Placental Transfer of Ephedrine Does Not Affect Neonatal Outcome

Hughes, Samuel C.; Ward, M. G.; Levinson, Gershon; Shnider, Sol M.; Wright, Raymond W.; Gruenke, Larry D.; Craig, J. C.

doi:10.1097/00132582-198603000-00010

Cited by 10 publications

(11 citation statements)

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“…Hughes et al 23 showed that ephedrine readily crosses the placenta, with an umbilical vein: maternal artery ratio of 0.71. No difference has been demonstrated in neurobehavioural scores if the duration of maternal hypotension is less than 2 min.…”

Section: Discussionmentioning

confidence: 99%

Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study

Prakash

Pramanik

Chellani

et al. 2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study

Prakash

Pramanik

Chellani

et al. 2010

International Journal of Obstetric Anesthesia

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“…In the same study, no significant interaction between (-)-ephedrine and caffeine was observed. When considered as a pure compound, the absorption of oral ephedrine is reported to be complete in humans (Wilkinson and Beckett 1968a) and pharmacokinetic studies revealed a large volume of distribution including transfer of ephedrine across the placenta and into maternal milk (Hughes et al, 1985). Furthermore, Berlin et al (2001) demonstrated that the maximal plasma ephedrine concentration (Cmax) and areas under the curves for up to 8 hours were proportional to the doses.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2013

EFSA Journal

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The ANS Panel provides a scientific opinion evaluating the safety in use of Ephedra herb and its preparations originating from Ephedra species when used in food, e.g. in food supplements. Ephedra species contain alkaloids of biological relevance: ephedrine, pseudoephedrine, norephedrine, norpseudoephedrine (cathine), methylephedrine and methylpseudoephedrine. They have sympathomimetic activity and some of them are also used as active ingredients in medicinal products for which adverse effects are described. The use of Ephedra herb in food supplements is prohibited in several European countries, however food supplements containing Ephedra herb, also in combination with caffeine, are offered for sale via the internet. The Panel reviewed the available scientific data on a possible association between the intake of Ephedra herb, its preparations or its alkaloids and potential harmful effects on health. There is wide variation in the concentration of the individual ephedra alkaloids in different Ephedra species and in their preparations for use in food. No adequately specified individual preparations of Ephedra herb are known for which sufficient toxicological data for hazard characterisation exist. Due to the absence of adequate data on genotoxicity, short-term, long-term and reproductive and developmental toxicity the Panel could not provide advice on a daily intake of Ephedra herb and its preparations that do not give rise to concerns about harmful effects to health. Ephedra herb and its preparations in food supplements may result in exposure to total ephedra alkaloids or ephedrine which falls within or may exceed the therapeutic dose ranges for the individual ephedra alkaloids or ephedrine, respectively, in medicinal products. Such an exposure could lead to severe adverse effects, which may be enhanced by the combination with caffeine. The Panel concluded that Ephedra herb and its preparations containing ephedra alkaloids used as food supplements were of significant safety concern at the estimated use levels. In particular, EFSA was requested to review the existing scientific data on the possible link between the intake of Ephedra species and harmful effects on health, and to provide advice on a tolerable upper intake level (UL) for Ephedra species for the general population, and as appropriate, for vulnerable subgroups of the population. In the absence of a tolerable upper intake level, EFSA was asked to provide advice on a daily intake of Ephedra species that does not give rise to concerns about harmful effects to health.The risk assessment was performed by the EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS Panel) in accordance with the 2009 EFSA Guidance on safety assessment of botanicals and botanical preparations intended for use as ingredients in food supplements.In addressing the Terms of Reference of this request, the ANS Panel noted that the term -tolerable upper intake level‖, was used by EFSA so far only for nutrients, such as vitamins or minerals, to describe the maximum ...

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“…De manière un peu inattendue, l'APD induisait une augmentation des résistances de la circulation utérine, surtout à l'acmé des contractions. Cette augmentation des résis-tances était en partie corrigée par l'utilisation d'éphédrine, y compris en l'absence d'hypotension maternelle [51,52]. Cette vasoconstriction utéroplacentaire pourrait avoir une double explication.…”

Section: Analgésie Périmédullaire Et Anomalies Du Rcf : éPidémiologieunclassified