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Discuss how you would explain to Mr Qureshi why he does not need insulin at this stage. What other advice could you give Mr Qureshi regarding his lifestyle and other things he can do to maximize his diabetic control. Mr Qureshi mentions that he has experienced nausea and occasional vomiting since he started on gliclazide and wonders if this is a side effect of the drug and if he should be worried about it. What would you advise him about side effects of gliclazide. The following patient is being investigated for recurrent urinary tract infection.
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The reasons for this are not know, but suggestions include nicotine induction of detoxifying enzymes, inhibition of harmful enzymes or stimulation of factors that protect neurons. Treatment of Parkinsons disease is not usually started until symptoms are interfering with daily life and should be initiated under supervision of a specialist. The aim of drug therapy is to slow progression of the disease, but there is no cure.
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The first three are techniques that can be used by podiatrists in the course of their professional practice providing they are registered with the Health Professions Council and hold a certificate of competence in the use and administration of local anaesthetics. Other techniques for local anaesthetic administration are given for the sake of completeness.
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Lithium is similar to sodium in that it forms positive ions and can pass through sodium ion channels in neuronal cell membranes. It tends to accumulate inside neurons and may interfere with nerve action potentials or the activation of second messenger systems within the neuron.
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