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Adverse drug reactions present a major clinical problem. It has been estimated that up to up to Many adverse reactions are well known. Information about them can be found in patient information leaflets supplied with medicines, in the Monthly Index of Medical Specialties (MIMS) or in the British National Formulary. However, not all patients will suffer all possible adverse reactions.

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Although all websites were accessible at the time of writing, their existence cannot be guaranteed in the future. Each chapter is followed by one or more case studies to illustrate the clinical use of drugs and problems that may arise from drugвdrug interactions and adverse reactions. The situations are not based on any generic viagra online europe individuals; rather information has been gathered from many sources including my colleagues in physiotherapy and podiatry and used to construct the cases. Finally, the chapters are finished off with review questions to test the readerвs understanding of key concepts.

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The conduction pathway of electrical activity goes from the SA node to the atrioventricular node between atria and ventricles, then down the septum between the two ventricles to the apex of the heart and finally round the ventricles themselves. The conduction pathway in the heart is shown in Figure Electrical activity in the heart can be picked up by electrodes placed on the skin and recorded as the familiar electrocardiogram. The ECG is a record of the sum of all action potentials in the heart as it contracts. Action potentials are generated by depolarization followed by repolarization of the cardiac muscle cell membrane.