Now do cough medicine. The last time I looked at the literature, experts were asking why 95% of cough medicine was allowed to be sold when none of it was known to work. The list of OTC medical products that don’t work is very large.
The Uselessness of Phenylephrine
251–260 of 613 posts
Re: The Uselessness of Phenylephrine
#252Earlier quoted context omitted.
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 o…
This is especially important when it comes to children. This is because kids vary in weight in relation to age more than adults do, but the vast majority of drugs are dosed by age. This is just insanity at it's finest.
Yep, and that's only using the rough metric of bodyweight. There are a number of other major factors like size and health of liver, whether the patient has any under/over expression of metabolic enzymes, etc that can further complicate the determination of proper dosage.
Would be super cool if we had an objective measure of proper dosage - such as blood concentration or excreted metabolites - to give us more insight into how the drug is being metabolized by the individual.
Re: The Uselessness of Phenylephrine
#253The 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."
Yeah, US voters do seem to like electing presidents for things only Congress has the power to do. Of course, presidents also like proposing things they can't do.
Presidents' main differences are on foreign policy which is the one thing nobody asks them about.
Re: The Uselessness of Phenylephrine
#254I have the impression that many cold drugs are similarly useless. Dextromethorphan comes to mind[0]. I think its the nature of colds, they are not particularly severe and symptoms are easily influenced by placebo effects. Many of them are really just relying on caffeine for daytime meds and antihistamines for nighttime formulations. That whole market feels like a borderline scam.
Re: The Uselessness of Phenylephrine
#255Earlier quoted context omitted.
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 o…
This is especially important when it comes to children. This is because kids vary in weight in relation to age more than adults do, but the vast majority of drugs are dosed by age. This is just insanity at it's finest.
Is there any evidence that harm is being caused from age-based dosing?
Re: The Uselessness of Phenylephrine
#256Pseudoephedrine is wonderfully effective, but beware of its side effects. I used to take it regularly due to congestion related to seasonal allergies, but at a recent medical visit I discovered that my blood pressure had jumped from its usual 120/75 up to 150/105. (My doctor was also alarmed!) I no longer take pseudoephedrine. I'm told that the effect on blood pressure is usually mild, but based on my experience I'd…
there was a study published february 2022 that showed that acetaminophen also increases blood pressure. I was pretty aware that both pseudoephedrine and ephedrine raised blood pressure slightly - but it's always good to see it mentioned online where other people may not have known.
In my case, I was taking ibuprofen+pseudoephedrine, so acetaminophen wasn't a confounding factor.
And yes, there's plenty of literature showing a slight average increase in bp -- but it seems that there's a wide variance, with some people having dramatically larger side effects.
Re: The Uselessness of Phenylephrine
#257Earlier quoted context omitted.
It really is amazing how someone manages to be on the wrong side of seemingly everything, and yet is locked into office past the point of senility.
Another arrow in my quiver for why the US is honestly not a country to bet on for the next 20 years.
The only countries with better demographic trends than the US are in Africa.
Re: The Uselessness of Phenylephrine
#258Derek Lowe makes a good point that we're wasting everyone's time and money with useless phenylephrine and the fact that pseudoephedrine is so much better as a decongestant. The fact is that pseudoephedrine is not only banned in the US but it is also banned in many other counties for the same reason that it's a precursor for meth. The trouble is that banning pseudoephedrine seems to have only made matters considerably…
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Re: The Uselessness of Phenylephrine
#259Earlier 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…
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 adv…
I'm not saying it'd be good if acetaminophen got you high, just that one of the reasons it's still OTC is that it doesn't get you high, so there's no one champing at the bit to crack down on it, the way they robbed us of the highly-effective and fairly-harmless pseudoephedrine for the one and only reason that it can be illicitly turned into a street drug.
Re: The Uselessness of Phenylephrine
#260Earlier quoted context omitted.
This means that either your calibration mechanism for 'wrong side' is flawed, or the system is rigged in a way that it consistently produces bad outcomes. Speaking for myself, am shocked and outraged that red senators and other congresscritters are consistently on the wrong side of seemingly everything, yet they keep getting elected. Of course, my political calibration mechanisms are quite in tune.
> the system is rigged in a way that it consistently produces bad outcomes. Yes. That one. "Real" change (ie, still a useless liberal democracy, but at least a bit more in service to the people) would start with voter reform and getting rid of FPTP entirely.
You wouldn't like the results of either of those if you like "extreme" positions.
- The most popular replacement for FPTP (which is biased away from centrism) is RCV (which is biased towards it).
- FPTP does turn it into a two-party system, but US parties are weak. They don't control who joins them, who gets elected, or how anyone votes. In the UK you can actually get fired from the party for voting wrong.