herbals

Herbals

Herbals are not considered by some to be medications. They are not regulated by the FDA and can be obtained without a prescription. They do, however, have medicinal properties. Herbals are included on the NCLEX in the category of pharmacology. The list that follows includes some common herbals used by clients as well as some associated nursing precautions:

<![if !vml]><![endif]> Feverfew: This is used to prevent and treat migraines, arthritis, and fever. This herbal should not be taken with Coumadin, aspirin, NSAIDs, thrombolytics, or antiplatelet medications because it will prolong the bleeding time.

<![if !vml]><![endif]> Ginseng: This is used as an anti-inflammatory. It has estrogen effects, enhances the immune system, and improves mental and physical abilities. This herbal decreases the effects of anticoagulants and NSAIDs. It also should not be taken by clients taking corticosteroids because the combination of these two can result in extremely high levels of corticosteroids. High doses cause liver problems. A client with hypertension and bipolar disorder should be cautioned regarding the use of ginseng because this herbal can interfere with medications used to treat these disorders.

<![if !vml]><![endif]> Ginkgo: This improves memory and can be used to treat depression. It also improves peripheral circulation. Ginkgo should not be taken with MAO inhibitors, anticoagulants, or antiplatelets. It increases the bleeding time in clients taking NSAIDs, cephalosporins, and valproic acid. Clients with seizure disorders should not take ginkgo because it can exacerbate seizure activity.

<![if !vml]><![endif]> Echinacea: This is used to treat colds, fevers, and urinary tract infections. This herbal can interfere with immunosuppressive agents, methotrexate, and ketoconizole.

<![if !vml]><![endif]> Kava-kava: This herb is used to treat insomnia and mild muscle aches and pains. It increases the effects of central nervous system (CNS) suppressants and decreases the effects of levodopa. It can also increase the effect of MAOIs and cause liver damage.

<![if !vml]><![endif]> St. John’s Wort: This is used to treat mild to moderate depression. This herbal increases adverse CNS effects when used with alcohol or antidepressant medications.

<![if !vml]><![endif]> Ma Huang: This is used to treat asthma and hay fever, for weight loss, and to increase energy levels. It increases the effect of MAOIs, sympathomimetics, theophylline, and cardiac glycosides.