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Cerrahi Kliniklerde Çalışan Hekim ve Hemşireler Besin ve Gıda Takviyelerinin Etkilerini Neden Bilmelidir?

Yıl 2023, Cilt: 4 Sayı: 1, 18 - 30, 05.05.2023

Öz

Besin ve gıda takviyeleri sağlığı korumak ve hastalıkları tedavi etmek amacıyla dünya genelinde yaygın olarak kullanılmaktadır. Besin ve gıda takviyelerine ulaşım kolaylığı ve ürün pazarlamasının başarısı, kitle iletişim araçları, yakın çevre ve bireysel etkenler her geçen gün kullanımında artışa neden olmaktadır. Cerrahi süreçte besin ve gıda takviyesi kullanımı sedasyon süresinin uzaması, analjezi durumunun etkilenmesi, kanama ve pıhtılaşma bozuklukları, kardiyak sorunlar (hipertansiyon, hipotansiyon, taşikardi, anjina), diürez, sıvı-elektrolit dengesizlikleri, hipoglisemi gibi yan etkilere neden olabilmektedir. Aynı zamanda bu ürünlerin cerrahi dönemde kullanılan ilaçlarlar ile farmakokinetik ve farmakodinamik etkileşimleri olabilmektedir. Cerrahi süreçte besin ve gıda takviyesi kullanımına bağlı hastada oluşabilecek sorunları önlemek için cerrahi birimlerde çalışan hekim ve hemşirelerin ameliyat öncesi hastaların besin ve gıda takviyelerinin kullanım öykülerini sorgulaması, bilgilerini kaydetmesi ve hastaya eğitim vermesi gerekmektedir. Hekim ve hemşirelerin bu rollerini yerine getirebilmesi için besin ve gıda takviyeleri hakkında bilgi sahibi olması gereklidir. Bu derlemenin cerrahi alanda çalışan hekim ve hemşirelere besin ve gıda takviyelerinin cerrahi sürece etkisi konusunda yol gösterici olacağı düşünülmektedir.

Kaynakça

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  • 3. Yuan H, Ma Q, Ye L, Piao G. The Traditional Medicine and Modern Medicine from Natural Products. Molecules. 2016;21(5):559.
  • 4. WHO. General guidelines for methodologies on research and evaluation of traditional medicine Geneva: World Health Organization; 2000 [Available from: http://whqlibdoc.who.int/hq/2000/WHO_EDM_TRM_2000.1.pdf.
  • 5. Ichim MC. The DNA-based authentication of commercial herbal products reveals their globally widespread adulteration. Front Pharmacol. 2019;10:1227.
  • 6. Atalay D, Erge HS. Gıda Takviyeleri ve Sağlık Üzerine Etkileri. Food and Health. 2018;4(2):98-111.
  • 7. NCCIH. Complementary, Alternative, or Integrative Health: What’s In a Name? National Center for Complementary and Integrative Health2022 [Available from: https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name.
  • 8. GTBD. Gıda Takviyesi Kullanımı ve Beslenme Alışkanlıkları Ölçümü Anketi Gıda Takviyesi ve Beslenme Derneği2020 [Available from: https://gtbd.org.tr/gida-takviyesi-kullanimi-ve-beslenme-aliskanliklari-olcumu-anketi-nisan-2020/.
  • 9. Donoghue TJ. Herbal Medications and Anesthesia Case Management. Aana j. 2018;86(3):242-8. 10. Zhang J, Onakpoya IJ, Posadzki P, Eddouks M. The Safety of Herbal Medicine: From Prejudice to Evidence. Evid Based Complement Alternat Med. 2015;2015:316706.
  • 11. WHO. WHO traditional medicine strategy: 2014-2023: World Health Organization; 2013.
  • 12. Wu C-H, Wang C-C, Kennedy J. Changes in Herb and Dietary Supplement Use in the US Adult Population: A Comparison of the 2002 and 2007 National Health Interview Surveys. Clin Ther. 2011;33(11):1749-58.
  • 13. GTBD. Gıda Takviyesi ve Beslenme Araştırması Gıda Takviyesi ve Beslenme Derneği2021 [Available from: https://gtbd.org.tr/5-gida-takviyesi-ve-beslenme-arastirmasi-basinda-genis-yanki-buldu/.
  • 14. Saggar S, Mir PA, Kumar N, Chawla A, Uppal J, Kaur A. Traditional and Herbal Medicines: Opportunities and Challenges. Pharmacognosy Res. 2022;14(2).
  • 15. Brumley C. Herbs and the perioperative patient. AORN J. 2000;72(5):783-96.
  • 16. MacKichan C, Ruthman J. Herbal product use and perioperative patients. AORN J. 2004;79(5):947-59.
  • 17. Abe A, Kaye AD, Gritsenko K, Urman RD, Kaye AM. Perioperative analgesia and the effects of dietary supplements. Best Pract Res Clin Anaesthesiol. 2014;28(2):183-9.
  • 18. Lucenteforte E, Gallo E, Pugi A, Giommoni F, Paoletti A, Vietri M, et al. Complementary and Alternative Drugs Use among Preoperative Patients: A Cross-Sectional Study in Italy. Evid Based Complement Alternat Med. 2012;2012:527238.
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  • 20. Alqathama A, Alluhiabi G, Baghdadi H, Aljahani L, Khan O, Jabal S, et al. Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship? BMC Complement Med Ther. 2020;20(1):65.
  • 21. Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013;173(5):355-61.
  • 22. Marcus DM. Dietary supplements: What's in a name? What's in the bottle? Drug Test Anal. 2016;8(3-4):410-2.
  • 23. Karakoç MD. Onkoloji hastalarının tamamlayıcı ve alternatif tedavi yöntemlerini kullanma durumları. Pam Med J. 2020;13(1):69-80.
  • 24. Zengin S, Kahraman S. Anjiyografi Yapılan Koroner Arter Hastalarında Geleneksel Besin Öğelerinin Kullanımı. GETATDER.1(3):9-15.
  • 25. Guilmetdinov EF, Al-Khalaf M, Bhatt J, Parsons R, Sim TF. Complementary medicines use amongst elective surgery patients at a public tertiary hospital: A prospective observational cohort study in Australia. Complement Ther Clin Pract. 2019;35:284-9.
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  • 28. Yazici G, Erdogan Z, Bulut H, Ay A, Kalkan N, Atasayar S, et al. The use of complementary and alternative medicines among surgical patients: A survey study. J Perianesth Nurs. 2019;34(2):322-9.
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  • 34. Kitaguch K, Sasaoka N, Soeda T, Egawa J. [The Implication of Dietary Supplements and Herbal Medicines in Perioperative Period]. Masui. 2016;65(11):1152-9.
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  • 36. Cummings III KC, Keshock M, Ganesh R, Sigmund A, Kashiwagi D, Devarajan J, et al., editors. Preoperative Management of Surgical Patients Using Dietary Supplements: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement. Mayo Clin Proc; 2021: Elsevier.
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  • 39. Franco Ruiz S, González Maldonado P. Dietary supplements and the anesthesiologist: Research results and state of the art. Rev Colomb Anestesiol. 2014;42(2):90-9.
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Why Should Physicians and Nurses Working in Surgical Clinics Know the Effects of Nutrient and Nutritional Supplements?

Yıl 2023, Cilt: 4 Sayı: 1, 18 - 30, 05.05.2023

Öz

Nutrient and nutritional supplements are widely used around the world to maintain health and to treat diseases. The ease of access to nutrient and nutritional supplements and the success of product marketing, the influence of mass media and close circle and individual factors cause an increase in its use day by day. The use of nutrient and nutritional supplements in the surgical process may cause side effects such as prolongation of the sedation period, effect of analgesia, bleeding and coagulation disorders, cardiac problems (hypertension, hypotension, tachycardia, angina), diuresis, fluid-electrolyte imbalances, and hypoglycemia. In addition, these products may have pharmacokinetic and pharmacodynamic interactions with drugs used in the surgical period. In order to prevent the problems that may occur in the patient due to the use of nutrient and nutritional supplements during the surgical process, physicians and nurses working in the surgical units should question the history of the use of nutrient and nutritional supplements of the patients before the operation, record their information and train the patient. For physicians and nurses to fulfill these roles, they should have information about nutrient and nutritional supplements. It is believed that this review will guide physicians and nurses working in the surgical field about the effect of nutrient and nutritional supplements on the surgical process.

Kaynakça

  • 1. Broughton G, Crosby MA, Coleman J, Rohrich RJ. Use of herbal supplements and vitamins in plastic surgery: a practical review. Plast Reconstr Surg. 2007;119(3):48e-66e. 2. Karunamoorthi K, Jegajeevanram K, Xavier J, Vijayalakshmi J, Melita L. Tamil traditional medicinal system-siddha: an indigenous health practice in the international perspectives. CELLMED. 2012;2(2):12.1-.1.
  • 3. Yuan H, Ma Q, Ye L, Piao G. The Traditional Medicine and Modern Medicine from Natural Products. Molecules. 2016;21(5):559.
  • 4. WHO. General guidelines for methodologies on research and evaluation of traditional medicine Geneva: World Health Organization; 2000 [Available from: http://whqlibdoc.who.int/hq/2000/WHO_EDM_TRM_2000.1.pdf.
  • 5. Ichim MC. The DNA-based authentication of commercial herbal products reveals their globally widespread adulteration. Front Pharmacol. 2019;10:1227.
  • 6. Atalay D, Erge HS. Gıda Takviyeleri ve Sağlık Üzerine Etkileri. Food and Health. 2018;4(2):98-111.
  • 7. NCCIH. Complementary, Alternative, or Integrative Health: What’s In a Name? National Center for Complementary and Integrative Health2022 [Available from: https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name.
  • 8. GTBD. Gıda Takviyesi Kullanımı ve Beslenme Alışkanlıkları Ölçümü Anketi Gıda Takviyesi ve Beslenme Derneği2020 [Available from: https://gtbd.org.tr/gida-takviyesi-kullanimi-ve-beslenme-aliskanliklari-olcumu-anketi-nisan-2020/.
  • 9. Donoghue TJ. Herbal Medications and Anesthesia Case Management. Aana j. 2018;86(3):242-8. 10. Zhang J, Onakpoya IJ, Posadzki P, Eddouks M. The Safety of Herbal Medicine: From Prejudice to Evidence. Evid Based Complement Alternat Med. 2015;2015:316706.
  • 11. WHO. WHO traditional medicine strategy: 2014-2023: World Health Organization; 2013.
  • 12. Wu C-H, Wang C-C, Kennedy J. Changes in Herb and Dietary Supplement Use in the US Adult Population: A Comparison of the 2002 and 2007 National Health Interview Surveys. Clin Ther. 2011;33(11):1749-58.
  • 13. GTBD. Gıda Takviyesi ve Beslenme Araştırması Gıda Takviyesi ve Beslenme Derneği2021 [Available from: https://gtbd.org.tr/5-gida-takviyesi-ve-beslenme-arastirmasi-basinda-genis-yanki-buldu/.
  • 14. Saggar S, Mir PA, Kumar N, Chawla A, Uppal J, Kaur A. Traditional and Herbal Medicines: Opportunities and Challenges. Pharmacognosy Res. 2022;14(2).
  • 15. Brumley C. Herbs and the perioperative patient. AORN J. 2000;72(5):783-96.
  • 16. MacKichan C, Ruthman J. Herbal product use and perioperative patients. AORN J. 2004;79(5):947-59.
  • 17. Abe A, Kaye AD, Gritsenko K, Urman RD, Kaye AM. Perioperative analgesia and the effects of dietary supplements. Best Pract Res Clin Anaesthesiol. 2014;28(2):183-9.
  • 18. Lucenteforte E, Gallo E, Pugi A, Giommoni F, Paoletti A, Vietri M, et al. Complementary and Alternative Drugs Use among Preoperative Patients: A Cross-Sectional Study in Italy. Evid Based Complement Alternat Med. 2012;2012:527238.
  • 19. Özçelik G, Toprak D. Bitkisel tedavi neden tercih ediliyor? Ankara Med J. 2015;15(2).
  • 20. Alqathama A, Alluhiabi G, Baghdadi H, Aljahani L, Khan O, Jabal S, et al. Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship? BMC Complement Med Ther. 2020;20(1):65.
  • 21. Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013;173(5):355-61.
  • 22. Marcus DM. Dietary supplements: What's in a name? What's in the bottle? Drug Test Anal. 2016;8(3-4):410-2.
  • 23. Karakoç MD. Onkoloji hastalarının tamamlayıcı ve alternatif tedavi yöntemlerini kullanma durumları. Pam Med J. 2020;13(1):69-80.
  • 24. Zengin S, Kahraman S. Anjiyografi Yapılan Koroner Arter Hastalarında Geleneksel Besin Öğelerinin Kullanımı. GETATDER.1(3):9-15.
  • 25. Guilmetdinov EF, Al-Khalaf M, Bhatt J, Parsons R, Sim TF. Complementary medicines use amongst elective surgery patients at a public tertiary hospital: A prospective observational cohort study in Australia. Complement Ther Clin Pract. 2019;35:284-9.
  • 26. Soós S, Palásti AF, Darvas K, Harsányi L. [The use of herbal remedies prior to elective surgical procedures at an urban hospital and a university clinic in Hungary. Descriptive study]. Orv Hetil. 2020;161(1):17-25.
  • 27. Egbaria A, Omary A, Baji NA. Patterns of usage of complementary and alternative medicine in surgical patients: a cross-sectional study from Palestine. 2021.
  • 28. Yazici G, Erdogan Z, Bulut H, Ay A, Kalkan N, Atasayar S, et al. The use of complementary and alternative medicines among surgical patients: A survey study. J Perianesth Nurs. 2019;34(2):322-9.
  • 29. Uysal Aİ, Altıparmak B, Toker MK, Gümüş Demirbilek S. Ameliyat planlanan hastalar arasında bitkisel ürün kullanımı ve bitkisel ürünlerin nötrofil lenfosit oranına etkisi: Kesitsel araştırma. JARSS. 2020;28:158-62.
  • 30. Bayraktar S, Yavaşcaoğlu B, Özyurt G. Opere edilecek olgularda bitkisel ürün kullanımının değerlendirilmesi. Uludağ Tıp Derg. 2014;40(1):37-141.
  • 31. Asher GN, Corbett AH, Hawke RL. Common Herbal Dietary Supplement-Drug Interactions. Am Fam Physician. 2017;96(2):101-7.
  • 32. Mehmood Z, Khan MS, Qais FA, Ahmad I. Herb and modern drug interactions: efficacy, quality, and safety aspects. New look to phytomedicine: Elsevier; 2019. p. 503-20.
  • 33. King AR, Russett FS, Generali JA, Grauer DW. Evaluation and implications of natural product use in preoperative patients: a retrospective review. BMC Complement Altern Med. 2009;9:38.
  • 34. Kitaguch K, Sasaoka N, Soeda T, Egawa J. [The Implication of Dietary Supplements and Herbal Medicines in Perioperative Period]. Masui. 2016;65(11):1152-9.
  • 35. Hatfield J, Saad S, Housewright C. Dietary supplements and bleeding. Proc (Bayl Univ Med Cent). 2022;35(6):802-7.
  • 36. Cummings III KC, Keshock M, Ganesh R, Sigmund A, Kashiwagi D, Devarajan J, et al., editors. Preoperative Management of Surgical Patients Using Dietary Supplements: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement. Mayo Clin Proc; 2021: Elsevier.
  • 37. Williams CT. Herbal Supplements: Precautions and Safe Use. Nurs Clin North Am. 2021;56(1):1-21.
  • 38. Pruitt R, Lemanski A, Carroll A. Herbal supplements: research findings and safety. Nurse Pract. 2018;43(5):32-7.
  • 39. Franco Ruiz S, González Maldonado P. Dietary supplements and the anesthesiologist: Research results and state of the art. Rev Colomb Anestesiol. 2014;42(2):90-9.
  • 40. NHS. Herbal Medicines with potential peri-operative complications 2018 [Available from: https://doclibrary-rcht.cornwall.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Anaesthetics/PreAssessmentClinicalGuidelines.pdf.
  • 41. De Hert S, Staender S, Fritsch G, Hinkelbein J, Afshari A, Bettelli G, et al. Pre-operative evaluation of adults undergoing elective noncardiac surgery: Updated guideline from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2018;35(6):407-65.
  • 42. Leite PM, Martins MAP, Castilho RO. Review on mechanisms and interactions in concomitant use of herbs and warfarin therapy. Biomed Pharmacother. 2016;83:14-21.
  • 43. Leite PM, Martins MAP, das Graças Carvalho M, Castilho RO. Mechanisms and interactions in concomitant use of herbs and warfarin therapy: An updated review. Biomedicine & Pharmacotherapy. 2021;143:112103.
  • 44. Posadzki P, Watson L, Ernst E. Herb–drug interactions: an overview of systematic reviews. Br J Clin Pharmacol. 2013;75(3):603-18.
  • 45. Sugumaran M, Cohen JC, Kacker A. Prevalence of over-the-counter and complementary medication use in the otolaryngology preoperative patient: a patient safety initiative. Laryngoscope. 2012;122(7):1489-92.
  • 46. Kritzinger S, Smith R. Pre-Operative Assessment Guidelines for Adults Undergoing Surgery Under General or Regional Anaesthesia Bradford, England: NHS; 2018 [Available from: https://www.bradfordhospitals.nhs.uk/wp-content/uploads/2019/05/Pre-op-Guidelines.pdf.
  • 47. Tinker JH, Miles RR, Newland MC, Hurlbert BJ, Sink BJ, Healey KM, et al. Recommendations and Guidelines For Preoperative Evaluation Of the Surgical Patient With Emphasis on the Cardiac Patient For Non-cardiac Surgery. University of Nebraska Medical Center; 2006.
  • 48. TARD. Anestezi Uygulama Kılavuzları Preoperatif Hazırlık 2005 [Available from: http://tard.org.tr/assets/kilavuz/3.pdf.
  • 49. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27(6):391-401.
  • 50. Almatroodi SA, Alsahli MA, Almatroudi A, Rahmani AH. Garlic and its active compounds: a potential candidate in the prevention of cancer by modulating various cell signalling pathways. Anticancer Agents Med Chem. 2019;19(11):1314-24.
  • 51. Chen X-W, S Serag E, B Sneed K, Liang J, Chew H, Pan S-Y, et al. Clinical herbal interactions with conventional drugs: from molecules to maladies. Curr Med Chem. 2011;18(31):4836-50. 52. Kreft S. Pharmacodynamic interactions between drugs and dietary supplements. Dietary Supplements: Elsevier; 2015. p. 127-35.
  • 53. Morihara N, Hino A. Aged garlic extract suppresses platelet aggregation by changing the functional property of platelets. J Nat Med. 2017;71(1):249-56.
  • 54. Woodbury A, Sniecinski R. Garlic-induced surgical bleeding: how much is too much? A&A Practice. 2016;7(12):266-9.
  • 55. Mousa SA. Antithrombotic effects of naturally derived products on coagulation and platelet function. Methods Mol Biol. 2010;663:229-40.
  • 56. Skalli S, Zaid A, Soulaymani R. Drug interactions with herbal medicines. Ther Drug Monit. 2007;29(6):679-86.
  • 57. Ang-Lee MK, Moss J, Yuan C-S. Herbal Medicines and Perioperative Care. JAMA. 2001;286(2):208-16.
  • 58. Dasgupta A. Antiinflammatory herbal supplements. Translational inflammation: Elsevier; 2019. p. 69-91.
  • 59. Whinney C. Perioperative medication management: general principles and practical applications. Cleve Clin J Med. 2009;76(4):S126.
  • 60. Heller J, Gabbay JS, Ghadjar K, Jourabchi M, O'Hara C, Heller M, et al. Top-10 list of herbal and supplemental medicines used by cosmetic patients: what the plastic surgeon needs to know. Plast Reconstr Surg. 2006;117(2):436-45; discussion 46-7.
  • 61. Choi S, Oh D-S, Jerng UM. A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin. PLoS One. 2017;12(8):e0182794.
  • 62. Nguyen T, Alzahrani T. Ginkgo biloba. StatPearls [Internet]: StatPearls Publishing; 2021.
  • 63. Adusumilli PS, Ben-Porat L, Pereira M, Roesler D, Leitman IM. The prevalence and predictors of herbal medicine use in surgical patients. J Am Coll Surg. 2004;198(4):583-90.
  • 64. Hassen G, Belete G, Carrera KG, Iriowen RO, Araya H, Alemu T, et al. Clinical Implications of Herbal Supplements in Conventional Medical Practice: A US Perspective. Cureus. 2022;14(7):e26893.
  • 65. Kaye A, Clarke R, Sabar R, Vig S, Dhawan K, Hofbauer R, et al. Herbal medicines: current trends in anesthesiology practice—a hospital survey. J Clin Anesth. 2000;12(6):468-71.
  • 66. Surana AR, Agrawal SP, Kumbhare MR, Gaikwad SB. Current perspectives in herbal and conventional drug interactions based on clinical manifestations. Futur J Pharm Sci. 2021;7(1):103.
  • 67. Lederer AK, Samstag Y, Simmet T, Syrovets T, Huber R. Complementary medicine usage in surgery: a cross-sectional survey in Germany. BMC Complement Med Ther. 2022;22(1):263.
  • 68. Soós S, Jeszenői N, Darvas K, Harsányi L. Herbal medicine use by surgery patients in Hungary: a descriptive study. BMC Complement Altern Med. 2015;15:358.
  • 69. Chadha RM, Egan BJ. Perioperative Considerations of Herbal Medications. Curr Clin Pharmacol. 2017;12(3):194-200.
  • 70. Chase C, Doyle A, John SS, Laurent T, Griffith S. Post-operative haemorrhage secondary to cinnamon use. A case report. Int J Surg Case Rep. 2022;95:107179.
  • 71. Rowe DJ, Baker AC. Perioperative risks and benefits of herbal supplements in aesthetic surgery. Aesthet Surg J. 2009;29(2):150-7.
  • 72. El Jaouhari SD, Meziane M, Touab R, lhamid Jaafari A, Lalaoui JS, Bensghir M. Herbal Medicine: A Survey of use in Moroccan Surgical Patients.
  • 73. Bellikci Koyu E, Yürekli BPŞ, Özdemir N, Büyüktuncer Z. Tip 2 Diabetes Mellituslu Hastaların Bitkisel Destek Kullanım Durumları. Akd Tıp D. 2021;7(3):377-84.
  • 74. Yılmaz E, Sezen FS, Çan G, Renda G, Sanrı H, Dilaver İ, et al. Aile hekimleri ve eczacıların bitkisel ürün kullanımına yaklaşımları: Trabzon ilinde pilot çalışma. Türk Aile Hek Derg. 2018;22(3):141-56.
  • 75. Gamsızlar Z, Kurt AE, Yücel A, Kartal M. Hekimlerin fitoterapi ürünlerine bakış açısı. J Clin Anal Med. 2011;2(2):1-3.
  • 76. Fakeye TO, Onyemadu O. Evaluation of knowledge base of hospital pharmacists and physicians on herbal medicines in Southwestern Nigeria. Pharm Pract (Granada). 2008;6(2):88-92.
  • 77. Soltanipour S, Keihanian F, Saeidinia A. Knowledge, attitude and practice of physicians towards herbal remedies in Rasht, north of Iran. Medicine (Baltimore). 2022;101(47):e31762.
  • 78. Yıldırım D, Baykal D, Can G. Kanıt Temelli Fitoterapi Uygulamalarının İncelenmesi. JAREN. 2020.
  • 79. Levy I, Attias S, Ben-Arye E, Goldstein L, Matter I, Somri M, et al. Perioperative Risks of Dietary and Herbal Supplements. World J Surg. 2017;41(4):927-34.
  • 80. Bhamra SK, Slater A, Howard C, Heinrich M, Johnson MRD. Health care professionals' personal and professional views of herbal medicines in the United Kingdom. Phytother Res. 2019;33(9):2360-8.
  • 81. Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol. 2014;4:177.
Toplam 78 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Aslı Emine Büyükkasap 0000-0003-3127-9414

Gülay Yazıcı 0000-0001-8195-3791

Yayımlanma Tarihi 5 Mayıs 2023
Gönderilme Tarihi 29 Aralık 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 1

Kaynak Göster

Vancouver Büyükkasap AE, Yazıcı G. Cerrahi Kliniklerde Çalışan Hekim ve Hemşireler Besin ve Gıda Takviyelerinin Etkilerini Neden Bilmelidir?. TSAD. 2023;4(1):18-30.