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Monoamine oxidase exists in two forms: MAO-A and MAO-B. MAO-A is the enzyme preferentially responsible for degrading serotonin and noradrenaline. Inhibition of this enzyme allows the concentration of these monoamines to increase in the brain, thereby producing an antidepressant effect.
Third generation β-blockers also cause peripheral vasodilation and do not adversely affect plasma lipid profiles. An example is celiprolol. Calcium channel blockers are used to treat ischaemic heart disease, arrhythmia and hypertension. This is a diverse group of drugs, which fall into three classes.
This is especially important for new drugs as adverse reactions can be missed during clinical trials. Patients as well as health care professionals can use the yellow card scheme. A new system of reporting adverse reactions, the National Reporting and Learning System has recently been set up by the National Patient Safety Agency.
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Patients are increasingly likely to be receiving at least one drug; many older patients are likely to be on more than one drug, and prescription of eight or nine drugs at the same time is not uncommon.
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A GP or a consultant, whichever is relevant, would have to be involved in the initial development of a CMP and review process so that physiotherapist could prescribe medication as appropriate for individual patients.
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PGDs are not suitable where patients need a range of different medicines at the same time.
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