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

561–570 of 613 posts

Re: The Uselessness of Phenylephrine

#561

Post by f1refly »

Nitramp wrote: post #553

Over here in Germany, when you ask for a decongestant, you usually get Xylometazolin as a spray. As I understand, that's both more effective and has fewer side effects (due to being local). You can also get pseudoephedrine, but I don't think it's as commonly used as these nasal sprays. Is that not an option in the US?

> As of 2021, no consumer products containing xylometazoline are marketed in the United States, however imported products containing xylometazoline are available online.

From the wikipedia article. Fascinating, it's the most common drug I use and it's not even available in US stores!

Re: The Uselessness of Phenylephrine

#562

Post by mnw21cam »

csnover wrote: post #285
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…

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…

I also think that doctors tend to dumb-down and downplay the actual truth of the effectiveness of treatments. Partly because for the majority of patients, being told that a treatment is realllyyy good can actually make it more effective, by the placebo effect. It also makes the patient happier and more confident in the abilities of the doctor.

I noticed that since I got "Dr." put in front of my name on my medical records, doctors tend to firstly ask what I'm a "Dr." in, and secondly tell it to me straight.

Re: The Uselessness of Phenylephrine

#563

Post by ZephyrOhm »

p_l wrote: 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.

Is it also possible to buy meth and turn it into ephedrine? That would be phenomenal

Re: The Uselessness of Phenylephrine

#564

Post by Madmallard »

LorenPechtel wrote: post #453
Madmallard wrote: post #374

Earlier quoted context omitted.

I’m feeling this way too hard. I have a condition where any food I consistently eat I become sensitized to and begin developing severe reactions that are alike anaphylaxis in nearly every way but not quite as severe. I have been hospitalized several times now with starvation issues. Yeah immune suppressants sorta worked but you can’t exactly stop a full on immune response so it just bought a little bir of time. (1) m…

At least I don't go down the anaphylaxis route. Unless the picture changes I won't have starvation issues, malnutrition is definitely an issue. I'm sure it's going to end up having to go with immune suppression (and I have every reason to suspect that's only going to be a temporary solution) but so far I've been able to avoid that. Never tried the psych stuff. One doctor suggested it but it felt very much like they w…

GDX stool testing was something recommended by an integrative dual resident at ucsd for me.

I think if you disturb the flora and lining too badly the normal tolerance mechanism with Tregs breaks down. That’s my theory anyway.

Re: The Uselessness of Phenylephrine

#565

Post by Madmallard »

Madmallard wrote: post #564
LorenPechtel wrote: post #453

Earlier quoted context omitted.

At least I don't go down the anaphylaxis route. Unless the picture changes I won't have starvation issues, malnutrition is definitely an issue. I'm sure it's going to end up having to go with immune suppression (and I have every reason to suspect that's only going to be a temporary solution) but so far I've been able to avoid that. Never tried the psych stuff. One doctor suggested it but it felt very much like they w…

GDX stool testing was something recommended by an integrative dual resident at ucsd for me. I think if you disturb the flora and lining too badly the normal tolerance mechanism with Tregs breaks down. That’s my theory anyway.

I also had no issue starting and stopping low dose benzos

Re: The Uselessness of Phenylephrine

#566

Post by headsoup »

refurb wrote: post #532
headsoup wrote: post #530

Earlier quoted context omitted.

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

But that's true in general. What's another way to describe the "best doctor in the country"? "Marginally better than the next best option".

If it has a word like 'standard' in it, you would assume there is a measure or definition for that standard, not just 'not the worst.'

Best doctor in the country can quite easily still be "bronze standard."

There's an expectation of quality in saying something is Gold Standard, it's not an entirely arbitrary label.

Re: The Uselessness of Phenylephrine

#567

Post by netizen-936824 »

rootusrootus wrote: post #518
netizen-936824 wrote: post #326

Earlier quoted context omitted.

This is entirely false. You can overdose from ~4 grams of APAP which you can ingest by taking 6 7.5/750 hydrocodone/APAP tablets That's not nearly enough hydrocodone to kill you

That seems low -- 4 grams is the max daily dose for OTC acetaminophen. According to this [1] the minimum single dose toxicity for APAP is more like 7.5 to 12 grams. Finding a value for a lethal hydrocodone dose is more difficult, but I did see 90 mg mentioned. For the dose of Vicodin you specified, 90mg of hydrocodone would correspond to 9 grams of APAP. So it's a race that it looks like either one could win. [1] htt…

>The United States FDA clearly states “severe liver damage may occur if you take more than 4000 mg of acetaminophen in 24 hours.”

>There is no question that the upper threshold on the maximum daily allowed dose of APAP has been the subject of controversy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/

Re: The Uselessness of Phenylephrine

#568

Post by burntoutfire »

xyzzy21 wrote: post #509
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…

Indeed. My experience has been that 75%-90% of US doctors are borderline incompetent and that I can and do routine out-diagnose my own maladies better. Of course this also means I can lead them by the nose to get them to diagnose anything I please. Which is horrifying - they are Epic Fail if I can do that. Admittedly I was at one time planning to become a doctor myself so I ravenously consumed everything about biolog…

The closest we currently get to scientific method in medicine is via double-blind large randomized trials, which is not applicable for a single doctor's practice.

Re: The Uselessness of Phenylephrine

#569

Post by MertsA »

ac29 wrote: post #368
wombatpm wrote: post #340

Earlier quoted context omitted.

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

No one is selling 99.99% grade alcohol as an antiseptic in the US. Its usually 70%. There are additives in ethanol sold as an antiseptic to discourage drinking (various bitterants, not benzene).

No one is selling 70% ethanol as an antiseptic, it's isopropyl alcohol. Those additives in ethanol not intended for consumption are 8 parts acetone and 1.5 parts methyl isobutyl ketone to 100 parts ethanol. There are some rare ethanol based rubbing alcohols sold but the vast majority is isopropyl because it's not just denatured with bitterants, they add toxic substances as well.

Here's the actual formula they have to use that's enshrined in the law. https://www.law.cornell.edu/cfr/text/27/21.49

Re: The Uselessness of Phenylephrine

#570

Post by MertsA »

mardifoufs wrote: post #394
drdeca wrote: post #342

Earlier quoted context omitted.

This makes me wonder if it would have been possible to, instead of using something that causes significant harms to health, instead something which just causes a rather unpleasant experience. But, I guess one important thing is whether such an additive is compatible with the altered substance still being usable for the purpose for which it is being made available. Now, presumably something as simple as “dissolve larg…

They already add a bittering agent to ethanol when it's sold as a disinfectant. It's not toxic, just very unpleasant

Not true, they add a bitterant but if it's in the US they're still required to add acetone and methyl isobutyl ketone as well.

https://www.law.cornell.edu/cfr/text/27/21.49

That formula clearly spells out rubbing alcohol and disinfectants under the authorized uses. It's toxic and unpleasant.

Post reply on HN