chapter 28 - ATI Testing

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HERBAL SUBSTANCE ADVERSE REACTIONS AND PRECAUTIONS Goldenseal • none at therapeutic or low doses; can stimulate the Cns and cause death from respiratory failure in large doses • Contraindicated during pregnancy, because it can stimulate the uterus. Kava (kava kava) • Chronic use causes dry, flaky skin and jaundice. • Chronic use and large doses can cause liver damage, including severe liver failure. ma huang (ephedra sinica) • Because it contains ephedrine, ma huang can stimulate the cardiovascular system and, at high doses, can cause death from hypertension and dysrhythmias. • stimulation of Cns may cause euphoria and, in high doses, psychosis. Vitamins, minerals, and supplements INTERACTIONS NURSING ADMINISTR<strong>ATI</strong>ON • none known • Question clients who are pregnant. • Can cause sedation when taken concurrently with Cns depressants. • interacts with any Cns stimulant to potentiate their effect. • may cause severe hypertension when taken with maOi antidepressants. • interacts with antihypertensive medications to decrease effect. • Question clients taking any Cns depressant, including alcohol, about use of kava. • ask clients who have any liver condition about concurrent use. • Question clients carefully about other medications. • products which include more than 10 mg per dose are forbidden to be sold in the u.s. PN PHARMACOLOGY FOR NURSING 355
Vitamins, minerals, and supplements HERBAL SUBSTANCE ADVERSE REACTIONS AND PRECAUTIONS st. John’s wort • mild adverse effects, including dry mouth, lightheadedness, constipation, Gi symptoms • skin rash when exposed to sunlight saw palmetto • Few adverse effects; can cause mild Gi effects • precaution: Can decrease psa, the marker used to detect prostate cancer Valerian • Can cause drowsiness, lightheadedness, depression • risk of physical dependence • precaution: Clients who have mental health disorders should use with caution • should be avoided by pregnant and lactating women INTERACTIONS • Can cause serotonin syndrome when combined with other antidepressants, amphetamine, and cocaine • decreases effectiveness of oral contraceptives, cyclosporine, warfarin, digoxin, calcium channel blockers, steroids, HiV protease inhibitors, and some cancer chemotherapy medications • possible additive effects with finasteride (proscar) • not known if valerian potentiates effects of Cns depressants NURSING ADMINISTR<strong>ATI</strong>ON • encourage clients using st. John’s wort to prevent prolonged sun exposure and use sunscreen. • Question male clients about use before they have psa tests. • Warn clients taking valerian about possibility of drowsiness when operating motor vehicles and other equipment. 356 PN PHARMACOLOGY FOR NURSING
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chapter 28 - ATI Testing

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