NUR318 Chapter 19 Alternative Preparations and Over-the-Counter Drugs

OTC Drugs: Nicotine and nicotine cessation products

increases clearance of many psychotropic medications

Phenylephrine / pseudoephedrine (Cold/cough/allergy/bronchodilator/antiasthmatic drugs)

interact with MAOIs and with stimulants

Caffeine

causes elevated BP and HR

Omeprazole

↑ diazepam half-life; ↑ concentrations of citalopram, sertraline, escitalopram

NSAIDs + SSRIs

↑ risk of GI/gastric bleeding

Reasons people choose herbals

Want more control/empowerment, believe they improve health, want to try something new, believe conventional medicine won't help, recommended by a healthcare professional, lower cost, believe "natural = safer/better tolerated"

What is St.John’s wort used for?

mild to moderate depression

Adverse effects of St.Johns wort

increases risk for SS if used with SSRIs, interferes with protease inhibitors, reduces effectiveness of oral contraceptives

Kava

inhibits monoamine oxidase B

Caution with Kava

interacts with antiparkinsonian drugs, benzodiazepines, and other drugs that act on the CNS; hepatotoxic

Valerian is used for

anxiolytic effective for sleep disorders; used with St.John’s wort

Adverse effects of Valerian

negates effects of MAOIs/warfarin/phenytoin; potential for dependence

Ginkgo is used for

may slow cognitive decline; effective antidote to erectile dysfunction of antidepressants

Cautions with Ginkgo

increases effects of anticoagulants; interacts with several drugs

Melatonin is used for

implicated in regulating circadian rhythm of sleep

Melatonin may reduce

sleep onset latency, duration and quality, and the number of nocturnal awakenings

Omega-3 Fatty acids have positive results for what

depression, schizophrenia, ADHD, autism, and substance use disorders

Safety and Efficacy of herbal products

Variable quality between manufacturers, look for 3rd party testing, not recommended during pregnancy/breastfeeding, side effects can vary