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These mediators include histamine and prostaglandins together with a range of other substances in small quantities (for example leukotrienes). The immediate effects are due principally to the action of histamine and include hyper-responsiveness and constriction of bronchial smooth muscle and inflammation of bronchial epithelium. Both of these effects combine to produce an increase in airway resistance, that is, a narrowing of the airway and difficulty breathing out. Other symptoms are wheezing and coughing. Patients usually describe the sensation as like having a tight band around the chest limiting the movement of the thorax.

The aim of insulin therapy is to achieve the best possible control of blood glucose concentration, without precipitating hypoglycaemic episodes, to avoid complications. Insulin is ineffective orally and has to be administered by injection. The usual route is subcutaneously, though the soluble rapid-acting preparations can be given intravenously in emergencies. These drugs lower blood glucose by a variety of mechanisms. They are of no use in IDDM, but do have a place in the treatment of NIDDM.

A disadvantage is that, because it is a protein, glucagon can provoke hypersensitivity reactions. Metoclopramide is a dopamine antagonist that stimulates gastric emptying and small intestine transit and is used to speed up transit time of barium follow-through examinations. Metoclopramide is also an antiemetic, which can be useful in radiological examinations and to counteract the effects of therapeutic radiography. The antiemetic effect is due to the blocking of dopamine receptors in the chemotrigger zone of the medulla.

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This could alter expected drug distribution. Age-dependent changes in the liver have the most impact on drug metabolism. Over the age of be further reduced by concomitant pathologies such as left ventricular dysfunction or congestive heart failure, both of which are more commonly found in older patients.

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Sor. orgmemberseffective-practicepres rad newsnews A physiotherapy perspective of non-medical prescribing is discussed here. Like podiatrists and radiographers, physiotherapists can, under PSDs, currently supply andor administer medicines to a named patient and under PGDs they can currently supply andor administer medicines to groups of patients who may not be individually identified prior to treatment.

They reduce symptoms such as runny nose and sneezing, but are less effective for nasal congestion. There are many order synthroid available and they differ in their duration of action, anticholinergic effects and incidence of drowsiness. Older antihistamines are the most likely to cause drowsiness.

Pleural fluid is secreted between this double membrane and acts as a lubricant reducing friction as the lungs move against the ribs during breathing. The pleural membranes also ensure that the chest cavity is airtight. This is essential for the lungs to be able to expand as the ribs move. The hard and soft palates divide the nose from the throat and mouth.

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Riluzole must be used under specialist supervision. 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 order synthroid spinal cord and areas around the ventricles.

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Cardiac glycosides interact with many other drugs; some increase the risk of toxicity (for example amiodarone and verapamil) and others reduce it (for example cholestyramine, colestipol and antacids), but also reduce therapeutic effect. Diuretics are used to treat cardiac failure and hypertension. Because cardiac failure results in hypertension and leads to oedema, diuretics are used in both cases because they encourage water loss and therefore produce a reduction in circulating blood volume. This lowers blood pressure, reduces the work the heart has to do and improves oedema by encouraging the movement of fluid from the tissues into the circulation. Of the different types of diuretics, the ones used in cardiac failure and hypertension are thiazide diuretics and loop diuretics.

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