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Pathological features of Alzheimers disease are extracellular plaques of β-amyloid protein and neurofibrillary tangles. β-amyloid plaques are found particularly in the hippocampus and association areas of the cerebral cortex. Similar plaques are seen in unaffected individuals, but there are many more in patients with Alzheimers disease. Their formation may be due to abnormal metabolism of a precursor protein.
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Cyclophosphamide is metabolized to a toxic metabolite called acrolein, which can cause haemorrhagic cystitis, a rare but serious complication. This effect can be counteracted by a high intake of fluid and by using a drug called mesna. Otherwise, cyclophosphamide can cause bone marrow depression, sterility and increased risk of other cancers. There are many drugs in this group of anti-cancer drugs. Some other examples are busulphan and cisplatin.
Levodopa is the precursor of dopamine and it does penetrate the brain where it is converted in the neurons to dopamine by decarboxylation. Levodopa is given orally and in order to maximize the amount that actually reaches the brain, it is given in combination with a decarboxylase inhibitor, carbidopa, which does not enter the brain. Because the drug is not converted into dopamine outside of the brain, this greatly increases the effective dose of levodopa and buys clonidine peripheral side effects. This combination seems to be the best treatment for most Parkinsons patients, at least in the early stages. The site of decarboxylation of levodopa in patients with Parkinsons disease is uncertain, but it may be that there is sufficient enzyme in the remaining dopamine nerve terminals or that conversion takes place in other neurons as they also contain decarboxylase enzymes.
Org Health Professions Council Standards of Proficiency www. medicines. org.
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Supplementary prescribing can be suitable in some areas of community physiotherapy. The advantages of physiotherapy supplementary prescribing in the community are that both patients and physiotherapists benefit in many ways.
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All antidepressants take weeks to have an effect, which is far longer than it takes to alter brain amines. It has been suggested that effects of antidepressants are due to adaptive changes in the brain, which may involve down regulation of receptors or some other change in their sensitivity.
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Podiatric surgeons are not doctors (that is Registered Medical Practitioners). Podiatric surgeons have specialized throughout their training, purely in the treatment of one area of the body, the foot and ankle. The podiatric surgeon has a special insight into the management of foot problems because of a unique training and background. This is combined with an especially close cooperative approach to the management of foot pathology, which includes general practitioners and other medical specialists, other podiatrists, physiotherapists and crucially the patients themselves in working towards their cure or improvement. The Health Professions Council is the statutory body responsible for the registration of podiatrists in the United Kingdom.
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This move is supported by the Society and College of Radiographers. There is no rigorous published information about the clinical use of PGDs or supplementary prescribing by radiographers, so only anecdotal information can be drawn on to buy clonidine debate. Based on anecdotal information, the following anomalies have been noted. A small-scale analysis of gastrointestinal practitioners within the northwest of England revealed marked differences between them, the most notable being in the detail included in PGDs and in practitioner understanding about PGDs.
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