Some info on various herbals . . . includes info on ginseng and its effect on bloodclotting . . .
Alternative medicines pose danger for surgery patients
By Caroline Helwick
NEW ORLEANS – Work by anesthesiologists is providing evidence "alternative medicines" may pose risks during surgery.
At the American Society of Anesthesiologists' annual meeting here recently, researchers from MD Anderson Cancer Centre in Houston described the case of a 37-year-old Chinese man who presented with bleeding after two operations, the first to remove a tumour in the neck and the second to restore vocal cord function. A meticulous workup revealed the patient's complications were triggered by long-term consumption of ginseng tea.
The patient had not reported his ginseng use, but his wife mentioned it in passing afterward. He survived the surgery, but required three procedures to manage the bleeding, said Dr. Jessie Leak, an anesthesiologist at MD Anderson.
"We know ginseng has properties that can interfere with blood clotting, which is why the herb should not be taken with Aspirin or other drugs that can also affect clotting," she noted. "This patient was not taking any other anticoagulants and still had problems. When you mix herbs, anticoagulants or antiplatelets, an anesthetic and a surgical field, you have a recipe for disaster."
Anesthesiologists and surgeons should elicit complete information about the patient's consumption of drugs, herbs, vitamins and other dietary supplements, she said.
In her presentation, Dr. Leak highlighted other broad types of potential complications.
• Cardiovascular instability: Ephedra, or ma-huang, a cardiovascular stimulant used in thousands of dietary supplements, has been linked with heart attacks, arrhythmia and chest pain. Considered by Dr. Leak to be the most dangerous herb on the market, it also has been associated with cerebral hemorrhages, strokes, psychosis and memory loss.
Other herbs and supplements linked with cardiovascular complications include ginseng, glycyrrhiza glabra (licorice), used for stomach problems, and vitamin E in doses greater than 1,200 IU. St. John's wort can decrease levels of digoxin by as much as 25%, therefore, patients taking these two in combination could jeopardize their cardiovascular health.
• Enhanced bleeding potential: Substances that can affect blood-clotting include ginseng, ginkgo biloba, feverfew, garlic and vitamin E in doses over 1,600 IU daily.
• Prolonged anesthesia: Kava-kava, used as a remedy for skin disorders and anxiety, enhances the effects of barbiturates and anti-anxiety medications and produces pain relief similar to a local anesthetic. Valerian and St. John's wort also may extend anesthesia's effects.
• Kidney and liver complications: Echinacea, used to boost the immune system; creatine, used to boost athletic endurance; and licorice all may exacerbate kidney and liver problems.
• Thyroid abnormalities: TRIAC (triiodothyroacetic acid) has been linked with abnormal thyroid function, severe diarrhea, fatigue, lethargy and weight loss.
• Electrolyte disturbances: Goldenseal may reduce the effectiveness of antihypertensive agents. Used as a diuretic, the herb is actually an aquaretic that facilitates the excretion of water only, not sodium and water.
• Decreased effectiveness of HIV medications: St. John's wort may significantly reduce the efficacy of protease inhibitors and contribute to drug resistance.
Lesser-known effects of herbs and supplements include postmenopausal bleeding from ginseng; manic episodes associated with ginseng combined with antidepressants; increased risk of suicide in severe depressives taking kava-kava; and increased risk of ulcers with feverfew.
link:
http://www.medicalpost.com/mpcontent/article.jsp?content=/content/EXTRACT/RAWART/3804/35B.html
they make at work just slows me down.
