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The third case study is a patient who any health care professional might see for different reasons. Mrs Charles is a middle-aged patient who has an ingrowing toenail and requires a TNA.

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This is a long chapter and as such warrants several case studies.

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Metabolism of drugs tends to make them less lipid soluble, more water soluble and therefore more likely to ionize. Tubular filtrate is normally slightly acid and this favours the excretion of basic drugs because they ionize more readily in acidic conditions and therefore do not diffuse easily back into plasma.

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However, cardiac glycosides have a very low therapeutic ratio and can be very toxic. Slowing of AV conduction can lead to AV block and arrhythmias.

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Lipid compartments include all cell membranes and adipose tissue.

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