all-heal

valerian

(vuh-lare-ee-en) valerian,

Amantilla

(trade name),

All-Heal

(trade name),

Baldrian

(trade name),

Baldrianwurzel

(trade name),

Belgium Valerian

(trade name),

Common Valerian

(trade name),

Fragrant Valerian

(trade name),

Garden Heliotrope

(trade name),

Garden Valerian

(trade name),

Indian Valerian

(trade name),

Mexican Valerian

(trade name),

Pacific Valerian

(trade name),

Tagara

(trade name),

Valeriana

(trade name),

Valeriana officinalis

(trade name),

Valerianae radix

(trade name),

Valeriana rhizome

(trade name),

Valeriane

(trade name)

Classification

Therapeutic: antianxiety agents
InsomniaAnxiety

Action

May increase concentrations of the inhibitory CNS transmitter GABA.

Therapeutic effects

Improvement in sleep quality.

Pharmacokinetics

Absorption: Unknown.Distribution: Unknown.Metabolism and Excretion: Unknown.Half-life: Unknown.

Time/action profile

ROUTE	ONSET	PEAK	DURATION
PO	30–60 min	2 hr	unknown

Contraindications/Precautions

Contraindicated in: Pregnancy and lactation.Use Cautiously in: Alcohol use (may have additive sedative effects); Surgery (discontinue use 2 weeks prior to elective procedures).

Adverse Reactions/Side Effects

Central nervous system

drowsiness
headache

Gastrointestinal

dry mouth

Miscellaneous

Benzodiazepine-like withdrawal symptoms with discontinuation after long-term use

Interactions

Additive CNS depression with alcohol, antihistamines, anesthetic agentssedative hypnotics and other CNS depressants.Alcohol-containing preparations may interact with disulfiram and metronidazole.Additive sedative effects can occur when used with herbal supplements with sedative properties such as kava, l-tryptophan, melatonin, SAMe, and St. John's wort.Oral (Adults) Tea—1 cup tea 1–5 times daily. Tea is made by steeping 2–3 g root in 150 mL boiling water for 5–10 min then straining. Tincture—1–3 mL 1–5 times daily. Extract—400–900 mg up to 2 hours before bedtime or 300–450 mg divided tid.

Availability

Capsules: ^OTCExtract: ^OTCTea: ^OTCTincture: ^OTC

Nursing implications

Nursing assessment

Assess degree of anxiety and level of sedation prior to and periodically throughout therapy.
Assess sleep patterns.
Assess response in the elderly population where drowsiness and loss of balance may pose a significant risk for injury.

Potential Nursing Diagnoses

Anxiety (Indications)
Risk for injury (Side Effects)

Implementation

Take one to two hours before bedtime if used for nighttime hypnotic.
Administer orally three to five times daily to control anxiety.

Patient/Family Teaching

Encourage patients to avoid stimulants such as caffeine and to provide an environment that promotes restful sleep.
May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to drug is known.
Caution patient to avoid use of alcohol and other medications or herbals that have a sedative effect; may increase drowsiness.
Advise patients to discontinue 2 weeks prior to elective surgical procedures.
Inform patients not to take this herbal supplement if pregnant or breast-feeding.
Notify patients that dependence with withdrawal symptoms may develop with prolonged use.

Evaluation/Desired Outcomes

Decreased anxiety level.
Improvement in sleep with a feeling of restfulness without drowsiness upon awakening.

all-heal

allheal

(ôl′hēl′)n. Any of several plants, such as self-heal or valerian, used in herbal medicine and reputed to have broad healing powers.

all-heal

(1) Heal-all, see there; Prunella vulgaris.
(2) Valerian, see there; Valeriana officinalis.