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Herbal Medications - Issues Related To Their Use - Part II

Herbal Medications - Issues Related To Their Use - Part II

Herbal Medications - Issues Related To Their Use - Part II

Craig V. Towers, M.D.
Craig V. Towers, M.D.
on behalf of e-Ed Credits

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Launch date: 05 Oct 2017
Expiry Date:

Last updated: 07 Feb 2018

Reference: 184898

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Description

As discussed in Part I and in review, hundreds of herbal ingredients are in existence and alone or in combination make up thousands of products that can be purchased by the public without a prescription. The purpose of this article is to inform nurses about some of the medical effects that can be seen with certain products. It is important to remember that a large portion of prescription and non-prescription drugs come from herbs or are derivatives of herbs. Therefore, many herbs can produce a medical effect when taken internally by an individual.

In the past, the FDA was beginning to review herbal products in conjunction with its review of over-the-counter drugs. However, this changed when ""The Dietary Supplement Health and Education Act of 1994"" was passed, which removed the FDA’s authority to regulate ""dietary supplements"". Herbal medicines and natural remedies are classified as ""dietary supplements"" and thus are no longer formally reviewed by the FDA. Herbal products are easier to obtain by the public and are much less expensive when compared to prescription drugs. The passage of this 1994 Act in conjunction with other factors has resulted in an explosion in the use of herbal products by people in the United States. Americans spent an estimated 3 to 4 billion dollars on herbal medicines and ""natural remedies"" in the year 2000, an increase of 10 fold from 1994. An estimated 80 million Americans used an herbal medication in the year 2000, excluding vitamins.

As discussed in Part I, many of the herbal products have been studied (primarily in Europe or Asia), however, the majority of these studies are not randomized and placebo controlled. Extensive herbal medication usage has been ongoing in Europe for a long period of time compared to that of the United States. In the early 1980’s, Germany developed its ""Commission E"" (CE), which was a 24-member group of physicians, pharmacists, toxicologists, and pharmacologists that reviewed the literature on 380 herbs and published monographs on their conclusions. This review process occurred from 1983 to 1995. The World Health Organization (WHO) has also started to review some herbal medications and is creating monographs. Twenty such monographs have been completed with an additional 30 due by the end of 2001 to 2002. Currently, there are no ongoing reviews in the United States by an organized group of researchers. The information regarding the herbs in this article comes from Commission E and WHO reports as well as the most recent literature.

Objectives

Upon completion of this course, the learner will be able to:
1. Describe the primary reason for usage and the proposed mechanism of action for Saw Palmetto, Kava Kava, Grape Seed, Cranberry, Valerian Root, Evening Primrose, and Milk Thistle.

2. Discuss which herbal products (reviewed in this article) should be used with caution in patients with multiple sclerosis, Parkinson’s disease, and epilepsy.

3. State the potential for a drug / herb interaction in those individuals taking certain medications in conjunction with the herbal products discussed in this article.

4. Discuss which herbal products (reviewed in this article) should not be used prior to receiving anesthesia and should be avoided by pregnant women.
Craig V. Towers, M.D.

Author Information Play Video Bio

Craig V. Towers, M.D.
on behalf of e-Ed Credits

Dr. Towers is currently Professor and Vice Chair of the Department of Obstetrics & Gynecology at University of Tennessee Medical Center Knoxville in the Division of Maternal-Fetal Medicine. He is still clinically active managing numerous high-risk pregnancies. He is also actively involved in research with over 90 publications in major medical journals. Though his research has spanned many areas in obstetrics, he has primary interests in drugs in pregnancy, infections in pregnancy, fetal heart monitoring, bleeding in pregnancy, and fetal lung maturity.

He has authored a book for consumers regarding the safety of over-the-counter medications that are used in treating the common cold entitled “I’m Pregnant & I Have a Cold – Are Over-the-Counter Drugs Safe to Use?” published by RBC Press, Inc. He is also one of the new Editors of the reference book for clinical care providers entitled “Drugs in Pregnancy and Lactation, published by Wolters & Kluwer.

Current Accreditations

This course has been certified by or provided by the following Certified Organization/s:

  • American Nurses Credentialing Center (ANCC)
  • 1.00 Hours

Faculty and Disclosures

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