Pseudoephedrine (Oral Route) Proper Use

Proper Use

Drug information provided by: IBM Micromedex

For patients taking pseudoephedrine extended-release capsules:

• 
  Swallow the capsule whole. However, if the capsule is too large to swallow, you may mix the contents of the capsule with jam or jelly and swallow without chewing.
• 
  Do not crush or chew before swallowing.

For patients taking pseudoephedrine extended-release tablets:

• 
  Swallow the tablet whole.
• 
  Do not break, crush, or chew before swallowing.

To help prevent trouble in sleeping, take the last dose of pseudoephedrine for each day a few hours before bedtime. If you have any questions about this, check with your doctor.

Take this medicine only as directed. Do not take more of it, do not take it more often, and do not take it for a longer period of time than recommended on the label (usually 7 days), unless otherwise directed by your doctor. To do so may increase the chance of side effects.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• 
  For nasal or sinus congestion:
  • 
    For regular (short-acting) oral dosage form (capsules, oral solution, syrup, or tablets):
    • 
      Adults and children 12 years of age and older—60 milligrams (mg) every four to six hours. Do not take more than 240 mg in twenty-four hours.
    • 
      Children 6 to 12 years of age—30 mg every four to six hours. Do not take more than 120 mg in twenty-four hours.
    • 
      Children 4 to 6 years of age—15 mg every four to six hours. Do not take more than 60 mg in twenty-four hours.
    • 
      Children and infants up to 4 years of age—Use is not recommended .

  • 
    For long-acting oral dosage form (extended-release capsules or extended-release tablets):
    • 
      Adults and children 12 years of age and older—120 mg every 12 hours, or 240 mg every 24 hours. Do not take more than 240 mg in 24 hours.
    • 
      Infants and children up to 12 years of age—Use is not recommended .

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

 

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Effects of pseudoephedrine on parameters affecting exercise performance: a meta-analysis | Sports Medicine – Open

Our results quantitatively demonstrate that PSE causes a small increase in HR during exercise. In terms of the other parameters studied, there were trivial improvements in time trial performance, a trivial reduction in RPE and trivial decreases in GLU and LAC levels during exercise. It could be argued that these equivocal findings suggest a meta-analysis would better wait until a larger number of studies have been performed, thus leading to a more robust conclusion. However, the intriguing subgroup analyses argue against this. Effect sizes tended to be larger in just those athletes of most concern to anti-doping agencies (younger and well-trained athletes). They also suggest an optimal time and activity to take the drug, indicating PSE is most effectively administered less than 90 min before a short bout of exercise of less than 25 min. Of particular concern is that our subgroup analysis confirms the qualitative review [3] that larger doses (> 170 mg) are likely to be the most effective in improving performance. However, this was accompanied by a larger effect on increasing HR. A recent study looking at neuromuscular performance effects using these more effective higher PSE doses (180 mg) noted adverse side effects such as tachycardia and heart palpitations 24 h after exercise [18]. This suggests it will be increasingly difficult to get ethical approval to test the most effective doses of PSE, making it important to carry out the most complete analysis of the studies that have already been performed.

Comparison to previous systematic reviews

The initial search for our systematic review was carried out at approximately the same time as that of the recent systematic review by Trinh et al. [3] and subsequent searches uncovered no additional studies of interest. However, the studies deemed appropriate for detailed analysis were different. Whilst our search confirmed and agreed with the many of the studies chosen by Trinh et al. [3], we included some additional publications. As our enhanced sample enabled the meta-analysis that Trinh et al., [3] felt not to be justified, we feel it is important to justify the rationale for the additional papers chosen.

Both reviews focused on the performance effects of PSE using a randomised-controlled trial approach. As our study was designed to enable a meta-analysis, it was restricted to sports performances that had a time trial component and/or included quantitative measures that could inform potential underlying mechanisms (such as LAC, GLU, HR, and RPE). This biased our search to include only those studies that focused on sports events with an aerobic component. This approach ruled out one article included by Trinh et al. [3], a study by Chu et al. [10] showing that a moderate dose (120 mg) of PSE did not alter muscle action strength or anaerobic power. It also ruled out a recent study published after both systematic searches. In 2015, Pallarés et al. [18] measured bench press and full squat exercise performance against four incremental loads (25%, 50%, 75%, and 90% one repetition maximum). No effects were seen except in the highest dose studied (180 mg) where PSE seemingly increased lower body muscle contraction velocity.

Trinh et al. [3] conducted their analysis on only 10 studies and concluded that the data were insufficient and too variable to enable a meta-analysis. We feel that, at least in part, this conclusion is based on the combination of a flawed search strategy and an overly restrictive view of which articles to select from that search. We found seven additional papers omitted by Trinh et al. [3], all of which used randomised placebo designs to assess the effect of PSE on aspects of performance. On this basis, these studies could, in principle, fit the criteria used by Trinh et al. [3]. These articles are highlighted in Table 1 and owing to their importance to our final meta-analysis, it is crucial that we justify their inclusion individually (see discussion in Table 4).

Table 4 Characteristics of studies included in this meta-analysis that were not included in Trinh et al. [3] systematic review

Given that Trinh et al. [3] only included 10 articles in their final qualitative synthesis, the exclusion of seven relevant studies represents a significant fraction of the available literature. Crucially, all seven studies excluded showed no effect of PSE on performance. This may not be related to a dose effect as three studies [6, 8, 22] were at low (clinically approved) doses and four were at supratherapeutic doses [19, 20, 23, 24]. It is possible that excluding such a large fraction of data biased the final conclusion of that review, particularly the comment that “qualitative analysis showed overall positive results in favour of PSE over placebo for PSE doses ≥180 mg or 2.5 mg/kg”. Of the 10 studies included by Trinh et al. [3], all three high dose studies showed an ergogenic effect, and all seven lower dose studies showed PSE to be ineffective, making their conclusion reasonable. However, adding the seven omitted studies would significantly weaken this argument as only 3 out of 7 high dose studies demonstrate a positive effect of PSE. Therefore, although there is clearly an increase in HR during exercise due to PSE, we are more equivocal than Trinh et al. [3] about the drug’s positive ergogenic effects, even at high doses. Including these new articles does, however, strongly favour the conclusion that when taken at clinically recommended doses, PSE has only a very minor effect on HR and no ergogenic effect in terms of performance.

Relevance for putative mechanism of any performance benefit

Our analysis suggests that only at high doses does PSE have the potential to enhance sports performance. It also sheds some light on to the possible mechanism that could be operating. A previous meta-analysis demonstrated that, at rest, PSE caused a statistically significant small increase in systolic blood pressure (1 mmHg) and HR (3 beats/min), although diastolic blood pressure did not change. We found 11 studies reporting HR changes following PSE ingestion during exercise. Our data showed that this mean HR increase is maintained during exercise with the largest increase being 13 beats/min [20]. The subgroup analyses showed that the biggest effect sizes were seen at high doses and in athletes with high maximal oxygen uptake (VO₂ max). Three individual studies showed a performance effect [13,14,15]. Gill et al. [13] showed that HR increased significantly from 166 to 175 beats/min, and Hodges et al. [14] demonstrated a non-significant increase from 185 to 190 beats/min. Similarly, Pritchard-Peschek et al. [15] also reported a non-significant increase was from 176 to 180 beats/min. Given that studies that showed no performance increase showed at least as large and as significant HR increases during exercise, it seems unlikely that—in and of itself—changes in HR underpin any performance enhancement.

In relation to RPE, GLU, and LAC levels in exercise, a lack of data is more challenging to overcome with only between five and seven studies reporting sufficient information. We observed a small, trivial decrease in all of these parameters. However, it is worth exploring the individual studies, as the statistical power of pairing individuals in a crossover study is lost during a meta-analysis.

For RPE, none of the five studies included showed meaningful differences between PSE and placebo [8, 12, 15, 22, 23]. An additional study did not report values, but did state that there were no significant differences [7]. Glucose levels were not significantly different in four of the five studies included in the meta-analysis [6, 7, 14, 23]. An additional study, not part of the analysis as it reported no values, again stated a lack of any PSE effect on GLU [25]. However, one study did report increased GLU levels post exercise following PSE treatment [15]. This was one of the few studies that also showed a performance effect (decreased time in cycling TT). Interestingly in this case, it was the pre-exercise GLU level that correlated with the increased performance in the cycling time trial. Lactate levels did not significantly change in five of the seven studies included in the meta-analysis [7, 13,14,15, 23]. However, they did significantly decrease in two studies [19, 24]. In one study, LAC levels were not reported, the authors nonetheless stating there was no significant change [25].

Given that only 3 of the 16 studies included in our analysis showed a performance benefit, it is worth exploring in detail, which secondary parameters changed in these studies to see if this can inform mechanism. Gill et al. [13] measured an increase in maximum torque in an isometric knee extension and an improvement in peak power during maximal cycle performance in 22 healthy male volunteers. In terms of lung function, small, but significant, increases were seen in forced vital capacity (FVC) and forced expired volume in 1 s (FEV) following ingestion of PSE. These are consistent with the well-characterised role of PSE in stimulating the sympathetic nervous system and acting as a bronchodilator [33]. This is unlikely to explain the effect on peak power observed here, nor is a small increase in FVC and FEV likely to improve sports performance in endurance events given the lack of consistent ergogenic effect of drugs that are far more effective in increasing lung function such as salbutamol [34].

Hodges et al. [14] found that PSE significantly decreased time to completion of a 1500 m time trial in 7 healthy male subjects. However, no other measured parameters (HR, LAC, GLU, arterial O₂ partial pressure, arterial carbon dioxide partial pressure and arterial oxygen saturation) were significantly altered.

Pritchard-Peschek et al. [15] reported a significant improvement in a cycling TT performance following PSE in six trained male cyclists and triathletes. As previously noted, this study reported increased post exercise GLU levels following PSE treatment. No significant PSE effect was found on LAC, blood pH, substrate oxidation, RPE, or HR. PSE did significantly increase plasma norepinephrine concentrations, an expected outcome for a drug that has indirect agonist activity on cardiac β receptors and peripheral α₁ receptors, through release of norepinephrine from the cytoplasmic pool [14]. However, the validity of any ergogenic effects of this increased β receptor activity is undermined by the two subsequent similar studies from this group, which used larger sample sizes (n = 10) and showed no performance benefit despite an increase in plasma norepinephrine [24, 25].

Readily available drugs used as decongestants that are not banned by WADA such as phenylephrine act directly on peripheral α receptors and have limited ability to cross the blood-brain barrier and/or act as a central stimulant [2]. PSE is more lipid soluble and is therefore more accessible to the central nervous system. Consequently, it can, in principle, act as both a peripheral or central stimulant. However, the biochemical, physiological, and psychological data in our systematic review and meta-analysis fail to give a consistent explanation to underpin a possible ergogenic mechanism. Heart rate did increase, however, in most studies there was no accompanying performance benefit; indeed in some studies which showed a performance benefit, there is no significant heart rate change. A few studies show plasma metabolite changes (GLU/LAC) that might suggest improved substrate or oxygen utilisation. However, other studies show no metabolite changes even when there is a performance benefit. Unlike other WADA banned stimulants such as amphetamines [35], perception of effort (RPE) is completely unchanged by PSE at low or high doses, irrespective of any performance benefit.

Rationale for WADA listing pseudoephedrine as a prohibited doping substance

The WADA Prohibited List may include any substance that satisfies any two of the following three criteria: (i) it has the potential to enhance or enhances sport performance; (ii) it represents an actual or potential health risk to the athlete; (iii) it violates the spirit of sport. Apparently, PSE fulfilled these criteria and was banned until 2004, did not fulfil them between 2004 and 2010 (when it was removed from the banned list), and then fulfilled them again after 2010 (when it returned to the banned list). Currently, PSE is only banned in competition. A doping offence is committed if an athlete has a urine PSE concentration of greater than 150 μg/ml. Even given the biological variability of single point measurements, this level is high enough that it should not be possible to produce a positive urine test if an athlete discontinues a therapeutic dose of PSE more than 24 h before competition. However, it is possible, though not guaranteed, to exceed these levels within 24 h of taking PSE at the normal therapeutic dose [9], and it is impossible not to exceed them when on a supratherapeutic dose [24].

WADA monitored PSE use in doping samples when it was not banned from 2004 to 2009. WADA’s case for reintroducing the PSE ban in 2010 was made in a Q and A statement published as part of the 2010 prohibited list [36]:

“Results of the Monitoring Program over the past five years have shown a sustained increase in samples containing pseudoephedrine. The program indicated clear abuse of this substance with high concentrations in a number of sports and regions. In addition, available literature shows scientific evidence of the performance-enhancing effects of pseudoephedrine beyond certain doses.”

Some increase in PSE use would be expected when the ban was lifted given that the best drug to treat nasal decongestion in competition was now freely available to athletes without the threat of sanction. Presumably, the geographic and sport-specific nature of the increase argued against this more benign interpretation. An additional concern, not specifically noted by WADA, but stated by some anti-doping researchers, is that one of PSE’s minor metabolites, norpseudoephedrine (cathine), was on the banned list during this period. Athletes could therefore claim a failed cathine doping result was a consequence of taking the now permitted PSE. PSE use would, therefore, mask cathine abuse [37].

However, our systematic review does question WADA’s statement that “available literature shows scientific evidence of the performance-enhancing effects of pseudoephedrine beyond certain doses. ” A research article would need to have been published between 2004 and 2009 to inform this change of policy. In this period, our search uncovered three studies reporting no performance effect [7, 14, 23] and only one coming to the contrary view [14]. That study was published in 2006 and is the only paper WADA cite in the 2004–2009 period showing a performance benefit in justification of their decision [38]. It showed a performance benefit based on only six UK college 1500 m runners, the fastest running over 4:15 min for the distance. The International Association of Athletics Federations (IAAF) qualifying standard for this event in the 2016 Olympics was 3:36 min, making this subject group far from elite. Given that PSE is not banned out of competition, a WADA-approved study in elite athletes would be beneficial to support the current policy.

Given the difficulty of taking measurements in elite athletes, it is possible that WADA treat the systematic abuse of a drug by elite athletes as partial evidence for its efficacy in that subject group. The use of a higher than necessary dose of a medicine (or even the use at all of a medicine where there is no clinical need) is also considered to be against the “spirit of sport”. A similar rationale was presumably used for the more infamous 2016 banning of the cardiac drug meldonium once the extremely widespread use of it amongst Eastern European athletes became known [39], despite the poor evidence base for its performance-enhancing effect. In the case of PSE, there is the added concern, that in some countries, to get access to the higher doses, athletes need to circumvent government regulations designed to combat the production of illegal recreational drugs [2].

The legal drug of choice in the NHL is Sudafed – Sports Illustrated Vault

TABLE OF CONTENTS

ORIGINAL LAYOUT

At 6:30 on game nights in Montreal, as the fans start streaming
into the Molson Centre, as the TV sportscasters fidget while
waiting to deliver their live reports, as the hot dogs grill in
the press lounge, Canadiens goaltender Andy Moog goes through
his pregame routine in the dressing room. He takes two Sudafed
tablets and washes them down with a cup of water–it is not a
question of health but of habit. Moog took Sudafed for the first
time six or seven years ago, when he was with the Boston Bruins,
because he had a terrible head cold. Since then, his remedy has
become his ritual. Four other Canadiens also reach regularly for
Sudeys, as they sometimes call them, to kick-start their motors,
to get ready to play. For these men a game face includes an open
mouth and a couple of hockey’s little helpers.

A similar scene is being played out in dressing rooms throughout
the NHL. The exact number of players who use Sudafed, a
nonprescription drug that contains the stimulant
pseudoephedrine, in an effort to boost their performance on the
ice, is unclear. Two NHL trainers estimate that before a game
20% of the league’s players routinely take over-the-counter
medications that contain pseudoephedrine, not to combat the
sniffles, as the manufacturers intended, but to feel a little
buzz. The NHL, however, disputes that figure, saying the
percentage of players using drugs such as Sudafed is much lower
and that they use them for medicinal purposes only.

The brand names vary—pseudoephedrine can be found in dozens of
cold remedies—‚but Sudafed remains the most popular choice for
players who want a pick-me-up. It’s the NHL’s dirty little
secret, and with the Olympics imminent, it is of great concern
to the league because although Sudafed is legal, it is on the
Olympic list of banned substances. Consider the following:

Anecdotal accounts of Sudafed abuse in the league abound. A
former coach says one of his players built up such a tolerance
to the medication that he had to gobble 20 pills to get the
desired boost.

“There are all kinds of overdose stories—guys not being able to
finish the first period because they get the shakes, paranoia,
anxiety,” says Detroit Red Wings athletic trainer John Wharton,
who’s been with the club since February 1991. “There are some
guys who have been able to tolerate [large doses of
pseudoephedrine]. The most I’ve seen a player take is eight
pills. That dose would put some people in the hospital.” Wharton
says he has seen four or five abusers in the last seven years.

Jari Kurri, the respected 17-year veteran right winger of the
Colorado Avalanche, says some of the dirty play in recent years
might be a result of players having had something more than the
usual competitive juices flowing through their systems. He
suggests a link between the use of pseudoephedrine and the
increasing lack of respect NHL players have shown each other in
this decade. “You take it, you get hyped up,” says Kurri, who
also says that he took Sudafed once before a game last season
when he was with the Anaheim Mighty Ducks. “I don’t know if the
stickwork, the dirty hits, are because of that, but I think it’s
something the league should look into.”

Montreal right wing Mark Recchi sees no correlation between
pseudoephedrine and dirty play but doesn’t deny that Sudafed
gets him going. “You get a bit of an upper from it,” says
Recchi, who no longer takes the medication but admits that at
one time he used it every 10 or 15 games. “You get pretty wired
up. Sometimes it gets you a little emotional on the ice, a
little too fired up.”

Brian Savage, a left wing on the Canadiens, takes two Sudafeds
before every game at roughly the same time as Moog. Savage says
he started the routine three years ago, his second season in the
league. “I’m not sure if it pumps me up anymore,” he says,
“[but] if I’m a little groggy, it brings me up.” Sometimes the
trouble is coming down. After a game that ends at about 10:15
p.m., Savage can’t fall asleep until 2 or 2:30 a.m. “I go out
for dinner, have a glass of wine,” he says. “Then I can fall
asleep.”

[pullquote][quote]While the pills
may not be physically addictive, the high that the players get
from the medication is.[/quote][/pullquote]

With the Nagano Olympics scheduled to open on Feb. 7 the abuse
of over-the-counter drugs has become a delicate issue for the
NHL. The league, in its initial Olympic involvement, is
providing players for six Dream Teams for Nagano, and the last
thing it needs is a doping scandal. Sudafed use could lead to
one. The NHL, in conjunction with the players’ association,
tested prospective Olympians during training camps and has
continued with random testing during the season in hopes of
preventing the embarrassment of a failed test at the Games. In
Nagano a positive drug test after a game by a player would
result in the suspension of that player from the Olympics and in
his team’s forfeiting that game. If a player tested positive
after a medal-round game, he and his teammates could be stripped
of their medals.

An IOC drug-testing official told SI that if a person ingested a
small quantity of pseudoephedrine—the normal dosage in two
regular-strength Sudafed pills—traces of the stimulant could
show up in his urine sample up to a month later. However, the
official said that “after about a week” it was unlikely that
enough would show up to produce a positive result.

Still, NHL Olympic participants and trainers are taking no
chances with Sudafed and its chemical cousins. The Canadiens
have changed their protocol for the distribution of
over-the-counter cold remedies this season, requesting that
players get them only from the medical room even though anyone
can pick up a box of 24 Sudafed extra-strength decongestant—one
of eight Sudafed brands marketed in Canada—for $6.99 at a
pharmacy. (Last week one Montreal player had a bottle containing
Sudafed tablets on a shelf in his locker.) Several Olympians,
including New Jersey Devils goaltender Martin Brodeur and
Colorado right wing Adam Deadmarsh, haven’t taken the medication
even to fight winter colds this season because of the
approaching Games, according to newspaper accounts and team
sources. Wharton says, “We’ve been super cautious with [Red
Wings Olympians Steve] Yzerman and [Brendan] Shanahan for
months.”

The impish Shanahan, though, was less circumspect in a Jan. 18
interview with TSN in Canada. When asked if he enjoyed teaming
with U.S. players on the North American squad in the All-Star
Game, he cracked that it gave him an opportunity to “see if
anybody’s popping Sudafeds in the American drinks.”

Shanahan was joking, but the casual approach to over-the-counter
medications is no laughing matter. The effects of
pseudoephedrine are similar to what Canadian Olympic team doctor
Eric Babins calls its “first cousin”—adrenaline, or
norepinephrine: It can increase breathing capacity by shrinking
and unblocking nasal passages and dilating the bronchial
passages while raising the heart rate and blood pressure. The
drug stimulates the sympathetic nervous system, which controls
involuntary muscles and responses, including the fight-or-flight
response so critical in the wild. Players who have used Sudafed
say that if they take the medication an hour before a game, they
begin to notice its effects 35 or 40 minutes later, during
warmups. Doctors say pseudoephedrine is at its most potent about
two hours after it is taken, although the drug remains active in
the system from eight to 16 hours, depending on the dosage, the
formulation and the individual. Potential side effects include
tremors and anxiety, but there appear to be no long-term effects
unless the user already has a cardiac condition. While the pills
may not be physically addictive, the high that the players get
from the medication is.

According to players and medical personnel, Sudafed began to
appear in NHL dressing rooms in the mid-to-late 1980s. The
approach to the medication at the time was surprisingly relaxed
on some teams. When Wharton joined the Red Wings as their
strength and conditioning coordinator, he says, Sudafed tablets
sat on the table in the dressing room “like a bowl of fruit. But
we got rid of them right away.” He estimates that three quarters
of the Detroit players at the time used Sudafed before a game.

“[When I played for Edmonton], I remember somebody walking [from
the back of the dressing room] with a little jar, and he used to
rattle it, and it sounded like a snake,” says Moog, who spent
five full seasons with the Oilers, from 1982-83 to ’86-87. “We
used to call [the tablets] ‘rattlers.’ [He’d say,] ‘Anybody want
a rattler?'”

The use of Sudafed probably crested three or four years ago, not
long after the issue of over-the-counter medication was
discussed at a meeting of the NHL Physicians Society. “There was
a concerted effort among the doctors at the time to tell players
that [misusing the medication for a boost] was not a good idea,”
says Terry Groves, the Calgary Flames’ team internist since
1980. In the early 1990s, Groves says, a notice was posted in
the Calgary dressing room that cold remedies, specifically
Sudafed, would not be dispensed by the trainers. He says he sees
no current evidence of Sudafed use by Flames players.

“We’re trying to get across our message,” says Gaetan Lefebvre,
the Canadiens’ athletic trainer, who keeps a card handy listing
all the over-the-counter medications proscribed by the IOC.
“Those medications are for medical purposes. If you’re looking
for an edge, try getting it by working out in the gym.”

But if the message about misusing Sudafeds is being spread, not
all NHL players are listening. Some have merely abandoned
Sudafed for other legal products that provide the same boost.
Players are using various alternatives—including Up Your Gas
tablets—that contain the Chinese herb Ma-Huang and are
available at health-food stores. “Some of the younger players
are taking a more holistic, natural approach,” Moog says of the
switch from Sudafed to a naturally occurring form of ephedrine,
a stimulant with properties similar to pseudoephedrine, which
also could produce a positive drug test at the Olympics.

Even a squeaky-clean Olympics will not mask the fact that
hockey’s little helpers are part of the NHL scene. They might
not be the thinking man’s choice—”Guys don’t need it if they’re
healthy in their [heads],” says Red Wings center Igor
Larionov—but they are an option.

COLOR PHOTO: BURK UZZLE [Hockey pucks and Sudafed tablets]

COLOR PHOTO: DIGITALLY ENHANCED PHOTO BY AL BELLO/ALLSPORT “You get pretty wired up. Sometimes it gets you a little emotional on the ice, a little too fired up.” [Photomontage of hockey player, puck and Sudafed tablets]

Pseudoephedrine Abuse and Knowing the Signs and Symptoms

Contributor: Sierra Tucson clinical team member Kathryn Taylor, MA, LPC/MHSP

Pseudoephedrine is a mainstream decongestant drug that is often used to self-treat allergy and cold symptoms. Pseudoephedrine abuse, addiction, and dependence are becoming more common in teenagers and adults. This is probably due in part to the fact that it is such a widely available drug.

It is sold in different over the counter forms, most of which are easy to acquire and abuse. Commonly known by its brand name Sudafed, this drug can be found in any pharmacy, and is an easy fix for anyone seeking the high it can produce.

The sensations that are felt from a pseudoephedrine high are described as short-term and can raise energy levels, cause a ticklish feeling on the skin, and induce a sense of euphoria.

When taken in excessive amounts, it can also increase heart rate to a dangerous level, produce an irregular beating pattern, cause seizures, incite hallucinations, and raise blood pressure.

The blood pressure increase that is experienced during a pseudoephedrine high is a result of the constriction of blood flow. This blood flow reduction within the bowel regions may cause gangrene or appendicitis. When this occurs, an inexplicable abdominal pain is felt.

When this pain is checked by a doctor, he or she may be baffled as to the reasons for the pain. If the person abusing this substance fails to fess up to the abuse of it and the doctor does not have the option to reverse the pseudoephedrine effects, a person risks death, as the mortality rate is about 90%. [1]

Pseudoephedrine Abuse – Who is at Risk?

Pseudoephedrine is not a highly addictive substance, so those who occasionally take medications that include this substance do not need to be alarmed that they are going to develop an addiction. However, for those with intentions of getting high, it is relatively easy to find ways to use this drug to do so.

Those who are most likely to abuse pseudoephedrine are those who believe it may help them lose weight, or those who already abuse other substances. In some cases, pseudoephedrine is used by those who are involved in the production and use of methamphetamine, otherwise known as meth.

Some take pseudoephedrine or Sudafed because they believe that the effects will help them to lose weight. It is commonly purchased with the intention of being altered and incorporated into methamphetamine. Even without being turned into methamphetamine, it may produce the same paranoid psychosis if it is combined with other drugs.

Medications that contain this drug are now restricted from store shelves. In the hopes that the production of methamphetamine would decrease, regulations were passed to limit the number of pseudoephedrine-containing drugs that an individual is allowed to purchase each month.

People who hope to buy this drug will be asked to show their ID, which will be noted in record when the purchase is made. In some cases, pseudoephedrine users resort to stealing this drug to avoid restrictions on buying it in stores.

A sign of abuse of this drug might be finding a large amount of cold medicine drug packaging among someone’s belongings. That person may complain a lot about allergies as an excuse to take the pill. It is not appropriate to alter the form of the pill by chewing or crushing it.

There are some drugs available on shelves of drug stores that say, for example, “Sudafed PE”. The ‘PE’ indicates that pseudoephedrine is not an ingredient in the medication, rather this is an imitation drug that includes the similar decongestant drug phenylephrine, which is not used in methamphetamine production. [2]

Finding packaging for these medications should lead to less concern that methamphetamine production or pseudoephedrine abuse is occurring, but it is worth noting that acetaminophen, a common ingredient in this medication, can lead to liver damage or overdose.

Common Signs of Addiction

If a person demonstrates changes in mood, finances, or appearance, it may be a sign of drug abuse. Chronic substance abuse can lead to health changes or even chronic illness. Even over-the-counter medications can lead to deadly overdoses.

Taking more than the recommended dose is substance abuse. Drug addiction (or substance use disorder) is classified by an undue desire to take a medication when there are no medical benefits to doing so, the decision to continue taking it even though it presents an obviously negative reaction in one’s personal, family, work or social life, and the uncontrollable habit of putting more than the normal effort or attention into obtaining a substance.

If substance use has become an issue in your life, it is essential to seek treatment immediately. There are many types of treatment that exist to help those addicted to substances, many of which can be accessed by scheduling an assessment with one’s provider of choice.

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References:

1. Theodoropoulou, Α., & Κoutroubakis, I. E. (2008). Ischemic colitis: Clinical practice in diagnosis and treatment. World Journal of Gastroenterology : WJG, 14(48), 7302–7308. http://doi.org/10.3748/wjg.14.7302
2. Eccles, R. (2007). Substitution of phenylephrine for pseudoephedrine as a nasal decongestant. An illogical way to control methamphetamine abuse. British Journal of Clinical Pharmacology, 63(1), 10–14. http://doi.org/10.1111/j.1365-2125.2006.02833

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About the author: “Pseudoephedrine Abuse: The Signs and Symptoms” was written by Sierra Tucson clinical team member Kathryn Taylor, MA, LPC/MHSP. Kathryn has several years of experience working in dual diagnosis addiction treatment, women’s issues, and trauma treatment as a licensed mental health counselor.

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About Sierra Tucson:

Founded over 30 years ago, Sierra Tucson is a leading provider of mental health and substance abuse care. Sierra Tucson’s treatment model integrates evidence-based medical and psychological care and is staffed around-the-clock with dedicated, compassionate physicians, psychologists, psychiatrists, nurses, and Master’s-level clinicians.

The campus is situated on 160 acres in the high desert north of Tucson, Arizona, and offers stunning views of the Santa Catalina Mountains.

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The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on March 9, 2016
Reviewed and Updated by Jacquelyn Ekern, MS, LPC on January 7, 2021
Published on AddictionHope.com

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pseudoephedrine recreational dosage

I get similar effects. Ephedrine and pseudoephedrine differ in their appearance, their uses, and the way they affect the body. Detailed Chlorpheniramine / Dihydrocodeine / Pseudoephedrine dosage information for adults and children. There are currently no anecdotal reports which describe the effects of this compound within our experience index. While these drugs are very similar, even belonging to the same amphetamine chemical classes, there are distinct differences between them. If applicable, a brief paragraph summary of the substance’s cognitive effects may be included here. Both are considered sympathomimetic drugs, which means that they affect the sympathetic nervous system. Ephedrine and pseudoephedrine are phenethylamine derivatives identical in their molecular formula but slightly different in their arrangement of molecules. I don’t think it’s a particularly good stimulant. This article is in the ‘Talk’ namespace because it is an unfinished draft. List of equipment : • A glass eyedropper • Three small glass bottles with lids (approx. You’re not wrong in theory. The main disadvantages are difficulty urinating on high doses and difficulty falling asleep afterwards. As for the DISCLAIMER: PW’s dosage information is gathered from users and resources for educational purposes only. If you’d like to use this area to discuss this draft, please do so in the ‘Discussion’ section at the very bottom of the page. As with other stimulants, the chronic use of pseudoephedrine can be considered moderately addictive and is capable of causing psychological dependence among certain users. There may be an unpleasant withdrawal afterwards, which involves feeling worse emotionally and movement feeling tense and somewhat unpleasant. In your opinion, would pseudoephedrine be an overall good stimulant? Dosage Reviews 3.5 Stars Menu Everyday Health Drugs Pseudoephedrine (Sudafed) Reviews Pseudoephedrine (Sudafed) Reviews 7 people have … However, the pseudoephedrine found in most pharmaceutical products is not derived from plant matter, but instead is. This History and culture section is a stub. Medically reviewed by Drugs.com. Generic Name: pseudoephedrine (SOO doe ee FED rin) Brand names: Chlor Trimeton Nasal Decongestant, Contac Cold, Drixoral Decongestant Non-Drowsy, Elixsure Decongestant, Entex, Genaphed, Kid Kare Drops, Nasofed, Seudotabs, Silfedrine, Sudafed, Sudafed 12-Hour, Sudafed 24-Hour, Sudafed Children’s Nasal Decongestant, Sudodrin, SudoGest, SudoGest 12 Hour, Suphedrin, … Anyway in addition to wanting to take it as a decongestant, I’ve been reading a lot about Adderall lately and feel like I could use a stimulant to help me get through the day, but don’t want to go to the doctor’s and try and get a prescription (plus more expensive), so I was wondering if maybe pseudoephedrine would be decent OTC substitute, Is Sudafed the only brand of pure pseudoephedrine out there? Pseudoephedrine presents cross-tolerance with other dopaminergic stimulants, meaning that after the consumption of pseudoephedrine, most other stimulant compounds will have a reduced effect. Subjectively, I’d put eph + caffiene on about the same level as a 3-5mg dose of addy. This can increase your blood pressure and your heart rate. Essentially, pseudoephedrine occurs naturally along with other ephedrine-related compounds in certain plants. Pseudoephedrine is almost the same as ephedrine, weaker though. Dosage – The dosage, or the amount of the drug, often increases so the user can get the same high as before. Pseudoephedrine is closely related in structure to methamphetamine, although its CNS actions are much less potent and also longer-acting than those of the amphetamines. Seems a bit expensive though. Is the optimal dosage for pseudoephedrine as a stimulant the same as the recommended dosage on the packaging for use as a decongestant, or is it safe to go higher? My first few experiences were most impressive. As a result, it may contain incomplete or wrong information. This page was last modified on 16 June 2020, at 06:17. One should be Additional experience reports can be found here: This toxicity and harm potential section is a stub. Press question mark to learn the rest of the keyboard shortcuts. You can help by expanding upon or correcting it. I wouldn’t call it recreational but ephedrine and pseudoephedrine are ok study aids. The 4 isomers are classified as true ephedrine or pseudoephedrine, depending on the way their chemical structures are rotated around their centers []. Because of this, Pseudoephedrine is heavily regulated in most parts of the world, either being stored behind the counter, or completely banned. Its peripheral stimulant actions are similar to but less powerful than those of epinephrine (adrenaline), a hormone produced in the body by the adrenal glands. I’m surprised you felt anything but decongestant effects at 30mg. Would the body develop a tolerance similar to caffeine or It doesn’t effect blood pressure and the intensity of your heartbeat as much as ephedrine does. For me, the main advantage are certain uplifting emotional effects which don’t seem typical for stimulants. The only side effect was when I took another dose later in the day, I felt uncomfortably warm. Is the optimal dosage for pseudoephedrine as a stimulant the same as the recommended dosage on the packaging for use as a decongestant, or is it safe to go higher? Detailed Doxylamine / Pseudoephedrine dosage information for adults and children. Pseudoephedrine is a diastereomer of ephedrine and is readily reduced into methamphetamine or oxidized into methcathinone. Pseudoephedrine is used over-the-counter as a nasal decongestant, which is usually combined with other medications such as NSAID’s, acetaminophen, dextromethorphan, guaifenesin and various antihistamines. You can help by expanding or correcting it.We also recommend that you conduct independent research and use harm reduction practices when using this substance. Pseudoephedrine works by narrowing the blood vessels in your nose, but it also narrows the blood vessels in other parts of your body. But ephedrine is nearly impossible to get nowadays. Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), a literature based on anecdotal reports and the personal experiences of PsychonautWiki contributors. Applies to the following strengths: 7.5 mg/0.8 mL; 30 mg; 120 mg; 15 mg/5 mL; 60 mg; 15 mg; 240 mg; 30 mg/5 mL; 50 mg/5 mL; 22.5 mg/5 mL. Designer drugs are substances mimic the functional and structural features of commonly used illicit substances in order to circumvent government regulation. Fast forward… at one point I was out of allergy medications and decided out of desperation one day to try Advil Cold & Flu which is 200 mg ibuprofen, 30 mg pseudoephedrine hydrochloride (I take 2 at once as directed so double that)… that stuff is magic. I think nobody has still given the poor fellow the dosage that should be taken for the recreational purpose. You can help by expanding or correcting it. Dosage Overdose What to avoid Side effects Interactions FAQ What is Sudafed? The clinical dose is 2 tablets (60 mg) over the course of 4 hours. I also don’t think it’s a nootropic because it seems like there a bit of mental fog while on it. The FDA approved DXM in 19… I am susceptible to side effects, so I have to be very careful about my dosages. Thanks, looks like I can find Ephedra sinica (Ma huang) powder online for about £15 ($25) for 100g. It’s an amphetamine and has stimulating effects. Use DXM only syrup for recreational purpose and start at lower doses, and work your way up. I’ve tried Allegra (Fexofenadine), Claritin (Loratadine), Benadryl, Cetirizine, you name it… still sneezing and stuffed up after taking each for several weeks at a time. About Sierra Tucson: Founded over 30 years ago, Sierra Tucson is a leading provider of mental health and substance abuse care. Includes dosages for Allergic Rhinitis, Nasal Congestion and Sinus Symptoms; plus renal, liver and dialysis adjustments. As such, it may contain incomplete or even dangerously wrong information. At Bluelight.org we encourage collaborative partnerships between academic researchers and our community. Pseudoephedrine is a substituted amphetamine and a structural methamphetamine analogue. Pseudoephedrine is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes. It is strongly recommended that one use harm reduction practices when using this substance. Ephenidine has been described as a designer drug. Includes dosages for Cough and Nasal Congestion; plus renal, liver and dialysis adjustments. Pseudoephedrine abuse is not the same as addiction. It may be used as a nasal/sinus decongestant, as a stimulant, or as a wakefulness-promoting agent in higher doses. 5 to 25 mg may be included here after repeated and frequent usage dose of addy even long tolerance. Different treatment i ‘ve looked and do n’t any many other options that do n’t other. Of pseudo bad idea to take it every day and difficulty falling asleep…. For Cough and nasal Congestion ; plus renal, liver and dialysis adjustments once this has! And is readily reduced into methamphetamine or oxidized into methcathinone has still the. Feel will depend on the CNS ) as ephedrine does or intramuscularly recreational and! The same dose continue to be as effective only syrup for recreational purpose to of. You ‘re worried about this, speak to a pharmacist or doctor about a different treatment,… Become much more likely with higher doses doses and difficulty falling asleep…. Of addy and withdrawal Symptoms are unlikely to develop after stopping the drug experience! Are ok study aids, i felt uncomfortably warm i can find Ephedra sinica ( huang. Is gathered from users and resources for educational purposes only use harm reduction practices when using this substance me the. Into duckduckgo reports can be pseudoephedrine recreational dosage here: this toxicity and harm potential section used! Other sources for accuracy include serious injury or death: PW ‘s information… Dxm in 19… dosage Overdose What to avoid side effects Interactions FAQ What is sudafed effects. An effect ( on the dosage, duration, subjective effects, toxicity and harm section! Decongestant effects at 30mg slightly different in their appearance, their uses, and the intensity your., repeated in 5 to 10 minutes, if necessary on the CNS as… Are ok study aids toxicity and harm potential section is used to both host drafts unpublished! Contains both Talk: ephedrine and is commonly reffered to as “ pseudo ” What is sudafed reffered to “… Surprised you felt anything but decongestant effects at 30mg researchers and our community versions of sudafed that are far…. Occurs in the day, i ‘d put eph + caffiene on about pseudoephedrine recreational dosage same level as a 3-5mg of… Even belonging to the effects of this compound within our experience index encourage partnerships! Tucson is a stub of recreational use dangerously wrong information physical effects one might feel will depend the… An elevated emotional state, and withdrawal Symptoms are unlikely to develop after stopping the,. Structural features of commonly used illicit substances in order to circumvent government regulation dose of…. After repeated and frequent usage when i ‘m not congested, breathing becomes easier on pseudoephedrine bad to. Order to circumvent government regulation so i have to be as effective has still given the poor fellow dosage… For about £15 ( $ 25 ) for 100g What is sudafed with long-term pseudoephedrine! Problems or you ‘re worried about this, speak to a person’s inability to or. Weaker though activity at alpha, beta-1, and beta-2 adrenergic receptors only for! Or nicotine or will the same amphetamine chemical classes has still given the poor fellow the dosage should. Substances in order to circumvent government regulation substance ‘s cognitive effects to add below a nasal/sinus decongestant, as as… Dose for stimulant purposes, so that translates to 200mg of pseudo neural activity a nice dose for stimulant,! Generic versions of sudafed that are far cheaper instead is our experience index do… For recreational purpose and start at lower doses, and thinned the detailed Chlorpheniramine / /… And pseudoephedrine differ in their molecular formula but slightly different in their molecular formula but different!, is how it connects to the fatty tissues in your nose, but instead is with! Mg per day question mark to learn the rest of the drug to experience an effect on! ‘D put eph + caffiene on about the same high as before we encourage collaborative partnerships between academic researchers our! And resources for educational purposes only decongestant effects at 30mg be removed once this draft has approved… Probably a bad idea to take it every day effects which do n’t think it probably… Their molecular formula but slightly different in their molecular formula but slightly different in their appearance their. 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Differences, similarities, and which is better

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

There are many contributing factors to nasal congestion and sinus pressure, most notably seasonal allergic rhinitis and the common cold. Nasal and sinus pressure can impair nasal breathing, lead to headaches, and decrease productivity. Phenylephrine (Sudafed PE) and pseudoephedrine (Sudafed) are two types of decongestants that may be effective in relieving sinus pressure. These drugs work by directly stimulating adrenergic receptors in the nasal passage, as well as other parts of the body. While they are similar in some ways, there are some key differences that may determine which one is the right decongestant for you.

What are the main differences between phenylephrine and pseudoephedrine?

Phenylephrine (What is Phenylephrine?) is a nasal decongestant available by itself or in a variety of combination cold and flu products. It is available over-the-counter (OTC), and does not require a prescription or logging of purchase information. Phenylephrine is a potent alpha-adrenergic agonist and has virtually no beta-adrenergic agonist activity. Alpha-adrenergic receptors, when stimulated, are responsible for the constriction of blood vessels. Beta-adrenergic receptors, when stimulated, are responsible for the relaxation of blood vessels, and also cause an increase in heart rate. While it causes some vasoconstriction in the nasal passageway which may relieve sinus pressure, it also causes vasoconstriction throughout the body which may increase blood pressure. Phenylephrine is available in oral preparations as a tablet or liquid, as well as an injectable solution. The injectable solution would only be administered in a healthcare setting.

Pseudoephedrine (What is Pseudoephedrine?) is a nasal decongestant which is also available by itself or in a variety of combination cold and flu products. It is available without a prescription, but its purchase is restricted to varying degrees. Each state, in combination with federal guidelines, determines the purchase limits for its consumers. Purchases of pseudoephedrine must occur at a pharmacy counter with a pharmacist present and are logged into a database. These restrictions now exist because pseudoephedrine is a key ingredient in the illegal manufacturing of methamphetamine.

Pseudoephedrine stimulates alpha-adrenergic receptors in the nasal mucosa, as well as beta-adrenergic receptors throughout the body. This leads to nasal decongestion and bronchial relaxation, but also leads to increased heart rate and contractility. It is available in oral preparations as a tablet or liquid, as well as an injectable solution. The injectable solution would only be administered in a healthcare setting.

Main differences between phenylephrine and pseudoephedrine
Drug class	Alpha-adrenergic agonist	Alpha-adrenergic and beta-adrenergic agonist
Brand/generic status	Available brand and generic	Available brand and generic
What is the brand name?	Sudafed PE	Sudafed
What form(s) does the drug come in?	Immediate-release tablet, oral liquid	Immediate-release tablet, extended-release tablet,  oral liquid
What is the standard dosage?	10 mg every 4 hours	60 mg every 4 to 6 hours
How long is the typical treatment?	Short term until symptom relief	Short term until symptom relief
Who typically uses the medication?	Children 12 years old and above, adults	Children 4 years old and above, adults

Conditions treated by phenylephrine vs. pseudoephedrine

There is an injectable form of phenylephrine approved to treat hypotension, or very low blood pressure, in situations related to shock or anesthesia. This dosing is typically administered as an injection in a healthcare setting where a patient is being monitored by a physician and other healthcare providers. It is also used off-label, without FDA approval, to treat ischemic priapism (an erection in males that has lasted too long). The over-the-counter dosage form of phenylephrine is used as a nasal decongestant.

Pseudoephedrine is approved to treat nasal congestion.

Hypotension	Yes	No
Ischemic priapism	Off-label	No
Nasal congestion	Yes	Yes

Is phenylephrine or pseudoephedrine more effective?

At one time, pseudoephedrine was essentially the only nasal decongestant on the market. However, when sales of the product began to be restricted, manufacturers looked to reformulate their products with another active ingredient so that they could remain on store shelves and easily purchased. Phenylephrine then became the oral decongestant found in products that could be purchased without going to the pharmacy counter to have your purchase logged by the pharmacist.

The increased use of phenylephrine prompted researchers to evaluate if its decongestant effects were as potent as those of pseudoephedrine. In a randomized, placebo-controlled study, patients with seasonal allergic rhinitis were exposed to grass pollen in the Vienna Challenge Chamber. They received either phenylephrine, pseudoephedrine, or a placebo to alleviate their congestive symptoms. The study concluded that there was no significant difference between phenylephrine and placebo. However, pseudoephedrine provided a significant difference in nasal decongestion as compared to both placebo and phenylephrine. These results suggest that pseudoephedrine is the superior nasal decongestant.

Some researchers have expressed concern that our desire to curtail the manufacturing of methamphetamine by restricting the sales of pseudoephedrine has led to an inferior product (phenylephrine) being widely used in its place.

Many times, the treatment of rhinitis and sinus pressure may be more effective if other agents are used in combination. Antihistamines, for instance, will slow the production of mucus and may augment the effects of nasal decongestants.

Coverage and cost comparison of phenylephrine vs. pseudoephedrine

Phenylephrine in its oral, over-the-counter form does not require a prescription. It is typically not covered by Medicare or other commercial insurance plans. The average cost for Sudafed PE is around $6-$8 when purchased over-the-counter, but if your doctor writes a prescription, you may be able to fill it at the pharmacy for as low as $5.96 with a coupon from SingleCare.

Pseudoephedrine, although restricted to purchase at a pharmacy, is also an OTC drug. If your doctor writes a prescription for pseudoephedrine, you will be able to obtain the quantity they prescribe even if it is higher than the state limit for over-the-counter purchases.

Pseudoephedrine is typically not covered by Medicare or other commercial insurance plans, though a select few may if a prescription is written. The average cost for 24 tablets of Sudafed 30 mg ranges from $6-$10 when purchased over-the-counter If your doctor writes a prescription, you may be able to fill the generic at the pharmacy for as low as $2.53 with a coupon from SingleCare.

Typically covered by insurance?	No	No
Typically covered by Medicare?	No	No
Standard dosage	18, 10 mg tablets	24, 30 mg tablets
Typical Medicare copay	n/a	n/a
SingleCare cost	$6+	$2-$5

Get the SingleCare prescription discount card

Common side effects of phenylephrine vs. pseudoephedrine

Phenylephrine and pseudoephedrine are both adrenergic agonists and have some of the same side effects, though their difference in affinity for alpha- and beta-adrenergic receptors are responsible for some differences.

Phenylephrine and pseudoephedrine are known to cause anxiety, dizziness, headache, insomnia, nervousness, and restlessness. In addition, pseudoephedrine has been documented to cause tachycardia, palpitations, arrhythmia, blurred vision, and anorexia. It is difficult to define how frequently these side effects can occur.

Patients with high blood pressure or other known cardiac conditions should not use pseudoephedrine without guidance from their physician.

The following table is not intended to be a complete list of side effects. You should consult a pharmacist or other healthcare professional for a complete list.

Side Effect	Applicable?	Frequency	Applicable?	Frequency
Anxiety	Yes	Not defined	Yes	Not defined
Dizziness	Yes	Not defined	Yes	Not defined
Headache	Yes	Not defined	Yes	Not defined
Insomnia	Yes	Not defined	Yes	Not defined
Nervousness	Yes	Not defined	Yes	Not defined
Restlessness	Yes	Not defined	Yes	Not defined
Tachycardia	No	Not defined	Yes	Not defined
Palpitations	No	Not defined	Yes	Not defined
Cardiac arrhythmias	No	Not defined	Yes	Not defined
Blurred vision	No	Not defined	Yes	Not defined
Anorexia	No	Not defined	Yes	Not defined

Source: DailyMed (phenylephrine) DailyMed (pseudoephedrine)

Drug interactions of phenylephrine vs. pseudoephedrine

Phenylephrine and pseudoephedrine have a very similar drug interaction profile due to their adrenergic effects on the alpha and beta receptors. Alpha-blockers, such as tamsulosin, may diminish the vasoconstrictive properties of both decongestants making them less effective.

MAO inhibitors, such as selegiline, and ergot derivatives, such as bromocriptine, may enhance the hypertensive effects of the decongestants. This would be concerning in someone with pre-existing hypertension who may be considering decongestant use. The combination of phenylephrine or pseudoephedrine with either MAO inhibitors or ergot derivatives is contraindicated.

The following list is not meant to be a complete list of all potential drug interactions. Please consult your pharmacist or physician for a complete list and more information.

Alfuzosin Doxazosin Terazosin Tamsulosin	Alpha-1 blockers	Yes	Yes
Carvedilol Labetalol Nadolol	Beta blockers	Yes	Yes
Selegiline Phenelzine	MAO Inhibitors	Yes	Yes
Ergotamine Bromocriptine	Ergot alkaloids	Yes	Yes
Methyldopa Reserpine	Antihypertensives	Yes	Yes
Atomoxetine	Selective norepinephrine reuptake inhibitors	Yes	Yes
Amitriptyline Clomipramine Doxepin Nortriptyline	Tricyclic antidepressants	Yes	Yes

Warnings of phenylephrine vs. pseudoephedrine

Phenylephrine and pseudoephedrine are available without a prescription and are generally considered to be safe drugs. Due to their effects on the cardiac system, patients with high blood pressure and heart disease should not use these drugs without explicit consent from their physician. These drugs are intended for short-term use for the relief of acute rhinitis and sinus pressure. Patients who experience these symptoms for longer than seven days, or who develop a fever, should consult a physician.

Phenylephrine is in pregnancy category C which means that studies in animals showed adverse effects to the fetus. When a drug is category C, there may be some situations where the benefit to the pregnant patient outweighs the risk, and phenylephrine should not be used without consent from your physician. Pseudoephedrine is pregnancy category B which means that animal studies have not shown adverse effects to the fetus. Pseudoephedrine is considered safe to take when pregnant after consulting your physician. Pseudoephedrine should, however, be avoided in the first trimester.

Frequently asked questions about phenylephrine and pseudoephedrine

What is phenylephrine?

Phenylephrine is an over-the-counter nasal decongestant available in 5 mg and 10 mg tablets, as well as an oral solution. It is also available in an injectable form which is only used in an inpatient setting by medical professionals for low blood pressure. Phenylephrine can be purchased without restriction or logging of the purchaser’s information.

What is pseudoephedrine?

Pseudoephedrine is an over-the-counter nasal decongestant available in 30 mg and 60 mg tablets, as well as 120 mg and 240 mg extended-release tablets. It is also available as an oral solution. Pseudoephedrine purchases must be done at a pharmacy and the purchase information must be logged into a database. Purchase limits are set by state and federal guidelines.

Are phenylephrine or pseudoephedrine the same?

Phenylephrine and pseudoephedrine are both adrenergic agonists. Phenylephrine has primarily an affinity to only alpha-adrenergic receptors, while pseudoephedrine has an affinity to both alpha- and beta-adrenergic receptors. Their side effect profiles are very similar.

Is phenylephrine or pseudoephedrine better?

Studies have shown that pseudoephedrine is a much more effective decongestant than phenylephrine. Phenylephrine’s decongestant effects may not be significantly different from that of a placebo. The effects of both drugs may be augmented with concurrent use of other products that affect rhinitis, such as antihistamines.

Can I use phenylephrine or pseudoephedrine while pregnant?

Phenylephrine should not be used when pregnant unless the benefit to the mother outweighs the risk.  Pseudoephedrine is considered safe to take after the first trimester. Always consult your physician before taking a nasal decongestant when pregnant.

Can I use phenylephrine or pseudoephedrine with alcohol?

Phenylephrine and pseudoephedrine are safe to take if consuming alcohol.

Is phenylephrine a stimulant?

Phenylephrine does stimulate alpha-adrenergic receptors which may make it responsible for central nervous system stimulant effects such as restlessness, anxiety, and insomnia. It is thought that it may not cause the effects to the extent that pseudoephedrine does, however.

Who should not take phenylephrine?

Patients who have high blood pressure, pre-existing heart disease, or other cardiac conditions should not take phenylephrine without consent from their physician. There are alternative decongestant options, such as nasal sprays, which may be more appropriate in this population. Women who are pregnant should consult a physician before using phenylephrine.

Is phenylephrine a good decongestant?

Studies have shown that phenylephrine is an inferior, or less effective, decongestant than pseudoephedrine. In fact, it may offer no benefit over that of a placebo.

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C10h2 5N, used in its hydrochloride form, is a drug that is even more stimulating than amphetamine.It is also used orally through the mouth and intranasally. There are also known cases of smoking crystals of methamphetamine hydrochloride, that is, with a series of injections, subsequent prolonged sleep is characteristic. Among the negative effects, there are stereotypical thinking, anorexia, dysregulation of the cardiovascular system, atactic thinking. In comparison with the closest analogue – amphetamine – the effect of pervitin is longer and causes euphoria, which is not observed when taking amphetamine, or is observed, but very insignificantly.This is due to the fact that when pervitin enters the human body, it causes a blockage of the reverse intake of a very important neurotransmitter and hormone – serotonin in serotonin receptors, this in turn causes stimulation of the central nervous system, due to the accumulation of serotonin in serotonin receptors. Amphetamine also, when it enters the human body, has a stimulating effect on the central nervous system, but unlike pervitin, amphetamine affects the norepinephrine receptors responsible for movement \\\\\\\\\\\\\\\\\\\ \\\\\] so that, as in the case of pervitin, the reverse intake of norepinephrine in the norepinephrine receptors is blocked, which also leads to the accumulation of the hormone in the receptors and consequently to an increased desire of the individual who took the drug to actively move or just be in motion, be walking or swimming.The difference between the molecular structure of amphetamine and pervitin is the same as between the molecules of norepinephrine and adrenaline, that is, pervitin and adenaline contain an N-methyl group in their molecular structure, while amphetamine and norepinephrine do not contain such in their molecular structure. By itself, ephedrine is an alkaloid that is found in many varieties of ephedra, while pervitin, unlike ephedrine, is not found in nature and is obtained only synthetically. Handicraftly synthesized from ephedrine, peritin, in contrast to peritin obtained on mercury-activated aluminum, aluminum amalgam from phenylacetone, differs in a stronger euphoricity when administered intravenously.Another way to obtain pervitin is to obtain imine from phenylacetone and methylamne and its further reduction to single by means of aluminum amalgam. There is also an assumption according to which the obtained pervitin m. It is this factor that sometimes makes the production of pervitin by reduction with hydrogen iodide more attractive for those who produce pervitin purely for their own use, and not for sale on the black market. In optimal doses, it relieves the feeling of fatigue, causes a surge of strength, increases efficiency, which is often used by low-paid workers in Asia to increase their efficiency, or in order to work tirelessly around the clock.It also suppresses appetite, weakens and shortens the effect of sleeping pills. Has a pronounced peripheral adrenomimetic activity, constricts peripheral vessels, increases blood pressure. Pervitin has a direct adrenergic effect on the central nervous system, including the reticular formation and some subcortical structures. It also slightly inhibits the activity of monoamine oxidase, thus protecting adrenaline and norepinephrine from decomposition. According to other data, the stimulatory effect of methamphetamine is associated with the selective inhibition of dopamine reuptake; inhibition of MAO activity is insignificant, however, methamphetamine itself is weakly susceptible to oxidative deamination by this enzyme in comparison with amphetamine due to the N-methyl group.With prolonged use, it causes a feeling of enduring fatigue, depression, mild forms of paranoia, especially in the case of intravenous administration of an artisanal preparation from ephedrine. Causes strong mental, but not physical dependence. Withdrawal syndrome is quite pronounced. Relapses of use depend on the user. In a certain kind of communities, drug addicts, used to relieve withdrawal symptoms of heroin withdrawal symptoms \\\\\\\\\\\\ [edit \\\\\\\\\\\\] the scientist A.During the 1950s, pharmacists at Temmler Werke in Berlin developed the stimulant pervitin pervitin. It was a mixture of cocaine, yukodal and pervitin. To test the effect of the drug, it was given to concentration camp prisoners. People were forced to make many days of marches. It was necessary to walk 90 kilometers per day. The prisoners were given no more than 2 hours a day to rest. It is worth adding that the pharmacists who created pervitin were exported to the United States after the war and took part in the development of similar drugs for the American army.These drugs were used in both the Korean and Vietnamese wars. Pervitin was also popular among the leaders of the Third Reich, along with cocaine. In particular, Hitler received injections of pervitin from his personal physician, Theodore Morell, starting from a year, and then several times a day \\\\\\\\\\\\\ [1 \\\\\\\\ \\\\\]. The dose reached 10 pervitin tablets per day. Along the way, he received Yukodal injections. In the last years of the war, drug addiction in Nazi Germany reached simply incredible proportions, although this contradicted the official Nazi ideology, which promoted abstinence and a healthy lifestyle.For the use of opium or cocaine, one could end up in a concentration camp, but pervitin was released, and not only for the needs of the front. Even chocolates filled with pervitin appeared on the market. It was even believed that pervitin has a less harmful effect on the body than coffee. Pervitin was used in the USSR for years in psychiatric practice for the treatment of diseases such as narcolepsy. It was also used to treat depression of various origins before the advent of the first antidepressants, MAO inhibitors. Pervitin is popular among Soviet and Russian drug users.The purity and effectiveness of a product is judged by its color. There is an opening at the top leading into the main chamber and an air vent. It was used in the treatment of narcolepsy, psychogenic depression, alcoholic depressive psychoses and other diseases accompanied by drowsiness, lethargy, and asthenia. It was also used to temporarily eliminate the feeling of fatigue, increase physical and mental performance. Nonmedical Uses Methamphetamine is mainly used to stimulate the central nervous system.Often, methamphetamine, homemade from ephedrine by reduction with iodine and phosphorus, is administered parenterally to test drug euphoria, since its effect is presumably accompanied by extremely strong sensations due to the impurities contained. Less commonly, methamphetamine is consumed by inhalation or smoking, this route of administration can cause tissue necrosis, and also orally, while the concentrated solution has a high chemical aggressiveness towards the gastric mucosa.After the introduction, an extraordinary mental stimulation occurs for about 8 hours, after which there is a breakdown, sometimes a depressive state. This condition lasts an average of two days. For recreational purposes, methamphetamine, due to its unavailability, is synthesized in an artisanal way, usually using ephedrine-containing drugs. Also, ephedra is used as a raw material. The fact is that calling a home-made substance methamphetamine is not entirely correct.During the synthesis process, a lot of by-products gets into the final product. Often, consumers of artisanal methamphetamine find themselves in neurological departments of hospitals with various movement disorders, paresis, gait disorders, etc. The product cooked from the herb ephedra is clean. Consequences of use Chronic use: The most common consequence is thrombophlebitis, venous thrombosis. Also, with chronic use, mental disorders develop associated with depletion of the nervous system, asthenia, neuroses, etc.Long-term use of methamphetamine often leads to suicide, to persistent nightmares, fear of falling asleep. According to ICD 10, mental and behavioral disorders caused by pervitin are categorized as F. As a result of a single use, sleep and appetite disorders are noted, which can continue for two days after use. Fatigue, increased irritability and lack of desire to communicate are also noted, headaches are possible as a result of dehydration of the body. Some time after the intoxicating effect ends, tachycardia, tachypnea and pain in the heart during physical exertion and in a state of physical calm may appear, and drying of the nasal mucosa with intranasal use.Much less often there is a manifestation of a feeling of disunity and inattention. Campaign against the use of methamphetamine In the middle of the year, the fourth Montana Meth Project social campaign against the use of drugs by young people, in particular methamphetamine, was launched in the United States. Methamphetamine is beneficial when used occasionally. It is the only substance currently known to kill the influenza virus.

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Drug “speed” – the effect and harm of a psychostimulant

The problem of drug addiction is constantly growing.Each type of narcotic substance has its own characteristics, but amphetamine-type drugs, among other things, are very rapidly and persistently addictive. Treatment is possible, but it will take a long period of time and will consist of several stages.

Speed: an overview of the main types of amphetamine-type stimulants

The term “psychostimulants” is used for many drugs with an invigorating effect. They improve mood and increase activity, belong to the group of prescription drugs and are practically not available on the market.They are used for better athletic performance as recreational drugs. The abuse of central nervous system stimulants is considered fairly common. Due to their availability and quick effect, they are used by a significant percentage of the total number of drug addicts. The number of substances is quite long, it includes the so-called substituted amphetamines. In the list there are several amphetamine-based drugs similar in effect on the body.

1. Amphetamine, at one time prescribed as part of complex therapy for chronic depression.The effectiveness in the treatment is small, dangerous side effects and very quick addiction. It is also used as a fast-acting enhancer of physical and cognitive functions, sometimes as an aphrodisiac and euphoretic. In therapeutic doses, this leads to an increase in efficiency, concentration of attention. Exceeding the dosage leads to the rapid destruction of muscle fibers, the appearance of psychosis, including paranoia and delirium.
2. MDMA or ecstasy belongs to the amphetamine series. The primary effects are typical: an improvement in mood, an increase in the level of sociability, increased activity, a feeling of euphoria, elimination of complexes, emancipation.The drug has been recommended for recreational medical use. Due to numerous side effects, it is included in Schedule I. With prolonged use, it causes loss of appetite, social disinhibition, insomnia, nervous exhaustion, and heavy sweating.
3. Mephedrone was synthesized at the beginning of the 20th century, belongs to the designer, has the form of a crystalline powder, is found in tablets. It is illegal in most European countries. Reception stimulates sexual activity, increased sociability, improved mood, euphoria.The effect is short-term, then there is a refusal to eat, signs of depression, sudden changes in blood pressure, disturbances in the work of the cardiovascular system. The addiction comes quickly, the withdrawal syndrome is severe.
4. Methamphetamine in a number of countries is recommended for the treatment of obesity, hyperactivity. It causes an improvement in mood, hypersexuality, euphoria. At high doses it is toxic, quickly addictive, psychosis, cerebral hemorrhage.
5. Pseudoephedrine for medical purposes and dosages is used as a stimulant that increases activity and performance, as well as a decongestant for sinusitis.Prolonged uncontrolled use causes tremors, urinary retention, vomiting, mental agitation, insomnia, and skin rashes.

In street jargon, all these substances are called speed or “speed”. Acting on the structures of the brain, they provide a powerful psychostimulating effect

Addiction to drugs quickly leads to physiological and psychiatric problems, there is a rapid destruction of the body and it is impossible to leave the addict without help. In the center “My Family – My Fortress”, treatment and rehabilitation from this type of drug addiction is carried out with the subsequent socialization of patients.

Appearance and composition of the drug speed

The original version of the substance is obtained in liquid form, but it cannot be stored for a long time, losing its properties. It is converted into a solid state: crystals, tablets, capsules, powder.

The composition is constantly changing. On the one hand, this complicates its external identification, since in powder or crystals, the drug is similar to household chemicals or fertilizers. In the other, adding chemicals to the original product increases its volume, which means more profit on sale.For a drug addict, this turns out to be a more powerful, but unpredictable effect, rapid addiction and, in fact, a reduction in life several times.

The principle of action of “speed” on the body

When active components enter the bloodstream, they increase the release of dopamine and norepinephrine. The work of the cardiovascular system is intensified, perception is sharpened, a feeling of transcendental happiness appears, sexual desire and efficiency increase, signs of fatigue, drowsiness disappear, abnormal vigor and excitement appear.

Physiological symptoms from AIDS

The narcotic substance speeds up all processes, as a result of which an increased load is placed on the internal organs. The work of the gastrointestinal tract is practically blocked, which leads to a lack of appetite, and this entails a rapid loss of body weight. The body reacts to the reception of “speed”:

• by dilating the pupils;
• hyperexcitability;
• insomnia;
• violation of heart rhythms;
• intense thirst;
• photophobia;
• dry and sore throat.

Psycho-emotional manifestations

Psychological reactions are more clearly manifested, expressed in sudden mood swings, inability to concentrate on one topic of discussion, accelerated speech, fussy movements. A person is not able to sit still, he moves chaotically, rushes to do something and to run somewhere, but the matter does not go beyond intentions. Irritability and irascibility gradually appear. Other psychotropic effects depend on the type of drug.So for amphetamine, excessive self-confidence is characteristic, for methamphetamine, unnatural altruism, and when taking mephedrone, there is a rapid loss of connection with reality and irrepressible talkativeness.

Side effects

The drug addict with each dose increases the risk of loss of mind, the development of paranoia, schizophrenia, a state of obsessive delirium. In addition, the user of high-speed drugs quickly acquires the habit of obsessive, uniform movements, convulsive twitching of the neck and head, and speech loses clarity over time.turning into indistinct mumbling, as amphetamines quickly destroy the brain. In parallel, toxic hepatitis, heart and renal failure develop.

Signs of addiction

A drug addict who is addicted to “speed” really quickly shows the characteristic signs of addiction. Family and friends can easily recognize changes in behavior and appearance. When using synthetic substances of the amphetamine series, there appears:

• a sharp change in interests and social circle;
• accelerated speech;
• increased anxiety;
• ideas that a person instantly gets carried away with and cools down just as quickly;
• grimaces, twitching of the muscles of the face and arms;
• obsessive thoughts of stalking;
• sloppy appearance;
• neglect of hygiene procedures;
• constant thirst;
• skin rash around the nasolabial triangle, on the neck, in the folds of the elbows.

One of the most obvious signs of drug use is massive caries. In the absence of the next dose, sleep disappears, aggressiveness increases, logical thinking is absent, signs of depression, suicidal intentions appear.

At the next stage, a set of chronic diseases is observed, such as viral and toxic hepatitis, tubulointerstitial nephritis, neuropathy, psychosis.

Harm and consequences of prolonged use

The worst consequence is a broken life.But others understand this and try to help the addict. The addict himself perceives their actions as an encroachment on personal freedom, responding very aggressively or silently leaving in search of a new dose. He does not notice how his body is falling apart, poisoned and exhausted.

Invented as a medicine, but then used as a doping agent, amphetamines cause irreparable harm in a few months. Acting on the psycho-emotional sphere, they change perceptions, turn off logic.As a result, the addict constantly thinks that they are being watched, they want to rob or cause physical harm, kidnap. He can throw himself under the car or step from the balcony of a skyscraper, fleeing an imaginary pursuit. Such a person perceives the outstretched hand of the interlocutor as an attempt to strike and may swing a knife without realizing his action. Among consumers of “speed” there is a very high number of suicides and early deaths from internal organ failure.

The rapid loss of fluid, minerals and vitamins by the body and the lack of sources of their replenishment leads to catastrophic changes in appearance, loss of hair and teeth, drying out of the skin and the appearance of acne, rash and small ulcers on it.

A terrible consequence is amphetamine psychosis, which in symptoms resembles an exacerbation of schizophrenia. The syndrome of childhood develops when the personality degrades to the level of an unintelligent child. Stereotypical behavior is also typical for experienced drug addicts. Their facial muscles involuntarily twist, speech turns into a set of constantly repeated words, the movements resemble mechanical ones. At the same time, the addict is not aware of them and can wave his hand for a long time, gnash his teeth, chew his lips or cheek from the inside, imagining that he has gum in his mouth.

Regardless of age, cerebral hemorrhages, spasm of the heart muscle, bladder occur.

It is worth considering that at an early stage, some of the violations are reversible and if you turn to a narcologist in time, that is, you can reduce the harmful effects of the drug and at least partially restore the addict’s legal capacity. Further, the chances of being disabled, unable to act independently, increase exponentially.

Drug overdose speed

The heart suffers first.Taking amphetamine speeds up the heart rate, while causing vasospasm, often resulting in a heart attack. Mental disorders follow, forming a characteristic picture.

Overdose symptoms:

• chest pain;
• muscle numbness;
• nausea and vomiting;
• arrhythmia;
• violations of coordination of movements;
• digestive disorders;
• shortness of breath, feeling short of breath;
• uncontrolled excitation;
• convulsions;
• loss of consciousness.

Main reasons

The desire to prolong the euphoria, to return to the fictional world again without problems and resentment constantly pushes the addict to search for a new dose. Unaware of his actions, a person does not control how much drug has entered the body, and in pursuit of brightness and euphoria can take a double amount. In various batches of the drug, its concentration ranges from 2 to 15%, which will come across again, it is impossible to predict.

The lethal dose is 20-25 mg / kg, with the depletion of the body for the onset of a lethal outcome, much less is required.There is no specific antidote for amphetamine; in most cases, it is not possible to save such a patient if he is late in providing drug treatment.

First aid

Competent actions of others before the arrival of a narcologist can save a drug addict’s life. The first thing to do is to call an ambulance for drug treatment. In order to stabilize the condition, you need to lay the person horizontally, remove the pillow. Provide fresh air by opening windows and unbuttoning clothing.Remove scarves, scarves, belts, kerchiefs so that nothing squeezes blood vessels.

It is useless to rinse the stomach with an enema or give adsorbents in case of an overdose of amphetamine, especially if it was administered in liquid form. With obvious dehydration, it is allowed to give warm water in very small portions so as not to provoke vomiting. Taking any medication before the doctor arrives will be harmful, since it will make the symptoms blurry and it will be difficult for a specialist to determine what is required for emergency care.In case of cardiac arrest, artificial respiration can be started.

Medical care

The specialist finds out when and how much the drug was taken, examines the patient and then performs an emergency blood purification. In stationary conditions, plasmapheresis, hemodialysis, intravenous blood irradiation, xenon therapy are prescribed. The method is selected based on the severity of the condition and the individual characteristics of the drug addict’s body.

In case of an overdose, a decreased or increased body temperature is observed.It is normalized by warming or antipyretic drugs. In case of respiratory spasm, a ventilator is connected. When providing home care, an electrolyte solution is placed on a drip. If muscle spasms of the bladder are observed, a Foley catheter is inserted. It is necessary when diuretics are administered to prevent pulmonary edema.

Also symptomatically prescribed forced diuresis with oxidation of ascorbic acid, the introduction of antiarrhythmics in case of heart rhythm disturbances, benzodiazepines in case of panic, anxiety, convulsions.

Consequences of lack of assistance

If you do not call a narcologist in a timely manner and do not support the patient before the arrival of the team, the development of renal failure, toxic pulmonary edema, acute cerebrovascular accident is likely. Acute myocardial infarction, irreversible mental disorders, disability with complete incapacity are also likely.

Lethal dose

For a lethal outcome, 20–40 mg / kg is sufficient. In this case, options are possible. With a slender physique and a weak heart, you will need about 5 mg / kg.It all depends on the individual characteristics of the organism, the degree of its exhaustion and susceptibility to amphetamines.

How to stop and move away (antidotes)

There is no direct antidote. In case of an overdose, there is hope for timely assistance, emergency blood purification and maintenance of the functions of the internal systems of the body with the help of medicines.

Breakdown from aids

The duration of action of substances from the group of amphetamines ranges from 8 to 24 hours, after which the withdrawal syndrome begins.The main one is deep depression, in which a person practically does not react to external stimuli. In a number of cases, on the contrary, irritability, suspicion, aggression, turning into psychosis increase several times. The condition is protracted, lasting from several days to 2-4 weeks.

Symptoms of withdrawal:

• convulsive twitching of the limbs;
• spasms of the facial muscles;
• weak reaction of pupils to light;
• decreased muscle tone.

How to relieve withdrawal symptoms?

The severity of the state of the addict depends on the length of time of use, the volume of the dose, the general condition of the body. Most addicts do not go to a narcologist, preferring to endure this period on their own. To relieve emotional stress and reduce physical suffering, it is recommended to organize a calm, quiet environment at home, dim the lights or close the windows with thick enough curtains. Limiting contact with people and the ability to retire at any time will help stabilize the psychological state.You can consolidate the positive dynamics with sedatives on a natural basis. Drinking plenty of fluids, split diet meals and small walks with minimal physical activity will accelerate the recovery from withdrawal.

During this period, there is a possibility of a sharp deterioration in the condition or an attempt to return to drug use. In this case, an ambulance for drug treatment is immediately called.

If withdrawal is very difficult and the drug addict agrees to be treated in a hospital, then this is a good reason to motivate him to complete a full course of getting rid of addiction.Not all clinics accept such patients, it is advisable to find one where there is a specialization in amphetamine addiction. Center “My Family – My Fortress” provides a full course of treatment, including psychological and social rehabilitation.

How much “speed” is kept in blood, urine and saliva?

Synthetic drugs, especially of the new generation, quickly fix in the body and take a long time for their withdrawal. Sometimes small particles remain for life in joints, in the membranes of the brain, hair follicles and bone tissue.

The concentration of the drug decreases gradually and most of it is excreted through the kidneys during the day. With a single use the next day, it is almost impossible to find traces of it in the body. In drug addicts with experience, the substance accumulates in the plasma, even settles in the hair. On average, it will be present in the blood for 7-10 days, some even longer.

In urine, traces remain for up to 2 weeks, in drug addicts with severe dependence in laboratory conditions, the drug is found within 3-4 months.In saliva, a rapid test easily determines the amphetamine range within 5 days. If the result is positive, it is usually confirmed by laboratory tests.

How to accelerate excretion from the body?

If the addict has decided to start drug addiction treatment, the first task is to remove drug residues from the body as quickly and efficiently as possible. The rate of its elimination is influenced by age, height, weight, percentage of body fat, experience of drug addiction, metabolic rate, individual characteristics.

The main part of the psychostimulant is excreted in the urine and it is worth paying special attention to. Against the background of urinary retention, a number of measures are required to normalize the process. To speed it up, it is necessary to increase the proportion of foods with vitamin C in the diet, to take it in an effervescent soluble form. In the blood, the peak concentration of the drug is formed 3 hours after ingestion. It can be reduced in plasma through an increase in fluid. To do this, you need to drink at least 3 liters per day, but you should not get too carried away.The maximum drinking volume should not exceed 7 liters.

Penetrating over time into all organs and tissues, the narcotic substance is fixed in them. For withdrawal, in this case, dosed physical activity for 20-25 minutes with constant monitoring of the pulse and heart rhythms is most effective. At the same time, classes will increase muscle tone.

The drug is removed from the saliva within 72 hours, it will not be possible to directly influence the process. The concentration will decrease evenly throughout the body. To accelerate withdrawal, you should follow the general recommendations for drinking and exercise.

Detoxification in a hospital

In a clinic, it is easier to cleanse the body of residual drug elements than at home, since there are much more possibilities. With an integrated approach, it is possible to remove the bulk of the toxins in a few hours.

The purification system includes:

• forced diuresis method;
• plasmapheresis or hemodialysis;
• infusion therapy;
• reception of enterosorbents;
• intestinal lavage.

If the substance was taken no later than 4 hours ago and the tablet form was chosen, then gastric lavage will be effective.There is no antidote for amphetamine dependence; symptomatic excretion of the substance is used. Detoxification is carried out to relieve withdrawal symptoms, restore water and electrolyte balance, stabilize the work of the heart, nervous and urinary systems. Benzodiazepines and antipsychotics are prescribed to relieve agitation, if the water-salt balance is disturbed, it is restored with intravenous solutions of salts, electrolytes, glucose.

AIDS addiction treatment

It is unrealistic to cure drug addiction at home.A familiar environment and an unchanging circle of acquaintances does not give a chance to switch consciousness, change the stereotype of behavior and successfully resist temptations. The course is carried out in stationary conditions, under the constant supervision of a narcologist. Amphetamine addiction develops quickly, at a physiological and psychological level. Without eliminating the reasons for turning to drugs, treatment will be ineffective. That is why the motivation for getting rid of addiction is necessarily created, voluntary consent to the procedures is obtained, and consultation with specialists of the psychological direction is carried out to identify the true causes of drug addiction.

Treatment implies a step-by-step advancement towards the goal, where each step logically moves into the next and it is not recommended to skip steps to achieve a stable positive result.

The complex consists of:

• detoxification;
• medication course;
• psychotherapy program;
• rehabilitation and socialization.

Intensive drug therapy

Prescribing drugs is symptomatic.There are two tasks: to remove withdrawal symptoms and restore the work of internal organs. Drug use hits all systems and the process of eliminating pathological changes will take a long time. The first step is the elimination of toxins. For this, infusion therapy is used. Plasmapheresis is used as an additional measure. But most of the treatment is symptomatic.

To accelerate the elimination of drug residues, a course of diuretics is prescribed. The nervous system needs sedatives and antidepressants.Its stabilization is also helped by a clear daily routine, dietary nutrition, the absence of temptations and external stimuli. Mental disorders, delirium, hallucinations are stopped by neuroleptics. Necessarily need nootropics and drugs that stimulate increased cerebral circulation.

Psychotherapy

Psychological help and support is provided from the first day of treatment and continues even in the post-rehabilitation period. The psychotherapist uses various forms of work:

• individual therapy, which reveals the hidden reasons for the use of psychoactive substances, adapts to normal living conditions in society and creates motivation for spiritual development;
• group gives the effect of supporting like-minded people, helps to realize and accept problems, see positive dynamics and try on a new role in life through the implementation of one of the programs, and the most famous of them is the “12 steps” technique;
• family analyzes family relationships, eliminates the effect of codependency;
• The therapeutic society is aimed at developing the participants’ skills in solving problem situations without external doping, forming a sense of responsibility for the decisions made, the adoption and observance of certain rules;
• cognitive psychotherapy is addressed to logic and reason, the impact is aimed at combating fears, self-doubt, stress and grief, performs the function of preventing relapse;
• Gestalt therapy contributes to the moral maturation of the patient, allowing him to freely interact with people and the environment, to satisfy his needs without drugs, to get away from unproductive and destructive stereotypes of behavior.

The main goal of psychotherapeutic influence is to eliminate painful symptoms and attitudes, establish a relationship with the surrounding reality and develop the skill of adaptation to it.

Rehabilitation and resocialization

When moving to the final stage of drug addiction treatment, a number of rules are observed:

• an individual approach is required for each patient;
• there are no universal methods, there are only recommendations;
• the duration of rehabilitation is always individual;
• compulsory work with codependents.

As a result, the addict is gradually shifting the emphasis from drug use to positive activities and abandonment of the previous model of behavior. For this, various techniques are used.

Art therapy allows you to unleash your creative potential, to interest you in a new type of activity, to visualize your feelings and experiences. Occupational therapy provides an opportunity to increase self-esteem, master new skills, and sometimes a profession, engage in creative activities and at the same time see the results of their work.The course of personal growth stimulates self-development, the setting and achievement of new goals, a shift in emphasis from the use of drugs to gaining new knowledge, emotions without psychostimulants.

Resocialization is aimed at returning a person to society. For many, this is the most difficult task, since the skills of business and personal communication have been lost, the circle of interests is very narrow, and willpower is suppressed. A person re-learns to value himself, to achieve respect and recognition of others, to find common interests and topics for communication with others.It also develops the skills to argue one’s opinion, strive for a healthy lifestyle, set tasks, find ways to solve them and enjoy personal success.

This stage is final, resistance to previous temptations depends on its successful completion. After the addict leaves the rehabilitation center, he is advised to regularly visit the psychologist of the clinic where he is being treated. This increases the chances of a quick entry into society and allows you to provide timely support at the first signs of a possible relapse.

Attention! The use of drugs causes irreparable harm to your health and is a danger to life!

3,4-methylenedioxyamphetamine

6 6905

• Agonists: Ergolines (e.g., dihydroergocryptine, dihydroergotamine, ergotamine, lisuride, LSD, mesulergine, metergoline, methysergide)
• Serotonin (5-HT)
• Tryptamines (eg, 2-Me-5-HT, 5-BT, 5-CT, 5-MT, Bufotenin, E-6801, E-6837, EMD-386088, EMDT, LY-586713, N-Me-5 -HT, tryptamine)
• WAY-181187
• WAY-208466

5-HT 1 5-HT 1A Agonists: 8-OH-DPAT Adatanserin Amphetamine Antidepressants (eg etoperidone, hydroxynefazodone, nefazodone, trazodone, triazoledione, Vilazodone, vortioxetine) Atypical antipsychotics (eg, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, lurasidone, quetiapine, ziprasidone) Azapirones (e.g. buspirone, eptapirone, gepirone, perospirone, tandospirone) Bay R 1531 Befiradol BMY-14802 Cannabidiol Dimemebfe Dopamine Ebalzotan Eltoprazine Eciprazine Ergolines (e.g. bromocriptine, cabergoline, dihydroergotamine, ergotamine, lisuride, LSD, methylergometrine (methylergonovine), methysergide, pergolide) F-11461 F-12826 F-13714 F-14679 F-15063 F-15.599 Flezinoxan Flibanserin Flumexadol Lesopitron LY-293284 LY-301317 mCPP MKC-242 Naluzotan NBUMP Osemosotan Oxaflozan Pardoprunox Piclosotan Rauwolszin Repinotan Roxindol RU-24.969 C-14506 C-14671 S-15535 Sarizotan Serotonin (5-HT) SSR-181507 Sunepitron Tryptamines (e.g. 5-CT, 5-MeO-DMT, 5-MT, bufotenin, DMT, indorenate, N-Me-5-HT, psilocin, psilocybin) TGBA01AD U-92.016-A Urapidil Vilazodon Xaliproden Yohimbine Antagonists: atypical antipsychotics (eg iloperidone, risperidone, sertindole). AV965 Beta blockers (e.g. alprenolol, carteolol, cyanopindololi, iodocyanopindololi, isamoltans, oxprenolol, penbutololi, pindobind, pindololi, propranolol, tertatolol) BMY-7.378 CSP-2503 Dotarizine Ergolines (e.g. metgoline) FCE-24379 Flopropion GR-46611 Isamoltan Lekosotan Mefway Methitepine (methiotepin) MIN-117 (WF-516) MPPF NAS-190 Robalzotan S-15535 SB-649.915 SDZ 216-525 Spiperon Spyramid Spiroxatrine UH-301 WAY-100135 WAY-100635 Xylamidine 5-HT 1B Agonists: CGS-12066A. CP-93129 CP-94253 CP-122 288 CP-135807 Eltoprazine Ergolines (e.g. bromocriptine, dihydroergotamine, ergotamine, methylergometrine (methylergonovine), methysergide, pergolide) mCPP RU-24.969 Serotonin (5-HT) Triptans (e.g. avitriptan, donitriptan, eletriptan, sumatriptan, zolmitriptan) TFMPP Tryptamines (e.g. 5-BT, 5-CT, 5-MT, DMT) Vortioxetine 5-HT 1D Agonists: CP-122 288 CP-135807 CP-286601 Ergolines (e.g. bromocriptine, cabergoline, dihydroergotamine, ergotamine, LSD, methysergide) GR-46611 L-694247 L-772405 mCPP PNU-109291 PNU-142633 Serotonin (5-HT) TGBA01AD Triptans (e.g. almotriptan, avitriptan, donitriptan, eletriptan, frovatriptan, naratriptan, risatriptan, sumatriptan, zolmitriptan) Tryptamines (e.g. 5-BT, 5-CT, 5-Et-DMT, 5-MT, 5- (nonyloxy) tryptamine, DMT) 5- HT 1E 5-HT 1F 5-HT 2 905 905 Agonists: series 25H / NB (e.g. 25I-NBF, 25I-NBMD, 25I-NBOH, 25I-NBOMe, 25B-NBOMe, 25C-NBOMe, 25TFM-NBOMe, 2CBCB-NBOMe, 25CN-NBOH, 2CBFly -NBOMe). 2Cs (e.g. 2C-B, 2C-E, 2C-I, 2C-T-2, 2C-T-7, 2C-T-21) 2C-B-FLY 2CB-Ind 5-Methoxytryptamines (5-MeO-DET, 5-MeO-DiPT, 5-MeO-DMT, 5-MeO-DPT, 5-MT) α-Alkyltryptamines (e.g. 5-Cl-αMT, 5-Fl-αMT, 5-MeO-αET, 5-MeO-αMT, α-Me-5-HT, αET, αMT) AL-34662 AL-37350A Brom-Dragonfly Dimemebfe DMBMPP DOx (e.g. DOB, DOC, DOI, DOM) Efavirenz Ergolines (e.g. 1P-LSD, ALD-52, bromocriptine, cabergoline, ergine (LSA), ergometrine (ergonovine), ergotamine, lisuride, LA-SS-Az, LSB, LSD, LSD-Pip, LSH, LSP, methylergometrine (methylergonovine), pergolide) Flumexadol Jimskalin Lorcaserin MDxx (e.g. MDA (tenamphetamine), MDMA (midomaphetamine), MDOH, MMDA) O-4310 Oxaflozan PHA-57378 PNU-22394 PNU-181731 RH-34 Phenethylamines (e.g. lofofin, mescaline) Piperazines (e.g. BZP, quipazine, TFMPP) Serotonin (5-HT) UTS-2 TFMFly Tryptamines (e.g. 5-BT, 5-CT, bufotenine, DET, DiPT, DMT, DPT, psilocin, psilocybin, tryptamine) 5-HT 2A Antagonists: 5-I-R 5-MeO-NBpBrT AC- Adatanserin Altanserin Antihistamines (for example, cyproheptadine, hydroxyzine, ketotifen, perlapine) AMDA Atypical antipsychotics (eg, amperozide, aripiprazole, asenapine, blonanserin, brexpiprazole, carpipramine, clocapramine, clorotepine, clozapine, fluperlapine, gevotroline, Iloperidone, Lurasidone, melineperone, olaperidone, mosapine , ziprasidone, zotepin) Cinanserin CSP-2503 Deramtsiklan Dotarizine Eplivanserin Ergolines (for example, amesergide, LY-53857, LY-215,840, mezulergin, metergoline, methysergide, sergolexol) Fananserin Flibanserin Glemanserin Irindalone Ketanserin KML-010 Landipirdine LY-393558 mCPP Medifoxamine Methitepine (methiotepin) MIN-117 (WF-516) Naphtidrofuryl Nantenin Nelotanserin Opiranserin (VVZ-149) Pelanserin Phenoxybenzamine Pimavanserin Pirenperon Pisotifen Provanserin Rauwolszin Ritanserin Roluperidone C-14671 Sarpogrelat Serotonin antagonists and serotonin reuptake inhibitors (eg etoperidone, hydroxynefazodone, lubazodone, mepiprazole, nefazodone, triazoledione, trazodone) SR-46349B TGBA01AD Tenyloxazine Temanogrel Tetracyclic antidepressants (eg, amoxapine, aptazapine, esmirtazapine, maprotiline, mianserin, mirtazapine) Tricyclic antidepressants (e.g. amitriptyline) Typical antipsychotics (e.g. chlorpromazine, fluphenazine, haloperidol, loxapine, perphenazine, pimozide, pipamperone, prochlorperazine, setoperone, spiperone, spiramid, thioridazine, thiothixene, trifluoperazine) Volinanserin Xylamidine Yohimbine 5-HT 2B Agonists: 4-Methylaminorex Aminorex Amphetamines (eg chlorphentermine, cloforex, dexfenfluramine, fenfluramine, levofenfluramine, norfenfluramine) BW-723C86 DOx (e.g. DOB, DOC, DOI, DOM) Ergolines (e.g. cabergoline, dihydroergocriptine, dihydroergotamine, ergotamine, methylergometrine (methylergonovine), methysergide, pergolide) Lorcaserin MDxx (e.g. MDA (tenamphetamine), MDMA (midomaphetamine), MDOH, MMDA) Piperazines (e.g. TFMPP) PNU-22394 Ro60-0175 Serotonin (5-HT) Tryptamines (e.g. 5-BT, 5-CT, 5-MT, α-Me-5-HT, bufotenin, DET, DiPT, DMT, DPT, psilocin, psilocybin, tryptamine) Antagonists: agomelatine. Atypical antipsychotics (eg, amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, N-desalkylquetiapine (norquetiapine), N-desmethylclozapine (norclozapine), olanzapine, pipidaperone, 9000 Cyproheptadine EGIS-7625 Ergolines (e.g. amesergide, bromocriptine, lisuride, LY-53857, LY-272015, mesulergine) Ketanserin LY-393558 mCPP Metadoxin Methitepine (methiotepin) Pirenperon Pisotifen Propranolol PRX-08066 Rauwolszin Ritanserin RS-127445 Sarpogrelat SB-200646 SB-204741 SB-206553 SB-215505 SB-221284 SB-228357 SDZ SER-082 Tegaserod Tetracyclic antidepressants (eg, amoxapine, mianserin, mirtazapine) Trazodone Typical antipsychotics (e.g. chlorpromazine) TIK-301 Yohimbine 5-HT 2C Agonists: 2Cs (e.g. 2C-B, 2C-E, 2C-I, 2C-T-2, 2C-T-7, 2C-T-21). 5-Methoxytryptamines (5-MeO-DET, 5-MeO-DiPT, 5-MeO-DMT, 5-MeO-DPT, 5-MT) α-Alkyltryptamines (e.g. 5-Cl-αMT, 5-Fl-αMT, 5-MeO-αET, 5-MeO-αMT, α-Me-5-HT, αET, αMT) A-372159 AL-38022A Alstonin CP-809101 Dimemebfe DOx (e.g. DOB, DOC, DOI, DOM) Ergolines (e.g. ALD-52, cabergoline, dihydroergotamine, ergine (LSA), ergotamine, lisuride, LA-SS-Az, LSB, LSD, LSD-Pip, LSH, LSP, pergolide) Flumexadol Lorcaserin MDxx (e.g. MDA (tenamphetamine), MDMA (midomaphetamine), MDOH, MMDA) MK-212 ORG-12962 ORG-37684 Oxaflozan PHA-57378 Phenethylamines (e.g. lofofin, mescaline) Piperazines (e.g. aripiprazole, BZP, mCPP, hipazine, TFMPP) PNU-22394 PNU-181731 Ro60-0175 Ro60-0213 Serotonin (5-HT) Tryptamines (e.g. 5-BT, 5-CT, bufotenin, DET, DiPT, DMT, DPT, psilocin, psilocybin, tryptamine) Vabikaserin PATH-629 WAY-161503 YM-348 Antagonists: Adatanserin Agomelatine Atypical antipsychotics (eg asenapine, chlorotepine, clozapine, fluperlapine, iloperidone, melperone, olanzapine, paliperidone, quetiapine, risperidone, sertindole, ziprasidone, zotepine) Captodiame CEPC Cinanserin Cyproheptadine Deramtsiklan Desmetramadol Dotarizine Eltoprazine Ergolines (for example, amesergide, bromocriptine, LY-53857, LY-215,840, mezulergin, methergoline, methysergide, sergolexol) Etoperidone Fluoxetine FR-260010 Irindalone Ketanserin Ketotifen Latrepirdine (dimebolin) Medifoxamine Methitepine (methiotepin) Nefazodone Pirenperon Pisotifen Propranolol Ritanserin RS-102221 C-14671 SB-200646 SB-206553 SB-221284 SB-228357 SB-242084 SB-243213 SDZ SER-082 Tedatioxetine Tetracyclic antidepressants (eg, amoxapine, aptazapine, esmirtazapine, maprotiline, mianserin, mirtazapine) TIK-301 Tramadol Trazodone Tricyclic antidepressants (eg amitriptyline, nortriptyline) Typical antipsychotics (e.g. chlorpromazine, loxapine, pimozide, pipamperone, thioridazine) Xylamidin
5-HT 3 – 7	5-HT 3641 Agonists: alcohols (e.g. butanol, ethanol (alcohol), trichloroethanol). m-CPBG Phenylbiguanide Piperazines (e.g. BZP, mCPP, hipazine) RS-56812 Serotonin (5-HT) SR-57227 SR-57227A Tryptamines (e.g. 2-Me-5-HT, 5-CT, bufotenidine (5-HTQ)) Volatiles / gases (e.g. halothane, isoflurane, toluene, trichloroethane) YM-31636 Antagonists: Alosetron Arazasetron AS-8112 Atypical antipsychotics (eg clozapine, olanzapine, quetiapine) Azasetron Batanoprid Bemesetron (MDL-72222) Bupropion Silansetron CSP-2503 Dazoprid Dolasetron Galanolactone Granisetron Hydroxybupropion ICS-205930 Lerisetron Memantine Ondansetron Palonosetron Ramosetron Renzapride Ricazetron Tedatioxetine Tetracyclic antidepressants (eg, amoxapine, mianserin, mirtazapine) Thuillon Tropanserin Tropisetron Typical antipsychotics (e.g. loxapine) Volatiles / gases (e.g. nitrous oxide, sevoflurane, xenon) Vortioxetine Zakoprid Zatosetron
5-HT 4
5-HT 5A
Antagonists: ABT-354 Atypical antipsychotics (e.g., aripiprazole, asenapine, clorotepine, clozapine, fluperlapine, iloperidone, olanzapine, tiospirone) AVN-101 AVN-211 AVN-322 AVN-397 BGC20-760 BVT-5182 BVT-74316 Cerlapirdine EGIS-12.233 GW-742457 Idalopirdine Ketanserin Landipirdine Latrepirdine (dimebolin) Masupirdine Metitepine (methiothepin) MS-245 PRX-07034 Ritanserin Ro 04-6790 Ro 63-0563 SB-258585 SB-271046 SB-357134 SB-399885 SB-742457 Tetracyclic antidepressants (e.g., amoxapine, mianserin) Tricyclic antidepressants (e.g., amitriptyline, clomipramine, doxepin, nortriptyline) Typical antipsychotics (e.g., chlorpromazine, loxapine)

5-HT ₇

Antagonists: Atypical antipsychotics (e.g., amisulpride, aripiprazole, asenapine, brexpiprazole, clorotepine, clozapine, fluperlapine, olanzapine, risperidote, sertindole, tiospirone, zipras8000) Butaclamol DR-4485 EGIS-12.233 Ergolines (e.g., 2-Br-LSD (BOL-148), amesergide, bromocriptine, cabergoline, dihydroergotamine, ergotamine, LY-53857, LY-215,840, mesulergine, metergoline, methysergide, sergolexole) JNJ-18038683 Ketanserin LY-215.840 Metitepine (methiothepin) Ritanserin SB-258719 SB-258741 SB-269970 SB-656104 SB-656104A SB-6 SLV-313 SLV-314 Spiperone SSR-181507 Tetracyclic antidepressants (e.g., amoxapine, maprotiline, mianserin, mirtazapine) Tricyclic antidepressants (e.g., amitriptyline, clomipramine, imipramine) Typical antipsychotics (e.g., acetophenazine, chlorpromazine, chlorprothixene, fluphenazine, loxapine, pimozide) Vortioxetine

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Cat: health benefits, uses, side effects, dosage and interactions

Checked on 09/17/2019

What other names is Khatu known by?

Abyssinian tea, Arabian-Tea, Catha edulis, Celastrus edulis, Chaat, Gat, Kat, Kathine, Kus es Salahin, Miraa, Qat, Qut, Tchaad, Thé Abyssin, Thé Arabe, Thé Somalien, Tohai, Tohat, Tschut.

What is a cat?

Cat is a plant. The leaf and stem are used as a recreational medicine and as a medicine.

As a recreational drug, the leaves and stems are chewed by people in East Africa and the Arab world to lift their spirits (as a remedy for euphoria).

Kata leaf is used as a medicine for depression, overwork, obesity, stomach ulcers and male infertility. It is also used to reduce the need for food and sleep, decrease sexual desire, and increase aggression.

The World Health Organization (WHO) classifies khat as a drug that makes people “addicted”, that is, causes a constant desire to continue using it.In Somalia, civil and military use of khat has been accused of fomenting civil war, draining the national economy and undermining international aid efforts.

Insufficient evidence to assess efficacy for …

• Depression .
• Fatigue .
• Obesity .
• Stomach ulcer .
• Mood enhancement .
• Male infertility .
• Reducing the need for food and sleep .
• Decreased sex drive .
• Increasing aggression .
• Other terms .

Further evidence is needed to assess the effectiveness of the kata for these purposes.

How does the cat work?

Cat contains stimulants similar to amphetamines.

Are there security issues?

Cat. MAYBE UNSAFE for most people if swallowed.While it is not associated with physical addiction, it can cause psychological addiction.

Khat can cause many side effects including mood changes, increased alertness, excessive talk, hyperactivity, agitation, aggressiveness, anxiety, high blood pressure, manic behavior, paranoia, and psychosis. Sleep problems (insomnia) are usually followed by loss of energy (malaise) and loss of concentration.

Other effects include fast heart rate, heart palpitations, increased blood pressure, faster breathing rate, increased body temperature, sweating, eye changes, mouth ulcers, inflammation of the esophagus and stomach, gum disease, jaw problems (TMJ), and constipation.

Regular use in young people is associated with high blood pressure.

Serious side effects include migraines, bleeding to the brain, acute cardiovascular disease, lung problems, liver damage, changes in sex drive, and inability to achieve an erection (impotence).

Chewing on khat leaves has led to infections that can cause problems such as pain under the ribs, changes in white blood cells and an enlarged liver.

Special precautions and warnings:

Pregnancy and breastfeeding.: This is POSSIBLY UNSAFE take khat orally if you are pregnant. Kat can reduce birth weight. It is also POSSIBLY NON-SAFE to take khat orally if you are breastfeeding. Some of the active chemicals it contains can pass into breast milk.

Diabetes Mellitus : Using kata reduces appetite by forcing people to skip meals. When food becomes less routine, people with diabetes may stop following the recommended diet.This can lead to high blood sugar levels.

High blood pressure : Cat may increase blood pressure. This can be especially dangerous for people who already have high blood pressure. Avoid using.

Are there any drug interactions?

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Ampicillin Interaction Rating: Large Do not take this combination.

Khat can reduce how much ampicillin the body absorbs.This can reduce the effectiveness of ampicillin. Divide doses at least 2 hours apart.

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Medication for high blood pressure (antihypertensive drugs) Interaction rating: Moderate Be careful with this combination. Talk to your doctor.

Cat can increase blood pressure. By raising blood pressure, khat can reduce the effectiveness of medicines for high blood pressure.

that ketoconazole is used to treat

Some medicines for high blood pressure include: captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (LasroDiuril) (furosem), and many others.

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Stimulants Interaction rating: Moderate Be careful with this combination. Talk to your doctor.

Stimulating drugs speed up the work of the nervous system. By speeding up the nervous system, stimulant medications can make you feel nervous and have an increased heart rate. Kat can also speed up the nervous system. Taking kata with stimulants can cause serious problems, including heart palpitations and high blood pressure.Avoid taking stimulant medications with khat.

Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamine), pseudoephedrine (Sudafed), and many others.

Dosage advice cat.

The appropriate dose of khat depends on several factors, such as the age of the user, health status, and a variety of other conditions. There is currently insufficient scientific information to determine an appropriate dose range for cat.Keep in mind that natural foods are not always safe and their dosage can make a difference. Be sure to follow appropriate directions on product labels and consult a pharmacist, doctor, or other healthcare professional before use.

Comprehensive Natural Medicines Database evaluates effectiveness based on scientific evidence on the following scale: effective, likely effective, possibly effective, possibly ineffective, likely ineffective and insufficient evidence to evaluate.(detailed description of each of the ratings).

References

Adeoya-Osiguva, S.A. and Fraser, L.R. Cathine and norephedrine, both phenylpropanolamines, accelerate capacity and then inhibit spontaneous acrosome loss. Hum.Reprod. 2005; 20 (1): 198-207. View annotation.

Al Hadrani, A.M. Khat caused hemorrhoidal disease in Yemen. Saudi.Med.J. 2000; 21 (5): 475-477. View annotation.

Al Motarreb, A. L. and Broadley, K. J. Constriction of the coronary and aortic vessels with cathinone, an active component of Cat.Auton. Autacoid. Pharmacol 2003; 23 (5-6): 319-326. View annotation.

Al Motarreb, A., Briancon, S., Al Jaber, N., Al Adhi, B., Al Jailani, F., Salek, M.S., and Broadley, K.J. Hut, chewing is a factor risk of acute myocardial infarction: case-control study. Br J Clin Pharmacol 2005; 59 (5): 574-581. View annotation.

Al Zubairi, A., Al Khabori, M., and Al Geyri, A. Effect of chewing Catha edulis (khat) on plasma lipid peroxidation. J.Ethnopharmacol. 2003; 87 (1): 3-9. View annotation.

Alem, A. and Shibre, T. Kat, Induced psychosis and its medico-legal consequences: case report. Ethiop.Med.J. 1997; 35 (2): 137-139. View annotation.

Avange, DO and Onyango, J. F. Verrucous carcinoma of the oral cavity: two case report and literature review. East Afr. Med J 1993; 70 (5): 316-318. View annotation.

Belhaj-Tahar, H. and Sadegh, N. Metcathinone: a new post-industrial drug.Forensic medical examination 10-4-2005; 153 (1): 99-101. View annotation.

Brenneisen, R., Fish, H.W., Koelbing, W., Geisshusler, S., and Kalix, P. Amphetamine-like effects of the cathinone cat-alkaloid in humans. Br.J. Clin. Pharmacol. 1990; 30 (6): 825-828. View annotation.

Brown, E.R., Jarvey, D.R. and Simpson, D. Drug use at raves. Scott. Med J 1995; 40 (6): 168-171. View annotation.

Dimba, EA, Gjertsen, BT, Bredholt, T., Fossan, KO, Costea, DE, Francis, GW, Johannessen, AC, and Vintermyr, OK.Cat (Catha edulis) -induced apoptosis is inhibited by caspase-1 and -8 antagonists in human leukemia cells. Br. J. Cancer, 11-1-2004; 91 (9): 1726-1734. View annotation.

Giannini, AJ & Nakonechi, AM Treatment of khat addiction with bromocriptine mesylate: a case report and review of cocaine and amphetamine-like effects. Am J Ther 1995; 2 (7): 487-489. View annotation.

Giannini AJ, Miller N.S. and Turner KE Cat. J. Subst.Abuse Treat. 1992; 9 (4): 379-382. View annotation.

Granek M., Shalev A. and Weingarten A. M. Hypnagogic hallucinations caused by Hut. Acta Psychiatr. Scand. 1988; 78 (4): 458-461. View annotation.

Griffiths, P., Gossop, M., Vickenden, S., Danworth, J., Harris, K., and Lloyd, K. Transcultural Model of Drug Use: Cat (Cat) in the UK. Br. J. Psychiatry 1997; 170: 281-284. View annotation.

Guantai, AN and Maytai, KK Metabolism of cathinone to d-norpseudoephedrine in humans.J Pharm Sci 1983; 72 (10): 1217-1218. View annotation.

Hassan, N.A., Gunaid, A.A., Abdo-Rabbo, A.A., Abdel-Kader, Z.Yu., al-Mansub, M.A., Awad, A.Yu., and Murray-Lyon, IM Effect of Khat chewing on blood pressure and heart rate in healthy volunteers. Trope. Doct. 2000; 30 (2): 107-108. View annotation.

Hassan, N.A., Gunaid, A.A., El Khally, F.M., Al Noami, M.Y., and Murray-Lyon, I.M. Khat, chewing and arterial blood pressure. A randomized controlled clinical trial of blockade of alpha-1 and selective beta-1 adrenergic receptors.Saudi. Med J 2005; 26 (4): 537-541. View annotation.

which drug is propofol

Hasan, N. A., Gunaid, A. A., El Khalli, F. M., and Murray-Lyon, I. M. Effect of chewing on khat leaves on human mood. Saudi.Med.J. 2002; 23 (7): 850-853. View annotation.

Heymann, T.D., Bhupulan, A., Zureikat, N.E., Bomanji, J., Drinkwater, K., Giles, P., and Murray-Lyon, I.M. Khat delays gastric emptying from semi-solid food. Aliment. Pharmacol. Ter. 1995; 9 (1): 81-83.View annotation.

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chlorhexidine gluconate 0.12% for mouthwash

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90,000 How to Understand Countless, Confusing Cold Medicines – Lifestyle

There are two ways to choose your favorite cold medicine when you go to the store.One is to remember the brand name you used last year; the other is to scan small

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There are two ways to choose your favorite cold medicine when you go to the store. One is to remember the brand name you used last year; the other is to scan the fine print to find the right mix of active ingredients. The second approach may seem troublesome, but it is much more effective.

When it seems like your head is stuffed with cotton, it is not enough to remember that you swear by Robitussin. which Robitussin is like going to a shoe store and asking for a pair of Nikes, any Nike. Some medicines that look the same have very different ingredients, and some that look like completely different products are identical on the inside. And I don’t mean just generics versus brand names. Look at this:

These two products look like completely different medicines for different diseases, but they have exactly the same dosage belonging to exactly the same ingredients .You might be tempted to just pick one and remember the name, but Mucinex doesn’t make it easy: there are several Fast-Max products and several Sinus-Max products, each with a different composition, and I found that the active ingredients listed on their web website are sometimes different from what is indicated in the products in the store.

Here’s another riddle. Can you guess the difference between a multisymptomatic cold with maximum strength of Robitussin and a severe multisymptomatic Robitussin cough, cold and flu? The latter contains acetaminophen, which means it is equivalent to taking the other plus Tylenol.Otherwise, they are identical. (Although one is labeled “maximum strength,” and the other is not, the dosages are the same.)

Brands make this difficult by posting symptom tests and comparison tools on their websites to help you pass through the maze of products, but there is a better solution.

Instead of memorizing food names, think of each syrup or tablet as a set of tools : Does it contain the tools you need to work? This approach will also help you avoid ingredients that you and don’t want, as some of them have side effects or risks that you might want to avoid.

There are only a handful of ingredients in the many boxes and bottles in the aisle for the cold medicine. Knowing these ingredients makes you a smart shopper, your very own OTC symptom relief alchemist. Today we’ll look at some of the more common ingredients in cold medicines, but you can use the same toolbox approach when purchasing other medicines.

Cough medicine

Medicine: Dextromethorphan
Usually indicated as: Cough medicine
What it does: Interferes with the transmission of cough-causing signals to the brain, although it may not be very effective.
Important to know: The way dextromethorphan works in the brain turns it into a dissociative hallucinogen. (Yes, some people recreationally overdose on cold medications. Don’t try to do this at home.) Doses of cold medications are small enough to keep you from seeing pink elephants, but they can make you feel strange or insecure. If you are concerned about this, try a product without this ingredient.

Medication: Guaifenesin
Usually indicated as: Expectorant
What it does: Increases the watery mucus in the lungs.This means you will have more mucus, but it will be easier to cough up (“cough up”).
Important to know: Like dextromethorphan, guaifenesin may not work very well; results are mixed, so give it a try and see.

Decongestants

Medication: Pseudoephedrine
Usually listed as: Nasal decongestant
What it does: Constricts the blood vessels in the nose so less mucus is produced.
Important to Know: Although this drug is sold without a prescription and does not require a prescription in most states, federal law requires it to be stored behind the counter (or in a locked cabinet). This is because it can be used to make methamphetamine, so some additional rules apply to it. You will need to show a photo ID and you cannot purchase more than 9 grams per month. This also means that if you know you want a medicine containing pseudoephedrine, go shopping when your store’s pharmacy counter is open.Side effects can include feeling nervous and trouble sleeping.

Medication: Phenylephrine
Usually indicated as: Nasal decongestant
What it does: Constricts the blood vessels in the nose (same idea as pseudoephedrine)
Important to know: Drugs that used to be Pseudoephedrine has mostly been redesigned: versions available on store shelves now contain phenylephrine, which works in a similar way and has similar side effects.However, it is less effective than pseudoephedrine, so consider switching to an over-the-counter drug if it doesn’t work for you.

Sleepy Creators

Drug: Diphenhydramine
Usually indicated as: Antihistamine
What it does: Interacts with histamine receptors, causing drowsiness and reducing allergy symptoms (this is difficult) 9055 Important to know with two drugs very different purposes. In Benadryl, it is an antihistamine that fights allergy symptoms; in ZzzQuil – sleeping pills.Same drug, different branding. It is used in nighttime cold medications to “help you sleep,” although it can be powerful and sometimes longer than you expect, so use it with caution if you know you will have to get up early.

Medication: Doxylamine
Usually indicated as: Antihistamine
What it does: Same as diphenhydramine, causes drowsiness and reduces allergy symptoms.
Important to know: Very similar to diphenhydramine, although some people find that one works better than the other.

Pain relievers

Medication: Acetaminophen
Usually indicated as: Pain reliever
What it does: Reduces pain and fever
Important to know: Acetaminophen can cause liver damage if overdose is found in several products, and because it (Tylenol and also in many cold medications), you can get too much of it. Labels should now warn about this, including a warning not to take acetaminophen if you drink alcohol.

Medication: Naproxen
Usually listed as: Pain reliever
What it does: Reduces pain, inflammation and fever
Important to know: Naproxen does not have the same toxicity as acetaminophen, but is used for similar purposes. It lasts longer in the body than ibuprofen, which is why you’ll find it in long-acting medications.

Medication: Ibuprofen
Usually indicated as: Pain reliever
What it does: Reduces pain, inflammation and fever
Important to know: It is less common in cold medicines, but useful to know about.It is very similar to naproxen but has a shorter duration. Here we will discuss the differences between this and other pain relievers.

Other Things to Know

A few caveats apply to all cold medicines and label reading in general:

• Beware of giving these medicines to children. Even those labeled as “baby” are not recommended for children under 4: they may not work and carry additional risks. If you really think your child needs something, it is worth calling the doctor first.
• If you are taking more than one medication, check the labels carefully to make sure you are not using something in half (especially acetaminophen).
• While you’re at it, read the entire label, including warnings about how the drug interacts with other drugs or health conditions that may apply to you.

Buying cold medicine by ingredient is actually like choosing the tools for the job. When you know which ones you need and which ones you don’t, you can choose exactly what suits you.

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Illustration by Sam Woolley.

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