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Related post: claimed that it diminishes the oxygenating power of hemoglobin. The nitrogen excre- tion is rather more diminished than the assimilation, so that there may be a gain in body-nitrogen. Transitory albuminuria may occur. Nervous Disturbances. These are rarely serious. The psychic func- tions show a slowness and want of energy. Anxiousness and insomnia Buy Bisoprolol are quite frequent. There is a general muscular debility, tremors, and want of control over movements. 316 MANUAL OF PHARMACOLOGY The reflexes are heightened. Vertigo and a tabetic condition may set in. There is then an Purchase Bisoprolol Online increase of excitability in the sensory and pain areas, and consequently head- ache and neuralgias; but the latter are in part due to referred pain from the cardiac disturbances. They are often early and quite characteristic, and take the form of pain and hyperesthcsia in the precordial region, left nipple and ulnar surface of left arm. Nicotin Blindness. This is relatively rare. It seems to be favored by alcoholism. The Bisoprolol 2.5 Mg sight gradually becomes dim, Bisoprolol Mg with central scotoma, impaired accommodation, and often miosis. It is always bilateral. The anatomic changes consist in retrobulbar optic neuritis, with subsequent atrophy. Until degeneration has set in, a complete cure can usually be effected by abstaining from nicotin; later, this will only arrest the further progress (de Schweinitz, 1896). Other Toxic Amblyopias. Many poisons may produce blindness, temporary or Bisoprolol Online permanent, in susceptible individuals, especially on continued administration. This has been recorded for stramonium, cannabis, chloroform, opiates, carbon disulphid, arsenic, lead, iodoform, aspidium, quinin, salicyl, methyl alcohol, etc. For most of these the changes are analogous to those of nicotin. With methyl alcohol, quinin and salicyl, the retinal ganglion cells are also involved. The metals and aspidium may produce primary optic atrophy without preceding neuritis (de Schweinitz, 1896 and 1902). Of other effects which have been attributed to nicolin, but with insufficient Buy Cheap Bisoprolol cause, may be mentioned: impotence, epilepsy, and insanity (G. W. Jacoby, 1898; Naecke, 1909). Treatment. It will be seen that tne catalogue of injurious actions to be charged against the abuse of this drug is sufficiently large; but on the other hand, it must be noted that these are absent with moderate use, and can be abolished if the use of the drug is promptly limited on their first appearance. Actual withdrawal is not always necessary. Limitation in quantity, the use of tobacco poor in nicotin, sufficient expectoration, and the avoidance of deep inhalation of the smoke, are often sufficient. Quick total withdrawal does not lead to abstinence symptoms, as with morphin (except possibly in some especially neurotic subjects), although it may disturb the function of the bowels for a few days. The principal point in the treatment is to keep the thought of the patient off the topic Bisoprolol Hctz of tobacco, and to supply the accustomed stimulus to the Bisoprolol 10 Mg mouth in some other manner, as by chewing ginger or gentian. The use of tobacco must, of course, be avoided in pathologic conditions in which there are special contraindications to it in heart disease, dyspep- sia, inflammation of the respiratory tract, etc. PREPARATIONS NICOTIN Tabacum (Tobacco). "The commercial dried Purchase Bisoprolol leaves Order Bisoprolol Online of Nicotiana Tabacum, Linn6 (N. O. Solanaceae)." An annual plant, probably indigenous in tropical America, and now cultivated in most parts of the world. The annual production of the world is estimated at 1,000,000 tons (1,000,000,000 kg). Other species also contain the nicotin. The plant was introduced into Europe shortly after the discovery of America. Its use by smoking was practised by the natives at the time of Columbus. The important constituents are nicotin, which is also present to a less extent in all other parts of the plant, and a volatile oil developed in drying and "sweating." Bisoprolol 2.5 The percentage of nicotin varies between i and 8 per cent.: In Havana and Maryland, 1.5 to 3; Virginia and Kentucky, 6 to 8; South American, 2 to 6; German, 1.5 to 3. A num- ber of other alkaloids have also been announced to exist in small amount in Order Bisoprolol tobacco (Pictet and Rotschy, 1901). The dried Generic Bisoprolol leaves were formerly official, but are now obsolete in medicine; if used, an infusion may be made. The dose was given as 0.5 Gm. Nicotin, CioHuNz, is a fluid, volatile, oxygen-free alkaloid, of strongly basic charac- ters. It forms salts, most of which are soluble. It is colorless and almost odorless when freshly prepared; but it partly decomposes on keeping, acquiring a characteristic odor and a brown color. The dose would be to o.ooi Gm. GELSEMIUM 317 LOBELIA The herb Lobelia inflata was used by the American Indians as a substitute for tobacco. It was introduced into medicine by Samuel Thompson about the beginning of the nineteenth Buy Bisoprolol Online century as the main basis of his peculiar system of treatment. The chief constituent is the alkaloid Lobelin with actions resembling nicotin (Edmunds, 1904). Small doses lower the COo threshold of respiration (Wieland, 1913). Large doses paralyze the respiratory center and cardiac muscle (Muto and Iwakawa, Bisoprolol Fumarate 1910). Relatively small doses paralyze the bronchial muscles (Dresser, 1889), which may ex- plain its use in asthma. It is also somewhat employed in other respiratory disorders as expectorant, emetic and cathartic; but it is an unreliable, depressant and dangerous drug. The nausea and emetic action are central (Eggleston and Hatcher, 1915). Poisoning is treated by evacuation and stimulants. PREPARATIONS LOBELIA Lobelia, U.S. P., B.P. (Indian Tobacco). The dried leaves and flowering tops of Lobelia inflata. Dose, 0.15 Gm., 2^ gr., U.S.P. Fldext. Label., U.S.P.Dose, 0.15 c.c., 2% minims, U.S.P. * Tr. Label., U.S.P. 10 per cent. Dose, i c.c., 15 minims, U.S.P. Maximum dose, 2 c.c., 30 minims. Tr. Label. Aeth., B.P. 30 per cent, in Spir. Aeth. Dose, 0.3 to i c.c., 5 to 15 minims, B.P. CONIUM Conium or "Water- Hemlock," an Umbelliferous herb, contains a number of alka- loids, of which coniin is the most important. This is a simple derivative of Piperidin, and was the first alkaloid synthetized. Children are sometimes poisoned by eating the root. The juice is believed to have been the poison administered to Socrates. It was introduced into medicine by Stoerck, 1770, but is now practically obsolete. It was formerly used as a sedative and antispasmodic in chorea, mania, convulsions, whoop- ing cough and asthma; and locally in hemorrhoids and other anal lesibns. Its per- ipheral actions are similar to those of nicotin, but it produces more pronounced pa-
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