Download black cohosh ( blakcoe

Name /bks_53161_deglins_md_disk/blackcohosh
02/11/2014 09:17AM
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Adverse Reactions/Side Effects
Neuro: SEIZURES (in combination with evening primrose and chasteberry), headache, dizziness. GI: GI upset, hepatotoxicity. Derm: rash. Misc: weight gain,
1
black cohosh ( blak coe-hosh)Remifemin
cramping, breast tenderness, vaginal spotting/bleeding.
Other Name(s):
baneberry, black snakeroot, bugbane, phytoestrogen, rattle root, rattleweed, rattle
top, squawroot
Classification
Therapeutic: none assigned
Do not confuse black cohosh with blue or white cohosh
Common Uses
Management of menopausal symptoms. Premenstrual discomfort. Dysmenorrhea.
Mild sedative. Rheumatism.
Action
Therapeutic effects are produced by glycosides isolated from the fresh or dried rhizome with attached roots. Mechanism of action is unclear. Therapeutic Effects:
May decrease symptoms of menopause, including hot flashes, sweating, sleep disturbance, and anxiety. Has no effect on vaginal epithelium.
Pharmacokinetics
Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.
Route/Commonly Used Doses
PO (Adults): Tablets (Remifemin威)— 20 mg bid. Liquid extract— 0.3– 2 mL
bid-tid. Tincture— 2– 4 mL bid– tid. Dried rhizome— 0.3– 2 g tid. Do not use for
more than 6 mo.
NURSING IMPLICATIONS
Assessment
● Assess frequency and severity of menopausal symptoms.
● Monitor BP for patients on antihypertensive drugs; may increase effects and cause
hypotension.
Potential Nursing Diagnoses
Sleep deprivation (Indications)
ROUTE
ONSET
PEAK
DURATION
PO
unknown
unknown
unknown
Contraindications/Precautions
Contraindicated in: OB: Pregnancy and lactation.
Use Cautiously in: Breast cancer (may increase risk of metastasis); Hormonesensitive cancers; Protein S deficiency (increased risk for thrombosis); Liver disease.
⫽ Genetic Implication.
placement therapy and antiestrogens (e.g., tamoxifen). Concurrent use with hepatotoxic drugs mayqrisk of liver damage. Alcohol-containing preparations
may interact with disulfiram and metronidazole. Maypcytotoxic effects of cisplatin. May precipitate hypotension when used in combination with antihypertensives.
Natural-Natural Products: Mayqrisk of hepatotoxicity when used with chaparral, comfrey, kava-kava, and niacin.
● Assess for history of seizures or liver disease.
TIME/ACTION PROFILE
⫽ Canadian drug name.
Interactions
Natural Product-Drug: Unknown effects when combined with hormone re-
Implementation
● Administration with food may help to minimize nausea.
Patient/Family Teaching
● Advise patient to notify health care professional if pregnancy is planned or sus-
pected. Avoid use during pregnancy; may induce a miscarriage.
● Patients with seizures, liver dysfunction, excessive alcohol intake, cancer, or other
medical problems should be advised to consult their health care professional
prior to initiating self-therapy with this herb.
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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● Advise patient to consult health care professional before taking with other estro-
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gen replacements.
● Emphasize the importance of continued medical supervision for Pap smears,
mammograms, pelvic examinations, and BP monitoring at the intervals indicated
by health care professional.
Evaluation
● Resolution of menopausal vasomotor symptoms.
Why was this drug prescribed for your patient?
䉷 2015 F.A. Davis Company