Herbal medications

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Herbal medications

• Barb Hays, RN
• Winter 2005, 6

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History

• 2000 BC Here, eat this root
• 1000 AD That root is heathen. Here, say this
  prayer
• 1850 AD That prayer is superstition. Here,
  drink this potion
• 1940 AD That potion is snake oil. Here,
  swallow this pill
• 1985 AD That pill is ineffective. Here, take
  this antibiotic
• 2000 AD That antibiotic doesnt work anymore.
  Here, eat this root
• -- Carolyn R. Allen PhD, R Ph

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• Not since the early 1900s have so many bought
  so much with so little
• sound science

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Dietary Supplement Health Education Act (1994)

• Deregulation
• Remove vitamins, dietary supplements, herbs,
  other natural products from strict FDA control.

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No quality control.We depend on the scruples of
the manufacturer.

• Since 1994 market has been flooded
• No regulations to ensure purity or
  standardization
• Manufacturer not required to prove safety or
  efficacy (opposite to situation of new
  prescription drugs)
• No mandatory reporting of adverse effects

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Dietary Supplement Health Education Act (1994)

• Risks
• 2900 adverse-event reports (including 104 deaths)
  to FDA about
• Ephedra
• St. Johns Wort
• Ginseng
• No standard for reporting, no mandatory reporting
• FDA estimates 100 times more events than reported

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No quality control.We depend on scruples of
manufacturer

• Standardization problems (from sample of 50
  different Ginkgo Biloba products)
• 6 contained no active ingredient
• Content in other varied fourfold
• 1 out of 3 products contain undeclared
  pharmaceuticals (methyltestosterone, ephedrine,
  phenacetin)
• Heavy metals (lead, arsenic, mercury) in some

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No quality control.We depend on scruples of
manufacturer

• Overvaluing herbal use at expense of mainstream
  medical treatment can
• Misdirect people away from more effective
  treatment
• Delay entering system/diagnosis
• Interact with or counteract prescribed
  medications (especially cancer/HIV treatments)

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For example, Ginkgo Biloba

• Decreases platelet aggregation
• Strokes
• Drug interaction
• Valproic acid (dec. )
• Anticoagulants (inc. )
• MOAIs (inc. )

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And Saw Palmetto

• It makes the symptoms go away
• Good thing?
• Bad thing?

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Or Kava Kava?

• Increased effects of CNS depressants, including
  anesthesia
• Hepatic failure?

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Echinacea high failure rate

• Contaminations
• Bacterial
• Heavy metals
• Quality control
• Excess contamination
• Lack of product

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Or St. Johns Wort

• Newer research indicates it may be less effective
  than previously believed
• Reduces blood concentration of Indinavir (for
  AIDS) by 90
• Can begin process that amplifies excretion of a
  wide variety of drugs could be deadly to those
  who rely on chemicals to protect a transplanted
  heart from immune rejection

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Valerian

• Increases the effects of many drugs
• Valium
• Anticonvulsants
• Antidepressants
• Prozac
• Elavil, Tofranil
• ETOH

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Licorice (even the black candy)

• Increases blood pressure
• Can cause fluid retention

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• Bottom line implications?
• Respect
• Use
• teach