Ephedra

The term ephedra refers to the drug derived from some plants belonging to the genus Ephedra, family Ephedraceae; these are widespread suffrutics in the dry areas of temperate regions, including Italy, and on tropical mountains; however, the species of major commercial interest - Efedra sinica, Efedra intermedia, Efedra equisetina - are of predominantly Asian origin. The leaves are reduced to scales, the stem and branches are green, slender, longitudinally striped and angular, and it is precisely the parts of the area - collected in autumn - that constitute the drug ephedra (also known as ma huang ).

Inside you can recognize some alkaloids in a concentration close to 1%, among which ephedrine (60-80%) and pseudoephedrine (20-34%) stand out. The presence of these substances justifies the traditional use of ephedra as a diaphoretic and useful preparation in the treatment of bronchial asthma, bronchitis, nasal congestions, drowsiness and overweight. Ephedrine, acting as an adrenergic agonist, increases the release of norepinephrine from nerve endings and interacts directly with alpha and beta adrenergic receptors; all this results in a bronchial dilatation associated with an increase in thermogenesis (accelerates metabolism) and arterial pressure (ephedrine causes vasoconstriction); at the level of the central nervous system it acts as a stimulant, with a similar action - even if inferior - to that of amphetamines; it also reduces food intake and reduces the conversion of excess carbohydrates into fats. However, the use of pure ephedrine (ephedrine hydrochloride or sulphate) is not free from contraindications, due to the possibility of adverse effects on the cardiovascular level (it causes palpitations and hypertension, for this reason it must be used with particular caution by those suffering from heart problems), gastrointestinal (nausea, vomiting, constipation), psychiatric (determines restlessness, nervousness and convulsions) and metabolic (it is contraindicated in the presence of diabetes and hyperthyroidism). Pure pseudoephedrine, having similar structure and actions, is used as a nasal decongestant and has similar contraindications, although the adverse effects, at the same dosage, are more attenuated.

The ephedra drug, used for example in the form of an infusion, has the same indications as its characteristic alkaloids, but performs a milder action and has fewer contraindications (either because of the lower amount of active ingredients taken, or because of the modulating action of the fitocomplesso). However, the risk of damage from abuse and important contraindications have led many countries, including Italy and the United States, to ban the sale of ephedra and its inclusion, once very popular, in weight loss supplements ; however, ephedrine and pseudophedrine continue to be used in various pharmaceutical products, many of them OTC.