Patients must not be taking other photosensitizing drugs, for example phenothiazines and benzodiazepines, NSAIDs and some antibiotics. Psoralens are naturally occurring plant extracts found in the parsnip family and the technique has a long history, being used by Egyptians and Indians to treat vitiligo as long ago as in the skin and photochemotherapy is still used to treat it. Psoralen causes stimulation of melanocytes and some repigmentation in vitiligo.

The dermis also contains lymphocytes, mast cells and macrophages, which respond to injury, infection, allergens and harmful chemicals by releasing inflammatory substances. The dermis has a good blood supply and variation in blood flow through the dermis and the production of sweat are important in body temperature control. Sensory nerve endings found in the dermis are sensitive to touch, pressure, pain and change in temperature.

A basic knowledge of the clotting mechanism, the causes and consequences of anaemia and lipid metabolism is needed in order to appreciate how these conditions can be treated. Haemostasis is a protective mechanism to stop bleeding from damaged blood vessels. The normal homeostatic control of bleeding consists of three components.

This led to the suggestion that idiopathic Parkinsons disease may be caused by some, as yet, unidentified neurotoxin. It is possible that overactivity of glutamate could cause neuronal damage [as may also be the case in motor neuron disease and Alzheimers disease]. Other known toxic causes include Wilsons disease, where there is deposition of copper in the basal nuclei, and mercury and manganese poisoning.

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This is best exemplified by the staphylococcus strains now called MRSA (meticillin imiquimod cream price Staphylococcus aureus, or multi-resistant Staphylococcus aureus. Meticillin is now unavailable in the United Kingdom). Resistance to antimicrobial drugs can be innate or acquired. With innate resistance an entire bacterial species or a certain percentage of a population are naturally resistant to a drug.

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ACE inhibitors and angiotensin II receptor inhibitors limit the action of angiotensin II and suppress aldosterone production. These effects have benefits in the treatment of cardiac failure and hypertension because the resulting vasodilation and water loss lowers blood pressure. Ischaemic heart disease can be treated with nitrates, potassium channel activators, β-blockers and calcium channel blockers. All these drugs either improve the blood supply to the myocardium or reduce its metabolic demand for oxygen, or both.

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Mrs Xavier wonders if it would be alright to give her granddaughter montelukast if she has an asthma attack again. What should you tell her. You should be able to answer these review questions using the information provided in this chapter.

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Other areas of research include the development of drugs that block the capacity of oncogenes to turn cells malignant; antagonists of growth factors; inhibitors of cell cycle control factors; and gene therapy to restore tumour suppressor gene function. Cancer occurs when mutated cells divide uncontrollably, taking up space and spreading to distant parts of the body. Treatment is usually with a combination of surgery, irradiation and chemotherapy. The aim of chemotherapy is to interfere with cell division in tumour cells without damaging normal healthy cells. However, because cancer cells are similar to normal cells, chemotherapy is toxic to rapidly dividing cells in bone marrow, hair follicles and the gastrointestinal tract.

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