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Vitamin K antagonists block the activity of vitamin K resulting in the production of inactive clotting factors by the liver. They take a few days to have effect because circulating clotting factors already in existence have to be used up. Examples of vitamin K antagonists are warfarin and phenindione (normally used only when patients cannot tolerate warfarin). Patients on long-term warfarin should have an oral anticoagulant treatment booklet. Warfarin has many interactions with commonly prescribed drugs.

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Adverse reactions can occur with any drug use and can be either related to or unrelated to the expected pharmacological effect. Variation in buy phentermine with prescription of a drug can occur in different individuals and indeed in the same individuals on different occasions. This can result from either differing concentrations of a drug at its site of action, or differing physiological responses to the same concentration of a drug. Adverse drug reactions present a major clinical problem.

This drug interacts with the acetylcholine receptor at the neuromuscular junction, initially stimulating it and then preventing buy phentermine with prescription stimulation by endogenous acetylcholine, resulting in paralysis. Suxamethonium is metabolized at its site of action by the enzyme pseudocholinesterase. The effect of suxamethonium is not reversed by the use of anticholinesterase drugs, but would be prolonged. Side effects of suxamethonium are bradycardia and, rarely, malignant hyperthermia.

Although generally asthma responds best to β to antimuscarinic drugs, both types of drugs may be needed. If these do not control phentermine 37.5 prices, xanthine bronchodilators may be required in addition to one or both of the other two. Attacks of asthma can be prevented by prophylactic use of cromoglicate, although this drug is of no use in an acute attack or in chronic bronchitis. Leukotriene receptor antagonists can be used to reduce the inflammation of asthma particularly in the late phase.

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