Chapter 48

Herbal and Dietary Supplement Therapy

Mosby items and derived items 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Chapter 48
Lesson 48.1

Mosby items and derived items 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 2

Objectives
Describe the possible impact of the use of
herbal and dietary supplement products on cultural/ethnic beliefs Summarize the primary actions, uses, and interactions of the herbal and dietary supplement products cited

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Slide 3

Herbal and Dietary Supplements

All natural is NOT synonymous with better Some herbal medicines/supplements are harmful
Adverse effects Drug interactions

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Dietary Supplement Health and Education Act of 1994

Almost all herbal medicines, vitamins,
minerals, amino acids for health reclassified as dietary supplements, a food category Allows manufacturers to include information about products effects on the body on labels and in advertisements Must state that product is not evaluated by FDA Does not stop others from making claims

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Slide 5

Dietary Supplements
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

Several organizations test for labeled potency, good manufacturing practices, and contaminationnot safety or effectiveness

Mosby items and derived items 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 6

Label Certification

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Slide 7

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

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Slide 8

Assessment
Discuss patients reasons for interest and/or
use Obtain list of patient symptoms and information about changes in symptoms since supplement use Find out source of recommendation Obtain complete list of all medications Determine cultural/ethical beliefs contributing to supplement use decision Discuss cultural and ethnic beliefs with patient
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Slide 9

Patient Education

Expectations of therapy Discuss medication information Ensure understanding of proper use Promote the development and maintenance of a written record of monitoring parameters Complete the Premedication Data column of the patient self-assessment form to track response to drug therapy

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Herbal Therapy
Aloe
Topically for pain, inflammation, itching

Black cohosh
Reduce symptoms of PMS, dysmenorrhea, menopause

Chamomile
Anti-inflammatory and antispasmodic effects

Echinacea
Nonspecific immunostimulant

Ephedra
Bronchodilator, nasal decongestant
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Herbal Therapy (contd)

Feverfew
Reduce frequency and severity of migraines

Garlic
Lower serum cholesterol and triglycerides

Ginger
Alleviate nausea and vomiting

Ginkgo
Treat short-term memory loss, headache, dizziness, tinnitus, emotional instability

Ginseng
Unsubstantiated claims to increase resistance to stress and disease
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Herbal Therapy
Goldenseal
Antiseptic and astringent

Green tea
Improve cognitive performance

Saw palmetto
Reduce DHT levels associated with BPH

St. Johns wort

Treat mild depression; wound healing

Valerian
Used for restlessness, promotes sleep
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Slide 13

Other Dietary Supplements

Coenzyme Q10 Creatine Gamma-hydroxybutyrate (GHB) Lycopene Melatonin Policosanol Omega-3 fatty acids S-adenosylmethionine (SAM-e)

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