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Thread: very, very good news...............

  1. #105
    Tropical Fish Enthusiast jimscott's Avatar
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    How are you going to figure out before hand which so=called law abiding citizens are going to be responsible and which are going to shoot themselves in the foot or shoot their siblings, spouses, wives, family pet, parents, classmates or actually scare a real criminal into shooting them?

  2. #106
    rattler's Avatar
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    how do you know which person who gets a drivers license or buys a car isnt going to get drunk and run over some 5 year old crossing the street? dont know about you but my understanding everyone is innocent until they do something that breaks the law.......the above is way more common than a shooting
    cervid serial killer
    Know guns, know peace, know safety. No guns, no peace, no safety
    I didn't get stimulated but he kept his promise on change, that's about all I got left!
    http://www.wolfpointherald.com/--http://www.safety-brite.net/

  3. #107
    rattler's Avatar
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    jim your really starting to torque me off....i give you facts and you give one editorial that tells you in it that it made up the numbers....the other has no facts whatsoeve and holds no more weight than a two year old pounding on a key board cause it has no facts to back it up........

    you say we are to stupid to have guns, well than we are to stupid to have cars, we are to stupid to have swimming pools ponds and trampolines(swimming pools, ponds and trampolines are more of a hazard than a gun, ask your insurance company), to stupid to be in charge of our own medication and should be forced to go to the hospital every day to get our meds....at the moment im on a couple of pills that can stop my heart and fry my kidneys and liver with a single overdose or if one of the girls decided to grab a bottle and take a bunch yet your not screaming to take all medication away from houses cause some child may find them and take them....you say we are to stupid to have guns, do you know how freaking idiotic that argument is?
    cervid serial killer
    Know guns, know peace, know safety. No guns, no peace, no safety
    I didn't get stimulated but he kept his promise on change, that's about all I got left!
    http://www.wolfpointherald.com/--http://www.safety-brite.net/

  4. #108
    Cardiac Nurse JB_OrchidGuy's Avatar
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    Jim I challenge you to look up the medication Digoxin. MANY MANY MANY people are on this drug. This drug is so dangerous that the pts have to have levels drawn in their systems. If a child were to take that medication they would go into dig toxicity.

    No offense to anyone personally, but i cannot stand the big brother mentality. I have to agree with Rattler here too. People are considered innocent till proven guilty and by always focusing on the few bad things that have happened your doing two thing. Your focusing on the negative instead of the positive and your also accusing the majority of the people who KNOW about guns and are educated on how to clean and use them of being incompetent of doing that.

    I know a moron who forgot he had a bullet loaded in his gun and went to uncock it on his led and shot himself. He was an idiot too. Broke all kinds of safety rules. That is why education is so important. Think about it. If you don't knwo about something your more likely to hurt yourself.
    JB
    Friend me on facebook with JB_orchidguy@yahoo.com.
    Growlist Updated 05/08/13

  5. #109
    Tropical Fish Enthusiast jimscott's Avatar
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    Okay, I'll bite:

    Digoxin
    From Wikipedia, the free encyclopedia
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    Digoxin
    Systematic (IUPAC) name
    4-[(3S,5R,8R,9S,10S,12R,13S,14S)-3-
    [(2S,4S,5R,6R)-5-[(2S,4S,5R,6R)-5-
    [(2S,4S,5R,6R)-4,5-dihydroxy-6-methyl-
    oxan-2-yl]oxy-4-hydroxy-6-methyl-oxan-
    2-yl]oxy-4-hydroxy-6-methyl-oxan-2-yl]
    oxy-12,14-dihydroxy-10,13-dimethyl-1,
    2,3,4,5,6,7,8,9,11,12,15,16,17-tetra
    decahydrocyclopenta[a]phenanthren-
    17-yl]-5H-furan-2-one
    Identifiers
    CAS number 20830-75-5
    ATC code C01AA02 C01AA05 C01AA08
    PubChem 30322
    DrugBank APRD00098
    Chemical data
    Formula C41H64O14
    Mol. mass 780.938 g/mol
    Physical data
    Melt. point 249.3 °C (481 °F)
    Solubility in water 64.8 mg/mL (20 °C)
    Pharmacokinetic data
    Bioavailability 60 to 80% (Oral)
    Protein binding 25%
    Metabolism Hepatic (16%)
    Half life 36 to 48 hours
    (patients with normal renal function)
    3.5 to 5 days
    (patients with impaired renal function)
    Excretion Renal
    Therapeutic considerations
    Pregnancy cat. A (Au), C (U.S.)

    Legal status S4 (Au), POM (UK), ℞-only (U.S.)

    Routes Oral, Intravenous
    Digoxin (INN) (IPA: /dɨˈdʒɒksɨn/[1]), also known as Digitalis, is a purified cardiac glycoside extracted from the foxglove plant, Digitalis lanata.[2] Its corresponding aglycone is digoxigenin. Digoxin is widely used in the treatment of various heart conditions, namely atrial fibrillation, atrial flutter and sometimes heart failure that cannot be controlled by other medication. Digoxin preparations are commonly marketed under the trade names Lanoxin, Digitek, and Lanoxicaps. It is also available as a 0.05 mg/mL oral solution and 0.25 mg/mL or 0.5 mg/mL injectible solution.

    Contents [hide]
    1 Actions
    2 Mechanism of action
    3 Clinical use
    4 Adverse effects
    5 Other information
    6 In the news
    7 See also
    8 References
    9 Further reading



    [edit] Actions
    The main pharmacological effect of digoxin are on the heart. Extracardiac effects are responsible for many of the adverse effects (see below).

    Its main cardiac effects are

    A decrease of conduction of electrical impulses through the AV node, making it a commonly used antiarrhythmic agent in controlling the heart rate during atrial fibrillation or atrial flutter.
    An increase of force of contraction via inhibition of the Na+/K+ ATPase pump (see below).

    [edit] Mechanism of action
    Digoxin binds to a site on the extracellular aspect of the α-subunit of the Na+/K+ ATPase pump in the membranes of heart cells (myocytes). This causes an increase in the level of sodium ions in the myocytes, which then leads to a rise in the level of calcium ions. The proposed mechanism is the following: inhibition of the Na+/K+ pump leads to increased intracellular Na+ levels, which in turn slows down the extrusion of Ca2+ by the Na+/Ca2+ exchange pump that relies on the high Na+ gradient. This effect causes an increase in the length of Phase 4 and Phase 0 of the cardiac action potential, which when combined with the effects of Digoxin on the parasympathetic nervous system, lead to a decrease in heart rate. Increased amounts of Ca2+ are then stored in the sarcoplasmic reticulum and released by each action potential, which is unchanged by digoxin. This leads to increased contractility of the heart. This is a different mechanism from that of catecholamines.

    Digoxin also increases vagal activity via its action on the central nervous system, thus decreasing the conduction of electrical impulses through the AV node. This is important for its clinical use in different arrhythmias (see below).


    [edit] Clinical use
    Today, the most common indications for digoxin are probably atrial fibrillation and atrial flutter with rapid ventricular response. High ventricular rate leads to insufficient diastolic filling time. By slowing down the conduction in the AV node and increasing its refractory period, digoxin can reduce the ventricular rate. The arrhythmia itself is not affected, but the pumping function of the heart improves owing to improved filling.

    The use of digoxin in heart problems during sinus rhythm was once standard, but is now controversial. In theory the increased force of contraction should lead to improved pumping function of the heart, but its effect on prognosis is disputable and other effective treatments are now available. Digoxin is no longer the first choice for congestive heart failure, but can still be useful in patients who remain symptomatic despite proper diuretic and ACE inhibitor treatment. It has fallen out of favor because it was proven to be ineffective at decreasing morbidity and mortality in congestive heart failure. It is shown to increase quality of life, however.

    Digoxin is usually given by mouth, but can also be given by IV injection in urgent situations (the IV injection should be slow, heart rhythm should be monitored). The half life is about 36 hours, digoxin is given once daily, usually in 125 μg or 250 μg dosing. In patients with decreased kidney function the half life is considerably longer, calling for a reduction in dosing or a switch to a different glycoside (such as digitoxin which although having a much longer elimination half-life of around 7 days, is mainly eliminated from the body via the liver, and thus not affected by changes in renal function).

    Effective plasma levels are fairly well defined, 1-2.6 nmol/l. In suspected toxicity or ineffectiveness, digoxin levels should be monitored. Plasma potassium levels also need to be closely controlled (see side effects below).


    [edit] Adverse effects
    The occurrence of adverse drug reactions is common, owing to its narrow therapeutic index (the margin between effectiveness and toxicity). Adverse effects are concentration-dependent, and are rare when plasma digoxin concentration is <0.8 μg/L.[3] They are also more common in patients with low potassium levels (hypokalemia), since digoxin normally competes with K+ ions for the same binding site on the Na+/K+ ATPase pump.

    Common adverse effects (≥1% of patients) include: loss of appetite, nausea, vomiting, diarrhea, blurred vision, visual disturbances (yellow-green halos), confusion, drowsiness, dizziness, nightmares, agitation, and/or depression. Less frequent adverse effects (0.1%–1%) include: acute psychosis, delirium, amnesia, shortened QRS complex, atrial or ventricular extrasystoles, paroxysmal atrial tachycardia with AV block, ventricular tachycardia or fibrillation, heart block[3] but when systematically sought, the evidence for this is equivocal.[4] The pharmacological actions of digoxin usually results in electrocardiogram (ECG) changes, including ST depression or T wave inversion, which do not indicate toxicity. PR interval prolongation, however, may be a sign of digoxin toxicity. Additionally, increased intracellular Ca2+ may cause a type of arrhythmia called bigeminy (coupled beats), eventually ventricular tachycardia or fibrillation. The combination of increased (atrial) arrhythmogenesis and inhibited atrio-ventricular conduction (for example paroxysmal atrial tachycardia with A-V block - so-called "PAT with block") is said to be pathognomonic (i.e. diagnostic) of digoxin toxicity.[5]

    An often described but rarely seen adverse effect of digoxin is a disturbance of colour vision (mostly yellow and green colour) called xanthopsia. It has been proposed that the painter Vincent Van Gogh's "Yellow Period" may have somehow been influenced by concurrent digitalis therapy.

    Digoxin has an interaction with the antimalarial medication Hydroxychloroquine.[specify]


    [edit] Other information
    Digoxin has potentially dangerous interaction with verapamil,[6] amiodarone, erythromycin, and epinephrine (as would be injected with a local anesthetic).

    In overdose, the usual supportive measures are needed. If arrhythmias prove troublesome, or malignant hyperkalaemia occurs (inexorably rising potassium level due to paralysis of the cell membrane bound ATPase-dependent Na/K pumps), the specific antidote is antidigoxin (antibody fragments against digoxin, trade names of Digibind and Digifab).[7] Toxicity can also be treated with higher than normal doses of potassium. Digoxin is not removed by hemo or peritoneal dialysis with enough effectiveness to treat toxicity.

    Researchers at Yale University looked at data from an earlier study to see if digoxin affected men and women differently. That study determined that digoxin, which has been used for centuries and makes the heart contract more forcefully, did not reduce deaths overall but did result in less hospitalization.

    Researcher Dr. Harlan Krumholz said they were surprised to find that women in the study who took digoxin died more frequently (33%) than women who took a dummy pill (29%). They calculated that digoxin increased the risk of death in women by 23%. There was no difference in the death rate for men in the study.


    [edit] In the news
    Charles Cullen admitted in 2003 to killing as many as 40 hospital patients with overdoses of heart medication—usually digoxin—at hospitals in New Jersey and Pennsylvania over his 16-year career as a nurse. On March 10, 2006 he was sentenced to 18 consecutive life sentences and is not eligible for parole for 397 years.[8]
    Following the April 25, 2008 recall of Digitek (digoxin); the law firm of Levin, Fishbein, Sedran & Berman filed a class action lawsuit against the Icelandic generic drug maker Actavis. The plaintiffs include a woman who alleges she experienced “changed cardiac symptom episodes of nausea, and dizziness” from her Digitek consumption.
    On December 4, 1986, a 2-year old girl got into her great grandmother's Digoxin, and developed life-threatening complications. On November 13, 1990, the story was aired on Rescue 911 (see video).
    On April 25, 2008 the FDA issued a press release alerting the public to a Class I recall of digoxin made by Digitek. These digoxin tablets had been produced at double-strength for months, causing many patients to overdose from digoxin toxicity.
    On December 16, 1982, episode number 52 in season 3 of Magnum P.I., Heal Thyself, aired. In it, Dr. Karen Harmon is accused of killing three of her patients by giving them overdoses of digoxin.

    [edit] See also
    Acetyldigoxin
    Cardiac glycoside
    Digitalis
    Digitoxin
    Digoxigenin

    [edit] References
    ^ OED
    ^ A. Hollman (1996). "Digoxin comes from Digitalis lanata" (letter). British Medical Journal 312 (7035): 912.
    ^ a b Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006. ISBN 0-9757919-2-3
    ^ Thompson, D.F.; Carter, J.R. (1993). "Drug-induced gynecomastia". Pharmacotherapy 13 (1): 37–45. PMID 8094898.
    ^ Doering, W.; Konig, E.; Sturm, W. (1977). "Digitalis intoxication: specifity and significance of cardiac and extracardiac symptoms. part I: Patients with digitalis-induced arrhythmias (author's transl)". Z Kardiol 66 (3): 121–8. PMID 857452.
    ^ Kaplanski, J.; Weinhouse, E.; Topaz, M.; Genchik, G. (1983). "Verapamil and digoxin: interactions in the rat". Res Commun Chem Pathol Pharmacol 42 (3): 377–88. PMID 6665298.
    ^ Flanagan, R.J.; Jones, A.L. (2004). "Fab Antibody Fragments: Some Applications in Clinical Toxicology" (full text (subscription)). Drug Safety 27 (14): 1115–1133. doi:10.2165/00002018-200427140-00004. PMID 15554746.
    ^ "Victims' families set to confront killer", USA Today, 2006-01-01.

    [edit] Further reading
    Rang HP, Dale MM, Ritter JM, Moore PK. Pharmacology, 5th edition. Edinburgh: Churchill Livingstone; 2003. ISBN 0-443-07145-4
    Summary of product characteristics, Digoxin 0,125 mg, Zentiva a.s.
    Lüllmann. Pharmakologie und Toxikologie (15th edition), Georg Thieme Verlag, 2003. ISBN 3-13-368515-5

  6. #110
    rattler's Avatar
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    on your editorial:


    Everyone has a gun. What will this mean? In the minds of the other side — those who found the Supreme Court's decision disastrous — it means bullets flying everywhere.
    actually all the Heller desision did was make DC play by the same rules as say Montana or Florida as far as what goes on in a persons home....the Heller desision doesnt change any current laws in states such as Montana or Florida or even Virginia one bit...it just stated that citizens of DC get to own handguns, keep them in their house(Heller did nothing to change any rules about a handgun outside of your house in DC) and be able to use them for self defence......bullets arent flying everywhere in Florida, and Floridas are actually more lax than what the Heller ruling says DC has to allow its citizens to do.....

    Let's start with that idea. Everyone has a gun. What will this mean? In the minds of some people — those who think last week's Supreme Court decision protecting gun ownership was wonderful — it means if you come after me now, I can take you down. If you try to take what's mine, I can defend myself — by shooting you dead, if need be.
    actually like in any other state, you get in an arguement with a person, pull out a gun and shoot them with no real reason to fear for their life, your going to jail for homicide, all Heller did was make it so a person can defend themself with a handgun if someone breaks INTO THEIR OWN HOME....the Heller ruling did nothing to say everyone can carry a gun in their pocket around DC, other than the part of the ruling that states that the 2nd amendment applies to individuals and not the militia, the rest of it has to do with what a person must be allowed to do in their home.....even in Montana, Texas and Florida where it is considered legal to kill a person that breaks into your house, as well as making it so the family of that individual can not bring a civil suit against you....such incidences are fully investigated by the police and if it is thought that the event was staged to cover up a murder....your likely going to jail and maybe the electric chair.....the cops and county/distric attorney have to rule it a good shoot for you not to go to jail....
    cervid serial killer
    Know guns, know peace, know safety. No guns, no peace, no safety
    I didn't get stimulated but he kept his promise on change, that's about all I got left!
    http://www.wolfpointherald.com/--http://www.safety-brite.net/

  7. #111

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    you say we are to stupid to have guns, well than we are to stupid to have cars, we are to stupid to have swimming pools ponds and trampolines(swimming pools, ponds and trampolines are more of a hazard than a gun, ask your insurance company), to stupid to be in charge of our own medication and should be forced to go to the hospital every day to get our meds....at the moment im on a couple of pills that can stop my heart and fry my kidneys and liver with a single overdose or if one of the girls decided to grab a bottle and take a bunch yet your not screaming to take all medication away from houses cause some child may find them and take them....you say we are to stupid to have guns, do you know how freaking idiotic that argument is?

    The purpose of cars is to get from one place to another, or at least for enjoyment. The purpose of swimming pools is to be able to get exercise, or at least to have fun. The purpose of trampolines is to get exercise, or at least for recreation. The purpose of medication is to improve health, or at least to slow the deterioration of health due to illness. The purpose of guns is to kill, or at least to injure. That's the main difference. That's why it should be illegal to possess guns.

  8. #112
    rattler's Avatar
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    most of my rifles are used purely for recreation and have never been used on something with a heart beat.......trampolines are inherently more dangerous than guns for a homeowner which is why my home owners insurance doesnt care if i have a rifle in the house but will drop me if i have a trampoline in the yard.......which means after crunching the numbers my homeowners insurance is not concerned about my daughters grabbing a rifle and accidentally shooting her friend in my house but they are concerned about my daughters inviting their friends over and jumping on the trampoline, falling off and getting hurt or killed.....

    accidental poisonings from meds is far more common than accidental shootings in the home............
    cervid serial killer
    Know guns, know peace, know safety. No guns, no peace, no safety
    I didn't get stimulated but he kept his promise on change, that's about all I got left!
    http://www.wolfpointherald.com/--http://www.safety-brite.net/

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