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Apomorphine is a potent dopamine receptor agonist used in advanced disease. It has to be administered by subcutaneous injection and causes such severe nausea and vomiting that an antiemetic has to be administered for two days prior to treatment. Dopamine receptor agonists have similar, but less severe, central side effects to levodopa. Amantadine stimulates release of dopamine from nerve terminals and reduces the re-uptake of dopamine. Rigidity, hypokinesia and tremor are all improved.
Lepirudin is a synthetic version produced by recombinant DNA technology, which has to be given by injection. It is used specifically in patients that have developed hypersensitivity to heparin. The chief adverse effect of anticoagulants is haemorrhage; hypersensitivity reactions are also possible. Platelet inhibitors are most effective in preventing arterial thrombosis. Aspirin reduces platelet aggregation by inhibiting the enzyme cyclo-oxygenase, which is necessary for the formation of thromboxane A in patients with heart disease such as angina and arrhythmia as well as those with previous thrombotic disease. Dipyridamole has a similar effect on cyclo-oxygenase as aspirin.
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If a drug is highly lipid soluble, then it will be distributed to many parts of the body and have a large volume of distribution. In addition, basic drugs tend to bind to tissue proteins and as a result have a large volume of distribution. On entering the body, drugs are treated as if they are toxic substances, which need to be detoxified, if a mechanism exists, and eliminated as soon as possible. This means that most drugs are subjected to some kind of metabolism and then excreted. Metabolism involves changes to the molecular structure of a substance and these changes are produced by the action of enzymes.
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Bupivacaine is often used to produce continuous epidural anaesthesia during labour. Prilocaine is similar to lidocaine but has a longer duration of action and is less toxic.
- They have the same effect on central nervous tissue as they have on peripheral nervous tissue; that is, they inhibit conduction of nerve impulses.
- Uric acid crystals can form stones in the kidneys, in the ureters or in the bladder.
- These are reserved for severe active rheumatic disease (but not systemic lupus erythematosus) that is unresponsive to other drugs and must only be used under close medical supervision.
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- Atypical anti-psychotic drugs are recommended for newly diagnosed schizophrenics and those who cannot tolerate other drugs or who are not getting adequate control from other drugs.
Also in labour. This practice was widely condemned by the clergy as the work of the devil until Today, either inhalation or intravenous anaesthetics or a combination of the two is used to produce general anaesthesia.
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Mycobacteria are intracellular organisms and infect lung tissue mainly, but other tissues such as bones, joints and the brain can be infected. Treatment for tuberculosis is a long and difficult process, taking up to two years and requiring combinations of at least three different antibiotics.
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Drugs are potentially toxic substances and must be eliminated by the body as quickly as possible. This is often at odds with their intended therapeutic use, but nevertheless is what generally happens. The main route of excretion of drugs and drug metabolites is via the kidneys. Elimination varies amongst individuals and depends on the rate of metabolism of a particular drug, the rate of production of urine and the pH of urine. The nephron is the basic structural and functional unit of which there are about one million in each kidney. It is a blind ending tube, which begins with the Bowmans capsule.
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Gout can occur at any age, but the first attack often affects men between the ages of Almost all people with gout have excess uric acid in their blood, a condition called hyperuricaemia.
11.12.2017
Gottlieb
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The usual route is subcutaneously, though the soluble rapid-acting preparations can be given intravenously in emergencies. These drugs lower blood glucose by a variety of mechanisms.
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