Pseudoephedrine/ephedrine/decongestants causing

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... 

Ephedrine Releases NE from sympathetic neurons and can cause amphetaminelike CNS effects. Clinical use decongestant (note similar use of phenylpropanolamine and pseudoephedrine). 

Notably, pseudoephedrine is a diastereomer of ephedrine and considerably racemic ephedrine (dl-ephedrine) has not been found naturally, however, it is prepared synthetically and is inactive for commercial purposes. Ephedrine and pseudoephedrine are completely stable compounds under changing temperature conditions, but they are quite unstable when exposed to sunlight or in the presence of oxygen pressure [2]. The unique molecular structure of ephedrine causes its different stereoisomers to be valuable for pharmaceutical applications such as nasal decongestant, pupil dilator, bronchodilator, and central nervous system stimulant. Ephedrine is a sympathomimetic substance and the principle mechanism of ephedrine activity is its influence, by enhancing the activity of noradren-alin, on post-synaptic a- and (3-receptors in the nervous system. Stimulation of a 1-adrenergic receptors produces contraction of vascular smooth muscle. 

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