Ephedrine

General

• Substance that is similar in structure to methamphetamine which has similar, albeit milder, effects

Performance Enhancing Effects

• Increase energy, stamina, muscle strength, and fat loss
• Sensation of feeling high or stimulated

Medical Indications

• Asthma due to activity as a bronchial smooth muscle relaxer
• Allergies due to decongestant properties

Adverse Effects

• Tremors, irritability, headache, dizziness
• Confusion, anxiety, hallucinations, psychosis, convulsions
• Difficulty with respiration
• Rapid, irregular heartbeat
• Significantly elevated blood pressure
• Myocardial infarction, pulmonary edema, CHF

Mechanism

• Increase release of noradrenaline and stimulates alpha and beta receptors
  • This leads to increased peripheral vasoconstriction which leads to increased blood pressure
  • There is also increased heart rate and cardiac output

Treatment

• Stimulant toxidromes should be treated with benzodiazepines
• Rarely, phentolamine sulfate 5 mg IV or 100 mg po
• Dexamethasone for life threatening hyperpyrexia
• Consider consult with medical toxicologist or poison control