Lake C R, Rosenberg D, Quirk R
Department of Psychiatry, Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, MD 20814-4799.
Int J Obes. 1990 Jul;14(7):575-82.
We surveyed phenylpropanolamine (PPA) use and overuse among 309 diet center clients. Fifty-one percent of all subjects surveyed reported using PPA drugs: 44 percent used cold medicines and 16 percent used diet aids. Twenty-two percent of diet aid users and 7 percent of cold medicine users reported that they deliberately used more than the dosage recommended to improve efficacy. Among diet aid users, 59 percent also regularly consumed caffeine. Despite package warnings, individuals who had been told by their doctors that they were hypertensive used PPA products as often as normotensive individuals. PPA, the fifth most frequently used drug in the USA, is contained in over-the-counter (OTC) diet aids as well as OTC and prescription cold medicines. Severe adverse drug reactions (ADRs) including hypertensive crisis, stroke and death have been attributed to PPA products. Clinical studies have shown that using greater than recommended doses of PPA and using PPA in combination with caffeine may increase the risk of ADRs. Overweight patients may be particularly at risk for ADRs to PPA because they are likely to be hypertensive and to use diet aids. We recommend informing diet center clients of the potential dangers of consuming PPA products, especially more than the recommended dose, in the presence of hypertension, and when other sympathomimetic drugs are being taken.
我们对309名饮食中心客户使用和滥用苯丙醇胺（PPA）的情况进行了调查。在所有接受调查的对象中，51%报告使用过PPA类药物：44%使用过感冒药，16%使用过减肥药。在使用减肥药的人群中，22%报告故意超量使用以提高疗效；在使用感冒药的人群中，这一比例为7%。在使用减肥药的人群中，59%还经常摄入咖啡因。尽管药品包装上有警示，但那些被医生告知患有高血压的人使用PPA产品的频率与血压正常的人一样高。PPA是美国第五大常用药物，存在于非处方（OTC）减肥药以及OTC和处方感冒药中。包括高血压危象、中风和死亡在内的严重药物不良反应（ADR）都与PPA产品有关。临床研究表明，超量使用PPA以及将PPA与咖啡因联合使用可能会增加ADR的风险。超重患者可能尤其容易出现PPA的ADR，因为他们可能患有高血压且会使用减肥药。我们建议告知饮食中心客户，在患有高血压、正在服用其他拟交感神经药物以及超量服用PPA产品（尤其是超过推荐剂量）时，使用PPA产品存在的潜在危险。
