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Name /bks_53161_deglins_md_disk/sawpalmetto 02/17/2014 10:05AM Plate # 0-Composite pg 1 # 1 Interactions Natural Product-Drug: Hormonal action may interfere with other hormonal 1 saw palmetto Other Name(s): American Dwarf Palm Tree, Cabbage Palm, Ju-Zhong, Palmier Nain, Sabal, Sabal Fructus, Saw Palmetto Berry, Serenoa repens Classification Therapeutic: benign prostatic hyperplasia (BPH) agents Common Uses Benign prostatic hyperplasia. therapies (testosterone, hormonal contraceptives). Avoid use with antiplatelet or anticoagulant drugs (mayqbleeding risk). Natural-Natural Products: Concomitant use with herbs that affect platelet aggregation such as ginger, garlic, gingko, and ginseng mayqbleeding risk. Route/Commonly Used Doses PO (Adults): Lipophilic extract (80– 90% fatty acids)— 160 mg twice daily or 320 mg once daliy. Whole berries— 1– 2 grams daily. Liquid extract from berry pulp— 1– 2 mL three times daily. Tea (efficacy is questionable due to lipophilicity of active constituents)— 1 cup three times daily. Tea is prepared by steeping 0.5– 1 gram dried berry in 150 mL boiling water for 5– 10 minutes. NURSING IMPLICATIONS Assessment Action Exerts antiandrogenic, anti-inflammatory and antiproliferative properties in prostate tissue resulting in improvement in BPH symptoms such as frequent urination, hesitancy, urgency and nocturia. Comparable in efficacy to finasteride but may be less effective than prazosin. Therapeutic Effects: Decreased urinary symptoms of BPH. Pharmacokinetics Absorption: Unknown. Distribution: Unknown. Metabolism and Excretion: Unknown. Half-life: Unknown. ● Assess patient for symptoms of benign prostatic hypertrophy (BPH) (urinary hesi- tancy, feeling of incomplete bladder emptying, interruption in urinary stream, impairment in size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy. ● Rectal exams prior to and periodically throughout therapy to assess prostate size are recommended. Potential Nursing Diagnoses Impaired urinary elimination (Indications) Deficient knowledge, related to medication regimen (Patient/Family Teaching) Implementation TIME/ACTION PROFILE ● Take on a full stomach to minimize GI effects. ROUTE ONSET PEAK DURATION PO 1–2 mos unknown 48 wk (longest studied treatment duration) Contraindications/Precautions Contraindicated in: Pregnancy and lactation. Use Cautiously in: Prior to surgery (discontinue 2 weeks before to prevent bleeding). Patient/Family Teaching ● Advise patients to start therapy with this herbal supplement only after evaluation by a health care professional who will provide continued follow up care. ● Inform patients that saw palmetto does not alter the size of the prostate but still should relieve the symptoms associated with BPH. ● Tell patients that taking this herbal supplement with food should reduce the GI ef- fects and make it easier to tolerate. Evaluation Adverse Reactions/Side Effects CNS: dizziness, headache. GI: nausea, vomiting, constipation and diarrhea. ⫽ Canadian drug name. ⫽ Genetic Implication. ● Decrease in urinary symptoms of BPH. Why was this drug prescribed for your patient? CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued. PDF Page #1