Carolina Facial Plastic Surgery

What Medications Are You Taking?

Herbal medicine or botanicals are increasingly popular. And while medical doctors do not necessarily object to their patients ingesting these non-prescription products, patients undergoing surgery are advised that:

“There have not been enough studies of botanicals in the U.S. for us to state that there definitely will or will not be a reaction during surgery, but most anesthesiologists and surgeons will err on the side of caution…we recommend discontinuing some herbal medications at least two to three weeks prior to surgery.”*

What particularly concerns me and other surgeons is that patients taking these substances often do not regard them as medicines, so when asked, “What medications are you taking,” the patients frequently do not reveal that they are taking these products. According to the American Society of Anesthesiologists, “Seven out of 10 people using these will not tell their physicians.” Our practice’s unswerving routine is to raise the subject with all patients, at the “preoperative visit,” several weeks prior to the surgery date and give them the following list of the more common herbal medications and their potential complications that could arise during surgery.**

Ginseng

Ginseng is used to enhance energy levels. If combined with stimulants used by anesthesiologists, it can cause tachycardia and high blood pressure. It can also decrease the effect of Warfarin, causing the blood to thicken and develop clots.

Ephedra

Ephedra is included in over-the-counter diet aids. It interacts with inhalants used for anesthesia to affect blood pressure. If used with monoamine oxidase inhibitors or Oxytocin, the patient can experience high blood pressure and irregular heart rate during surgery.

Feverfew

Feverfew is often used to treat migraines. It inhibits platelet activity that can increase bleeding during surgery.

Valerian

Valerian is a mild sedative to help sleep. It causes a potential increase in the effect of barbiturates used in anesthesia, which causes a deeper effect of anesthesia.

Ginkgo Biloba

Ginkgo Biloba is a circulatory stimulant. It decreases platelet activity and clotting ability.

St. John’s Wort

St. John’s Wort is used to treat anxiety and depression. It may prolong the effects of some narcotics and anesthetics.

Licorice

Licorice treats symptoms of gastritis and duodenal ulcers. It can cause edema and chronic liver problems and increase the risk of renal insufficiency.

Herbal Medicine WarningEchinacea

Echinacea is used to enhance the immune system; it may cause hepatotoxicity and possible liver damage.

Ginger

Ginger treats nausea. It can increase bleeding time.

Goldenseal

Goldenseal is a diuretic and laxative. It can worsen edema and increase blood pressure.

*.Jessie A. Leak, M.D., Associate Professor, Department of Anesthesia, M.D. Anderson Cancer Center, Houston, a researcher who specializes in the study of herbal medication.

**Compliments, Jessie A. Leak, M.D.

Herbs, Foods, Spices, and Medications to Be Avoided for at least Two Weeks before Surgery

Absorbine Bog bean Feldene Percogesic
Absorbine Jr. Boldo Fenugreek Peristin
Acodeen-30 Borage Seed Oil Feverfew Plantain
Braska Fiogesic Tablets and Capsules Poplar
Advil Bromelain Fiorinal Capsules and Tablets Quassia
Agrimony Buff-A-Comp Fish Oils Red Clover
Alfalfa Buffadyne Fucus Rid-A-Pain
Alka-Seltzer Extra Bufferin-All Varieties Garlic Robaxisal
Strength Butalbital Ginger Roman Chamomile
Alka-Seltzer Cama-Inlay Tabs Ginkgo Roxiprin
Flavored Capsicum Ginseng Rumarub
Alpha Phed Capsule Carisoprodol Glepirin Tablets Safflower
Anacin Analgesic Celery Goldenseal Sine-Aid
Caplets and Tablets Clove Heet Sine-Off
Chloracol Capsules Horseradish SK–65 Compound Capsules
Anacin Maximum Clinoril Ibuprofen(Mortrin, Nuprin, Advil, Anaprox) Solan’s
Strength Analbalm Congespirin Icy Hot Soltice
Analgesic Balm Compound Indocin Soma Compound (or with Codeine)
Angelica Cope Infra-Rub SPD Stendin
Anise Coricidin Licorice Southern prickly ash
Effervescent Counterpain Rub Lini-Balm Stinging nettle
Anti acids and Damason Lortab ASA Supac Surin
Pain Reliever Danshen Meadowseet Sweet Clover
Anti phiogistine Darvon with AsjA Mentholatum Sweet Vernal
4-Way Cold Tablets Darvon-N with ASA Meprobamate and Aspirin Tablets Synalogos DE Capsules
A.P.C. Dencorub Midol Talwin
Diet Pills Monaceet with Codeine Tolectin
Arthralgen Di-Gesic Improved Morgesic Tonka bean
Arthritic Doan’s Rub Musterole Traminicin
Arthritis Pain Formula Dolprin 33 Naprosyn Turmeric
Asafoetida Dong quai Northern prickley ash Vanquish
Ascriptin with Dristan Neurabaim Vitamin E
Aspen Surgaesic Norgesic Forte Voltaren
Codeine Tablets Easprin Oil-O-Sol Yager’s Liniment
Aspercreme Ecotrin Omega Oil Yarrow
Axotal Empirin with Codeine Orphengesic Zomax
Bac #3 Emprazil Oxycodone Zorprin
Bac Tablets Emul-O-Balm Pabirin Buffered Tablets
Banalg End-Ake Panalgesic
Baumodyhne Equagesic Papain
Bayer Aspirin Varieties Esotrin

European Mistletoe

Passionflower

Pau d’ Arco

BC Powders Excedrin Extra Pepto-Bismol
Black Cohosh

Ben Gay

Strength

Exocaine

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