Nasal decongestant ephedrine

Nasal decongestants (ephedrine, Tachycardia Nonselective activation of... 

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 An amphetamine-like drug used as a nasal decongestant. 

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. 

Ephedrine is found in the ephedra plant (Ephedra sinica— the Chinese herb Ma Huang). It is used as a nasal decongestant... 

Ephedrine is useful for the treatment of chronic and moderate type of bronchial asthma, used as nasal decongestant and as a mydriatic without cycloplegia. It is also useful in preventing ventricular asystole in Stokes Adams syndrome. It is also used in narcolepsy, however amphetamines are the drug of choice. 

Nasal Decongestants for Systemic Use Sympathomimetics (pseudoephedrine, phenylpropanolamine, phenylephrine) and structural analogues (epinephrine, ephedrine)... 

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... 

A stimulant that affects the nervous system, ephedrine has been used for decades as a component of nasal decongestants and asthma treatments. Ephedrine is also well known in athletic circles for its performance-enhancing properties. It causes high blood pressure and elevated heart rate, and is believed to increase the metabolism of those taking it for extended periods of time. This gives athletes more energy and allows calories to be burned more quickly. 

Amphetamine was the first anorectic drug to be introduced into clinical practice. It was originally synthesised in the 1920 s as a potential substitute for ephedrine and marketed under the trade name of Benzedrine for use as a nasal decongestant. Initially, it was thought to have very little, if any, effect on the central nervous system. However, within a relatively short time it was noted that, in contrast to what had first been thought, amphetamine had pronounced stimulant and mood elevating properties. 

Cocaine alkaloid is still occasionally used as an olive oil solution for minor otic surgery. Ephedrine was once available as a nasal decongestant in mineral oil solutions. 

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. 

Pseudoephedrine, as previously discussed, is the three diastereomer of ephedrine, with virtually no direct activity and fewer CNS side effects than ephedrine. (+)-Pseudoephedrine is widely used as a nasal decongestant. 

Ephedrine and pseudoephedrine (2-methylamino-l-phenylpropan-l-ol) are natural epimeric amino alcohols extracted from various species of the family of plants Ephedra. These plants have been used for millennia in China as stimulants and nasal decongestants. The structures of natural (—)-ephedrine and (+)-pseudoephedrine are depicted in Figure 3.3. The figure also shows norephedrine, which is the nitrogen-unsubstituted counterpart of ephedrine. These compounds are nowadays commercially available as inexpensive crystalline white solids and have been extensively used in phosphorus chemistry, as detailed in the next sections. 

Ephedrine is a sympathomimetic or central nervous system stimulant. It is a potent stimulator of a, pi and p2 adrenergic receptors. The effects include vasoconstriction, raised blood pressure and pulse, bronchodilation and diuresis. Ephedrine-based drugs are used as nasal decongestants, bronchodilators and in anaphylactic shock. In excess they cause insomnia, tachycardia and dizziness. 

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