Hagedorn


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hawthorne (Crataegus Species)

(haw-thorn) ,

aubepine

(trade name),

cum flore

(trade name),

hagedorn

(trade name),

maybush

(trade name),

whitehorn

(trade name)

Classification

Therapeutic: antihypertensives
HypertensionMild to moderate HFAnginaSpasmolyticSedative

Action

Active compounds in hawthorne include flavonoids and procyanidins.
Increase coronary blood flow.
Positive inotropic and chronotropic effects because of increased permeability to calcium and inhibition of phosphodiesterase.

Therapeutic effects

Increased cardiac output.
Decreased BP, myocardial workload, and oxygen consumption.

Pharmacokinetics

Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile

ROUTEONSETPEAKDURATION
POunknown6-8 wkunknown

Contraindications/Precautions

Contraindicated in: Pregnancy (potential uterine activity); Lactation.
Use Cautiously in: Concurrent use with ACE inhibitors and digoxin; Do not discontinue use abruptly.

Adverse Reactions/Side Effects

Central nervous system

  • agitation
  • dizziness
  • fatigue
  • vertigo
  • headache
  • sedation (high dose)
  • sleeplessness
  • sweating

Cardiovascular

  • hypotension (high dose)
  • palpitations

Dermatologic

  • rash

Gastrointestinal

  • nausea

Interactions

May potentiate effects of digoxin, calcium channel blockers, and beta blockers.Concurrent use with phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil ) and nitrates may potentiate vasodilatory effects.May cause additive CNS depression when used with other CNS depressants.Additive effect with other cardiac glycoside–containing herbs (digitalis leaf, black hellebore, oleander leaf, and others).Additive hypotensive effects with herbs than lower BP such as ginger, panax ginseng, coenzyme Q-10and valerian.Additive effect with other cardioactive herbs (devil’s claw, fenugreek, and others).
Oral (Adults) Heart failure—160–1800 mg standardized hawthorne leaf with flower extract in 2–3 divided doses daily. Hawthorne fluid extract (1:1 in 25% alcohol)—0.5–1 mL tid; hawthorne fruit tincture (1:5 in 45% alcohol)—1–2 mL tid; dried hawthorne berries—300–1000 mg tid.

Availability (generic available)

Dried fruit: OTC
Liquid extract of the fruit or leaf: OTC
Tincture of the fruit or leaf: OTC

Nursing implications

Nursing assessment

  • Monitor intake and output rations and daily weight. Assess for peripheral edema, auscultate lungs for rales and crackles during therapy.
  • Assess BP and pulse periodically during therapy.

Potential Nursing Diagnoses

Decreased cardiac output (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Administered as 2–3 divided doses daily at the same time.
  • May be taken without regard to food.

Patient/Family Teaching

  • Advise patients that there are other proven therapies available for treatment of heart failure. These therapies should be employed prior to initiating treatment with hawthorne.
  • Tell patient not to take hawthorne without the advice of health care professional.
  • Instruct patients in the symptoms of a heart attack (pain in the region of the heart, jaw, arm, or upper abdomen; sweating; chest tightness) and heart failure (shortness of breath, chest tightness, dizziness, sweating) and to promptly contact health care professional if they occur.
  • Advise patient to report weight gain or persistent swelling of the feet to health care professional.
  • May cause dizziness and fatigue. Patients should avoid driving or other activities that require mental alertness until response to herb is known.
  • Avoid alcohol and other CNS depressants while taking hawthorne without consulting health care professional.
  • Profuse sweating and dehydration under extreme heat may increase the BP-lowering properties of hawthorne, leading to severe hypotension. Warn patients to avoid exertion in hot weather to minimize the risk of side effects.
  • Instruct patients that hawthorne helps control the symptoms of heart failure but does not cure the disease. Lifestyle changes (salt restriction, weight management, exercise as tolerated, adherence to medication regimens) still need to be followed.
  • Instruct patient to consult health care professional before taking Rx, OTC, or other herbal products concurrently with hawthorne.
  • Advise female patients to use contraception during therapy and to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Decrease in symptoms of HF. Effects may not be seen for 6 wks.
  • Improved cardiac output as evidenced by improved activity tolerance.

Hag·e·dorn

(hahg'ĕ-dōrn),
Werner, German surgeon, 1831-1894. See: Hagedorn needle.
References in periodicals archive ?
Ultimately, Hagedorn recognizes the military had little control over the policy vacuum that led to the swift and dramatic dilution of the government's traditional monopoly over the use of force.
Although the number of job offers is not directly measurable, Hagedorn and Iourii show that it is roughly equal to what they call "the sum of labor market tightness"--that is, the ratio of the aggregate stock of vacancies to the unemployment rate.
The Great Barrier Reef is iconic and of vast importance in terms of biological diversity and species richness," Hagedorn emphasizes.
Mr Hagedorn, who has four years' flying experience in his German-built Flight Design CT-SW, left Barrow-in-Furness in the morning and was heading for RAF Kinloss where he had been cleared to land.
Following her diagnosis, Mrs Hagedorn has had to give up teaching, and endured 18 weeks of chemotherapy.
Legislative Sponsors, Senator Bob Hagedorn, Representative Ellen Roberts, and Representative Sara Gagliardi were awarded plaques on behalf of CNA in appreciation of their support.
Hagedorn said such rules will have to be adopted by all communities for them to have any impact.
The Hagedorn Community Center was originally built in 1929 as a public school.
James Hagedorn, the president of Scotts Miracle-Gro, just announced that his company has developed a new, slower-growing, genetically-engineered grass that hardly ever has to be mowed.
The metadata issues in particular have been well documented (Shreeves, Kaczmarek, & Cole, 2003; Halbert 2003; Hagedorn, 2003; Arms, Dushay, Fulker, & Lagoze, 2003), but we highlight some of the major issues in all areas of concern below.
Linda Serra Hagedorn, University of Southern California
Hagedorn, vice president of materials, was paid a salary of $130,000 in 2003, up from $125,000 in both 2001 and 2002.