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Page 1 Identifying Interactions Between Prescription and Herbal Medications Lorraine W. Bock, MSN, CRNP, CEN.

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Presentation on theme: "Page 1 Identifying Interactions Between Prescription and Herbal Medications Lorraine W. Bock, MSN, CRNP, CEN."— Presentation transcript:

1 Page 1 Identifying Interactions Between Prescription and Herbal Medications Lorraine W. Bock, MSN, CRNP, CEN

2 Page 2 Objectives: 1.) Appreciate the magnitude of use of non- prescription herbs, vitamins, and supplements in the United States today. 2.) Understand the use of common herbal medications and supplements available on the market. 3.) Recognize common pharmaceuticals that pose of risk of drug/herb interactions. At the completion of this program the learner will:

3 Page 3 How many of you are currently taking a non-prescription vitamin herb or supplement on a regular basis?

4 Page 4 Supplement Use in the US Nearly 20% of Americans use a vitamin, herb, or supplement daily Over 50% of Americans admit to using a vitamin, herb, or supplement in the last 30 days Over 17 billion dollars is spent annually by consumers on the purchase of vitamins, herbs, and supplements National Center for Complimentary and Alternative Medicine

5 Page 5 What are we talking about? Vitamins Minerals Herbs Botanicals Amino Acids “Natural Products” Any substance intended to be taken by mouth for the purpose of supplementing the diet,contains one or more of the substances listed, and is labeled as a dietary supplement.

6 Page 6 Most Commonly Used Vitamins, Herbs, & Supplements Multivitamin/Multimineral Fish Oils/Omega III/DHA Glucosamine/Glucosamine Chondroitin Echinacea Flaxseed Ginseng Vitamins – B-complex, E, & C Calcium

7 Page 7 Multivitamins/Multiminerals Used to provide the addition of a variety of vitamins and minerals to one’s diet. Supplement nutrition

8 Page 8 Interactions/Side Effects Avoid drinking milk to take MVI Avoid salt substitute products Avoid taking at the same time as anti- acids Take only one MVI product at a time May alter the effect of: diuretics, BP medications, tretinoin/isotretinoin, bactrim/sulfa drugs, & NSAIDS

9 Page 9 Fish Oils/Omega III/DHA Heart Health –Decrease lipid levels –Lower BP –Dilate blood vessels Brain & Nervous System Function Reduce Inflammation Cancer Prevention

10 Page 10 Interactions/Side Effects Worsen diabetic control Immune suppression May alter the effects of: NSAIDS, Plavix, Celebrex, Heparin/Lovenox, Coumadin, Xenical/Alli, Thrombolitics, BP medications

11 Page 11 Glucosamine Glucosamine Chondroitin Osteoarthritis Joint Pain/Swelling Restore Cartilage Irritable Bowel Diseases

12 Page 12 Interactions/Side Effects Caution in those with Shellfish Allergies May alter the effects of: NSAIDS, Diabetic agents including insulin, Diuretics, K++ supplements, Anticoagulants

13 Page 13 Echinacea Shorten Viral Infections Immune Booster

14 Page 14 Interactions/Side Effects May alter the effects of: corticosteriods, antibiotics, diabetes medications, chemotherapy drugs May worsen: MS, Immune Disorders, TB, Leukemia, Lupus, Collagen Diseases, Stomach Problems Do not use in: HIV, Organ Transplant Patients, Pregnancy

15 Page 15 Flaxseed Anti-inflammatory Colon Health –IBS, Crohn’s, Colitis Cancer Prevention –Breast Cancer Heart Health –Lower lipids –Lower BP

16 Page 16 Interactions/Side Effects May slow the absorption of all drugs May alter the effects of: blood thinners, diabetic medications, NSAIDS, Contraceptives, Hormone Replacement Therapies, Anti-hyperlipidemics

17 Page 17 Ginseng Battle Stress & Fatigue Mental Clarity Emetic Stimulate Endocrine Activity Lower Blood Sugar

18 Page 18 Interactions/Side Effects May alter the effects of: diabetes medications, blood thinners, NSAIDS, Thrombolytics, CA++ channel blockers, antidepressants, antipsychotics, MAO Inhibitors, Opiate Pain medications Should not be combined with caffeine products

19 Page 19 Vitamin B Supplements Mental Clarity Fatigue Prevention of Neural Tubal Birth Defects Treat Anemias Peripheral Neuropathies Skin Disorders

20 Page 20 May alter the effects of: Tetracycline, Anticonvulsants, Cholchicine, Metformin, Bile Acid Sequestrants, H2 Blockers,Proton Pump Inhibitors, Chemotherapeutic Agents, Antidepressants, Levodopa, Erythropoetin Interactions/Side Effects

21 Page 21 Vitamin E Skin Health/Scar Reduction Menopausal Symptoms Diabetes Cancer Heart Health

22 Page 22 Interactions/Side Effects May alter the effects of: Tricyclic Antidepressants, Phenothiazines, AZT, Beta Blockers, Bile Acid Sequestrants, Statins, Cyclosporin, Tamoxifen, Female Replacement Hormones, Medbendazole, Orlistat, Warfarin

23 Page 23 Vitamin C Immune Builder Menopausal Symptoms Enhance Iron Absorption Cancer Prevention Lyme Disease Treatment

24 Page 24 Interactions/Side Effects May alter the effects of: NSAIDS, Acetaminophen, Barbiturates, Aluminum-containing antiacids, Nitrates, Chemotherapy drugs, Female Hormone Supplements, Crixivan, Tetracycline, Warfarin Enhances iron absorption

25 Page 25 Calcium Prevention of Osteoporosis Weight Loss Muscle Cramps Menopausal/PMS Symptoms Heart Health

26 Page 26 Interactions/Side Effects May alter the effects of: Alendronate, Aluminum Containing Antiacids, Beta Blockers, Ca++ Channel Blockers, Bile Acid Sequestrants, Corticosteriods, Digoxin, Estrogen Supplements, Gentamycin, Quinalones, Tetracycline, Anticonvulsants, Thiazide Diuretics, Lithium, Thyroid Supplements

27 Page 27 Pharmaceuticals with High Potential for Interactions Coumadin Thiazide Diuretics Phenytoin Phenobarbitol Lithium Thyroid Medications Oral Diabetic Agents Corticosteriods BP Medications Cyclosporin NSAIDS Digoxin

28 Page 28 Coumadin/Warfarin Cayenne Feverfew Garlic White Willow Bark St. John’s Wort Ginkgo Biloba Alfalfa Dong Qui Vitamin A, K, C, E Quinine Papain Devils Claw Green Tea Danshen Coenzyme Q10

29 Page 29 Thaizide Diuretics Artichokes Dandelion Celery Seed Goldenseal Juniper Horsetail Buckthorne Gingko Biloba Cleavers Folic Acid Magnesium Potassium Zinc Uva-Ursa Buchu Licorice Digitalis Gravel Root

30 Page 30 Phenytoin Kava Valerian Root Evening Primrose Oil Shankapulshpi St. John’s Wort Black Cohosh Ginkgo Biloba

31 Page 31 Phenobarbital Thujones Vitamin B6 Woodworm Evening Primrose Oil Gingko Biloba Passion Flower Kava Valerian Root Folate Biotin Vitamin D Dong Quai Glutamine

32 Page 32 Lithium Butchers Broom Dandelion Bochu Juniper Folic Acid L-tryptophan Essential Fatty Acids Coffee Psyllium Fiber Sodium

33 Page 33 Thyroid Medications Horseradish Kelp Iodine Calcium Soy Bugleweed Lemon Balm Iron

34 Page 34 Oral Diabetic Agents Butchers Broom Bochu Dandelion Juniper Devil’s Claw Gymnema Sylvestri MSM Karela Chromium Vanadium Magnesium

35 Page 35 Corticosteroids Astragalus Echinacea Licorice Root Alfalfa Zinc Horny Goat Weed Buckthorne Grapefruit Juice Pomegranate Juice Selenium Potassium Melatonin Magnesium N-acetyl Cysteine (NAC) Vitamins A, D, B6 Zinc

36 Page 36 BP Medications Magnesium Niacin Calcium Grapefruit Juice Alistrol Coenzyme Q Garlic Hawthorne Fish Oil Folic Acid

37 Page 37 Cyclosporin Grapefruit Juice St. Johns Wort Chinese Skullcap Gingko Biloba Omega III Fatty Acids Grapefruit Quercetine Vitamin E Magnesium Red Wine Potassium Milk Pomegranate Apple

38 Page 38 NSAIDS Glossypol Coffee Arabica Cola Uva-Ursi Alcohol White Willow Bark

39 Page 39 Digoxin Aloe Vera Yellow Foxglove Siberian Ginseng Quinine Licorice Psyllium Fiber Hawthorne Berry Eleutherococcus Senticosus

40 Page 40 Conclusion Over 50% of Americans will utilize vitamins, herbs, and supplements to treat a health concern in the next 30 days. Many of these natural therapies will interact either positively or negatively with another substance the person is taking. Knowing some of the more common interactions may help prevent or minimize health concerns related to drug-herb interations.

41 Page 41 Contact Information Lorraine W. Bock, MSN, CRNP, CEN Bock Family Healthcare 1773 West Trindle Road Carlisle PA (717) – office (717) – cell

42 Page 42 Resources Nursing Herbal Medicine Handbook, 3 rd Edition. ©2006. Lippincott, Williams, & Wilkins National Center for Complimentary and Alternative Medicine Holistic Online.com National Institutes of Health Database


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