The nurse is obtaining a history from a patient who discloses daily use of St. John's wort in addition to prescription drugs. Which effect of this dietary supplement would most concern the nurse?
A) It accelerates the metabolism of some drugs.
B) It enhances the effects of digoxin.
C) It counteracts the effects of CNS depressants.
D) It increases the risk of bleeding.

Question

Quizplus · Accepted Answer

St. John's wort has the potential to interact with many drugs through three different mechanisms. One mechanism, induction of P450, accelerates the metabolism of many drugs, causing loss of therapeutic effects. St. John's wort reduces the effects of digoxin, because P-glycoprotein transports drugs out of tubular cells of the kidney and into the urine, greatly reducing digoxin levels. St. John's wort does not counteract the beneficial effects of CNS depressants; it can actually intensify the effects of serotonin. St. John's wort is not known to increase the risk of bleeding.

The Nurse Is Obtaining a History from a Patient Who