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The Uselessness of Phenylephrine

science.org

521–530 of 613 posts

Re: The Uselessness of Phenylephrine

#522
Sometimes the most helpful thing when I have a problem is being listened to and accepted. It is frustrating to see doctors that only pretend to listen, and I wonder to what degree such doctors are satisfied with their work. We finally have for our child a pediatrician who gives us what I hope will someday be normal care and attention.

Re: The Uselessness of Phenylephrine

#523

I’m skeptical the regulations will ever get rolled back, because it’s just so trivially easy to get spooked by the idea of making meth, but as mentioned in this article, I don’t think pseudoephedrine would become a significant source of methamphetamine again if it was made easily available over the counter. Because the cartels have gotten really, really good at making meth. Extremely pure and extremely cheap, and the…

I wonder if there is something they can add to it that is harmless to humans but makes it impractical or too expensive to use as a precursor for making meth.

Re: The Uselessness of Phenylephrine

#525

Earlier quoted context omitted.

Multiple clarifications - Antihistamines do not directly dry up your runny nose/post nasal drip. Rather, they reduce the histamine response, which is helpful when something is caused by allergies. It's usually not that helpful with an actual cold (but allergic rhinitis is often mistaken for a cold). Sudafed is what the parent was referring to with Pseudophedrine; a decongestant. This works by shrinking blood vessels,…

Do any of these compounds actually do what they say? I have always found all cold medicines to be entirely worthless. Supposedly a study found guaifenesin to be no better than a placebo: http://rc.rcjournal.com/content/59/5/788

Guaifenesin is mostly useless and only approved so that they can stick it next to your dextromethorphan as an emetic to stop you from abusing it. I was vomiting from COVID and I was incredibly pissed off when I found out it was actually just because they poisoned my cough syrup on purpose.

Re: The Uselessness of Phenylephrine

#526

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…

The fact that I am here is 100% due to the medical science of the 1970s. I was born with a hole in my heart. The fact that I lived past 19 is due to the medical science of the late 1990s. That same area of my heart had a short circuit that would sporadically cause 200bpm+ heart rates and cause me to nearly pass out. It’s called Wolf-Parkinson-White syndrome. I had a cardiac ablation which 100% cured me of that. The fact that I am here now is because of modern medicine. I just completed colon cancer treatment for which I lost a foot of colon and had chemotherapy. As I write this I can’t believe that I am not even listing everything that has happened to me and considered myself generally healthy. Anyway medicine in the US is definitely responsible for my still being alive. I’m sure other health care systems would have kept me alive too but it is pure speculation and luck I suppose. I could just as easily have gotten a bad doctor and not been so lucky.

Re: The Uselessness of Phenylephrine

#527

Earlier quoted context omitted.

This is really good news but hardly a comprehensive meta analysis over thousands of infants.

Well, it's not the only study, it's just an example. I think it was already generally considered safe but doctors were worried it might be passed on through breastfeeding.

Sure but I would not equate with coffee which empirically we know can be well-tolerated by most of the population basically from birth to death.

Adderall (dl mixture) is just not the same. We know Adderall tends to exacerbate acne and some forms of dermatitis but we don't know how much. We don't know if the pupil effects contribute to driving incidents. We don't know if dry mouth from Adderall is worse for dental health than the dry mouth that some people get after heavy espresso or other stimulating substances, like pseudoephedrine. We don't think the risk of paranoid behavior is high but it is higher than coffee, of course.

And of course some not insignificant portion of the population can tolerate coffee or pseudoephedrine, but we're not too sure about Adderall. Schizophrenic, bipolar, OCD individuals, those with tics, tachycardia, etc, need to tread carefully with stimulants, even maybe sudafed.

Re: The Uselessness of Phenylephrine

#528
post #365

Earlier quoted context omitted.

If data science was that efficient on healthcare records, we'd know it by now and everyone would do it. There is no 'big healthcare data'. We gather mostly noise, and records are full of blatant mistakes. Medicine is still more art than science today, and records mostly give you a 'feeling' for the patient's condition in light of your MD education, with a little hard data sprinkled on top.

This is a fallacy. At any point in history you can say “if X field was so good, we’d have Y by now”. In 1925 you could’ve said, “if biology’s understanding of bacteria is so good, we’d have antibiotics by now”. Within 5 years, they did. There is certainly noise in healthcare data especially when patient-reported, but is it noise to say that a patient having X procedure later does or doesn’t have serious complications…

The first flu vaccine came about in 1945. Knowing as much as we did about viruses then, you might think we would have a cure for influenza (or the common cold) by now. Here we are almost 80 years later... big data may be coming but if takes that long it won't be in my lifetime.

Re: The Uselessness of Phenylephrine

#529

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…

Nowhere is this more evident than in the treatment of endometriosis. It seems like even gynaecologists are woefully ignorant & untrained in this disease, leading to so much unnecessary suffering by women (my wife included). Guys & gals, if you or your partner suffer from endometriosis, listen up! * Find the best gynaecologist you can that specialises in endo & can perform excision surgery. * Burning off the lesions (…

It seems that every case of endometriosis comes with a horror story of years, if not decades, of being ignored or not being taken seriously

Re: The Uselessness of Phenylephrine

#530
post #501

Earlier quoted context omitted.

The messaging in the US most commonly used to justify the lack of universal coverage and unreasonable cost of care is that we pay the most because we get the best treatments and best doctors and best outcomes, so I don’t think it’s fair to blame laymen for believing that. Also, it’s not just patients that think this way. (Or, at least, if the clinicians know, they aren’t saying much to their patients.) I’ve had docs…

But if the alternative to a 15% response rate is “no treatment” then you are getting the gold standard. In many other countries those medicines aren’t even considered or paid for.

Only if Gold Standard means "not quite as bad as the other options," which I'm not sure is a definition that'd stick.
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