Ī study has also found that pseudoephedrine can reduce milk production in breastfeeding women. Long-distance truck drivers and athletes, for example, have reportedly used pseudoephedrine as a stimulant to increase their state of alertness/awareness. There have been reports of off-label uses of pseudoephedrine for its stimulant properties. Activation of β2-adrenergic receptors produces relaxation of smooth muscle of the bronchi, causing bronchial dilation and in turn decreasing congestion (although not fluid) and difficulty breathing. Thus, by constriction of blood vessels, mainly those located in the nasal passages, pseudoephedrine causes a decrease in the symptoms of nasal congestion. The constricted blood vessels now allow less fluid to leave the blood vessels and enter the nose, throat, and sinus linings, which results in decreased inflammation of nasal membranes, as well as decreased mucus production. When these receptors are activated, the muscles contract, causing the blood vessels to constrict (vasoconstriction). α-Adrenergic receptors are located on the muscles lining the walls of blood vessels. Pseudoephedrine acts on α- and β2-adrenergic receptors, to cause vasoconstriction and relaxation of smooth muscle in the bronchi, respectively. ![]() The vasoconstriction that pseudoephedrine produces is believed to be principally an α-adrenergic receptor response. Its principal mechanism of action relies on its direct action on the adrenergic receptor system. Pseudoephedrine is a sympathomimetic amine. Antacids increase the rate of pseudoephedrine absorption, while kaolin decreases it. Increase of ectopic pacemaker activity can occur when pseudoephedrine is used concomitantly with digitalis. Beta-adrenergic antagonists may also interact with sympathomimetics. The antihypertensive effects of methyldopa, mecamylamine, reserpine, and veratrum alkaloids may be reduced by sympathomimetics. Interactions Ĭoncomitant or recent (previous fourteen days) monoamine oxidase inhibitor use can lead to hypertensive reactions, including hypertensive crises. The safety and effectiveness of nasal decongestant use in children is unclear. Pseudoephedrine is contraindicated in patients with diabetes mellitus, cardiovascular disease, severe or uncontrolled hypertension, severe coronary artery disease, prostatic hypertrophy, hyperthyroidism, closed angle glaucoma, or by pregnant women. ![]() It has also been reported that pseudoephedrine, among other sympathomimetic agents, may be associated with the occurrence of stroke. Pseudoephedrine, particularly when combined with other drugs including narcotics, may also play a role in the precipitation of episodes of paranoid psychosis. Rarely, pseudoephedrine therapy may be associated with mydriasis (dilated pupils), hallucinations, arrhythmias, hypertension, seizures and ischemic colitis as well as severe skin reactions known as recurrent pseudo-scarlatina, systemic contact dermatitis, and nonpigmenting fixed drug eruption. Infrequent ADRs include tachycardia or palpitations. ![]() Adverse effects Ĭommon adverse drug reactions (ADRs) associated with pseudoephedrine therapy include central nervous system stimulation, insomnia, nervousness, excitability, dizziness and anxiety. Treatment for urinary incontinence is an off-label use ("unlabeled use") for these medications. Erection is largely a parasympathetic response, so the sympathetic action of pseudoephedrine may serve to relieve this condition. Pseudoephedrine is also used as a first-line prophylactic for recurrent priapism. Pseudoephedrine is also indicated for vasomotor rhinitis, and as an adjunct to other agents in the optimum treatment of allergic rhinitis, croup, sinusitis, otitis media, and tracheobronchitis. Pseudoephedrine is indicated for the treatment of nasal congestion, sinus congestion, and Eustachian tube congestion. According to one study, pseudoephedrine may show effectiveness as an antitussive drug (suppression of cough). Due to its stimulating qualities, however, the oral preparation is more likely to cause adverse effects, including urinary retention. Pseudoephedrine can be used either as oral or as topical decongestant. The same vasoconstriction action can also result in hypertension, which is a noted side effect of pseudoephedrine. Other beneficial effects may include increasing the drainage of sinus secretions, and opening of obstructed Eustachian tubes. It reduces tissue hyperemia, edema, and nasal congestion commonly associated with colds or allergies. Pseudoephedrine is a stimulant, but it is well known for shrinking swollen nasal mucous membranes, so it is often used as a decongestant. ( December 2011) ( Learn how and when to remove this template message) ![]() Unsourced material may be challenged and removed. Please help improve this article by adding citations to reliable sources in this section. This section needs additional citations for verification.
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