Mailing List Archive Mailing List Archive
On Wed, 8 Nov 2000 14:34:16 -0800, you wrote:
>...but better now than never. Ephedra is bad news. Phenylpropanolamine =
(PPA,
>used in OTC "weight loss" pills) and pseudoephedrine (Sudafed) deserve
>similar consideration. All of these are CNS stimulants---they simulate
>epinephrine's effects on vital organs, the CNS, and blood vessels. Heart
>rate and blood pressure increase, as may anxiety. Divers who take them =
could
>well be more susceptible to underwater panic. And then there are =
drug/drug
>interactions, which can cause hypertension, changes in sensorium, and =
any
>number of problems that are well known to the FDA but are not widely
>publicized.
It's PPA that's in the news lately.. there's serious statistical
evidence that phenylpropanolamine can cause an increased risk of
hemorrhages in women. It's a sympathomimetic.. a compound that mimics
stimulants of the nervous system found naturally in the body. So is
Pseudoephedrine (Sudafed). There may be useful parallels pertaining to
PPA & Ephedra or Pseudafed Re: diving, just remember, caution is a
GOOD thing
>The bottom line: If you take a medication or, especially, a dietary
>supplement, do your homework. The FDA approves medications based on
>recommendations of physicians who work with the manufacturer and/or who
>participate in clinical trials. More frightening are the unregulated =
drugs,
>such as ephedra, ma huang, homeopathic remedies and botanicals. These
>remedies usually are extracts of herbs, barks, or other plant substances=
and
>can have extremely potent effects. The consumer has no way of knowing =
what
>s/he's ingesting.
Bottom line, the jury hasn't even plugged in the coffeepot.BUT!! there
is some real evidence that any CNS stimulant should be
contra-indicated in diving.
PPA turns up in a MULTITUDE of OTC (Over-The-Counter) products.
Many of the most popular cold remedies (Alka-Seltzer Cold Plus, Tavist
D, Triaminic) contain PPA.. most of the rest contain
pseuoephedrine..This is a no-brainer..
IF YOU'RE SICK> DON'T DIVE!!!
Reality sucks, don't it?
>Don't wait for a government agency or for anyone to warn you about these
>issues. Ephedra should have been pulled from the market years ago. I =
predict
>that we'll see either 1) more of these "natural" substances being banned=
by
>FDA or 2) the pharmaceutical companies getting into the business of
>"legitimizing" the so-called natural medications. The "snake oil" effect=
and
>profit potential create too lucrative a marketing opportunity to pass =
up.
>
>Best,
>Barbara/San Francisco
If they pull ephedra, they'll have to pull Starbuck's, too. and the
PC's are ALREADY pressing the snake oil.
I think we agree on 2 basic points
1) all decongestants are stimulants
2) divers should avoid stimulants while they're diving
>----- Original Message -----
>From: "anthony rue" <true@gu*.co*>
>To: <quest@gu*.co*>
>Sent: Tuesday, November 07, 2000 7:37 AM
>Subject: Stroke Alert (ephedra health risk)
>
>
>> http://www.nejm.org/content/haller/1.asp
>>
>> Just released this morning, by The New England Journal of Medicine:
>>
>> Because of its potential public health implications, this article is =
being
>> released before its publication date. The final version of the report =
will
>> be published on December 21.
>>
>> Dietary supplements that contain ephedra alkaloids (sometimes called =
ma
>> huang) are widely promoted and used in the United States as a means of
>> losing weight and increasing energy. In the light of recently reported
>> adverse events related to use of these products, the Food and Drug
>> Administration (FDA) has proposed limits on the dose and duration of =
use
>of
>> such supplements. The FDA requested an independent review of reports =
of
>> adverse events related to the use of supplements that contained =
ephedra
>> alkaloids to assess causation and to estimate the level of risk the =
use of
>> these supplements poses to consumers.
>> ...
>>
>> Ephedrine and related alkaloids have been associated with adverse
>> cardiovascular events, including acute myocardial infarction, severe
>> hypertension, myocarditis, and lethal cardiac arrhythmias. (10,11)
>> Constriction of coronary arteries and, in some cases, vasospasm are
>believed
>> to be the mechanisms of myocarditis and myocardial infarction. The
>> adrenergic effects of ephedrine shorten cardiac refractory periods,
>> permitting the development of reentrant cardiac arrhythmias. Ephedrine=
can
>> predispose patients to both hemorrhagic and ischemic stroke. (12)
>> Subarachnoid hemorrhage is thought to be a result of the hypertensive
>action
>> of ephedrine, which can be short lived, or of cerebral vasculitis, =
which
>has
>> been described in association with a variety of sympathomimetic drugs.
>> (13,14) Thrombotic stroke is presumably related to vasoconstriction of
>large
>> cerebral arteries, which leads to local thrombosis as a result of =
stasis
>and
>> sympathomimetic-induced platelet activation.
>>
>> Because of the severity of the adverse events that we reviewed and, in
>> particular, the occurrence of events that caused permanent disability =
and
>> death, we conclude that dietary supplements that contain ephedra =
alkaloids
>> pose a serious health risk to some users. Although the incidence of
>serious
>> adverse effects cannot be determined from our analysis, our findings
>arouse
>> concern about the risks of these products, given that they have no
>> scientifically established benefits. Our findings indicate the need =
for a
>> better understanding of the determinants of individual susceptibility =
to
>the
>> serious adverse effects of dietary supplements containing ephedra
>alkaloids
>> so that appropriate dosing guidelines and warnings can be devised.
>>
>>
>> ---------------------------------------------------------------------
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>> For additional commands, e-mail: quest-help@gu*.co*
>>
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