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TIME/ACTION PROFILE
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ginkgo (ging-ko)
Other Name(s):
Bai guo ye, fossil tree, ginkgo folium, Japanese silver apricot, kew tree, maidenhairtree, salisburia adiantifolia, yinhsing
Classification
Therapeutic: antiplatelet agents, central nervous system stimulants
Common Uses
Symptomatic relief of organic brain dysfunction (dementia syndromes, short-term
memory deficits, inability to concentrate, depression). Intermittent claudication.
Vertigo and tinnitus of vascular origin. Improvement of peripheral circulation. Premenstrual syndrome.
Action
Improves tolerance to hypoxemia, especially in cerebral tissue. Inhibits development
of cerebral edema and accelerates its regression. Improves memory, blood flow (microcirculation), compensation of disequilibrium, and rheological properties of
blood. Inactivates toxic oxygen radicals. Antagonizes platelet-activating factor. Interferes with bronchoconstriction and phagocyte chemotaxis. Therapeutic Effects:
Symptomatic relief of dementia syndromes. Inhibits arterial spasm, decreases capillary fragility and blood viscosity. Improves venous tone, relaxes vascular smooth
muscle.
ROUTE
ONSET
PEAK
DURATION
PO
unknown
unknown
unknown
Contraindications/Precautions
Contraindicated in: Hypersensitivity; Pregnancy and lactation.
Use Cautiously in: Bleeding disorders; Children (fresh seeds have caused seizures and death); Diabetes; EpilepsySurgery (discontinue use 2 weeks prior).
Adverse Reactions/Side Effects
CNS: CEREBRAL BLEEDING, dizziness, headache, vertigo, seizure. CV: palpitations.
GI: flatulence, stomach upset. Derm: allergic skin reaction. Hemat: bleeding.
Misc: hypersensitivity reactions.
Interactions
Natural Product-Drug: Theoretically may potentiate effects of anticoagulants,
thrombolytics, antiplatelet agents, and MAO inhibitors. May alsoqrisk of
bleeding with some cephalosporins, valproic acid, and NSAIDs. Maypeffectiveness of anticonvulsants. May alter insulin metabolism requiring dose adjustments
of antidiabetic drugs.
Natural-Natural Products: Mayqrisk of bleeding when used with other herbs
with antiplatelet effects (including angelica, arnica, chamomile, feverfew, garlic, ginger, and licorice).
Route/Commonly Used Doses
Organic Brain Syndromes
PO (Adults): 120– 240 mg ginkgo leaf extract daily in 2 or 3 doses.
Intermittent Claudication
PO (Adults): 120– 240 mg ginkgo leaf extract daily in 2 or 3 doses.
Vertigo and Tinnitus
PO (Adults): 120– 160 mg ginkgo leaf extract daily in 2 or 3 doses.
Pharmacokinetics
Absorption: 70– 100% absorption.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.
⫽ Canadian drug name.
⫽ Genetic Implication.
Cognitive Function Improvement
PO (Adults): 120– 600 mg per day.
Premenstrual Syndrome
PO (Adults): 80 mg BID starting on the 16th day of the menstrual cycle until the 5th
day of the next cycle.
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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● Instruct patient not to exceed recommended doses because large doses may result
NURSING IMPLICATIONS
Assessment
● Notify patients receiving anticoagulant or antiplatelet therapy not to take this medi-
in toxicity (restlessness, diarrhea, nausea and vomiting, headache).
● Exclude other treatable causes of dementia prior to instituting treatment with
ginkgo.
● Assess cognitive function (memory, attention, reasoning, language, ability to per-
form simple tasks) periodically throughout therapy.
● Assess frequency, duration, and severity of muscle cramps (claudication) experi-
enced by the patient prior to and periodically throughout therapy.
● Assess for headache and neurosystem changes (thromboembolism).
Potential Nursing Diagnoses
Disturbed thought process (Indications)
Acute pain (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)
cation without approval of health care professional and frequent monitoring.
● Instruct patient to consult health care professional before taking any prescription
or OTC medications concurrently with ginkgo.
Evaluation
● Improvement in walking distances pain-free.
● Improvement in tinnitus and vertigo.
● Improvement in short-term memory, attention span, and ability to perform simple
tasks.
● Improvement in sexual function.
● Decreased symptoms of premenstrual syndrome.
Why was this drug prescribed for your patient?
Implementation
● Start dose at 120 mg per day and increase as needed to minimize side effects.
● Administration for a minimum of 6– 8 wk of 80 mg (tid) (not ⬍6 wk) is required
to determine response.
● May be administered without regard to food.
● Use of dried leaf preparations in the form of a tea is not recommended because of
insufficient quantity of active ingredients.
● Advise patients to avoid crude ginkgo plant parts which can cause severe allergic
reactions.
● Take this herb at the same time daily.
● Keep this herb out of the reach of children as seizures may occur with increased
doses of ginkgo seeds.
Patient/Family Teaching
● Advise patient to observe for easy bruising and other signs of bleeding and report
to health care professional if they occur.
● Caution patient to keep this herb out of the reach of children because ingestion has
been associated with seizures.
● Warn patient to avoid handling the pulp or seed coats because of the risk of con-
tact dermatitis. Wash skin under free-flowing water promptly if contact does occur.
䉷 2015 F.A. Davis Company
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