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Related article: of this destruction, the evidence is incomplete. It indicates that the morphin may be
destroyed in various organs, and more actively in habituated animals.
Tauber, 1890, could not demonstrate any destruction on perfusing morphin through
excised liver or kidney. Cloetta, 1903, claims the disappearance of one-sixth to one-
third of the morphin digested with oxygenated emulsions of lung, liver, and especially
brain; no destruction with filtered extracts; so that the action is not due to soluble
ferments, but presumably oxidative. The destruction is increased in habituated
animals. Albanese, 1909, found practically no destruction by liver pulp, from either
normal or habituated animals; Purchase Flagyl but marked destruction during abstinence following
habituation. Other organs showed similar but weaker destruction. Dorlencourt, 1913,
again claims that morphin is destroyed by liver in vitro, and that this is increased by
habituation. (Theories of decomposition, Spitta, 1908).
THE MORPHIN GROUP 22Q
Fate In Chick-embryos. If morphin is injected into fertilized eggs, which are then
incubated, no destruction of morphin or its derivatives occurs if the embryo dies
before it is half developed. If development is completed, heroin is destroyed abso-
lutely; morphin very largely, codein and dionin not at all. The destruction therefore
takes place only after a certain development, perhaps of the nervous system, has been
reached. The alkyl groups protect the morphin against oxidation, just as they do in
the adult organism, while the acetyl groups are evidently easily separated (Grueter,
1916). Purchase Flagyl
Fate in Frogs. In these, the destruction is very small, and no tolerance is acquired.
The excretion is very slow, extending over eight days, and occurs exclusively through
the alimentary tract (B. Frenkel, 1910).
Fate of Codein. This behaves quite differently from morphin: about
80 per cent, is excreted unchanged, mainly in the urine, but somewhat
also in the feces (Tauber, 1892). Repeated administration does not
increase its destruction, nor does it appear to produce tolerance in
animals (Bouma, 1903).
Heroin. The greater part is excreted unchanged in the urine; some
also in the feces. A part is destroyed and this destruction is greatly
increased in habituation (Langer, 1912).
Odorous Substances. The substances which give the characteristic odor to opium are
excreted Purchase Flagyl largely by the urine, and also in the breath, sweat and milk.
Toxicology. Acute Symptoms of Morphin and Opium Poisoning.
Suicidal and accidental poisoning by morphin or opium is common, and
familiarity with its successive symptoms is therefore important. The
following description of the morphin effects applies equally to opium (with
ten times the dose); except that the symptoms do not appear quite (but
almost) as promptly.
Moderate Therapeutic Doses (5 to 15 mg.; }/{% to ^ gr. of morphin).
The symptoms set in promptly (five to ten minutes after hypodermic,
fifteen to thirty minutes after oral administration). They begin with
slight flushing of face, sensation of warmth and comfort; lassitude, giddi-
ness, dreamy state, with free imagination but confused intelligence; mouth
dry and thirsty.
The patient becomes sleepy; skin pale; respiration and pulse slowed;
pupils constricted. Nausea and vomiting are exceptional with this
dosage.
In a short time Purchase Flagyl the sooner, the larger the dose a natural sleep sets
in, lasting six to eight hours or more; the patient commonly awakens
refreshed.
Intravenous Injection. If the injection accidentally enters a vein, there
is tinnitus, tachycardia, fainting, but usually rapid recovery.
Larger Therapeutic Doses (20 to 30 mg.; ^ to Purchase Flagyl 3^ gr.). The initial
symptoms are the same. Sleep occurs more Purchase Flagyl promptly and is more pro-
found. On awakening there is usually some confusion, nausea, anorexia,
and constipation.
Toxic Doses (100 to 300 mg.; \\^ to 5 gr.). The initial symptoms are
as described. The somnolence deepens rapidly into sleep and coma;
severe symptoms being generally conspicuous in five to ten minutes after
hypodermic, or fifteen to forty minutes after oral administration; rarely
delayed for one or two hours.
In the earlier stages of the coma, the patient can be partially aroused
to a confused consciousness, but relapses promptly into lethargy.
As the coma deepens (i.e. almost always within two hours, and often
230 MANUAL OF PHARMACOLOGY
in half an hour after taking the poison), the patient can not be roused, the
reflexes disappear, the muscles relax, the jaw drops. The miosis becomes
extreme ("pin-point pupil"); the skin pale, with Purchase Flagyl cold sweat, finally
cyanotic; fall of temperature; respiration very slow, irregular, often
Cheyne-Stokes; pulse slow, feeble and often irregular. Convulsions are
rare in adults, more common in infants; they are sometimes violent, but
rarely if ever tetanic.
The respiration stops before the heart. The pupils almost always
dilate as the terminal asphyxia sets in. (With heroin, death is due to the
convulsions; Langer, 1912.)
The time of death is usually seven to twelve hours; sometimes in two
hours or even less. Survival over twelve hours indicates a good prognosis.
Autopsy findings are not characteristic. There are only the common asphyxial
lesions: Cerebral and meningeal congestion, sometimes with serous effusion; lungs hypere-
mic and Purchase Flagyl sometimes edematous; general venous congestion; rarely intestinal or cerebral
ecchymoses.
Ordinary Fatal Dose. With morphin, this is 0.2 to 0.4 Gm. (3 to 6 gr.) ;
with opium, 3 Gm. (45 gr.). There is, however, considerable idiosyn-
crasy, and 60 mg. (i Purchase Flagyl gr.) of morphin must be regarded as dangerous.
With 250 mg. (4 gr.) the prognosis is unfavorable, even under treatment,
although patients have been saved after 4 Gm. (60 gr.) of morphin.
Recovery. This may occur even after asphyxial convulsions. The
respiration and pulse improve, the coma becomes lighter, and passes into
a very prolonged sleep, often lasting for one or two days. On awakening,
the patient is Purchase Flagyl troubled with headache, constipation and digestive disturb-
ances, often vomiting, itching, impotence of the bladder; exceptionally
excessive depression. Sometimes the recovery is interrupted by a serious
relapse, perhaps through the reabsorption of morphin from the intestine.
Idiosyncrasies. Infants are highly susceptible to morphin; as to older
children, there is difference of opinion. The female sex, and patients
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