last day at the job and, as a present, they gave us all copies of the Merck Manual.
It is the new edition. It has bible-esque pages (you know, the really thin pages .... bible-esque) which I assume is important.
What is the Merck Manual? Only the greatest book I have ever received.
Let's flip to a random page:
p934 (Dermatologic Disorders): Did you know that Pruritus (itching) can be a symptom of primary skin disease or of systemic disease? How about the fact that skin diseases notorious for causing intense pruritus include scabies, pediculosis, insect bites, urticaria, atopic and contact dermatitis, lichen planus, miliaria and dematitis herpetiformis?
new page:
p1836 (Neurologic Disorders): Use of hypnotics in sleep disorders. Hypnotics act at the benzodiazepine recognition site of the gamma-aminobutryic acid (GABA) receptor and augment the inhibitory effects of GABA. Hypnotics should be used cautiously in patients with pulmonary insufficiency. In the elderly, any hypnotic, even in small doses can cause restlessness, excitement, or exacerbation of delerium and dementia.
awesome ... 2991 pages of medical diagnosis. With a small bible-esque font.
by the by, GABA is one of the brain's major inhibitory neurotransmitters and is formed from glutamate in a one step process. It looks like this:
HOOC-CH2-CH2-CH2-NH2
Except in physiological conditions the carboxylate is deprotonated and the amine is protonated. Just like most amino acids. Glutamate (or glutamic acid) has the basic amino acid back bone with a propionic acid side chain.
This is pretty basic for a lot of you, but for me ... pure fascination.
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