CARDIOVASCULAR PHYSIOLOGY III, INTERNATIONAL REVIEW OF PHYSIOLOGY. Vol. 18

Please consult

The Bookshelf

(continued

CARDIOVASCULAR REVIEW Guv roN

1979,

from

product

page 39)

in summary

III, INTERNATIONAL Vol. 18. Edited by A. C. Baltimore, University Park Press,

Brand

the wealth of data at hand. chapters about the microcirculation disagree whether interstitial pressure is subatmospheric, or whether capillary fluid exchange really occurs as Starling envisioned may do so in the brain capillaries but may not in the review

each

helps

that

Functional

chapter

correlation.

presents

us advance

The five chapters

updating

an

to the

accurate

frontiers

the macrocirculation

and

well

methane

and dichlorotetrafluoroethane)with alcohol acid. The Mistometer at the mouthpiece a measured dose of 125 pg of the bronchodilator. Each unit contains about 300 inhalations. INDICATIONS: Isuprel is indicated for the treatment of bronchospasm associated with acute and chronic bronchial asthma, pulmonary emphysema, bronchitis, and bronchiectasis.

THE SPONTANEOUS FROM DESCARTES more, Johns Hopkins

CONTRAINDICATION:

patients

lung.) written

LEOD,

Lorimer

CARE

myocar-

with status asthmaticus and abnormal blood gas tensions, improvement in vital capacity and in blood gas tensions may not accompanyapparent relief of bronchospasm. Facilities for administer-

ing oxygen mixtures and ventilatory assistance are necessary for such patients. Occasional patients have been reported to develop severe paradoxical airway resistance with repeated, excessive use of isoproterenol inhalation preparations. The cause of this refractory state is unknown. It is advisable that in such instances the use of this preparation be discontinued immediately and alternative therapy instituted, since in the reported cases the patients did not respond to of her forms of therapy until the drug was withdrawn. Deaths have been reported following excessive use of isoproterenol inhalation preparations and the

exact

SICK;

THE

and 311

to twelve

M cJames

was noted

in

hours

produce

minimal

or no relief.

REAC lONS: The mist from the Isuprel Mistometer unit contains alcohol which may cause an occasional patient some transient throat irritation. Tachycardia, palpitation, nervousness, nausea, and vomiting may occur from overdosage. Rarely do headache, flushing of the skin, tremor, dizziness, weakness, sweating, precordial distress. or anginaltype pain occur. The inhalation route is usually accompanied by a minimum of side effects. These untoward reactions disappear quickly and do not, as a rule, inconvenience the patient to the extent that the drug must bC discontinued. No cumulative

effects

have been

reported.

ADMINISTRATION: lnhalations may be repeated at not less than 3 to 4 hour intervals as part of a programmed regimen of treatment of obstructive lung disease complicated by a reversible bronchospastic component.Oneapplication from DOSAGE

the

AND

Mistometer

unit

may be regarded

as equivalent

in effectiveness to 5 to 7 operatIons of a hand-bulb nebulizer using a 1 :100 solution. ChIIdren Dosg: Same as adults since children smaller ventilatou , exchange capacity automatically provides proportionally smaller aerosol intake. HOWSUPPUED

oral

nebulizer.

15 ml refill

u. .-J4 .,iiiuJ,k.

writing

arrest

ADVERSE

$15.00.

When

Cardiac

During the course ofover 25 years of use of lsuprel there has been no clinical evidence of teratogenic effects. However, use of any drug in pregnancy, lactation, or in women of childbearing age requires that the potential benefit of the drug be weighed against its possible hazards to the mother or child.

Much useful information is contained in this book, which will appeal to historically minded readers in all the health professions. Two weaknesses are, however, evident. The early chapters seem overly speculative in their effort to show that “naming” existed in various cultures long ago. More important, the description of the modern era is heavily committed to “American” (is, U.S.A.) nursing, with little or no serious attention to other countries, neighboring or distant.

42

is unknown.

instances.

PRECAUTIONS: Epinephrine should not be administered concomitantly with Isuprel, as both drugs are direct cardiac stimulants and their combined effects may induce serious arrhythmia. If desired they may, however, be alternated, provided an interval of at least four hours has elapsed. Isoproterenol should be used with caution in patients with cardiovascular disorders including coronary insufficiency, diabetes, or hyperthyroidism. and in persons sensitive to sympathomimetic amines. A single treatment with the Isuprel Mistometer unit is usually sufficient for controlling isolated attacks of asthma. Any patient who requires more then three aerosol treatments within a 24-hour period should be under the close supervision of his physician. Furthor therapy with the bronchodilator aerosol alone is inadvisable when three to five treatments within six

EMERGENCE OF MODERN Vzass L. BIJLLOUGH. London,

pp,

cause

several

GENERATION CONTROVERSY, TO OPARIN. By Jom FARLEY. BaltiUniversity Press, 1974, 226 pp

By Boz’zwix Ltd., 1979,

in

of isoproterenol

useofan adrenergic aerosol as it may lose its effective-

ness. In patients

think

OF THE

NURSING. Croom Helm

cardiac

Excessive be discouraged

should

of Bethune as a brilliant chest surgeonbook will hold little appeal. But for those who this man’s response to the enervating effect of depression, injustice and disease COmingled, this informal portrait will help. It is informal, it is unsatisfyingly incomplete, yet more bricks are laId. The three authors knew Bethune and they narrate their recollections of him, and Montreal, and the world in the 1930’s. THE

preexisting

WARNINGS:

NOTICES

THE MONTREAL YEARS By W smzi LIaBlE PARI and STANLEY RYERSON. Toronto, & Co., Publishers, 1978, 167 pp, $12.95.

For those who which he was-this seek to understand

with

Use

arrhythmias associated with tachycardia is generally considered contraindicated because the cardiac stimulant effect of the drug may aggravate such disorders.

(It

Fancy presents a compelling thesis to the effect that spontaneous generation-a concept now treated with disdain or dension-had a sound and rational theoretical basis in the 17th through the 19th centuries. Contrary to popular opinion, not all scientists’ belief in spontaneous generation vanished when Pasteur’s studies appeared; indeed, Farley contends that it was only after Oparin’s discoveries that the battle ended. And that was less than a half-century ago. BETHUNE:

cent (w/w) and ascorbic

unit delivers approximately

dial contraction and relaxation, systemic blood flow determinants, vascular capacitance, reflex circulatory control, and cardiogenic hypertension. Clinicians who still think in terms of contractility, preload, and afterload will find that physiologists have advanced far beyond these primitive concepts. Hence, this text aims at teachers and students of physiology. Clinicians will find it a challenging and disconcerting “review” of how much they don’t know. Alan T. Marty, M.D., F.C.C.P. Evansville, Indiana

BOOK

Bronchodllator

33 per

of ultrastructuralcover

USP

DESCRIPTION: Isuprel Mistometer contains 15 ml of Isuprel hydrochloride 1 :400 or 0.25 per cent w/w (2.8 mg per ml) in inert propeflants (dichlorodifluoro-

as to trans.

it.

Hydrochloride,

MISTOMETER Potent

Three

Nevertheless

of

Isoproterenol

It is no use wishing that Starling’s laws of the heart and capillary still apply-they don’t, at least not with the same simplicity with which they were originally formulated. Documenting this and other complexity by critically sifting 1, 160 references, this book dashes the hopes of those looking for oneline, take-home messages about what’s new in circulatory physiology. Instead, the authors’ central structuring conviction-that it is necessary to expose the weak points in all experimental techniques-shows us how to maintain a highly critical attitude

toward

presented

below.

ISUPREL#{174} Hydrochloride

PHYSIOLOGY

OF PHYSIOLOGY. and D. B. YOUNG, 368 pp, 75 illus., $24.95.

complete

information

please

mention

CHEST

Isuprel Mistometer, 15 ml vial with Code No. I 350. Isuprel Mistometer, only. Code No. I 360.

T U

gBREON Park

LABORATORIES Ave., New York,

INC.

N.Y. 10016