Cold medication

Methamphetamine is synthesized, or cooked, by a simple chemical reaction from its precursor pseudoephedrine (Figure 2.3), a stimulant commonly found in over-the-counter allergy and cold medications (such as Sudafed ). Because methamphetamine is made relatively easily from pseudoephedrine, many pharmacies and drug stores now restrict the amount of pseudoephedrine-containing medications that individual customers can buy to avoid the possibility of stockpiling pseudoephedrine for the purpose of making methamphetamine. Meth dealers and makers in the United States have also been... 

Chlorpheniramine (Chlor-Trimeton, etc) 4-8 mg + Slight sedation common component of OTC "cold" medication... 

Sharfstein 3M, North M, Serwint JR. Over the counter but no longer under the radar—pediatric cough and cold medications. N Engl J Med 2007 357 232. 

Neal, Jordan, and Carol Kaufmann. A Fatal Combination Brother s Misuse of Prescription Drugs. Reader s Digest 173 (October 2008) 19. Along with facts and arguments, evidence of the seriousness of prescription drug abuse comes from real-life stories. In this article, Jordan Neal tells of the death of her brother from a combination of a cold medication, OxyCon-tin, and alcohol. 

DXM is the active ingredient found in OTC cough and cold medications. When taken in recommended doses, these medications are safe and effective. 

A chemical cousin of ephedrine, pseudoephedrine (Figure 5.2b) is found in many allergy and cold medications, such as Sudafed and Actifed , and acts to open nasal passages and sinuses to clear nasal congestion. Pseudoephedrine is also a nervous system stimulant—it is much less potent than... 

Anonymous, Police are alarmed by abuse of cold medication, Union Leader, Manchester, NH, p. B3, December 10, 2002. 

MAOIs frequently are not the first choice when an antidepressant is needed. This is because their side effects include sedation, dizziness, insomnia, sexual dysfunction, rapid heartbeat, constipation, and agitation. Severe sudden elevation of blood pressure, especially when the patient eats aged meats and cheeses, or takes some over-the-counter cold medications, poses a serious threat of a stroke or other symptoms including headache, vomiting, and palpitations. 

N. Kikuchi and T. Ohhata, High-performance liquid chromatography for pharmaceutical analyses. II. Major components in commercial cold medications, Iwate-Ken Eisei Kenkyusho Nenpo, 26 61 (1983). 

In 1995, CHADD also had smaller grants from Abbott Laboratories ( 37,000) and Burroughs Wellcome ( 18,000). Abbott is the manufacturer of the stimulant pemoline (Cylert), used to treat ADHD. Burroughs Wellcome makes several medications used in pediatric medicine, including well-known antibiotics and cold medications. They also make the highly stimulating antidepressant Wellbutrin. 

Scenario Let s imagine an advertising agency that has the opportunity to land a multimillion dollar client who wants to launch a new product (over-the-counter common-cold medication). The client wants to know what the... 

Smith, M.B. Feldman, W. Over the counter cold medications a critical review of clinical trials between 1950 and 1991. J. Am. Med. Assoc. 1993, 269, 2258-2263. 

Burton, B.T. Rice, M. Shmertzler, L.E. Atrioventricular block following overdose of decongestant cold medication. 

Caffeine is used as a central nervous system (CNS) stimulant, anorexiant, diuretic, and in a number of analgesic and cold medication compounds. It is also used in the treatment of spinal headaches and has been used as a respiratory stimulant in preterm infants. 

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-... 

Avoid taking barbiturates, tricyclic antidepressants, antihistamines, central nervous system depressants, and OTC cold medications with MAOIs. 

Immunoassays may not be specific for the tested drug. Similar drugs may result in a positive test for example, pseu-doephedrine, present in cold medications, may produce a positive response in immunoassays designed to detect amphetamine and methamphetamine. Therefore it is imperative that positive screening tests be confirmed by an alternate, more definitive test. The most widely accepted method for drug confirmation is GC-MS. For further discussion of this technique, the reader is referred to Chapter 7. Liquid chromatography-tandem mass spectrometry is also used for rapid detection of drugs of abuse. 

Phenylpropanolamine (PPA). Until recently, PPA was widely available in a number of nonprescription cold medications and diet control products. Adverse effects are similar to those described for ephedrine. In response to an FDA warning of increased risk of hemorrhagic stroke, especially in women, PPA has been withdrawn from the market by most manufacturers. Before this withdrawal, PPA was another popular starting product for synthesis of S(-f-)-methamphetamine. PPA is also a metabolite of ephedrine and pseudoephedrine. 

Josephs, J.L. Characterization of Over-the-Counter Cough/Cold Medications by Liquid Chromatography/Electrospray Mass Spectrometry, Rapid Commun. Mass Spectrom. 9, 1270-1274 (1995). 

Overdose of M blockers Poisoning most commonly follows excessive ingestion of over-the-counter (OTC) antihistamines and cold medications, or attempts to induce hallucinations. Note that M-blocking side effects (and possible toxicity) occur with both tricyclic antidepressants and phenothiazines. Management is largely symptomatic, although physostigmine can be seful and may counter both peripheral and central effects. 

Ethanol has been used widely as a beverage, a medicinal, and a solvent in numerous pharmaceutical preparations. Such common usage often overshadows the fact that ethanol is a toxic substance. Ethanol consumption is associated with a variety of long-term effects, including cirrhosis of the Uver, death of brain cells, and alcoholism. Alcohol consumed by the mother can even affect the normal development of her unborn child and result in fetal alcohol syndrome. For these reasons, over-the-counter cough and cold medications that were once prepared in ethanol are now manufactured in alcohol-free form. 

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