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Related post: angina Buy Tretinoin Cream 0.05 pectoris. Intraocular Tension. This is raised by amyl nitrite, even when the general blood pressure is lowered (Wessely, 1915). This enjoins caution when using nitrites in glaucoma. The retinal vessels are also Where To Buy Tretinoin Gel dilated (Hirschfelder, 1915). The Tachycardia. This is due mainly to depression of the vagus center, for after section of the vagi, or after atropin, nitrites cause but little further acceleration (Mayer and Friedrich, 1875). The slight remaining quickening is abolished by dividing the accelerators (Dossin, 1911). The rate of the excised heart is not changed by nitrites (Plumier, 1905). The excitability of the vagus trunk to direct electric stimulation persists. The depression of the vagus center is due to the fall of blood pressure, and not to a direct action of the nitrite, for no quickening occurs if the pressure is kept level by partial compression of the aorta Buy Tretinoin Gel (Filehne, 1879; Sollmann). The vagus center may still respond to strong reflex stimulation (Mayer and Friedrich). In man, the Purchase Tretinoin Cream acceleration on inhaling amyl nitrite is considerable, often to double. No acceleration occurs in heart-block. This has a diagnostic value, similar to atropin (Belloir and DuBos, 1913). Character of Pulse. As the result of the quickening, the excursions of the heart are smaller. The blood-pressure waves appear particularly low, because the pressure wave Buy Tretinoin Cream Online is more readily dissipated, on account of the dilatation. The pulse, on the other hand, may be bounding, because the arteries are emptied more completely during diastole. The heart-muscle shows no important direct change; however, the better coronary circulation and the lowered peripheral resistance may improve and relieve a weakened heart (MacNider, 1908). The excised mammalian heart is scarcely affected by moderate doses, perhaps slightly stimulated, then depressed (Loeb, 1903; Plumier, 1905; Dossin, 1911). The excised frog's heart may be quickened by low concentrations (i :io,ooo) ; higher concentrations Tretinoin Gel Buy weaken (1:5,000), or stop (1:1,000) the contraction. Methemoglobinemia. Excessive doses of nitrites form methemo- globin (Gamgee, 1868) and this causes cyanosis and asphyxia. However, since the blood corpuscles are not destroyed, the animals generally recover. Respiration. This is accelerated (Mayer and Friedrich), probably by the changes in the blood and circulation. The Bronchial Muscles. These are relaxed by nitrites (Doyon, 1906; excised, Titone, 1913; surviving lungs, Baehr and Pick, 1913). This may explain their use in asthma. The smoke of the "Charta Potassi Nitratis" (paper impregnated with saltpeter) probably owes a part of its effect Tretinoin Cream Buy to nitrite compounds. Gall-bladder. This is relaxed by nitrites (Lieb and McWhorter, Buy Tretinoin Uk 1915). Intestinal Muscle. Hirschfelder, 1915, finds that the systemic administration of nitrites relaxes the intestinal constriction produced by lead salts. It has been used clinically in lead colic, but with limited success. NITRITES, NITROGLYCERIX, AND OTHER ALKYL NITRATES 379 Digestion. Nitrites cause some slight interference with the digestive ferments (Hale, 1910); but probably not enough to be important. Sodium nitrite is supposed to produce some gastric irritation, by the liberation of nitrous acid this is not sufficient to interfere with its therapeutic use. Urine. The variations produced in the secretion of urine appear to be purely secon- dary, and will depend upon whether the renal arterioles or those of the general circulation Buy Tretinoin Cream 0.1 are relatively more dilated; the former causing an increase, the latter a diminution, of urine. In patients with excessively high blood pressure, the nitrites generally increase, sometimes quite considerably, the excretion of urine, nitrogen, total solids and phenol- sulphonephthalein (Lawrence, 1912). Pressure of the Cerebrospinal Fluid. This is increased by amyl nitrites, presum- ably through the methemoglobin asphyxia (Dixon and Halliburton, 1913 and 1914). The effects on metabolism have been studied by Surveyor, 1906. Temperature. Small doses have no effect on normal temperature, but are antipyretic in fever, by dilating the skin vessels (Jacobj, 1913; Krauss, 1913). Ethyl Nitrite, as "Sweet Spirits of Niter," has been used popularly as a diaphoretic and diuretic. Its action is not very Where Can I Buy Tretinoin Gel energetic. Large doses of nitrites also lower the Buy Tretinoin Cream 0.025 normal temperature by depressing the circulation. Fate. Some 60 to 70 per cent, of the nitrites disappear in the body, their fate being unknown. Rapidity and Duration of Action. This constitutes the principal difference between the members of the group. Amyl nitrite, when inhaled, acts in ten to fifteen seconds, the action disappearing again within seven minutes. Glyceryl trinitrate, ethyl nitrite, and sodium nitrite act in two to Where Can I Buy Tretinoin Cream ten minutes, the action persisting a half to two hours. With erythrol nitrate, the effects appear only after half an hour, and last five hours (Wallace and Ringer, 1909; E. Matthew, 1909; Rzenko.wski, 1909; J. L. Miller, 1910). The following table from Matthew shows Cheap Tretinoin Cream in detail the average relation for oral ad- ministration in man. (The fall in diastolic pressure is about half of that in the systolic pressure; Lawrence, 1912.) Brut; Dosage Fall begins, minutes Maximal fall reached Maximum main- tained
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