Pseudoephedrine: Abuse & Overdose

Instructor: Megan Gilbert

Megan has a master's degree in nursing and is a board certified Women's Health Nurse Practitioner. Her area of clinical focus is the impact of infectious disease on pregnancy. She has experience teaching college allied health classes. She is also a certified EMT and holds a certificate of added qualification in electronic fetal monitoring.

This lesson discusses pseudoephedrine, the readily available stimulant medication. It covers potential for abuse and misuse, it's role in methamphetamine and reason for it's regulations, and review overdose concerns.

Available at a Pharmacy Near You

You're minding your own business at the pharmacy, buying something for your allergies when a woman comes up behind you and asks for a favor. She looks tired and says she has money, but left her ID at home - can you buy her some pseudoephedrine? You see the sign by the pharmacy that reads ''ID required to buy all products containing pseudoephedrine.'' What's the big deal? Why do you need ID to buy allergy medication?

Pseudoephedrine is a powerful medication for the treatment of congestion and occasionally for the treatment of cough as it helps open the airways. But it also has more complicated and devious uses.

Beyond treating congestion, what else can pseudoephedrine be used for?
medication

Abuse

Is this woman buying pseudoephedrine because she's addicted? Pseudoephedrine is a stimulant medication that belongs to the amphetamine family, and is considered a potential drug of abuse. A stimulant is a substance that causes increased alertness and energy for a short period of time. Caffeine is an example of a common stimulant. Cocaine is another example of a stimulant, although a much more dangerous one.

It can cause feelings of:

  1. Increased energy
  2. Excitability
  3. Decreased appetite
  4. Increased blood pressure
  5. Increased heart rate

Generally, pseudoephedrine misuse does not result in dependency, and withdraw symptoms are very uncommon. It's highly unlikely this woman is a pseudoephedrine addict.

Methamphetamine

Is there something more serious she could be doing with the pseudoephedrine? Pseudoephedrine is a key ingredient used in the production of methamphetamine. Methamphetamine is a stimulant street drug with high abuse and addiction potential.

As a result, individuals are now required to have photo identification when buying this medication and specific limits are in place.

Current buying limits as of February 2017:

  • Daily: 3.6 grams pseudoephedrine base
  • 30 day: 9 grams of pseudoephedrine base

Some states now require a prescription for anyone to buy a product containing pseudoephedrine and many countries follow this same policy.

This woman could be buying pseudoephedrine to make methamphetamine.

Overdose

An overdose is a potentially dangerous quantity of medication, food, or substance. If you suspect someone may have consumed an unsafe amount of a medication (or other substance) you should call 911 or poison control at 1-800-222-1222 (in the United States), particularly if that medication is pseudoephedrine.

Pseudoephedrine overdoses are well-documented and are reported at levels not significantly above normal dosing. This means that they can happen by accidentally combining too many medications that contain pseudoephedrine if an individual is not carefully monitoring what is in normal cough and cold remedies.

It is also important to keep all medications away from children as they may mistake brightly colored medication for candy.

Overdose can result in:

  • Ischemic myocardial infarction (heart attack)
  • Hallucinations
  • Psychosis
  • Hyperirritability
  • Ataxia (unable to control your muscles)
  • Stroke
  • Irregular heart rhythm
  • Hypertension (elevated heart rate)
  • Death

Lesson Summary

What could that woman have wanted with the pseudoephedrine she was asking you to buy? Maybe her ID was just at home? It is an excellent medication to treat congestion. However, pseudoephedrine is used for more than just treating congestion.

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