster, aphrodisiac, and mental stimulant •OD has occured • Precursor to meth • Contraindicated in pt with heart conditions, HTN, diabetes, and thyroid disease |
| Feverfew | –Reduces frequency and severity of migraines |
| Garlic | –Lowers serum cholesterol and triglycerides • Reduces platelet aggregation; used with extreme caution in patients receiving platelet inhibitors; monitor for bleeding |
| • Ginger | –Alleviates nausea and vomiting |
| Ginkgo | –Treat short-term memory loss, headache, dizziness, tinnitus, emotional instability • Vasodilator improves cerebral blood flow • help w intermittent claudication, ED, improve peripheral blood flow diabetics • monitor for bleeding |
| Ginseng | –Unsubstantiated claims to increase resistance to stress and disease • May affect platelet aggregation, monitor for bleeding • Raises insulin levels in animals, monitor for hypoglycemia |
| Goldenseal | –Antiseptic and astringent • Some patients may believe (inaccurately) that it will prevent detection of drugs in urine |
| Green tea | –Improves cognitive performance • Stimulant effects may increase with other stimulants |
| St. John’s wort | –Treat mild depression; wound healing • May cause photosensitivity • Contributes to serotonin syndrome ; need washout period |
| Valerian | –Used for restlessness, promotes sleep • Do not confuse with Valium • Avoid other CNS depressants |
| Coenzyme Q10: | for heart failure, CV disease |
| Creatine | –Performance-enhancing substance, may cause water retention; patients with renal failure should avoid |
| Gamma-hydroxybutyrate (GHB) | –“Rave” drug can cause death, banned by FDA, but still marketed as dietary supplement, can purchase kits and recipes on Internet; euphoriant, sedative at higher doses; coma, vomiting, aspiration, and death have occurred |
| Lycopene | –May reduce risk of cancers, lower LDL, cholesterol |
| Melatonin | –Sleep aid and treatment for jet lag, withdrawal from benzodiazepines • Causes drowsiness, use safety precautions; may cause paradoxical response |
| Policosanol | –Lower cholesterol levels, platelet inhibitor, enhances anticoagulants, monitor for bleeding |
| Omega-3 fatty acids | –Reduce incidence of MI, lower triglycerides, stabilize plaque formation, reduce risk of blood clots, lower blood pressure |
| S-adenosylmethionine (SAM-e) – | Treats depression, osteoarthritis (expensive) • Stomach distress, may interact with other antidepressants |
| Which herbal supplement is promoted as a weight-loss product, energy booster, aphrodisiac, and mental stimulant? | b) Black cohosh |
| Which substance is said to increase memory by increasing cerebral blood flow? | d) Ginkgo biloba |
| • Which substance is said to increase resistance to stress and strengthen overall vitality? | a) Ginseng |
| What is the primary use for melatonin? | b) Sleep aid |
| What is an effect of ingesting gamma-hydroxybutyrate (GHB)? | b) Intoxication and sedation |
Created by:
Gdaniels