This section is from the book "Materia Medica Pharmacy, Pharmacology And Therapeutics", by W. Hale White. Also available from Amazon: Materia Medica Pharmacy, Pharmacology And Therapeutics..
Powder the ingredients separately, and mix them thoroughly in a warm mortar. Dry the resulting, uniform paste rapidly, and when it is perfectly dry, reduce it to a powder of the desired degree of fineness. H3C,H6O7 + 3Khco3 + H2O = K3C6H5O7 + 3Co2 + 4H2O.
A fine, white powder, odorless, and having a sweetish, saline taste. Solubility. - Completely in water, with effervescence.
Dose, 5 to 60 gr.; .30 to 4.00 gm.
No action. Being neutral, they are not even antacid.
These are the least irritating to the stomach of all potassium salts; being neutral, they have no action on gastric juice. They circulate as potassium carbonate. Both are more powerfully diuretic than any other potassium salts, and act by directly stimulating the renal cells. They are diaphoretic, especially the citrate; but neither of them causes a great increase of the perspiration. How they produce this effect is not certainly known.
As neither impairs digestion, they are chiefly used for remote effects.
They have been largely given for rheumatic fever, but are now rarely employed. Many believe both salts are of great value in gout; if that is so, it is doubtful how they act, for they do not increase the power of blood plasma to dissolve sodium biurate. They are powerfully antiscorbutic; that is to say, they prevent scurvy; but they are not so efficacious as lemon-juice, lime-juice, and fresh vegetables.
Although in health the diuresis produced by the potassium citrate and acetate is slight, and the urea and other solids of the urine are actually decreased, yet clinical experience points clearly to the fact that both these salts are, in chronic Bright's disease, powerful diuretics. They are frequenly used in this disease and in feverish conditions, and also to increase the amount of urine, and thus to remove pathological fluids in cases of pleuritic effusion, ascites, etc. Diuretics are best combined, and the following is a good mixture: Potassium acetate, 20 gr.
1.20 gm.; tincture of squill, 10
.60 c.c.; spirit of nitrous ether, 30
2.00 c.c.; juice of broom, 1 fl.
4.00 c.c.; water to 8 fl
30.00 c.c.; juice of broom, B. P., is obtained by bruising fresh broom tops, expressing the juice, adding one-third part of alcohol and filtering after seven days.
They render the urine alkaline, and are much employed for this purpose, having the advantage over other potassium salts that they do not derange digestion. Not only do they prevent the precipitation of uric acid, and thus hinder the formation of uric acid gravel, but they will dissolve small uric acid calculi. Roberts states that to keep the urine at the alkalinity necessary for this purpose, 40 to 60 gr. 2.50 to 4.00 gm. of the acetate or citrate should be dissolved in four ounces 120. c.c of water, and taken every four hours. If more than this is used, harm is done; for an insoluble biurate forms on the surface of the calculus. With many patients it suffices if such a dose in a tumbler of water be taken at bed-time; for during the night the acidity of the urine is highest, as there is no alkaline tide due to meals. Owing to the depressing action of potassium salts, they should be used with care in persons suffering from heart disease.
Both these salts may be used in slight pyrexia, such as that of a common cold, on account of their diaphoretic properties.
These salts, like the carbonates and bicarbonates, are mild saline expectorants, especially suitable for cases of bronchitis with viscid, scanty expectoration, as they increase the secretion and lessen the viscidity. The iodide is, however, still more efficacious.