Herbal drugs

Herbal drugs

Herbal medicine	Common uses	Special considerations
Aloe	Oral Constipation Bowel evacuation Topical Minor burns Skin irritation	The laxative actions of aloe may take up to 10 hours after ingestion to be effective. Monitor the patient for signs of dehydration; geriatric patients are particularly at risk.
Constipation	Oral Anxiety or restlessness Diarrhea Motion sickness Indigestion Topical Inflammation Wound healing Cutaneous burns Teas Sedation Relaxation	People sensitive to ragweed and chrysanthemums or others in the Compositae family may be more susceptible to contact allergies and anaphylaxis. Patients with hay fever or bronchial asthma caused by pollens are more susceptible to anaphylactic reactions. Pregnant women shouldn’t use chamomile. Chamomile may enhance anticoagulant’s effect.
Cranberry	Prophylaxis for urinary tract infection (UTI) Treatment of UTI Prevention of renal calculi	Only the unsweetened form of cranberry prevents bacteria from ad-hering to the bladder wall and preventing or treating UTIs
Echinacea	Supportive therapy to prevent and treat common cold and acute and chronic infections of the upper respiratory tract	Echinacea is considered supportive therapy and shouldn’t be used in place of antibiotic therapy.
Feverfew	Prevention and treatment of migraines and headaches Hot flashes Rheumatoid arthritis Asthma Menstrual problems	Avoid using in pregnant patients because feverfew is also an abortifa-cient. Feverfew may increase the risk of abnormal bleeding when combined with an anticoagulant or antiplatelet. Abruptly stopping feverfew may cause “postfeverfew syndrome” in-volving tension headaches, insomnia, joint stiffness and pain, and lethargy.
Garlic	Decrease cholesterol and triglyceride levels Prevent atherosclerosis Age-related vascular changes Prevent GI cancer Coughs, colds, fevers, and sore throats	Odor of garlic may be apparent on breath and skin. Garlic may prolong bleeding time in patients receiving anticoagulants. Excess raw garlic intake may increase the risk of adverse reactions. Garlic shouldn’t be used in patients with diabetes, insomnia, pemphi-gus, organ transplants, or rheumatoid arthritis or in those who have re-cently undergone surgery.
Ginger	Nausea (antiemetic) Motion sickness Morning sickness GI upset (colic, flatulence, in-digestion) Hypercholesteremia Liver toxicity Burns Ulcers Depression	Ginger may increase the risk of bleeding, bruising, or nosebleeds. Pregnant women should obtain medical advice before using ginger medicinally. Ginger may interfere with the intended therapeutic effects of certain conventional drugs.
Ginkgo biloba	“Memory” agent Alzheimer’s disease Multi-infarct dementia Cerebral insufficiency Intermittent claudication Tinnitus Headache	Adverse effects occur in less than 1% of patients; the most common is GI upset. Ginkgo biloba may potentiate anticoagulants and increase the risk of bleeding. Ginkgo extracts are considered standardized if they contain 24% flavonoid glycosides and 6% terpene lactones. Seizures have been reported in children after ingestion of more then 50 seeds. Treatment should continue for 6 to 8 weeks but for no more than 3 months.
Ginseng	Fatigue Improve concentration Treat atherosclerosis Also believed to strengthen the body and increase resistance to disease after sickness or weakness	Ginseng may cause severe adverse reactions when taken in large doses (more than 3 g per day for 2 years), such as increased motor and cognitive activity with significant diarrhea, nervousness, insomnia, hy-pertension, edema, and skin eruptions. Ginseng may potentiate anticoagulants and increase the risk of bleeding.
Green tea	Prevent cancer Hyperlipidemia Atherosclerosis Dental caries Headaches Central nervous system (CNS) stimulant Mild diuretic	Green tea contains caffeine. Avoid prolonged and high caffeine intake, which may cause restless-ness, irritability, insomnia, palpitations, vertigo, headache, and adverse GI effects. Adding milk may decrease adverse GI effects of green tea. Green tea may potentiate anticoagulants and increase the risk of bleeding.
Kava	Antianxiety Stress Restlessness Sedation Promote wound healing Headache Seizure disorders Common cold Respiratory infections	Kava is contraindicated in pregnancy and lactation. Kava shouldn’t be used in combination with St. John’s wort. Kava shouldn’t be taken with other CNS depressants, monoamine oxidase inhibitors, levodopa, antiplatelets, alcohol, or anxiolytics. Kava can cause drowsiness and may impair motor reflexes and men-tal acuity; advise the patient to avoid hazardous activities. Effects should appear within 2 days of initiation of therapy.
St. John's wort	Mild to moderate depression Anxiety Psychovegetative disorders Sciatica Viral infections	Effects may take several weeks; however, if no improvement occurs after 4 to 6 weeks, consider alternative therapy. St. John’s wort interacts with many different types of drugs. St. John’s wort shouldn’t be used in combination with prescription antidepressants or antianxiety medications.
Vitex	Premenstrual syndrome	Vitex should be taken in the morning with water. Vitex is a very slow acting substance; it may take several cycles to see an effect.
Yohimbine	Impotence (works as an aphrodisiac)	Yohimbine may cause CNS excitation, including tremor, sleeplessness, anxiety, increased blood pressure, and tachycardia. Don’t use in patients with renal or hepatic insufficiency.