Ping wei san, a Chinese medicine for gastrointestinal disorders

OBJECTIVE: To describe the dilemma that American pharmacists face when their patient uses a traditional Chinese herbal formula. Ping wei san (PWS), an agent used to treat gastrointestinal disorders, is used to illustrate the problems encountered and to identify resources on Chinese herbal medicines available to pharmacists. DATA SYNTHESIS: In the US, Chinese herbal medicine is making its way into mainstream Western medicine. Patients may discover PWS in their search for a substitute for cisapride, which was partially withdrawn from the US market in July 2000. The pharmacist may be called on to assist in the management of patients who wish to use PWS for treatment of common gastrointestinal disorders like gastritis, esophageal reflux, gastric or duodenal ulcers, and acute or chronic enteritis. As with most other Chinese herbal formulas, English-language literature about PWS is limited and is often difficult to interpret. Pharmacists who are unfamiliar with the basic principles and terminology used in traditional Chinese medical practices will need to identify sources of information about this complementary alternative practice to be able to provide pharmaceutical care for patients taking a Chinese herbal formula like PWS. CONCLUSIONS: To develop a pharmaceutical care plan for patients using a Chinese herbal medicine therapy such as PWS, the pharmacist will need to become familiar with traditional Chinese medical practices and terminology describing indications, therapeutic effects, and risks. Fortunately, resources are available to pharmacists who need assistance in interpreting information on Chinese herbal therapies so that they can appropriately manage patients using them.