Japanese ginseng


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ginseng (Panax Ginseng)

(jin-seng) ,

Asian ginseng

(trade name),

Chinese ginseng

(trade name),

hong shen

(trade name),

Japanese ginseng

(trade name),

Korean ginseng

(trade name),

red ginseng

(trade name),

renshen

(trade name),

white ginseng

(trade name)

Classification

Therapeutic: none assigned
Improving physical and mental staminaGeneral tonic to energize during times of fatigue and inability to concentrateSedative, sleep aid, antidepressantDiabetesEnhanced sexual performance/aphrodisiacIncreased longevityAdjunctive treatment of cancerIncreased immune responseIncreased appetite

Action

Main active ingredient is ginsenoside from the dried root.
Serves as CNS stimulant and depressant.
Enhances immune function.
Interferes with platelet aggregation and coagulation.
Has analgesic, anti-inflammatory, and estrogen-like effects.

Therapeutic effects

Improves mental and physical ability.
May improve appetite, memory, sleep pattern.
May reduce fasting blood glucose level in diabetic patients.

Pharmacokinetics

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

Time/action profile

ROUTEONSETPEAKDURATION
POunknownunknownunknown

Contraindications/Precautions

Contraindicated in: Pregnancy (androgenization of fetus); Lactation; Children ; Manic-depressive disorders and psychosis; Hypertension; Asthma; Infection; Organ transplant recipients (can interfere with immunosuppressive therapy) ; Hormone-sensitive cancers.
Use Cautiously in: Autoimmune diseases; Cardiovascular disease; Diabetics (may have hypoglycemic effects); Patients receiving anticoagulants; Bleeding disorders; Schizophrenia (may cause agitation).

Adverse Reactions/Side Effects

Central nervous system

  • agitation
  • depression
  • dizziness
  • euphoria
  • headaches
  • insomnia (most frequent)
  • nervousness

Cardiovascular

  • hypertension
  • tachycardia

Gastrointestinal

  • diarrhea

Genitourinary

  • amenorrhea
  • vaginal bleeding

Dermatologic

  • skin eruptions

Endocrinologic

  • estrogen-like effects

Miscellaneous

  • fever
  • mastalgia
  • stevens-johnson syndrome (life-threatening)

Interactions

May ↓ anticoagulant activity of warfarin.May interfere with MAO inhibitors treatment and cause headache, tremulousness, and manic episodes.May enhance blood glucose lowering effects of oral hypoglycemics and insulin.May interfere with immunosuppressant therapy.Use with caution when taking estrogens.May ↑ risk of bleeding when used with herbs that have antiplatelet or anticoagulant activities.May prolong the QT interval when used with bitter orange, country mallowand ephedra and ↑ risk of life-threatening arrhythmias.May ↑ risk of hypoglycemia when used with herbs with hypoglycemic potential.May potentiate effects of caffeine in coffee or tea and CNS stimulant effects of mate.
Oral (Adults) Capsule—200–600 mg/day; extract—100–300 mg 3 times daily; crude root—1–2g/day; infusion—tea—1–2g root daily (1/2 tbsp/cup water) up to 3 times daily (P. ginseng tea bag usually contains 1500 mg of ginseng root). Do not use for longer than 3 mo. Cold/flu prevention—100 mg daily 4 weeks prior to influenza vaccination and continued for 8 weeks; Chronic bronchitis—100 mg BID for 9 days combined with antibiotic therapy; Erectile dysfunction—900 mg TID; Type 2 diabetes—200 mg daily.

Availability (generic available)

Root powder: OTC
Extract in alcohol: OTC
Capsules: OTC
Tea bags: OTC

Nursing implications

Nursing assessment

  • Assess level of energy, attention span, and fatigue person is experiencing prior to initiating and periodically duringtherapy.
  • Assess appetite; sleep duration; and perceived quality, emotional lability, and work efficiency prior to and during therapy.
  • Patients with chronic medical problems should not use this herb without the advice of health care professional.
  • Assess for ginseng toxicity (nervousness, insomnia, palpitations, and diarrhea).
  • Monitor patients with diabetes more frequently for hypoglycemia until response to the agent is ascertained.
  • Assess for the development of ginseng abuse syndrome (occurs when large doses of the herb are taken concomitantly with other psychomotor stimulants such as coffee and tea. May present as diarrhea, hypertension, restlessness, insomnia, skin eruptions, depression, appetite suppression, euphoria, and edema).

Potential Nursing Diagnoses

Energy field disturbance (Indications)
 (Indications)

Implementation

  • May be taken without regard to food.
  • Take at the same time daily and do not increase dose above the recommended amount because of potential toxic effects.

Patient/Family Teaching

  • Warn patients with cardiovascular disease, hypertension or hypotension, or on steroid therapy to avoid the use of this herb.
  • Caution pregnant or breastfeeding women not to use this herb.
  • Instruct patient in the symptoms of ginseng toxicity and to reduce dose or stop use of the herb if they occur.
  • Inform patient to limit the amount of caffeine consumed.
  • Advise patients with diabetes to monitor blood sugar levels until response to this agent is known.
  • Inform patient that the recommended course of therapy is 3 wk. A repeated course is feasible. Do not use for longer than 3 mo.
  • Teach patient about the signs and symptoms of hepatitis (yellow skin or whites of eyes, dark urine, light colored stools, lack of appetite for several days or longer, nausea, abdominal pain) and to stop use of the herb and promptly contact health care professional if they occur. (This herb is hepatoprotectant at low doses, but hepatodestructive at high doses.).
  • Caution patient not to exceed recommended doses because of potential side effects and toxicity.
  • If diarrhea develops, stop herb.
  • Instruct patient to consult health care professional before taking any Rx or OTC medications concurrently with ginseng.

Evaluation/Desired Outcomes

  • Improved energy level and sense of well-being.
  • Improved quality of sleep.
  • Improved concentration and work efficiency.
  • Improved appetite.
  • May need to take for several weeks before seeing results.

Japanese ginseng

A Japanese species of ginseng (Panax japonicus) purported to have similar effects as American ginseng.
See also: ginseng
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