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Local anaesthetics preferentially bind to channels in the inactive state and prevent them from opening again. This is similar to the mechanism of action of some antiepileptic drugs.


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In addition, the patient has slight impairment of vision and high levels of anxiety, which causes her to rush. The following case study shows a situation where it would be appropriate for a physiotherapist supplementary prescriber to prescribe medication for a patient. A a six month history of low back pain and leg pain for pain management.

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These include dyskinesias, restlessness, anxiety, confusion, disorientation, insomnia or a schizophrenia-like syndrome. Dyskinesias can be particularly severe, involving unusual writhing movements of the limbs and grimacing and chewing movements of the face. After five years of treatment about half of patients will experience the drug becoming less effective and a gradual recurrence of symptoms, especially hypokinesia, occurs. Another type of deterioration is the shortening of action of each dose with time (end of dose deterioration) and unpredictable fluctuations in response to treatment, which can happen quite abruptly.

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