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Common side effects include headaches, heartburn, and flushed skin. Sildenafil acts by blocking phosphodiesterase 5 PDE 5, an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis.
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Resistance to antibiotics can develop by the following mechanisms: enzymes produced by bacteria destroy the drug; the bacterial cell wall becomes impermeable to a drug or the drug is rapidly removed; drug binding sites within bacteria become altered; alternative metabolic pathways develop in bacteria using enzymes not affected by the drug. The development of resistance can be reduced by less indiscriminate use of antibiotics, using them only where there is a distinct clinical need and ensuring that patients complete the entire course of antibiotics.
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Osteoarthritis is the most common form of arthritis worldwide. It occurs in about people over starts slowly with individual joints.
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They provide an alternative for those who cannot tolerate ACE inhibitors because of a persistent dry cough, but should not be used in pregnancy either.
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