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In addition, drugs that reduce the availability of monoamines cause symptoms of depression. From such observations the monoamine theory of depression and mania was formed: Depression is due to an absolute or relative decrease in monoamines, or a decrease in receptor sensitivity, at certain receptor sites in the brain. Mania is due to an absolute or relative excess of monoamines or an increase in receptor sensitivity at these sites. Even after years of research, it is still not clear which receptor sites or which monoamines are involved, although noradrenaline, serotonin and dopamine are all implicated. Neither does the theory explain how mania and depression can exist in the same patient. Much research has involved investigation of cerebrospinal fluid, blood and urine of patients to see if there are any abnormalities of monoamine metabolites.

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When and by whom should the patient be reviewed. Case study A patient has been flomax cheap abdominal radiotherapy for a period of time for the treatment of colon cancer. She has suffered quite serious nausea as a result of the treatment. You have supplied metoclopramide to the patient on a regular basis under PGDs. The patient is now complaining that this drug does not seem to work any more. She has also been experiencing facial muscle spasms and wonders if this could be a side effect of her radiotherapy or the drug.

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Department of Health Calman Hine Report Policy Framework for Commissioning of Cancer Services, HMSO, Flomax cheap. Department of Health Review of Prescribing, Supply and Administration of Medicines; Final report, Department of Health, London. Department of Health Medicines Matters: A Guide to Mechanisms for the Prescribing, Supply and Administration of Medicines, National Practitioner Programme Department of Health Core Prescribing Group, London. Department of Health and Social Security Neighbourhood Nursing; a Focus for Care, HMSO, London. Francis, G. and Hogg, D.

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This can result from either differing concentrations of a drug at its site of action, or differing physiological responses to the same concentration of a drug. Adverse drug reactions present a major clinical problem.

  • Local anaesthesia is the reversible loss of sensation in an area of the body.
  • Non-compliance and reasons why patients do not always take drugs as prescribed should be appreciated.
  • Central side effects with long-term therapy of levodopa can be serious enough for treatment to be stopped.
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  • The two polynucleotide strands of DNA coil around each other so that the bases project towards the inside of the helix.
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The formulary of drugs appropriate in the management of podiatric conditions is limited. The range of drug classes requested by podiatrists in the United Kingdom and prescribed by podiatrists in the United States of America in podiatric general practice are anti-microbials, local anaesthetics, non-steroidal anti-inflammatory drugs, analgesics, corticosteroids and anxiolyticssedatives.

Hypersensitivity reactions to drugs involve immunological reactions. Large molecules such as vaccines, insulin and dextrans can provoke immune reactions themselves but most drugs are too flomax cheap to be antigenic on their own. In some patients, something that cannot be predicted is that a drug or drug metabolite can combine with tissue proteins to form an antigenic conjugate. In this situation, the patient shows a response, which can be described under one of the classical definitions of allergic response (that is, type see below). Such reactions require initial exposure to the drug to cause sensitization, after which, subsequent exposure to the same drug triggers an immunological reaction.

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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. Adverse effects of paclitaxel and docetaxel are similar, being hypersensitivity reactions, bone marrow suppression, peripheral neuropathy, hair loss and cardiac arrhythmias. Podophyllotoxin is extracted from the mandrake plant, Podophyllum peltatum. A derivative of this chemical, etoposide, is used in small cell lung cancer, lymphoma and testicular cancer. The mode of action of etoposide is not completely known, but it may be due to an inhibitory effect on topoisomerase similar to that of doxorubicin. Adverse effects of etoposide are nausea and vomiting, hair loss and bone marrow suppression.


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