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Dehydration of endothelial cells of brain capillaries may allow diffusion of contrast agent into the brain. If this happens, the contrast agent may provoke seizures. LOCAs are the safer contrast agents in this respect. There is a link between osmolality of iodine contrast media and the risk of renal toxicity. LOCAs have lower renal toxicity than HOCAs ( kg as first choice.

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At the back of the brain stem is the cerebellum, which is concerned primarily with the fine control of movement. Above the brain stem is the hypothalamus and thalamus, which together make the diencephalon. The hypothalamus is a small structure that plays an extremely important role in many aspects of emotion, motivation and response to stress. It has centres that control eating, drinking and sexual behaviour. It also regulates the autonomic nervous system and the endocrine system and maintains homeostasis.

Mrs Charles currently requires a wheelchair in which she is pushed around by her carer. Mrs Charless drug therapy is pyridostigmine bromide prednisolone Discuss the treatment of this patient using the questions below as a guide. They are intended to stimulate discussion not limit debate. The following patient was initially referred to the podiatrist because he has fungally infected toenails. He now sees the podiatrist every two months and on this visit, he is complaining of a rash on the plantar surface of his feet, which is red and itchy.

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Adverse effects include postural hypotension, bradycardia and fluid retention. Like cardiac disorders and hypertension, disorders of coagulation, anaemia and hyperlipidaemia are all conditions that are more common in older patients. All are treatable with drug therapy and possibly changes in lifestyle as well. Health care professionals, in the course of their professional practice, are sure to come across patients on the drugs commonly used in these conditions. Some of them are of particular significance to podiatric practice.

In hypertensive patients over African origin of any age calcium channels blockers or diuretics are now the drugs of first choice. Membrane stabilizers are used to treat arrhythmia. They act directly on sodium ion channels to restrict the entry of sodium ions into cardiac muscle cells. These drugs therefore act to slow the rate of depolarization, which is more marked in ectopic pacemakers, allowing the SA node to regain control of cardiac rhythm. Lidocaine is ineffective orally and its use is restricted to preventing and treating ventricular arrhythmia after myocardial infarction. (Lidocaine by virtue of the same mechanism of action is used as a local anaesthetic.

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