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Early signs of lithium toxicity are vomiting and severe diarrhoea followed by tremor, ataxia, renal impairment and convulsions. Many non-steroidal anti-inflammatory drugs interact with lithium to increase its plasma concentration and risk of toxicity.

  • These are the minimum legal requirements and they are intended for the safety of all concerned.
  • She has suffered quite serious nausea as a result of the treatment.
  • This can be prevented by concurrent use of a bronchodilator.
  • It can be achieved by writing an instruction within the patient case notes or, for example by a doctor indicating on an X-ray request form that particular medication should be given as part of the examination.
  • Consequently, water-soluble drugs are not well distributed throughout the body.

They would be able to provide a better service for patients if they were prescribing under a CMP. A CMP could be written with a doctor as soon as the patient is admitted into hospital, providing the patient agrees.

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Human cells have membranes rather than cell walls and so are unaffected by penicillins. Many bacteria produce an enzyme called penicillinase, which destroys some penicillins. Flucloxacillin is not affected by penicillinase and is used for staphylococcus infection. Resistance to penicillins also occurs by reduction in entry of the drug into the bacterial cell and by alteration of penicillin binding protein. Adverse reactions to penicillins are rare; diarrhoea can occur due to alteration in normal gastrointestinal bacteria.

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Beta blockers are also useful in treating hypertensive patients who do not respond adequately to other antihypertensive drugs, and some types of arrhythmia because they slow the heart rate.

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He asks you what would be better reducing the fat in his diet, increasing his intake of fruit and vegetable or getting more regular exercise (although he says he hates the idea of joining a gym). How would you advise him.

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The Review recommended that there should be provision for regular clinical review by the assessing clinician (note: dependent prescriber is now referred to as a supplementary prescriber, Following the Health and Social Care Act to a wider group of health care professions. New types of prescriber were recognized, including the concept of a supplementary prescriber.

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