UVA is principally responsible for photo-ageing and penetrates tissues far more deeply than UVB. Long-term risks of PUVA include accelerated skin ageing and an increased incidence of skin cancer. Patients must not be taking other photosensitizing drugs, for example phenothiazines and benzodiazepines, NSAIDs and some antibiotics.

The oesophagus conveys food to the stomach. In the stomach food is stored while further digestion takes place. The stomach produces acid and enzymes to begin protein digestion. It can take onto the small intestine. Stomach acid and enzymes can destroy some drugs and they have to be protected by an enteric coat so they pass unharmed into the small intestine.

Case study Mrs Dexter is She is being treated systemically with acyclovir at a dose of and what can you advise her if she should suffer from any of the side effects. Systemic antiviral treatment reduces pain severity, duration and complications of shingles. It should be started within Are there any cautions with use of this drug.

Any excess LDLs in the circulation are of a size to deposit cholesterol in the walls of damaged arteries. High levels of circulating LDLs are associated with the glucophage 500mg price in india of atherosclerosis. This prevents accumulation of cholesterol in the blood. HDLs are not atherogenic because of their small size. Total plasma cholesterol is the sum of cholesterol carried in all forms of lipoproteins, with about In the liver, cholesterol can be stored in liver cells, used to form more VLDLs, used to form bile acids or excreted as cholesterol in bile.

An example is acipimox. Because of side effects, use of these drugs is now limited to treatment of familial hyperlipidaemia in combination with bile acid sequestrants. There are many disorders of the cardiovascular system and blood. Common cardiovascular disorders are cardiac failure, ischaemic heart disease, arrhythmias and hypertension. Although these conditions cannot be cured by drug therapy, there are many drugs available to help control them.

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As cells repeatedly divide a mass forms known as a tumour, which needs a blood supply. Angiogenesis is the process by which tumours develop their own blood supply. By the time cancer has been diagnosed, cell growth and spread of malignant cells has probably occurred. In order to understand how drugs used to treat cancer work, an overview of DNA structure and replication and the process of protein synthesis is necessary. There follows a brief outline of these processes.

There are necessary for the synthesis of many of them. Clotting factors circulate in an inactive form. Once the reaction is triggered by tissue or blood vessel damage, one factor activates the next by a cascade mechanism leading to the formation of prothrombinase.

Anti-cholinergic drugs were originally used prior to the development of levodopa because many signs of excessive parasympathetic activity are seen in Parkinsons patients (salivation, sweating and incontinence). The basal nuclei contain many excitatory cholinergic neurons. As the nigrostriatal tract progressively degenerates, the release of inhibitory dopamine declines and the cholinergic system becomes relatively overactive. The glucophage 500mg price in india of action of anti-cholinergic drugs appears to be at muscarinic receptors in the basal nuclei. However, as the disease progresses, the loss of dopaminergic activity becomes so great that anti-cholinergic drugs cannot compensate for it.

Thromboembolic disease is the result of thrombus and embolus formation and can take the form of a heart attack or a stroke or blockage of a blood vessel elsewhere in the body. Thromboses in arteries and veins are slightly different. Venous thrombi form in slow moving blood and contain a lot of fibrin.

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Positive symptoms of delusions, hallucinations and thought disorder are improved. Many anti-psychotic drugs have what are called Parkinsonian or extra-pyramidal side effects. These are abnormalities of movement that resemble Parkinsons disease (see page Anti-psychotics that also have anti-cholinergic activity cause fewer Parkinsonian side effects.

ACE inhibitors should not be used in pregnancy. Angiotensin II receptor antagonists are used to treat cardiac failure and hypertension. Not surprisingly, they have a similar effect to ACE inhibitors but this is brought about by preventing angiotensin II from binding to its receptors.

Although the lungs are the major site of infection, the organism can also infect other tissues such as bones, joints and the brain. In the lungs, mycobacteria infect alveolar macrophages and this initiates an inflammatory reaction that involves many of the cells of the immune system. Infected cells form granulomas enclosing the organism and replacing healthy tissue. In the centre of a granuloma is an area of necrotic tissue, referred to as caseation, which can become fibrotic and calcified. The granulomas contain bacteria lying dormant but capable of becoming reactivated later in the patients life if they become ill from some other cause or become immunosuppressed.

It is an antimetabolite that is converted to an enzyme necessary for DNA synthesis. Adverse effects of flucytosine are gastrointestinal upset, anaemia, neutropenia, thrombocytopenia and alopecia, all mild and reversible. This group of drugs inhibits an enzyme necessary for ergosterol synthesis.

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