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The Uselessness of Phenylephrine

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Re: The Uselessness of Phenylephrine

#221
post #13

The 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.

The US would elect a baby-eating space alien from Tau Ceti VI as president if Zbleqq'takkx's primary platform plank was "make it so you can buy real Sudafed without a lot of hassle and faff."

Re: The Uselessness of Phenylephrine

#222

Earlier quoted context omitted.

> OTC medicines that by current standards would not be made OTC Acetaminophen would almost certainly be in this category, if it could even get FDA approval at all. The effective dose is dangerously close to a toxic dose that causes liver damage, and not comfortably-far from the LD50. The only reasons acetaminophen is OTC is that it's been informally grandfathered in, makes an absolute fortune for pharmaceutical compa…

How is this "dangerously close to toxic"? Extra strength is 500mg. Adults should not take more than 3000mg in a day. Taking 7000 more more can lead to liver problems. https://medlineplus.gov/ency/article/002598.htm Common dosage forms and strengths: Suppository: 120 mg, 125 mg, 325 mg, 650 mg Chewable tablets: 80 mg Junior tablets: 160 mg Regular strength: 325 mg Extra strength: 500 mg Liquid: 160 mg/teaspoon (5 mill…

Note that metabolism of drugs is roughly proportional to bodyweight. A petite 100 lb person may only need 200mg for an effective dose. An obese 400 lb person may require ~4x that dosage for the equivalent effect.

The one-size-fits-all drug dosing we do in this country seems crazy to me.

"Research Chemical" drug users have developed techniques to calibrate doses of substances with unknown potency - start with ~100th of what you expect to be an active dose and then gradually double it until proper effects are achieved.

I'd imagine it would be more expensive for pharmacies to distribute drugs in this way, but allowing patients to titrate their doses could significantly reduce/avoid negative side effects from just throwing the same standardized dose at every person with a prescription regardless of bodyweight.

Re: The Uselessness of Phenylephrine

#223
post #19

I'm also irked by the fact that OTC cough suppressants like dextromethorphan are equally useless.

In the vast majority of cases for my family, Dextromethorphan is a miracle drug. We're in the middle of cold and allergy season here, and my kids (and I) stop coughing within 5-10 minutes of taking an appropriate dose. Once every 3-4 years I'll get a cough so bad that DXM won't fix, and when that happens my doc gives me a prescription for a codeine based cough syrup that fixes it (and renders me useless as a human be…

I dunno, codeine makes me love my family even more, as an anecdote...

Re: The Uselessness of Phenylephrine

#224

I've recently had to deal with the medical profession a lot more than in the past and I'm finding this sort of thing everywhere. OTC medicines that by current standards would not be made OTC, surgeries that are extremely common but have never had quality randomized trials, official sounding diagnoses that on inspection are actually defined as "we have no idea", lack of consensus about how to treat some of the most co…

> OTC medicines that by current standards would not be made OTC Acetaminophen would almost certainly be in this category, if it could even get FDA approval at all. The effective dose is dangerously close to a toxic dose that causes liver damage, and not comfortably-far from the LD50. The only reasons acetaminophen is OTC is that it's been informally grandfathered in, makes an absolute fortune for pharmaceutical compa…

This is very silly, acetaminophen is very effective against pain, and for many people (e.g. me) is tolerated much better, especially at higher doses, than ibuprofen etc. There is already way to much panic about drugs/medicines, especially pain meds, especially especially for chronic conditions, without further hysterics about the 'threat' of useful and well tolerated chemicals. (Not a doctor, not offering medical advice.)

>doesn't get you high

A huge point in its favor if you can't lay in bed opiated all day.

Re: The Uselessness of Phenylephrine

#225

Earlier quoted context omitted.

How is this "dangerously close to toxic"? Extra strength is 500mg. Adults should not take more than 3000mg in a day. Taking 7000 more more can lead to liver problems. https://medlineplus.gov/ency/article/002598.htm Common dosage forms and strengths: Suppository: 120 mg, 125 mg, 325 mg, 650 mg Chewable tablets: 80 mg Junior tablets: 160 mg Regular strength: 325 mg Extra strength: 500 mg Liquid: 160 mg/teaspoon (5 mill…

My understanding is that acetaminophen toxicity has been a problem particularly for children, because 1) the toxic dose is lower, 2) many common OTC products for children include some amount of acetaminophen among their active ingredients and 3) parents may give their children multiple such products (one for runny nose, one for fever reduction, one for nighttime relief, etc.) over the course of a day and end up excee…

acetaminophen is often put in medications because it's toxic. It's there to dissuade people from *gasp* taking too much and possibly experiencing some positive feelings or enjoyment that offends the sensibilities of decision makers. Better that we destroy a few people's livers than that those people get a buzz. (to be clear, this last sentence is not my view. I'm mocking that view)

Re: The Uselessness of Phenylephrine

#226

I am suffering with a bad/cold flu right now and this has made me mad as hell! What if someone is so sick they can't fathom to walk into a pharmacy? Fuck senators.

Thank God I have about 100 different people I could call and ask to pick up medicine for me were I in that situation.

Lucky you.

Re: The Uselessness of Phenylephrine

#227

I've recently had to deal with the medical profession a lot more than in the past and I'm finding this sort of thing everywhere. OTC medicines that by current standards would not be made OTC, surgeries that are extremely common but have never had quality randomized trials, official sounding diagnoses that on inspection are actually defined as "we have no idea", lack of consensus about how to treat some of the most co…

You seem to be under the impression that there is some 'advanced technology' out there that will magically solve your problems that the US fails to have. In my experience, many people have a quasi-religious belief in the capability of modern medicine to perform what would otherwise be called a miracle. This belief is typically held without any evidence whatsoever. In reality, there are a plethora of conditions, some…

Ignoring them is unethical. Treating them with an unscientific treatment is unethical.

Re: The Uselessness of Phenylephrine

#228

Earlier quoted context omitted.

American law is so disjointed. On one hand, we're decriminalizing drugs. Pot is widely legal now. Other states are allowing mushrooms and LSD. Cocaine and heroin are not legal, but have all but been decriminalized on the West Coast. Meanwhile it's harder than ever to get pain killers from your doctor, even when you have a demonstrated need for them. Same with ephedrine -- a very useful drug -- it's very difficult to…

It's not inconsistent to treat different things differently and different drugs are radically different in their individual health and societal effects. I live in Seattle where marijuana is legal. Alcohol and marijuana are widely consumed and I rarely see any large-scale problems from it. Obviously, there are many people who can't handle either of those, but their failure to handle it well seems to not impinge on oth…

You don't see anyone who is using opioids in the privacy of their own home who aren't out on the streets, so your sampling is massively biased.

And the way we should look at drug addition with opiates isn't by looking at the homeless users, but consider the fact that we're all potentially one bad car accident away from getting hooked on pain killers, and asking what kind of support we would need to avoid winding up homeless due to that.

Punishment via the criminal justice system is what is likely to wind up with you losing your job and winding up out there in that camp with them. So how should you be treated if it happens to you?

And the glib answer of "put a bullet in my head" or whatever isn't an acceptable response. Treat the problem seriously and propose how society helps you help yourself to get clean without at trip through a homeless camp. And the people who refuse to deal with the reality that it could happen to them or engage with the problem are likely those most at risk of lacking the self-awareness to recognize when it starts happening to them.

Re: The Uselessness of Phenylephrine

#229
post #20

Earlier quoted context omitted.

or maybe like sudafed pe is an advertisement, a reminder to check behind the counter for the real thing

The "PE" stands for "placebo, essentially"

That's essentially the selling point behind Zicam and other homeopathic drugs.

Re: The Uselessness of Phenylephrine

#230

Earlier quoted context omitted.

> OTC medicines that by current standards would not be made OTC Acetaminophen would almost certainly be in this category, if it could even get FDA approval at all. The effective dose is dangerously close to a toxic dose that causes liver damage, and not comfortably-far from the LD50. The only reasons acetaminophen is OTC is that it's been informally grandfathered in, makes an absolute fortune for pharmaceutical compa…

How is this "dangerously close to toxic"? Extra strength is 500mg. Adults should not take more than 3000mg in a day. Taking 7000 more more can lead to liver problems. https://medlineplus.gov/ency/article/002598.htm Common dosage forms and strengths: Suppository: 120 mg, 125 mg, 325 mg, 650 mg Chewable tablets: 80 mg Junior tablets: 160 mg Regular strength: 325 mg Extra strength: 500 mg Liquid: 160 mg/teaspoon (5 mill…

Most people don't read the label on medicines that they take. Take two extra strength acetaminophen tablets, combination liquid cold medicine, some of the sleep aids with diphenhydramine + acetaminophen, a glass of wine, repeat for 3 days, and you're easily into danger territory.
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