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Crude coal tar is the most effective, but few outpatients tolerate the mess and smell. In hospitals, coal tar is often combined with ultraviolet B (UVB) radiation. There are many proprietary preparations, which are more refined and therefore more acceptable to patients, but they are less effective. They are used as a creams, lotions, ointments and bath oils in concentrations from Coal tar preparations are less irritating to normal skin than dithranol, but can cause folliculitis. Keratolytics break down keratin and soften skin, which improves penetration of other treatments.

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However, the organism appears to have characteristics of both protozoa and fungi so its classification is currently uncertain. This organism has been renamed as Pneumocystis jiroveci and reclassified as a fungus by some authorities.

  • In addition, through an effect in the central nervous system cardiac glycosides cause an increase in parasympathetic activity and therefore slow conduction through the AV node, hence their usefulness in atrial flutter and atrial fibrillation.
  • Adverse reactions can occur with any drug use and can be either related to or unrelated to the expected pharmacological effect.
  • Both preparations are classified as prescription-only medicines but are included in the list of drugs that registered Podiatrists can access and supply.
  • Any health care professional who trains to be a supplementary prescriber could prescribe prescription-only analgesics if it was appropriate to the individual clinical management plan.

Figure shows the renin-angiotensin-aldosterone pathway. Vasoconstriction and the salt and water reabsorption activity of aldosterone result in restoration of blood volume and therefore blood pressure.

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Vitamin K is essential for successful formation of many clotting factors so lack of vitamin K can cause a coagulation disorder. Normal bile acid production is necessary for absorption of vitamin K from the small intestine.

This means that the effect of the original oncogene is blocked. Cancer cells produce enzymes that can breakdown the extracellular matrix between normal cells and allow cancer cells to invade and spread in normal tissue. New drugs are being developed that inhibit these enzymes. In order for tumours to grow they need to develop a blood supply. Drugs are being developed that inhibit angiogenesis, which is the growth of new blood vessels.

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Repeated treatment is often necessary and can be painful. One preparation contains podophyllum, which is a cytotoxic drug and must not be used in patients who are pregnant or considering pregnancy or breast-feeding. Podophyllum inhibits cell division in virally infected cells. Treatment with wart paints is usually once or twice a day with abrasion between applications. Perseverance with treatment is essential and surrounding skin should be protected with plasters or Vaseline.

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This consultant podiatrist is using supplementary prescribing in primary care, mostly with older patients many of whom are living in nursing homes.

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Partial constriction is the result of parasympathetic stimulation and an increase in this brings about further bronchoconstriction.

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