Hypertensive Urgency: An Undesirable Complication of a "Male Performance" Herbal Product.

MedStar author(s):
Citation: Journal of Emergency Medicine. 57(1):43-46, 2019 Jul.PMID: 31031073Institution: MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Blood Pressure/de [Drug Effects] | *Hypertension/et [Etiology] | *Pausinystalia/ae [Adverse Effects] | Antihypertensive Agents/tu [Therapeutic Use] | Blood Pressure/ph [Physiology] | Clonidine/tu [Therapeutic Use] | Dietary Supplements/ae [Adverse Effects] | Electrocardiography/mt [Methods] | Emergency Service, Hospital/og [Organization & Administration] | Humans | Labetalol/tu [Therapeutic Use] | Male | Middle Aged | Pausinystalia/me [Metabolism]Year: 2019Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0736-4679
Name of journal: The Journal of emergency medicineAbstract: BACKGROUND: Hypertensive urgency is a clinical scenario that may be associated with herbal supplement use and that requires special consideration with regard to emergency department management.CASE REPORT: A 49-year-old man presented to the emergency department with palpitations and severely elevated blood pressure without evidence of end organ dysfunction. Hypertension failed to be controlled with multiple doses of oral clonidine and intravenous labetalol. The patient later admitted to using an herbal supplement containing yohimbine, a selective 2-adrenoreceptor antagonist specifically linked to cases of refractory hypertension. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Between 17-35% of the U.S. adult population may use herbal supplements on a sporadic or regular basis; pharmacologically active agents in herbal supplements may affect both a patient's presentation and response to treatment. Most patients do not mention over-the-counter and herbal products in their medication profile unless specifically asked, and therefore it is important for emergency physicians to be aware of the pharmacologic effects of herbal supplements in the evaluation and treatment of refractory severe hypertension.Copyright (c) 2019 Elsevier Inc. All rights reserved.All authors: Prescott A, Smereck JOriginally published: Journal of Emergency Medicine. 2019 Apr 25Fiscal year: FY2020Fiscal year of original publication: FY2019Digital Object Identifier: Date added to catalog: 2019-05-21
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 31031073 Available 31031073

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

BACKGROUND: Hypertensive urgency is a clinical scenario that may be associated with herbal supplement use and that requires special consideration with regard to emergency department management.

CASE REPORT: A 49-year-old man presented to the emergency department with palpitations and severely elevated blood pressure without evidence of end organ dysfunction. Hypertension failed to be controlled with multiple doses of oral clonidine and intravenous labetalol. The patient later admitted to using an herbal supplement containing yohimbine, a selective 2-adrenoreceptor antagonist specifically linked to cases of refractory hypertension. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Between 17-35% of the U.S. adult population may use herbal supplements on a sporadic or regular basis; pharmacologically active agents in herbal supplements may affect both a patient's presentation and response to treatment. Most patients do not mention over-the-counter and herbal products in their medication profile unless specifically asked, and therefore it is important for emergency physicians to be aware of the pharmacologic effects of herbal supplements in the evaluation and treatment of refractory severe hypertension.

Copyright (c) 2019 Elsevier Inc. All rights reserved.

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