EPHEDRINE

What is ephedrine?

Ephedrine is used for temporary relief of shortness of breath, chest tightness, and wheezing due to bronchial asthma. Ephedrine may also be used for other conditions as determined by your doctor.

Ephedrine is a decongestant and bronchodilator. It works by reducing swelling and constricting blood vessels in the nasal passages and widening the lung airways, allowing you to breathe more easily.

Ephedrine is a medication used to prevent low blood pressure during spinal anesthesia.^[1] It has also been used for asthma,narcolepsy, and obesity but is not the preferred treatment. It can be taken by mouth or by injection into a muscle, vein, or just under the skin. Onset with intravenous use is fast, while injection into a muscle can take 20 minutes, and by mouth can take an hour for effect. When given by injection it lasts about an hour and when taken by mouth it can last up to four hours.^[1]

Common side effects include trouble sleeping, anxiety, headache, hallucinations, high blood pressure, fast heart rate, loss of appetite, and inability to urinate. Serious side effects include stroke, heart attack, and abuse.^[1] While likely safe in pregnancy its use in this population is poorly studied.^[2][3] Use during breastfeeding is not recommended.^[3] Ephedrine works by turning on α and βadrenergic receptors.^[1]

Ephedrine was first isolated in 1885.^[4] It is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system.^[5] It is available as a generic medication.^[1] The wholesale cost in the developing world is about 0.69 to 1.35 USD per dose.^[6] In the United States it is not very expensive.^[7] It can normally be found in plants of the Ephedra type. Dietary supplements that contain ephedrine are illegal in the United States. An exception is when used in traditional Chinese medicine.^[1]

Important safety information:

• ephedrine may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to ephedrine. Using ephedrine alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• If your symptoms do not improve within 7 days or if you develop a high fever, check with your doctor.
• If you have trouble sleeping, ask your pharmacist or doctor about the best time to take this medication.
• Do not take diet or appetite control medicines while you are taking ephedrine.
• Before you begin taking any new prescription or nonprescription medicine, read the ingredients to see if it also contains ephedrine. If it does or if you are uncertain, contact your doctor or pharmacist.
• Diabetes patients - ephedrine may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.
• Use this medication with caution in the elderly because they may be more sensitive to its effects.
• Use ephedrine with extreme caution in children. Safety and effectiveness have not been confirmed.
• Pregnancy and breast-feeding: It is unknown if this medication can cause harm to the fetus. If you become pregnant while taking ephedrine, discuss with your doctor the benefits and risks of using ephedrine during pregnancy. Ephedrine is excreted in breast milk. If you are or will be breast-feeding while you are using ephedrine, check with your doctor or pharmacist to discuss the risks to your baby.                                                                                                                                                                                                 History
• Ephedrine in its natural form, known as má huáng (麻黄) in traditional Chinese medicine, has been documented in China since the Han dynasty (206 BC – 220 AD) as anantiasthmatic and stimulant. In 1885, the chemical synthesis of ephedrine was first accomplished by Japanese organic chemist Nagai Nagayoshi based on his research ontraditional Japanese and Chinese herbal medicines. The industrial manufacture of ephedrine in China began in the 1920s, when Merck began marketing and selling the drug as ephetonin. Ephedrine exports between China and the West grew from 4 to 216 tonnes between 1926 and 1928.
  In traditional Chinese medicine, má huáng has been used as a treatment for asthma and bronchitis for centuries.

REFERENCE:

https://en.wikipedia.org/wiki/Ephedrine 

PERSONAL OPINION:
EPHEDRINE a medication used to prevent low blood pressure during spinal anesthesia. It has also been used for asthma,narcolepsy, and obesity but is not the preferred treatment. Serious side effects include stroke, heart attack, and abuse. While likely safe in pregnancy its use in this population is poorly studied.