Mark Corson

By L. Ortega. Wilkes University. 2018.

There are 2 Homeopathic Uses: Watercress is used to treat irritation of to 4 stamens with yellow anthers and filaments best aygestin 5 mg, which also the efferent urinary tract buy aygestin 5mg amex. There are about Contraindications include stomach or intestinal ulcers and 25 sections on each seed surface order aygestin 5 mg with amex. The intake of large quantities of the has 2 to 6 flowers, 2 to 4 of which are sterile. There are 3 Pediatric Use: The drug should not be administered to stamens and an ovary with 2 feather-like styles. Mode of Administration: The comminuted herb, freshly The leaves are arranged in two rows, are parallel-veined and pressed juice, as well as other galenic preparations of the 5 to 15 mm wide. How Supplied: Habitat: Asia, North America and Europe Capsules — 500 mg Production: Wheat bran is the fruit wall, seed shell and outer Preparation: To make a tea. Wheat germ 2 gm drug (1 to 2 teaspoonfuls), cover for 10 to 15 minutes oil is the fatty oil derived from cold-pressing the embryo of and strain. Daily Dosage: The daily dosage is 2 to 3 cups of the tea Not to be Confused With: Wheat bran is sometimes confused before meals, 4 to 6 gm of the dried herb, 20 to 30 gm of the with rye bran; wheat germ oil with other oils such as sesame fresh herb or 60 to 150 gm of freshly pressed juice. Phospolipids (1%) Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3, Glycolipids (0. In addition, a significant reduction of Daily Dosage: As a laxative, the dose is 15 to 40 g 1 to 2 postprandial lipid levels is exhibited. For a full/ of the drug as a bath additive for injured or irritated skin (due partial bath: minimum 0. Fatty oil: triacylglycerols (60 to 75%), diacylglycerols (to 4%): chief fatty acids linoleic acid (50 to 65%), oleic acid Storage: Store tightly sealed in a cool place. Reichling J, Rimpler G, Phospholipids (9 to 14%) Schneider G, (Eds) Hagers Handbuch der Pharmazeutischen Praxis. Berlin, Glycolipids (0 to 2%): particularly acyldigalaktosyl glycerols Heidelberg 1998. It is a valuable dietetic because of the Medicinal Parts: The medicinal part is the root. The female Unproven Uses: Folk medicine internal uses include consti- flowers are in short-stemmed umbel-like clusters. The fruit is a 1- to 2-seeded, Indian Medicine: Flatulence, constipation, itching and me- thin-skinned, 7 to 8 mm thick, globose black berry. The root is plausible, but efficacy for the other indications has not been fleshy, wrinkled horizontally, yellowish-gray on the outside sufficiently proven. The plant is No health hazards are known in conjunction with the proper categorized as extremely poisonous. Consumption of 40 berries is Wood Vine presumed fatal for an adult; 15 for a child. The resin is a drastic Pohlmann J, The cucurbitacins in Bryonia alba and Bryonia purgative. The toxicity Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3, of the drug declines rapidly with dehydration and storage Nachdruck, Georg Olms Verlag Hildesheim 1979. Due to the cucurbitacin content, the drug has a severely irritating effect Roth L, Daunderer M, Kormann K, Giftpflanzen, Pflanzengifte, on skin and mucous membranes. Unproven Uses: Internally, the drug is used for catarrh of the Flower and Fruit: The ovules are in pairs on the upper respiratory tract. Externally, it can be used for nervous unrest surface of the seed scales, in axils of the spirally arranged and neuralgic pain. It can also be used for sprains, strains, covering scales, which are in turn fused into cones. The contusions, bruising and as a prophylactic treatment for cones are 10 to 16 cm long and 3 to 5 cm thick, with bedsores. The The plant is contraindicated for conditions like bronchial fruit is diclinous, monoecious. The seeds are long-winged on asthma, other obstructive bronchial diseases and whooping one side. Whole-body baths involving the essential oil should only be undertaken in consultation with a physician in the Leaves, Stem and Root: The tree grows up to 50 m and presence of larger skin injuries, severe feverish or infectious occasionally up to 75 m tall. The needles are dark green on the upper be avoided when the patient suffers from acute infections of surface with two white stripes on the lower surface. Bronchial originated from former Yugoslavia, Bulgaria, Poland, Roma- spasms could become worse following administration of the nia and Albania. The use of outdated essential oils with Not to be Confused With: May occur with turpentine oils, unsaturated terpene carbohydrates could lead to severe cone oils, fir needle oils, camphors, bornyl acetate and irritation of the skin and mucous membranes. It should be followed with gastric lavage with sodium Alpha-pinene (6 to 35%) sulfate solutions, intestinal emptying through administration of sodium sulfate, instillation of paraffin oil and medicinal Camphene (9 to 20%) charcoal, and shock prophylaxis (suitable body position, quiet, warmth). Bornyl acetate (2 to 10%) The treatment for poisonings consists of the treatment of Santene (2 to 3%) spasms with diazepam (I. Monitoring of Leaves, Stem and Root: The plant is roughly 60 to 120 cm kidney function is necessary. The basal leaves are Mode of Administration: Liquid preparations for internal and whorled, broad, elliptical to linear-lanceolate and heavily external use. Daily Dosage: Habitat: The plant is found from Lapland to Italy but not on Drops — 4 drops, 3 times daily in water or with sugar the British Isles. Inhalation — add a few drops to hot water; and inhale Production: White Hellebore root-stock is the rhizome of several times daily Veratrum album.

This group of disorders features lymphocyte and plasma cell infiltration of the lung parenchyma best 5mg aygestin. Interna- teinemia cheap 5mg aygestin free shipping, a rare lymphoproliferative disorder characterized tional consensus statement discount aygestin 5 mg on line. Am J Respir Crit Care Med 176:636, 2007 have an autoimmune disease or dysproteinemia. Residents of skilled nursing describe chronic ankle swelling and calf swelling and facilities are especially vulnerable. The majority of patients with predispos- carbon monoxide transfer because of loss of gas ing genetic factors will not develop clinical evidence of exchange surface. Alveolar hyperventilation caused by reflex stimulation travel; obesity; cigarette smoking; use of oral contracep- of irritant receptors tives; pregnancy; postmenopausal hormone replacement; 4. Increased airway resistance caused by constriction of air- surgery; trauma; and medical conditions such as antiphos- ways distal to the bronchi pholipid antibody syndrome, cancer, systemic arterial 5. Decreased pulmonary compliance caused by lung edema, hypertension, and chronic obstructive pulmonary dis- lung hemorrhage, or loss of surfactant ease. Thrombophilia contributes to the risk of venous thrombosis, often because of an inherited risk factor in Right Ventricular Dysfunction combination with an acquired predisposition. Anatomic dead The diagnosis is challenging because the symptoms and 2 space increases because breathed gas does not enter gas signs are nonspecific. Increased pulmonary vascular resistance caused by vascular history is unexplained breathlessness. Impaired gas exchange caused by increased alveolar dead initial diagnostic evaluation with D-dimer testing alone space from vascular obstruction, hypoxemia from (see later) without obligatory imaging tests (Fig. Sudden, severe calf discomfort suggests lodges peripherally, near the innervation of pleural nerves. Physical findings, if present at all, may simply concomitantly with peripheral pulmonary infarction. The patient etiologies include fat embolism after blunt trauma and presents with severe thigh swelling and marked tenderness when the inguinal area and common femoral vein are palpated. In extreme cases, patients will be unable to walk or may require a cane, crutches, or walker. Upper Ruptured Baker’s cyst extremity venous thrombosis may present with asymme- Cellulitis try in the supraclavicular fossa or in the circumference Postphlebitic syndrome or venous insufficiency of the upper arms. Cement embolism and bony fragment embolism can occur after total hip or knee replacement. Amniotic fluid embolism occurs when fetal membranes leak or tear at the placental margin. Pulmonary edema in this syn- drome is probably caused by alveolar capillary leakage. The vein is not compressible, and thrombus (far “classic” signs such as tachycardia, low-grade fever, neck left arrow) is visualized directly in the deep venous system. In such cir- cumstances, clinical improvement often fails to occur despite standard medical treatment of the concomitant alveolar-arterial O2 gradient can reliably differentiate or illness. When a normal vein is imaged in cross- patients with myocardial infarction, pneumonia, sepsis, can- section, it readily collapses with gentle manual pressure cer, the postoperative state, and during the second or third from the ultrasound transducer. When imaging is continued comfort such as a Baker’s cyst (also known as a popliteal below the chest to the knee, pelvic and proximal leg or synovial cyst) or a hematoma. Sometimes asymptomatic early-stage A normal or near-normal chest x-ray in a dyspneic lung cancer is diagnosed incidentally. Warfarin Anticoagulation Primary therapy should be reserved for patients at Usual start dose is 5–10 mg. How- parenteral drugs (see later) are continued as a transi- ever, anticoagulants do not directly dissolve thrombus tion or “bridge” to stable, long-term anticoagulation with that already exists. The most popular nomo- Risk stratify gram uses an initial bolus of 80 units/kg followed by an initial infusion rate of 18 units/kg per hour. This is especially useful if the patient will undergo Secondary Individualize Primary an invasive procedure such as surgical embolectomy. Enoxaparin 1 mg/kg twice daily and tinzaparin Pharmacogenomics may provide the gateway to 175 units/kg once daily have received U. An additional 10% of dosing variance can be explained by allelic vari- Fondaparinux Fondaparinux, an anti-Xa pentasac- ants of the cytochrome P-450 enzyme 2C9. No laboratory monitoring is future, if rapid turnaround of genetic testing becomes required. Patients weighing <50 kg receive 5 mg, patients possible, warfarin could be dosed according to specific weighing 50–100 kg receive 7. The dose must be adjusted downward for patients with renal dysfunction because Complications of Anticoagulants The most the drug is excreted by the kidneys. If warfarin is initiated as aged with cryoprecipitate or fresh-frozen plasma (usually monotherapy during an acute thrombotic illness, a para- 2–4 units) to achieve rapid hemostasis. During pregnancy, warfarin should be avoided if pos- Furthermore,variables such as increasing age and comor- sible because of warfarin embryopathy, which is most bidities such as systemic illness, malabsorption, and diar- common with exposure during the sixth through twelfth rhea reduce the warfarin-dosing requirement. However, women can take warfarin No reliable nomogram has been established to pre- postpartum and breastfeed safely. Based on a who have good family and social support, a permanent 212 residence, a telephone, and no hearing or language impair- or prophylaxis of extremely high-risk patients are “softer” ment can often be managed as outpatients. The filter itself may fail member or a visiting nurse can administer a parenteral anti- by permitting the passage of small- to medium-sized coagulant. The filters can be retrieved up to several months voked by surgery or trauma, 3 months of anticoagulation after insertion unless a thrombus forms and is trapped suffices. However, a “trial and error” ties), I recommend standard-intensity anticoagulation.

The patient has had congestive heart failure generic aygestin 5 mg with visa, previ- ously controlled with oral digoxin and furosemide aygestin 5mg sale. On examination buy discount aygestin 5mg, his blood pressure is 150/100 mm Hg and heart rate 104 beats per minute. Which of the following is the most effective and most rapid method of reducing pre- load in this patient? Left-sided heart failure can present with dyspnea, orthopnea, paroxysmal nocturnal dyspnea, tachypnea, crackles or wheezes, and an S3 or S4 gallop. The lack of jugular venous distension and/or hepatomegaly suggests absence of right-sided heart failure. Diagnostic and prognostic usefulness of natriuretic peptides in emergency department patients with dyspnea. Acutely decompensated heart failure: diagnostic and therapeutic strategies for the new millennium. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. When they apprehended her, they noted her pupils were large and that she seemed “high. She notes that without her “smokes,” she craves the drug, becomes very sleepy, depressed, and has a huge appetite. She lost her job because she was late and stealing, secondary to her desire to “smoke. Her pupils are widely dilated; she has a low-grade fever, tachycardia, and hypertension. Considerations This patient has many of the clinical signs and symptoms of cocaine intoxication. Cocaine, a sympathomimetic with local anesthetic characteristics, has potent vaso- constrictive properties. Rapidly fatal complications include severe hypertension (with concomitant end- organ damage), hyperthermia, and dysrhythmia. The mainstays of treatment are benzodiazepines (often in large dosages) and supportive measures. Acute cocaine intoxication may be difficult to distinguish from other conditions such as heat stroke, sedative-hypnotic withdrawal, intoxication with other sympathomi- metics/anticholinergics, thyrotoxicosis, and infections or structural lesions of the central nervous system. Before the mid 1980s, the main routes of administra- tion were intranasal and intravenous injection of cocaine hydrochloride. This leads to a general stimulatory state including vasoconstriction and increased myocardial contractility. This effect is also responsible for many of the dysrhythmias and conduction abnormalities associated with cocaine use. Symptoms of cocaine intoxication include euphoria, feelings of power or aggres- sion, agitation, anxiety, hallucinations (classically formication, a tactile sensation of insects crawling on the skin), and delusions. Physical examination may reveal mydriasis, tachycardia, hypertension, hyperthermia, diaphoresis, tremors, or seizures. Coingestants or contaminants may result in atypical presentations (eg, cocaine plus heroin: mixed sympathomimetic-opioid presentation). Severe dysrhyth- mias, myocardial infarction, seizures, and subarachnoid hemorrhage may result and potentially kill the patient. Body packers, who swallow cocaine wrapped in packets to smuggle it into the country, may die precipitously if a packet ruptures. Cocaine causes coronary vasoconstriction while also increasing the myocardial oxygen demand and platelet aggregation. These patients are typically younger, nonwhite, ciga- rette smokers without other risk factors for coronary artery disease. Benzodiazepines, often in large doses, are useful in treating cocaine-induced chest pain. If acute coro- nary syndrome is suspected, aspirin, nitrates, and morphine are advisable. Thrombolytic therapy of an acute myocardial infarction should be avoided if coronary vasospasm or dis- section is suspected or severe, uncontrolled hypertension exists. Emergent coronary artery catheterization may provide the best diagnostic information. For patient with hyperthermia or agitation, a basic metabolic panel and cre- atine kinase help rule out renal failure, metabolic acidosis, and rhabdomyolysis. Patients with altered mental status or seizures should have a computed tomography of the head performed. In general, patients with acute cocaine intoxication require only supportive care including monitoring and intravenous fluids. Agitation is best controlled using benzodi- azepines such as lorazepam or diazepam. Phenothiazines (such as haloperidol) should be avoided because they may lower the seizure threshold, contribute to hyperthermia, and have dysrhythmic effects. Atrial dysrhythmias may respond to benzodiazepines or other standard therapies (except β-blockers). Intravenous sodium bicarbonate administration may be useful for wide-complex tachycardias (or lidocaine if the dysrhythmia is refrac- tory to bicarbonate). Even labetalol (mixed α- and β-blocker) has been associated with excess morbidity and mortality in animal studies of cocaine toxicity.

The cucurbitacins contained in the seeds are toxic proven 5 mg aygestin, cytotoxic Wagner H aygestin 5 mg on-line, Wiesenauer M buy cheap aygestin 5mg line, Phytotherapie. Kowalewski Z, Wierzbicka K, Flavonoid compounds in the Homeopathic Uses: Homeopathic uses include cardiac blossoms of Iberis amara, L Planta Med, 20:328-39. N-acetyl-D-galactosamine specific Unproven Uses: Folk medicine usage includes digestion lectins from the seeds of Soja hispida, Bauhinia purpurea. Symptoms of poisoning could include vomiting, diarrhea, colic and Bitter Milkwort kidney irritation. Symptoms of Flower and Fruit: The blue or occasionally white or pink poisoning could include vomiting, diarrhea, colic and kidney flowers are in many-blossomed racemes. Cases of poisonings have, however, never been 2 lateral ones are large, petal-like, patent and 3-veined. The ovary is superior and bilocular In case vomiting has not already occurred, gastric lavage witfi a spoon-like style. The fruit is an obcordate capsule, should be induced using burgundy-colored potassium per- compressed at die sides and enclosed in the sepals. The stems are branched at the base, decumbent or activated charcoal, begin therapy for poisoning. Intubation and Production: Bitter Milkwort herb, including its roots, is die oxygen respiration also may be necessary. Saponins (1-2%) The upper surface is a shiny dark green and the underside Bitter principles: polygalin (polygamarin) paler. Phenol glycosides: monotropitoside (methyl salicylic acid- primveroside) Habitat: The plant is indigenous to tropical Asia but is widely cultivated in other regions today, such as the Polygalite (acerite, 1. Bitter Orange Unproven Uses: Bitter Milkwort is used for conditions of the peel consists of the dried outer peel of ripe fruits of Citrus respiratory tract, cough and bronchitis. Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3, Nachdruck, Georg Olms Verlag Hildesheim 1979. The peel is thick, rough and orange when flower oil are used as a preventive measure for gastric and ripe. Chinese Medicine: Uses in Chinese medicine include pain in Further information in: the epigastrum, vomiting and anorexia. Unproven Uses: Folk medicine uses include loss of appetite and dyspeptic symptoms. Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3, Nachdruck, Georg Olms Verlag Hildesheim 1979. Chinese Medicine: Bitter Orange peel is used for coughs, colds, anorexia, to reduce apathy and for uterine and anal Roth L, Daunderer M, Kormann K, Giftpflanzen, Pflanzengifte. Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3, Preparation: To prepare a tea, add 1 tsp of drug to 150 ml of Nachdruck, Georg Olms Verlag Hildesheim 1979. Extract: 1 to 2 g Tang W, Eisenbrand G, Chinese Drugs of Plant Origin, Tea: 1 cup 1 hour before meals Springer Verlag Heidelberg 1992. A desensitizing and Bittersweet Nightshade cardiotonic effect has been observed in clinical trials with Solanum dulcamara patients suffering from rheumatic polyarthritis. The • Eczema corolla has a very short tube and 5 long tips, which become • Furuncles revolute when mature. There are 5 stamens with • Warts golden yellow anthers, which lean toward each other, and 1 Unproven Uses: In folk medicine, Bittersweet Nightshade is superior ovary. The fruit is an oblong, scarlet and many- used internally for nose bleeds, rheumatic conditions, asthma seeded berry. The Homeopathic Uses: Solanum dulcamara is used for inflam- stem is twining or creeping, woody below, angular and mation of the respiratory and gastrointestinal tracts, the joints usually glabrous. Soladulcidine variety—soladulcidinetetraoside Preparation: A decoction is prepared by adding 1 to 2 g of Solasodine variety—solasonine, solamargine drug to 250 ml water. Steroid saponins Daily Dosage: The average daily internal dose is 1 to 3 gm Mixed varieties also occur. The main active principles are the steroid alkaloid glycosides whose resorption is probably promoted by the saponins. Homeopathic Dosage: 5 drops, 1 tablet or 10 globules every They stimulate phagocytosis, are hemolytic, cytotoxic, 30 to 60 minutes (acute) or 1 to 3 times a day (chronic); antiviral, anticholinergic and have local anaesthetic parenterally: 1 to 2 ml, sc, acute: 3 times daily; chronic: once properties. Leaves, Stem and Root: The plants grow as a shrub or tree extending up to 25 m high. The obovate leaves have double- serrate margins; the young leaves are very sticky. Habitat: Black Alder originated in the damp regions of Willuhn G, Phytopharmaka in der Dermatologie. Production: Black (English) Alder bark is the bark and branch rind of Alnus glutinosa. It is gathered from the shrubs Wolters B, Der Anteil der Steroidsaponine an der antibiotischen or trees growing wild. Other Names: Common Alder, Owler, Tag Alder tr Wolters B, (1965) Planta Med 13:189. Phytopharmaka und Mode of Administration: Leaves and bark are prepared as pflanzliche Homdopathika, Fischer-Verlag, Stuttgart, Jena, New infusions and decoctions for internal and local use. It is also used as a tonic for hair loss, as it improves blood circulation to the scalp. The fertile flowers treated with cortisone foam and sterile coverings; tetanus develop into crimson berries.