funnily enough, phenylephrine is used daily in ophthalmology for dilated eye exams.
On that note, there's a bunch of esoteric drops that used to be used because of their useful pharmacokinetics, diagnostic/therapeutic abilities (cocaine, hydroxyamphetamine, pilocarpine 0.125%, homatropine), but are no longer being manufactured due to cost.
The Uselessness of Phenylephrine
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Re: The Uselessness of Phenylephrine
#62Sometimes I wonder if NSAIDs are the same deal, or if there's just a subset of people they don't work well on.
Tylenol (acetaminophen) does nothing for me. Advil (ibuprofen) does usually work. I used to get more headaches when I was younger, but I rarely get them now. Two things that have changed that might be related: I no longer use CRT screens, and I no longer drink diet soda (used to drink 4-6 cans a day, most days).
Aside from headaches, Advil does better on other aches and pains than Tylenol, which does almost nothing. And it's better for the liver.
Re: The Uselessness of Phenylephrine
#63The article comes so close to explaining a way to make it work, likely due to his hesitancy to recommend exceeding the recommended dose: > Why is oral phenylephrine so useless? It is extensively metabolized, starting in the gut wall. You can find a bioavailability figure of 38% in the literature, but that appears to be the most optimistic number possible, and you can also find studies that show 1% or less. Overall, t…
Do we have a study showing these (second dose within 30 minutes or paracetamol + phenylephrine) performing better than placebo?
Re: The Uselessness of Phenylephrine
#64I wonder how difficult it would be to get the restrictions on pseudoephedrine rolled back now that it appears unlikely they're accomplishing their original goal of limiting the methamphetamine supply. Concern (legitimate and otherwise) over ability to breathe is a popular topic in politics lately.
Very difficult. Regulations live on regardless of their negative effects because there's very little incentive to get rid of them.
Worse, there is an incentive to keep them going as there are entire industries and associated careers built around them.
Re: The Uselessness of Phenylephrine
#65My drug of choice for colds is NyQuil. It's always been great for opening up my nasal passages enough to let me breathe easily and then knocking me the fuck out so I could sleep off most of the cold. I remember several years ago when all of a sudden NyQuil stopped doing anything useful. I had no idea why but I directly observed that it was like it had been replaced with a non-functioning placebo. Only a couple years…
In Canada you can find cough & cold medications in both the Phenylephrine and Pseudoephedrine formulation, often under near-identical labels (IIRC one can buy "Tylenol Cough and Cold" with either active ingredient, for example - carefully checking the label is the only way to tell). I didn't realize there was a difference until one day after running out of Phenylephrine-based medication I bought the Pseudoephedrine-based one - it was a night and day difference! Now I tell everybody with a cold to check the labels and buy the good stuff.
Interesting case study in being able to sell a low-quality product (one of the most important active ingredients doesn't work!) side-by-side with a much better product and most people won't ever notice that one is better.
Re: The Uselessness of Phenylephrine
#66The lack of availability of proper pseudoephedrine in USA led to situation where there are papers describing how to turn methamphetamine into pseudoephedrine, not the other way around. With explanation in abstract that its easier to buy meth than pseudoephedrine.
It would be interesting to see if there were any reliable stats on how many, if any, people were caught by the ID check laws trying to manufacture from pseudoephedrine, because even at the height of the meth panic that engendered the laws something like 95% of pseudoephedrine outside of a handful of high-risk areas was very obviously not being used for any illegal purposes.
Re: The Uselessness of Phenylephrine
#67Earlier quoted context omitted.
> With explanation in abstract that its easier to buy meth than pseudoephedrine. People may laugh at this, as they should since it is an absurd situation, but this isn't entirely wrong. Neither my wife or I drive and during the pandemic she gave up her license after getting an appointment at the DOL was difficult. Both of us carry US passport cards as our ID. This has resulted in several situations where we've been t…
Why not get a non-motorist ID card? Every US state has these; here's Washington's: https://www.dol.wa.gov/driverslicense/gettingidcard.html
I believe this is the key element:
> she gave up her license after getting an appointment at the DOL was difficult.
I'm not sure what DOL is a reference to; however I now many individuals struggled to get appointments at the Secretary of State (SoS) and that is also where one (at least where I live) would need to get a non-motorist ID. Same amount of frustration / time spent to get a non-motorist ID as it would be to renew your driver license.
Re: The Uselessness of Phenylephrine
#68Earlier quoted context omitted.
> With explanation in abstract that its easier to buy meth than pseudoephedrine. People may laugh at this, as they should since it is an absurd situation, but this isn't entirely wrong. Neither my wife or I drive and during the pandemic she gave up her license after getting an appointment at the DOL was difficult. Both of us carry US passport cards as our ID. This has resulted in several situations where we've been t…
Why not get a non-motorist ID card? Every US state has these; here's Washington's: https://www.dol.wa.gov/driverslicense/gettingidcard.html
But why get one? A passport/passport card is a _better_ ID document in almost every way. State non-motorist IDs should really cease to exist and we should increase access to passport cards
Re: The Uselessness of Phenylephrine
#69Earlier quoted context omitted.
> With explanation in abstract that its easier to buy meth than pseudoephedrine. People may laugh at this, as they should since it is an absurd situation, but this isn't entirely wrong. Neither my wife or I drive and during the pandemic she gave up her license after getting an appointment at the DOL was difficult. Both of us carry US passport cards as our ID. This has resulted in several situations where we've been t…
Why not get a non-motorist ID card? Every US state has these; here's Washington's: https://www.dol.wa.gov/driverslicense/gettingidcard.html
We are aware of these. The reason is: Because unless you get the "enhanced" version, due to the ridiculous REAL ID situation you have to have another card anyway. For me in particular, where I work operates a medical clinic in a facility owned by the federal government so a non-enhanced card doesn't get me in the door, but a passport card does.
For my wife, it's because she has even less tolerance for paperwork than I do and it's easier to just go to the pharmacies we know have their heads bolted on straight than it is to gather up all of the stuff and go to the overworked and harried DOL.
Re: The Uselessness of Phenylephrine
#70Phenylephrine must be totally useless since pseudoephedrine barely does anything in my experience!
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