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The heart consists of four chambers: two atria and two ventricles and is divided into right and left sides. The walls of the atria and ventricles consist of cardiac muscle, with that of the left ventricle being the thickest. Collectively cardiac muscle is known as the myocardium. The heart functions as a double pump to circulate blood through the lungs and round the rest of the body. The circuit of blood through the heart is as follows. Blood enters the right atrium from the superior and inferior vena cavae. The atrium contracts and from here the blood passes through the tricuspid valve to the right ventricle. The ventricle contracts and blood flows through the pulmonary valve and pulmonary arteries to the lungs.
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Most drugs are treated as potentially toxic substances and are metabolized by the liver. This detoxifies them and some drugs are almost totally inactivated on first pass through the liver. Eventually a drug will be excreted from the body. This usually occurs via the kidneys, although some drugs can be lost in faeces or exhaled air. This chapter discusses the processes of administration, absorption, distribution, metabolism and excretion of drugs together with factors affecting these processes.
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Ankylosing spondylitis particularly affects the iliosacral and vertebral joints which eventually become fused. Due to ossification of ligaments connecting order viagra pay with paypal vertebrae, the spinal column becomes curved and rotational motion is restricted. Extra-articular involvement includes conjunctivitis, psoriatic inflammation of the skin and nails and lung fibrosis. Systemic lupus erythematosus is a systemic inflammatory disease with formation of autoantibodies against DNA, wide spread immune complex deposition and complement activation. Symptoms include arthritis, a characteristic butterfly rash on the face, myalgia, glomerulonephritis, vasculitis, pericarditis and inflamed and fibrosed lungs.
Four main groups of drugs are used as premedication and as adjuncts to general anaesthesia: sedatives; antimuscarinic drugs; muscle relaxants; and analgesics. Often, short-acting sedatives may be used to allay anxiety and produce some sedation and amnesia. Oral benzodiazepines, such as diazepam or midazolam are commonly used. These drugs also reduce muscle tone, which is useful during surgery. They have no analgesic effect, so may be used together with opioid analgesics. As a side effect benzodiazepine sedatives produce a degree of respiratory depression.
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Drugs with a TR of one or less cannot be used therapeutically. A type A adverse drug reaction is a possibility if a patient is given a higher than recommended dose for any particular route of administration due to practitioner error. In order to avoid this it is good clinical practice for drug dosages to be checked by another member of staff prior to administration. Where this is not possible, or impracticable, extreme care must be taken to ensure that a patient receives the right dose of the correct medicine by the route intended. Overdose is also possible if the correct dosage of a drug is administered via the wrong route. For example, a local anaesthetic injected into a blood vessel rather than into the tissues produces a rapid rise in blood level and this increases the risk of unwanted effects of the drug.
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Drug therapy of disease is ever expanding; new drugs exist for effective treatment or cure of more diseases than ever before. Correct use of drugs is paramount. It is therefore important for health care professionals to have an understanding of therapeutic uses of medicines, normal doses, adverse effects, interactions with other drugs, precautions and contraindications. It is equally important to be able to judge whether a change in a patients condition is caused by drug therapy, or a change in the disease process. Medication can lead to symptoms such as dizziness, fatigue, dry mouth, constipation and patients may or may not associate new symptoms with drug use. Health care professionals are increasingly involved in the administration of drugs to patients, either as an exemption to the Medicines Act directions, or as supplementary prescribers.
Merkel cells are attached to a sensory neuron and function to detect the sensation of touch. Melanocytes produce the pigment melanin, which contributes to buy cheap viagra with mastercard colour and provides some protection against sunlight. Langerhans cells are found in the stratum spinosum. They are part of the immune system and help protect the skin from microbial infection. Hair follicles, sebaceous glands and sweat glands are part of the epidermis, but they penetrate into the dermis.
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The best practice is for the clinician with the direct responsibility for the patient, if suitably trained, to be able to initiate immediately the required therapeutic regime. For podiatrists and podiatric surgeons to have access to a relevant range of POM in common use, as part of their overall surgical and non-surgical patient management, will minimize delays in the commencement of treatment and reduce delays in providing diagnostic or therapeutic interventions.
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See Figure a diagram of the digestive system.
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