However, these studies did not separate the effects of ephedrine from that of caffeine and so more intense research is awaited in this direction. [Robert a] it is to be noted that caffeine and ephedrine work synergistically which could be dangerous in patients with pre-existing cardiac or blood pressure abnormalities. Caffeine affects the adenosine-mediated dilation of blood vessels by antagonizing its receptors. The resulting increased availability of free adenosine monophosphate furthers the activity of ephedrine and catecholamine stimulation resulting in reduced cardiac refractory periods and increased cardiac output and consequently elevated blood pressure. [Charles N. Krome] It is necessary to look into the inherent risks associated with the use of ephedrine. Ephedrine has a very high percentage of adverse reactions compared to all other herbal supplements. As reported by Bent et al. (2003), ephedrine alone accounts for around 64% of all adverse medical reactions due to herbal products. This in view of the fact that ephedrine products constitute only 1% of the total herbal market is a shocking and revealing statistic. [Robert a] Haller and Benowitz reviewed 140 adverse cases of ephedrine usage and submitted them to the FDA between 1996 and 1999. These cases clearly indicate that ephedrine usage has both cardiovascular as well as cerebrovascular complications. Ephedrine has also been clinically documented to cause nephrolithiasis in cases of severe and long-term abuse. Cardiomyopathy, arrhythmia and sudden deaths have been reported in relatively young people. In one of the reported cases ephedrine and beta agonists (used for asthma) interacted resulting in ventricular arrhythmia followed by cardiac arrest. [Charles...
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