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From: marsthom@qedbbs.com (Mark Thompson)
Newsgroups: alt.drugs
Subject: ROBO FAQ FODDER
Message-ID: 
Date: 24 Jul 93 12:26:50 GMT
Sender: bbs@qed.UUCP
Organization: The QED BBS, Lakewood CA
Lines: 185

ROBITUSSIN - You Asked For It.
 
Apparently Robitussin comes in several varieties, many of which contain
other drugs than Dextromethorphan that are potentially dangerous at the
doses that some people seem to be taking "recreationally".
 
The only Robitussin product without any of these other additives is
Robitussin Maximum Strength, which may have been deliberately marketed
to avoid product liability suits by the parents of people chugging
other Robitussin products: it has the highest dose of Dextromethorphan,
none of the additional drugs, and the lowest amount of alcohol of any 
form
of Robitussin, so it's probably "safest", "strongest" and most appealing 
to
people who use Robitussin as an intoxicant. Notice also that neither
Robitussin-PE nor Robitussin Expectorant contain Dextromethorphan.
 
 
Robitussin products:
 
Product           DM    PPA     PM     GFN    PE      AP      EtOH   
(dose)
----------------- ----- ------- ------ ------ ------ ------- ------  
-------
Maximum Strength  15mg                                        1.4%   5ml
DM                10mg                 100mg                  1.4%   5ml
CF                10mg   12.5mg        100mg                  4.25%  5ml
PE                                     100mg  30mg            1.4%   5ml
Night Relief      30mg   10mg    50mg                650mg           
Fl.Oz.
Expectorant                            100mg                  3.5%   5ml
----------------- ----- ------- ------ ------ ------ ------- ------  
-------
 
        DM   = Dextromethorphan    (a "nonnarcotic antitussive" opiate)
        PPA  = Phenylpropanolamine (an adrenergic/sympathomimetic amine)
        PE   = Pseudoephedrine     (an adrenergic/sympathomimetic amine)
        PM   = Pyrilamine maleate  (an antihistamine/anticholinergic)
        GFN  = Guaifenesin         (an expectorant)
        EtOH = Alcohol
 
(Robitussin CF and Robitussin Night Relief also contain Propylene 
Glycol.)
 
 
Chemical Identity:
 
3-methoxy-17-methyl,(9a,13a,14a)-Morphinan
 
Dextromethorphan is a salt of the methyl-ether of the d-isomer of 
levorphanol,
a narcotic analgesic.
 
The Wyeth-Ayerst product listing for Phenergan in the 1990 PDR shows
the structural formula for Dextromethorphan.
 
Dextromethorphan is an opiate.
 
 
Standard Blurb:
 
Dextromethorphan hydrobromide is a non-narcotic antitussive with
effectiveness equal to codeine. It acts in the medulla oblongata to 
elevate
the cough threshold. Dextromethorphan does not produce analgesia or 
induce
tolerance, and has no potential for addiction. At usual doses, it will 
not
depress respiration or inhibit ciliary activity. Dextromethorphan is 
rapidly
metabolized, with trace amounts of the parent compound in blood and 
urine.
About one half of the administered dose is excreted in the urine as
conjugated metabolites.
 
 
Overdose:
 
Dextromethorphan may produce central excitement and mental confusion.
Very high doses may produce respiratory depression.
 
One case of toxic psychosis (hyperactivity, marked visual and auditory
hallucinations) after ingestion of a single dose of 20 tablets (300mg)
of Dextromethorphan has been reported.
 
Dextromethorphan may cause respiratory depression with a large overdose.
Treat respiratory depression with naloxone if dextromethorphan toxicity 
is
suspected.
 
The antidotal efficacy of narcotic antagonists to Dextromethorphan has 
not
been established.
 
 
Drug Abuse and Dependence:
 
According to WHO Expert Committee on Drug Dependence, dextromethorphan 
could
produce very slight psychic dependence but no physical dependence.
 
 
Other Side Effects:
 
Antihistamines (Pyrilamine) have anticholinergic side effects that may be
dangerous at higher doses, including dry mouth, agitation, and
increased intraocular pressure. Potentially dangerous if you have 
glaucoma.
 
Sympathomimetic amines (Phenylpropanolamine and Pseudoephedrine) are
speed-like in their effects, and can cause insomnia, nervousness,
rapid heart rate and dangerously high blood pressure.
 
Acetaminophen is hepatotoxic, and shouldn't be taken by people with
liver disease. Repeated doses of acetaminophen larger than 1500mg have
been suspected of causing toxic symptoms.
 
Guaifenesin can cause nausea and vomiting at high doses.
 
Persons taking MAO-Inhibitors or Tricyclic Antidepressants should not 
take
Robitussin.
 
Driving, or consuming alcohol, is dangerous when using Dextromethorphan.
 
Dextromethorphan "may cause respiratory depression" that means it can
induce weak or shallow breathing. At extreme overdoses breathing might
cease completely, though there are no reports of this occurring yet.
 
 
Sources:  Physician's Desk Reference (PDR) 44th Edition 1990    R615.103
          Physician's Desk Reference (PDR) 41st Edition 1987
          PDR - Non Prescription Drugs     11th Edition 1990    R615.703
          Various hearsay and anecdotal sources...
 
 
An "I Told You So":
 
SHULGIN, ALEXANDER T.
"Drugs of abuse in the future."
Clinical Toxicology; 1976 Aug Vol 8(4) 405-456
 
Explores a possible approach to the problem of drug abuse, based on an 
outline
which anticipates the chemical and pharmacological directions toward 
which the
drug-oriented subculture might turn. From the main classifications of 
drugs
which have abuse reality and abuse potential--opiates, stimulants,
depressants, and hallucinogens--the commonly known and used drugs, as 
well as
their new and experimental derivatives, are described, and their methods 
of
derivation and effects are detailed. Among the opiates are morphine, 
heroin,
and thebaine and the derivatives acetorphine, ethorpine, cyprenorphine,
methylmorphanan, meperidine, and Fentanyl. The sympathomimetic 
(stimulant)
agents include amphetamine, methamphetamine, methylphenidate, 
phenmetrazine,
levophacetoperane, fenethylline, ephedrine, and ecgonine. Among the
depressants described are phenobarbital, metharbital, glutethimide,
methaqualone, and phencyclidine. The hallucinogens include psilocybin,
harmaline, mescaline, and atropine. The possibility that some 
prescription and
over-the-counter drugs (e.g., dextromethorphan) may become future abuse
problems is explored, and a list of controlled substances and recent 
additions
or reclassifications is included.
 
 
-----------------------------------------[23-APR-92]----------------------
----

PS. Some of the more hallucinogenic opiates, such as Talwin/Pentazocine
and other cyclazocine opiates are sigma opiate receptor agonists.
It turns out that some of PCP's hallucinogenic effects (PCP is not an 
opiate, but acts primarily on the NMDA receptors) are due to it's
activity at the sigma opiate receptors. Dextromethorphan probably
effects sigma receptors, which probably accounts for the reports
people on alt.drugs have been making about its effectiveness as
an hallucinogen.