Dergal Julie M, Gold Jennifer L, Laxer Dara A, Lee Monica S W, Binns Malcolm A, Lanctôt Krista L, Freedman Morris, Rochon Paula A
Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
Drugs Aging. 2002;19(11):879-86. doi: 10.2165/00002512-200219110-00005.
Herbal medicines and conventional drug therapies are often taken in combination. The objective of our study was to identify the range of natural health products and conventional drug therapies used by older adults (aged 65 years and over) attending a memory clinic, and to specifically evaluate the frequency of potential interactions between herbal medicines and conventional drug therapies.
We interviewed consecutive patients attending the Memory Disorders Clinic at the Baycrest Centre for Geriatric Care, a University of Toronto teaching hospital, between 4 July and 15 August 2000. Patients were asked to bring to their appointment all natural health products (i.e. herbal medicines, vitamins and minerals) and conventional drug therapies (i.e. prescription and over-the-counter) they were currently using. We collected information on current and previously used natural health products and current conventional drug therapies. Patients were classified as having the potential for an interaction if they were using a current herbal medicine in combination with a conventional drug therapy and the interaction had been reported previously in the medical literature.
We interviewed 195 consecutive patients attending the Memory Disorders Clinic at the Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
Of the 195 patients in our sample, 33 (17%) were 'current users', 19 (10%) were 'past users', and 143 (73%) were 'never users' of herbal medicines. Among the 52 patients who were 'current or past users', the most frequently used herbal medicines were ginkgo (Ginkgo biloba) [39 users], garlic (n = 10), glucosamine sulphate (n = 9) and echinacea (n = 8). Among the 33 patients who were current users, the most commonly used herbal medicines were Ginkgo biloba (n = 22), glucosamine sulphate (n = 8) and garlic (n = 6). Among the 33 current users, we identified 11 potential herb-drug interactions in nine patients. The 11 herb-drug interactions we identified were between ginkgo and aspirin (acetylsalicylic acid) [n = 8], ginkgo and trazodone (n = 1), ginseng and amlodipine (n = 1) and valerian and lorazepam (n = 1).
Herbal medicines are widely used. Almost one-third of current users of herbal medicines were at risk of a herb-drug interaction. The most common potential herb-drug interaction was between ginkgo and aspirin. This finding has important potential implications because both of these products are regularly used by older people. Physicians and other healthcare providers should be aware of potential herb-drug interactions and should monitor and inform their patients accordingly.
草药与传统药物疗法常常联合使用。我们研究的目的是确定在记忆门诊就诊的老年人（65岁及以上）使用的天然保健品和传统药物疗法的范围，并特别评估草药与传统药物疗法之间潜在相互作用的频率。
我们于2000年7月4日至8月15日期间，对在多伦多大学教学医院贝可瑞斯特老年护理中心记忆障碍门诊连续就诊的患者进行了访谈。要求患者在就诊时带上他们目前正在使用的所有天然保健品（即草药、维生素和矿物质）以及传统药物疗法（即处方药和非处方药）。我们收集了关于目前和以前使用的天然保健品以及目前的传统药物疗法的信息。如果患者目前正在使用一种草药并与一种传统药物疗法联合使用，且这种相互作用先前已在医学文献中报道，那么该患者被归类为有潜在相互作用。
我们对加拿大安大略省多伦多市贝可瑞斯特老年护理中心记忆障碍门诊连续就诊的195名患者进行了访谈。
在我们样本中的195名患者中，33名（17%）是草药“当前使用者”，19名（10%）是“过去使用者”，143名（73%）是草药“从未使用者”。在52名“当前或过去使用者”中，最常使用的草药是银杏（银杏叶）[39名使用者]、大蒜（n = 10）、硫酸葡萄糖胺（n = 9）和紫锥菊（n = 8）。在33名当前使用者中，最常用的草药是银杏叶（n = 22）、硫酸葡萄糖胺（n = 8）和大蒜（n = 6）。在33名当前使用者中，我们在9名患者身上发现了11种潜在的草药 - 药物相互作用。我们发现的11种草药 - 药物相互作用分别是银杏与阿司匹林（乙酰水杨酸）之间的相互作用[n = 8]、银杏与曲唑酮之间的相互作用（n = 1）、人参与氨氯地平之间的相互作用（n = 1）以及缬草与劳拉西泮之间的相互作用（n = 1）。
草药被广泛使用。几乎三分之一的草药当前使用者存在草药 - 药物相互作用的风险。最常见的潜在草药 - 药物相互作用是银杏与阿司匹林之间的相互作用。这一发现具有重要的潜在意义，因为这两种产品都经常被老年人使用。医生和其他医疗保健提供者应意识到潜在的草药 - 药物相互作用，并应相应地对患者进行监测和告知。
