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Herbal and DietarySupplement Therapy

Chapter 48

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Slide 2 

Chapter 48

Lesson 48.1

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Objectives

• Describe the possible impact of the use of herbal and dietary supplement products oncultural/ethnic beliefs

• Summarize the primary actions, uses, and

interactions of the herbal and dietarysupplement products cited

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Slide 4 

Herbal and Dietary Supplements

• “All natural” is NOT synonymous with “better” • Some herbal medicines/supplements are

harmful

 Adverse effects

Drug interactions

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Dietary Supplement Healthand Education Act of 1994

•  Almost all herbal medicines, vitamins,minerals, amino acids for health reclassifiedas “dietary supplements,” a food category 

•  Allows manufacturers to include information

about products’ effects on the body on labelsand in advertisements

• Must state that product is not evaluated byFDA

• Does not stop others from making claims

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Dietary Supplements

• Herbal medications, vitamins, minerals,amino acids, other chemicals used for healthreclassified

No safety, effectiveness requirements

Vast majority of claims unproven No standardized manufacturing requirements

• Several organizations test for labeledpotency, good manufacturing practices, and

contamination—not safety or effectiveness

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Slide 7 

Label Certification

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Role of Health Care Professional

• Moral, ethical responsibility to recommendonly medicines proven safe and effective

• Factors to consider  Most supplements not scientifically tested

Consumers may be misinformed Supplements cannot cure serious conditions

Quality control is deficient

Exercise caution for pregnant or pediatric patients

Watch for adverse effects Examine label carefully

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Assessment

• Discuss patient’s reasons for interest and/or use

• Obtain list of patient symptoms andinformation about changes in symptoms since

supplement use• Find out source of recommendation

• Obtain complete list of all medications

•Determine cultural/ethical beliefs contributingto supplement use decision

• Discuss cultural and ethnic beliefs withpatient

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Patient Education

• Expectations of therapy• Discuss medication information

• Ensure understanding of proper use

• Promote the development and maintenanceof a written record of monitoring parameters

• Complete the Premedication Data column of the patient self-assessment form to trackresponse to drug therapy

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Herbal Therapy

•  Aloe Topically for pain, inflammation, itching

• Black cohosh

Reduce symptoms of PMS, dysmenorrhea,

menopause

• Chamomile

 Anti-inflammatory and antispasmodic effects

• Echinacea Nonspecific immunostimulant

• Ephedra

Bronchodilator, nasal decongestant

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Herbal Therapy (cont’d) 

• Feverfew Reduce frequency and severity of migraines

• Garlic

Lower serum cholesterol and triglycerides

• Ginger   Alleviate nausea and vomiting

• Ginkgo

Treat short-term memory loss, headache,

dizziness, tinnitus, emotional instability

• Ginseng

Unsubstantiated claims to increase resistance tostress and disease

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Herbal Therapy

• Goldenseal  Antiseptic and astringent

• Green tea

Improve cognitive performance

• Saw palmetto

Reduce DHT levels associated with BPH

• St. John’s wort 

Treat mild depression; wound healing

• Valerian

Used for restlessness, promotes sleep

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Oth Di t

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Slide 14 

Other DietarySupplements

• Coenzyme Q10 • Creatine

• Gamma-hydroxybutyrate (GHB)

• Lycopene• Melatonin

• Policosanol

• Omega-3 fatty acids• S-adenosylmethionine (SAM-e)

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