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Sulphonamides interact with warfarin by enhancing the actions of these drugs. The most important adverse effects of sulphonamides are rashes, renal failure and various blood disorders. Trimethoprim inhibits another enzyme, dihydrofolate reductase, in the same folic acid metabolic pathway.
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You see Mrs Dexter a few months later and she tells you that, although the rash has gone, she is still in considerable pain. She says that normal painkillers do not do any good. What advice can you give Mrs Dexter about what appears to be neuropathic pain. You may need to refer to Chapter treatment of neuropathic pain in the BNF.
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Drugs have been developed to block these receptors. An example is memantine. There are many disorders of the CNS. Psychiatric disorders include types of depression, psychosis and anxiety. Neurological disorders include Parkinsons disease, epilepsy and Alzheimers disease.
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The role of the podiatric surgeon is to provide specialist management of foot pathology by surgery and alternative measures, either directly or by referral to podiatrists or other healthcare professionals. In the United Kingdom, podiatrists have had access to a range of POMs by means of an exemption order (since administered local anaesthetics) for administration, sale or supply (and recently, November a number of antibiotics and some NSAIDs. Indemnity provision is provided via the Society of Chiropodists and Podiatrists and has been modified in view of the extended list of POMs. Discussions with the Societys indemnity insurance provider indicated that no issues with indemnity were apparent.
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Excretion occurs via the kidneys but only a small percentage of the drug appears in the urine in its original form. Therefore, the risk of adverse effects is increased in patients with hepatic or renal disorders.
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The success of chemotherapy depends on the drugs being relatively more toxic to the infecting organism than to the cells of the human host. This is known as selective toxicity. Chemotherapy also applies to treatment of cancers. Cancer cells are similar to normal cells and most anticancer drugs show little selective toxicity and therefore produce serious adverse effects. Conventionally, micro-organisms include bacteria, viruses and fungi; protozoa and parasitic worms are parasites. However, bacteria, viruses and fungi are also parasitic, in that they live in or on other living organisms.
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