Ephedrine‐Induced Cardiac Ischemia: Exposure Confirmed with a Serum Level

@article{Schier2003EphedrineInducedCI,
  title={Ephedrine‐Induced Cardiac Ischemia: Exposure Confirmed with a Serum Level},
  author={Joshua G. Schier and Stephen J. Traub and Robert S. Hoffman and Lewis S. Nelson},
  journal={Journal of Toxicology: Clinical Toxicology},
  year={2003},
  volume={41},
  pages={849 - 853}
}
Abstract The temporal association of symptoms consistent with ephedrine toxicity after ingestion of ephedrine‐containing dietary supplements is heavily relied upon to confirm exposure. Few reports in the literature attempt to associate toxicity with serum levels of these drugs. We report a case of ephedrine‐induced cardiac ischemia confirmed by a plasma level. A 22‐year‐old woman ingesting an ephedrine‐ and caffeine‐containing product for 2 days presented with multiple symptoms, including… 

HARMACODYNAMICS AND RUG ACTION hort-term metabolic and hemodynamic ffects of ephedra and guarana ombinations

Objective: Serious adverse health events have been reported with the use of dietary supplements containing ephedra and guarana. We sought to determine whether repeated dosing and multi-ingredient

How to Induce Arrhythmias with Ephedrine?

TLDR
Ephedrine is an alpha-beta agonist widely used for nasal decongestion, nervous system stimulation, and spinal anesthesia during cesarean section, and sympathomimetic drug that acts both on α- and β -adrenergic receptors.

A beating heart cell model to predict cardiotoxicity: effects of the dietary supplement ingredients higenamine, phenylethylamine, ephedrine and caffeine.

Mechanistic pharmacokinetic modelling of ephedrine, norephedrine and caffeine in healthy subjects.

TLDR
A saturable process appears to be involved in the metabolism of ephedrine to norephedrine and caffeine pharmacokinetics and their interactions, which is mainly related to the amount of the former in the absorption compartment.

Cardiac Troponin T and Cardiac Dysfunction in Extremely Low-Birth-Weight Infants

TLDR
In ELBW infants, serum cTnT levels are higher than normally seen in term infants and adults, and they are higher in infants with greater perinatal stress as well as those who show evidence of cardiac dysfunction requiring pressor support.

Pathology of emesis: its autonomic basis.

  • W. Hasler
  • Medicine, Psychology
    Handbook of clinical neurology
  • 2013

28 Days repeated oral dose toxicity test of aqueous extracts of mahwangyounpae-tang, a polyherbal formula.

Determination of L-ephedrine, pseudoephedrine, and caffeine in rat plasma by liquid chromatography-tandem mass spectrometry.

TLDR
The rapid and simple liquid chromatography tandem mass spectrometry method was developed and validated and successfully applied in toxicokinetic studies of ephedrine, administered alone, in combination with caffeine, and in the herbal source Ma Huang.

References

SHOWING 1-10 OF 14 REFERENCES

Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine.

TLDR
Analysis of the 37 patients indicates that ma huang use is temporally related to stroke, myocardial infarction, and sudden death, and underlying heart or vascular disease is not a prerequisite for ma hUang-related adverse events.

Ephedrine pharmacokinetics after the ingestion of nutritional supplements containing Ephedra sinica (ma huang).

TLDR
The current study suggests that the increased incidence of ma huang toxicity results from accidental overdose often prompted by exaggerated off-label claims and a belief that "natural" medicinal agents are inherently safe.

Pharmacokinetics and Cardiovascular Effects of Ma‐Huang (Ephedra sinica) in Normotensive Adults

TLDR
Ma‐haung had variable effects on blood pressure and increased heart rate in healthy, normotensive adults and pharmacokinetic parameters for ephedrine were in agreement with those previously reported; however, the absorption rate was much slower after ingestion of ma‐huang.

Ephedrine-type alkaloid content of nutritional supplements containing Ephedra sinica (Ma-huang) as determined by high performance liquid chromatography.

TLDR
A validated HPLC method for the determination of ephedrine-type alkaloids, commonly found in Ephedra supplements, is presented and may contribute to toxicity associated with these products.

Ephedrine abuse causing acute myocardial infarction

“On the street”, the more expensive illegal psychostimulants, such as cocaine or amphetamine, may be mixed with or substituted for cheaper drugs such as ephedrine — with added risk to the user. We

Pharmacodynamics and pharmacokinetics of single nasal (5 mg and 10 mg) and oral (50 mg) doses of ephedrine in healthy subjects

TLDR
E even at low doses and by the nasal route can decrease tiredness in healthy persons; this is accompanied by a substantial increase in blood pressure and orthostatic hypotension exposing individuals in case of intensive physical exercise to cardiovascular risks.

The pharmacokinetics of ephedrine after oral dosage in asthmatics receiving acute and chronic treatment.

TLDR
Pharmacokinetic assessment of the data indicated no significant intra-subject changes in kinetic parameters before or after chronic treatment with ephedrine HCl alone or in combination with theophylline and a barbiturate.

Content versus label claims in ephedra-containing dietary supplements.

  • B. GurleyS. GardnerM. Hubbard
  • Chemistry, Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2000
TLDR
Assay of 20 ephedra-containing dietary supplements showed that alkaloid content often differed markedly from label claims and was inconsistent between two lots of some products.

Pharmacology of ephedra alkaloids and caffeine after single‐dose dietary supplement use

TLDR
This work assessed the pharmacokinetics and pharmacodynamics of a dietary supplement that contains ma huang (Ephedra) and guarana (caffeine) and concluded that these herbal stimulants are safe and effective as dietary supplements.