Atropine Uses and Side Effects

Atropine Uses and Side Effects Atropine is a competitive antagonist of acetylcholine which binds to the muscarinic receptor in order to inhibit the parasympathetic nervous system. It causes a reversible blockade of the action of acetylcholine and it can be overcome by increasing the concentration of acetylcholine at receptor sites of the effectors organ (e.g. by using the anticholinesterase agents which inhibit the destruction of acetylcholine). Atropine is an alkaloid or an extremely poisonous drug derived from a plant called atropia belladonna, also known as deadly nightshade. Belladonna is Italian word which means beautiful woman. In the Renaissance, woman used the juice of berries of atropia belladonna to dilate pupils as it was perceived as more attractive. Eye Atropine acts in the eye to block the action of acetylcholine, relaxing the cholinergically innervated sphincter muscles of the iris. This results in dilation of the pupil (mydriasis). The cholinergic stimulation of accommodative ciliary muscle of the lens in the eye is also blocked. This results in paralysis of accommodation (cycloplegia). Besides, the elevation of intraocular pressure (IOP) occurs when the anterior chamber is narrow. It will further raise IOP in glaucoma patients because it will obstruct evacuation of aqueous humor by the Schlemm channel. Atropine is thus contraindicated in these patients. Another effect of antimuscarinic drugs is to reduce lacrimal secretion which produces dryness in eyes. Atropine has a slower onset and more prolonged effect in eye as maximum mydriatic effect occurs around 30 to 40 minutes and maximum cycloplegia takes several hours. Mydriasis usually lasts 7 to 12 days and cycloplegia may persist for 14 days or longer. Cardiovascular system The vagus (parasympathetic) nerves that innervate the heart release acetylcholine (ACh) as their primary neurotransmitter to slow the heart rate. ACh binds to muscarinic receptors (M2) that are found on cells comprising the sinoatrial (SA) and atrioventricular (AV) nodes. Atropine has a potent and prolonged effect on the heart muscle. It inhibits the effect of excessive vagal nerve activation on the heart like sinus bradycardia and AV nodal block (delay in the conduction of electrical impulses at the AV node of the heart) by binding to muscarinic receptors in order to prevent ACh from binding to and activating the receptor. Thus, atropine speeds up the heart rate and increases conduction velocity as it very effectively blocks the effects of parasympathetic nerve activity on the heart. There are little effects on blood pressure since most resistance blood vessels do not have cholinergic innervations. Small doses of atropine used may decrease the heart rate, yet, large doses used definitely causes increasing of the heart rate. Central nervous system Atropine has minimal stimulant effects on the central nervous system, especially medullary centers, and a slower, longer-lasting sedative effect on the brain. Low doses atropine may produce mild restlessness and higher doses may produce agitation and hallucination. With still larger doses, stimulation is followed by depression leading to circulatory collapse and respiratory failure after a period of paralysis and coma. Respiratory tract The parasympathetic nervous system regulate bronchomotor tone and secretionary glands of the airway. Since atropine is an antagonist muscarinic drug, it inhibits the secretion of nose, mouth, pharynx and bronchi, and thus dries the mucous membranes of the respiratory tract. And it also relaxes bronchial smooth muscle, producing bronchodilation and decreasing airway resistance. The effect is more important in patients with airway disease like asthma. Gastrointestinal tract Motility and secretions of gastrointestinal tract are declined by atropine. GI smooth muscle motility is affected from the stomach to the colon by decreasing tone, amplitude and frequency of the peristaltic contractions. However, the gastric secretion is only slightly reduced. Genitourinary tract The antimuscarinic action of atropine relaxes smooth muscle of the ureters and bladder wall in order to decrease the normal tone and amplitude of contractions of the ureters and bladder. Atropine has not significant effect on the uterus. Sweat glands Small doses of atropine inhibit the activity of sweat glands, producing hot and dry on the skin. Sweating may be sufficiently depressed and this will elevate the body temperature if using the larger doses in adult or at high environmental temperatures. For the infant or children who are administered large doses or even ordinary doses may cause atropine fever. Atropine is rapidly and well absorbed from the gastrointestinal tract, mucosal membrane, conjunctival membranes, and to some extent through intact skin when given by oral route, solution, ointment or injection route (directly goes into muscle or vein). Pharmacological activity of paranteral administration is 2-3 times greater than enteral route. Distribution Atropine is rapidly cleared from the blood and is distributed throughout the body. It crosses the blood-brain barrier and placenta. Peak plasma concentrations of atropine are reached within 30 minutes. The duration of action of atropine administered by general route would be approximately 4 -6 hours. Metabolism After administration, atropine disappears rapidly from the blood with a half-life of 2 hours. The half-life of atropine is slightly shorter in females than males. Then it is metabolized in the liver by oxidation and conjugation to give inactive metabolites. Excretion The drugs effect on parasympathetic function declines rapidly in all organs except the eye. Effects on the iris and ciliary muscle persist for more than 3 days. About 50% of the dose is excreted within 4 hours and 90% in 24 hours in the urine, about 30 to 50% as unchanged drug. Therapeutic uses As preanaesthetic medicationts Atropine is used to block two effects in particular during anaesthesia, secretions in the respiratory tract in response to the irritating nature of some inhalant anaesthetics, and bradycardia (slowing of the heart) which accompanies most anaesthetics due to the block of muscarinic receptors in the heart. Overall, atropine can reduce the risk of airway obstruction and increase the heart beat when anaesthetic drug is going to be used. Ophthalmological uses Topical atropine is used as a cycloplegic (temporarily paralyze the accommodation) and as a mydriatic (dilate the pupils) for accurate measurement of refractive error in patients. A second use is to prevent synechiae (adhesion) formation in uveitis and iritis. After local administration in the form of ophthalmic solution, the onset of atropine is around 30 minutes and it effects last very long: dilation of pupil can persist several days. Cardiovascular disorders Injection of atropine is used in the treatment of bradycardia (an extremely low heart rate) due to excessive vagal tone on the SA and AV node. It accelerates the cardiac rate by reduction of vagal tone and suppression of reflex bradycardia during arterial hypertension. In addition, atropine is also used primary for sinus node dysfunction (inappropriate atrial rates) and symptomatic second-degree heart block (irregularities in the electrical conduction system of the heart). Respiratory disorders Parenteral atropine can be used as a preoperative medication to suppress bronchiolar secretions when anaesthetics are used. It can be used to treat asthma, chronic bronchitis and chronic obstructive pulmonary disease. Gastrointestinal disorders Atropine is seldom used to treat pepti-ulcer nowadays. Atropine can provide some relief in the treatment of common travelers diarrhea (irritable bowel movement). It is often combined with an opioid antidiarrheal drug in order to discourage abuse of the opioid agent. Urinary disorders Atropine is used to relieve bladder spasm after urologic surgery and for treating urinary urgency caused by minor inflammatory bladder disorder. Hyperhidrosis It is an excessive and profuse perspiration. Atropine can reduce the secretion of sweat glands by inhibiting the Ach binds to the muscarinic receptors. Cholinergic poisoning By blocking the action of ACh, atropine also can be used as an antidote for organophosphate poisoning caused by inhibition of cholinesterase and nerve gases. The atropine serves as an effective blocking agent for the excess ACh but does nothing to reverse the inhibition of cholinesterase. Troops, who are likely to be attacked with chemical weapons often carry autoinjectiors with atropine and obidoxime which can be quickly injected into the thigh. It is the only known antidote for VX nerve gas. Some of the nerve gases attack and destroy acetycholinesterase (an enzyme hydrolyzes ACh to give choline), so the action of acetylcholine becomes prolonged. Therefore, atropine can be used to depress the effect of ACh. Parkinsons disease Atropine is used to treat the symptom of Parkinson such as drooling sweating rigidity and tremors. However, with the wide array of uses and side effects that atropine has, it has been replaced by several other medicines that are more effectively in treating Parkinsons. Adverse effect Atropine and its possible side effect can affect individual people in various ways. The following are some of the side effects that are known to be associated with atropine. Not all the patients using this antimuscarinic drug will experience the same effects. These effects are intensified as the dosages are increased. General chest pain, excessive thirst, weakness, dehydration, feeling hot, injection site reaction, fever. Eye dilation pupil, pupil poorly reactive to light, photophobia, blurred vision, decreased accommodation, decreased contrast sensitivity, decreased visual acuity, dry eyes or dry conjunctiva, acute angle closure glaucoma, irritated eyes, allergic conjunctivitis or blepharoconjunctivitis, heterophoria, red eye due to excess blood supply (hyperaemia). Psychiatric hallucination, mental confusion, agitation, restlessness, anxiety, excitement especially in elderly, fatigue. Central nervous system headache, nervousness, dizziness, drowsiness, muscle twitching, abnormal movement, coma, difficult concentrating, insomnia, amnesia, ataxia (loss of the ability to coordinate muscular movement). Cardiovascular tachycardia (increasing in heartbeat), acute myocardial infarction, cardiac dilation, atrial arrhythmias, paradoxical Bradycardia (if low does Atropine used), asystole (absence of heart beat), increased blood pressure or decreased blood pressure. Respiratory slow respiration, breathing difficulty, pulmonary edema, respiratory failure. Gastrointestinal nausea, abdomen pain, vomiting, decreased bowel sounds, decreased food absorption, delayed gastric emptying, reduction of salivary secretions, loss of taste, bloated feeling. Genitourinary urinary retention, urine urgency, bed-wetting, difficult in micturation. Dermatologic dry mucous membrane, dry warm skin, flushed skin, oral lesion, anhidrosis (absence of sweating), dermatitis, rash, hyperthermia (elevated of body temperature) Overdose and Treatment Widespread paralysis of parasympathetically innervated organs can characterize serious over dosage with atropine. Dry mucous membranes, widely dilated and nonresponsive pupils, tachycardia, fever, hallucination and flushed skin are mental and neurological symptoms which may last 48 hours or longer. Severe intoxication, respiratory depression, blood pressure declines, coma, circulatory collapse and death may occur with over dosage of atropine.

Wind Power: The Cheap, Effective and Reliable Energy Source :: Exploratory Essays Research Papers

Wind Power: The Cheap, Effective and Reliable Energy Source In 1996, the Moores were faced with a disturbing problem. A nearby mine owned by Arch Coal had removed the top of a mountain near the town of Blair to access the coal seam beneath. Most residents chose to move out to avoid the "blast rock," or chunks of rock that came raining down after the massive blasts, and the thick chocking dust that filled the town. The Moores, however, stayed. According to Victoria Moore, the conditions were atrocious. The thick dust upset their son's asthma, and the sound of explosions constantly shook the town. "If you were inside, it interrupted your life. If you were outside, it interrupted your life," said Victoria. "...I couldn't sit on my porch without getting dust on me, I couldn't even walk in my grass. I couldn't get in my car. I couldn't even let my kids go out and play." Finally even the Moores were forced to move out (Buying Blair). This Logan County coal mine is one of hundreds across the United States. The majority of the coal from these mines g oes to run coal-fired power plants that provide electricity to homes across America. The sad part of this story really is that it did not need to happen. Now, with massive advancements in wind energy, coal has become largely outdated and ineffective. Instead of removing the top of the mountain near Blair, a wind farm could have been built. Electricity produced from new wind farms is more economical in dollar terms than electricity produced by new coal-fired power plants. And, if the detrimental environmental side effects and costs of burning coal are factored in, wind power looks even better. Wind power has been around since early civilization. It possibly preceded the use of animals to grind grain, and was invented either in China or Persia. Historians speculate that the windmill technology was then moved to Europe during the crusades. The Dutch were the first major industrial users of windmills. They used them to pump sea water out of the hand made dikes to increase land area. Until the invention of electricity, windmills were mostly used for pumping and grinding grain (Berry). In the US, as electricity became widely used, many people still living too far away from the power lines attempted to use their water pumping windmills to run generators. This failed because the pumping wind mills were used for high torque, low speed applications, which was the opposite of what the electric generators required.

The Realm of African-American Literature

In the realm of African-American literature, poet and writer Langston Hughes is considered one of the primary proponents that gave birth and development to the genre of Harlem Renaissance. This genre, which enjoyed popularity and support in the late 1920s until mid-1930s, was a cultural movement that depicted the life of â€Å"new Negros,† second-generation black Americans and direct descendants of African slaves in America. Harlem Renaissance was known for its incorporation of music, particularly jazz and the blues, in its everyday mirroring of African-American life through literature. Hughes as a major proponent of the Harlem Renaissance movement created literary pieces that sought to express his thoughts and feelings as an African-American artist while at the same time, providing social criticism against the oppressive nature of the predominantly white American society. His literary works, in effect, became channels through which he was able to artistically express his and his fellow African-Americans' sentiments about the realities they face in American society. Among Hughes major works of literature, the short story â€Å"The Blues I'm Playing† depict the dynamics that both white and black Americans experienced during the early 20th century. In this period, there was still evident division and discrimination between white and black Americans, with the black Americans gradually emerging as a major force in American society through their unique culture. â€Å"Blues† effectively illustrated the dynamics among Americans, white and black alike, as they struggled to assert the superiority of their respective race, culture, as well as gender. It is then this paper's main thrust to discuss and analyze â€Å"Blues† in the context of three prevalent themes illustrated in the story: friction between white and black Americans through conflicting views about each group/sector's race, culture, and viewpoints about gender roles. More specifically, the analysis involves a character analysis of Oceola Jones and Mrs Dora Ellsworth, a black American and white American, respectively. The character analysis centers on the presence or absence of change in the life of Oceola as she delved herself deeper into white American culture, and how, despite Mrs Ellsworth's efforts to â€Å"acuulturate† her in white American society, Oceola's roots and inherent ‘black Americanness' prevailed. In the end, Oceola ended up being more triumphant, cultivated, and artistic than her patron Mrs Ellsworth. In illustrating the changes that occurred to Oceola during her process of acculturation to the white American elitist society, it is vital to demonstrate these changes through the themes of conflict between her and Mrs Ellsworth in terms of their respective race, culture, and gender. Noticeable throughout the story was Oceola's seemingly passive attitude towards Mrs Ellsworth pretentious belief that she was, indeed, one of the few people who truly recognize art in its purest form. In contrast to Oceola, Mrs Ellsworth, because of her wealthy stature, took an active role in pursuing and creating what she called â€Å"pure art† through the proteges she had recruited through the years. The first theme of racial conflict emerged when Mrs Ellsworth expressed her traditional and prejudiced views about Oceola and black Americans in general. Though Mrs Ellsworth was congenial towards Oceola, her persistence to cling to society's prejudice against black Americans was immediately demonstrated through her desire to educate Oceola on the principles of pure art, avoiding, the best she can, to acknowledge the fact that she was a black American. Her attitude was reiterated once again in her insistence to acknowledge the genius of one of her Jew proteges, even though she held prejudiced views against Jews. Racial conflict emerges with Mrs Ellsworth apparent showing of her discrimination and prejudice against non-white peoples. Even the very act of recruiting talented young people and finance their education to music and the arts was her way of creating a distinction between her and her young, poor yet talented artists. By financing the education of these talented artists, she directly controls the kind of education they will receive, thereby controlling also the kind of art that they will produce. It is through art, then, that Mrs Ellsworth â€Å"oppress† her proteges like Oceola: by controlling the art that they produce, she holds the power to suppress the protege's desire to pursue his/her art simply because Mrs Ellsworth financed his/her education. Le Blanc's analysis of the racial conflict extant between Oceola and Mrs Ellsworth echoed the dynamics of racial conflict between them. While Mrs Ellsworth actively expressed discrimination and prejudice against people who belong to a particular race other than white American, Oceola's passive response towards her financer's behavior showed that racial conflict was a sublime one. Indeed, as Le Blanc explicated in his study of both women characters in â€Å"Blues† (16). Of course, in her paternalism, Mrs Ellsworth does not quite view Oceola as her equal. Despite the young woman's superior talent, Mrs Ellsworth persistently believes that Oceola lacks not just money, but certain cultural and emotional advantages. The older woman looks down upon her protege's attachment to the physical and sensual world. This sensual world is manifested in jazz, Harlem, and Pete, and all these represent her connection to her black community and culture. Apart from the presence of racial conflict in â€Å"Blues,† a more apparent theme demonstrated was Oceola and Mrs Ellsworth's conflicting views towards art per se. Oceola, exposed with Harlem culture, associated her music and art with the people she had been with, particularly her Harlem community and the church choir she used to teach prior to her being a protege under Mrs Ellsworth financial support. Mrs Ellsworth went through great lengths in order to assert the fact that the art she preferred, the art of elite people liker her, was truly American society's superior culture. But Oceola remained passive to Mrs Ellsworth's active advocacy to promote what she perceived as her â€Å"superior art.† Being the woman's mere protege, she expressed kept her own thoughts and feelings about the issue of â€Å"art for art's sake.† Interestingly, Oceola's honest view of art made more sense than Mrs Ellsworth learned viewpoints about it. At one point, Hughes voiced out through the character of Oceola the real nature and function of art to human society: â€Å"Why did they or anybody argue so much about life or art? Oceola merely lived-and loved it†¦If you wanted to play the piano or paint pictures or write books, go ahead! But why talk so much about it?† This honest view of art in Oceola's terms was the author's way of expressing his disagreement to the dichotomy of superior culture and inferior culture. African-Americans, who gave birth to Harlem culture, as well as contributed significantly to the world of art through the music genres of jazz and the blues, created art based on their experiences as an African-American and with their community. Art for art's sake was a credo not subsisted to in a collectivist culture like African-American's; art was created as a result of the people's interaction with each other, the product of harmonious unity and interconnectedness as peoples of a particular race, with specific traditions and heritage. In Mrs Ellsworth attempt to expose Oceola to Western (European) art in order to ‘forget' her Harlem roots and influence, she only reiterated her perceived superiority. She was a woman who held herself in high-esteem because she believed that she was promoting a noble cause, preserving pure, untainted art-art that merely exists for itself, an art that is autonomous to its creator and devoid of any other human element or influence in it. Mrs Ellsworth's perception of art was a â€Å"separation of art from life† (Bone, 23). In her failure to acknowledge art as the work of an individual and as devoid of any meaning nor influence, Mrs Ellsworth was indirectly destroying the concept of culture altogether, in the same way that she tried to change Oceola by ‘destroying' her strong Harlem roots, influence, and culture. Hughes' villainous portrayal of Mrs Ellsworth showed that an attempt to bridge â€Å"the gap between the two races by means of art† (1062). Unfortunately, Mrs Ellsworth's insistence to hold on to her prejudiced beliefs and perceived superiority became hindrances that led to the eventual deterioration of her relationship with Oceola. The issue of degradation was also reflected in the conflict that Mrs Ellsworth wanted to create as she took in Oceola as her protege (1060). It is inevitable that Mrs Ellsworth should compare herself against Oceola, who, despite the lack of opportunities and privileges in life, was able to create beautiful music without the proper training or education. Mrs Ellsworth tried to assert her superiority by indirectly assuming the persona of Oceola, whom she believed she owns and can control. That is, by supporting Oceola, she indirectly fills in the ‘gaps' in her life. Oceola remained unrestrained and free to express herself through her music; she was also able to produce beautiful art through music. These are the qualities that Mrs Ellsworth sought to have, and believed she had, by financially supporting Oceola. Thus, gender conflict emerged with the â€Å"contrasting meaning and significance and music to each woman† (Brent, 11). As Brent discussed in her analysis of Mrs Ellsworth and Oceola, the former's art was an â€Å"abstraction,† ‘rising above the banalities of everyday life.' Oceola's music, however, â€Å"music is a living, breathing practice which is fully integrated with her personal, everyday experiences.† These distinctions between the two women reflect the kind of society and reality they lived in: Mrs Ellsworth lived not for anyone nor herself, but on art alone. Oceola, meanwhile, preferred to liver her life not only with Pete, but with her Harlem community as well. Characterizing white and black American differences and conflict through the two women characters provided the in-depth look that Hughes wanted to show to his readers. It is through the characters of Oceola and Mrs Ellsworth that readers were able to witness the persistence and pervasiveness of prejudice and discrimination, regardless of one's gender or socio-economic status in life.

Human Resources Information System ( Hrms ) Human Resource...

HRIS, which is also known as Human Resources Information System or (HRMS) Human Resource Management System, is actually a hybrid of human resources and information technology by HR software. This allows HR activities and processes to be carried out electronically. Human Resources Information System is a system that can keep track of all your employees and information to keep. It is, as a rule in a database or, more generally carried out in a series of connected databases. These include the name and contact information and some or all of the following options from the employee: Department, Job title, Grade, Salary, Salary history, Position history, Supervisor, Training completed, Special qualifications, Ethnicity, Date of birth,†¦show more content†¦Larger companies tend to systems must have an acceptable level of customization †¢ Advantages of HRIS †¢ A HRIS can reduce the amount of paperwork and manual registration †¢ It retrieves information quickly and accurately †¢ It provides a quick analysis of HR issues Most HRIS Contain: †¢ Personal history - name, date of birth, gender †¢ Work history - the salary, the first day worked, employment status, position in the organization, assessment of data and hopefully, pre-organizational information †¢ completed training and development, both internally and externally †¢ Career plans including mobility †¢ Skills inventory - skills, training, skills, looking for transferable skills Staff Induction Policy POLICY STATEMENT 1. GENERAL AL-CHARAG trusts that every single new worker MUST be given auspicious prompting preparing. This preparation is viewed as an imperative piece of staff enlistment and coordination into the workplace. This arrangement, related strategies and rules characterize the Organization s dedication to guarantee that all staff is upheld amid the time of impelling, to the formal of the representative and Organization alike.. 2. AIM AL-CHARAG trusts that every single new worker MUST be given auspicious prompting preparing. This preparation is viewed as an imperative piece of staff enlistment and coordination into the workplace. This arrangement, related strategies and rules characterize the Organization s