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Ephedrine is not phenylephrine.

To the Editor: In his review of Dermatology in Emergency Care (Feb. 12 issue),1 Dr. Greaves incorrectly uses the generic name ephedrine for a 2 percent phenylephrine spray used to treat a localized mucosal reaction. Phenylephrine hydrochloride is an α-adrenergic agonist that is useful for topical as well as intravenous vasoconstriction. It is commonly dispensed (in the United States, at least) as a 1 percent concentration. Ephedrine, a generic, indirect-acting sympathomimetic agent, is ubiquitous in perioperative care. It is dispensed in 5 percent ampules that are generally diluted before use. These drugs are therefore not equivalent.