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. Lin, Hsiang-Wen; Mahady, Gail B.; Popovich, Nicholas G. 2008-01-01 Objectives To describe the conceptual development of a measure for assessing pharmacist knowledge of herbal and dietary supplements. Methods A standardized approach to constructing a multiple-choice competency examination following 8 pre-specified criteria (eg, specifying the target spectrum of herbal and dietary supplements) was used to create an item bank. The quality of each item was evaluated by 5 herbal and dietary supplement content experts based on specific criteria in 3 rounds of review. Results From 122 initial items, 56 items were retained for the item bank representing 4 content areas: efficacy/effectiveness, safety, drug- supplement interactions, and regulation.

The experts tended to agree that the constructed items represented a wide range of difficulty. Conclusion The initial development of a conceptually based item bank/measure of pharmacist herbal and dietary supplement knowledge lays the groundwork for a large-scale validation study. The measure should be useful as a standalone tool and as a component of a knowledge, attitude, and behavior survey for the assessment of pharmacist traits related to herbal and dietary supplements. PMID:18698390. Levy, Ilana; Attias, Samuel; Ben-Arye, Eran; Goldstein, Lee; Schiff, Elad 2017-04-01 Dietary and herbal supplements (DHS) are widely used in the general population, including during hospitalization.

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Yet, their potential interactions with prescription drugs have seldom been delineated among inpatients. We aimed to evaluate potentially dangerous interactions of DHS with prescribed medications among inpatients. This was a cross-sectional prospective study involving a cohort of patients hospitalized in 12 departments of a public academic medical center (Bnai Zion Medical Center, Haifa, Israel) from 2009 to 2014. DHS users were determined via a questionnaire. The Natural Medicine database was used to search for potential DHS-drug interactions for identified DHS, and the clinical significance was evaluated using Lexi-interact online interaction analysis.

Medical files were assessed for documentation of DHS use. Univariate and multivariate logistic regression analyses were used to characterize potential risk factors for DHS-drug interactions.

Of 927 patients consenting to answer the questionnaire, 458 (49%) reported DHS use. Of these, 215 (47%) had at least one potential interaction during hospitalization (759 interactions). Of these interactions, 116 (15%) were potentially clinically significant.

Older age OR = 1.02 (1.01-1.04), p = 0.002, males OR = 2.11 (1.35-3.29), p = 0.001 and increased number of used DHS OR = 4.28 (2.28-8.03), p. Nieva, Reynaria; Safavynia, Seyed A; Lee Bishop, Kathy; Laurence, Sperling 2012-01-01 The use of complementary and alternative medicine is common and continues to rise each year, both in the general population and among those with cardiovascular disease. While some supplements may incur risk, particularly when used concomitantly with cardiovascular medications, others have proven benefits. However, supplements such as antioxidants and many herbs can have significant interactions with cardiovascular medications.

This study aimed to identify the percentage of patients enrolled in a cardiac rehabilitation program taking herbal, vitamin, and mineral supplements. Electronic and paper charts of 235 patients enrolled in a phase 3 cardiac rehabilitation program were reviewed. Their demographics, medical history, and medications were stratified in an Excel chart, using a large matrix from which data were imported into Matlab for analysis. Custom Matlab programs were created and compiled to determine variables of interest, including percentages of patients with a specific medical condition taking certain supplements. Sixty-seven percent of patients enrolled in the cardiac rehabilitation program were taking vitamins, with or without minerals (67%, 158 of 235).

Multivitamin is the most common form of supplement (51%, 119 of 235), followed by fish oil/omega-3 polyunsaturated fatty acids (27%, 64 of 235). The majority of patients in a phase 3 cardiac rehabilitation program are taking some form of herbal, vitamin, or mineral supplement. Given frequent, complicated patient medication regimens, it is important to educate patients on the potential benefits as well as lack of evidence and possible dangers of supplements.

Nieva, Reynaria; Safavynia, Seyed A.; Bishop, Kathy Lee; Sperling, Laurence 2015-01-01 PURPOSE The use of complementary and alternative medicine is common and continues to rise each year, both in the general population and among those with cardiovascular disease. While some supplements may incur risk, particularly when used concomitantly with cardiovascular medications, others have proven benefits. However, supplements such as antioxidants and many herbs can have significant interactions with cardiovascular medications.

This study aimed to identify the percentage of patients enrolled in a cardiac rehabilitation program taking herbal, vitamin, and mineral supplements. METHODS Electronic and paper charts of 235 patients enrolled in a phase 3 cardiac rehabilitation program were reviewed. Their demographics, medical history, and medications were stratified in an Excel chart, using a large matrix from which data were imported into Matlab for analysis.

Custom Matlab programs were created and compiled to determine variables of interest, including percentages of patients with a specific medical condition taking certain supplements. RESULTS Sixty-seven percent of patients enrolled in the cardiac rehabilitation program were taking vitamins, with or without minerals (67%, 158 of 235).

Multivitamin is the most common form of supplement (51%, 119 of 235), followed by fish oil/omega-3 polyunsaturated fatty acids (27%, 64 of 235). CONCLUSION The majority of patients in a phase 3 cardiac rehabilitation program are taking some form of herbal, vitamin, or mineral supplement.

Given frequent, complicated patient medication regimens, it is important to educate patients on the potential benefits as well as lack of evidence and possible dangers of supplements. PMID:22878561. For its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. And fresh or dried plants.

People use herbal medicines to try to maintain or improve their health. Deconinck, Eric; Custers, Deborah; De Beer, Jacques Omer 2015-01-01 The standard procedures for the identification, authentication, and quality control of medicinal plants and herbs are nowadays limited to pure herbal products. No guidelines or procedures, describing the detection or identification of a targeted plant or herb in pharmaceutical preparations or dietary supplements, can be found. In these products the targeted plant is often present together with other components of herbal or synthetic origin. This chapter describes a strategy for the fast development of a chromatographic fingerprint approach that allows the identification of a targeted plant in herbal preparations and dietary supplements. The strategy consists of a standard chromatographic gradient that is tested for the targeted plant with different extraction solvents and different mobile phases.

From the results obtained, the optimal fingerprint is selected. Subsequently the samples are analyzed according to the selected methodological parameters, and the obtained fingerprints can be compared with the one obtained for the pure herbal product or a standard preparation. Calculation of the dissimilarity between these fingerprints will result in a probability of presence of the targeted plant.

Optionally mass spectrometry can be used to improve specificity, to confirm identification, or to identify molecules with a potential medicinal or antioxidant activity. Mathon, Caroline; Ankli, Anita; Reich, Eike; Bieri, Stefan; Christen, Philippe 2014-01-01 The adulteration of herbal supplements is of growing importance, especially when they contain undeclared compounds like sibutramine that are unsafe drugs. Sibutramine was withdrawn from US and European markets in 2010. In this study, an HPTLC-UV densitometric method was developed for the quantification of sibutramine in herbal diet foods. Sample extracts were directly applied onto HPTLC silica gel plates and separated with a mobile phase made of a toluene-methanol mixture.

Sibutramine was quantified at 225 nm and its unequivocal identification was confirmed by MS using a TLC-MS interface. During two surveys, 52 weight loss supplements obtained via the Internet were screened. Half of those were adulterated with sibutramine at amounts reaching up to 35 mg per capsule. The results of this validated HPTLC method were compared with those obtained by HPLC-UV and HPLC-MS/MS.

The results were not significantly different with the three methods. Araujo, James L; Worman, Howard J 2015-05-06 Despite the widespread use of herbal and dietary supplements (HDS), serious cases of hepatotoxicity have been reported. The popular herbal weight loss supplement, Hydroxycut, has previously been implicated in acute liver injury.

Since its introduction, Hydroxycut has undergone successive transformations in its formulation; yet, cases of liver injury have remained an ongoing problem. We report a case of a 41-year-old Hispanic man who developed acute hepatocellular liver injury with associated nausea, vomiting, jaundice, fatigue and asterixis attributed to the use of a newer formulation of Hydroxycut, SX-7 Clean Sensory. The patient required hospitalisation and improved with supportive therapy. Despite successive transformations in its formulation, potential liver injury appears to remain an ongoing problem with Hydroxycut.

Our case illustrates the importance of obtaining a thorough medication history, including HDS, regardless of new or reformulated product marketing efforts. 2015 BMJ Publishing Group Ltd.

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Worman, Howard J 2015-01-01 Despite the widespread use of herbal and dietary supplements (HDS), serious cases of hepatotoxicity have been reported. The popular herbal weight loss supplement, Hydroxycut, has previously been implicated in acute liver injury. Since its introduction, Hydroxycut has undergone successive transformations in its formulation; yet, cases of liver injury have remained an ongoing problem. We report a case of a 41-year-old Hispanic man who developed acute hepatocellular liver injury with associated nausea, vomiting, jaundice, fatigue and asterixis attributed to the use of a newer formulation of Hydroxycut, SX-7 Clean Sensory. The patient required hospitalisation and improved with supportive therapy.

Despite successive transformations in its formulation, potential liver injury appears to remain an ongoing problem with Hydroxycut. Our case illustrates the importance of obtaining a thorough medication history, including HDS, regardless of new or reformulated product marketing efforts. PMID:25948859. Snyder, Frank J; Dundas, Mary L; Kirkpatrick, Carol; Neill, Karen S 2009-01-01 Herbal supplements (HS) are used by older persons and are often perceived as safe, although there is limited research that examines why this perception exists. A questionnaire was developed and pilot tested to investigate the use and perceived safety of HS among a convenience sample of 112 adults aged 60 to 92 in southeast Idaho. Fifty-five percent of the participants (n = 62) reported using HS in the past. Ninety-five percent (n = 59) of those using HS and 75% (n = 37) of nonusers reported they believed most or some HS were safe.

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Perception of herbal supplement safety was greatly influenced by family and friends, and HS users had a greater perception of safety than nonusers (p.