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In the absence of bile, vitamin K replacement has to be given by intramuscular or intravenous injection. Vitamin K can be used to counteract the effects of warfarin in the event of excessive bleeding. A thrombus is a blood clot that forms unnecessarily, usually in response to damage to the lining of buy levitra online with mastercard vessels or disease such as arteriosclerosis. A part of a thrombus that breaks off and circulates in the blood is known as an embolus. Thromboembolic disease is the result of thrombus and embolus formation and can take the form of a heart attack or a stroke or blockage of a blood vessel elsewhere in the body. Thromboses in arteries and veins are slightly different.

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Imidazoles are often the drugs of first choice for treating tinea because they are more effective than other topical drugs described above. The mode of action of imidazoles is to make fungal cells leaky by inhibiting an enzyme necessary for ergosterol synthesis. Ergosterol is an essential component of fungal cell membranes. Examples of imidazoles available without prescription are clotrimazole, available as Daktarin). Ketoconazole and tioconazole are currently prescription-only medicines, but qualified podiatrists registered with the Health Professions Council are able to access and supply tioconazole Ketoconazole is not available on the NHS for tinea infections, but tubes of maximum registered podiatrists.

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Asthma is often, but not always, caused by an allergic response and bronchitis is caused by chronic irritation of the lungs. Both conditions can be treated with inhaled bronchodilators. Although generally asthma responds best to β to antimuscarinic drugs, both types of drugs may be needed. If these do not control symptoms, xanthine bronchodilators may be required in addition to one or both of the other two. Attacks of asthma can be prevented by prophylactic use of cromoglicate, although this drug is of no use in an acute attack or in chronic bronchitis.

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There are no drugs to cure cardiac failure but the condition can be controlled by drug therapy. Drug groups used to control cardiac failure are cardiac glycosides, diuretics, ACE inhibitors and angiotensin II receptor antagonists.

  • Methyldopa can be used again as an example here.
  • The nephron is the basic structural and functional unit of which there are about one million in each kidney.
  • This method is used for the complete anaesthesia of a single limb, usually the arm.
  • It is excreted in the sebum and achieves high concentration in hair follicles and hair.
  • Metoclopramide is a dopamine antagonist that stimulates gastric emptying and small intestine transit and is used to speed up transit time of barium follow-through examinations.
  • The refractory period is the time interval when a second contraction cannot occur and repolarization is the recovery of the resting potential due to efflux of potassium ions.

Its significance is that other drugs metabolized by the same enzymes are metabolized faster and therefore circulate in a lower concentration than expected for a given dose. This could mean that they become ineffective.

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It is often the presenting symptom and a leading cause of death in patients with HIV. An organism called Pneumocystis cariniiwhich used to be classified as a protozoan, causes this type of pneumonia.

Undecenoates are mixtures of similar fatty acids with antifungal activity. Preparations should be protected from light as this denatures them. They have a peculiar odour (similar to sweat) that is difficult to mask. Preparations of undecenoates are available as over-the-counter medicines, for example Mycota. This is the product of a reaction between tannic and boric acids. Tannic acid is an astringent; boric acid is an antifungal.

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It is also formulated in combination with a sulphonamide, when it is known as co-trimoxazole, to treat pneumonia in patients with HIV. Due to the synergistic effect of the two drugs, this combination is more effective than either drug alone. Adverse effects on the production of blood cells occur with prolonged use of trimethoprim. The quinolones inhibit a bacterial enzyme, DNA gyrase. This enzyme is involved in the unwinding of DNA prior to replication. Inhibition of this enzyme prevents DNA replication and bacterial cells cannot survive.


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Conversely, the elimination of basic drugs such as amfetamine, antihistamines, morphine and tricyclic antidepressants can be increased by making tubular filtrate more acidic by administration of ammonium chloride. Although generally not as important as renal excretion, other routes of excretion account for elimination of some drugs.

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An antihistamine, for example chlorphenamine, can be given by slow intravenous infusion after adrenaline and for in and circulating blood volume and intravenous aminophylline or nebulized salbutamol in addition to oxygen are indicated.

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