Pseudoephedrine Essay

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Pseudoephedrine and Beta-Blockers
There are over 135 over-the-counter and prescription drugs that contains pseudoephedrine (Salerno, Jackson, & Berbano, 2005). Many of these are familiar brands such as Allegra-D, Benadryl Allergy and Sinus Tablets, Claritin-D Non-Drowsy 24 Hour Tablets, Robitussin Cold Severe Congestion Capsules, Sudafed 24 Hour Tablets, Thera-Flu Cold and Cough Hot Liquid, Tylenol Sinus Severe Congestion Caplets, and Vicks 44M Cough, Cold and Flu Relief (Salerno, Jackson, & Berbano, 2005). Pseudoephedrine can elevate the blood pressure (BP) posing risk to hypertensive patients (Salerno, Jackson, & Berbano, 2005). For BP management using beta-blockers, pseudoephedrine, a seemingly innocent common cold remedy, may and can significantly
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Other adverse effects of pseudoephedrine are arrhythmias, prolongation of the QT interval, angina pectoris, and myocardial infarction. Pseudoephedrine increases the availability of naturally released catecholamines in tissues by direct stimulation of both alpha- and beta-adrenergic receptors that can lead to toxicity, a mechanism that can occur is taken beyond the safe recommended dose (Fidan, Izci, Tellice, Alizade, & Açar, 2015).
Patients with hypertension and coronary disease can be safely treated with beta-blockers reducing myocardial oxygen demands and slowing down myocardial contraction. However, beta-blockers are no longer considered first line therapy for hypertension due to the increased risks in developing diabetes and its use for other complicated cardiac conditions such as heart failure and angina. Consequently, patients who are on beta-blockers, can experience the direct vasospastic effect of pseudoephedrine paired with a dysfunctional endothelium leading to excessive vasospasm that could potentially result to myocardial infarction (Fidan, Izci, Tellice, Alizade, & Açar, 2015). Beta-blockers can reverse the vasospasm in young, healthy patients and even reverse the effects on coronary arteries in an emergency situation who have experienced pseudoephedrine toxicity (Akay & Ozdemir,
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