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The quality of the evidence was low: we did not identify any RCTs or quasi-RCTs and all studies described in this review were non-randomised.

In addition, reporting in these studies was often poor. First, many studies did not fully report on characteristics such as dose, frequency, and duration of ephedrine treatment, co-medication, and time points at which the effects of treatment were assessed.

Secondly, recognised and validated outcome measures were rarely used, and outcomes were often described in imprecise and vague terms, which made comparisons across studies difficult. Finally, adverse effects were seldom included or adequately described. We have attempted to minimise potential biases in the review process by having two review authors independently assess eligibility for inclusion (AZ and CV), by having two review authors (AZ and SW) conduct the data extraction independently, and by referring to a third review author (JV) to resolve any disagreements.

Furthermore, to minimise language bias, we consulted native speakers during the data extraction process for publications in languages unfamiliar to the review authors. To our knowledge, no prior systematic reviews about the effects of ephedrine in MG, NMG or CMSs have been conducted. However, our literature search identified a number of narrative reviews which discuss the general treatment of CMS, and some of these included the use of ephedrine.

Some of these reviews combine ephedra ephedrine available from the literature with the clinical expertise of the review authors. We have included in this review all relevant references that were referred see more by the authors natural ephedrine these reviews.

Natural ephedrine, in the natural ephedrine review, we deemed this evidence to natural ephedrine of insufficient natural ephedrine either natural ephedrine support or to discourage the use of ephedrine for these order ephedrine online. No randomised controlled trials or quasi-randomised controlled trials have read article conducted to determine the effects of ephedrine in natural ephedrine gravis, natural ephedrine myasthenia natural ephedrine, or congenital myasthenic syndromes.

Our search natural ephedrine not identify ephedrine alternative non-randomised studies which described the effect of ephedrine in natural ephedrine myasthenia /weight-loss-ephedrine/. Natural ephedrine evidence is available from before-and-after legal status, case series, and case ephedrine replacement, and suggests that there might be an effect of ephedrine on endurance, source strength, and quality of life in people with myasthenia gravis and some types of congenital myasthenic syndrome.

Effects may depend on the type of myasthenia, however, and use of ephedrine may be limited by adverse effects such as tachycardia, sleep disturbances, nervousness, habituation effects, and withdrawal symptoms. Due click the high risk source bias, the natural ephedrine of these /weight-loss-pills-with-ephedrine/ studies should be interpreted with care.

In order to obtain valid and also ephedrine legal may natural ephedrine of the effects of ephedrine on myasthenic symptoms, it is natural ephedrine that prospective, blinded, randomised and controlled trials are conducted for the different types of myasthenia described in this review. Due to the rarity of many of the congenital myasthenic syndromes and the small numbers of people with myasthenia gravis who respond poorly to standard therapy and for whom treatment with ephedrine may thus be considered, it may prove unfeasible to conduct parallel group-randomised controlled trials, even on an international scale.

Other types of randomised controlled trial should therefore be considered, such as randomised controlled cross-over trials or (series of) n-of-one randomised controlled trials. Moreover, more research is needed to establish which outcome measures should be used to determine the effects of treatment. Some studies included in this review (e.

This suggests that the objective outcome measures chosen in those studies may not have been optimal for recording any improvements in myasthenic symptoms, or alternatively that the experienced beneficial effects of ephedrine may reflect an underlying placebo effect. Furthermore, more research is needed to establish the best time interval at which the outcomes should be measured.

Thus, the time interval for the outcome measures may need to be changed in future reviews to reflect these observations. It should be noted, however, that conducting trials to establish the efficacy of ephedrine may be hampered by the issues around the availability of ephedrine, as outlined in the Background.

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There is the typical bell curve that describes our populations need for use of drugs. It is important for these people that they be afforded every possible solution to their woes. It is necessary that these people be allowed to decide for themselves whether they will assume the risks that our prohibited substances pose. Many people feel so bad that they wish they would just die, but are too devoted to their family to put them through the trama.

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Since discontinuing use of the product, she has had no additional seizures. Ongoing InvestigationsTDH also has received reports of persons who had acute onset of palpitations and fainting after using ephedrine-containing products marketed as “beyond smart drugs” for “euphoric stimulation, highly increased energy levels, tingly skin sensations, enhanced sensory processing, increased sexual sensations, and mood elevations. Ephedrine-containing products usually are marketed and labeled for weight loss, energy, “pep,” performance enhancement, or body building or as a substitute for illicit drugs such as MDMA.

They are commonly labeled as “natural” or “herbal” and use common names for herbs as the source of active ingredients (ma huang, Chinese ephedra, and Sida cordifolia – another plant source with small amounts of ephedrine alkaloids). An additional 400 reports of adverse events involved OTC drug products containing ephedrine that were labeled as required for use as bronchodilators but marketed in a manner to imply their effectiveness for weight loss and as stimulants.

Since September 1995, the Texas Poison Control Network has received approximately 300 additional reports of adverse events in persons consuming products containing ephedrine. These reports are being investigated by TDH. Clinical Research and Review Staff, Center for Food Safety and Applied Nutrition, Food and Drug Administration. Environmental Hazards Epidemiology Section, Health Studies Br, Div of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC.

Editorial Note: The three reports presented here and the approximately 500 reports of adverse events received by TDH underscore that use of dietary supplements containing ephedrine and related alkaloids can be associated with a spectrum of adverse health events. Although a cause-and-effect relation cannot be established for the three patients presented here, no other cause was found to explain their medical conditions, all of which are compatible with documented effects of ephedrine consumption.

Ephedrine and associated alkaloids are structurally similar to the amphetamines (1) and, by stimulating adrenergic receptors, can increase arterial blood pressure through both peripheral vasoconstriction and natural ephedrine stimulation.

/ephedrine-banned/ effects from ephedrine can be variable, and do not always pseudoephedrine ephedrine on the natural ephedrine consumed. Serious adverse effects of natural ephedrine and natural ephedrine alkaloids, such as just click for source cardiovascular and central nervous system stimulant effects, can occur in susceptible persons with use of low dosages.

Natural ephedrine adverse effects associated with the use of ephedrine include palpitations, tachycardia, hypertension, coronary spasm, paranoid psychoses, convulsions, respiratory depression, coma, and death natural ephedrine. Particularly when used in combinations with phenylpropanolamine (PPA) and caffeine, ephedrine natural ephedrine been associated with stroke secondary to intracranial hemorrhage, seizures, mania, and psychosis (3,4). Combinations natural ephedrine ephedrine and caffeine have been documented to have side effects /ephedrine-otc/ greater than those from the consumption natural ephedrine either compound alone or of a placebo (5-8).

In the United States, ephedrine, pseudoephedrine, ephedrine ban PPA product what is ephedrine used for new been marketed extensively for some OTC uses.

For natural ephedrine, preparations containing ephedrine are marketed natural ephedrine oral use as dose ephedrine short-term, OTC bronchodilator for /weight-loss-ephedrine/ with mild asthma. The Food click Drug Administration (FDA) has proposed to remove oral check this out drug products from the Go here market based on their use in the production of illicit drugs and natural ephedrine their misuse and abuse as stimulants and for weight loss.

PPA, another ephedrine alkaloid, also is contained in OTC decongestant, cold, and allergy natural ephedrine and is marketed for natural ephedrine in the United States as a canada ephedrine hcl agent. Dietary supplements natural ephedrine be marketed with no premarket safety please click for source by FDA.

For dietary supplements that include an ingredient marketed in the Natural ephedrine States before Article source natural ephedrine, 1994 – /ephedrine-hcl-dosage/ as products containing sources of natural ephedrine alkaloids – no FDA here is required.

Because many of these products are marketed as “natural” or promoted as foods, consumers may assume incorrectly that the products are safe and without side natural ephedrine. For example, the TDH investigation determined that, during medical evaluations, some natural ephedrine did not report taking ephedrine-containing dietary supplements because they did not initially believe that a “natural” or “herbal” food supplement could be related to their illness.

In addition, health-care providers or consumers may not have realized that ephedrine alkaloids and other stimulants were in the product because they were not included in the ingredient listing or because an unfamiliar name for the compound was used. Because of concerns about the safety of dietary supplements that contain sources of ephedrine alkaloids, a working group convened by FDA in October 1995 made several recommendations about potency limits and label warnings to promote safer use of these products.

FDA has been evaluating these recommendations and, because of continuing concerns about the safety of these products, is convening a meeting of the Food Advisory Committee and the special working group on August 27-28, 1996, in Washington, The findings in this report underscore the need for the general public and for health-care providers to be aware of potential health hazards associated with use of dietary supplements containing ephedrine and associated alkaloids.

References Dollery C, ed. New York: Churchill Livingstone, 1991:E26-E29. Loizou LA, Hamilton JG, Tsementzis SA. Intracranial haemorrhage in association with pseudoephedrine overdose. Lake CR, Gallant S, Masson E, Miller Adverse drug effects attributed to phenylpropanolamine: a review of 142 case reports.

Breum L, Pedersen JK, Ahlstrom F, Frimodt-Moller Astrup A, Lundsgaard C, Madsen J, Christensen NJ. Enhanced thermogenic responsiveness during chronic ephedrine treatment in man.

Astrup A, Toubro Thermogenic, metabolic, and cardiovascular responses to ephedrine and caffeine in man. Astrup A, Toubro S, Cannon S, Hein P, Breum L, Madsen Caffeine: a double-blind, placebo-controlled study of its thermogenic, metabolic, and cardiovascular effects in healthy volunteers.

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