rabbit tobacco lavender About Rabbit-tobacco Did you know that Rabbit

Smoking products include cigarettes, bidi (rolled tobacco), hookah (nargileh), sulfa and chillum or kankad surti (dry tobacco leaves), khaini (lime-mixed tobacco), gutkha (areca nut) and paan (betel quid) with tobacco ingredients are forms of smokeless tobacco products

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When industries fail to block or weaken a policy, they aggressively threaten and sometimes proceed with legal action against governments to undermine and delay implementation

Octreotide is first-line because: Causes splanchnic vasoconstriction Portal venous pressure & blood flow to varices Rapid onset effective hemostasis Safer than vasopressin (fewer systemic side effects) Recommended by Baveno & AASLD guidelines Other options: Omeprazole useful in peptic ulcer bleeding, not varices Sucralfate mucosal protectant, no role in acute bleeding Metoclopramide prokinetic, no hemostatic effect Uses of Octreotide Acute esophageal & gastric variceal bleeding Acromegaly Carcinoid syndrome VIPoma Severe secretory diarrhea Mechanism of Action (MOA) Somatostatin analog Inhibits release of vasodilatory hormones (glucagon) Causes splanchnic vasoconstriction Portal venous inflow variceal pressure bleeding control Minimum & Maximum Dose (Acute Variceal Bleed) #Minimum dose: IV bolus 50 micrograms, followed by 50 micrograms/hour infusion #Maximum dose: Continuous infusion up to 100 micrograms/hour (based on response) (Duration: usually 25 days) Mnemonic OCTREO = OCTREO-tide tightens the PORTAL pipe Tightens splanchnic vessels stops variceal bleed Clinical Pearl Start octreotide immediately in suspected variceal bleeding do not wait for endoscopy

Pseudo-science meets advertising Both my parents smoked, as did most of my aunts and uncles (there were at least twenty nine)