Pseudoephedrine interactions

Higher differences for the interaction of both the biological and the synthetic receptors with the two enantiomers are found for the propanol-derivatives than for the ethanol-derivatives (Norephedrine, Metaraminol vs. Octopamime, Noradenaline Pseudoephedrine, Ephe-drine vs. Synephrine, Adrenaline). 

Many commonly used medications also contain substances that are eliminated by the MAOIs and must not be taken by these patients. The list of medications to be avoided inclndes the narcotic pain reliever meperidine (Demerol), and many over-the-connter cold remedies containing dextromethorphan or pseudoephedrine. Finally, patients taking MAOIs must also avoid medications that elevate serotonin levels. This inclndes certain appetite snppressants and antidepressants including the SSRIs, venlafaxine, duloxetine, mirtazapine, nefazodone, and trazodone. Medications that interact with the MAOIs cannot be taken until at least 2 weeks after the MAOI has been stopped. 

Pseudoephedrine (Sudafed, Novafed, Afrinol, Others) [OTC] [Decongestant/Sympothomimetic] Uses Deconge tant Action Stimulates a-adren gic rec tors w/ vasoconstriction Dose Adults. 30-60 mg PO q6—8h Peds. 4 mg/kg/24 h PO qid -1- in renal insuff Caution [C, +] Contra Poorly controlled HTN or CAD, w/MAOIs Disp Tabs, caps, Liq SE HTN, insomnia, tach, arrhythmias, nervousness, tremor Interactions T Risk of HTN crisis W/ MAOIs T effects W/BBs, sympathomimetics X effects W/TCAs -1- effect OF methyldopa, reserpine EMS Found in many OTC cough/cold pr >arations use sympathomimetics w/ caution, may T adverse effects OD May cause N/V, HTN, arrhythmias, and Szs symptomatic and supportive... 

Wilson BE, Hobbs WN. Case report pseudoephedrine-associated thyroid storm thyroid hormone—catecholamine interactions. Am J Med Sci 1993 306(5) 317-9. 

Diastereomeric complexes can also be formed by ion-pairing of an enantiomer with a chiral counterion. In order to form this diastereomeric complex, it has been postulated that at least three interaction points between the ion pair are required [250]. Nearly all of these form weak complexes in aqueous mobile phases. Consequently, the chromatographic methods that have been developed have been either silica or diol columns with low-polarity mobile phases. Enantiomeric amines, such as the beta-blockers, have been optically resolved when (-l-)-lO-camphorsulfonic acid was used as the chiral counterion [251]. Enantiomers of norephedrine, ephedrine, pseudoephedrine, and phenyramidol have all been resolved from their respective enantiomers with n-dibutyltartrate [252]. Enantiomers of naproxen, a chiral carboxylic acid, are resolved from each other by either using quinidine or quinine in the mobile phase [253]. In these studies, silica... 

Based on the observation that the best ee is obtained with bifunctional chiral agents (ephedrine, pseudoephedrine, norephedrine, and valinol see Scheme 43), we tentatively conclude that a multipoint interaction between the reactant molecule, the chiral inductor, and the zeolite interior is necessary to induce preferential adsorption of tropolone alkyl ether from a single enantiotopic face. The dependence of chiral induction (% ee) on the nature of cations (Scheme 45) suggests a crucial role of the cation present in the supercages in the chiral induction process. This is further strengthened by the results observed with wet and dry zeolites. The presence of water decreases chiral selectivity (Scheme 45). Water molecules... 

Most sympathomimetic amines, such as amphetamine, are available only by prescription others such as phenylephrine and pseudoephedrine, which also are reported to interact similarly with MAO inhibitors, are found in most popular non-prescription cold and allergy preparations. It is important that patients being treated with MAO inhibitors avoid using products containing these agents. 

A technique based on the formation of a multiple emulsion with an external aqueous phase was developed for the encapsulation of water-soluble drugs in order to replace the external oil phase. Possible unwanted interactions between the oil and the emulsified wax such as swelling or dissolution of the wax, clean-up requirements of the final product, and recovery of the oil phase could be eliminated. In analogy to the encapsulation of water-soluble drugs within polymeric microparticles by a w/o/w-solvent evaporation method, a molten wax phase was used instead of an organic polmer solution. A heated aqueous solution of pseudoephedrine HCl was emulsified into the molten carnauba wax, followed by the emulsification of this w/o-emulsion into a heated external aqueous phase. The temperature of the internal and external aqueous phases had to be kept above the melting temperature of the wax in order to avoid premature... 

Although pseudoephedrine toxicity was a possible diagnosis, the authors concluded that serotonin syndrome was more likely, from an interaction of pseudoephedrine with fluoxetine. Patients should be warned about the hazards of taking selective serotonin re-uptake blockers and then self-medicating with ephedrine or pseudoephedrine. 

As with other sympathomimetic agents, theoretical drug interactions with ephedra alkaloids are possible. Despite this potential, only a handful of adverse drug interactions have been reported. This is especially pertinent when considering the extensive use of both ephedra-containing supplements and ephedrine- or pseudoephedrine-containing OTC products. The most notable interaction exists between nonselective monoamine oxidase inhibitors and ephedra- or ephedrine-containing products. 

Trade names Apo-Bromocriptine Bromed Cryocriptina Kripton Parilac Parlodel (Novartis) Pravidel Serocryptin Indications Amenorrhea, parkinsonism, infertility Category Dopamine receptor agonist Half-life initial 6-8 hours terminal 50 hours Clinically important, potentially hazardous interactions with erythromycin, lanreotide, pseudoephedrine, sympathomimetics... 

Clinically important, potentially hazardous interactions with alprazolam, amphetamines, astemizole, clarithromycin, clozapine, desipramine, dexibuprofen, dextroamphetamine, diethylpropion, droperidol, duloxetine, erythromycin, haloperidol, imipramine, isocarboxazid, linezolid, lithium, MAO inhibitors, mazindol, meperidine, methamphetamine, midazolam, moclobemide, nortriptyline, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, phenytoin, pimozide, pseudoephedrine, selegiline, serotonin agonists, sibutramine, St John s wort, sumatriptan, sympathomimetics, tramadol, tranylcypromine, trazodone, tricyclic antidepressants, troleandomycin, tryptophan, zolmitriptan... 

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