December 05, 2007

The News That Is Not News

Posted by Froz Gobo

After running the anchor leg in my family's version of the flu-fever-five-thousand™ relay, the muscles are only minimally achy, the fog of delirium has mostly burned off, and only a slight cough remains. This is the treatment of my choice for the last.

In a three-way comparison, honey was significantly more effective than no treatment (P<0.001) for relief of symptoms, and dextromethorphan (the active ingredient in most OTC cough remedies -FG) was not, Ian M. Paul, M.D., of Penn State, and colleagues, reported in the December issue of Archives of Pediatrics and Adolescent Medicine. "Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection," they concluded.

While it's encouraging to see an inexpensive, minimally processed product that is widely available from local sources get some scientific validation, something seems sketchy about the experiment: The parents knew what they were giving the children then characterizing the results. It wasn't really blind. Does that jeopardize the conclusion?

*cough* *cough*


Comments
1

Yes.

Or maybe you could classify this under "The Healing Power of the Placebo."

Posted by: arthegall at December 5, 2007 10:08 AM
2

Yeah, but enough dextromethorphan will get you high as a fucking kite, so: advantage pharmaceuticals!

Posted by: apostropher at December 5, 2007 10:32 AM
3

Sorry to hear your family got taken down, too. Last week was teh suck at my house.

Posted by: apostropher at December 5, 2007 10:32 AM
4

The parents knew what they were giving the children then characterizing the results. It wasn't really blind. Does that jeopardize the conclusion?

Um, that's not quite right. "Children and their parents did not know whether they were receiving honey or dextromethorphan, but those assigned to no treatment were aware of it." A lack of blinding wouldn't necessarily make the conclusion too dodgy anyhow; open-label trials are pretty common. The red flag is next-day, self-reported data, which is nearly always of questionable accuracy.

Posted by: apostropher at December 5, 2007 10:37 AM
5

2: Not that I would ever drink entire bottles of robitussin...

Posted by: froz gobo at December 5, 2007 10:43 AM
6

They have gel caps now! Soooooo much easier than high school!

Posted by: apostropher at December 5, 2007 10:56 AM
7

How convenient! I swore off dextromethorphan forever just yesterday. That is NOT a kind of fucked up I enjoy.

(and the parents did NOT know whether they were giving the kids honey or DXM :-) )

Posted by: Kristina at December 5, 2007 01:45 PM
8

That is NOT a kind of fucked up I enjoy.

That's crazy talk, K. Woo-hoo, cold medicine!

Posted by: apostropher at December 5, 2007 02:25 PM
9

At the bottom of the article:

The study was funded by the National Honey Board, an industry-funded agency of the U.S. Department of Agriculture.

So I'd take it with a grain of pollen or two.

Posted by: maurinsky@yahoo.com at December 5, 2007 04:13 PM
10

I had a friend who became addicted to cough medicine in gaol. When he got out he continued the use and it killed him (organ failure) pretty quickly.
Anything with 'eth' or 'eph' in its ingredients (pseudoephedrine) is speed based - it has no medicinal qualities, it's just covering the symptons with a dust of go-juice. It also affects the various spincters in the body, preventing the release of fluids.
The medicinal qualities of Honey has always been recognised by natural health practioners. Its efficacy was featured in a (very good) movie called Bliss, where the heroine was 'Honey Barbara' (the scrumptious Helen Jones).

Posted by: waldo at December 5, 2007 06:00 PM
11

a (very good) movie called Bliss

Where the elephant sat on the car!

Posted by: apostropher at December 5, 2007 06:38 PM
12

When I was a kid, for a bad nighttime cough Mom would give me a spoonful of Bourbon and sugar. I stopped coughing and went to sleep, but to this day I cannot stand the taste of Bourbon.

Posted by: caradoc at December 6, 2007 10:02 AM
13


12. She should have served it over mint and crushed ice.

Why not take honey, bourbon, and dextromethorphan all at once? The only side affect should be a slight "fog of delirium."

Posted by: Joel at December 6, 2007 01:29 PM
14

Why not take honey, bourbon, and dextromethorphan all at once?

Because I'm at work, dude.

Posted by: apostropher at December 6, 2007 02:15 PM
15

Anything with 'eth' or 'eph' in its ingredients (pseudoephedrine) is speed based - it has no medicinal qualities, it's just covering the symptons with a dust of go-juice.

That's not exactly true...they are bronchial dilators, loosening chest congestion and allowing expectoration. I don't mind people talking shit about pharmaceutical companies (because they're fucking evil), but make sure you're up on your facts, my dear sir. :)

Posted by: Mr. Sticky at December 7, 2007 01:23 AM
16

15: Um, what just happened to the referred post on "go-juice"?

Posted by: TokyoTom at December 7, 2007 03:30 AM
17

From here in kidswithrotovirusland, I send my understanding.


Anyone want any projectile vomit?

Posted by: drfranklives at December 7, 2007 12:08 PM
18

Mr Sticky

read, learn, stfu.

Pseudoephedrine is a sympathomimetic amine — that is, its principal mechanism of action relies on its indirect action on the adrenergic receptor system. While it may have weak agonist activity at α- and β-adrenergic receptors, the principal mechanism is to displace norepinephrine from storage vesicles in presynaptic neurons. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the aforementioned postsynaptic adrenergic receptors.

These adrenergic receptors are located on the muscles lining the walls of blood vessels. When activiated by pseudoephedrine, the muscles contract, causing the blood vessels to constrict (vasoconstriction). These constricted blood vessels now allow less fluid to leave the blood vessels and enter the nose, throat and sinus linings, which results in decreased inflammation of nasal membranes as well as decreased mucous production. Thus, by constriction of blood vessels, mainly those located in the nasal passages, pseudoephedrine causes a decrease in the symptoms of nasal congestion....
However it has also been successful in treating stress incontinence by increasing the pressure (tension) exerted by the muscles of the bladder neck and the urethra, which helps retain the urine within the bladder....
Common adverse drug reactions (ADRs) associated with pseudoephedrine therapy include: CNS stimulation, sleeplessness, nervousness, excitability, dizziness and anxiety. Infrequent ADRs include: tachycardia and/or palpitations. Rarely, pseudoephedrine therapy may be associated with hallucinations, arrhythmias, hypertension, seizures and ischemic colitis; as well as severe skin reactions known as recurrent pseudo-scarlatina, systemic contact dermatitis, and nonpigmenting fixed drug eruption.
It has also been reported that pseudoephedrine, amongst other sympathomimetic agents, may be associated with the occurrence of stroke.
Pseudoephedrine should be used with caution in patients with: diabetes mellitus, cardiovascular disease, hypertension, prostatic hypertrophy, hyperthyroidism, closed angle glaucoma and/or pregnancy.
Contraindications for the use of pseudoephedrine include: concomitant or recent (previous fourteen days) monoamine oxidase inhibitor (MAOI) therapy, severe or uncontrolled hypertension, and/or severe coronary artery disease...People with bipolar disorder should use care when taking pseudoephedrine, as it can cause insomnia and thus trigger a manic episode...There have also been reports of off-label uses of pseudoephedrine for its stimulant properties. Some people, long-distance truck drivers and sports athletes for example, have reportedly used pseudoephedrine as a stimulant to increase their state of alertness/awakedness.... The United States Congress has recognized the use of pseudoephedrine in the illicit manufacture of methamphetamine


Posted by: waldo at December 9, 2007 08:07 AM
19

Pardon me as I follow your lead with a little cut and paste as well:

medicinal: of, pertaining to, or having the properties of a medicine

medicine: any substance or substances used in treating disease or illness; medicament; remedy.

remedy: something that cures or relieves a disease or bodily disorder

So medicinal essentially refers to something that cures or relieves/treats. Instead of getting self-righteous, indignant, and a little abusive you could have realized a poor choice with your words? Perhaps "curative," instead of, "medicinal," is what you were going for?

However it has also been successful in treating stress incontinence by increasing the pressure (tension) exerted by the muscles of the bladder neck and the urethra, which helps retain the urine within the bladder....

Hmm...sounds like a medicinal use, and you were kind enough to supply it for me. Let me extend my sincerest thanks.

Pseudoephedrine acts directly on both alpha- and, to a lesser degree, beta-adrenergic receptors. Through direct action on alpha-adrenergic receptors in the mucosa of the respiratory tract, pseudoephedrine produces vasoconstriction. Pseudoephedrine relaxes bronchial smooth muscle by stimulating beta2-adrenergic receptors.

Relaxing the bronchial smooth muscles = bronchial dilator...so my original statement still stands. It can also be used as a first line treatment/therapy of priapism, so there is another medicinal use.

read, learn, and stfu

Wow, you don't handle being crossed very well at all, despite your predilection to verbally attack anyone whose opinion or viewpoint does not match your own. I guess one-way streets are acceptable in Oz.

And since I'm pretty sure you won't be able to accept this from me without a vitriolic rebuttal, please direct anything else involving me specifically to my email...even though I'm quite sure you LOVE an audience. K? Thanks! Bye!

Posted by: Mr. Sticky at December 9, 2007 01:30 PM
20

oops...thought I'd included my email addy in the space provided in my previous post. In case it doesn't work again:

demo_grafix@hotmail.com

Posted by: Mr. Sticky at December 9, 2007 01:32 PM
21

NEJ on cold drugs vs. placebos:

http://content.nejm.org/cgi/content/full/357/23/2321?query=TOC

Posted by: TokyoTom at December 10, 2007 12:42 AM
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