Cultural Considerations

CULTURAL CONSIDERATIONS

Studies have shown that people from different ethnic back-grounds respond differently to certain drugs used to treat mental disorders. The nurse should be familiar with these cultural differences. Studies have also shown that African Americans respond more rapidly to antipsychotic medica-tions and tricyclic antidepressants than do whites. Also, African Americans have a greater risk for developing side effects from both these classes of drugs than do whites. Asians metabolize antipsychotics and tricyclic antidepres-sants more slowly than do whites and therefore require lower dosages to achieve the same effects. Hispanics also require lower dosages of antidepressants than do whites to achieve the desired results (Woods et al., 2003).

Asians respond therapeutically to lower dosages of lith-ium than do whites. African Americans have higher bloodlevels of lithium than whites when given the same dosage, and they also experience more side effects. This suggests that African Americans require lower dosages of lithium than do whites to produce desired effects (Chen et al., 2002).

Herbal medicines have been used for hundreds of years in many countries and are now being used with increasing frequency in the United States. St. John’s wort is used to treat depression and is the second most commonly pur-chased herbal product in the United States (Malaty, 2005). Kava is used to treat anxiety and can potentiate the effects of alcohol, benzodiazepines, and other sedative–hypnotic agents. Valerian helps produce sleep and is sometimes used to relieve stress and anxiety. Ginkgo biloba is primar-ily used to improve memory but is also taken for fatigue, anxiety, and depression.

It is essential for the nurse to ask clients specifically if they use any herbal preparations. Clients may not consider these products as “medicine” or may be reluctant to admit their use for fear of censure by health professionals. Herbal medicines are often chemically complex and are not stan-dardized or regulated for use in treating illnesses. Combin-ing herbal preparations with other medicines can lead to unwanted interactions, so it is essential to assess the clients’ use of these products.