Phenylpropanolamine
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Phenylpropanolamine (PPA) is a drug of the phenethylamine family used in bronchial and nasal decongestants, and also as an appetite suppressant. There are four optical isomers of phenylpropanolamine: d- and l-norephedrine, and d- and l-norpseudoephedrine. D-norpseudoephedrine is also known as cathine, and occurs naturally in the stimulant plant Catha edulis (khat). This isomer is commonly used in European medications described as "phenylpropanolamine", whereas in the United States a racemic mixture of d,l-norephedrine is usual. A scientific study (Kernan et al. 2000) found an increased risk of hemorrhagic stroke in women who used phenylpropanolamine, although it is not clear which isomer is to blame. A study at the Yale University School of Medicine in 1999 had produced similar results. Reports of cases of hemorrhagic strokes in PPA users had been circulating since the 1970s. In November 2000, the FDA issued a public health advisory against the use of the drug. The agency estimates that PPA caused between 200 and 500 strokes a year among 18-to-49-year-old users. An item on the agenda of the 2000 Commission on Narcotic Drugs session called for including norephedrine in Table I of United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances[1] (http://www.unodc.org/unodc/en/document_1999-12-21_1.html).
See Also
References
- Implementation of the international drug control treaties: changes in the scope of control of substances (http://www.unodc.org/unodc/en/document_1999-12-21_1.html), Commission on Narcotic Drugs, Forty-third session, Vienna, 6-15 March 2000.
External links
- Kernan et al., Phenylpropanolamine and the Risk of Hemorrhagic Stroke 2000 N Engl J Med 343:1826-1832 (http://content.nejm.org/cgi/content/abstract/343/25/1826)
- FDA phenylpropanolamine advisory (http://www.fda.gov/cder/drug/infopage/ppa/advisory.htm)
- Doubt Is Their Product (http://www.powerlinefacts.com/Sciam_article_on_lobbying.htm) by David Michaels, Scientific American, June 2005de:Norephedrin