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

The Uselessness of Phenylephrine (2022)

science.org

Post reply on HN
Print view View original

121–130 of 350 posts

Re: The Uselessness of Phenylephrine (2022)

#121

Post by phone8675309 »

tptacek wrote: post #97
kstrauser wrote: post #85

Earlier quoted context omitted.

For me, it’s a matter of it’s none of their business . No one’s accused me of making meth, but here’s all my PII in a database “just in case”. It’s literally harder for me to buy cold medicine than a gun. I hate everything about that situation.

I mean, the reason they keep the database is especially clear here, right? They're just trying to enforce a rate limit. It's the most obvious public policy response you can have to "a drug that in small quantities is a useful decongestant, but in moderate quantities or above is an ultra powerful stimulant whose abuse is ravaging parts of the country".

The primary question to me is whether the risk of data breech outweighs the harm from not keeping the data, and while 20 years ago this tradeoff may have made sense, I'm not so sure it makes sense now.

Re: The Uselessness of Phenylephrine (2022)

#122

Post by underlipton »

akira2501 wrote: post #66
jimmaswell wrote: post #60

Earlier quoted context omitted.

And now we've got a fentanyl epidemic filling the void and even more power handed to Mexican cartels since meth got harder to produce domestically. Drugs continue to win the war on drugs.

You can't fight a war against inanimate objects. You can fight a war against drug addicts. You cannot possibly win a war against drug addicts without addressing the fundamental problem.

The "fundamental problem" is the breakdown of community (drug abuse being primarily being a function of the existence or lack of interpersonal involvement and responsibilities that would preclude spending time and money on them). People who are comfortable huddling in their cars, homes, and exclusive social clubs, and who would rather spend money on cops rather than social programs, aren't going to like the fix for that.

Re: The Uselessness of Phenylephrine (2022)

#123

Post by jrockway »

kstrauser wrote: post #78
jrockway wrote: post #44

Earlier quoted context omitted.

I think that people are hoping for larger effects. I have been a lifelong allergy sufferer. Many years ago, my doctor gave me an intranasal antihistamine. It came with a piece of paper about the studies done on it. Patients rated their symptoms on a 1-5 scale, and the study observed the ratings with and without. The placebo group rated their symptoms, say, 4.0. The people on the drug rated them 3.5. I would say that'…

Huh, that’s an interesting point and I bet there’s something to it. I’m taking OTC allergy meds right now but still have some symptoms; it’s not an instant and complete cure. Anyone who expects an instant improvement from most kinds of medicines is going to be sorely disappointed, and doctors need to diligently explain that such-and-such will help a problem, not immediately fix it altogether.

Yup, exactly. OTC allergy meds are often an improvement; I certainly notice if I forget to take them. But it's not like my nose turns into the air-intake equivalent of one of those helicopters that sucks up water for fighting forest fires. Such a technology may not exist ;) (That said, pseudoephedrine is pretty good for me on the worst days.)

Re: The Uselessness of Phenylephrine (2022)

#124

Post by AlbertCory »

the_sleaze9 wrote: post #115
AlbertCory wrote: post #92

Public service announcement: sinus rinse (e.g. NeilMed) works. Available in every drug store with no prescription or pharmacist involvement necessary. It's gross, though. Do it in private.

I have swollen nasal polyps (or something) which causes every single cold I get to eventually transform into a 2 week sinus infection + cough ordeal. Netty pot with salty water and a pinch of baking soda, and an even saltier water gargle clears things up nicely. And is very budget friendly.

It was when I had the mother of all sinus infections that someone told me about this. Never had the problem again. YMMV.

People imagine it must burn, because getting water up your nose when swimming burns. But the salt & baking soda neutralizes that.

Re: The Uselessness of Phenylephrine (2022)

#125

Post by MockObject »

JoeAltmaier wrote: post #77
akira2501 wrote: post #66

Earlier quoted context omitted.

You can't fight a war against inanimate objects. You can fight a war against drug addicts. You cannot possibly win a war against drug addicts without addressing the fundamental problem.

Most of us cannot make these drugs ourselves. To restrict them effectively would certainly curtail their abuse?

Hard drugs have been illegal in America for generations, and yet every city has had a junkie community all this time. How much more failure must we entertain?

Re: The Uselessness of Phenylephrine (2022)

#127

Post by tech_ken »

rscho wrote: post #116

Phenylephrine is ineffective when taken orally. It is super effective topically or iv. I can definitely tell, because it's the most commonly used vasopressor used under anaesthesia (iv). Also used topically to avoid nosebleeds during nasal intubation.

Curious about how this aligns with the bioavailability point discussed in the article. Presumably if the gut lining is where the bulk of metabolism occurs then IV sidesteps this and increase the bioavail drug, leading to improved efficacy.

Re: The Uselessness of Phenylephrine (2022)

#128

Post by MockObject »

scarface_74 wrote: post #89
onco wrote: post #81

Earlier quoted context omitted.

Ehh. Your experience is similarly anecdotal. You ignore that there is a placebo effect, blood pressure is a surrogate marker for cardiac events, and drugs can have adverse effects. It’s best to look at all cause mortality in your example. Many studies have looked at that endpoint if you are curious.

It’s “anecdotal” that I can measure with a machine that gives a number and that I track over a period time? It’s not like I said “I feel better” when taking it. So my blood pressure just magically comes down after I’m taking it?

What did you think "anecdote" means? Why wouldn't your individual report of your meter measurements count? You haven't shown us the data, shown that you've controlled for confounding factors, or anything.

You posted an anecdote.

Re: The Uselessness of Phenylephrine (2022)

#130

Post by saulpw »

nonethewiser wrote: post #83
jawns wrote: post #33

I laughed out loud when I read about the lobbyists who are trying to keep phenylephrine from being taken off store shelves. In one article about the FDA panel vote, a lobbyist said that most consumers hate the alternatives -- nasal sprays because of the discomfort and pseudoephedrine because it's stored behind the pharmacy counter -- and so depriving them of a hassle-free option is anti-consumer. The fact that the ha…

I always assumed that was the whole point. A placater. This probably isn’t even news to them.

I believe the official word is "placebo" :)
Post reply on HN