Nursing - Use of Herbals - Research Paper Example

?Use of Herbals Introduction For many years, herbals have been used to treat various conditions like, liver diseases, asthma, and rheumatoid arthritis among others (Cassileth, Yeung, and Gubili & 2008). There is also an increase in the use of these compounds among people living with HIV/AIDS. This has made the use of herbal medicines be among ancient medical practices gaining popularity alongside conventional medicines. This popularity is particularly attributed to clinical studies that have acknowledged the importance of herbal remedies in treating and preventing diseases. Studies have also shown improvements in the control of quality and evaluation of these compounds. Considering that many herbal compounds do not undergo chemical processing, many people think that they are safe, and have no side effects even when taken beyond measure (Cassileth, Yeung, and Gubili & 2008). They also tend to use these compounds alongside prescribed medicines having the impression that they will improve treatment. Despite their proven values, herbals do not have the perceived safety, and neither do they all improve treatment when used alongside prescribed drugs. One of the emerging issues in modern times is that herbal compounds are not as safe as they are thought to be. In fact, they may be counterproductive when used by patients undergoing certain treatments and those on prescription medications. History of herbal medicine use The use of herbals has a long history dating back about ten thousand years. Some of the longest records of the use of herbal medicines include those found in Egypt, India and ancient China. Herbals also have a long history in other indigenous cultures including the Native American and African cultures. With the advent of chemical analysis in the 19th century, scientists started extracting and modifying active ingredients contained in plants and came up with pharmaceuticals. Even with the development of pharmaceuticals, natural remedies to human health still represent a significant portion of the US market, and other parts of the globe. In places like Germany, for example, the sales turnover of one herbal product called silymarin amounts to $180 million annually (Breevort, 1996). This herbal compound is used almost exclusively for treating liver problems. Almost a third of outpatients seeking medical care from liver clinics use this product according to Breevort (1996). Breevort (1996) also explains that marketing of herbals between 1992 and 1996 increased threefold. Studies also reveal that over the last two decades, there has been growth in the level of public dissatisfaction with the prices of prescription medications, coupled with a growing interest in organic or natural remedies in the United States. This essentially has led to an increase in herbal medicines use. How herbals work Unlike doctors practicing conventional medicine, herbalists try to find and deal with the underlying causes of a health problem instead of treating individual symptoms. This is done based on the belief that the use of herbal tonics and tinctures can help the body heal itself by restoring harmony and balance, and activating the life force of the body (Cassileth, Yeung, and Gubili & 2008). Just like naturopathic medicine, it aims at supporting the body’s natural ability to achieve optimal health, and facilitating the innate healing mechanisms of the body. The compounds used for conducting herbal treatments are extracted from roots, barks, berries, seeds, leaves, flowers and petals of plants, and are presented as complex mixtures of many different compounds. Efficacy and safety of herbal products There are a number of scientific literatures that have documented the safety and efficacy of herbal products including their toxic effects. Many of these reports contradict the popular view asserting that herbals are natural compounds and, therefore, are harmless. A study conducted by the National Poison Information Service during the period 1991-1995 recorded 785 cases of confirmed or probable cases of adverse reactions to herbal treatment (Shaw, Leon, Kolev, & Murray, 1997). Among these, hepatotoxicity was the most common according to Shaw et al (1997). Although tests for abnormal liver function mostly normalize immediately the offending drug is withdrawn, reports of acute liver failure, and chronic disease requiring organ transplant have been reported in some cases. Any evaluation of herbal compounds is subject to various major challenges. For one, the use of concoctions or mixed extracts, and variations in the methods of extracting the herb could result in elephantine variations in the levels of specific alkaloids. The biologically active ingredients have been standardized and structurally defined for only a few of the herbs. Furthermore, some herbal compounds cannot work alongside pharmaceutical products to enhance healing. In this sense, they could pose threats to the health of many patients, cancer patients especially, among whom the use of non-prescription herbal remedies is widespread as they try to manage the symptoms of, or control the disease (Cassileth, Yeung, and Gubili & 2008). Cassileth, Yeung and Gubili (2008) explain that a study conducted on cancer patients reveals that although herbal compounds are biologically active agents that can be effective under appropriate circumstances, they may be counterproductive when used by patients undergoing chemotherapy. These adverse effects are also witnessed among patients using other medications prescribed by physicians, or acquired over-the-counter (OTC). Evidence of herbal compounds interfering with prescriptions has also been documented in relation to St John's Wort, an antidepressant that is popular for counteracting the effects of warfarin. Adverse effects of this herb can result in the death of the patient. Its interactions with birth control pills may also produce undesirable side effects. The fact that something is natural does not imply it is harmless. The belief in the antithesis has been the biggest selling point of herbal medicine. Contrarily, scientific studies have revealed that many plants contain toxins which they use for their self-protection (Cassileth, Yeung, and Gubili & 2008). These present many potential dangers to users of herbal drugs. The dubious safety associated with herbal compounds has fooled many people into assuming that these compounds have no side effects. In fact, some of these people have taken them in excess oblivious that the herbal compounds are not benign. Essentially, herbal compounds are unrefined pharmaceuticals, and this means that they have the capacity to yield physiologic changes in the bodies of patients, for better or worse. On a negative sense, they may enhance unrelated life threatening effects like high blood pressure. Significance of herbal medicine use Recent estimates released by the World Health Organization (WHO) reveal that 80% of people globally rely on herbal treatments for their primary healthcare (Shaw, Leon, Kolev, & Murray, 1997). This issue is, therefore, important in the current practice of medicine in that it will form the basis of regulating the use of herbal compounds. This step is vital because the increased use of non-prescribed herbal medicines among patients and even those using conventional medicines posses a significant threat to their health. It should be noted that drugs are often more powerful when administered in the presence of other drugs, this applies whether the drug is harmful or beneficial. By reading of books on herbal medicine, many people have tended to prefer engaging in self-diagnosis some going ahead to select and mix herbal remedies for themselves. This could have undesirable effects in case of misdiagnosis, and the patient may end up being an unnecessary burden to the healthcare system. The use of herbal drugs presents a significant challenge to conventional medicine considering that they may elicit unprecedented response when used together with the latter. Furthermore, herbal remedies consumed for the purposes of improving one’s health may produce unexpected responses. This is mainly because herbs contain active compounds some of which are untested and unknown as noted by Shaw, Leon, Kolev and Murray (1997). One or more of the active compounds could have an adverse effect on a part of a person’s body that was not targeted. Overuse of such untested compounds might result in grievous health problems. The regulation of herbal compounds is, therefore, crucial in ensuring that companies manufacture herbal remedies based on specified standards, and with the safety of patients in mind. This is so considering that standardization facilitates prescription of drugs in right dosages. The issue of herbal compounds is also noteworthy in advancing the education of Advanced Practice Registered Nurses (APRNs). A study conducted on APRNs averaging 16.7 years of nursing practice indicates that most of them do not inquire of their patients about their use of herbal drugs (Waszak, 2004). About 74% reported inquired from their patients about OTC medications, but only 35% asked about the use of herbals (Waszak, 2004). Even so, those who asked only concentrated on a few herbals like ginseng, Echinacea, glucosamine and chondroitin, Ginkgo biloba and St. John’s Wort (Waszak, 2004). This is an indication of lack of knowledge on these medications and their possible use among APRNs. The role of the Advance Practice Registered Nurses in relation to the use of herbal medications APRNs have a role to play in the control of un-prescribed and unwarranted use of herbals as noted by Waszak (2004). In many cases, they are primary care providers, and therefore interact more with patients. This puts them in a better position in so far as inquiring from the patients about their use of herbal compounds and vitamins is concerned. The APRNs should do this to ensure that the herbals are used appropriately in an effort to promote patient safety. APRNs with prescriptive authority may recommend the use of herbal medications. This provides some level of control on the use of herbal remedies compared to when patients rely on their personal diagnosis and prescription, or prescription from traditional medicine men/women. However, the Oregon State Board of Nursing (OSBN) Policy Statement requires that such nurses be regulated by the standards of their prescriptive authority. These standards require that APRNs assess the patient for their current use of various medications, potential risks and benefits, and possible drug interactions. Conclusion There is a need to control the use of herbal compounds whether they are used exclusively, or alongside conventional medicines. For a long time, many people have assumed that these compounds are safe and highly effective. However, scientific studies have revealed alarming levels of risks associated with these compounds, and especially when they interact with prescribed medications. APRNs must, therefore, be educated to increase their ability to discuss herbal compounds, and OTCs with their patients. Timely updates on both herbals and OTCs should also be readily accessible to the APRNs for them to provide reliable information to patients on the safe use of these products. References Breevort, P. (1996). “The U.S. botanical market-an overview.” Herbalgramm, 1996(36):49-57. Cassileth, B. Yeung, K. and Gubili, J. (2008). “Herbs and other botanicals in cancer patient care.”Current Treatment Options in Oncology, 9(2-3):109-116. Shaw, D., Leon, C., Kolev, S. & Murray, V. (1997). “Traditional remedies and food supplements. A 5-year toxicological study (1991-1995).” Drug Safety, 17(5):342-56. Waszak, L. (2004). “Are Advanced Practice Registered Nurses Communicating With Their Patients About Over-the-Counter Medications and Herbal Products?” Sigma Theta Tau International Conference. Retrieved 13 February, 2012 Http://Www.Nursinglibrary.Org/Vhl/Handle/10755/153533 Read More