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DRUGS THAT STIMULATE ADRENORECEPTORS (ADRENOMIMETICS) Adrenomimetics are drugs that act like the neurotransmitter norepinephrine, stimulating adrenoreceptors.
The process of transferring the excitation impulse to adrenergic synapses includes several stages (see Fig. 7.3): the synthesis of the mediator in the nerve ending, its deposition in the vesicles (vesicles) of the adrenergic nerves. The mediator (neurotransmitter, transmitter) of excitation in adrenergic synapses is norepinephrine (less often adrenaline and dopamine). Nerve impulses reach the nerve endings and cause the mediator to be released from the vesicles into the synaptic cleft.
The mediator excites the adreno-receptors of the membrane of the cells of the executive organs, which is accompanied by specific effects (increased myocardial contractility, narrowing of arterioles, an increase in blood pressure, relaxation of the muscles of the bronchi, etc.). After interaction with receptors, most of norepinephrine and its metabolites (70-80%) are recaptured by the presynaptic membrane and used again.
Another, smaller part (10-15%) of the mediator is inactivated by the corresponding enzymes: MAO, catechol-O-methyltransferase. The adrenoreceptors of the membranes of the cells of the executive organs have unequal sensitivity to various medicinal substances, they are divided into ?- and ? Stimulation of various drug adrenoreceptors is accompanied by corresponding changes in the functions of organs and tissues (see Table 7.2). With the help of drugs, it is possible to change the functions of adrenergic synapses, regulating the specific activity of systems and internal organs (heart, bronchi).
Depending on the nature of the action on the adrenergic synapse (stimulation or blockade of adrenergic receptors, a decrease in the release of the mediator by the endings of adrenergic nerves, inhibition of inactivation and reuptake of the mediator), drugs are divided into adrenomimetics and adrenoblockers.
Drugs that excite adrenoreceptors (adrenomimetics) are usually distinguished by their effect on adrenoreceptors: stimulants of ?- and ? -adrenergic receptors (epinephrine, norepinephrine); ? 1 -adrenergic stimulants (phenylephrine, midodrine); ?
2 -adrenergic stimulants : peripheral (anticongestants) - naphazoline, xylometazoline, oxymetazoline; predominantly central action - clonidine, guanfacine; stimulants ? 2 -adrenergic stimulants (salbutamol, fenoterol, hexoprenaline, salmeterol); sympathomimetics (indirect adrenomimetics) - ephedrine and its preparations. For medical purposes, it is obtained from the adrenal glands of slaughtered cattle and synthetically. According to the chemical structure, it corresponds to the endogenous one.
Endogenous is formed mainly in the chromaffin cells of the adrenal medulla. Epinephrine affects all organs and systems innervated by adrenergic nerves.
From the point of view of practical medicine, the action of epinephrine on the cardiovascular system deserves the greatest attention.
Important is the fact that the vessels of different areas Carbonate Buy online 500mg of General - Calcium health the body react differently to the introduction of epinephrine. The vessels of the skin, mucous membranes, abdominal organs and kidneys under the influence of epinephrine constrict, and the vessels of the heart, skeletal muscles and brain expand.
In the conditions of the whole organism, the narrowing of the vessels of the abdominal cavity and skin under the influence of epinephrine leads to a sharp increase in blood pressure, resulting in a redistribution of blood from the abdominal organs to the vessels of other areas of the body. Epinephrine enhances and speeds up heart contractions, facilitates atrioventricular conduction by acting on ? By increasing the automatism of the fibers of the conduction system of the heart, it can cause the development of cardiac arrhythmias.