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In this case, careful monitoring is needed because unpredictable interactions between antiepileptic drugs are possible. Withdrawal from antiepileptic drugs should be gradual to avoid the risk of precipitating rebound seizures.

  • Most drugs are more effective at relieving the positive symptoms and all provide better results in acute schizophrenia.
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The pacemaker forms part of a conduction system that transmits electrical activity through the heart by means of action potentials so that contractions are coordinated and the heart can function as an efficient pump. The conduction pathway of electrical activity goes from the SA node to the atrioventricular node between atria and ventricles, then down the septum between the two ventricles to the apex of the heart and finally round the ventricles themselves.

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Antihistamines are used in the treatment of allergic rhinitis and hay fever. They reduce symptoms such as runny nose and sneezing, but are less effective for nasal congestion. There are many antihistamines available and they differ in their duration of action, anticholinergic effects and incidence of drowsiness. Older antihistamines are the most likely to cause drowsiness. Newer ones, for example acrivastine, are preferred because they penetrate the blood-brain barrier less easily and cause less sedation. Nevertheless, all antihistamines should be labelled with a warning that they may cause drowsiness and patients should not drive or operate machinery when taking them.


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This is a group of cardiac muscle cells in the right atrium that depolarize spontaneously. Depolarization of cardiac muscle cells brings about contraction.

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This will increase the pharmacological activity of both drugs, but the action of warfarin is of most importance. Drug interaction is not always an adverse reaction.

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The study of the effects that drugs can have on the body and how they produce these effects is known as pharmacodynamics. An adverse reaction is any reaction to a drug that is harmful to the patient.

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Carrier proteins can be inhibited by drugs or persuaded to pick up false transmitters. For example, selective serotonin reuptake inhibitors inhibit membrane carriers for serotonin, and methyldopa is taken up into neurons by the carrier for dopa and subsequently converted to the false transmitter methylnoradrenaline.

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Plasma protein binding therefore reduces active drug concentration and ultimate response to the drug.

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