rudbeckia

echinacea (Echinacea Purpurea)

(ek-i-nay-sha) ,

American coneflower

(trade name),

black sampson

(trade name),

black susan

(trade name),

brauneria angustifolia

(trade name),

kansas snakeroot

(trade name),

purple coneflower

(trade name),

red sunflower

(trade name),

rudbeckia

(trade name),

sampson root

(trade name),

scurvy root

(trade name)

Classification

Therapeutic: immune stimulants

Bacterial and viral infectionsPrevention and treatment of colds, coughs, flu, and bronchitisFeversWounds and burnsInflammation of the mouth and pharynxUrinary tract infectionsVaginal candidiasis

Action

Medicinal parts derived from the roots, leaves, or whole plant of perennial herb (Echinacea).

Echinacea purpurea herba has been reported to promote wound healing, which may be due to an increase in white blood cells, spleen cells, and increased activity of granulocytes, as well as an increase in helper T cells and cytokines.

E. purpurea radix has been shown to have antibacterial, antiviral, anti-inflammatory, and immune-modulating effects.

Therapeutic effects

Resolution of respiratory and urinary tract infections.

Decreased duration and intensity of common cold.

Improved wound healing.

Stimulates phagocytosis; inhibits action of hyaluronidase (secreted by bacteria), which helps bacteria gain access to healthy cells.

Externally, has antifungal and bacteriostatic properties.

Pharmacokinetics

Absorption: Unknown.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

Time/action profile

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraindications/Precautions

Contraindicated in: Multiple sclerosis, leukosis, collagenoses, AIDS, tuberculosis, auto-immune diseases; Hypersensitivity and cross-sensitivity in patients allergic to plants in Asteraceae/Compositae plant family (daisies, chrysanthemums, marigolds, etc.); Obstetric: Pregnancy and lactation.

Use Cautiously in: Diabetes; Pediatric: May increase risk of rash in children; Tinctures should be used cautiously in alcoholics or patients with liver disease; Do not take longer than 8 wk—may suppress immune function.

Adverse Reactions/Side Effects

Central nervous system

• dizziness
• fatigue
• headache
• somnolence

Ear, Eye, Nose, Throat

• tingling sensation on tongue
• sore throat

Gastrointestinal

• nausea
• vomiting
• heartburn
• constipation
• abdominal pain
• diarrhea

Dermatologic

• allergic reaction
• rash (more common in children)

Miscellaneous

• fever

Interactions

May possibly interfere with immunosuppressants because of its immunostimulant activity.May ↑ risk for hepaotoxicity from anabolic steroids, methotrexate, or ketoconazole when taken with echinacea.May ↑ midazolam availability.May ↑ risk for hepatotoxicity when taken with kava-kava.

Oral (Adults) Tablets—6.78 mg tablets, take 2 tabs 3 times daily. Capsules—500–1000 mg 3 times a day for 5–7 daysFluid extract—1–2 mL tid; solid form (6.5:1)—150–300 mg tid. Should not be used for more than 8 wk at a time. Tea—1/2 tsp comminuted drug, steeped and strained after 10 min, 1 cup 5–6 times daily on the first day, titrating down to 1 cup daily over the next 5 days. Echinacea purpuren herb juice—6-9 mL/day. Liquid—20 drops every 2 hr for the first day of symptoms, then 3 times daily for up to 10 days.

Topical (Adults) Ointment, lotion, tincture used externally—1.5–7.5 mL tincture, 2–5 g dried root.

Availability

Capsules: ^OTC

Tablets :

Dried Root: ^OTCThe dried root can be steeped and strained in boiling water and taken as a tea

Liquid extract: ^OTC1:1 in 45% alcohol

Tincture: ^OTC1:5 in 45% alcohol

Blended teas: ^OTC

Echinacea purpuren herb juice: ^OTC

Nursing implications

Nursing assessment

• Assess wound for size, appearance, and drainage prior to the start of and periodically during therapy.
• Assess frequency of common mild illnesses (such as a cold) in response to use.

Potential Nursing Diagnoses

Impaired skin integrity (Indications)

Implementation

• Tinctures may contain significant concentrations of alcohol and may not be suitable for children, alcoholics, patients with liver disease, or those taking disulfiram, metronidazole, some cephalosporins, or sulfonylurea oral antidiabetic agents.
• Prolonged use of this agent may cause overstimulation of the immune system, and use beyond 8 wk is not recommended. Therapy of 10–14 days is usually considered sufficient.
• May be taken without regard to food.

Patient/Family Teaching

• Herb is more effective for treatment than prevention of colds. Take at first sign of symptoms.
• Advise patient to seek immediate treatment for an illness that does not improve after taking this herb.
• Instruct patient that the usual course of therapy is 10–14 days and 8 wk is the maximum.
• Inform patient that use of this herb is not recommended in severe illnesses (e.g., AIDS, tuberculosis) or autoimmune diseases (e.g., multiple sclerosis, collagen diseases, etc.).
• Caution patient that prolonged use of this herb may result in overstimulation of the immune system, possibly with subsequent immunosuppression.
• Warn pregnant or breastfeeding women not to use this herb.
• Instruct patient to consult health care professional before taking any prescription or OTC medications concurrently with echinacea.
• Keep tincture in a dark bottle away from sunlight. Should be taken several times a day.
• Store herb in airtight container away from sunlight.

Evaluation/Desired Outcomes

• Improved wound healing.
• Infrequent common illnesses.
• Illnesses of shorter duration and less severity.

echinacea

Fringe medicine
A flower essence believed to provide a sense of self in the face of adversity. 

Herbal medicine
A perennial herb, the roots and rhizomes of which contain betain, essential oils (including caryophylene and humulene), echinocoside (which has antibacterail activity), glycosides, inulin, isobutyl amides, resin and sesquiterpene. It is antibacterial, antiviral and diaphoretic; it has been used topically for eczema, herpes, insect and snake bites, itching and wounds, and internally for gastrointestinal, respiratory and urinary tract infections, infectious mononucleosis, septicaemia, sore throat, toothaches and to detoxify blood.