Live data from Hacker News

The Uselessness of Phenylephrine

science.org

511–520 of 613 posts

Re: The Uselessness of Phenylephrine

#511
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…

I think that's what they ended up doing, post-Prohibition. A bottle of rubbing alcohol from the drugstore is either isopropyl alcohol, which is toxic by itself but not intentionally so, or ethanol mixed with a denaturing agent that's more benign than methanol or whatever they were using back in the day.

Different denaturants for different purposes.

Choose your poison:

27 CFR § 21.151 - List of denaturants authorized for denatured spirits. https://www.law.cornell.edu/cfr/text/27/21.151

Re: The Uselessness of Phenylephrine

#512

Earlier quoted context omitted.

How is this "dangerously close to toxic"? Extra strength is 500mg. Adults should not take more than 3000mg in a day. Taking 7000 more more can lead to liver problems. https://medlineplus.gov/ency/article/002598.htm Common dosage forms and strengths: Suppository: 120 mg, 125 mg, 325 mg, 650 mg Chewable tablets: 80 mg Junior tablets: 160 mg Regular strength: 325 mg Extra strength: 500 mg Liquid: 160 mg/teaspoon (5 mill…

Check your labels more carefully! I just looked at a bottle of it here. Yes, 500mg. Adult dose: 2. That's 1,000mg. Every 6 hours to a maximum of 6 per day. That's 3,000mg/day. Danger at 7,000mg/day means a therapeutic ratio of less than three--nothing like that should be OTC and it's use should be carefully considered.

Ah, but two every 6 hours is 4000 mg/day, and my bottle claims that's safe. When I'm anywhere near that dose, I have a > 102F fever, which means I'm in peak form to compute dosages and timings.

Of course that's over the counter. Prescription strength also exists.

I'm a fan of switching between two pain killers / fever reducers (and only one liver killer), overlapping the effective time window by a few hours, but keeping both at ~50% the recommended max daily dose (a doctor recommended this to me a few years ago).

Of course, that makes the dose schedule more complicated, getting back to the problem it is trying to solve.

Re: The Uselessness of Phenylephrine

#513

Earlier quoted context omitted.

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

He’s definitely wrong. Sometime last year I had a cold and I know pseudoephedrine helps me. I ran out and wanted to buy some at the local cvs. Now, I’m not a US citizen but I’ve been here a few years already and am a permanent resident. I do not have a US state ID or a US driving license, and in my many years it has _never_ been a problem. Everyone was always happy with my green card as my ID - bars, domestic flights…

Makes sense. I stand corrected. I was under the assumption you could use a passport.

Re: The Uselessness of Phenylephrine

#514
post #329

Earlier quoted context omitted.

In my mind it gets worse when the procedure is identified: A difficult shoulder surgery by an orthopedic surgeon gets refused because it might be result in a mediocre outcome and lower his 'success' rate. The patient can't get the surgery because no surgeon wants to 'risk' his success rate numbers.

Seems like a good system to me. If a doctor expects a lower than average success rate for performing some specific operation, he should let some other doctor do it anyway.

If a doctor estimates that this particular patient+disease+procedure combination has a lower chance of success than the average patient who needs a similar category of procedure, then unless they're severely mistaken, every other doctor will also estimate the same way and refuse that difficult case.

Re: The Uselessness of Phenylephrine

#515
post #142
post #113

Earlier quoted context omitted.

Which means it's not available outside of the pharmacist counter's more-limited hours. And there's often an additional line to wait in before acquiring. And, as another thread points out, extra ID requirements. So how exactly do the costs/benefits on this "public policy" sum out? Benefits: • some grandstanding politicians enjoy the superficial appearance of being "tough on meth" Costs: • Americans waste $billions on…

> Larger cross-border criminal organizations – of the kind that regularly murder politicians south-of-the-border – grow in market-share, sophistication, & power. Are you suggesting my neighborhood friendly drug dealer could hook me up with some real sudafed? Might be nicer than trying to get it from the pharmacy when I need it.

Not sure if you're joking, but he's suggesting that if bulk pseudoephedrine were still available, cartel meth wouldn't have 99% of the market like it does today.

Because yeah, your neighborhood dealer would make his own meth and would probably have lots of Sudafed.

Re: The Uselessness of Phenylephrine

#517

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…

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…

Evidence based is good if you can get it. If not things that are suspected or even experimenting with your own body is worth it.

For example if there is no evidence that a better diet or reducing EMF or strength exercise or drinking pure water etc. will help your condition but there is no harm and fairly low cost to try.

Stay sceptical and open minded too.

Re: The Uselessness of Phenylephrine

#518

Earlier quoted context omitted.

I also wonder where the idea that the FDA 'denatures' hydrocodone with acetaminophen comes from. AFAICT, if you overdose on vicodin it's more likely the hydrocodone will kill you before the acetaminophen.

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] https://www.uspharmacist.com/article/acetaminophen-intoxicat...

Re: The Uselessness of Phenylephrine

#519
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.

The cartels end up selling $200 bottles of cough medicine and making more money that way. Then they lobby to keep it illegal.
Post reply on HN