156 DEPRESSANTS TO CENTRAL NERVOUS SYSTEM 



a loss or depression of the sexual reflex and usually that of the 

 bladder. 



Respiratory System. Full doses slow and depress the respi- 

 rations, owing to a slight depression of the respiratory center. 

 Therapeutic doses have no effect except to diminish the cough reflex 

 and lessen the tone of the respiratory muscles. 



Circulatory System, In ordinary doses there is no effect but 

 in large amounts the circulation is depressed, the heart beat is slower, 

 softer and weaker with a shortened systole and lengthened diastole. 

 The blood vessels are dilated and blood pressure is lowered. The 

 potassium ion is responsible for this action upon the heart as the 

 other bromides do not have any such action. 



Sexual Organs. Both sexual desire and power are diminished 

 throuo'h depression of the cerebrum and cord. 



Bladder. There is a marked diminution of the functional 

 activity and muscular power of the bladder under long continued 

 doses. 



Absorption and Elimination. Potassium bromide is rapidly 

 absorbed and begins to be quickly eliminated, chiefly by the kidneys 

 (increasing the secretion of the urine). It is also eliminated by the 

 skin, saliva, mammary glands and bronchial mucosa. Under pro- 

 longed dosage, it tends to accumulate in the body, being found in 

 all parts, especially the blood. 



Temperature. Large doses lower temperature by depressing the 

 circulation. 



BROMISM 



Bromism or chronic bromine poisoning is shown by drowsiness, 

 depression, some cutaneous anesthesia, muscular weakness, poor cir- 

 culation, cold extremities, anemia, and cutaneous eruptions. The 

 treatment consists in withdrawing the drug, and aiding its elimina- 

 tion by administering sodium chloride which hastens its excretion. 

 Administer plenty of water. Diuretics and purgatives should also 

 be given. Keep up the body activity and administer stimulants such 

 as caffeine and strychnine as the physiological antidotes. 



Comparison of the Bromides. With a few minor exceptions 

 the bromides are identical in action. Potassium bromide contains 

 66 per cent, of bromine and is the most toxic to the heart and mus- 

 cular system. Sodium bromide contains 78 per cent, of bromine 

 but is less hypnotic than the preceding salt as sodium increases 

 cerebral activity but, on the other hand, since the sodium ion does 

 not affect the heart and muscles, it is less toxic. 



Ammonium bromide produces some slight cardiac stimulation on 

 account of the ammonium ion, but otherwise is identical in action 

 ■ with the potassium salt. 



Lithium bromide is the most hypnotic of the group. It contains 



