RT Book, Section A1 Lo, Sansan S. A2 Atchabahian, Arthur A2 Gupta, Ruchir SR Print(0) ID 57260361 T1 Chapter 10. Herbal Medicines and Supplements T2 The Anesthesia Guide YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176049-2 LK accessanesthesiology.mhmedical.com/content.aspx?aid=57260361 RD 2024/03/29 AB Preoperative assessment of potential herbal medicine use is important for preoperative instruction and understanding of perioperative risks and complicationsDietary supplements and alternative medicines are exempt from FDA regulation:Increasing usage, but are significantly underreported and often not addressedSignificant biological effects including:Direct effectsDrug interactions: pharmacodynamic and pharmacokineticEase of access without prescriptionsVariable manufacturing quality control standards (potency, contaminants)Limited clinical studiesOf note, this chapter does not include nonherbal supplements such as vitamins, minerals, amino acids, or hormonesMany herbal medications have cardiovascular, coagulation, and sedative effects that may be associated with perioperative complications including MI, strokes, bleeding, and transplant rejection