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Examples in use are diclofenac and ibuprofen. Side effects of NSAIDs are discussed in Chapter unlikely to be a problem with short-term use as adjuncts to general anaesthesia.

  • This could be due to increased pituitary adrenocorticotrophic hormone production, which in turn could be due to a disorder of hypothalamic control.
  • A mixture of soluble (rapid and short duration of action) and isophane human insulin twice a day is the most commonly used regime.
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In some circumstances, it may be advantageous to administer a drug rectally, for example if a patient is unconscious or vomiting, or uncooperative in some way, but generally, it is considered an unpleasant method. Many of the general factors considered above that affect absorption from the gastrointestinal tract apply equally to this route of administration.

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Some drugs can combine with proteins in the skin to form antigens. See Figure and these cause damage to skin cells resulting in rashes, lumps and itchy weeping skin.

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If you were a physiotherapist, would you consider this patient suitable for supplementary prescribing under a clinical management plan. A basic knowledge of the structure of the skin is required in order to understand how disorders arise and how they can be treated. The skin consists of three layers: the epidermis, the dermis and the subcutis. Cells on the border between the dermis and the epidermis are constantly dividing and moving towards the skin surface. These cells are known as keratinocytes because they produce and contain keratin.


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With long-term therapy, fat-soluble vitamin supplements are necessary. Fibrates suppress endogenous cholesterol synthesis by a mechanism not fully understood but which leads to lower levels of circulating VLDLs and LDLs.

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With ageing, there is also reduced gastrointestinal blood flow, which can further delay absorption of drugs from the gastrointestinal tract. Alteration in absorption can also make older people more vulnerable to the ulcerogenic effects of some drugs, for example non-steroidal anti-inflammatory drugs.

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The two taxanes currently in use are paclitaxel, which is used in the treatment of ovarian cancer and metastatic breast cancer and docetaxel, which is used to treat metastatic breast cancer, small cell lung cancer and prostate cancer.

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There are two types of diabetes mellitus: insulin dependent diabetes mellitus (IDDM, Type mellitus, where there is insulin resistance and impaired insulin secretion. IDDM must be treated by insulin replacement or the patient will die from diabetic ketoacidosis.

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Some health care professionals may be treating mainly older patients, or younger patients or high-risk patients, and will become experienced and familiar with drugs in their areas of expertise. Health care professionals can be ideally placed to spot adverse drug reactions and to play an important role in the long-term monitoring of commonly prescribed drugs.

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