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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. The Medicines Act secondary legislation since then, provides a legal framework for the manufacture, licensing, prescription, dispensing and administration of medicines. An exemption to the Medicines Act allows certain professionals, including podiatrists, access to specified prescription-only medicines, providing they are appropriately registered with the Health Professions Council. The use of patient group directions allows many health care professionals to administer prescription-only medicines to specific groups of patients without a normal prescription.

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Digoxin is a drug with a narrow therapeutic ratio, which means therapeutic doses are very close to those that can cause toxic effects. Would you recognize signs of digoxin toxicity and would you know what to do if Mr Frobisher showed these signs. This is a case study of a patient who might be seen in a podiatry clinic. Mr Buckley is sore on the upper surface of the third toe on his right foot. On examination, you find that this sore has all the characteristics of an ulcer. Mr Buckleys feet are cold to the touch and he confirms that he often finds it difficult to keep his price of xanax warm.

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The sequence of bases forms a set of instructions or a code for the assembly of amino acids into proteins. A stretch of DNA that codes for a particular protein is known as a gene. DNA is packaged into the nucleus of cells in the condensed form of chromosomes. In human cells there are sperm and egg cells where there are Replication of DNA takes place before a cell divides and necessitates the uncoiling and separation of the two strands. This requires the action of enzymes. New nucleotides pair C cytosine G guanine T thymine A adenine base sugar base phosphate Figure with the existing bases of each strand: adenine nucleotides pair with thymine; guanine nucleotides pair with cytosine.

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Conversely, the elimination of basic drugs such as amfetamine, antihistamines, morphine and tricyclic antidepressants can be increased by making tubular filtrate more acidic by administration of ammonium chloride. Although generally not as important as renal excretion, other routes of excretion account for elimination of some drugs.

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Training to be independent prescribers andor supplementary prescribers is provided by Higher Education Institutions in the United Kingdom according to a curriculum developed and agreed with the HPC. Supplementary prescribing is likely to be most suitable with patients who have chronic conditions and can be managed by a supplementary prescriber between reviews by the doctor.

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Grieving is a natural process that serves a purpose in recovery from loss. It is important to realize that some medical conditions can mimic the symptoms of generalized anxiety disorder, for example hyper- or hypothyroidism, hypoglycaemia, drug or alcohol withdrawal and cardiac arrhythmias. Anxiety and fear are both associated with general arousal of the CNS and may be due to over activity in the RAS. Neurotransmitters in the RAS are serotonin and GABA. It is thought that GABA normally moderates the activity of serotonin-containing neurons and that in anxiety syndromes some of this moderation is lost due to changes in receptor sensitivity, or due to overactivity of a natural inhibitor of GABA. An inhibitor of GABA has not been identified, but it has been tentatively called GABA modulin.


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By the time cancer has been diagnosed, cell growth and spread of malignant cells has probably occurred. In order to understand how drugs used to treat cancer work, an overview of DNA structure and replication and the process of protein synthesis is necessary.

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It could be that doctors do not always prescribe effectively.

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