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Medicines in this category have been used for many years by doctors to treat and prevent many different conditions, including high blood pressure, angina, irregular heartbeat, anxiety, and migraines. In the management of migraines, propranolol is used as a preventative.
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GSL items may be supplied from premises other than a registered pharmacy, for example a shop or supermarket and by persons other than a pharmacist and without supervision of a pharmacist. For this reason, they are often known as over-the-counter (OTC) drugs.
Some drugs are almost completely inactivated by first pass metabolism in the liver. The extent of first pass metabolism varies from individual to individual and can lead to unpredictable effects for some drugs administered orally. Other tissues where significant metabolism of drugs can occur include the intestinal mucosa, the lungs and plasma. There are two general types of metabolic reactions, which are known as Phase Phase on its chemical nature, it is possible for a drug to be metabolized by either type of reaction only.
See Figure Phase reactions to a more water-soluble metabolite, which is more likely to be excreted by the kidney or go on to Phase reaction, which involves the addition of oxygen to the drug molecule. In the liver, oxidation reactions are catalysed by a group of enzymes known as the microsomal mixed function oxidase system or the cytochrome P Oxidative reactions take place in many other tissues as well.
Thymectomy increases the chances of a patient going into remission, although it may take for the benefits to be seen. Drug therapy has to be tailored to individual patients and includes anticholinesterase drugs, anti-inflammatory corticosteroids and immunosuppressant drugs. Anticholinesterase drugs work by inhibiting the enzyme that normally destroys acetylcholine after it has stimulated its receptors at the neuromuscular junction.
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