Haemophilia is a sex-linked recessive inherited disorder of coagulation. There are two types: haemophilia A, or classical haemophilia, is due to lack of Factor VIII and haemophilia B, or Christmas disease, is due to lack of Factor IX. Both diseases have similar symptoms of excessive bleeding from wounds, easy bruising, bleeding into joints, bleeding into the sheath of nerve trunks resulting in paralysis or muscle spasticity, bleeding into the urinary tract and bleeding into the central nervous system. Treatment of both conditions is by replacement of the missing factor. Antihaemophilic globulin and Christmas factor complex are prepared from fresh normal plasma.

They are not used in chronic bronchitis. Cromoglicate and related drugs do not cause bronchodilation and therefore are of no use in an acute asthma attack. It is important that patients understand this. These drugs are available as powder and aerosol inhalers for use on a regular basis.

Side effects of riluzole are nausea, vomiting, tachycardia, headache, dizziness and vertigo. Multiple sclerosis is an autoimmune disease of the central nervous system in which the cells that produce the myelin sheath of neurons are progressively destroyed. Particular areas of the central nervous system affected are the optic nerves, brain stem and cerebellum, corticospinal tracts of the spinal cord and areas around the ventricles. Demyelination leads to variable symptoms depending on where the lesions are. Double vision and vertigo are common presenting signs of brain stem involvement.

Case study You are treating Pete, a young man of accident. In conversation, he tells you that he has depression and is currently going through a particularly bad patch that has lasted several months. When taking his history, you noted that he was taking amitriptyline, day. Pete does not think his medication is improving his mood and tells you that his family thinks his medication should be changed. Could you offer any advice.

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What do you think might have happened to Ms. Clarke after the previous operation. How can you reassure her that this will not happen again. You should be able to answer these review questions from the material in this chapter. injection of drugs.

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British Journal of Anaesthesiology. Drugs Aging. Nederlands Tijdschrift voor Geneeskunde in Dutch. Current Drug Targets. Huf, Gisele ed. Tijdschrift voor Psychiatrie in Dutch. Annals of Oncology. Behavioural Pharmacology. American Journal on Mental Retardation. Medical Journal of Australia. The American Journal of Medicine. Reproductive Toxicology. Modern Anesthetics.

Handbook of Experimental Pharmacology. Benzodiazepines — side effects, abuse risk and alternatives. American Family Physician. April Genus Pharmaceuticals. January 21, Patient UK. October 25, Archived from the original on September 27, American Journal of the Medical Sciences. December Strassbourg: Council of Europe, Pompidou Group. Disposition of Toxic Drugs and Chemicals in Man 8th ed.

These drugs are used to destroy thrombi that are occluding blood vessels. They are most effective given soon after the thrombus has formed, for example within of a myocardial infarction. All of the drugs in use activate plasminogen resulting in the production of the active enzyme plasmin. Clinical uses include treatment of acute myocardial infarction, pulmonary embolism and peripheral thromboembolism and in the restoration of circulation through arterial grafts and intravenous catheters.

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The cell wall of gram-negative bacteria is complex and includes an outer double lipid layer, which limits susceptibility to some antibiotics. Broad-spectrum antibiotics are effective against most bacteria, whereas narrow spectrum antibiotics may be effective against only some. The use of broad-spectrum antibiotics can reduce populations of normal flora (the resident harmless bacteria that we all have), which can cause adverse effects and superinfections of fungi and other drug-resistant micro-organisms. Bacteriostatic antibiotics inhibit bacterial growth and proliferation, while bactericidal antibiotics actually kill bacteria. Many antibiotics are bacteriostatic at low concentrations and bactericidal at higher concentrations.

There is also an increase in LDL receptors on liver cells, which would encourage removal of LDLs from the circulation by liver cells. Fibrates also increase the activity of lipoprotein lipase, which normally breaks down lipoproteins in muscle cells. An example of a fibrate is bezafibrate. A serious side effect or fibrates is a ativan gel 1 mg/ml syndrome, which is made worse by concurrent use of statins. Such a combination is not recommended except in cases of severe familial hyperlipidaemia.

Despite vaccination programmes in many parts of the world, tuberculosis remains the largest single cause of death by infectious disease, causing three million deaths worldwide annually. The problem is compounded by the emergence of resistant strains of the organism and the return of infection to parts of the world where the disease had been eradicated. Mycobacteria take a long time to duplicate themselves ( organisms for identification and there is a long period between infection and clinical manifestation of disease. Mycobacteria are unusual organisms in that the cell wall has several outer waxy lipid layers, which makes drug penetration very difficult.

Anti-inflammatory corticosteroids depress the immune system. Response to infection can be severely impaired as a result of inhibition of the activity of leukocytes and reduction in their numbers. Infections such as tuberculosis can spread extensively before they are discovered.

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In this respect, it is important that radiographers pay due attention to policies and comply as required with Trust governance. Radiographers, and other staff, should be adequately trained and educated in support of reducing risk to patients and also improving care and management (Society and College of Radiographers, to offer in-house training for those who wish to use PGDs and such courses are likely to include: stated outcomes; assessment that verifies the outcomes have been attained; remedial procedures for those who do not pass. The stated outcomes of PGDs are: Understand the concept of patient group directions Understand the historical and legal background to patient group directions Understand the meanings of pharmacodynamics and pharmacokinetics in relation to the drugs that the radiographer is able to supply and administer Understand the pathophysiological processes in the conditions under which the patient group directions can be used Understand the protocols and guidelines that exist to support the use of patient group directions.

Hirudin is a substance produced by medicinal leeches, which directly inactivates thrombin. Lepirudin is a synthetic version produced by recombinant DNA technology, which has to be given by injection. It is used specifically in patients that have developed hypersensitivity to heparin. The chief adverse effect of anticoagulants is haemorrhage; hypersensitivity reactions are also possible. Platelet inhibitors are most effective in preventing arterial thrombosis.

EMLA is indicated prior to venepuncture and whenever pre-injection analgesia of the skin is required. This technique may be used by physiotherapists and radiographers under patient group directions. The anaesthetic is injected in or around the area requiring anaesthesia. The drug diffuses through the tissues and directly affects the nerve endings in the skin preventing conduction of nerve impulses.

Absence seizures are brief periods of loss of consciousness with little motor activity, maybe just eyelid blinking or muscle jerking. Sometimes there is complete relaxation of muscles. This type of epilepsy is common in children.

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