Nitrox and Sudafed

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Merlin

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jenmichigan's post reminded me of something I had heard before. Someone had said that diving Nitrox while taking Sudafed was a no-no. Is this based on specific problems with nitrox or is it for the reasons mentioned by BillP and others in jen's posting. Maybe the increased drowsiness leads you to be less aware, which is more critical with nitrox due to MOD restrictions?

I dive nitrox so I was particularly interested.

Any info out there?
 
Hi Merlin:

Sudafed (pseudoephedrine) is in the family of chemicals called sympathomimetic amines. (The same family as adrenaline). It is a mild central nervous system (CNS= brain in this case) stimulant. Increased partial pressure of oxygen is also a central nervous system stimulant. (Remember CNS O2 toxicity and seizures from high PO2's?) There is some concern that the potential additive effects of two CNS stimulants might predispose a recreational nitrox diver to seizures at depth.

DAN published an article in their Nov/Dec '99 Alert Diver addressing this question. Their conclusion was that occasional use of pseudoephedrine while diving air is unlikely to cause a problem. They also seemed to have no significant problem with mixing occasional pseudephedrine with oxygen partial pressures of 1.4ATA or less like you might see when diving nitrox conservatively. They did recommend against daily use of pseudoephedrine when diving air or nitrox, or any use of pseudoephedrine with PO2's greater than 1.4ATA.

HTH,

Bill
 
Lambertsen and Clark in Pharmacol Rev 23:37-133, 1971 stated that the following increased the risk of O2 toxicity:

Adrenocortical hormones (steroids, cortisone, hydrocortisone)
CO2 inhalation (CO2 retention)
Dextroamphetamine
Epinephrine
Hyperthermia High temperature)
Insulin
Norepinephrine
Paraquat
Hyperthyroidism (High thyroid condition)
Vitamin E deficiency

Things that delay onset or decrease severity of O2 toxicity

Acclimatization to hypoxia
Adrenergic blocking drugs (beta blockers, have other deleterious effects))
Antioxidants
Chlorpromazine (Thorazine)
GABA (Gamma aminobutyric acid
Ganglionic blocking drugs
Glutathione
Hypothyroidism (Low thyroid condition)
Reserpine
Starvation
Succinate
Trisaminomethane
Intermittent exposure*
Disulfiram*
Hypothermia*
Vitamin E*
* Potentially useful as protective agents
(Adapted in Bove, AA, Diving Medicine, 1997)

 
Good info, guys! I'm printing it for reference later. I'll assume there are the usual disclaimers with any advice dispensed over the internet :wink:
 
No representations are made that in any way offer a diagnosis, treatment or cure for any illness or condition, either discussed or implied. Answers to questions are offered as information only and should always be used in conjunction with advice from your personal diving physician. I take no responsibility for any conceivable consequence which might be related to any answer that is freely given to questions on this site.

Now- may I ask why you are interested in whether or not a disclaimer is necessary?
 
Most people read stuff on the internet and assume that because it is there that it must be true. If you give them advice on a BB, then it must be GOSPEL! I know that alot of doctors/lawyers/CPA's/etc who give comment/advice to people often put a disclaimer at the end because otherwise people run off and do foolish things without doing their homework, simply because someone claiming to be an authority gave them advice.

I try to make sure I do my homework.

You, scubadoc, I have heard of and I have been to your website many times in the past. BillP, I can't say that I know him or his reputation.

My comment about the diclaimer was more comical than anything else, because I know how people get foolish in this country (US).

BTW, that is a very nice text. You should save it and put it in the signature section. :)
 
Merlin, I'm glad to see someone who doesn't believe everything he reads on the Internet. Especially from me!

King Neptune asked me to help moderate (regulate?) the board I guess because he liked my posts, and I think he said Dr. Deco suggested it. While I have an interest in decompression theory and practice and diving medicine I claim no special expertise. (Other than a yellowing piece of paper on the wall of my office that says I'm a "Diving Medical Officer" FWIW- and that ain't much.) I would hazard a guess that DocV knows as much or more about diving medicine and Ralph Cohn knows as much or more about decompression (for just two easy examples) than I, and they are not listed as moderators. And when you get into other categories on the board where you'll see my name listed there are plenty of other board members with more knowledge than I. This board is a tremendous source for information that is by no means limited to the "officially" listed moderators.

When I don't know or can't find out, I usually don't answer. I often respond to questions after pulling several books off the shelf and/ or searching the web. (Maybe I should be board librarian rather than moderator?) When I do answer, I don't answer as some guru making pronouncements from on top the mountain, but rather as a student raising his hand in class. I usually learn as much or more from giving the answer as the questioner does from asking. I try to make my answers as "correct" as possible, but hey, I've been wrong before and will be wrong again. It doesn't bother me when someone points mistakes out, so feel free to disagree.

When I have a decompression question, I ask Dr. Powell. And when I have a diving medicine question, I ask Dr. Campbell. (That's why I suggested to King Neptune that he be invited to the board!) I'll be happy to continue to chip in my 2¢ worth for discussion purposes as a fellow diver and board member, but if you ever disagree with what I say, feel free to chime in. I'll probably learn from it!

Happy diving,

Bill

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Should I add this to my signature? (grin)
 
That one is very nice indeed, but they forgot "close cover before striking" and "objects in mirror are closer than they appear".

No disrespect was intended towards anyone's qualifications. You just never know who is really who. I have seen DocV elsewhere but I wasn't aware he had any specific medical training, just alot of dive time. Maybe that's where the name comes from.

An interesting board indeed. Thanks again to both you and scubadoc for the info on sudafed.
 
Dear Readers:

Those are all wonderful disclaimers and I would like to add my "ditto" to those above. :doctor:

On a more serious note, however, I do wish to add that the opinions expressed by me, Michael R. Powell, Ph.D. (a.k.a. Dr. Deco), are mine alone as a private citizen. While I am an employee of NASA, these ideas and opinions should not be construed as necessarily representing the official policy of the U.S. Government.
_______________________
Michael R. Powell, Ph.D.
 
I am a new scuba diver. with only about 20 dives. But have an interest in EAN Diving. I decided to start taking the class and Have been filling out the book work. When it said that sudephedrine was a bad idea because of it being a mild stimulant I became alarmed because Adhd medicine such as aderall and rittalin are far more of a stimulant than sudaphedrine. Yet I cannot find anything on this topic on the internet. Is it ok for me to dive nitrox. I don't know if my doctor would know anything about dive medicine or not. Write back if anyone has heard!
 
https://www.shearwater.com/products/swift/

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