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In joints this causes the synovium to become inflamed. Initially, episodes of inflammation last only a week or so with no symptoms in between. However, untreated acute attacks occur more frequently and chronic inflammation results in damage to affected joints leading to stiffness and limited mobility. Attacks of gout usually develop very quickly. The first attack often occurs in the middle of the night with the sufferer waking up with extreme joint pain. Typically the first metatarsal-phalangeal joint of the big toe is affected, although the finger joints and the joint at the base of the thumb may also be involved.
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In some patients, particularly those with HIV and on multiple therapy, more serious exfoliative dermatitis and StevensJohnson syndrome has occurred with fluconazole.
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The first three of the following drugs are available in many preparations as over-thecounter medicines. An example of each is given.
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Actions on D the prevention of nausea and vomiting, particularly in patients being treated with cancer chemotherapy or radiotherapy. Anxiety and insomnia are discussed together because the drugs used to treat them are often the same.
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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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