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Aukaverkanir og milliverkanir náttúrulyfja, náttúruvara og fæðubótarefna

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Authors
Ólöf Þórhallsdóttir
Kristín Ingólfsdóttir
Magnús Jóhannsson
Issue Date
2002-04-01

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Other Titles
Herbal medicine - Adverse effects and drug-interaction
Citation
Læknablaðið 2002, 88(4):289-97
Abstract
Objective: The aim of the study was to estimate the frequency of adverse effects and drug-interactions attributable to the use of herbal medicine and dietary supplements in Iceland. A further objective was to assess the perception and attitudes of Icelandic physicians towards these products. Material and methods: A questionnaire was sent to all physicians registered in Iceland, a total of 1083. Physicians were questioned as to whether they had become aware of adverse effects or drug interactions that could be related to the use of herbal medicines or dietary supplements. Several questions concerned education and attitudes towards these products. A search was made using the computer system of the University Hospital in order to find cases of hospitalization resulting from consumption of herbal medicine. Details on admissions to the Emergency Department of the hospital were studied daily for one month. Enquiries made to the Icelandic Poison Center from 1997-2000 and formal reports submitted to the Icelandic Medicines Control Agency and the Surgeon General were examined. Results: Of the 410 physicians that responded, 134 had become aware of adverse effects and 25 had become aware of herbal/drug interactions. Details on 253 adverse effects and 13 interactions were presented. Hospitalization was estimated to have been the consequence of 38 cases, 14 of which had been considered life-threatening. Of those who responded, 17% reported asking their patients always/frequently if they used herbal medicines or dietary supplements, whilst 62% reported asking occasionally/ seldom and 19% never asking. Approximately 55% of the respondents regard it as being very important/important that patients consult a physician before using herbal products or dietary supplements. Conclusions: Adverse effects and interactions between herbal medicines/dietary supplements and prescribed drugs appear to be under-reported in Iceland. It is important to increase awareness and education in this field amongst physicians and other health-care professionals in Iceland.
Tilgangur: Markmið rannsóknarinnar var að kanna fjölda aukaverkana og milliverkana sem rekja má til neyslu náttúrulyfja, náttúruvara og fæðubótarefna hér á landi. Markmiðið var jafnframt að kanna viðhorf lækna á Íslandi til þessara efna. Aðferðir: Spurningalisti var sendur til allra lækna á landinu, alls 1083. Spurt var hvort viðkomandi læknir hafi orðið/hugsanlega orðið var við auka- eða milliverkanir sem rekja mætti til neyslu náttúrulyfja, náttúruvara eða fæðubótarefna hér á landi. Einnig var spurt um viðhorf til efnanna. Þar sem ekki finnast sérstök skráningarnúmer fyrir sjúkdómsgreiningar þar sem þátt eiga náttúrulyf, náttúruvörur eða fæðubótarefni í skráningarkerfum Landspítala-háskólasjúkrahúss, var leit gerð í tölvukerfum sjúkrahússins eftir skráningarnúmerum sem þóttu líkleg til að sýna innlagnir vegna neyslu náttúruefna. Jafnframt var fylgst daglega með bráðamóttökum sjúkrahússins í einn mánuð, fyrirspurnir vegna náttúruefna til Eitrunarmiðstöðvar voru skoðaðar og að lokum athugað hvort tilkynningar hefðu borist Lyfjastofnun eða Landlæknisembættinu. Niðurstöður: Spurningalistanum svöruðu 410 læknar. Þar af höfðu 134 orðið varir/hugsanlega orðið varir við fyrrgreindar aukaverkanir og 25 við milliverkanir. Upplýsingar komu fram um 253 aukaverkanir og 13 milliverkanir. Innlögn á sjúkrahús var talin afleiðing 38 tilvika og í 14 tilvikum var talið að aukaverkun hafi stofnað lífi sjúklings í hættu. Af þeim læknum sem svöruðu listanum sögðust 17% alltaf/oft spyrja sjúklinga sína hvort þeir neyti náttúrurefna, 62% stundum/sjaldan og 19% aldrei. Um 55% læknanna sögðu þó að þeim fyndist skipta mjög miklu/ miklu máli að sjúklingar nefni neyslu sína á áðurnefndum efnum. Ályktanir: Auka- og milliverkanir vegna náttúruefna virðast vera vanskráðar hérlendis. Nauðsynlegt er að auka fræðslu um aukaverkanir og milliverkanir náttúrulyfja, náttúruvara og fæðubótarefna og hvetja til virkrar skráningar og tilkynningar auka- og milliverkana sem hljótast af neyslu þessara efna.
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