An essential part of our patient assessment is obtaining a list of medications that you may currently be taking.  This not only provides information about possible drug interactions, it may also help us better understand your medical history and current state of health.  We are usually adept at figuring out that if a person is on digoxin and lasix, they probably have a history of congestive heart failure.  If on Coumadin these persons are at risk for bleeding and the patients who take insulin are diabetic.  Knowing indication for and side effects of medications can help us make well-informed decisions regarding your healthcare intervention.

 

Most EMS providers are consistent with asking the patient, “What medications are you currently taking?” and obtaining a list of prescription drugs.  How often, though, do you tell us about your over-the-counter(OTC) meds, vitamins or herbal and nutritional supplements?  Currently, it is estimated that up to 40% of the population is now using herbal remedies or nutritional supplement. Why is it important to know, as most people think these are OTC drugs or only vitamins or herb! It stems from the fact that, even though these items are not regulated by prescription, they can have significant impact on your overall health, especially if taken with certain prescription medications.

 

Take for instance, many people are now taking a combination of garlic, for its purpose of lowering cholesterol, and ginkgo biloba, for its claims of being a memory booster.  Both of these herbs, while considered safe, have blood-thinning effects.  If you are also taking Coumadin and using these herbs on a daily basis, there is certainly an increased risk of bleeding, especially after trauma or in cases of suspected strokes.

 

During the current cold and flu season, it is not uncommon to see remedy ads for Echinacea and Goldenseal, both herbs, are popular in many products and claim to boost the immune system to reduce cold symptoms.  Echinacea has few adverse side effects, if taken as directed, unless you may have allergies to plants in the daisy family.  Goldenseal, on the other hand, has potential for more serious effects.  A current urban legend is that massive doses of this herb might mask the appearance of certain drugs in urine screens.  The DANGER of this rumor is that massive doses may cause not only stomach upset, but also effect the heart and brain and may progress to seizures, respiratory arrest, slow heart rates, and cardiac arrest.

 

Energy preparations have a combination of ma huang, ginseng, and/or guarana in additions to caffeine.  All of these herbs have stimulant properties which can result in fast heart rates, high blood pressure, nervousness, sleeplessness and heart palpitations.  There have been documented deaths with the use of supplements containing ma huang.

 

You need to become aware of the use and side effects of herbal medications.  A reference book regarding herbals should be selected based on its objective presentation rather than one to convince the reader about the safety of such preparations. Above all else talk with your doctor or pharmacist before you choose herbal medications. Remember, the use of these and other herbs, alone or in combination with other prescription meds, may actually be the cause of your emergency call.  Keep a list of ALL medications you take routinely, prescription or supplements, present to the EMS provider in case of emergencies.