Ephedrines occurrence

The main limitation to the clinical use of the MAOIs is due to their interaction with amine-containing foods such as cheeses, red wine, beers (including non-alcoholic beers), fermented and processed meat products, yeast products, soya and some vegetables. Some proprietary medicines such as cold cures contain phenylpropanolamine, ephedrine, etc. and will also interact with MAOIs. Such an interaction (termed the "cheese effect"), is attributed to the dramatic rise in blood pressure due to the sudden release of noradrenaline from peripheral sympathetic terminals, an event due to the displacement of noradrenaline from its mtraneuronal vesicles by the primary amine (usually tyramine). Under normal circumstances, any dietary amines would be metabolized by MAO in the wall of the gastrointestinal tract, in the liver, platelets, etc. The occurrence of hypertensive crises, and occasionally strokes, therefore limited the use of the MAOIs, despite their proven clinical efficacy, to the treatment of atypical depression and occasionally panic disorder. 

Reports, particularly in the European literature, have described the occurrence of renal calculi in chronic ephedrine users (107-111). A review of cases... 

Ephedrine and pseudoephedrine share properties with cocaine and with the amphetamines because they (1) stimulate (3-receptors directly, and (2) also cause the increased release of norepinephrine. Chronic exposure to abnormally high levels of circulating catecholamines can damage the heart. This is certainly the case with cocaine and methamphetamine (116,117), but ephedrine-related cardiomyopathy is an extremely rare occurrence, occurring only in individuals who take massive amounts of drug for prolonged periods of time. Only two papers have ever been published on the subject (118,119). 

Black and Kelley (134) and Peronnet and Chatin (135) reported on the occurrence of ephedrine and -ephedrine in the North-African Ephedra alata Decnc. Massagetov (136) reported on two Russian species, E. equisetina and E. intermedia, as practical sources of ephedrine. 

Hordenine (anhaline, eremursine, peyocactine, 4-[2-(dimethylamino)ethyl]-phenol. For formula, data, and occurrence, see j phenylethylamine alkaloids. H. is biosynthesized from phenylalanine or tyrosine via tyramine and N-methyltyramine. H. is a sympathico-mimetic. It has diuretic effects, at higher doses it increases blood pressure, and is generally similar to ephedrine and tyramine. In addition H. is an antifee-dant for locusts. H. is used as a cardiac stimulant of low toxicity and as a disinfectant in cases of dysentery. Lit. Acta Crystallogr., Sect. C 47,1450 (1991) Beilstein EIV 13. 1790 Hager (5.) 5, 708 f. nj. Nat. Prod. 50, 422 (1987) 53,882 (1990) Karrer, No. 2471 see also phenylethylamine alkaloids. 

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