Question

The physician has ordered Paxil (paroxetine) for a client with generalized anxiety disorder. The nurse should instruct the client to avoid herbal preparations that contain: A. Hypericum B. Angelica C. Chamomile D. Echinacea

Short answer

Answer: A. Hypericum (St. John's Wort)

Step-by-step solution

Understand Paxil (paroxetine) usage.

Paxil (paroxetine) is an antidepressant medication belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It is used in the treatment of generalized anxiety disorder, depression, and other mood disorders. It works by restoring the balance of serotonin (a neurotransmitter) in the brain, which consequently helps improve mood and relieve anxiety.

Evaluate the potential interaction between Paxil and Hypericum (A)

Hypericum, also known as St. John's Wort, is an herbal supplement used to treat mild to moderate depression. When taken with Paxil (paroxetine), it can interfere with the effectiveness of the medication and cause a dangerous increase in serotonin levels, which may lead to a condition called serotonin syndrome. Symptoms of serotonin syndrome can range from mild (shivering and diarrhea) to severe (muscle rigidity, fever, and seizures). Therefore, taking Hypericum with Paxil should be avoided.

Evaluate the potential interaction between Paxil and Angelica (B)

Angelica is an herbal supplement commonly used for digestive issues and other health conditions. There is no significant evidence or documented interaction between Angelica and Paxil (paroxetine). Thus, it is less likely to cause an issue if taken together with Paxil.

Evaluate the potential interaction between Paxil and Chamomile (C)

Chamomile is an herbal supplement well-known for its calming effects and is often used in teas for relaxation. While Chamomile has mild sedative effects, there is no significant evidence or documented interaction between Chamomile and Paxil (paroxetine) that would cause harm to the client.

Evaluate the potential interaction between Paxil and Echinacea (D)

Echinacea is an herbal supplement used to support the immune system and help fight infections. There is no significant evidence or documented interaction between Echinacea and Paxil (paroxetine). Consequently, it is unlikely to cause any harm if taken together with Paxil.

Reach a conclusion based on your evaluation

Based on the analysis of each herbal preparation's potential interactions with Paxil (paroxetine), we can conclude that the client with generalized anxiety disorder should avoid consuming herbal preparations that contain: A. Hypericum (St. John's Wort) This is because combining Hypericum with Paxil can lead to a potentially dangerous increase in serotonin levels, which may cause serotonin syndrome.