Drilldown: Medicines

Artemisia absinthium (1) · Atropa belladonna (1) · Banisteriopsis caapi (1) · Betel (1) · Black Drink (1) · Brugmansia (1) · Calcium (carbonate, citrate, gluconate, chloride salts) (1) · Chocolate (1) · Coca (1) · Coffee (1) · Guarana (1) · Hyoscyamus niger (1) · Khat (1) · Kola (1) · Lactated Ringer's solution (1) · Magnesium (oxide, citrate, sulfate, hydroxide, gluconate, chloride salts) (1) · Mandragora officinarum (1) · Mescal Bean (1) · Mimosa hostilis (1) · Phalaris arundinaceae (1) · Potassium chloride (1) · Sodium bicarbonate (1) · Sodium chloride (1) · Tea (1) · Yerba mate (1)

''Areca catechu'' (the nut); ''Piper betle'' (the leaf) (1) · ''Brugmansia'' spp., Angel's trumpet, ''borrachero'', ''toé'' (1) · ''Camellia sinensis'' (formerly ''Thea sinensis'') (1) · ''Catha edulis''. Chat, qat, the Flower of Paradise (1) · ''Coffea arabica'', ''Coffea canephora'' (robusta) (1) · ''Cola nitida'', ''Cola acuminata'' (1) · ''Erythroxylum coca'', ''E. novogranatense'' (1) · ''Ilex paraguariensis'' (1) · ''Ilex vomitoria'' (1) · ''Mimosa tenuiflora''. Jurema preta, tepescohuite (1) · ''Paullinia cupana'' (1) · ''Sophora secundiflora''. Texas mountain laurel, frijolillo (1) · ''Theobroma cacao'' (1) · Deadly nightshade (1) · Henbane, black henbane (1) · K-Dur, Klor-Con, Slow-K, Micro-K, K-Lyte/Cl (1) · Lactated Ringer's Injection (Baxter, B. Braun, ICU Medical); Hartmann's solution (intl.) (1) · Mag-Ox, Slow-Mag, MagCitrate, Milk of Magnesia (hydroxide); IV sulfate generic (1) · Mandrake (1) · Neut, many generic; OTC oral: Alka-Seltzer (with aspirin/citric acid), baking soda (1) · Normal saline, NaCl injection, many; nebulized: HyperSal, PulmoSal (1) · Reed canary grass (1) · The ayahuasca vine, ''yagé'', ''caapi'', ''mariri'' (1) · Tums, Caltrate, Os-Cal, Citracal; many generics (1) · Wormwood, absinthe, la Fée Verte, the Green Muse (1)

Research material · Classic Psychedelic · Stimulant · Opioid · Sedative-Hypnotic · Phenethylamine · Tryptamine · Benzodiazepine · Botanical · [[:Category:Antihypertensives|Antihypertensive]] · Dissociative · Anticonvulsant · Antidepressant · Plant Medicine · Analgesic · Antiparkinsonian · Antipsychotic · Empathogen · Neuroleptic · Cathinone

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None (2) · Active alkaloid is cytisine, a nicotinic acetylcholine receptor agonist. NOT a classical 5-HT2A psychedelic. (1) · Active principle is thujone, a GABA-A antagonist (the opposite of most CNS depressants). Also present in cooking sage (''Salvia officinalis''), tansy, and ''Thuja'' cedars. (1) · Caffeine (1.5–2%) + theobromine + kolanin (a glycoside). (1) · Caffeine (highest of the ''Ilex'' genus) plus saponins that produce ritual vomiting at high doses. (1) · Caffeine (sometimes called 'mateine' historically, though chemically identical), theobromine, theophylline, plus polyphenols. (1) · Caffeine + theophylline + L-theanine. L-theanine (an amino acid unique to tea) modulates glutamate and produces an 'alpha-wave' calming overlay on caffeine's stimulation, hence tea's reputation as a 'cleaner' stimulant than coffee. (1) · Caffeine is a non-selective adenosine A1/A2A receptor antagonist; also weak PDE inhibition. Beans contain theobromine (3,7-DMX) and theophylline (1,3-DMX) in smaller amounts. (1) · Contains the β-carboline alkaloids harmine, harmaline, and tetrahydroharmine, reversible monoamine oxidase inhibitors (RIMAs) that allow oral DMT to reach the brain. (1) · Contains varying amounts of DMT, 5-MeO-DMT, bufotenine, and gramine depending on strain and growing conditions. (1) · Highest natural caffeine content of any plant (2–7% by dry weight, ~2–4× coffee). Caffeine is bound to tannins, producing a slower release than pure coffee caffeine. (1) · Primary alkaloid is (S)-(-)-cathinone, a phenylpropanolamine close kin to amphetamine. Releases dopamine and norepinephrine. Also contains cathine (=norpseudoephedrine) and norephedrine. (1) · Primary alkaloid is arecoline, a muscarinic agonist (M1, M2, M3, M4) and partial agonist at nicotinic receptors. Produces alertness, salivation, sweating, mild euphoria. (1) · Primary alkaloid is cocaine, a tropane that blocks reuptake of dopamine and norepinephrine (and serotonin). At low oral doses from leaf chewing, the slow release favors NE-mediated alertness over DA-mediated euphoria. (1) · Primary alkaloid is theobromine (3,7-dimethylxanthine), with minor caffeine. Also contains phenethylamine, anandamide (an endogenous cannabinoid), tryptophan (serotonin precursor), and flavanols. The combined effect is mild stimulation + mood elevation. (1) · Root bark contains ~1% N,N-dimethyltryptamine (DMT) and related tryptamines. Oral activity requires MAOI co-administration. (1) · Tropane alkaloids: hyoscyamine (dominant; the racemic form is atropine), scopolamine. Competitive muscarinic antagonism. (1) · Tropane alkaloids: hyoscyamine, scopolamine, atropine, apoatropine. (1) · Tropane alkaloids: hyoscyamine, scopolamine, in higher seed concentrations than belladonna or datura. (1) · Tropane alkaloids: scopolamine (dominant), hyoscyamine, atropine. Competitive antagonism at muscarinic acetylcholine receptors. (1) · '"`UNIQ--vote-00000016-QINU`"' Bicarbonate is not benign: high-volume use produces hypernatremia, metabolic alkalosis, hypokalemia, and (in arrest) paradoxical intracellular acidosis'"`UNIQ--ref-00000017-QINU`"'. (1) · '"`UNIQ--vote-00000037-QINU`"' Hypertonic 3% is the standard urgent treatment of severely symptomatic hyponatremia'"`UNIQ--ref-00000038-QINU`"'. (1) · '"`UNIQ--vote-00000086-QINU`"' Calcium content is a relative contraindication for co-administration with citrated blood products through the same line'"`UNIQ--ref-00000087-QINU`"'. (1) · '"`UNIQ--vote-00001302-QINU`"' Renally cleared; accumulation in advanced CKD can produce neuromuscular and cardiac depression. Hypomagnesemia frequently co-exists with hypokalemia and is often the reason refractory potassium loss does not correct until magnesium is repleted. (1)

'"`UNIQ--vote-00000006-QINU`"' (3) · '"`UNIQ--vote-00000008-QINU`"', '"`UNIQ--vote-00000009-QINU`"' (8) · '"`UNIQ--vote-0000000C-QINU`"', '"`UNIQ--vote-0000000D-QINU`"', '"`UNIQ--vote-0000000E-QINU`"', '"`UNIQ--vote-0000000F-QINU`"' (1) · '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"' (1) · '"`UNIQ--vote-00000039-QINU`"', '"`UNIQ--vote-0000003A-QINU`"', '"`UNIQ--vote-0000003B-QINU`"', '"`UNIQ--vote-0000003C-QINU`"', '"`UNIQ--vote-0000003D-QINU`"' (1) · '"`UNIQ--vote-00000065-QINU`"' (1) · '"`UNIQ--vote-00000088-QINU`"', '"`UNIQ--vote-00000089-QINU`"', '"`UNIQ--vote-0000008A-QINU`"', '"`UNIQ--vote-0000008B-QINU`"' (1) · '"`UNIQ--vote-000000AD-QINU`"', '"`UNIQ--vote-000000AE-QINU`"' (1) · '"`UNIQ--vote-000000CF-QINU`"', '"`UNIQ--vote-000000D0-QINU`"', '"`UNIQ--vote-000000D1-QINU`"' (1) · '"`UNIQ--vote-000002EE-QINU`"', '"`UNIQ--vote-000002EF-QINU`"' (1) · '"`UNIQ--vote-000003A0-QINU`"', '"`UNIQ--vote-000003A1-QINU`"' (1) · '"`UNIQ--vote-0000069B-QINU`"', '"`UNIQ--vote-0000069C-QINU`"' (1) · '"`UNIQ--vote-00000747-QINU`"', '"`UNIQ--vote-00000748-QINU`"' (1) · '"`UNIQ--vote-0000081E-QINU`"' (1) · '"`UNIQ--vote-000012B7-QINU`"', '"`UNIQ--vote-000012B8-QINU`"', '"`UNIQ--vote-000012B9-QINU`"', '"`UNIQ--vote-000012BA-QINU`"', '"`UNIQ--vote-000012BB-QINU`"' (1) · '"`UNIQ--vote-00001303-QINU`"', '"`UNIQ--vote-00001304-QINU`"', '"`UNIQ--vote-00001305-QINU`"', '"`UNIQ--vote-00001306-QINU`"', '"`UNIQ--vote-00001307-QINU`"', '"`UNIQ--vote-00001308-QINU`"', '"`UNIQ--vote-00001309-QINU`"' (1)

None (15) · 10-20 mEq PO daily for prevention; treat established hypokalemia per measured deficit, typically 40-100 mEq/d in divided doses; IV 10 mEq/h peripheral, 20 mEq/h central with telemetry (1) · A ''marduuf'' bundle (~50 g fresh leaves) chewed over a couple of hours (1) · A measured pour of absinthe diluted 5:1 with cold water over sugar (the louche ritual) (1) · IV: 1 mEq/kg bolus in arrest indication, then titrated to ABG and clinical status; PO: 325-2000 mg up to QID as antacid (1) · One cup (~40–60 mg caffeine; about half of brewed coffee) (1) · One cup (~80–145 mg caffeine for brewed; 60–100 mg for instant) (1) · Oral: 1000-1500 mg elemental calcium/day in divided doses for supplementation; IV gluconate 1 g (4.65 mEq) over 5-10 min for hyperkalemia or symptomatic hypocalcemia (1) · Replacement oxide 400-800 mg/d in divided doses (high diarrhea rate); citrate 200-400 mg/d (better tolerated, better absorbed); IV sulfate 1-2 g over 5-60 minutes for hypomagnesemia or torsades; eclampsia 4-6 g IV loading then 1-2 g/h (1) · Volume and concentration titrated to clinical status; symptomatic hyponatremia: 3% NaCl 100-150 mL bolus, reassess (1) · Volume titrated to clinical status; typical adult bolus 500-1000 mL, then reassess (1)

0.225%, 0.45%, 0.9%, 3%, 5% IV solutions; 0.9% nasal spray; 3% and 7% nebulizer solutions; oral tablets (1 g) (1) · 250, 500, 1000 mL IV bags. Composition per liter: Na+ 130 mEq, K+ 4 mEq, Ca2+ 3 mEq, Cl- 109 mEq, lactate 28 mEq (1) · 4.2%, 7.5%, 8.4% IV (1 mEq/mL at 8.4%); 325, 650 mg oral tablets; bulk powder (1) · 8, 10, 20, 25 mEq tablets/capsules (most ER); effervescent and oral solution; IV concentrate (must be diluted) (1) · A ''betel quid'': areca nut slice + betel leaf + slaked lime (calcium hydroxide) ± tobacco ± spices, chewed (1) · Acid/base extraction of fresh young grass for tryptamines; combined with an MAOI (1) · Bark/woody stem decocted with a DMT-source plant (''Psychotria viridis'', ''Diplopterys cabrerana'') to make ayahuasca (1) · Bright red seeds, traditionally ingested or smoked. Highly toxic, narrow margin between active and lethal (1) · Carbonate 200, 400, 500, 600 mg elemental tablets and chewables; citrate 200, 250, 315 mg elemental; gluconate 1 g (94 mg elemental, 4.65 mEq) IV; chloride 1 g (270 mg elemental, 13.6 mEq) IV (1) · Dried leaves and twigs, infused in a gourd (''mate'') and drunk through a metal straw (''bombilla'') (1) · Dried leaves, infused. Six major processings: white, green, yellow, oolong, black, pu-erh (1) · Dried leaves; absinthe liqueur (120–160 proof, with hyssop, lemon balm, fennel, anise, sometimes Acorus calamus) (1) · Fermented and roasted seeds, ground. Mexican tradition: drunk with chili, cornmeal, achiote. European tradition: with sugar and milk (1) · Flowers or leaves infused or smoked. Highly variable potency; narrow toxic margin (1) · Fresh leaves and tender twigs chewed; degrades on drying (1) · Fresh nuts chewed; also dried and powdered (1) · Leaves and seeds, traditionally smoked or infused. Possibly the original Pythia oracle plant (1) · Leaves chewed with a pinch of slaked lime (the lime converts cocaine HCl to freebase for buccal absorption); also drunk as tea (''mate de coca'') (1) · Leaves, berries, root. Historically: belladonna cigarettes ("Asthmador") OTC in US until the 1970s (1) · Oxide 400, 500 mg tablets (240, 300 mg elemental); citrate 100, 150, 200 mg tablets; hydroxide oral suspension 400 mg/5 mL; sulfate IV 500 mg/mL ampules (1) · Roasted beans, ground; brewed (drip, French press, espresso, cold brew, percolated) (1) · Roasted seeds ground to powder, mixed with water; commercial syrups and energy drinks (1) · Root bark acid/base-extracted for DMT; or as the resurrected ''jurema preta'' brew (decocted with an MAOI such as ''Peganum harmala'') (1) · Root, traditionally carved into ''mannikens'' or infused into wine (1) · Toasted leaves and twigs decocted to a near-black concentrate (1)

None (19) · Indication-specific; renal clearance limits tolerable cumulative dosing (1) · IV peripheral 10 mEq/h (40 mEq/L); IV central 20 mEq/h with cardiac monitoring; PO single doses generally ≤40 mEq (1) · No fixed maximum; titrated to clinical endpoints (1) · No fixed maximum; titrated to pH and bicarbonate level; chronic high oral doses cause metabolic alkalosis and volume overload (1) · No fixed maximum; titrated; sodium correction rate in chronic hyponatremia must not exceed 8-10 mEq/L per 24 hours to avoid osmotic demyelination (1) · ~2500 mg elemental/d combined diet + supplements (chronic; UL) (1)

buccal); refined cocaine has its own profile (1) · inhalation (2) · intranasal (1) · IV (5) · IV (gluconate or chloride for acute use) (1) · nebulized (1) · ophthalmic (1) · Oral (19) · Oral (buccal absorption) (1) · Oral (buccal) (1) · Oral (leaf (1) · Oral (with MAOI) (2) · smoked (extracted DMT) (1) · topical (1)

None (16) · 15–30 min (2) · Acute: minutes (IV); chronic: bone effect over months (1) · Hours (PO); IV faster but rate-limited (1) · Immediate (IV) (1) · Immediate (IV); within minutes (oral antacid) (1) · Immediate intravascular expansion (1) · Oral: hours; IV: minutes (1) · ~15–30 min (1)

None (16) · 2–4 h (1) · 3–4 h (1) · 3–5 h (subjective) (1) · IV: hours, dependent on ongoing acid load; oral antacid: ~30 minutes (1) · Roughly 20-25% of an IV bolus remains intravascular at 1 hour (1) · Roughly 20-30% remains intravascular at 1 hour (1) · Variable (2) · Variable; depends on ongoing losses (1)

None (17) · Not applicable (electrolyte and buffer) (1) · Not applicable (electrolyte solution) (1) · Not applicable (electrolyte) (1) · Not meaningfully described (electrolyte) (1) · Not meaningfully described (electrolyte; renally cleared) (1) · Not meaningfully described for an electrolyte; distribution between intra- and extracellular compartments is the relevant kinetic (1) · ~5 h (caffeine) (2)

None (18) · 100% (IV) (1) · 100% (IV); essentially complete (oral) (1) · 100% (IV); rapidly neutralized by gastric acid (oral) (1) · 60-80% (oral) (1) · Carbonate ~30-40% (best with food and acid); citrate ~24% (absorbable without acid; preferred in achlorhydria, PPI use, post-bariatric) (1) · Highly salt-dependent: citrate ~25-30%; oxide ~4% (limited and causes osmotic diarrhea); chloride ~12% (1) · ~99% (caffeine) (1)

None (18) · Generally safe at replacement doses; treat the underlying cause of hypokalemia.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · IV sulfate is the cornerstone of eclampsia/preeclampsia management; oral replacement also safe.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limit to <200 mg/d (~2 cups brewed) (1) · Routine antacid and acidosis correction acceptable (1) · Routinely supplemented in pregnancy; needs higher in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Standard fluid and electrolyte management (1) · Standard resuscitation fluid in pregnancy (1)

None (14) · Currently legal in most jurisdictions with thujone limits (1) · Leaves legal in Bolivia, Peru, Colombia; cocaine internationally controlled (1) · OTC (oral salts) and [[USLegal:Prescription only|Rx-only]] (IV) in US (1) · OTC (oral supplements) and [[USLegal:Prescription only|Rx-only]] (IV) in US (1) · Plant unrestricted; pharmaceutical atropine Rx-only (1) · Schedule I in US since 1993 (despite traditional use elsewhere); legal in Ethiopia, Kenya, Yemen, Somalia, Djibouti (1) · Unrestricted (food) (1) · [[USLegal:Prescription only|Rx-only]] (higher concentrations and IV) and OTC (low-dose supplements) in US (1) · [[USLegal:Prescription only|Rx-only]] for IV formulations; OTC for oral (1) · [[USLegal:Prescription only|Rx-only]] for parenteral formulations; OTC for oral, nasal, and many nebulizer products (1) · [[USLegal:Prescription only|Rx-only]] in US (1)