Dosage

“ It is therefore much wiser to direct immediate efforts to the securing and maintaining of health, reaction and tone—irrespective of the amount of drug required—until there is time and opportunity for the undertaking of competent withdrawal—a stage of handling and treatment concerning whose physical and clinical phenomena and manifestations and dangers too few are educated to and familiar with.
In regulating the administration of drug as to size and intervals of dosage—amounts should be sufficient to allow the patient long intervals between doses. ”

“ A white, odorless powder with a sweet, metallic taste. Soluble in water (1:12) and in glycerin (1:15) ; insoluble in alcohol.
Action and Uses: Nauseant expectorant and emetic. Emetic doses and the prolonged use of expectorant doses are somewhat dangerous. Externally, a pustulant.
Dosage: Expectorant, 0.005 Gm. or 1/12 grain (U.S.P.) , in solution. It is best to begin with small doses (0.001 Gm. or 1/60 grain) which may be repeated hourly, care being taken to avoid too great depression. ”

“ An American physician, who was conversant with their practice, assured me that in one of their prescriptions they had one hundred and seventy-five ingredients, to be taken in three doses, and they are sure enough doses, as the common way of paying a doctor is by the potful thirty to sixty cents per pot, each holding from two quarts to one gallon, and a dose is as much as a man can swallow at one time, frequently a quart. ”

“ THE DOSES OF MEDICINE. Generally in the following prescriptions the ordinary dose for an adult is stated. The young require a smaller dose than older persons, or those at maturity; and the very aged cannot bear as large doses as the middle aged. The following is designed to exhibit the dose proportioned to the age; the dose for a person of middle age being one drachm:
There are some medicines however which require to be given to children in much larger proportioned doses than those stated above. For example, a child of three years might require half as much castor oil for a dose as an adult. ”

“ If half a grain of a certain drug is the normal dose for an adult, the proper dose of the same drug for a small infant, say, less than a year old, may be about one twenty-fifth of the adult dose. How small, in proportion, should then be the dose given to a cell a billion times as small as the infant? ”

“ The usual method pursued by medical men in calculating the doses of medicine for children is to average the dose in proportion to their approximate weight or to figure out a dose upon the assumption that at 12 years of age half of an adult dose will be about right. ”

“ I am well satisfied that the regulation of the dose of a medicine is even more important than it is usually supposed to be. Substances perfectly inert and useless in one dose may prove in another active and valuable. Hence may be explained the great efficacy of many mineral waters, whilst the ingredients which impart activity to them are found comparatively inert, when they become the elements of an artificial combination; and hence probably the failure of many alterative medicines, when no other rational cause can be assigned for it. ”

“ Few persons who have not been specially educated in science have ever learned this great lesson of Materia Medica, "that everything depends on the size of the dose." It is not merely that a small dose will often produce effects differing in degree from those produced by a large dose ”

“ Then the dose of the medicine is to be lessened. It is administered with most advantage in the form of a pill. A quarter of a grain is the least dose which need be used in the beginning for an adult; and it may be given twice or thrice in the day. The dose is to be increased according to its effects: and it is stated by M. Magendie, that some persons have borne the augmented quantity of thirty grains in the day: but from four to six grains per diem, is the maximum amount usually required. ”

“ In apportioning the dose of a very active medicine, it is of the greatest moment to determine the relative degrees of power between the system and the remedy, and to know to what extent the latter is likely to be carried, consonantly with the powers of life to resist it; thus, after a patient has been exhausted by protracted and severe suffering and watching, a dose, different to one at the commencement of the disease is requisite. ”

“ The ordinary dose when used as medicine is from 1⁄4 to 1⁄2 grain, and is very unstable and treacherous in its effects. Some patients will tolerate large doses while in others small doses produce unpleasant effects. Deaths are recorded from the use of 1-7 to 1 grain. ”

“ We ought to have noticed that each medicinal dose contains a great number of atoms which are perfectly inactive, in consequence of their being shut up in the interior of the molecules, and not brought into contact with our organs; it therefore follows that every time we by any means whatever, come to divide these molecules into smaller corpuscles, and thus augment their whole surface, the energy of the dose will so increase that the smallest part will become capable of exercising an influence, if not superior, at any rate equal to that of the entire dose in its primitive condition. ”

“ The Discussion on Poisons. would have taken a centigramme; at the end of twenty days, increasing another milligramme, you would have taken three hundred centigram-t mes; that is to say, a dose which you would support without inconvenience, and which would be very dangerous for any other person who had not taken the same precautions as yourself. ”

“ Professor Muff related a very extraordinary and convincing proof of the wonderful efficacy of the system of infinitesimal doses, which the section were doubtless aware was based upon the theory that the very minutest amount of any given drug, properly dispersed through the human frame, would be productive of precisely the same result as a very large dose administered in the usual manner. Thus, the fortieth part of a grain of calomel was supposed to be equal to a five-grain calomel pill, and so on in proportion throughout the whole range of medicine. ”

“ The Doses of Medicinal Substances are specific with respect to each, and can therefore be only learnt from experience; the young and eager practitioner, however, is too often betrayed into the error of supposing that the powers of a remedy always increase in an equal ratio with its dose, whereas The dose alone very often determines its specific action. ”

“ The majority omit chemical formulae. An alphabetical arrangement is followed in all. The maximum doses of preparations are given in several pharmacopoeias and the physician must indicate on his prescription, if he exceeds this limit, by using a note of exclamation after each article, that he purposely intends such a dose to be employed. ”

“ It defendeth every body from all hurtfull Causes and Diseases, and admits not the least venomous Air, but if the Dose be augmented, it doth also display its vertues, by a visible operation, and drives out by Sweat and Urine, or Spittle, sometimes upwards and downwards, every noxious thing, and operateth even as you will have it, according as your dose is either more or less, and as your Disease needeth. A dose that is very small and void of any visible operation, is wont to heal many Diseases, yea and the greatest part of them. ”

“ The operation of the law which has thus formed the first object of this inquiry, will be found, like every other, to have a natural and well defined limit; it is easy to perceive that by multiplying the number of ingredients too far, we shall either so increase the quantity and bulk of the medicine as to render it nauseous and cumbersome, or so reduce the dose of each constituent as to fritter away the force and energy of the combination. ”

“ If the patient be stronger than usual, or the symptoms very urgent, this dose may be given once in eight hours; and on the contrary in many instances half an ounce at a time will be quite sufficient. About thirty grains of the powder or eight ounces of the infusion, may generally be taken before the nausea commences.
The ingenuity of man has ever been fond of exerting itself to vary the forms and combinations of medicines. ”

“ The Solution of Iron Subsulphate (Monsel’s solution) is used only as a hemostatic, and Iron Hydrate with Magnesia as an antidote in arsenic-poisoning. The dose of the latter is a tablespoonful every ten to fifteen minutes.
Lead.—The preparations of lead are used internally and externally as sedatives and astringents. Lead Acetate (Plumbi Acetas) is employed internally in diarrhea. The dose is from 1 to 3 grains (0.06-0.2 gm.) , in pill form. [Pg 33]
The Solution of Lead Subacetate (Liquor Plumbi Subacetatis) is employed externally. ”

“ In the preparation of a Compound Powder, i.e., a powder containing two or more ingredients, it is of the greatest importance that they should be uniformly and thoroughly incorporated, else it is evident that a small portion of it, such as is usually prescribed as a dose, may contain an excess of one ingredient—it may be an active or dangerous one, and operate powerfully—whilst the next dose may be comparatively inert. ”

“ Calibrate daily with at least six working standards over the range 0.01 to 3 mg analyte per sample. a. Add known amounts of calibration stock solution, or a dilution thereof, in n-hexane to 95% ethanol in 10-mL volumetric flasks and dilute to the mark. b. Analyze together with samples and blanks (steps 11 and 12) . c. Prepare calibration graph (peak area or height vs. mg analyte) . Determine desorption efficiency (DE) at least once for each lot of silica gel used for sampling in the calibration range. ”

“ The degree of solubility possessed by a medicinal substance may perhaps be regarded by some practitioners as a circumstance of but little or no importance; it will however appear in many cases that it not only influences the activity of a remedy, but, like its dose, goes far to determine its specific operation; indeed, where a medicine is not, in itself, very soluble, the increase of its solubility by any chemical expedient, is tantamount to an increase of its dose. ”

“ Perhaps I was not wise in giving myself so large an injection on a day when I was overheated and below par otherwise because of the strain I have been under in handling this case. However that may be, the added centigram produced so much more on top of the five centigrams previously taken that for a time I had reason to fear that that additional centigram was just the amount needed to bring my experiments to a permanent close. ”

“ The quantity or dose is the most important of these; many substances which are deadly in large doses being exceedingly useful as remedies in small quantities; such are prussic acid, opium, digitalis, arsenic, &c. Then again, the mechanical and chemical state of aggregation are all-important; a solid being usually much less active than a fluid or a gas, and a pure substance much more active than one mixed with insoluble materials. ”

“ Prescribers ought not to forget that the action of medicines is not simply proportioned to the amount, but that each remedy has a dose below which it either produces no effect or one contrary to that which we desire it to produce. ”

“ One-hundredth of a grain of nitro-glycerine is a sufficient dose. Taking an average man's weight as 150 pounds, it results that his body is appreciably affected in its state by the 115-millionth part of its weight of this nitrogenous compound. ”

“ The process of dilution is carried on in the same way as the attenuation of the powder was done; each successive dilution with alcohol reducing the medicine to a hundredth part of the quantity of that which preceded it. In this way the dilution of the original millionth of a grain of medicine contained in the grain of powder operated on is carried successively to the billionth, trillionth, quadrillionth, quintillionth, and very often much higher fractional divisions. ”

“ In fact the Unguentum Armarium and Sympathetic Powder resemble some more recent prescriptions; the latter consisting in an infinite dilution of the common dose in which remedies are given, and the two former in an infinite dilution of the common distance at which they are applied.
Whether philosophers, and more especially metaphysicians, have any peculiar tendency to dabble in drugs and dose themselves with physic, is a question which might suggest itself to the reader of their biographies. ”

“ A man aged thirty-three, a heavy drinker, to whom veronal had been prescribed, in fifteen-grain doses, with chloral hydrate and bromide of ammonium, had gradually increased the dose from 15 to 30 grains, or even 60 grains. ”

“ His view is that the pharmacopaeal doses are in nearly every instance much too low. Excessive timidity has cut down the dose until it has ceased to produce a real effect upon the disease.
Medical men, according to his view, have been afraid of producing a poisonous effect with their drugs. ”

“ The dose, as a general rule, at the commencement is a teaspoonful three times daily, gradually increased as the stomach is able to bear it. It is rarely requisite to exceed a table-spoonful twice or thrice daily; large quantities either derange the stomach and liver, or pass off unabsorbed by the bowels. ”

“ The ordinary mode of preparing a decoction is to use one ounce of the plant, root, bark, flower, or substance to a pint of water. The dose internally varies from a tablespoonful to one ounce.
ALTERATIVES.
Alteratives are a class of medicines which in some inexplicable manner, gradually change certain morbid actions of the system, and establish a healthy condition instead. They stimulate the vital processes to renewed activity, and arouse the excretory organs to remove matter which ought to be eliminated. ”