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Several factors are known to influence the diffusion of substances across the cell membrane: the membrane must be permeable to the substance in question; there must be a concentration gradient; the molecular sizeweight of the substance must be small enough; a large surface area is necessary for efficient diffusion; a short distance is necessary for efficient diffusion. In practice, there is a concentration gradient because the drug is given in sufficient dose, most drug molecules are small enough to be absorbed (otherwise, they would be of no use) and the surface area and distance of the absorbing membrane are favourable. Simple diffusion is depicted in Figure Simple diffusion of drug molecules depends mostly on lipid solubility.

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This formulary was gradually expanded over the next few years and listed in the British National Formulary. Meanwhile, in for the Department of Health recommended two types of prescriber: the independent prescriber who would be responsible for assessment of patients with undiagnosed conditions and for decisions about clinical management required, including prescription; the dependent prescriber who would be responsible for the continuing care of patients already assessed by the independent prescriber, which may include prescribing. Over the next few years, following the Health and Social Care Act prescribing by nurses and pharmacists was introduced. After much consultation with the medical, pharmacy and nursing professions and the Department of Health and the Medicines Control Agency as well as meetings of the Committee on Safety of Medicines and the Medicines Commission, amendments were made to the legislation to allow nurses and pharmacists to become supplementary prescribers as from April A similar process occurred with the podiatry, physiotherapy and radiography professions and led to changes to the NHS Regulations in April prescribing to these professions. Extended formulary nurse prescribing was discontinued in nurse independent prescribing.

Supplementary prescribing must not continue until a new agreement has been made with the patient and a drugstore prices for viagra independent prescriber. Any GSL, P or POM medicine (including controlled drugs since July where there is a patient need and the doctor has agreed in a patients CMP) can be prescribed under a CMP. This includes the prescribing of: (Black triangle drugs are those recently licensed and still being monitored for adverse reactions; unlicensed medicines are those not licensed in the United Kingdom.

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