kava-kava

(redirected from Kao)
Also found in: Acronyms, Encyclopedia, Wikipedia.

kava-kava (Piper Methysticum)

(ka-va ka-va) ,

Ava pepper

(trade name),

intoxicating pepper

(trade name),

kao

(trade name),

kew

(trade name),

tonga

(trade name),

wurzelstock

(trade name),

yagona

(trade name)

Classification

Therapeutic: antianxiety agents
Anxiety, stress, restlessness, insomnia, benzodiazepine withdrawalMild muscle aches and painsMenstrual cramps and PMS

Action

Alters the limbic system modulation of emotional processes.
Shown to have centrally-acting skeletal muscle relaxant properties activated.

Therapeutic effects

Relief of anxiety.
Sedation.

Pharmacokinetics

Absorption: Peak plasma level occurs about 1.8 hr after an oral dose.
Distribution: Enters breast milk.
Metabolism and Excretion: Elimination occurs primarily by renal excretion (both unchanged and metabolites) and in the feces. Metabolized by the liver (reduction or demethylation).
Half-life: Approximately 9 hr.

Time/action profile

ROUTEONSETPEAKDURATION
PO1.8 hrunknown8 hr

Contraindications/Precautions

Contraindicated in: Obstetric / Lactation: Pregnancy (may affect uterine tone) and lactation; Patients with endogenous depression (may ↑ risk of suicide); Children <12 yr; Hepatitis or other liver disease.
Use Cautiously in: Concurrent use of other hepatotoxic agents; Depression and Parkinson's disease (may worsen symptoms); Should not be used for >3 mo to prevent psychological dependence.

Adverse Reactions/Side Effects

Central nervous system

  • dizziness
  • headache
  • drowsiness
  • sensory disturbances
  • extrapyramidal effects

Ear, Eye, Nose, Throat

  • Pupil dilation
  • red eyes
  • visual accommodation disorders

Gastrointestinal

  • hepatotoxicity (life-threatening)
  • gastrointestinal complaints

Dermatologic

  • allergic skin reactions
  • yellow discoloration of skin
  • pellagroid dermopathy

Hematologic

  • ↓ lymphocytes
  • decreased platelets

Metabolic

  • weight loss (long term, high dose)

Neurologic

  • ataxia
  • muscle weakness

Interactions

Additive effect when used with alprazolam.Potentiates effect of CNS depressants (ethanol, barbiturates, benzodiazepines, opioid analgesics ).Has ↓ effectiveness of levodopa in few cases.May have additive effects with antiplatelet agents.May ↑ risk of liver damage with other hepatotoxic agents.Concurrent use with other hepatotoxic products such as DHEA, coenzyme Q-10 (high doses), and niacin can ↑ risk of liver damage.May have additive sedative effects when used with other herbs with sedative properties.
Oral (Adults) Antianxiety—100 mg (70 mg kavalactones) 3 times daily; Benzodiazepine withdrawal—50–300 mg/day over one week while tapering benzodiazepine over 2 weeks (use 70% kavalactone extract). Insomnia—180–210 mg kavalactones. Typically taken as a tea by simmering the root in boiling water and then straining.

Availability (generic available)

Dried root extracts (alcohol or acetone based) containing 30–70% kavapyrones:

Nursing implications

Nursing assessment

  • Assess muscle spasm, associated pain, and limitations of movement prior to and periodically during therapy.
  • Assess degree of anxiety and level of sedation (visual disturbances and changes in motor reflexes are side effects) prior to and periodically during therapy.
  • Assess sleep patterns and level of sedation upon arising.
  • Prolonged use may lead to ↓ of platelet and lymphocyte counts and ↑ liver function tests.

Potential Nursing Diagnoses

Anxiety (Indications)
Impaired physical mobility (Adverse Reactions)
Risk for injury (Side Effects)

Implementation

  • Prepared as a drink from pulverized roots, tablets, capsules, or extract.

Patient/Family Teaching

  • Inform patient that significant, serious side effects may occur with prolonged use. Use for longer than 1 mo is not recommended without supervision of health care professional.
  • Caution patient to avoid alcohol or other CNS depressants while taking this herb; may increase sedative effect.
  • May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to herb is known.
  • Warn patients to stop use of the herb immediately if shortness of breath or signs of liver disease (yellowing of the skin or whites of the eyes, brown urine, nausea, vomiting, light-colored stools, unusual tiredness, weakness, stomach or abdominal pain, loss of appetite) occur and contact health care professional.
  • Advise patients who have liver disease or liver problems, or persons who are taking drug products that can affect the liver, to consult health care professional before using kava-containing supplements.
  • Inform patient that although there is no evidence of physiological dependence, the risk of psychological dependence still exists.
  • Advise female patients to use contraception during therapy and to notify health care professional immediately if pregnancy is planned or suspected or if breastfeeding.
  • Instruct patient to consult health care professional before taking any Rx, OTC, or other herbal products concurrently with kava-kava.
  • Kava has been banned in other countries due to hepatotoxicity.

Evaluation/Desired Outcomes

  • Decrease in anxiety level.
  • Decrease in muscle spasms.
  • Relief of insomnia.
References in periodicals archive ?
The cosmetics division of the Kao group seeks to stimulate the creation of strong brands within the new global portfolio put together in May 2018.
Kao said he went into a research rabbit hole of sorts and discovered a problem.
Kao APS will work with Colordyne to deliver UV and aqueous pigment inkjet solutions in the European market.
Kao Advanced Printing Solutions is comprised of Kao's inkjet ink development and manufacturing operations in Japan along with Kao Collins Inc.in Cincinnati, Ohio, USA and Kao Chimigraf in Barcelona, Spain.
U skladu s njima muskarcima se pripisuju karakteristike kao sto su snaga, poduzetnost, odlucnost ili racionalnost, a zenama osjetljivost, pasivnost, pokornost ili pozrtvovnost.
Kao had no disclosures relevant to her presentation.
Kao develops professional-use products primarily in Japan through Kao Professional Services company, Ltd.
In addition to improved latency and resilience, Kao Data said its customers who become LINX members will benefit from improved routing control, increased capacity and redundancy.
The Sage Group, LLC, an independent investment bank that provides corporate finance advice to premium branded consumer and retail companies, has served as the exclusive financial advisor to Oribe Hair Care, a luxury hair care brand, in its sale to Kao USA Inc., a wholly owned subsidiary of Kao Corporation, a manufacturer and marketer of top beauty brands based in Japan, the company said.
In 1988, the Jergens brand became part of the Kao Group, a global personal care and specialty chemicals manufacturer based in Japan.
The new analysis, focused on those patients from the Americas, shows that the primary efficacy outcome from the TOPCAT trial was a statistically significant 18% lower in women than in men, David Kao, MD, reported at a meeting of the Heart Failure Association of the ESC.