nanci
Junior Member
Posts: 57
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Post by nanci on Oct 30, 2019 7:06:25 GMT -5
patients may not view herbal supplements as medications and that they may go unreported and inadvertently cause intraoperative or postoperative complications.
Garlic, ginger, kava to name a few- best to look them up and verify.
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Post by Kim Hall on Oct 30, 2019 14:05:52 GMT -5
1.Why is it important for anesthesia providers to be vigilant when interviewing patients preoperatively? I agree that patients often do not consider herbals as medications so it is important to ask directly about them in order to get a detailed peroperative assessment.
2.What herbal supplements pose a concern for impaired coagulation? Which herbs may potentiate other anesthetic medications that we currently use? The herbals that start with G impair coagulation while kava and valerian potentiate anesthetic.
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Post by Kristen Horsman on Oct 31, 2019 11:33:12 GMT -5
1.Why is it important for anesthesia providers to be vigilant when interviewing patients preoperatively? It is very important because patients who use herbal remedies are at an increased risk of intraop complications such as "blood loss, cardiac instability, prolongation of anesthesia, and adverse drug interactions". 2.What herbal supplements pose a concern for impaired coagulation? Which herbs may potentiate other anesthetic medications that we currently use? Impaired coagulation: ginseng, ginkgo biloba, garlic, ginger, chamomile, kava Drug interactions; Echinacea (simvastation, lansoprazole, losartan), Ephedra (MAOIs), Ginseng (warfarin, phenelzine, opioids, digoxin), ginkgo biloba (terpenoids and flavonoids)
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Post by Lu Lin on Oct 31, 2019 13:37:00 GMT -5
1. It is very important during the preop interview to specifically ask patients what supplements and herbal medications they take, especially since many patients do not consider them to be significant enough to mention, It would serve us well to pointedly ask our patients what - if any - they take.
2. The herbal supplements that can impair coagulation are: garlic, ginger, chamomile (potentiates Warfarin), kava. Supplements that might potentiate other anesthetic medications are: Kava, Valerian.
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Post by Chuck Eder on Oct 31, 2019 21:00:01 GMT -5
Usually, you need to specifically ask the patient if they take any herbal supplements or OTC meds. Most patients don't realize that these supplements can have an effect on their body's ability to clot. Sometimes you need to dig deep in the preop interview to uncover these meds.
Most of the supplements that start with "G" can affect bleeding with the patient's surgery. Gingko, garlic, and ginseng. Examples of ones that can potentiate anesthetics are Kava and Valerian. One would think that these supplements should have warnings posted on their bottles regarding the possible surgical side effects of concurrent usage.
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Post by Belinda Gardner on Oct 31, 2019 22:23:29 GMT -5
Just as with all medication it is important that we have a complete list of all things patients take that may effect their anesthetic or put them at risk for untoward events during surgery which as we have reviewed can include many herbal medications. This is a good reminder of the significance in ensuring a thorough preop evaluation. I routinely review the medication list input by nursing and notice that they do includes vitamins and other supplements which is good they ask for these specifically. I recall that the G's (Gingko, Garlic, Ginseng, Ginger) can effect coagulation and may increase the risk for bleeding. This was a good review on Kava and Valerian's potential effects on anesthetics and will catch my attention if I see them on a patient medication list. I think the primary care physicians have an obligation to their patients with regard to teaching them about these potential side effects and encouraging cessation prior to surgery.
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Post by Laurie on Oct 31, 2019 22:28:17 GMT -5
I agree that it is important to question our patients about everything that they take and to ask specifically about herbal and OTC drugs. Examples that can impair coagulation are garlic, ginger, chamomile and kava. Supplements that might potentiate other anesthetic medications are Kava and Valerian.
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Post by jessica switzman on Nov 4, 2019 11:22:04 GMT -5
Herbal Supplements can impair coagulation, but I have yet to see this happen. Usually, patients would have to be taking larger amts than the recommended dosage. I believe it is best for the patient to be off all herbal supplements prior to surgery.
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