The goal of reducing peripheral circulation is to increase coronary and cerebral perfusion pressures and therefore increase oxygen exchange at the cellular level. While epinephrine does increase aortic, cerebral, and carotid circulation pressure, it lowers carotid blood flow and end-tidal CO2 or ETCO2 levels. It appears that epinephrine may improve macrocirculation at the expense of the capillary beds where perfusion takes place. History
Extracts of the adrenal gland were first obtained by Polish physiologist Napoleon Cybulski in 1895. These extracts, which he called nadnerczyna, contained adrenaline and other catecholamines. American ophthalmologist William H. Bates discovered adrenalines usage for eye surgeries prior to 20 April 1896. Japanese chemist Jōkichi Takamine and his assistant Keizo Uenaka independently discovered adrenaline in 1900. In 1901, Takamine successfully isolated and purified the hormone from the adrenal glands of sheep and oxen. Adrenaline was first synthesized in the laboratory by Friedrich Stolz and Henry Drysdale Dakin, independently, in 1904. Society and culture
Brand names
Common brand names include Asthmanefrin, Micronefrin, Nephron, VapoNefrin, and Primatene Mist. Delivery forms
Epinephrine is available in an autoinjector delivery system. There is an epinephrine metered-dose inhaler sold over the counter in the United States to relieve bronchial asthma. It was introduced in 1963 by Armstrong Pharmaceuticals.A common concentration for epinephrine is 2.25% w/v epinephrine in solution, which contains 22.5 mg/mL, while a 1% solution is typically used for aerosolization. Adults: 0.5–0.75 ml of a 2.25% solution in 2.0 ml normal saline. Pediatrics: 0.25–0.75 ml of a 2.25% solution in 2.0 ml normal saline. References
External links
"Epinephrine". Drug Information Portal.
Tuberculosis verrucosa cutis is a rash of small, red papular nodules in the skin that may appear 2–4 weeks after inoculation by Mycobacterium tuberculosis in a previously infected and immunocompetent individual. It is also known as "prosectors wart" because it was a common occupational disease of prosectors, the preparers of dissections and autopsies. Reinfection by tuberculosis via the skin, therefore, can result from accidental exposure to human tuberculous tissue in physicians, pathologists and laboratory workers; or to tissues of other infected animals, in veterinarians, butchers, etc. TVC is one of the many forms of cutaneous tuberculosis, such as the tuberculous chancre (which results from the cutaneous inoculation in immunocompetent people without previous exposure), and the reactivation cutaneous tuberculosis (the most common form, which appears in previously infected patients). Other forms of cutaneous tuberculosis are: lupus vulgaris, scrofuloderma, lichen scrofulosorum, erythema induratum and the papulonecrotic tuberculid. It was described by René Laennec in 1826. Signs and symptoms
Because the TVCs entry point usually is the site of a trauma, wound or puncture in the skin (during an autopsy, for example), the most frequent site for the wart are the hands. But it can occur anywhere in the skin, such as in the sole of the feet, in the anus, and, in the case of children from developing countries, in the buttocks and knees.