Ezuruike Udoamaka, Prieto Jose M
Department of Pharmaceutical and Biological Chemistry, Centre for Pharmacognosy and Phytotherapy, University College London School of Pharmacy London, UK.
Front Pharmacol. 2016 Aug 10;7:248. doi: 10.3389/fphar.2016.00248. eCollection 2016.
It is becoming increasingly evident that patients with diabetes do not rely only on prescription drugs for their disease management. The use of herbal medicines is one of the self-management practices adopted by these patients, often without the knowledge of their healthcare practitioners. This study assessed the potential for pharmacokinetic herb-drug interactions (HDIs) amongst Nigerian adult diabetic patients. This was done through a literature analysis of the pharmacokinetic profile of their herbal medicines and prescription drugs, based on information obtained from 112 patients with type-2 diabetes attending two secondary health care facilities in Nigeria. Fifty percent of the informants used herbal medicines alongside their prescription drugs. Worryingly, 60% of the patients taking herbal medicines did not know their identity, thus increasing the risk of unidentified HDIs. By comparing the pharmacokinetic profile of eight identified herbs taken by the patients for the management of diabetes against those of the prescription drugs, several scenarios of potential HDIs were identified and their clinical relevance is discussed. The lack of clinical predictors points toward cultural factors as the influence for herb use, making it more difficult to identify these patients and in turn monitor potential HDIs. In identifying these possible interactions, we have highlighted the need for healthcare professionals to promote a proactive monitoring of patients' use of herbal medicines.
越来越明显的是,糖尿病患者在疾病管理中并非仅依赖处方药。使用草药是这些患者采取的自我管理措施之一,而医护人员往往对此并不知情。本研究评估了尼日利亚成年糖尿病患者中发生药代动力学草药 - 药物相互作用(HDIs)的可能性。这是通过对他们所使用的草药和处方药的药代动力学特征进行文献分析来完成的,这些信息来自于在尼日利亚两家二级医疗机构就诊的112名2型糖尿病患者。50%的受访者在服用处方药的同时还使用草药。令人担忧的是,60%服用草药的患者不知道所服用草药的具体成分,从而增加了无法识别的HDIs风险。通过比较患者用于控制糖尿病的8种已识别草药与处方药的药代动力学特征,确定了几种潜在HDIs的情况并讨论了其临床相关性。缺乏临床预测指标表明文化因素是影响草药使用的因素,这使得识别这些患者并进而监测潜在HDIs变得更加困难。在识别这些可能的相互作用时,我们强调了医护人员积极监测患者草药使用情况的必要性。
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