Ephedrine Sulfate and One Touch Advanced Gel

• Generic Name: ephedrine
• Dosage Forms: n.a.
• Other Brand Names: Akovaz

Used parenterally for treatment of clinically important hypotension in the setting of anesthesia.

Increases systolic and mean arterial BP when administered as a direct IV (“bolus”) injection following development of hypotension in patients receiving neuraxial and/or general anesthesia. Such effects observed across a variety of surgical settings, including obstetric surgery in pregnant women undergoing cesarean delivery with neuraxial anesthesia.

Although ephedrine historically considered the vasopressor of choice in obstetric anesthesia, some evidence suggests that phenylephrine may provide more favorable fetal acid-base balance. Experts currently recommend either IV ephedrine or phenylephrine for treatment of hypotension during neuraxial anesthesia; however, consideration should be given to selection of phenylephrine in the absence of maternal bradycardia because of improved fetal acid-base status in uncomplicated pregnancies.

IM use of ephedrine also evaluated in this setting; however, results have been equivocal.

Bronchospasm

Used orally as a bronchodilator for symptomatic treatment of asthma.

Used in fixed-combination with guaifenesin as self-medication for the temporary relief of mild symptoms of intermittent asthma (e.g., wheezing, chest tightness, shortness of breath).

Use of an OTC bronchodilator may be appropriate in patients with mild symptoms of intermittent asthma; however, those with more severe asthma (i.e., persistent asthma) or worsening asthma (symptoms not relieved within 60 minutes or with maximum recommended dosages, increasing frequency of asthma attacks) should consult a clinician for other treatment options.

While oral ephedrine was once widely used in the treatment of asthma, the drug generally has been replaced by more selective and rapid-acting agents (e.g., inhaled β2-adrenergic agonists).

CNS Conditions

Has been used in the treatment of narcolepsy or depressive states; however, cardiovascular effects of the drug limit usefulness in these conditions.

Obesity

Previously used for self-medication in the management of obesity.

Dietary supplements containing ephedrine alkaloids are no longer commercially available in the US.

Nasal Congestion

Has been used as a nasal decongestant, but of doubtful value when used for this condition.

Myasthenia Gravis

Has been used in patients with myasthenia gravis; however, randomized controlled studies are needed to evaluate potential benefit.

Misuse and Abuse

Has been misused and abused by athletes, bodybuilders, weight lifters, and others, including high school- and college-aged individuals engaged in sports.

Dietary supplements containing ephedrine alkaloids are no longer commercially available in the US.

Ephedrine has been used in clandestine synthesis of methamphetamine and methcathinone. Federal restrictions to reduce the potential for misuse (diversion) and abuse of ephedrine include limiting the amount that can be purchased to 3.6 g per day or 9 g per month, requiring storage behind the counter or in a locked cabinet, requiring purchasers to provide approved photographic identification, and requiring retail distributors to maintain a written or electronic logbook of purchases for at least 2 years. Additional requirements have been enacted in some states; follow state requirements if such requirements are more stringent than federal restrictions.

• Generic Name: benzocaine / butamben / tetracaine topical
• Dosage Forms: gel
• Other Brand Names: Cetacaine

Vitamins are compounds that you must have for growth and health. They are needed in small amounts only and are usually available in the foods that you eat. Ascorbic acid, also known as vitamin C, is necessary for wound healing. It is needed for many functions in the body, including helping the body use carbohydrates, fats, and protein. Vitamin C also strengthens blood vessel walls.

Lack of vitamin C can lead to a condition called scurvy, which causes muscle weakness, swollen and bleeding gums, loss of teeth, and bleeding under the skin, as well as tiredness and depression. Wounds also do not heal easily. Your health care professional may treat scurvy by prescribing vitamin C for you.

Some conditions may increase your need for vitamin C. These include:

• AIDS (acquired immune deficiency syndrome)
• Alcoholism
• Burns
• Cancer
• Diarrhea (prolonged)
• Fever (prolonged)
• Infection (prolonged)
• Intestinal diseases
• Overactive thyroid (hyperthyroidism)
• Stomach ulcer
• Stress (continuing)
• Surgical removal of stomach
• Tuberculosis

Also, the following groups of people may have a deficiency of vitamin C:

• Infants receiving unfortified formulas
• Smokers
• Patients using an artificial kidney (on hemodialysis)
• Patients who undergo surgery
• Individuals who are exposed to long periods of cold temperatures

Increased need for vitamin C should be determined by your health care professional.

Vitamin C may be used for other conditions as determined by your health care professional.

Claims that vitamin C is effective for preventing senility and the common cold, and for treating asthma, some mental problems, cancer, hardening of the arteries, allergies, eye ulcers, blood clots, gum disease, and pressure sores have not been proven. Although vitamin C is being used to reduce the risk of cardiovascular disease and certain types of cancer, there is not enough information to show that these uses are effective.

Injectable vitamin C is given by or under the supervision of a health care professional. Other forms of vitamin C are available without a prescription.