Common supplements and herbals

Common supplements and herbals

Drug monograph · NCLEX study reference
Therapeutic class	Dietary supplements
Pharmacologic class	Hormone supplement, fatty acids, fiber, herbal products
Onset / peak / duration	Variable.
Half-life / level	Not standardized.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Discontinue.
Pregnancy / lactation	Many herbals not recommended; verify each.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Common supplements and herbals — Dietary supplements; Hormone supplement, fatty acids, fiber, herbal products.

Identification

• Therapeutic class: Dietary supplements.
• Pharmacologic class: Hormone supplement, fatty acids, fiber, herbal products.

Pharmacology

• Mechanism of action: Vary; commonly used over the counter, with clinically important interactions.
• Onset / peak / duration: Variable.
• Half-life / therapeutic level: Not standardized.

Clinical use

• Indications: Sleep regulation (melatonin), triglyceride lowering (fish oil), constipation and cholesterol (psyllium), gut health (probiotics); herbals used for various purposes.
• Usual dose, route, frequency: PO; not standardized or regulated like prescription drugs.
• Maximum dose / adjustments: Quality and potency vary by product.

Safety

• Contraindications: Bowel obstruction (psyllium), immunosuppression caution (some herbals, probiotics).
• Black box warning: None.
• Interactions: St. John's wort induces many CYP enzymes (reduces oral contraceptives, warfarin, antiretrovirals, immunosuppressants, and more); ginkgo, garlic, ginseng, and fish oil increase bleeding risk with anticoagulants; kava and valerian add sedation; hawthorn affects cardiac drugs.
• Pregnancy / lactation: Many herbals not recommended; verify each.
• High-alert: No.

Adverse effects

• Common side effects: Vary; psyllium causes bloating; melatonin causes drowsiness.
• Serious effects to report: Bleeding (with anticoagulant-interacting herbals), serotonin syndrome (St. John's wort with serotonergic drugs).
• Antidote / reversal: Discontinue.

Nursing process

• Assessment before administration: Full supplement and herbal history, prescription interactions.
• Interventions during therapy: Always ask about supplement and herbal use; counsel on interactions.
• Monitor: Effects and interactions with prescribed drugs.
• Evaluation / expected outcome: Intended supplement effect without harmful interaction.

Patient teaching

• Patient teaching: Tell every provider about all supplements and herbals; they can interact with prescription medicines; take psyllium with plenty of water.
• Notify provider if: Unusual bleeding, excessive sedation, new symptoms.
• Administration tips: Disclose all supplements; psyllium with a full glass of water.