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 ?
Hagedorn "willfully, unlawfully and feloniously" consented and permitted another person to take for his own personal use and benefit the said rifles by failing to return it after his term as city mayor.
Bayron was Hagedorn's city administrator when he ran for re-election in 1995.
Most recently, Hagedorn spent the past eight years as vice president of operations at Siemens Healthcare Diagnostics, which he joined in 2010,
The case, however, was formally filed at the Sandiganbayan only on January 23.The ombudsman recommended to the anti-graft court to set Hagedorn's bail bond at P40,000.Among the witnesses listed by the ombudsman to testify against Hagedorn were incumbent Puerto Princesa City mayor Lucilo Bayron, acting City General Services Officer Tiburcio Magay and the city government's property custodian.
Hagedorn thinks the media business is going through the biggest change in 15 years, since digital advertising first went mainstream.
"We invested north of $10 million globally to create a [data management platform] five years ago for all of our clients because we thought it was going to be the new standard in marketing," says Hagedorn. "We're the first holding company to pay for doing one independently."
Necessarily, Hagedorn relies heavily on secondary sources from general American history, and, particularly, on surveys of educational history that were published throughout the twentieth century.
A gifted story teller, Hagedorn displays the journalistic skills and instincts she honed at the Wall Street journal by introducing her book with a lengthy, engaging, and compelling, but, ultimately irrelevant, anecdote.
Patrick Gallagher Jr pointed out that the addition of Hagedorn would greatly complement his company's Northeastern activities.
Hagedorn has been named group executive and chief development officer with responsibility for the Global Development and Strategy Group.
Mary Hagedorn from the US's Smithsonian Institution, who perfected the techniques while working with coral in Hawaii, is liaising with Australian colleagues to deploy those techniques in the cause of conservation.
771-803), economists Marcus Hagedorn and Iourii Manovskii examine this topic from a new perspective and provide an alternative to the history-dependent thesis.