PIPERAZIN. — Piperazin (pyrazin hexahydride, dispermin, di-ethylene-di amin; piperazidin; ethylene-imin) is ob tained by the action of ammonia upon ethylene bromide or chloride. It oc curs in colorless, transparent, deliques cent needles, which absorb carbonic acid from the air. It is very soluble in water, the solution being practically tasteless and having an alkaline reaction. It must be kept from the air.
Piperazin is incompatible with alka loids and the salts of iron, tannic acid, alum, preparations of cinchona, Dono van's solution, potassium permanganate, sodium salicylate, acetanilid, and phe nacetin.
Dose.—The dose of piperazin is 15 grains per day. This quantity is dis solved in a pint of plain or carbonated water and taken in tumblerfuls at equal intervals. The solution must be pre pared fresh each day.
It cannot be prescribed in pill form on account of its highly hygroscopical property.
Action. — Piperazin forms with uric acid piperazin urate, a neutral and very soluble salt, even if the uric acid is present in excess. Upon its solvent power over uric acid rests its value in practice. In the laboratory it will act not only upon granular uric acid, but upon the hardest uric-acid cal culi, and if the calculi are not composed of pure uric acid, it will cause them to disintegrate by dissolving out the uric acid and leaving the rest to crumble. The albuminous substances forming a part of calculi are also dissolved. azin will render soluble twelve times as much uric acid as lithium carbonate; moreover, piperazin urate is seven times as soluble in water as lithium urate.
When taken in moderate doses, it is quickly eliminated by the kidneys, and gives the urine a brownish-red color. Ebstein and Sprague did not find by ex amination of the latter that the output of uric acid or urea was increased; deed, has argued that in doses of 15 grains a day it checked uric-acid elimination.
Regarding piperazin, following conclu sions are formulated: 1. Piperazin is not wholly oxidized in the body, and may be detected in the urine of those to whom it is exhibited. 2. In solutions of 1 per cent. in normal urine, when kept in contact at a temperature of 102.2° F.
for a given time, it has the property of dissolving to a great extent a fragment of a uric-acid calculus. 3. The stronger the solution of piperazin in urine (up to 7.5—), the earlier did the solvent action begin and the more rapid was the com pletion. 4. Notwithstanding this, with the stronger solutions of piperazin in urine the rate of solubility was not so markedly rapid over the weaker solu tions as might be expected. 5. The sol vent action in similar circumstances was greater than any other of the substances employed: namely, borax, lithium ci trate, sodium carbonate, and potassium citrate. 6. Piperazin, in weak and strong solutions in urine, converted the undis solved portion of the calculus into a soft granular or pulpy condition. 7. Neither borax, lithium citrate, sodium carbonate, nor potassium citrate, in similar circum stances, rendered the fragment of cal culus soft or pulpy. John Gordon (Brit. Med. Jour., June 16, '94).
Poisoning by Piperazin. — D. D.
Stewart (Thor. Gaz., Feb., '94) has noticed untoward effects when large doses have been given: Feelings of nervousness and apprehension (halluci nations); intermittent clonic spasms of the upper extremities, spreading to the muscles of the abdomen and legs, the patient becoming dazed, unable to think clearly, and for some hours partly un conscious; muscular prostration, with inco-ordination; coarse tremors, uncer tainty of gait for several days, due rather to impairment of co-ordination than to any paretic condition of the muscles.
Case of poisoning from 20 grains of piperazin taken at once. When seen, three or four hours after taking the drug, the patient was found cyanosed and semicomatose, with pupils contracted; pulse, 50; and temperature, 97.4° F. The respiration was depressed and mut tering delirium present. Tips of fingers and lips were cyanotic. Loss of motion complete in lower limbs, but sensation almost intact. Reaction established after several hours. Next day loss of mo tion returned and hypostatic congestion of both lungs present. On sixth day of treatment paraplegia disappeared. C. H. P. Slaughter (Med. News, Mar. 14, '96).