Ephedra sinica, a species of ephedra (Ma huang), contains the alkaloids ephedrine and pseudoephedrine, which have been found to induce central nervous system stimulation, bronchodilation, and vasoconstriction with ephedrine toxicity associated with stroke, myocardial infarction and sudden death.Ma huang has been used in traditional Chinese medicine for more than 5 millennia. Beverages made from the plant have been referred to under many names, e.g., yellow river, Mormon tea, and whorehouse tea. The jointed green stems of the ma huang are the chief photosynthetic organs of the plant and contain the alkaloids. In commercially available Ma huang products the percentage of ephedrine varies greatly from 1.1 to 15.3 mg per dosage unit. Ephedrine is well absorbed after oral administration is excreted primarily unchanged in the urine with a serum half-life of 2.7 to 3.6 hours. The pathogenesis of the cardiac toxic effects remains incompletely defined but probably related to increased blood pressure secondary to elevations in heart rate, cardiac output and peripheral resistance including vasoconstriction of the coronary arteries. Long term ephedrine use may lead to conditions seen with pro
