Asthma ephedra

Ephedrine and pseudoephediine are a vasodilator and decongestant respectively used widely in the treatment of asthma and the symptoms of colds and influenza. These pharmaceuticals were derived originally fi om the plant Ephedra sinica and used in traditional Chinese medicinal preparations. Although some are still produced fi om such sources, the major production is via a fermentation process followed by a chemical catalytic reaction. As shown in Figure 1, the intermediate / -phenylacetylcarbinol (PAC) is produced by decarboxylation of pyruvate followed by ligation to benzaldehyde. 

Ma Huang (Ephedra sinica) is another potentially harmful herb that is available in the United States. Claims of utility of Ma Huang for the treatment of bronchial asthma, cold and flu symptoms, fevers or chills, headaches and other aches, edema, and lack of perspiration have been made [23], Ma Huang contains approximately 1% of ephedrine and therefore possesses central nervous stimulatory potential [24], However, ephedrine is difficult to extract and purify from Ma Huang, so it presently has no street value. 

Ephedrine is the main alkaloid produced in the roots of Ephedra sinica, preparations of which have found medical application in China for at least 5000 years. It was first purified from its natural source in 1887, and its chemical synthesis was achieved in 1927. It was initially used in cardiovascular medicine, but subsequently found wider application in the treatment of mild hayfever and asthma. It is also used as a nasal decongestant and cough suppressant. 

Ephedra (ma huang) is a popular botanical incorporated into a variety of formulations for weight loss, energy or performance enhancement, and symptomatic control of asthma. A pharmacodynamic interaction leading to a fatality has been reported with concurrent use of caffeine and ephedra (62), possibly as a result of additive adrenergic agonist effect of the ephedrine alkaloids and caffeine on the cardiovascular system and the CNS (63). Ephedra was recently withdrawn from the market (64). 

Ephedra distachya L. China 1-ephedrine, 1-methylephedrine, 1-norephedrine, methylephedrine, d-pseudoephedrinem, d-N-methy lpseudoephedrine. 30-3133 This herb is toxic. Treat asthma, sympathomimetic action, relieve headache, body ache, and coughing, lower fever by increasing perspiration. 

N.A. Ephedra nevadensis Wats. Pseudoephedrine, 1-ephedrine, d-pseudoephedrine.100 A decongestant and asthma remedy, for hypertension, hay fever. 

This alkaloid was first isolated from Ephedra equisetina, a plant (ma huang) that has been used as medicine by the Chinese since antiquity. Most of the present supply is probably synthetic. Its chemical structure is closely related to epinephrine and tyramine, and differs from epinephrine chiefly by the absence of the two phenolic hydroxyls. Its effects on the circulation, intestines, bronchi, iris, etc., are superficially similar to those of epinephrine. It requires that larger doses be given but they are more lasting, due probably to ephedrine s much greater stability and resistance to oxidation. The effects can be produced by oral administration. Unlike epinephrine, it is not sensitized by cocaine or by denervation. From this, it has been argued that its point of attack is not sympathomimetic but muscular. It also stimulates the CNS. A number of isomers with similar actions are known. Ephedrine is used therapeutically in hay fever and asthma, in which it is less... 

Despite suffering from asthma, Wheeler had succeeded in the tough world of college football. After Wheeler collapsed, he was taken away in an ambulance, and another player informed coaches that Wheeler had taken Ultimate Orange, an ephedra supplement. Trainers and paramedics tried to help Wheeler catch his breath with his inhaler. Unfortunately, the inhaler did not help and Wheeler died. 

Ephedra. Ephedras are leafless bushes that grow in deserts throughout the world. They are related to pine trees and bear tiny cones. Several species contain the drug ephedrine, a stimulant and a remedy for asthma. American ephedra, found throughout the western United States, is known as Mormon tea because early... 

The isoquinoline alkaloids are the second largest group of alkaloids, numbering about 6000, and can be viewed as five subgroups—the simple tetrahydroisoquinolines, the benzylisoquinolines, the phenethylisoquinolines, the Amaryllidaceae alkaloids, and the monoterpene isoquinolines. In addition, there are a number of simple phenethylamine derivatives, including ephedrine (originally from Ephedra species, but now synthesized) and pseudoephedrine, used for asthma and nasal... 

The medicinal use of Ephedra sinica in China dates from 2800bc. Ma Eluang (the stem and branch) was used primarily in the treatment of common cold, asthma, hay fever, bronchitis, edema, arthritis, fever, hypotension, and urticaria. Ephedra has been used to treat bronchoconstriction for centuries, because of its activity at /li-adrenergic receptors. It contains pseudoephedrine, ephedrine, and other similar alkaloids. These are sympathomimetics that either directly or indirectly stimulate a- and jS-adrenergic receptors. It has become less extensively used with the advent of more selective agonists. 

Taking ephedra along with other drugs If taken with other drugs simultaneously, ephedra may cause serious complications. Antidepressants, allergy, asthma, or cold medications containing ephedrine, pseudoephedrine or phenylpropanola-... 

Since there are two possible configurations for an asymmetrically substituted carbon atom, a structure containing n such centres will, in theory, possess 2 stereoisomers. The actual number of stereoisomers that exist may be less than this due to steric effects. Compounds that have the same stereochemistry at one chiral centre but different stereochemistry at the others are known as diastereoisomers (diastereomers) a good example is given by the alkaloids ephedrine and pseudoephedrine. Ephedrine (the (1R, 2S) diastereoisomer) is a natural product isolated from Ephedra (the Ma Huang plant) and known to Chinese medicine for over 3000 years. It was used in the last century for the treatment of asthma. Pseudoephedrine (the (IS, 2S) diastereoisomer) is a decongestant and a constituent of several over-the-counter cold and flu remedies (Figure 4.12). 

For many centuries, the Chinese have used extracts from a group of herbs known as ephedra to treat asthma. Chemists have been able to isolate a compound from these herbs, which they named ephedrine, a potent dilator of air passages in the lungs. 

Pharmacology The actions of ephedra products are those of ephedrine and pseudoephedrine, which release norepinephrine from sympathetic nerve endings. In addition to nasal decongestion, the established clinical use of ephedrine is as a pressor agent Ephedra herbal products are commonly used for treatment of respiratory dysfunction (including bronchitis and asthma) and as mild CNS stimulants. In Chinese medicine, ephedra products are also used for relief of cold and flu symptoms, for diuresis, and for bone or Joint pain. 

The male client is scheduled for an elective surgical procedure. While in the preoperative waiting area he tells the nurse he is taking ephedra, which he says really helps his asthma. Which action should the preoperative nurse implement ... 

For centuries, Chinese herbal medicine has used extracts of Ephedra s/n/cato treat asthma. Investigation of this plant resulted in the isolation of ephedrine, a potent dilator of the air passages of the lungs. The naturally occurring stereoisomer is levorotatory and has the following structure (See Example 6.2)... 

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