101. Perioperative herbal supplement use in cancer patients: potential implications and recommendations for presurgical screening
- Author
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Nagi B. Kumar, Kathy Allen, and Heather Bell
- Subjects
Drug ,medicine.medical_specialty ,media_common.quotation_subject ,Herbal Medicine ,Alternative medicine ,Herb-Drug Interactions ,Health benefits ,Pharmacology ,complex mixtures ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,Neoplasms ,Preoperative Care ,medicine ,Humans ,Intensive care medicine ,Adverse effect ,Herbal supplement ,media_common ,business.industry ,food and beverages ,Cancer ,Hematology ,General Medicine ,Perioperative ,medicine.disease ,Analgesics, Opioid ,Oncology ,030220 oncology & carcinogenesis ,Pharmacodynamics ,Dietary Supplements ,Practice Guidelines as Topic ,030211 gastroenterology & hepatology ,business - Abstract
Background: Products made from botanicals that are used to maintain or improve health are known as herbal supplements, botanicals, or phytomedicines. Many herbs have a long history of use and claimed health benefits. However, many herbal supplements and botanicals have potent pharmacologic activity that can contribute to adverse effects and drug interactions. The use of herbal supplements by cancer patients in the perioperative period is common and consistent with the substantial increase in the use of alternative medical therapies. Methods: We reviewed the literature to examine the constituents, safety, pharmacokinetics, and pharmacodynamics of those herbal supplements that are predominantly used by cancer patients. Results: Different supplements possess antiplatelet activity, adversely interact with corticosteroids and central nervous system depressant drugs, have gastrointestinal manifestations, produce hepatotoxicity and nephrotoxicity, and produce additive effects when used with opioid analgesics. Conclusions: With the increasing use of herbal supplements by cancer patients, surgical staff need to screen patients presurgically for use of these supplements. Clinical practice guidelines are needed for screening and prevention of herbal supplement usage to prevent potential adverse events that may arise from herbal medications taken alone or combined with conventional therapies during the perioperative period. Herbal supplements commonly used by cancer patients in the perioperative period can produce pharmacokinetic interactions that can complicate surgery.
- Published
- 2005