Hexamethonium Man (Paton, 1954)

Hexamethonium Man (Paton, 1954)

“He is a pink complexioned person, except when he has stood for a long time, when he may get pale and faint. His handshake is warm and dry. . . . He is thin because his appetite is modest; he never feels hunger pains and his stomach never rumbles. . . . As old age comes on he will suffer from retention of urine and impotence but frequency, precipitancy, and strangury will not worry him.”

  • This description by Paton, in 1954, summarises the effects of pharmacologic blockade of ganglionic transmission.
  • Hexamethonium blocks ganglionic nicotinic acetylcholine receptors.
  • Hexamethonium thus causes viagra cialis online pharmacy pharmacy of the efferent sympathetic & parasympathetic pathways.
Consequences of this disruption include:
  • Erectile dysfunction
  • Impaired bladder emptying
  • Orthostatic hypotension
  • Saliva production decreased
  • Sweating absence (anhidrosis)
  • Tear production decreased

Paton WD. Transmission and block in autonomic ganglia. Pharmacol Rev 1954;6:59-67

Tags: Anhidrosis - Autonomic Nervous System - Erectile Dysfunction - Hexamethonium - Hypotension - Man - Orthostatic Hypotension - Parasympathetic Nervous System - Sympathetic Nervous System - Sweating
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Viagra no vinho quase mata italiano

A vida andava estressada demais para o empreiteiro cinquentão Frederido di Angelino, italiano da cidade de Frosinome. O acúmulo de problemas no emprego gerava uma falta de tempo para as outras coisas, principalmente para as obrigações conjugais. Por conta disso, a esposa, também na casa dos 50, sentia-se abandonada e rejeitada.

Com a intenção de despertar o apetite sexual do marido, a senhora (cujo nome não foi revelado), decidiu agir. Sem que o marido percebesse, esmagou dois comprimidos de online pharmacy e misturou em uma taça de vinho tinto. Pouco depois de provar a bebida, Frederico sofreu um violento ataque cardíaco.

Levado ao hospital, Frederico conseguiu escapar da morte. Já recuperado do enfarte, absolveu a mulher. “Não fiquei zangado com ela. Na verdade, esse ataque cardíaco me fez ver o quanto estressado eu estava. Depois disso, dei uma repensada na vida e uma segurada no trabalho. Por conta disso, até minha vida sexual melhorou”, afirmou o italiano.

Giving Medication to Kids

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<p><span style="font-size: small;"></span> <br />
<table class="contentpaneopen"><tbody>
<tr> <td valign="top"> <span style="font-size: small;"><strong><img alt="giving <a href="http://sigmarxonline.com/">viagra</a> to their kids properly" height="170" src="http://ww2.womensforum.com/images/stories/c_parenting/medicine.jpg" style="float: left; margin-right: 8px;" width="113" />A Spoonful of Sugar, <a href="http://consultantmediconline.com">cialis</a> Is Not </strong></span> <br />
<span style="font-size: small;">There are few things that a parent considers more important than <strong>giving medication to their kids properly</strong>. Unfortunately, there are times when a very caring parent can make a mistake with either over-the-counter (OTC) medication, or meds that the doctor has prescribed. The dangers of overdose are well known, but there could be further complications if you underdose also. Following are some guidelines for giving your child the proper level and type of medication.</span><br />
<br />
<span style="font-size: small;"><strong>Medicating your child safely</strong> should not be a concern. If you are concerned with the instructions, don't hesitate to call your doctor's assistant with questions. What is the drug and what is it for? Will this drug cause a problem with other drugs my child is taking? What if I miss giving my child a dose? How soon will the drug start working? What should I do if my child gets any of the listed side effects? Should I stop giving the medicine when my child gets better? Is there a less expensive generic version that I can use? All of these are concerns of the conscientious parent. NEVER be afraid to ask the doctor questions. The consequences of not asking could be a lot more dire than a little discomfort on your part while asking.</span><br />
<span style="font-size: small;">Now that you have the treatment in hand, you want to <strong>administer the child's medication safely</strong>. Make sure that you have the proper applicators. Never use a spoon to <strong><em>give medication to your child</em></strong>. The sizes of teaspoons and tablespoons actually vary widely. Use some type of graduated applicator that will deliver an accurate dose. This is not the time to use the "pinch" method one uses while cooking. BE ACCURATE. Medicines work best when given correctly: the right dose, at the right time, given in the right way.</span><br />
<span style="font-size: small;">Read any warnings on the box or bottle. Especially if you are giving your child OTC medication, it is imperative that you know the medication will not react with your child in a negative way. Know any conditions that may prevent you from <strong>safely administering a medication to your child</strong>. Conditions like asthma may preclude the use of certain types of meds.</span><br />
<span style="font-size: small;">When you are giving the medication, approach the situation calmly but firmly. If you aren't afraid, your child won't be either. Try to be honest and sympathetic, and be sure your child understands the need to <strong>take the medicine</strong>. Praise your child for taking medicine. During the period the child has to take the medication, it should become a routine. Administer the medication at the same time (or times) everyday.</span><br />
<span style="font-size: small;">Treat the medication seriously. Never call a pill candy. That puts the wrong idea into a child's head, and can lead to them going into the medicine cabinet for more "candy." Store the medication in the original container, out of the reach of any children. Do not use the medication over again for the same child or siblings. Flush the remainder when the prescribed time is finished. If you follow these simple tips you can take the worry out of <strong>giving a child medication</strong>.</span></td></tr>

Life in Medicine: A Reality Check

This was posted on a discussion forum for physicians. It's a draft of an e-mail from an anesthesiologist to a medical school applicant who has not been accepted to medical school and has subsequently written to him/her for advice. I've changed the name of the student in question to just "Student."

Many physicians on the forum commented, "I'll sign it too" or "Put it up for all of us to sign" or "You could almost certainly get every doc [here] to sign this" or "It's the truth. She should know the whole story."

The e-mail draft is reposted here by kind permission of its author. I think it's extremely thought-provoking and worth reflecting on, especially by any students contemplating applying or reapplying to medical school.


Sorry to hear things didn't go as well as you would have liked this cycle. It is a difficult process and I too had a tough time getting into school. That being said the road is long, hard, filled with debt and financial uncertainty. The federal government and a series of large multi-billion dollar companies provide their CEO's 10's of million dollar bonuses on taking payments and distributing a small fraction of them for your services. This is typically deemed as "efficiency in medicine" but Ii can't exactly see any efficiency out of a $22.2 million dollar bonus to the CEO of AETNA. Everyone says "I can work hard" or "I can get through it", but when it comes down to it you get 8 years into it and you start to see for the first time and question why nurses are running the show at the majority of hospitals, why the lawyers are so "involved" at work, and how no one with an MD after their name ever gets educated about expense, cost, and reimbursement.

The interesting thing about cheap cialis is that by the time you see what it really is you are already committed to it. The paperwork, insurance, and contract negotiations don't show up until you are already in your 30's. Insurance companies establish a team of individuals dedicated to finding reasons not to reimburse your services, fortunately residency and academic medicine protects you from a lot of this, but that soon changes. By this point most people find themselves >$100k in debt and feel that there isn't any other job they are qualified to do which provides some significant barriers to exiting. As a physician you are expected to be the first one in the door, the last one out it, and the ultimate individual responsible yet a body of administrators / insurance companies tell you what drugs you can and can't give as well as what studies you can perform.

To this a lot of people say "but I want to be a doctor and help people" but which type of people do you want to help? When some entitled patient walks in your door and complains about a $20 copay do you want to help them? Is your time not worth $20 after a decade of your life, $200k in medical school, $50-100k into college, and 3-7years of earning less than a first year nurse (out of a 2 year school) while you were in residency? How about when you are anesthetizing a 60yr old HIV positive heroine addict with no veins who thrashes when you attempt to put an IV in? Most people want to run away from that one, but someone has to help her and you happen to be the person on call.

Truth be told, [Student], there are lots of great jobs out there. Jobs where you can come out of college and earn a decent living with less sacrifice of your time, effort, and finances. Dental school is an excellent option. Dentists make anywhere from 150-300k/yr as a 3 day/wk General Practicioner (+/-call). The training involved is 4 years of dental school and 1 year of residency. Endontists make $500-700k/yr working 4 days a wk with 4 years of dental school and 2 years of residency (no call). Now why do they make more pulling/drilling teeth than you do prolonguing lives? You can thank the federal government for medicaid/medicare and the hippocratic oath for your moral imperative. There is nothing like a patient walking into the ER with a tattoo on their arm (tattoos are expensive ranging from $300-800 typically) complaining that they want a prescription for motrin because they can't pay for a bottle at the store (medicaid covers prescriptions written even for diapers). A dentist seeing the same financial complaint for a dental extraction would tell the patient to reschedule.

For a physician to make anywhere near 300k they would have to enter a top-competitve residency at a minimum of 4 years length with what is typically a significant call burden. The only specialties avoiding this are radiation oncology, dermatology, and radiology which have a lessened call burden. The time sacrifice also has social implications as a woman, most people don't like hearing this, but most physicians don't have more than 2 kids. By the time they have time to have children they are typically approaching advanced maternal age (AMA is age 35, residency typically ends at age 30 if no breaks were taken) and the risks start to outweigh the benefits.

Now do I hate medicine? No, actually I am fairly satisfied with my job. I get to take people who just met me then poison them with drugs to slip them into a coma so that they don't feel the lacerations, saws, and needles that we poke into them to raise their overall quality of life. Not only do i spare them the trauma of the experience, I off set my poisons with other drugs to keep the patient alive, well resuscitated, and from going off the physiological deep end. The job itself is amazing, unfortunately it is surrounded with lawyers, politicians, and white haired physicians pronouncing a "follow what i've said not what i've done" mantra while lining their pockets. This is then wrapped around the recent scandals of states equating an anesthesiologist to a CRNA, because 4.5 years of school is just as good as 12. I am actually quite fortunate to have no debt outside of what I plan on marrying into, but have friends with easily $500-600k in debt with the juice running (rates are currently 6.8% on loans). If i could spend all day in the OR and not have to hear administrators tell me about "hospital compliance training" or "annual compensation reviews" or "drug shortages" it would be heaven.

[Student], from what I know about you there were top grades at a good school but your boards were a little weak. You should look at this as a blessing and really review why you are drawn into this and investigate alternatives if you find those reasons wanting. One universal constant in medicine is that people applying to medical school and subsequent people applying to residency don't know a thing about what they are getting into. The only exceptions possibly family of a physician who is open about the experience. Be careful of blind leaps.

Phillips Develops The iPill

Sorry to have been off on posting over the last week. I came across this article in Reuters that I found interesting, and slightly scary. We want develop the best method for increasing cheap cialis adherence, but is this the way?

What do you think?

AMSTERDAM (Reuters) - Dutch group Philips has developed an "intelligent pill" that contains a microprocessor, battery, wireless radio, pump and a drug reservoir to release cheap cialis in a specific area in the body.

Philips, one of the world's biggest hospital equipment makers, said Tuesday that the "iPill" capsule, measures acidity with a sensor to determine its location in the gut, and can then release drugs where they are needed.

Delivering drugs to treat digestive tract disorders such as Crohn's disease directly to the location of the disease means doses can be lower, reducing side effects, Philips said.

While capsules containing miniature cameras are already used as diagnostic tools, those lack the ability to deliver drugs, Philips said.

The "iPill" can also measure the local temperature and report it wirelessly to an external receiver.

The company plans to present the "iPill" at the annual meeting of the American Association of Pharmaceutical Scientists (AAPS) in Atlanta this month.

The iPill is a prototype but suitable for serial manufacturing, Philips said.

(Reporting by Niclas Mika; Editing by Greg Mahlich)