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(Note: a nucleoside is a base [either purine or pyrimidine] plus a sugar molecule; a nucleotide is a base plus a phosphorylated sugar molecule. See Figure for a diagram of a nucleotide.
Adverse reactions to drugs can be divided into type A and type B (bizarre). These adverse drug reactions are generally dose-related and most can be predicted. They can be caused by an exaggeration of a drugs intended pharmacological effect or by an unwanted action or side effect. Type A adverse reactions are most likely to occur with drugs that have a steep doseresponse curve andor small therapeutic ratio. The TR of a drug is the ratio of the maximum non-toxic dose to the minimum dose that has a therapeutic effect and is essentially a measure of a drugs safety margin. TR maximum non-toxic doseminimum effective dose The most dangerous drugs are those with a small TR where the maximum non-toxic dose is very close to the effective dose.
Larger doses depress respiration and lower the level of consciousness of the patient. Local anaesthetics can affect both autonomic nerves and the neuromuscular junction. Apart from their local anaesthetic action, local anaesthetics have anticholinergic activity. This is due partly to prevention of acetylcholine release and partly to non-depolarizing competitive block of the acetylcholine receptors on the postsynaptic membrane. The importance of this clinically is that local anaesthetics should be used with great care in patients suffering from myasthenia gravis because of the danger exacerbating the condition and precipitating paralysis, particularly of the respiratory muscles. Such patients should be treated as high risk.
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This group of drugs is effective against many fungi. Imidazoles are often the drugs of first choice for treating tinea because they are more effective than other topical drugs described above.
18.11.2019
Ludwig
Verified
Non-compliance and reasons why patients do not always take drugs as prescribed should be appreciated. Some common reasons for non-compliance are that the patient has doubts about a drugs effectiveness, they believe they are cured, they misunderstand instructions, dosage regimes are too complicated, or they experience unacceptable side effects.
14.09.2019
Angelika
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Second generation β-blockers have greater cardio-selectivity and are less likely to cause bronchoconstriction. Examples are atenolol and bisoprolol.
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Ferdinand
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Prescriber A professional relationship between the independent prescriber and the supplementary prescriber is paramount to safe and effective supplementary prescribing. The two should be able to communicate easily, share access to the same common patient record and any guidelines used in the CMP, agree common understanding of and access to the written CMP and ideally review the patients progress together at agreed intervals.
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Martin
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