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It has an insidious onset and usually occurs between 30 and 50 years of age. Symptoms include uncontrolled movements, personality disorders, severe depression and anxiety. A47 C In Huntington's chorea, tetrabenazine is used to control movement disorders.

It probably causes a depletion of nerve endings of dopamine. However, it has a useful action in only a proportion of patients and its use may be limited by the development of depression, a symptom that may already be present due to the underlying disease itself. A48 D Whipple's disease is a rare malabsorption syndrome, which usually occurs in men aged 30-60 years of age.

It is caused by a bacterium, Tropheryma whippelii, which infiltrates the mucosa of the small intestine. The symptoms are characterised by arthritis, steatorrhea, weight loss, abdominal pain, fever and weakness. Treatment consists of prolonged administration of antibacterial drugs and the correction of nutritional deficiencies. Plasma substitutes should not be used to maintain plasma volume in burns or peritonitis. Close monitoring, including monitoring of fluid and electrolyte balance and urine output, is required in patients being administered plasma and plasma substitutes. Plasma substitutes should also be used with caution in patients with cardiac disease, liver disease or renal impairment. A50 A Midazolam is a water-soluble benzodiazepine that is often used in preference to diazepam, since recovery is faster than ca phentermine site tramadol with diazepam. It is indicated for the induction of anaesthesia, and in sedation with amnesia or in intensive care. A51 D Infliximab is licensed for the management of severe active Crohn's disease and in rheumatoid arthritis. Maintenance therapy with infliximab should be considered for patients who respond to the initial induction course.

Infliximab is administered by intravenous infusion and, for severe active Crohn's disease, it is started initially with 5 mg/kg and then 5 mg/kg 2 weeks after the initial dose.

A52 B Glyceryl trinitrate can be hydrocodone com ic apap used topically in the treatment of anal fissures. Being a nitrovasodilator when applied topically, glyceryl trinitrate tends to cause relaxation of the anal sphincter. It is applied to the anal canal until the pain stops.

A53 B Omalizumab is a monoclonal antibody that binds to immunoglobulin E. It hydrocodone com ic apap is used as additional therapy in asthma patients who have a proven IgE- mediated sensitivity to inhaled allergens and who are presenting with severe, persistent, uncontrolled asthma.

It is administered by subcutaneous injection and the dose is calculated based on the is tramadol a controlled drug immunoglobulin E concentration and body weight. A54 C Abciximab hydrocodone com ic apap is a monoclonal antibody that binds to glycoprotein IIb/IIIa receptors, thereby blocking the binding of fibrinogen to receptors on platelets. It is used as an adjunct to heparin and aspirin in high-risk patients undergoing percutaneous transluminal health drugs tramadol hcl coronary intervention. Baseline prothrombin time, activated clotting time, activated partial thromboplastin time, platelet count, haemoglobin and haematocrit should be measured at baseline. Patient monitoring is required after the start of treatment. A55 D Avandia contains rosiglitazone, which is a thiazolidinedione that is used as oral antidiabetic therapy. Thiazolidinediones reduce peripheral insulin resistance, resulting in reductions in blood-glucose concentrations. Inadequate response to oral antidiabetic therapy indicates failing insulin release and the impact of the introduction of rosiglitazone is of limited benefit on patient outcomes. A56 D Avandia (rosiglitazone) as with other thiazolidinediones is used either as monotherapy or in combination with either metformin or a sulphonylurea. A disadvantage of rosiglitazone is the risk of bitartrate hydrocodone heart failure as a side-effect. This risk is increased hydrocodone com ic apap when rosiglitazone is used in patients with cardiovascular disease and when used in combination with insulin. Blood-glucose control may deteriorate temporarily when a thiazolidinedione is substituted for an oral antidiabetic agent.

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