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U world – Neurological pharmacology

1.

St. John’s wort

A plant product (Hypericum perforatum), not regulated by

the U.S. Food and Drug Administration, is taken by some

individuals to relieve manifestations of mild depression.

NURSING ACTIONS

Adverse effects include photosensitivity, skin rash,

rapid heart rate, gastrointestinal distress, and

abdominal pain.

St. John’s wort can increase or reduce levels of some

medications if taken concurrently. The client should

inform the provider if taking St. John’s wort.

! Medication interactions: Potentially fatal serotonin

syndrome can result if St. John’s wort is taken

with SSRIs or other types of antidepressants.

Foods containing tyramine should be avoided.

Serotonin syndrome

Can begin 2 to 72 hr after starting treatment and can

be lethal.

MANIFESTATIONS

Confusion, agitation, poor concentration, hostility

Disorientation, hallucinations, delirium

Seizures leading to status epilepticus

Tachycardia leading to cardiovascular shock

Labile blood pressure

Diaphoresis

Fever leading to hyperpyrexia

Incoordination, hyperreflexia

Nausea, vomiting, diarrhea, abdominal pain

Coma leading to apnea (and death in severe cases)

CLIENT EDUCATION: Observe for manifestations. If any

occur, withhold the medication and notify the provider.