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Mrs Begum has been prescribed methotrexate by her consultant rheumatologist for rheumatoid arthritis that has not responded to other therapies. Mrs Begum has some preconceived ideas about methotrexate and is nervous about starting with it. She tells you that she knows someone who is being treated with methotrexate for cancer and has heard that it can cause many serious adverse reactions. She is not sure why she is being asked to take methotrexate at all and she thinks it very strange that she has been told to take the drug once a week only. Discuss how you could reassure Mrs Begum about the need to take methotrexate in her case, about the once weekly dosage and about the side effects and how likely they are to affect her.

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In essence, a PGD allows a range of specified health care professionals, including podiatrists, to supply andor administer a medicine directly to a patient with an identified clinical condition without them necessarily seeing a medical prescriber. So, patients may present directly to health care professionals using PGDs in their services without seeing a doctor. Alternatively, a doctor may have referred the patient. However the zenegra cheap presents, the health care professional working within the PGD is responsible for assessing that the patient fits the criteria set out in the PGD. In general, a PGD is not meant to be a long-term means of managing a patients clinical condition.

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A new system of reporting adverse reactions, the National Reporting and Learning System has recently been set up by the National Patient Safety Agency. Any health care zenegra cheap who becomes a supplementary prescriber or an independent prescriber would be expected to contribute to these schemes. Adverse reactions to drugs can be divided into type A and type B (bizarre). These adverse drug reactions are generally dose-related and most can be predicted.

Mr Davies is aware of this and asks you to explain why he has been prescribed it because he is pretty sure he does not have epilepsy. Why would chlorpromazine be prescribed as required. Would it be safe to treat Mr Davies injury with a non-steroidal antiinflammatory drug.

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