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The Uselessness of Phenylephrine

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Re: The Uselessness of Phenylephrine

#191

Post by VLM »

asdff wrote: post #124
cperciva wrote: post #116

Pseudoephedrine 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…

How did you control for the pseudoephedrine in this experiment?

I'm not OP, but its elimination half life is about six hours, so you'd superficially expect OP's BP to drop in a curve with a half life of six hours after the last dose. It would be really easy to chart with one of those wrist BP monitors and an excel spreadsheet.

Re: The Uselessness of Phenylephrine

#192

Post by ibejoeb »

leetbulb wrote: post #174
ibejoeb wrote: post #79

Earlier quoted context omitted.

You don't just ask the pharmacist for it. You have to produce an acceptable form of identification that can be used to record the transaction in the universal database. It's unavailable to anyone who doesn't have one of those.

If you don't have any form of identification, getting pseudoephedrine from a pharmacy is probably not too high on your to-do list.

I suspect you're wrong. How many people do you think would prefer not having medication to having medication?

Re: The Uselessness of Phenylephrine

#193

Post by sniperjoe360 »

caymanjim wrote: post #162
dataangel wrote: post #146

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…

> 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…

Although perhaps true about FDA clearance, I wouldn't be alarmist and characterize the effective dose as "dangerously" close to the LD50.

The highest dose that therapeutically is used is about 1000mg per dose. The fatal dose is about 15 times that amount.

To put it into perspective, a patient would have to be willfully taking 45 tylenol (325mg/pill) all at once to cause lethal liver damage. Doses like that are usually not accidental.

Re: The Uselessness of Phenylephrine

#194

Post by tpoacher »

dataangel wrote: post #146

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…

It's not just the US, it's pretty much the same everywhere.

Ex-doc here.

Re: The Uselessness of Phenylephrine

#195

Post by petschge »

dataangel wrote: post #146

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…

And now I am reminded of https://dx.doi.org/10.1136%2Fbmj.327.7429.1459 and the fact that there is no randomised controlled trials that show the effectiveness of parachutes either.

Re: The Uselessness of Phenylephrine

#196

Post by munificent »

nostromo wrote: post #115
munificent wrote: post #43

My drug of choice for colds is NyQuil. It's always been great for opening up my nasal passages enough to let me breathe easily and then knocking me the fuck out so I could sleep off most of the cold. I remember several years ago when all of a sudden NyQuil stopped doing anything useful. I had no idea why but I directly observed that it was like it had been replaced with a non-functioning placebo. Only a couple years…

American law is so disjointed. On one hand, we're decriminalizing drugs. Pot is widely legal now. Other states are allowing mushrooms and LSD. Cocaine and heroin are not legal, but have all but been decriminalized on the West Coast. Meanwhile it's harder than ever to get pain killers from your doctor, even when you have a demonstrated need for them. Same with ephedrine -- a very useful drug -- it's very difficult to…

It's not inconsistent to treat different things differently and different drugs are radically different in their individual health and societal effects.

I live in Seattle where marijuana is legal. Alcohol and marijuana are widely consumed and I rarely see any large-scale problems from it. Obviously, there are many people who can't handle either of those, but their failure to handle it well seems to not impinge on others as much. And, compared to them, there are a huge number of people able to consume alcohol and marijuana in a safe, healthy, non-problematic way.

I also live next to a couple of homeless encampments. Many of the people living there are clearly addicted to opioids and/or meth. In just this month and within a mile of my house:

* I saw a woman, topless, brandishing an umbrella, wandering between the sidewalk and into the street screaming at no one.

* A man was shot in the stomach in front of a food bank.

* Another man was shot in the neck at an encampment.

* A drive-by shot up an RV and car. (The people inside fortunately weren't hit.)

There's more I'm sure but these are just the ones I know about in the last few weeks.

It's entirely consistent to say that we should treat drugs that lead to the latter behavior differently from drugs that don't. Opioids and meth are incredibly destructive. I'm not saying what specific policies I advocate for them, just that it is reasonable to have different policies for those drugs compared to others.

Re: The Uselessness of Phenylephrine

#197

Post by cperciva »

asdff wrote: post #124
cperciva wrote: post #116

Pseudoephedrine 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…

How did you control for the pseudoephedrine in this experiment?

I stopped taking pseudoephedrine and the following day my blood pressure was back to normal.

Re: The Uselessness of Phenylephrine

#198

Post by munificent »

fullstop wrote: post #114
munificent wrote: post #43

My drug of choice for colds is NyQuil. It's always been great for opening up my nasal passages enough to let me breathe easily and then knocking me the fuck out so I could sleep off most of the cold. I remember several years ago when all of a sudden NyQuil stopped doing anything useful. I had no idea why but I directly observed that it was like it had been replaced with a non-functioning placebo. Only a couple years…

This works for one or two nights with me, and then it feels like I've built up a tolerance to it and I think that it actually keeps me awake. I'll use it if I have a cough which keeps me awake, and, if I time it right, I'm pretty good at recovering within a day or two.

Yes, I have the exact same response. If I take it more than a few days, I'll get a rebound effect.

My strategy is to take it full strength for a day or two and then taper it off gradually for the next few days after that.

Re: The Uselessness of Phenylephrine

#200

Post by somebodynew »

rootusrootus wrote: post #149
somebodynew wrote: post #82

Earlier quoted context omitted.

The ID check isn't for age verification. Federal law requires IDs to be recorded* to enforce restrictions on the maximum quantity that an individual is permitted to purchase per month. * Edit: Where the word "recorded" appears, this comment previously said "scanned and submitted to a central database". While most states use a central database, the comment reply below pointed out that this goes beyond the minimum that…

I am not aware of a centralized federal database. My understanding is that federal regulations stipulate that the pharmacy must see photo ID and take note of who bought the pseudoephedrine, when, how much, and keep that information logged either on paper or electronically. To be available to law enforcement on request. The Oregon law does have a central database requirement, however I believe this is in all cases a d…

You are correct, I was conflating two separate steps of the process. Federal law only requires keeping records and these could technically be done on paper. In practice, more than two thirds of the states participate in a central electronic database called the National Precursor Log Exchange.
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