Common Herbs that may be on the NCLEX

Herbs: Toxicities and Drug Interactions

Chamomile

Uses: Chamomile is often used in the form of a tea as a

sedative.

Reactions: Allergic reactions can occur, particularly in

persons allergic to ragweed. Reported reactions include
abdominal cramps, tongue thickness, tightness in the throat,
swelling of the lips, throat and eyes, itching all over the
body, hives, and blockage of the breathing passages. Close
monitoring is recommended for patients who are taking
medications to prevent blood clotting (anticoagulants) such
as warfarin.

1. WHAT IS RAGWEED? IS THIS A VARIETY OF THE CHAMOMILE HERB?

2. WHAT HAS COUMADIN OR WARFARIN GOT TO DO WITH THE USE OF
THIS HERB? WHAT TRIGGERS THE ALLERGIC REACTION FROM THIS
ANTI-COAG?

Echinacea

Uses: Largely because white blood cells in the laboratory

can be stimulated to eat particles, Echinacea has been
touted to be able to boost the body's ability to fight off
infection.

Reactions: The most common side effect is an unpleasant

taste. Echinacea can cause liver toxicity. It should be
avoided in combination with other medications that can
affect the liver (such as ketaconazole, leflunomide (Arava),
methotrexate (Rheumatrex), isoniazide (Nizoral).

1. HOW DOES IT REACT WITH THESE ANTI-FUNGAL MEDICATIONS

MENTIONED WHICH ARE USUALLY APPLIED ON SKIN AND NOT
INGESTED?

St. John's Wort

Uses: St. John's Wort is popularly used as an herbal

treatment for depression, anxiety, and sleep disorders. It
is technically known as Hypericum perforatum. Chemically, it
is composed of at least 10 different substances that may
produce its effects. The ratio of these different substances
varies from plant to plant (and manufacturer). Studies of
its effectiveness by the National Institutes of Health are
in progress.

Reactions: The most common side effect has been sun

sensitivity which causes burning of the skin. It is
recommended that fair- skinned persons be particularly
careful while in the sun. St. John's Wort may also leave
nerve changes in sunburned areas. This herb should be
avoided in combination with other medications that can
affect sun sensitivity (such as tetracycline/Achromycin,
sulfa- containing medications, piroxicam (Feldend). St.
John's wort can also cause headaches, dizziness, sweating,
and agitation when used in combination with serotonin
reuptake inhibitor medications such as fluoxetine (Prozac)
and paroxetine (Paxil).

Garlic

Uses: Garlic has been used to lower blood pressure and

cholesterol (Dr. Lucinda Miller notes that there is
"...still insufficient evidence to recommend its routine use
in clinical practice.")

Reactions: Allergic reactions, skin inflammation, and

stomach upset have been reported. Bad breath is a notorious
accompaniment. Studies in rats have shown decreases in male
rats' ability to make sperm cells. Garlic may decrease
normal blood clotting and should be used with caution in
patients taking medications to prevent blood clotting
(anticoagulants) such as warfarin /Coumadin.

1. DOES THE EQUATION DECREASE IN MALE RATS' SPERM CELLS =

HUMAN SPERM CELLS DECREASED? ;)

Feverfew

Uses: Most commonly used for migraine headaches.

Reactions: Feverfew can cause allergic reactions, especially

in persons who are allergic to chamomile, ragweed, or
yarrow. Nonsteroidal anti-inflammatory drugs (NSAIDs such
as ibuprofen (Advil), naproxen (Aleve) or Motrin) can reduce
the effect of feverfew. A condition called "postfeverfew
syndrome" features symptoms including headaches,
nervousness, stiffness, joint pain, tiredness, and
nervousness. Feverfew can impair the action of the normal
blood clotting element (platelets). It should be avoided in
patients taking medications to prevent blood clotting
(anticoagulants) such as warfarin (Coumadin).

I AM NOW REALIZING AS OF THIS MOMENT THAT SOME HERBS CAUSE

BLEEDING.

Gingko Biloba

Uses: This herb is very popular as a treatment for dementia

(a progressive brain dysfunction) and to improve thinking.

Reactions: Mild stomach upset and headache have been

reported. Gingko seems to have blood thinning properties.
Therefore, it is not recommended to be taken with aspirin,
nonsteroidal anti-inflammatory drugs (Advil), naproxen
(Aleve) or Motrin), or medications to prevent blood clotting
(anticoagulants) such as warfarin (Coumadin). Gingko should
be avoided in patients with epilepsy taking seizure
medicines, such as phenytoin (Dilantin), carbamazepine
(Tegretol), and phenobarbital.

Ginseng

Uses: Ginseng has been used to stimulate the adrenal gland,

and thereby increase energy. It also may have some
beneficial effect on reducing blood sugar .in patients with
diabetes mellitus. (Dr. Miller emphasized that there is
substantial variation in the chemical components of
substances branded as "Ginseng.")

Reactions: Ginseng can cause elevation in blood pressure,

headache, vomiting, insomnia, and nose bleeding. Ginseng can
also cause falsely abnormal blood tests for digoxin level.
It is unclear whether ginseng may affect female hormones.
Its use in pregnancy is not recommended. Ginseng may affect
the action of the normal blood clotting element (platelets).
It should be avoided in patients taking aspirin,
nonsteroidal antiinflammatory drugs (such as ibuprofen
(Advil), naproxen (Aleve) or Motrin), or medications to
prevent blood clotting (anticoagulants) such as warfarin
(Coumadin). Ginseng may also cause headaches, tremors,
nervousness, and sleeplessness. It should be avoided in
persons with manic disorder and psychosis.

Ginger
Uses: Ginger has been used as a treatment for nausea and
bowel spasms.

Reactions: Ginger may lead to blood thinning. It is not

recommended to be taken with medications that prevent blood
clotting (anticoagulants) such as warfarin (Coumadin).

Saw Palmetto

Uses: Saw palmetto has been most commonly used for

enlargement of the prostate gland. (Dr. Miller emphasized
that studies verifying this assertion are necessary.) Saw
palmetto has also been touted as a diuretic and urinary
antiseptic to prevent bladder infections.

Reactions: This herb may affect the action of the sex

hormone testosterone, thereby reducing sexual drive or
performance. Dr. Miller states that "While no drug-herb
interactions have been documented to date, it would be
prudent to avoid concomitant use with other hormonal
therapies (e.g., estrogen replacement therapy and oral
contraceptives...")

1. WHAT'S THE SIGNIFICANCE OF PROSTATE GLAND ENLARGEMENT?

WHAT BENEFIT / S?