United States or Faroe Islands ? Vote for the TOP Country of the Week !
Sterilized solutions of both, put up in ampules ready for hypodermic medication, are obtainable, the strength offered generally being 1 part of the active principle to 10,000 of the solution. Hypodermic tablets of epinephrin may also be obtained. Stronger solutions of 1 part to 1,000 may be dropped on the tongue, or tablets may be dissolved on the tongue.
The hypodermic administration of epinephrin solutions, 1:10,000, or solutions of pituitary extract, 1:10,000, should be considered; they are often valuable. If the shock occurs in ether or chloroform anesthesia, the vasopressor stimulating effect of inhalations of carbon dioxid gas may be considered, as advised by Henderson."
It seems probable that there may be a special nervous mechanism of the veins which may increase the blood pressure in them as epinephrin solution may cause some constriction. A quick method of estimating the venous pressure by lowering and raising the arm has long been utilized.
A few drops of an epinephrin solution 1:1,000 may be placed on the tongue, and repeated three times a day, or from 5 to 10 minims of a weaker solution may be given hypodermically. The usual precautions against overeating, overdrinking, severe physical exercise, sudden movements, overuse of tobacco, etc., should all be urged on the patient.
They have been given intravenously; they are frequently given hypodermically. They often act rapidly when a solution in proper dose is dropped on the tongue. The blood pressure rise from epinephrin is quickly over; that from the pituitary extract lasts longer. In large doses, or when it is too frequently repeated, epinephrin depresses the respiration. Pituitary extract acts as a diuretic.
These integrations stimulate the brain-cells, the ductless glands, and other parts, and the energizing secretions, among which are epinephrin, thyroid and hypophyseal secretions, are thrown into the blood-stream, while that most available fuel, glycogen, is also mobilized in the blood. This body-wide preparation for action may be designated kinetic reaction.
Venous pressure was not much affected by small doses of epinephrin, but with large doses it rose from 10 to 80 mm. Pituitary extract acts somewhat similarly to epinephrin. Caffein, though raising the arterial pressure, did not influence the venous pressure. Strychnin did not raise either pressure until the dose was sufficient to cause muscular contractions.
They think that when the venous pressure is increased only by large doses of epinephrin, pituitary extract and alcohol, the effect is due to failure of the heart, although it may be due to an increase of carbon dioxid in the blood, in other words, to asphyxia. Arterial hypertension may be divided into stages.
Camphor in doses large enough to cause convulsions stimulated the vasomotor center. In smaller doses it generally stimulated the center moderately, but not always. Even when this center was stimulated, however, the camphor did not necessarily increase the blood pressure. The rise in blood pressure from epinephrin is due entirely to its action on the peripheral blood vessels and the heart.
The blood pressure is temporarily raised and the heart stimulated by these treatments, but epinephrin is not used so often for cardiac failure as it was a short time ago. The most satisfactory action, especially from the epinephrin, is from small doses frequently repeated. Sometimes in serious emergencies it has been found to be of value when given intravenously in physiologic saline solution.
Word Of The Day