Geriatric Mental Health Disaster and Emergency Preparedness

226 Geriatric Mental Health Disaster and Emergency Preparedness
The potential for adverse reactions from the use of herbal remedies is
vastly lower than with pharmaceuticals, and most reactions that do occur
are minor in nature. That being said, herbs can be used inappropriately
and, as a result, can potentially exacerbate or worsen a condition or cause
new ones. The more complicated the health status of the patient, including
his or her use of multiple pharmaceuticals, the more caution a responsible
herbal practitioner should exercise.
n With regard to herb-drug interactions, it is important to keep in mind
that most problems occur from easily preventable mistakes that
would be manifest from a clear understanding of the herb’s activity.
One such example might be administering licorice to a patient on
hypotensive drugs. While a full discussion of the subject is beyond
the scope of this chapter, it is incumbent on the practitioner to be
well versed in the potential adverse effects and interactions of every
remedy that may be used by the older person whether pharmaceutical,
herbal, or other. Herb-drug combinations more likely to cause
problems are ones in which the herb and drug are known to have
either a similar or potentiating activity or a countervailing or antagonistic
activity.
n Herbs with a marked effect on hepatic, gastrointestinal, or renal
function are more likely to affect the bioavailability and metabolism
of drugs taken concomitantly.
n More caution should be exercised when combining herbs or drugs
that have a narrow therapeutic index or a known propensity to provoke
adverse reactions.
n A more conservative approach is required for frail or debilitated patients,
patients with known sensitivities or allergies to drugs or foods,
and patients on multiple drugs.
n Always consult a credentialed herbalist practitioner; proceed with
caution, and use fewer and milder herbs; and begin with lower doses
and build up gradually.
Conclusion
Herbal remedies can play an important role in both preparing for and
dealing with a disaster. In such cases, drugs may be in short supply or may
not be adequate on their own; water supplies may be tainted, exposure to
toxins increased, and greater stress levels may exacerbate many underly-