Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The Uselessness of Phenylephrine

science.org

Post reply on HN
Print view View original

331–340 of 613 posts

Re: The Uselessness of Phenylephrine

#331

Post by belkinpower »

joecool1029 wrote: post #150

Phenylephrine does have one use that the author missed: It's used in ophthalmology to dilate the pupils before eye exams. On the topic of other use case medications, I used to take Sudafed (the real pseudoephedrine kind) during allergy season for a few weeks each year and noticed my productivity skyrocketed during that time, when I normally had issues context switching. Eventually I narrowed it down to taking Sudafed…

I ran into the opposite situation a few weeks ago. I was wondering why my allergies were so much worse on the weekends, and eventually narrowed it down to me only taking my ADHD meds on weekdays.

Re: The Uselessness of Phenylephrine

#332

Post by chimeracoder »

robotresearcher wrote: post #313
greedo wrote: post #295

Earlier quoted context omitted.

90% of cancer cases are cured or suppressed? I have to call BS. Cancer is the number two cause of death in the US.

UK data from 2010-2011: "Half (50%) of people diagnosed with cancer in England and Wales survive their disease for ten years or more" [0] Since lots of cancers and lots of deaths are in old people, 10 year survival is quite a high bar. [0] https://www.cancerresearchuk.org/health-professional/cancer-...

> "Half (50%) of people diagnosed with cancer in England and Wales survive their disease for ten years or more" [0]

Lumping all forms of cancer together is misleading, because cancers have dramatically different mortality rates. You need to separate by type of cancer, or else you're really just measuring the relative prevalence of different cancers.

As it turns out, the UK has a relatively low survival rate of cancers compared to other developed countries, including the US.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Re: The Uselessness of Phenylephrine

#333

Post by hilbert42 »

pwned1 wrote: post #264
hilbert42 wrote: post #235

Derek 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…

Pseudoephedrine isn't banned, you just have to ask the pharmacist for it.

Right, 'banned' is a blut word here, I suppose I should have used 'restricted schedule' as per officialdom but the earlier HN article used 'banned'. Incidentally, many countries have banned it or made it only available on script (i.e.: where I live).

Never tried to get it myself since it went on script. Personally, I find it repulsive stuff - makes me feel sicker than the cold or flu alone so I no longer use it (makes me feel queasy on the stomach).

Re: The Uselessness of Phenylephrine

#334

Post by rscho »

wins32767 wrote: post #327
rscho wrote: post #300

Earlier quoted context omitted.

> When I ask for hard data on the surgeon’s actual success rate for this type of surgery, well, they don’t track that—but look, just trust me, the guy’s realllyyy good. For good reason. Tracking of clinical outcomes is the wet dream of insurance companies. It's very toxic to the healthcare system, because it pushes practitioners to focus on easy cases where a good outcome is expected and causes major inequalities in…

Risk adjusted scoring is entirely viable in this age of data science, there is just no appetite for it. Doctors fight very hard against it because who actually wants to be held accountable for outcomes? Insurance companies really aren't the villains in the US healthcare system, they're going to make money no matter what because they pass cost increases on to their subscribers and are capped in how much profit they ca…

Risk adjusted scoring is currently absolutely not viable. You underestimate the messiness of the healthcare system by a huge margin. We don't even manage to record basic vital signs consistently, so believe me when I tell you that you can forget about any kind of nice statistical trick given the weakness of our data gathering processes. Plus it's not a matter of objectivity. Surgeons will subjectively assess that doing easy cases will be better. And in addition, they'll be correct. That's what really matters.

Re: The Uselessness of Phenylephrine

#335

Post by fpgaminer »

ipaddr wrote: post #318
perlgeek wrote: post #178

Earlier quoted context omitted.

My impression of the medical system (both here in Germany, and through reports from the US) is that it's very much like everything else: much is crap, much is mediocre, some good, and a very small, excellent sliver. This goes for doctors, drugs, surgeries, devices. If you want good results, you really have to take matters into your own hands, search for possible treatments yourself, evaluate several doctors until you…

This is the reason why the US system is better than Canada. In Canada you can't shop around and need referrals for specialists.

IIUC the vast majority of Americans don't have that privilege either and need referrals. You have to be on more expensive health plans to be able to pick your specialist. (That's been my past experience with HMOs). I finally got on a PPO recently and it was a bizarre but pleasant experience to just ... refer myself to a specialist :)

Re: The Uselessness of Phenylephrine

#336

Post by chimeracoder »

ajross wrote: post #280
travisathougies wrote: post #159

Earlier quoted context omitted.

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…

> 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. Modern medical results would absolutely be viewed as a miracle to someone just a few decades back. Something like 90% of cancer cases are either cured or successfully suppressed (to the extent that the suf…

> Something like 90% of cancer cases are either cured or successfully suppressed (to the extent that the sufferer ends up dying of some other cause).

This is not correct. It's true in the US for prostate cancer, which is one of the most notoriously treatable forms of cancer, but it's not true for cancer at large.

(It's also not true for prostate cancer in many other developed countries, which actually have a worse track record at treating cancer than the US does)

Re: The Uselessness of Phenylephrine

#337

Post by ashtonkem »

nanidin wrote: post #189
arkades wrote: post #54

Earlier quoted context omitted.

Pseudoephedrine is still available -behind the counter-. You literally just have to ask the pharmacist for it. Let’s not turn grad students having a laugh into an actual statement on public policy.

My state attempted to make pseudoephedrine require a prescription. One of the state lawmakers that was opposed was a doctor and he cited studies where phenylephrine was less effective than placebo. I wrote to my representative, who called me after voting for the bill to tell me that some sheriff told him phenylephrine is equally effective. Every time you buy the stuff from the pharmacist, they're logging the purchase…

“I asked a cop about how effective an OTC medicine is” is an absolutely insane thing for anyone to say, let alone a legislator. Sadly it does not seem like such behavior receives the social opprobrium it deserves.

Re: The Uselessness of Phenylephrine

#338

Post by klodolph »

refurb wrote: post #293
klodolph wrote: post #219

Earlier quoted context omitted.

Not accidental, but very tragic. It's the #1 cause for calls to poison control, and accounts for 26,000 hospitalizations every year, and 500 deaths. Dying from an acetaminophen overdose is not a good way to go out, you spend a couple days in the hospital suffering as your organs fail and your loved ones watch. Other OTC drugs are much safer. I don't allow acetaminophen in the house. Pseoudoephedrine? Yes. Acetaminoph…

500 deaths (many intentional attempts at suicide) in a country of 350M where arguably every household has acetaminophen present is incredibly low .

By comparison, the number of accidental firearm deaths is around 430 per year, and somewhere around 40% of US households have a firearm. So we can say that having acetaminophen in the house is roughly as dangerous as having a firearm in the house. Obviously this is not some kind of direct comparison between firearms and acetaminophen.

I included the statistic in the first place because I thought it didn’t make sense to cherry pick the scariest statistics. I’m not fearmongering here, just trying to illustrate that acetaminophen should be treated with more care than we currently do. I think we could be making better health policy decisions about which medications are OTC and which aren’t, although this topic is incredibly complicated and doesn’t just come down to simple facts like toxicity.

Re: The Uselessness of Phenylephrine

#339

Post by Cannabat »

genewitch wrote: post #177
Robotbeat wrote: post #138

Earlier quoted context omitted.

I feel like the true “Cocaine Cola Classic” would still have some of that, um, regulated stimulant in it. Cocaine. Might be good for decongestion?

afaik coca cola is the only entity in the US allowed to import actual coca leaves, so, technically?

I’m not sure if it is still legal, but importing “coca tea” - that is, tea bags filled with shredded coca leaves - was legal at some point and a few enterprising folks imported a few kilos of it and processed it into the drug.

Re: The Uselessness of Phenylephrine

#340

Post by wombatpm »

rootusrootus wrote: post #307
samtho wrote: post #298

Earlier quoted context omitted.

Why can you go to the store and buy rubbing alcohol to drink? It’s primary ingredient is just ethanol. The FDA literally mandates that the ethanol is not able to be safely consumed and is cut with poison that is not easily separated from ethanol. Similarly, cutting opioids with Tylenol is not actually intended to be a deterrent to someone who gets their hands on the pills rather it deters people involved with illicit…

> Why can you go to the store and buy rubbing alcohol to drink? It’s primary ingredient is just ethanol. AFAIK most/all rubbing alcohol (at least that which is sold in the US) is isopropanol, not ethanol. You can buy ethanol in not-for-consumption form, as denatured alcohol.

And it’s chemistry that forces the additional benzene in denatured alcohol. Water- ethanol forms an Azeotrope at 95% ethanol. Benzene is added to break the azeotrope and get to 99.99% ethanol. Chemistry not a conspiracy
Post reply on HN