Sudafed...a medicine for clearing sinuses etc.

[DocVikingo]

DAN's most extensive discussion of Sudafed & scuba can be found in its response to an inquiry about pseudoephedrine & EAN. In a very long-winded fashion they seem to give it the nod if one needs to take something---->

http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=51

This is also the position of RSD's former diving doc--->

http://www.scubadiving.com/training/medicine/safemeds.shtml#decon

The latest research of which I am aware is the study by Taylor, et.al., back in '00 that I have cited in previous posts on Sudafed in the Diving Medicine forum---->

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=10999495&dopt=Abstract

If you have something more recent, please let me know.

Best regards.

DocVikingo

 

[RichLockyer]

juggernutt once bubbled...
I think(correct me if I am wrong) that Oxtox only occurs if you use Nitrox or enrich air...

"Nitrox" just means that you have more O2 in the gas and have to be even more cautious, but the fact is that the only difference between "nitrox" and "air" is the amount of O2.

Under hyperbaric pressures, the PO2 still rises.
At 130ft, air has a PPO2 of 1.04
At 90ft, EAN28 has a PPO2 of 1.04
At 70ft, EAN32 has a PPO2 of 1.00
At 60ft, EAN36 has a PPO2 of 1.01
At 50ft, EAN40 has a PPO2 of 1.01
At 35ft, EAN50 has a PPO2 of 1.03

When it comes to tox, all of these mixtures will behave the same at the above depths.

While all of these numbers are well within the accepted rec limit of 1.4 and you certainly aren't going to blow the NOAA time limits, the fact remains that OxTox is
A) Unpredictable
B) Affects every diver differently, even in the same conditions
C) Limits based on lab conditions (no drugs in use)

There have been tox incidents involving Sudafed BELOW 1.4.

 

[pasley]

NOT A DOCTOR OR MEDICAL EXPERT.

Sudafed is effective but it it also a vasal constrictor. Translation - it makes the blood vessels constrict.

Could this have implications for a diver?- I don't know. But consider this: If you are a diver with poor circulation in the extermities due to age or other causes, this could make the situation worse. Would this decrease in circulation increase your risk factors for DCI or oxygen toxcity? I don't know.

After I started diving my doctor addeded Sudafed to my daily allergy regimine to help keep my sinus clear and dry. I then discovered I suffer from Ranauds Syndrome after seveal annoying attacks in tempretures under 70F (as in 68F outside) of my hands and feet being freezing cold (I mean the wife screaming eek: if I touched her with my hands or feet) and me in physical pain from the cold. Doctor quickly figured out the problem and took me off the Sudafed which has improved the situation greatly.

Bottom line is each of us are unique (my normal body temp is 97.6 and BP varies from a high of 101/58 to a low of 85/50). Medications will effect us all differently. A pressure environment like diving may also change things. So discussing this medication specifically for use in diving with your knowledgable dive doctor before you dive would be recommended.

I also use AFRIN (be careful with it as it can be addictive with some insteresting results) 2 to 3 hours before the first dive of the day for insurance. Why so early? To give things time to drain before the dive. Due to my allergies I also use OCEAN SPRAY (salt water spray) daily which has helped.

NOT A DOCTOR OR MEDICAL EXPERT. Just my uninformed $0.02.

 

[H2OPrincess]

One thing that I haven't seen mentioned yet in this thread is to try out a medication on land before trying it at depth. You may find that certain, seemingly harmless, medications will cause different reactions.

I say this specifically because someone mentioned using Afrin before diving. A couple of years ago, I had a bad sinus infection and a doctor suggested I try Afrin, while waiting for the antibiotics to kick in. I bought some and tried it out - and ended up in the emergency room with convulsions. At that time, I found out that convulsions are a noted side effect of Afrin.

I suffered no ill effects, other than a screaming headache. However, imagine if I had been underwater!:wacko:

In my opinion - you should try any medication out on land before trying it underwater - sudafed, dramamine, afrin, antihistamines - and all the other stuff that divers often try to make diving more comfortable.

Just my 2 cents!
~Amber

 

[DocVikingo]

"One thing that I haven't seen mentioned yet in this thread is to try out a medication on land before trying it at depth."

You may not have seen it, but both of the first two hot linked articles in my post above do specifically recommend this.

Try reading them-they are informative.

Best regards.

DocVikingo

 

[The Iceni]

juggernutt once bubbled...
If it is Sudafed should be Ok I guess. Even though I see that even in shallow depth bad things can happen(see Dr Thomas incident)

Hi juggernaught,

As you rightly say bad things can happen at any depth. Indeed barotrauma is more likely to occur in the shallows owing to the more rapid pressure changes. This is why ear clearing is nearly always a problem during the first stages of the descent.

Can I also recommend the articles referenced by Dr Vikingo?

If you look at this more laterally you should be able to come to a sensible answer for yourselves.

1. What is the problem and is it safe to dive even if the symptoms can be treated?
2. Is there a "cure"
3. Does the cure cause problems of its own?
   [/list=1]
   
   Clearly it is not safe to dive with a streaming cold or a chest infection. However many divers find decongestants will save a dive when the only problem is a runny nose, eustachian catarrh or nasal congestion. In my experience sudafed is widely, and safely, used in such a scenario, however, as Rick M rightly posts, some people get severe side effects from it.
   
   The class of drugs of which sudafed is one, do cause effects on the heart and the central nervous system. they are adrenoceptor agonists. I.e. they act similar to adrenaline in sufficent doses.
   
   A more widely used drug in this category is salbutamol (or ventolin) which is used in the treatment of asthma. If taken in tablet form, or as a syrup in children, is produces all the side effects listed, including hyperactivity and palpitations so it is seldom prescribed as an oral medication. It is almost invariably prescribed as an inhaler;- a sufficent dose reaches the lungs without "poisoning" the rest of the body and as the necessary total qualtities required are so low, because it gets where it is needed at the right concentration, and is then rapidly removed from the body when it has done its work.
   
   I therefore tended to avoid sudafed and, when needed, used a topical nasal spray instead. In the UK xylometazoline hydrochloride 0.5% (Otrivine) is widely available over-the counter as a nasal spray and works effectively on the nose and sinuses WITHOUT acting systemically.
   
   In my experience this drug is great for simple nasal congestion but it does have the potential problem of wearing off, leaving a theoretical risk of sinus barotrauma on ascent. Having said that, if eustachian tube problems are that severe prior to the dive you shouldn't dive.
   
   By the way, my problem was not caused by oxygen toxicity, it was caused by an arterial gas embolism.