Ephedrine hypertension caused

Ephedrine may cause hypertension resulting in intracranial hemorrhage. It may induce anginal pain in patients with coronary insufficiency or ischemic heart disease. Large doses of inhaled or oral salmeterol (12 to 20 times the recommended dose) have been associated with clinically significant prolongation of the QTc interval, which has the potential for producing ventricular arrhythmias. 

Additive sympathomimetic effects may develop when decongestants are administered with other sympathomimetic drug s (see Chap. 22). Use of the nasal decongestants with the MAOIs may cause hypertensive crisis. Use of a decongestant with beta-adrenergic blocking dragp may cause hypertension or bradycardia. When ephedrine is administered with theophylline, the patient is at increased risk for theophylline toxicity. 

Ephedrine may negate the antihypertensive effects of guanethidine and may potentiate the pressor effects of MAO inhibitors causing hypertensive crisis and intracranial hemorrhage. 

Among the materials which may be dangerous in combination with MAO inhibitors are sedatives, tranquilizers, antihistamines, narcotics, and alcohol -- any of which can cause hypotensive crisis (severe blood pressure drop) and amphetamines (even diet pills), mescaline, asarone, nutmeg (active doses), macromerine, ephedrine oils of dill, parsely or wild fennel beer, wine, cocoa, aged cheeses, and other tyrosine-containing foods (tyrosine is converted into tyramine by bacteria in the bowel) -- any of which can cause hypotensive or hypertensive (severe blood pressure rise) crises. 

SYMPATHOMIMETICS CYTOTOXICS -PROCARBAZINE Co-administration of ephedrine, metaraminol, methylphenidate, phenylephrine or pseudoephedrine (including nasal and ophthalmic solutions) with procarbazine may cause a prolongation and t intensity of the cardiac stimulant effects and effects on BP, which may lead to headache, arrhythmias, hypertensive or hyperpyretic crisis The metabolism of sympathomimetics is impaired due to an inhibition of MAO It is recommended that sympathomimetics not be administered during and within 14 days of stopping procarbazine. Do not use any OTC nasal decongestants (sprays or oral preparations) or asthma relief agents without consulting the pharmacist/doctor... 

Sympathomimetic syndromes include tachycardia, hypertension, hyperthermia, sweating, mydriasis, hyperreflexia, agitation, delusions, paranoia, seizures and cardiac arrhythmias. These are commonly caused by amphetamine and its derivatives, cocaine, proprietary decongestants, e.g. ephedrine, and theophylline (in the latter case, excluding psychiatric effects). 

Antidepressants monoamine oxidase inhibitors can cause hypertension when combined with certain amines, e.g. pethidine, or indirect-acting sympa-thomimetics, e.g. ephedrine. Tricyclics potentiate catecholamines and some other adrenergic drugs. 

Sympathomimetics (indirectly acting) Combining MAOis with agents such as amphetamines, cocaine, ephedrine, methylphenidate, pemoline, pseudoephedrine, phenylpropanolamine, and others (including many cold and allergy medications) can cause a potentially fatal hypertensive crisis. 

By the mechanisms mentioned above, it is possible to correlate the clinical effects observed with the use of ephedrine, as well as to establish the possible effects before the consumption. The use of ephedrine in therapeutic doses raises the blood pressure by increasing cardiac output and also by inducing peripheral vasoconstriction. It may cause tachycardia. Its action on p- adrenergic receptors in the heart produces a positive ionotropic effect. Ephedrine has a stimulant action on the respiratory center. It also causes bronchodilatation, reduces intestinal tone and motility, and usually reduces the activity of the uterus. Its effects on a-adrenergic receptors results in vasoconstriction in the skin and mucous membranes [12], leading to hypertension, which may produce cerebral hemorrhage and pulmonary edema. 

Ephedrine, pseudoephedrine, and norpseudoephedrine are now produced primarily by synthesis. Ephedrine is used as a bronchodilator for treating the symptoms of asthma and for treating coughs. Pseudoephedrine and norpseudoephedrine are used for the same purposes and are included in formulae for over-the-counter remedies for treating symptoms of the common cold. All three of these alkaloids cause a rise in blood pressure and this is a deterrent to their use in patients with hypertension. 

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