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Beta in bronchial smooth muscle. Although they are selective for β have some affect on cardiac β at therapeutic doses, but could be if a patient decided to increase the dose above that recommended. β asthmatic attack and maintenance treatment of chronic asthma. They are more effective in treatment of the immediate phase reaction than the late phase reaction. β stimulants are less effective in chronic bronchitis, possibly because in this disease bronchoconstriction is due to reflex stimulation of acetylcholine receptors following stimulation of local irritant receptors in lung tissue.
There are many drugs in this group but little to choose between them.
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Adverse effects are bradycardia, heart block and possible precipitation of heart failure. Class I calcium channel blockers are contraindicated in patients who already have these conditions.
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Metabolism involves changes to the molecular structure of a substance and these changes are produced by the action of enzymes.
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An informal discussion with the Department of Health confirmed that Trusts retain the right to approve or veto the adoption of legislation into working practice, amplifying the requirement to seek formal Trust approval prior to implementation.
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You should be able to answer these review questions using the information provided in this chapter.
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These drugs produce a modest improvement in memory or slow progression of symptoms in some patients.
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Here some drug metabolites that have been excreted in bile can be regenerated by the action of bacteria in the large intestine.
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Acetylcholine, noradrenaline and serotonin all play a role in inducing sleep.
It can be used topically and orally to treat skin and nail infections. Given orally the drug is sequestered into hair and nails.
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Excision Dermatologists rarely recommend excision because this type of surgery leaves a permanent scar. Under local anaesthetic, cytotoxic drug is injected into warts.
Drugs in current use are not all covered in this text; neither is this work intended as a recommendation for any drug use. Professionals should always consult the latest edition of the British National Formulary for definitive information about medicines. Acknowledgements I would like to thank friends and colleagues who encouraged and supported me in the writing of this book from its early inception through to final completion. I especially want to thank Leah Greene for her technical expertise and unfailing assistance with computer applications.
I am grateful to Alison Barlow and Peter Bowden for their helpful ideas with matters relating to podiatry and Louise Stuart, MBE for an insight into supplementary prescribing; to Jan Dodgeon for help with topics relevant to radiography and Chris Frames and Chris ONeal for their help with devising physiotherapy case studies.
Many anti-psychotic drugs have what are called Parkinsonian or extra-pyramidal side effects. These are abnormalities of movement that resemble Parkinsons disease (see page Anti-psychotics that also have anti-cholinergic activity cause fewer Parkinsonian side effects. A more serious and irreversible side effect related to Parkinsonism is tardive dyskinesia. This occurs after many years of anti-psychotic drug use and is characterized by abnormal and disabling involuntary movements of the face, tongue, trunk and limbs.
Phenothiazines have pronounced sedative effects. They are also antiemetic (due to the blocking of dopamine receptors in the chemotrigger zone) and cause increased levels of prolactin (by inhibition of the effects of dopamine in the hypothalamic-pituitary pathway, and women.