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Side effects are gastrointestinal disturbances and headache. Halofantrine can also cause cardiac arrhythmia and should be avoided in patients with arrhythmias. These drugs aim to eliminate the resting stage of the parasite in the liver.

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This is because of the so-called вblood-brain barrierв. This is not an anatomical barrier as such, rather a combination of the tight junctions between endothelial cells of brain capillaries and the close association of glial cells with the outside of the capillaries. This arrangement makes diffusion of lipid-soluble drugs into the brain difficult and diffusion of water-soluble drugs almost impossible. A large number of drugs have a high affinity for albumin and other plasma proteins. Binding to plasma protein inhibits distribution outside the blood since only unbound drug will be further distributed.

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Legislation was passed in Act, permitting nurses to prescribe. Subsequently, pilot studies were implemented across England and Wales, addressing local and regional need, and the position today is that some PCTs are approaching the point of having more non-medical prescribers (for example nurses) than medical prescribers. Dr June Crownвs working partyвs second report considered who else should be able to take on prescribing responsibilities. The expectation was that extending prescribing would optimize the use of resources, enhance professional relationships and improve patient access to care. The report defined mechanisms for what were to become supplementary prescribing and independent prescribing, and recommended that other groups of professionals should be able to legally prescribe.

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