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1 TIME/ACTION PROFILE
ROUTE ONSET PEAK DURATION PDF Page #1
ginkgo (ging-ko) PO unknown unknown unknown

Other Name(s): Contraindications/Precautions

Bai guo ye, fossil tree, ginkgo folium, Japanese silver apricot, kew tree, maidenhair-
tree, salisburia adiantifolia, yinhsing
Classification
Therapeutic: antiplatelet agents, central nervous system stimulants
Contraindicated in: Hypersensitivity; Pregnancy and lactation.
Use Cautiously in: Bleeding disorders; Children (fresh seeds have caused sei-
zures and death); Diabetes; EpilepsySurgery (discontinue use 2 weeks prior).
Adverse Reactions/Side Effects
CNS: CEREBRAL BLEEDING, dizziness, headache, vertigo, seizure. CV: palpitations.
GI: flatulence, stomach upset. Derm: allergic skin reaction. Hemat: bleeding.
Misc: hypersensitivity reactions.

Common Uses Interactions

Symptomatic relief of organic brain dysfunction (dementia syndromes, short-term
memory deficits, inability to concentrate, depression). Intermittent claudication.
Vertigo and tinnitus of vascular origin. Improvement of peripheral circulation. Pre-
menstrual syndrome.
Action
Improves tolerance to hypoxemia, especially in cerebral tissue. Inhibits development
of cerebral edema and accelerates its regression. Improves memory, blood flow (mi-
crocirculation), compensation of disequilibrium, and rheological properties of
blood. Inactivates toxic oxygen radicals. Antagonizes platelet-activating factor. Inter-
feres with bronchoconstriction and phagocyte chemotaxis. Therapeutic Effects:
Symptomatic relief of dementia syndromes. Inhibits arterial spasm, decreases capil-
lary fragility and blood viscosity. Improves venous tone, relaxes vascular smooth
muscle.
Pharmacokinetics
Absorption: 70 100% absorption. PO (Adults): 120 600 mg per day.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.
Canadian drug name. Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent.
Natural Product-Drug: Theoretically may potentiate effects of anticoagulants,
thrombolytics, antiplatelet agents, and MAO inhibitors. May alsoqrisk of
bleeding with some cephalosporins, valproic acid, and NSAIDs. Maypeffective-
ness of anticonvulsants. May alter insulin metabolism requiring dose adjustments
of antidiabetic drugs.
Natural-Natural Products: Mayqrisk of bleeding when used with other herbs
with antiplatelet effects (including angelica, arnica, chamomile, feverfew, gar-
lic, ginger, and licorice).
Route/Commonly Used Doses
Organic Brain Syndromes
PO (Adults): 120 240 mg ginkgo leaf extract daily in 2 or 3 doses.
Intermittent Claudication
PO (Adults): 120 240 mg ginkgo leaf extract daily in 2 or 3 doses.
Vertigo and Tinnitus
PO (Adults): 120 160 mg ginkgo leaf extract daily in 2 or 3 doses.
Cognitive Function Improvement
Premenstrual Syndrome
PO (Adults): 80 mg BID starting on the 16th day of the menstrual cycle until the 5th
day of the next cycle.
Strikethrough Discontinued.
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2 Instruct patient not to exceed recommended doses because large doses may result
in toxicity (restlessness, diarrhea, nausea and vomiting, headache).
NURSING IMPLICATIONS Notify patients receiving anticoagulant or antiplatelet therapy not to take this medi- PDF Page #2
Assessment cation without approval of health care professional and frequent monitoring.
Exclude other treatable causes of dementia prior to instituting treatment with Instruct patient to consult health care professional before taking any prescription
ginkgo. or OTC medications concurrently with ginkgo.
Assess cognitive function (memory, attention, reasoning, language, ability to per-
form simple tasks) periodically throughout therapy.
Evaluation
Improvement in walking distances pain-free.
Assess frequency, duration, and severity of muscle cramps (claudication) experi-
Improvement in tinnitus and vertigo.
enced by the patient prior to and periodically throughout therapy.
Improvement in short-term memory, attention span, and ability to perform simple
Assess for headache and neurosystem changes (thromboembolism).
tasks.
Potential Nursing Diagnoses Improvement in sexual function.
Disturbed thought process (Indications) Decreased symptoms of premenstrual syndrome.
Acute pain (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching) Why was this drug prescribed for your patient?
Implementation
Start dose at 120 mg per day and increase as needed to minimize side effects.
Administration for a minimum of 6 8 wk of 80 mg (tid) (not 6 wk) is required
to determine response.
May be administered without regard to food.
Use of dried leaf preparations in the form of a tea is not recommended because of
insufficient quantity of active ingredients.
Advise patients to avoid crude ginkgo plant parts which can cause severe allergic
reactions.
Take this herb at the same time daily.
Keep this herb out of the reach of children as seizures may occur with increased
doses of ginkgo seeds.
Patient/Family Teaching
Advise patient to observe for easy bruising and other signs of bleeding and report
to health care professional if they occur.
Caution patient to keep this herb out of the reach of children because ingestion has
been associated with seizures.
Warn patient to avoid handling the pulp or seed coats because of the risk of con-
tact dermatitis. Wash skin under free-flowing water promptly if contact does oc-
cur.
2015 F.A. Davis Company