Cold medicines

Alka-Seltzer Plus Cold Medicine—phenylephrine HC1, chloqiheniramine maleate, acetaminophen Decodult Tablets—pseudoephedrine HC1, chloqihen-iramine maleate, acetaminophen Rblephrin Tablets—pseudoephedrine HC1, chloqihen-iramine maleate, acetaminophen Simplet Tablets—pseudoephedrine HC1, chloqihen-iramine, acetaminophen... 

TheraFlu Flu and Cold Medicine Original Formula Fbwder—pseudoephedrine HC1, chlorpheniramine maleate, acetaminophen... 

Achiral-chiral chromatography has also been accomplished using subcritical fluid chromatography (Phinney et al., 1998). In this work, the structurally related [3-blockers, 1,4-benzodiazepines, and two cold medicines were separated using methanol or ethanol modified carbon dioxide mobile phases. The (3-blockers were separated using cyanopropyl and Chiracel OD columns connected in series. Likewise, an amino bonded phase and Chiracel OD column were used for the separation of the 1,4-benzodiazepines. Guaifenesin and phenylpropanolamine from cough syrup were separated on cyanopropyl and Chiralpak AD columns in series. 

FIGURE 9.4 Analysis of cold medicine formulations containing active ingredients, impurities, and counterions. (Courtesy of Waters Corp.)... 

Fig. 9 Separation of a range of cold medicine ingredients. For the microemulsion compositions, see Table 10. (From Ref. 27.)... 

Cold medicine ingredients 1.66 SDS, 0.81% heptane, 6.61% butane-l-ol, borate-phosphate buffer, pH 7 9, 27... 

Cough and Cold Medicine Use in Children, http //www.fda.gov/cder/drug/advisory/cough cold 2008.htm... 

Similarly, some OTC medications, such as cough and cold medicines containing dextromethorphan, have beneficial effects when taken as recommended but they can also be abused and lead to serious adverse health consequences. Parents should be aware of the potential for abuse of these medications, especially when consumed in large quantities, which should signal concern and the possible need for intervention. 

Stimulants should not be mixed with antidepressants, which may enhance the effects of a stimulant or with OTC cold medicines containing decongestants, which may cause blood pressure to become dangerously high or may lead to irregular heart rhythms. 

By definition, any medication you can buy at your local pharmacy or grocery store without a prescription—cold medicines, pain relievers, sleep aids—is considered an over-the-counter (OTC) medication. 

Figure 5.2b The chemical structure of pseudoephedrine. Pseudoephedrine is found in many allergy and cold medicines.

Seyfer, J. and Wong, N.C., Cold medicine crusade, San Jose Mercury News, California, p. B1, February 17, 2003. 

The biological consequences of molecular shape can be dramatic. Look at the structures of dextromethorphan and levomethorphan, for instance. (The Latin prefixes dextro- and levo- mean "right" and "left," respectively.) Dextromethorphan is a common cough suppressant found in many over-the-counter cold medicines, but its mirror-image, levomethorphan, is a powerful narcotic pain-reliever similar in its effects to morphine. The two substances are chemically identical except for their shapes, yet their biological properties are completely different. 

This drug is produced legally in countries such as Brazil, Colombia, Ecuador, Mexico, and Peru. It is frequently smuggled into the country disguised as vitamins or in its original packaging as cold medicine. Flunitrazepam is not approved in the United States, but is has been used widely in Texas, and is readily available in Miami, Florida, where it is a growing problem. 

One of the side effects of fentanyl is drowsiness, so any other medication that causes drowsiness can greatly increase this effect in a user. For this reason, users of fentanyl must not consume alcoholic beverages, because a user can fall asleep quickly and possibly depress the user s respiratory system even more. Some medications to be avoided include barbiturates, antidepressants, tranquilizers, muscle relaxants, and antihistamines used in some cold medicines. 

Furthermore, 28 (46%) of the 61 patients in whom the presence or absence of a cold was recorded had caught a cold prior to exercise, and 23 (34%) of 68 patients took cold medicine or antipyretic analgesics (Fig. 47). 

ALCOHOL ANTIHISTAMINES t sedation with sedating antihistamines Additive effect Warn patients about this effect. Remember that cold medicines as well as allergy pills may well contain antihistamines... 

The ephedra alkaloids are all sympathomimetic amines, which means that a host of drug interactions are theoretically possible. In fact, only a handful of adverse drug interactions have been reported in the peer-reviewed literature. The most important of these involve the monoamine oxidase inhibitors (MAOI). Irreversible, nonselective MAOIs have been reported to adversely interact with indirectly acting sympathomimetic amines present in many cough and cold medicine. In controlled trials with individuals taking moclobemide, ephedrine s effects on pulse and blood pressure were potentiated, but only at higher doses than those currently provided in health supplements (137). Ephe-drine-MAOI interaction may, on occasion, be severe enough to mimic pheo-... 

As well intentioned as these new regulations are, they are not without their own problems. According to journalist Sarah Fenske of the Phoenix New Times, Arizona s government was convinced that if they cut the supply of the ingredients used to make crystal meth—namely, OTC cold medicines—the demand would drop as well. 

But when a law went into effect that regulated all cold medicines containing pseudoephedrine—one of the key ingredients meth cooks use—the results took them by surprise. Under the new law, everything from Sudafed to Tylenol Cold has to be kept behind the counter, and customers must sign a logbook that is faxed monthly to the police. 

Figure 33-1 5 Typical separation by MECC. (a) Some test compounds 1 = methanol, 2 = resorcinol, 3 = phenol, 4 = p-nitroaniline, 5 = nitrobenzene, 6 = toluene, 7 = 2-naphthol, 8 = Sudan III capillary, 50-p.m inside diameter, 500 mm to the detector applied voltage, ca. 15 kV detection UV absorption at 210 nm. (b) Analysis of a cold medicine 1 = acetaminophen, 2 = caffeine, 3 = sulpyrine, 4 = naproxen, 5 = guaiphenesin, 10 = noscapine, 11 = chloropheniramine and tipepidine applied voltage, 20 kV capillary, as in (a) detection UV absorption at 220 nm. (From S. Terabe, Trends Anal. Client., 1989,8, 129.)...

Representative applications of small-molecule pharmaceuticals included in this section are antibiotics, barbiturates, flavonoids, vitamins, basic drugs, cold medicines, and corticosteroids. An MEKC method was validated according to... 

B Yang, J Mo, X Yang, L Wang. Separation and determination of chlorphenamine maleate, acetaminophen and vitamin C of cold medicines by capillary electrophoresis with amperometric detection. Sepu 17 477-479, 1999. 

M Katoka, M Imamura, K Nishijima, K Nishi. Simultaneous determination method for the active ingredients in cold medicines by capillary electrophoresis. Iyakuhin... 

H Nishi, T Fukuyama, M Matsuo, S Terabe. Effect of surfactant structures on the separation of cold medicine ingredients by micellar electrokinetic chromatography. J Pharm Sci 79 519-523 1990. 

Each dose of a nighttime cold medicine contains 1000 mg of the analgesic acetaminophen. Acetaminophen, or N-acetyl-p-aminophenol, has the general formula CgHgNO. 

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