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Phase-non-specific drugs are cytotoxic at any point in the cell cycle and may be toxic to cancer cells in the resting phase. However, most cancer drugs are effective in the S phase of dividing cells, preventing normal DNA synthesis so that the cells go into apoptosis. Drug therapy aims to prevent cell division or cause cell death in the tumour without damaging normal healthy cells. Cancer cells are similar to normal cells, so this is often impossible and explains many of the side effects of chemotherapy. Cytotoxic drugs affect normal dividing cells producing unwanted adverse effects on bone marrow and the cells produced there; reduced healing; loss of hair due to damage to hair producing cells in hair follicles; damage to the gastrointestinal lining; reduced growth in children; sterility; and damage to the foetus. Nausea and vomiting are common with most anti-cancer drugs and are caused by toxic effects on the chemotrigger zone of the central nervous system.

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Individuals have different reactions to different NSAIDs. Some tolerate a particular drug while others do not. In the treatment of chronic pain, a number of drugs may be tried until one is found that produces the most acceptable result to the patient. Aspirin, is often the first choice of analgesia for mild to moderate pain in adults. In large doses, aspirin has anti-inflammatory effects and has a role in the treatment of chronic inflammatory disease.

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Given Mrs Singletons aversion to taking steroids, what could you say about their use to reassure her. Do you think this patient would be suitable for supplementary valium 10mg sleep with a clinical management plan and why. This is a patient who could be seen by any health care professional for different reasons. You are asked to discuss how you would answer general questions about the patients condition and treatment. You may find the British Thoracic Society Guidelines useful for this case study.

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The trachea divides into two bronchi, which enter the lungs. The bronchi divide into secondary and tertiary bronchi and further into smaller branches called bronchioles.

  • Discussions with those holding responsibility for creating the PGDs revealed that there was no mechanism for sharing paperwork between Trusts.
  • Haemophilia is a sex-linked recessive inherited disorder of coagulation.
  • 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.
  • These drugs are reserved for patients with the most severe forms of psoriasis that do not respond to, or cannot tolerate, topical or phototherapy.

Viscous secretion is treated with vigorous physiotherapy and the use of mucolytics. Infections in cystic fibrosis are often due to Staphylococcus aureus, Haemophilus influenzae or Pseudomonas aeruginosa.

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Extensive impetigo needs treating with a systemic antibacterial such as flucloxacillin. There are many topical antibacterials available.

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Antiviral drugs work by inhibiting the synthesis of viral DNA, RNA or proteins; by reducing the release of viral genetic material inside host cells; by interfering with viral penetration of host cell membranes; and by interfering with attachment of virus to host cell membranes. Resistance to antiviral drugs can occur by a number of mechanisms. HIV infection is treated with a combination of antiviral drugs with different mechanisms of action. Infection with fungi can be superficial affecting skin and nails, or systemic affecting internal organs, particularly the lungs. Systemic fungal infections have become more common due to overuse of antibiotics and increase in numbers of immunocompromized patients. Many antifungal drugs work by interfering with ergosterol production thus making the fungal cell membrane leaky.

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Drugs can also be given by injection. Methods of injection include subcutaneous, intramuscular, intravenous, intra-arterial, intra-articular, intraspinal and epidural. Drugs injected subcutaneously or intramuscularly have to diffuse between loose connective tissue or muscle fibres. The rate of absorption depends on the usual parameters for passage across cell membranes but also on the blood or lymphatic supply to a particular region. Increasing the blood supply by applying heat or massage will increase the rate of absorption. Conversely, for a local effect, addition of a vasoconstrictor to the injection decreases the rate of removal of the drug from the site of injection.


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With the exception of nail surgery, podiatrists undertake the treatment of foot problems by non-invasive methods (until recently podiatrists were known as chiropodists).

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Other known toxic causes include Wilsons disease, where there is deposition of copper in the basal nuclei, and mercury and manganese poisoning.

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A PSD can be a written statement defining the care of a named patient agreed between the doctor and other health care professionals. An example could be the variation of dose range of analgesic in a rheumatology patient by a physiotherapist.

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Supplementary prescribing would be appropriate in these situations.

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