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Cortisone (sp?)

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Road Cycling
Published
28 July 2004
Last activity
3 August 2004
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Krusty
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  1. "Mike Murray" <[email hidden]> wrote in message news:<JAXNc.174505$a24.37960@attbi_s03>...

    Quoted message said:
    Krusty said:

    IIRC Sudafed is banned. Even if I'm wrong in the case of cycling, it
    is many other sports...especially the Olympic sports such as
    gymnastics. It's a goddamn cold medicine. Sure it's a synthetic
    version of ephedrine, but even that drug has valid medical uses, e.g.,
    for asthma. You can buy it at CVS, Walgreens, and even my local 7/11
    without any problem. So it wouldn't surprise me if anit-histamines
    were banned either.

    Sudafed (pseudoephedrine) is a sympathomimetic decongestant. Neither it or
    ephedrine have any legitimate use in asthma. Sympathomimetics are banned in
    athletic competition because they have an amphetamine-like stimulant effect,
    although the restrictions have recently been relaxed. They have been used
    in an attempt to increase performance. This has also been associated with
    deaths in this context, in weight lifters as I recall. They are definitely
    dangerous drugs taken in overdose and/or in combination with athletic
    efforts. Pseudoephedrine is the only decongestant that is still on the
    market in the US. I am not really sure why because it shares the same side
    effects as the other formerly available decongestants; phenylpropanolamine
    and ephedrine which have been removed form the market because of adverse
    risk profiles.

    Antihistamines are not banned. Information on what drugs are allowable and
    under what circumstances can be found at:
    http://www.wada-ama.org/docs/web/standards_harmonization/code/list_standard_2004.pdf

    Mike Murray MD

    pseudoephedrine most definitely does have substantial effects on
    asthma. As a vaso-constrictor in mucos membranes it reduce the
    inflamatory response casued by allergies this inflamatory response is
    exactly the cause of asthma. for lack of a simplier way to put it
    asthma is congestion in the lungs and throat.

    I believe the reason pseudoephedrine has not been banned while other
    simliar products (such as ephedra) have been is due to potency, risk
    of overdose, and hysteria. As a vasoconstrictor, diuretic and an
    stimulant all such products cause added stress on the heart and
    cirulatory system. Adding to this Ephdedra etc. were being given to
    obese individuals who's hearts were already beeing taxed. As a result
    people were dieing.

    Again, please do research before acting like you know something or at
    least caveat your statements, as I have done above.

  2. "Mike Murray" <[email hidden]> wrote in message news:<JAXNc.174505$a24.37960@attbi_s03>...

    Quoted message said:
    Krusty said:

    IIRC Sudafed is banned. Even if I'm wrong in the case of cycling, it
    is many other sports...especially the Olympic sports such as
    gymnastics. It's a goddamn cold medicine. Sure it's a synthetic
    version of ephedrine, but even that drug has valid medical uses, e.g.,
    for asthma. You can buy it at CVS, Walgreens, and even my local 7/11
    without any problem. So it wouldn't surprise me if anit-histamines
    were banned either.

    Sudafed (pseudoephedrine) is a sympathomimetic decongestant. Neither it or
    ephedrine have any legitimate use in asthma. Sympathomimetics are banned in
    athletic competition because they have an amphetamine-like stimulant effect,
    although the restrictions have recently been relaxed. They have been used
    in an attempt to increase performance. This has also been associated with
    deaths in this context, in weight lifters as I recall. They are definitely
    dangerous drugs taken in overdose and/or in combination with athletic
    efforts. Pseudoephedrine is the only decongestant that is still on the
    market in the US. I am not really sure why because it shares the same side
    effects as the other formerly available decongestants; phenylpropanolamine
    and ephedrine which have been removed form the market because of adverse
    risk profiles.

    Antihistamines are not banned. Information on what drugs are allowable and
    under what circumstances can be found at:
    http://www.wada-ama.org/docs/web/standards_harmonization/code/list_standard_2004.pdf

    Mike Murray MD

    Jesus, I just realised you are an MD....As someone who is using the
    credentials to pretend to be an authority I must redouble my
    statement. Before pretending to be an authority on a topic and using
    your credentials to back you statments please do some research!!!
    pseudoephedrine IS effective for asthmatics. It works as a
    decongestant and a bronchodilator!

    Here is a website that discuses this class of drugs:

    http://www.elmhurst.edu/~chm/vchembook/663adrenergic2.html

    Note: This web page also confirms my belief that the reason
    pseudoephedrine is still legal while other forms are not is one of
    potency.

  3. (Steven) said:


    pseudoephedrine (Sudafed) is NOT banned buy the UCI, WADA or the IOC
    it is thresholded, as is Caffine. Cortical Steriods would never be
    confused for an Anabolic steriod in a drug test. The reason you would
    use a Cortical Steriod for a bee sting is to reducing the inflamation.

    Please do some research before pretending you know something...

    Before we have the OB spelling flames, I found 28,600 hits in google for
    'steriods', 46,400 hits for 'caffine', and 43,300 for 'inflamation'.

    -B
    Does that qualify as 'research'?

  4. Krusty said:

    You have to take a [censored] of sudafed to produce a significant
    stimulant type effect...less so with ephedrine...but speaking from
    personal experience with both...IMHO neither would increase
    performance.

    They might be good for weight loss, but they make you feel like [censored].

    Depends on the individual. There are very many people that can not tolerate
    even the usual dose of pseudoephedrine due to the jitteriness and other
    stimulant side effects. It is correct that ephedrine tends to produce more
    of this but both drugs share this property. More importantly, even small
    doses can cause marked increases in blood pressure in sensitive individuals.

    Although both drugs have some anorectic effect, neither drug will produce a
    sustained weight loss.

    --
    Mike Murray

  5. Mike Murray said:
    Quoted message said:

    Although both drugs have some anorectic effect, neither drug will produce a
    sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no "legitimate use" in treating
    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike Murray

  6. gwhite said:


    Mike Murray said:

    Although both drugs have some anorectic effect, neither drug will produce a
    sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no "legitimate use" in treating
    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike Murray

    Why would you beat this issue up? There are way better drugs for
    asthma, with fewer side effects.
    In any case, if you want to show its use, that's on you. He's the guy
    with the licence, and I'd take his word.

    Steve

    --
    Mark & Steven Bornfeld DDS
    http://www.dentaltwins.com
    Brooklyn, NY
    718-258-5001

  7. "Steven" <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:

    "Mike Murray" <[email hidden]> wrote in message


    news:<JAXNc.174505$a24.37960@attbi_s03>...

    Quoted message said:
    Quoted message said:
    Krusty said:

    IIRC Sudafed is banned. Even if I'm wrong in the case of cycling, it
    is many other sports...especially the Olympic sports such as
    gymnastics. It's a goddamn cold medicine. Sure it's a synthetic
    version of ephedrine, but even that drug has valid medical uses, e.g.,
    for asthma. You can buy it at CVS, Walgreens, and even my local 7/11
    without any problem. So it wouldn't surprise me if anit-histamines
    were banned either.

    Sudafed (pseudoephedrine) is a sympathomimetic decongestant. Neither it


    or

    Quoted message said:
    Quoted message said:

    ephedrine have any legitimate use in asthma. Sympathomimetics are banned


    in

    Quoted message said:
    Quoted message said:

    athletic competition because they have an amphetamine-like stimulant


    effect,

    Quoted message said:
    Quoted message said:

    although the restrictions have recently been relaxed. They have been


    used

    Quoted message said:
    Quoted message said:

    in an attempt to increase performance. This has also been associated


    with

    Quoted message said:
    Quoted message said:

    deaths in this context, in weight lifters as I recall. They are


    definitely

    Quoted message said:
    Quoted message said:

    dangerous drugs taken in overdose and/or in combination with athletic
    efforts. Pseudoephedrine is the only decongestant that is still on the
    market in the US. I am not really sure why because it shares the same


    side

    Quoted message said:
    Quoted message said:

    effects as the other formerly available decongestants;


    phenylpropanolamine

    Quoted message said:
    Quoted message said:

    and ephedrine which have been removed form the market because of adverse
    risk profiles.

    Antihistamines are not banned. Information on what drugs are allowable


    and

    Quoted message said:
    Quoted message said:

    under what circumstances can be found at:


    http://www.wada-ama.org/docs/web/standards_harmonization/code/list_standard_2004.pdf

    Quoted message said:
    Quoted message said:


    Mike Murray MD

    Jesus, I just realised you are an MD....As someone who is using the
    credentials to pretend to be an authority I must redouble my
    statement. Before pretending to be an authority on a topic and using
    your credentials to back you statments please do some research!!!
    pseudoephedrine IS effective for asthmatics. It works as a
    decongestant and a bronchodilator!

    I think you need to read Dr. Murray's post again: nowhere does he state that
    ephedrine or pseudoephedrine are without effect on asthma. Rather, he
    expresses the opinion that they have no legitimate role in treatment of this
    condition. At least with regards to pseudoephedrine, he apparently bases his
    opinion on the potential adverse effects.

    Andy Coggan (still a big Mike Murray fan)

  8. Mark & Steven Bornfeld DDS said:


    gwhite said:


    Mike Murray said:

    Although both drugs have some anorectic effect, neither drug will produce a
    sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no "legitimate use" in treating
    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike Murray

    Why would you beat this issue up?

    Because I suspect it could be wrong and it also provides a didactic opportunity.

    Quoted message said:

    There are way better drugs for
    asthma, with fewer side effects.

    That's a statement of technical proficiency, not economic efficiency, which happens to be far more
    important. So in other words, I have a suspicion that Mike's statement is blind to the more
    important issue of economic efficiency.

    Quoted message said:

    In any case, if you want to show its use, that's on you.

    No it's not. He made the claim, not me. It is well known that ephedrine used to be prescribed for
    asthma by "folks with licenses." (Since you've shown the license is important to you.) So all of
    the sudden ephedrine doesn't "work" for asthma? Which licensee are we lay people to believe?

    Quoted message said:

    He's the guy with the licence, and I'd take his word.

    Sure, he's licensed in medicine. I think if we get the information I requested we may find the
    question is not one of medicine but one of economics, so he is then out of his field. He made the
    claim. The onus is his.

  9. Krusty said:

    Is this substance completely banned? If so, why? I understand the
    dangers of long term use and the potential for abuse, but there are
    occasions, such as in 2002 where an american rider (can't remember
    who) got stung on the eyelid by a bee and was unable to continue.
    This seems like a case where cortisone could have been used in a
    reasonable manner. Also, many other sports allow the use of this
    substance.

    Cortisone is a steroid that reduced inflamation. It is useful for
    athletes because it allows them to recover from injury faster and also
    recover from the general wear and tear of training.

    Using a topical creme on a saddle sore will not have any apprecaible
    effect because it wont raise blood levels in any significant amount.
    The effect of the cortisol is just in the area where it is applied.
    On the other hand, a cortisone shot for a bee sting would have
    benefits to a rider in addition to the reduced inflamation in the area
    of the sting because it's very likey that a Tour rider has inflamation
    all over his body after a few days of racing.

  10. On Fri, 30 Jul 2004 01:32:24 GMT, Jack Hollis <[email hidden]>

    Quoted message said:
    Quoted message said:

    Is this substance completely banned? If so, why? I understand the
    dangers of long term use and the potential for abuse, but there are
    occasions, such as in 2002 where an american rider (can't remember
    who) got stung on the eyelid by a bee and was unable to continue.
    This seems like a case where cortisone could have been used in a
    reasonable manner. Also, many other sports allow the use of this
    substance.

    Cortisone is a steroid that reduced inflamation. It is useful for
    athletes because it allows them to recover from injury faster and also
    recover from the general wear and tear of training.

    Using a topical creme on a saddle sore will not have any apprecaible
    effect because it wont raise blood levels in any significant amount.
    The effect of the cortisol is just in the area where it is applied.
    On the other hand, a cortisone shot for a bee sting would have
    benefits to a rider in addition to the reduced inflamation in the area
    of the sting because it's very likey that a Tour rider has inflamation
    all over his body after a few days of racing.

    In addition, cortisone's anti-inflamatory properties has the added
    benefit of masking pain.

  11. Steven said:

    "Mike Murray" <[email hidden]> wrote in message news:<JAXNc.174505$a24.37960@attbi_s03>...

    Quoted message said:
    Krusty said:

    IIRC Sudafed is banned. Even if I'm wrong in the case of cycling, it
    is many other sports...especially the Olympic sports such as
    gymnastics. It's a goddamn cold medicine. Sure it's a synthetic
    version of ephedrine, but even that drug has valid medical uses, e.g.,
    for asthma. You can buy it at CVS, Walgreens, and even my local 7/11
    without any problem. So it wouldn't surprise me if anit-histamines
    were banned either.

    Sudafed (pseudoephedrine) is a sympathomimetic decongestant. Neither it or
    ephedrine have any legitimate use in asthma. Sympathomimetics are banned in
    athletic competition because they have an amphetamine-like stimulant effect,
    although the restrictions have recently been relaxed. They have been used
    in an attempt to increase performance. This has also been associated with
    deaths in this context, in weight lifters as I recall. They are definitely
    dangerous drugs taken in overdose and/or in combination with athletic
    efforts. Pseudoephedrine is the only decongestant that is still on the
    market in the US. I am not really sure why because it shares the same side
    effects as the other formerly available decongestants; phenylpropanolamine
    and ephedrine which have been removed form the market because of adverse
    risk profiles.

    Antihistamines are not banned. Information on what drugs are allowable and
    under what circumstances can be found at:
    http://www.wada-ama.org/docs/web/standards_harmonization/code/list_standard_2004.pdf

    Mike Murray MD

    pseudoephedrine most definitely does have substantial effects on
    asthma. As a vaso-constrictor in mucos membranes it reduce the
    inflamatory response casued by allergies this inflamatory response is
    exactly the cause of asthma. for lack of a simplier way to put it
    asthma is congestion in the lungs and throat.

    What are you talking about? Pseudoephedrine is not perscribed for
    asthma treatment. Speaking from experience, it doesn't do jack to
    improve my breathing. Inflamation in the lungs is controlled with
    corticosteriods, not antihistamines.

    Quoted message said:

    I believe the reason pseudoephedrine has not been banned while other
    simliar products (such as ephedra) have been is due to potency, risk
    of overdose, and hysteria. As a vasoconstrictor, diuretic and an
    stimulant all such products cause added stress on the heart and
    cirulatory system. Adding to this Ephdedra etc. were being given to
    obese individuals who's hearts were already beeing taxed. As a result
    people were dieing.

    Again, please do research before acting like you know something or at
    least caveat your statements, as I have done above.

    Maybe you should take your own advice.

  12. gwhite said:


    Mark & Steven Bornfeld DDS said:
    gwhite said:

    Mike Murray wrote:

    >Although both drugs have some anorectic effect, neither drug will produce a
    >sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no "legitimate use" in treating
    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike Murray

    Why would you beat this issue up?

    Because I suspect it could be wrong and it also provides a didactic opportunity.

    Quoted message said:

    There are way better drugs for
    asthma, with fewer side effects.

    That's a statement of technical proficiency, not economic efficiency, which happens to be far more
    important. So in other words, I have a suspicion that Mike's statement is blind to the more
    important issue of economic efficiency.

    Quoted message said:

    In any case, if you want to show its use, that's on you.

    No it's not. He made the claim, not me. It is well known that ephedrine used to be prescribed for
    asthma by "folks with licenses." (Since you've shown the license is important to you.) So all of
    the sudden ephedrine doesn't "work" for asthma? Which licensee are we lay people to believe?

    Sure, 30 years ago asthma treatment was quite a bit different. Drugs
    like theophylline, which used to be popular, are hardly used any more.
    The same goes for ephedrine. When I was talking these kinds of drugs
    they barely worked. Enough so that I could function if I was careful
    about my environment, but that's about it. Certainly no miracle.
    Probably the biggest benefit was the stimulant effect, which was good
    for keeping me awake long hours in college.

    Fortunately, the medications have improved significantly over the years,
    as has our understanding of how the disease works. These days most
    people get Advair, which is a a mixture of fluticasone propionate and
    salmeterol. This stuff blows that old [censored] away. Now I can pretty much
    operate like someone without asthma. You couldn't pay me enough to go
    back to those old medications.

    Quoted message said:
    Quoted message said:

    He's the guy with the licence, and I'd take his word.

    Sure, he's licensed in medicine. I think if we get the information I requested we may find the
    question is not one of medicine but one of economics, so he is then out of his field. He made the
    claim. The onus is his.

  13. Quoted message said:
    gwhite said:


    Mark & Steven Bornfeld DDS said:

    gwhite wrote:

    >Mike Murray wrote:
    >
    >
    >
    >>Although both drugs have some anorectic effect, neither drug will


    produce a

    Quoted message said:
    Quoted message said:
    Quoted message said:

    >>sustained weight loss.
    >
    >
    >Never mind that. Provide some citations that show ephedrine has no


    "legitimate use" in treating

    Quoted message said:
    Quoted message said:
    Quoted message said:

    >asthma.
    >
    >"Neither it or ephedrine have any legitimate use in asthma." -- Mike


    Murray

    Quoted message said:
    Quoted message said:
    Quoted message said:


    Why would you beat this issue up?

    Because I suspect it could be wrong and it also provides a didactic


    opportunity.

    Quoted message said:
    Quoted message said:
    Quoted message said:

    There are way better drugs for
    asthma, with fewer side effects.

    That's a statement of technical proficiency, not economic efficiency,


    which happens to be far more

    Quoted message said:
    Quoted message said:

    important. So in other words, I have a suspicion that Mike's statement


    is blind to the more

    Quoted message said:
    Quoted message said:

    important issue of economic efficiency.

    Quoted message said:

    In any case, if you want to show its use, that's on you.

    No it's not. He made the claim, not me. It is well known that


    ephedrine used to be prescribed for

    Quoted message said:
    Quoted message said:

    asthma by "folks with licenses." (Since you've shown the license is


    important to you.) So all of

    Quoted message said:
    Quoted message said:

    the sudden ephedrine doesn't "work" for asthma? Which licensee are we


    lay people to believe?

    Quoted message said:
    Quoted message said:

    Sure, 30 years ago asthma treatment was quite a bit different. Drugs
    like theophylline, which used to be popular, are hardly used any more.
    The same goes for ephedrine. When I was talking these kinds of drugs
    they barely worked. Enough so that I could function if I was careful
    about my environment, but that's about it. Certainly no miracle.
    Probably the biggest benefit was the stimulant effect, which was good
    for keeping me awake long hours in college.

    Fortunately, the medications have improved significantly over the years,
    as has our understanding of how the disease works. These days most
    people get Advair, which is a a mixture of fluticasone propionate and
    salmeterol. This stuff blows that old [censored] away. Now I can pretty much
    operate like someone without asthma. You couldn't pay me enough to go
    back to those old medications.

    Quoted message said:
    Quoted message said:

    He's the guy with the licence, and I'd take his word.

    Sure, he's licensed in medicine. I think if we get the information I


    requested we may find the

    Quoted message said:
    Quoted message said:

    question is not one of medicine but one of economics, so he is then out


    of his field. He made the

    Quoted message said:
    Quoted message said:

    claim. The onus is his.

    Ephedrine effectively relieves asthmatic symptoms but has been superseeded
    by more effective, local acting medications. Theophylline remains in use
    today as many of the meds from 'the the old days". Both have a minimal
    stimulating effect comparable to a cup or two of strong coffee. Caffeine is
    banned too btw, though a small intake is allowed.

    The newer meds are better and have less side effects but cost more. Perhaps
    they just cannot afford the new ones (ROFL!)

  14. Quoted message said:

    pseudoephedrine most definitely does have substantial effects on
    asthma. As a vaso-constrictor in mucos membranes it reduce the
    inflamatory response casued by allergies this inflamatory response is
    exactly the cause of asthma. for lack of a simplier way to put it
    asthma is congestion in the lungs and throat.

    I believe the reason pseudoephedrine has not been banned while other
    simliar products (such as ephedra) have been is due to potency, risk
    of overdose, and hysteria. As a vasoconstrictor, diuretic and an
    stimulant all such products cause added stress on the heart and
    cirulatory system. Adding to this Ephdedra etc. were being given to
    obese individuals who's hearts were already beeing taxed. As a result
    people were dieing.

    Again, please do research before acting like you know something or at
    least caveat your statements, as I have done above.

    Amen!

    I wonder where the 'MD' thing came from LOL

    It has been discussed to death yeah but everyone who have tried ephedrine
    knows that it has not amphetamine-like effects, it makes your heart race and
    give you an adrenaline-like stimulation with an aggresive touch but it is
    far below amphetamine. How often do you hear of ephedrine psychosis ROFL
    (it does happen though, very rarely probably in people already prone to
    schizophrenia)

    Right, forget about that old myth LOL

  15. "gwhite" <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:
    Mike Murray said:
    Quoted message said:

    Although both drugs have some anorectic effect, neither drug will


    produce a

    Quoted message said:
    Quoted message said:

    sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no


    "legitimate use" in treating

    Quoted message said:

    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike


    Murray

    Perhaps my statement was a bit over stringent. Ephedrine was used
    historically for treatment of asthma but it has been superceded by less
    toxic and more effective drugs. Maybe I should of said "Neither it
    (psuedoephedrine) or ephedrine have any CURRENT legitimate use in asthma."
    Safer and more effective drugs are available.

    It is difficult to find citations about out dated therapies like ephedrine
    in asthma but for those that want me to do citation searching for them here
    are some quick finds:

    Drugs. 1982 Nov;24(5):414-39.
    "Ephedrine is a relatively ineffective bronchodilator and often fails to add
    any useful bronchodilatation to theophylline. Also, there does seem to be a
    synergistic increase in side effects of the two drugs and this combination
    is therefore undesirable. Ephedrine has now been superseded by the more
    selective beta 2-adrenoceptor agonist drugs"

    [Federal Register: July 27, 1995 (Volume 60, Number 144)]
    "The Food and Drug Administration (FDA) is proposing to amend the final
    monograph for over-the-counter (OTC) bronchodilator drug products to remove
    the ingredients ephedrine, ephedrine hydrochloride, ephedrine sulfate, and
    racephedrine hydrochloride and to classify these ingredients as not
    generally recognized as safe and effective for OTC use. "

    JAMA. 1979 Feb 16;241(7):704-5.
    "The results of our study indicate that carbuterol is a safer and more
    effective bronchodilator than ephedrine."

    Chest. 1977 Sep;72(3):291-5.
    "fenoterol hydrobromide were significantly better than placebo or ephedrine"

    J Allergy Clin Immunol. 1977 Feb;59(2):178-81.
    "Compared to ephedrine, Th1165a (fenoterol) was demonstrated to be a potent
    bronchodilator with a prolonged duration of action. Adrenergic side effects
    were minimal, and no tolerance or toxicity was demonstrated."

    J Allergy Clin Immunol. 1997 Dec;100(6 Pt 1):789-91.
    "Even among adults with access to specialty care for asthma, self-treatment
    with nonprescription products was common and was associated with increased
    risk of reported hospitalization."

    Mike Murray

  16. "gwhite" <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:
    Mike Murray said:
    Quoted message said:

    Although both drugs have some anorectic effect, neither drug will


    produce a

    Quoted message said:
    Quoted message said:

    sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no


    "legitimate use" in treating

    Quoted message said:

    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike


    Murray

    Perhaps my statement was a bit over stringent. Ephedrine was used
    historically for treatment of asthma but it has been superceded by less
    toxic and more effective drugs. Maybe I should have said "Neither it
    (psuedoephedrine) or ephedrine have any CURRENT use in asthma."
    Safer and more effective drugs are available.

    I am sensitive to the issue of the decreased aggregate cost of care when
    using over the counter products compared to products that require a
    prescription and the attendant professional fees, etc. This is really a
    regulatory problem however. There is little rationale that supports the OTC
    availability of a less effective and more toxic therapy when the safer
    therapy requires a prescription. A more rational approach would be to have
    albuterol as an OTC product and require prescription for ephedrine and
    epinephrine, both of which are currently OTC.

    It is difficult to find citations about out dated therapies like ephedrine
    in asthma but for those that want me to do citation searching for them, here
    are some quick finds:

    Drugs. 1982 Nov;24(5):414-39.
    "Ephedrine is a relatively ineffective bronchodilator and often fails to add
    any useful bronchodilatation to theophylline. Also, there does seem to be a
    synergistic increase in side effects of the two drugs and this combination
    is therefore undesirable. Ephedrine has now been superseded by the more
    selective beta 2-adrenoceptor agonist drugs"

    [Federal Register: July 27, 1995 (Volume 60, Number 144)]
    "The Food and Drug Administration (FDA) is proposing to amend the final
    monograph for over-the-counter (OTC) bronchodilator drug products to remove
    the ingredients ephedrine, ephedrine hydrochloride, ephedrine sulfate, and
    racephedrine hydrochloride and to classify these ingredients as not
    generally recognized as safe and effective for OTC use. "

    JAMA. 1979 Feb 16;241(7):704-5.
    "The results of our study indicate that carbuterol is a safer and more
    effective bronchodilator than ephedrine."

    Chest. 1977 Sep;72(3):291-5.
    "fenoterol hydrobromide were significantly better than placebo or ephedrine"

    J Allergy Clin Immunol. 1977 Feb;59(2):178-81.
    "Compared to ephedrine, Th1165a (fenoterol) was demonstrated to be a potent
    bronchodilator with a prolonged duration of action. Adrenergic side effects
    were minimal, and no tolerance or toxicity was demonstrated."

    J Allergy Clin Immunol. 1997 Dec;100(6 Pt 1):789-91.
    "Even among adults with access to specialty care for asthma, self-treatment
    with nonprescription products was common and was associated with increased
    risk of reported hospitalization."

    Mike Murray

  17. Quoted message said:
    Quoted message said:

    You have to take a [censored] of sudafed to produce a significant
    stimulant type effect...less so with ephedrine...but speaking from
    personal experience with both...IMHO neither would increase
    performance.

    They might be good for weight loss, but they make you feel like [censored].

    Depends on the individual. There are very many people that can not


    tolerate

    Quoted message said:

    even the usual dose of pseudoephedrine due to the jitteriness and other
    stimulant side effects. It is correct that ephedrine tends to produce


    more

    Quoted message said:

    of this but both drugs share this property. More importantly, even small
    doses can cause marked increases in blood pressure in sensitive


    individuals.

    Quoted message said:


    Although both drugs have some anorectic effect, neither drug will produce


    a

    Quoted message said:

    sustained weight loss.

    --
    Mike Murray

    Ephedrine and pseudoephedrine are not really stimulants, they bind to alpha
    and beta adrenergic receptors and also release noradrenaline from neurons in
    the brain resulting in systemic effects such as increased BP,
    vasoconstriction and rapid heartbeat.

  18. Here where I live, theophylline is still in use as an anti-asthmatic for
    patients that don't respond to other meds. Pseudoephedrine is marketed as a
    decongestant and ephedrine as a bronchodilator, both in OTC meds and RX meds
    containing an antihistamine. The therapeutic effect is backed up with
    documentation and studies as required by law.

    There are so many studies and citations that is is very easy to pick a few
    to prove a 'point'. But it proves nothing....

    Quoted message said:

    Perhaps my statement was a bit over stringent. Ephedrine was used
    historically for treatment of asthma but it has been superceded by less
    toxic and more effective drugs. Maybe I should of said "Neither it
    (psuedoephedrine) or ephedrine have any CURRENT legitimate use in asthma."
    Safer and more effective drugs are available.

    It is difficult to find citations about out dated therapies like ephedrine
    in asthma but for those that want me to do citation searching for them


    here

    Quoted message said:

    are some quick finds:

    Drugs. 1982 Nov;24(5):414-39.
    "Ephedrine is a relatively ineffective bronchodilator and often fails to


    add

    Quoted message said:

    any useful bronchodilatation to theophylline. Also, there does seem to be


    a

    Quoted message said:

    synergistic increase in side effects of the two drugs and this combination
    is therefore undesirable. Ephedrine has now been superseded by the more
    selective beta 2-adrenoceptor agonist drugs"

    [Federal Register: July 27, 1995 (Volume 60, Number 144)]
    "The Food and Drug Administration (FDA) is proposing to amend the final
    monograph for over-the-counter (OTC) bronchodilator drug products to


    remove

    Quoted message said:

    the ingredients ephedrine, ephedrine hydrochloride, ephedrine sulfate, and
    racephedrine hydrochloride and to classify these ingredients as not
    generally recognized as safe and effective for OTC use. "

    JAMA. 1979 Feb 16;241(7):704-5.
    "The results of our study indicate that carbuterol is a safer and more
    effective bronchodilator than ephedrine."

    Chest. 1977 Sep;72(3):291-5.
    "fenoterol hydrobromide were significantly better than placebo or


    ephedrine"

    Quoted message said:


    J Allergy Clin Immunol. 1977 Feb;59(2):178-81.
    "Compared to ephedrine, Th1165a (fenoterol) was demonstrated to be a


    potent

    Quoted message said:

    bronchodilator with a prolonged duration of action. Adrenergic side


    effects

    Quoted message said:

    were minimal, and no tolerance or toxicity was demonstrated."

    J Allergy Clin Immunol. 1997 Dec;100(6 Pt 1):789-91.
    "Even among adults with access to specialty care for asthma,


    self-treatment

    Quoted message said:

    with nonprescription products was common and was associated with increased
    risk of reported hospitalization."

    Mike Murray

  19. "*sigh*" <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:


    There are so many studies and citations that is is very easy to pick a few
    to prove a 'point'. But it proves nothing....


    That's generally how science is done. The consensus of results forms the
    current truth. Unfortunately for you, the consensus of results indicates
    that ephedrine sucks as a bronchodilator. Sorry.

  20. Mike Murray said:


    "gwhite" <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:
    Mike Murray said:
    Quoted message said:

    Although both drugs have some anorectic effect, neither drug will


    produce a

    Quoted message said:
    Quoted message said:

    sustained weight loss.

    Never mind that. Provide some citations that show ephedrine has no


    "legitimate use" in treating

    Quoted message said:

    asthma.

    "Neither it or ephedrine have any legitimate use in asthma." -- Mike


    Murray

    Perhaps my statement was a bit over stringent. Ephedrine was used
    historically for treatment of asthma but it has been superceded by less
    toxic and more effective drugs.

    Thank you for responding. As I have stated, I have no argument with the technical superiority of
    modern asthma medicines over drugs like ephedrine -- in point of fact, I agree. As a youngster, I
    had asthma attacks that nearly killed me. Therefore I have personal experience with both new and
    old medicines. Despite its admitted shortcomings, ephedrine can be of use in treating the symptoms
    of asthma. As a technical issue, I do not believe this is arguable.

    Quoted message said:

    Maybe I should of said "Neither it
    (psuedoephedrine) or ephedrine have any CURRENT legitimate use in asthma."
    Safer and more effective drugs are available.

    Again, this is a technical statement of efficacy that is completely blind to economic
    considerations. I assert then, that it is incorrect or at the very least unproven and in serious
    doubt. "Availability" sounds nice. Rolls Royces and $10k racing bikes are "available."

    Perhaps an "example" best describes the idea:
    If I want to get some albuterol, to treat occasional symptoms of asthma, I need to go to a doctor to
    get a prescription. Currently in the US, a visit with doctor is extraordinarily expensive -- $80 is
    perhaps a typical figure. Moreover, the albuterol itself isn't that cheap. I also need to spend
    the opportunity cost (forgone opportunity to do something else with my time) of traveling to the
    doctor, plus waiting and visiting with the MD, and even more waiting to get the prescription
    filled. Therefore, the "good" medications have an associated cost, and one I contend is high. How
    do we frame the cost?

    Now today, due to government interference, pure ephedrine is not really available (except on the
    black market). But it was available about 10 years ago, or so. For this example let's ignore the
    fact of government interference and assume it were still freely available in pure 25 mg capsules.
    The cost of these was very low -- I recall obtaining a bottle of 100 doses for under $5. Thus the
    cost of ephedrine is comparitively low in material and opportunity costs.

    There is little more basic that the fact that people will tend to buy more of something if the cost
    goes down. The converse is also true. The patients who go to the MD's and acquire prescription
    medicines will report high rates of efficacy. If efficacy is strictly a rating of those who
    actually *get* the care, then there is little doubt of the conclusion. However, if a large group of
    folks are locked out of that care (they don't buy due to the cost), and simply wheeze through their
    days and nights, then we see that the *average* efficacy of these expensive medicines -- across the
    entire population that *could* use them -- probably does not look so good. For all it's side
    effect's, maybe low cost ephedrine looks good when the totality of considerations are made.

    Low cost substitutes, whatever their imperfections, help *drive down* the cost of the competing
    goods, like in any marketplace. The banning of ephedrine appears to be a cold attempt at turning
    profits at the expense of poor people, or just people who want to choose how to spend their own
    money. Even if it isn't the actual intent, that is its effect, as the Law of Unintended
    Consequences (*bad* consequences here) rears its ugly head once again.

    Who protects the consumer? The regulations do not acheive this (although they are certain to claim
    so), instead they protect the profits of the medical industry (regardless of intent), which already
    consumes 14% of the US GDP. This a trend which deserves serious questioning and an understanding of
    the basics of the dismal science would help. We need competing goods (meaning substitutes for this
    discussion) to drive down the cost of medical care -- it costs too much. Perhaps ephedrine is not
    the "right drug," but I suspect if things continue as they are we'll never really know. The fact
    that ephedrine has been pushed to black market status has it's own negative consequences. Perhaps
    more police and prisons are the answer. Perhaps taxes on evil rich people (doctors with incomes
    over $200k according to John Kerry) can solve all our health needs. The capital takes flight.

    "[I]t is advisable to understand the role of prices in a market economy..." -- Sowell

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    Sowell, Basic Economics

    PREFACE


    This is an introduction to economics for the general public. The
    growing sophistication of professional economists has not been ac-
    companied by any greater spread of knowledge about basic eco-
    nomic principles among the population at large. There are, in fact,
    very few incentives for economists to spend their time explaining
    the basics of economics to the public. Indeed, even the economic
    education of college students is not likely to get much attention
    from economists, if those students are not majoring in economics.

    The net result is that complex and high-powered economic
    analysis within the profession co-exists with utter ignorance and
    gross fallacies dominating the public, the media and various
    branches of government. Even scholars with Ph.D.s in other
    fields are often ill-informed or misinformed about economics,
    though that seldom deters them from having and voicing opin-
    ions on economic issues.

    Most of us are necessarily ignorant of many complex fields,
    from botany to brain surgery. As a result, we simply do not at-
    tempt to operate in those fields. However, every voter and every
    politician that they vote for has something to say about econom-
    ics. In that case, we need to know the basics. Explaining these ba-
    sics is the purpose of this book.

    It so happens that the first book of mine that was published,
    back in 1971, was an introductory economics textbook, full of the
    kinds of graphs and equations that such books are supposed to
    have. Today, however, Basic Economics does not contain a single
    graph or equation to express the kinds of ideas that economists
    deal with. Nor does it contain such common jargon among econ-
    omists as “oligopoly,” “marginal revenue product” or “Pareto op-
    timality.” This book is about economics, not about the vocabulary
    or visual aids of economists. Having taught introductory eco-
    nomics more times than I can remember, at colleges and universi-
    ties across the country, I know how handy those visual aids can
    be and how easy it is to lapse into familiar jargon. Avoiding these
    things has made it harder for me to write this book, but the whole
    point is to make it easier for you to read it.

    What I have also learned over the years is that there are many
    highly intelligent people who want to understand more about the
    way their country’s economy works, but who have no interest in
    the paraphernalia of the economics profession. This book is written
    for such people—and also for those high school and college stu-
    dents who are taking introductory economics as part of their efforts
    to become educated women and men, not necessarily candidates to
    major in the subject. It is also written with the hope that some econ-
    omists might discover how much of what they say in ways that are
    incomprehensible to outsiders could also be said in plain English.

    In keeping with the nature of this book as an introduction to
    economics for the general public, I have left out the usual hun-
    dreds of footnotes or end-notes in some of my other books. How-
    ever, those who wish to check up on some of the surprising facts
    they will learn about can find the sources listed at the end of the
    book. This will also be a place for those who simply wish to ex-
    plore further in some subject that they find intriguing.

    While it is advisable to understand the role of prices in a market
    economy before going on to other subjects, each chapter of this
    book has been written to stand alone, so that these chapters can be
    read in any order that your own interest dictates.

    Although many of the examples of basic economic principles in
    action are drawn from market economies, such as that in the
    United States, many others are not. One of the best ways to under-
    stand what a market economy does is by seeing what happens
    when the same economic activity takes place in a non-market
    economy, such as that of the late Soviet Union. Economic experi-
    ences from every inhabited continent appear in the chapters that
    follow, for basic economic principles are not limited to any given
    society or people.

    Thomas Sowell
    Rose and Milton Friedman Senior Fellow
    Hoover institution
    Stanford University

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