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Peripherally acting analgesics work by inhibiting the enzyme necessary for prostaglandin synthesis.
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Folic acid is converted into folate, which then has to be converted into an activated form by dihydrofolate reductase. In this way, trimethoprim interferes with the conversion of folate into its activated form, which is a cofactor in the synthesis of bacterial DNA.
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These adverse drug reactions are generally dose-related and most can be predicted. They can be caused by an exaggeration of a drugs intended pharmacological effect or by an unwanted action or side effect.
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