St. Johns Wort

St . Johns Wort and its Anesthetic Implications

St . John 's Wort or hypericum perforatum is a herb which has gained importance in the treatment of certain psychological conditions like depression , anxiety , sleep-related diss (Kaye , Kucera and Sabar et al , 2004 , vitiligo (Sabar , Kaye and Frost , 2001 , fibrositis , cancer obsessive-compulsive neurosis , headache and sciatica (Kaye , Baluch and Kaye , 2007 . It is also used in bronchitis , burns , gastritis , enuresis hemorrhoids , insect bites , hypothyroidism , scabies , kidney disease and wound healing (Emst , 2002 . It is popularly known as amber , hardhay goat weed , tipton weed or

klamath weed (Kaye , Kucera and Sabar et al 2004 . The main active compounds of this herb are hypericin pseudohypericin , rutin , quercitin and hyperin which probably act by GABA inhibition (Kaye et al , 2005 . Some researchers have also suggested serotonin receptor inhibition and monoamino oxidase inhibition (Sabar et al , 2001 . The herb can interact with other drugs and hence prior to administration of anesthesia , intake of St .John 's Wort must be questioned

Photosensitization drugs like tetracycline and piroxicam beta-sympathomimetic amines like pseudoephidrine , selective serotonin reuptake inhibitors and monoamine oxidase inhibitors should not be taken concomitantly with the herb (Kaye et al , 2005 . This is because these drugs can exaggerate the side effects the herb produces . Some of the important side effects of St . John 's herb are dizziness , dry mouth constipation , fatigue and nausea . Concomitant use with serotonin-reuptake inhibitors can cause serotonergic syndrome which manifests as hypertonicity , myoclonus , hallucinosis , autonomic dysfunction , hyperthermia and death (Sabar et al , 2001 . St...