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In addition to disturbing sleep, narcolepsy is associated with excessive sleepiness during the day. A multiple sleep latency test can help to confirm the diagnosis. Modafinil now offers an alternative to dexamphetamine and methylphenidate. The mechanism of action of modafinil is unclear. It does not bind with receptors for noradrenaline, dopamine or serotonin. Patients take a single dose in the mornings.

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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 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.

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In particular, they increase the risk of myopathy with statins. Some antiviral drugs in this group act by blocking an ion channel that allows the release of genetic material from viruses once they are inside the host cell and which allows viral particles to leave the infected host cell to infect other cells. Amantadine is such a drug, but its use in influenza A is no longer recommended by the National Institute for Health and Clinical Excellence. It has an unrelated use in the treatment of Parkinsons disease. Neuraminidase inhibitors inhibit an enzyme, neuraminidase, that is produced by virus infected cells and which helps viruses to leave infected host cells. Zanamivir and oseltamivir are examples, which are used to treat influenza A and B in vulnerable individuals (those over renal disease, immunosuppression or diabetes).

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The sale, supply and use of medicinal products are governed by the Medicines Act and European Directives. The Medicines Act divides all medicinal products into three categories: GSL items; P; and POM.

  • By such a mechanism, substances can be concentrated in certain parts of the body.
  • Myasthenia gravis is an autoimmune disorder, which is diagnosed in about people every year in the United Kingdom, mainly affecting women between Normal Myasthenia gravis nerve terminals muscle cell membrane mitochondrion junctional folds vesicles containing acetylcholine acetylcholine receptors acetylcholinesterase skeletal muscle is disrupted.
  • A CMP is agreed with individual patient and the supplementary prescriber manages the patients clinical condition, including prescribing, according to the CMP.
  • Management of cystic fibrosis is through a combination of physiotherapy and antibiotics.
  • These are the International Classification of Diseases (ICD- Revised.
  • In accordance with national advice, the survey revealed that more than half of them had been trained in-house while the remainder had attended a university-based post-registration programme.

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Loperamide is an opiate drug that decreases motility of the intestine. It does not cross the bloodbrain barrier easily and therefore does not have the central nervous system effects of other opiates.

The majority of clinical care should still be provided on an individual, patient-specific basis. The supply and administration of medicines under PGDs should be reserved for those limited situations where this offers an advantage for patient care without compromising patient safety, and where it is consistent with appropriate professional relationships and accountability. It may be necessary or convenient for a patient to receive a medicine (that is, have it supplied andor administered) directly from a health care professional other than a doctor. Unless already covered by exemptions to the Medicines Act, there are two ways of achieving this: by PGD or by patient specific directions. In essence, a PGD allows a range of specified health care professionals, including podiatrists, to supply andor administer a medicine directly to a patient with an identified clinical condition without them necessarily seeing a medical prescriber.

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More rarely, severe hypersensitivity reactions including fatal bone marrow depression have been reported. (For use of carbamazepine in neuropathic pain Valproate is effective in all types of epilepsy and is especially useful in children and older people because it does not cause sedation and generally has low toxicity. It is considered to be first-line treatment for generalized seizures. The exact mode of action of valproate is unclear. It inhibits enzymes that inactivate GABA, which causes an increase in GABA content of the brain and it possibly enhances the action of GABA. Side effects of valproate are few.


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