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Re: PLEASE can you help - Cam, Sunnely, anyone » caroline

Posted by SalArmy4me on September 5, 2001, at 15:01:34

In reply to PLEASE can you help - Cam, Sunnely, anyone, posted by caroline on September 5, 2001, at 14:49:21

The only thing I'm aware of is this: It suggests the use of beta-blockers as a treatment.

Pentel P. Toxicity of over-the-counter stimulants. JAMA. 1984;252:1898-1903:

"Over-the-counter stimulants (phenylpropanolamine hydrochloride, ephedrine, pseudoephedrine, caffeine) are used widely as decongestants, anorectic agents, amphetamine substitutes, and "legal stimulants." Toxic effects may result from overdose, drug interactions, or diseases that increase sensitivity to sympathomimetic agents. The most important toxic effect of the alpha-adrenergic agonist phenylpropanolamine is hypertension, which may result in hypertensive encephalopathy or intracerebral hemorrhage. The therapeutic index of phenylpropanolamine is low, and severe hypertension may occur after ingestion of less than three times the therapeutic dose. Ephedrine and pseudoephedrine may also cause hypertension, as well as tachyarrhythmias due to beta-adrenergic stimulation. Toxic reactions from caffeine are characterized by agitation, seizures, tachyarrhythmias, and hypotension. Management of toxic reactions to over-the-counter stimulants includes control of hypertension with a rapidly acting vasodilator, beta-blockers for tachyarrhythmias, and control of seizures."

Other source:

Grossman, Ehud MD. Messerli, H. Franz MD. High Blood Pressure: A Side Effect of Drugs, Poisons, and Food. Archives of Internal Medicine. 155(5):450-460, March 13, 1995:

"Most nonprescription anorexics contain combinations of an antihistamine and an adrenergic agonist (usually phenylpropanolamines, ephedrine, pseudoephedrine, or caffeine). All act by potentiating presynaptic norepinephrine release and directly activating adrenergic receptors. Known adverse effects of these substances include hypertension, tachycardia, ventricular ectopy, agitation, psychosis, and seizure [45]. The use of nasal decongestant and cough medications containing massive doses of oxymetazoline hydrochloride, phenylephrine hydrochloride, and ephedrine hydrochloride was reported to have resulted in severe hypertension, cardiomegaly, and congestive heart failure in a 34-year-old man [46]. Severe hypertensive crisis was reported in a young man after ingestion of seven azatadine maleatetopseudoephedrine sulfate (Trinalin) tablets (120 mg of pseudoephedrine and 1 mg of azatadine sulfate per tablet). Labetalol given intravenously was an effective treatment [47]. Phenylpropanolamine is the active ingredient in most diet aids and in many decongestant agents and is also used as a substitute for amphetamine. Excessive doses may result in severe hypertension and, in rare instances, hypertensive encephalopathy, intracerebral hemorrhage, and death [48-51]."


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poster:SalArmy4me thread:77865
URL: http://www.dr-bob.org/babble/20010902/msgs/77866.html