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Herbs and anesthesia concerns


Herbs

• Echinacea:
– used for URTI prevention
– it is immuno-stimulatory
– it can counteract steroids
– it can inhibit microsomal enzymes
• Garlic:
– used for hypercholesterolemia, high blood pressure, and coronary disease
– it augments warfarin, heparin, and aspirin
– it increases bleeding times
– it should be avoided for 7 days before surgery if bleeding is a concern
• Gingko Biloba:
– used for claudication, vertigo, and memory enhancement
– it decreased platelet activating factor which leads to spontaneous hematomas and hemorrhage
• Ginseng:
– increases resistance to stress, promotes diuresis, and facilitates digestion
– has anti-platelet effects and causes headaches
– can also cause nausea and vomiting, epistaxis, and high blood pressure
• Hoodia:
– used for weight loss and appetite suppression
– relatively new, no studies yet
• Kava kava:
– used for anxiolysis, anti-epilepsis, anti-psychosis, and sedation
– reacts adversely with CNS depressants, statins, alcohol, levodopa, causes sedation
• Saw palmetto:
– used for benign prostatic hypertrophy
– has free fatty acids and sterols
– can cause GI symptoms and headaches
• St. John’s wart:
– used for anxiety, depression, and sleeplessness
– can cause photosensitivity, restlessness, dry mouth, dizziness, fatigue, constipation, nausea and vomiting, cardiovascular collapse
– delayed emergence from anesthesia has been reported

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