Transcript Herbal Safety and Interactions with Prescription Drugs

Herbal Safety and Interactions with
Heart Disease Prescription Drugs
Introduction
Due to the increased consumption of herbal medicines, health
care professionals should be more aware and pay more
attention to patients taking them.
Furthermore, there has been very little research on the safety
of herbal medicine in the United States.
Patients need to understand that even though herbal
medicines may be natural, these products are not always safe.
Why is it a concern?
Drug Interactions
 Active ingredients in herbal medicines that are potent
chemicals.
 Interactions with other products and adverse reactions are also
likely for herbal medicine, which is something else that
manufacturers need to address correctly.
Not FDA Approved
 According to the U.S. Food and Drug Administration (FDA),
herbal medicines are put under the category of food. They
have different regulations than over-the-counter drugs and are
considered safe until proven unsafe.
 Herbal medicines are not FDA approved nor are labeled with
safety warnings. It is up to the manufacturers to make sure all
claims and information on the product label are correct.
(http://www.fda.gov/Food/DietarySupplements/)
Heart Disease and Herbal Medicines
Heart Disease
 Leading cause of death in the United States
A commonly taken prescription medication
for reducing the risk of pulmonary embolism, deep vein
thrombosis, preventing strokes and heart attacks in
patients with atrial fibrillation or artificial heart valves is:
Warfarin
 Anticoagulant
 Antagonizes vitamin K
 Inhibits the clotting of blood
Common Warfarin-Herb Interactions
Herb
Ginseng (Panax)
Common Uses
Boosts energy, stamina, and the
immune system, lowers LDL
cholesterol and blood pressure
Potential Effect
Increase blood pressure and
decreases the effect of warfarin
when overused
Garlic (Allium sativum)
Lowers total and LDL cholesterol Increase the risk of bleeding
and blood pressure, used as a
associated with warfarin
blood thinner and
prevent atherosclerosis
Ginkgo (Ginkgo biloba)
Improves memory and prevents
dementia and Alzheimer’s
disease, used to treat asthma,
sexual dysfunction, poor
circulation
Increase the risk of bleeding
associated with warfarin
Green Tea (Camellia sinensis)
Weight loss, improves mental
alertness, lowers cholesterol,
prevents cancer
Vitamin K can counteract the
effect of warfarin
Ginger (Zingiber officinale
Roscoe)
Treats various stomach ailments
like nausea, diarrhea, and
stomachache, used to treat joint
and muscle pain
Increases the risk of bleeding
associated with warfarin
For more information on herb interactions: Complementary and Alternative Medicine Guide (http://umm.edu/health/medical/altmed )
Safety Promotion
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Ask about your patients’ conditions and any prescription or overthe-counter medicines they take during past medical history.
Ask about your patients’ eating patterns and any nutritional or
herbal supplements, including herbal teas.
Tell your patients to notify you before they change their nutritional
supplements or eating pattern.
before you change your nutritional supplements or eating pattern.
Note exactly the amount of herbal medications taken by the patient.
Include frequency of the medicines taken and for what purpose.
Educate and help patients on how to purchase reliable herbal
medicines and look for companies with good manufacturing
practice.
Reflective Note
This is a presentation for nurses and physicians at
clinics/hospitals or conferences on the topic of herbal medicine
safety and its interactions with prescription drugs. One might
come across this presentation during team meetings or
conferences. It is extremely important to document herbal
medicines used by patients, especially patients with heart
conditions. Potential herb-drug interactions could occur and it is
important to educate health care providers on how to prevent
them. Physicians and nurses need to take more initiative in
asking patients about specific details on the herbal medicines
they are taking. It is also crucial for physicians and nurses to
educate patients on how to purchase reliable herbal medicines
and look for companies with GMP.
References
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Bradley J, McEwen BJ. (2015). The influence of herbal medicine on platelet function
and coagulation: a narrative review. Seminars in Thrombosis and Hemostasis, 41(3),
300-314.
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Ge, B., Zhang, Z., & Zuo, Z. (2014). Updates on the Clinical Evidenced HerbWarfarin Interactions. Evidence-Based Complementary and Alternative Medicine,
2014, 1-18.
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[Untitled photograph of doctor patient relationship]. Retrieved from:
http://i.huffpost.com/gen/1142793/images/o-DOCTOR-PATIENT-RELATIONSHIPfacebook.jpg
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[Untitled photograph of heart anatomy]. Retrieved from: http://jesupdoctor.com/wpcontent/uploads/2012/04/heart-disease-jesup-doctor-wayne-county-medical-clinic.jpg
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[Untitled photograph of natural herbs]. Retrieved from:
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[Untitled photograph of natural medicine still life]. Retrieved from:
http://www.acuhhs.com/wp-content/uploads/bigstock-Natural-Medicine-Still-Life7509941.jpg