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Table 35: Medications for streptococcal pharyngitis Agent Pediatric dosage Adult Route of Duration Dosage administration Benzathine <27kg: 0. Steroids are also e ective but should probably be reserved for patients in whom salicylates fail. Then refer to a -Palpitation (flushed cheeks) physician/ Paediatrician for -Cough -Crepitations definitive diagnosis and Hemoptysis -Diastolic murmur management plan. Edema -Loud P2 Ascites Chest pain Mitral -Fatigue -Atrial fibrillation Maintain airway, breathing and regurgitation -Cough -Cardiomegaly circulation. Then refer to a -Palpitation -Apical pansystolic physician/ paediatrician for -Edema murmur definitive diagnosis and -Ascites -Crepitations management plan. Then refer to a asymptomatic collapsing pulse physician/paediatrician for -Palpitation -Femoral Bruit (doroziez’s definitive diagnosis and -Breathlessness sign) management plan. Then refer to a -Dyspnoea -Slow carotid pulse physician/paediatrician for -Angina -Narrow pulse pressure definitive diagnosis and -Exertion -Thrusting apex beat management plan. Then refer to a Tricuspid Exercise venous distention with physician/paediatrician for Stenosis intolerancel a prominent V wave definitive diagnosis and Angina (rare; -In some patients, a management plan. Risk factors: Cardiac conditions at high risk of endocarditis for which prophylaxis should be considered prior to a high-risk procedure include: a. It may be referred to as a structural anomaly of the heart or great vessels that is or could be of functional signi cance. Aetiology: Conditions occurring in pregnancy: infections (Toxoplasmosis, Rubella, Parvovirus B19, Herpes, Varicella, Syphilis, Cytomegalovirus), Chromosomal abnormalities. Counselling of the patient and family by health care provider should include education on: a. Recommendations for physical exertion based on the patient’s ability,underlying haemo-dynamics, and the risk of acute decompensation/arrhythmias. Advice on healthy lifestyle (smoking cessation, weight loss/ maintenance, hypertension/lipid screening). Missed diagnosis or delayed treatment can lead to death or long-term complications like pulmonary hypertension and post-thrombotic syndrome(1). Mechanical prophylaxis is e ective when used in combination with early ambulation. Evaluation for stroke Examination Components Abrupt onset of extremity weaLness, hemisenso ry disturbance, visual disturbance, abnormal History speech, facial droop, abnormal gait or posture, dizziness and loss of balance, sudden decrease in level of consciousness. No historical feature distinguishes ischemic from hemorrhagic stroke, although nausea, vomiting, headache, and sudden change in level of consciousness are more common in hemorrhagic strokes. Physical Assessment of A#Cs, Vital signs #P, Temp, Pulses examination General exam: head and necL signs of trauma or seizure activity. Admit patient or organise for Referral to closest appropriate facility capable of treating acute stroke x. Alert receiving Hospital/Emergency Department Management of ischemic stroke Thrombolysis Stable stoke patients within 4. Intra-arterial thrombolysis should only be carried out by an appropriately trained interventional neuro-radiologist. Antiplatelet Aspirin 75mg or clopidogrel 75mg Agents daily started immediately where thrombolysis is not available. Statins Statins should be prescribed to patients who have had an ischaemic stroke, irrespective of cholesterol level. Avoid atenolol in adults over 60 years of age, unless they have coronary artery disease. If convulsions are not controlled within 10 minutes administer an additional 10mg per hour Cardiac Diseases in pregnancy a. Ischemic heart disease Chest pain characterized as a crushing pain radiating to the left arm. Hypertension in Athletes Hypertension is a common cardiovascular condition a ecting athletes. However, the management of hyper tension in athletes can di er from standard approaches, primarily due to the potential side e ects of some medications that may impair training and performance. The most challenging group is elderly athletes who often attribute their exertional dyspnea or fatigue to ageing. The unique liner does not require gloves and allows for easy removal for dressing changes. This patient-friendly product enables long-term use without the need for a full bandage, enabling easy splint removal. The open cell foam provides padding and prevents migration while the flannel reduces moisture retention. It is packaged in a roll format, allowing custom-cut lengths, thereby eliminating waste. 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Sedentary duties Tasks to diabetes prevention harvard buy glucotrol xl online from canada which military personnel are assigned that are primarily sitting in nature diabetes symptoms burning eyes order glucotrol xl now, do not involve any strenuous physical efforts diabetes service dogs utah purchase cheap glucotrol xl line, and permit the individual to diabetes medication 10 mg glucotrol xl have relatively regular eating and sleeping habits. Army Reserve (Selected, Ready, Standby, or Retired) are not considered as separations. Further study of medical terminology, however, is crucial to understanding medicine, and represents a large part of surgical assistant training curriculum. Successful completion of surgical procedures requires the surgeon and the assistant to accurately and efficiently navigate the steps in the proper sequence, and often in unison. Anatomic orientation terminology provides a key “language” for this communication. Which of the following most accurately describes the movement of the operative thumb (which direction it points) as you carry out the instructions The Lymphatic System: the arrangement of anatomic structures in the body support the physiologic function of the organ systems. These organ systems include the: musculoskeletal; cardio-pulmonary; circulatory; nervous; digestive; endocrine; excretory; reproductive; sensory; integumentary; and immune systems. Surgical procedures in one region impact all the body systems to a greater or lesser degree. For this reason, the surgical assistant is well-served to carry a fundamental understanding of the physiology within each organ system, its anatomic locations/s in the body, and be ever vigilant to correctly identify organ system structures. Avoiding or minimizing traumatic impact to structures peripheral to the procedure at hand, minimizes unnecessary mortality and morbidity of the case. The Musculoskeletal system: Skeletal anatomy must be committed to memory, including the skull, spine, and distal extremities. Tubercles, tuberosities, fossae, canals, and fissures represent important features relative to connective tissue attachment, vascular supply, bone growth, and bone marrow function. Joint alignment, articular cartilage, and soft tissue support; as well as muscular insertions, origins, and innervations; and principle including agonist/antagonist pairing should be studied. Such understanding underpins the importance for the identification and preservation of normal anatomy during surgery. Muscle Physiology: Muscle tissues throughout the body, including striated, smooth, and cardiac muscle types operate via myofibril motor units activated by nerve impulse and neurotransmitter action. Acetylcholine release and reuptake represents one key biochemical step in muscle metabolism and may be acted on by anesthetic agents used in the operating room. Another point of pharmaceutical intervention comes from the calcium ion and potassium ion exchange following contraction. Lactic acid build up in muscles becomes a potential issue for patients who have not been moved during very long procedures. The mechanism for this problem is described in which of the following statements: • Potassium in the intracellular space blocks repolarization of the muscle cell membrane • Calcium and potassium inside the cell reach toxic levels • Potassium displaces calcium across the nuclear membrane • Calcium displaces sodium across the nuclear membrane 10 B. A working knowledge of the blood supply to all organs, extremities, and tissues remains paramount to surgical success. Arteries, arterioles, capillaries, venules, and veins all have distinct properties and require specific handling. A working knowledge of this anatomy, as well as vascular tissue handling techniques, optimizes surgical success. Deliberate and permanent hemostasis for resection procedures also require precise planning and excellent technique. One measure of this phenomenon is “shear rate”, defined as the local velocity gradient between adjacent blood flow. Shear rate, incidentally, has also been shown to be one of the main regulators of platelet activation and thrombosis. This basic understanding underpins the necessity for resecting aneurismal tissue with meticulous care. The Cardio-Pulmonary System: Cellular function throughout the tissues and organs of the body rely on the delivery of oxygen and nutrients, and facilitation of cellular waste removal. Osmotic forces maintained at the cellular level, and physiologic safeguards such as vasodilation and vasoconstriction, preserve the integrity of the closed circulatory loop. He or she must also be fully aware of the challenge surgical procedures pose to a patient’s normal hemodynamic status. Patient blood volume, blood pressure, oxygen saturation, and cardiac function must be protected. Additional parameters such as tourniquet time, patient positioning, clotting status, and autonomic nerve (vagal) responses should also be well understood, since they affect patients’ immediate response to surgery. Normal lab values should be part of a surgical assistant’s working knowledge base, such as O2 saturation, clotting time, hemoglobin, hematocrit, etc. Which of the following cardio-pulmonary conditions may responsible and require urgent surgery For the surgical assistant, however, an in-depth knowledge of neuroanatomy from a procedure specific regional approach is also paramount. Careful study of the cranial nerves and their function provides a surgical assistant the ability for high-level communication with the surgeon on the potential complications of misidentification of structures especially in head and neck procedures. The spinal nerves, their dorsal and ventral roots, and their exit points along the spinal canal must be protected. On the front end of many surgical procedures, identification of these nerve structures must be accomplished with certainty. From the esophagus, through the diaphragm, and at numerous points along the alimentary canal, commonly performed surgical procedures address acute and chronic G. Access to each area of the abdomen, therefore, must be carefully planned and executed. Constant proactive prevention of intra-operative injury and post-operative surgical adhesions represent a skillset retained by the competent surgical professional. An in-depth study of microscopic anatomy and physiology of the digestive system should also be undertaken. This fundamental understanding underpins the necessity for adherence to proper technique. Furthermore, crucial production of digestive enzymes, hormones and chemical messengers are carried out in the pancreas, liver, and cells within the epithelial layers of the G. I tract itself and must be maintained to facilitate normal digestion of nutrients. Hormones are distributed by glands through the bloodstream and carry widespread, long-lasting, and powerful effects on cells of organs and tissues throughout the body. Careful study of the anatomy, function, control, and hormones produced by these glands must be undertaken. Surgery on these areas, furthermore, carry significant risk to vital structures adjacent to the glands themselves, thus intraoperative identification of structures is key. Minimally 21 invasive approaches often improve outcomes, but also add complexity to these procedures. By default, gross anatomy of the pelvis becomes critical, including skeletal structures and landmarks, innervation and vascular supply, and the extremely relevant pelvic floor. Pelvic systems and structures must be studied by the competent surgical assistant, especially with regard to female reproductive procedures. There are organ systems of the body that are involved in this process such as sweat glands, lungs, and the kidneys. The liver plays an important role as well, in detoxifying metabolites for excretion elsewhere. Sweat glands actively excrete lactic acid, urea, as well as various salts, pulling water from the tissues. Alveolar structure within 24 the lungs facilitate carbon dioxide and other toxic gases release from hemoglobin, as well as the uptake of oxygen. One of the most important functions of the kidney is the filtration and excretion of nitrogenous waste products from the blood. Through a complex physiologic process, the kidney nephron also maintains blood pH, regulates water content in blood, and therefore further affects systemic blood volume and blood pressure. Thorough knowledge of kidney anatomy, the urinary system, and normal blood chemistry and osmotic forces involved in excretion are necessary for complete understanding of this complex process. An adult body contains around 10 liters of lymph, consisting of salts, sugars, amino acids, hormones, coenzymes, neurotransmitters, fatty acids and the metabolic waste products. Movement of lymph occur through peristalsis, and muscular action of surrounding tissues.
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You are committed to diabetes mellitus yoga glucotrol xl 10mg without prescription spending as much time with each patient as needed diabetes symptoms high blood pressure glucotrol xl 10 mg free shipping, but does this apply when that time is spent discussing a private test In some jurisdictions diabetes diet dash generic glucotrol xl 10 mg online, such as Ontario diabetes diet guidelines after your visit generic glucotrol xl 10 mg amex, it is available publicly if a woman is identifiably at high risk. Confirmatory invasive testing can provide a more definitive diagnosis, but it carries a risk of miscarriage. In most Canadian jurisdictions, patients are responsible for paying for this test themselves, although policy may change and some provinces may choose to fund certain applications of the test, as seen in Ontario in early 2014. This is a challenging question and policy decisions about what medical services or devices will be paid for by public money involve consideration of many different factors. There are certainly other examples of technologies or tests that may provide a benefit, but which are not publicly funded because they are too expensive, or would provide a benefit to too few people, or because they replace something which is deemed adequate. For example, pregnancy termination at an earlier gestational age may be less physically risky and emotionally traumatic. However, we must also consider that these benefits are only available to women of economic means. This can have a significant benefit earlier treatment may result in fewer surgical complications and more successful rehabilitation, benefitting the patient and saving money for the health care system. We may sympathize with these patients, as it seems as if they are not harming anyone by using their private resources to secure quicker care. However, a commitment to equity means that it is not fair for people who can pay to have better or faster health care than those who cannot afford to pay. This issue places the individual clinician in a delicate situation, with potentially conflicting duties and priorities. There is the duty to the patient in front of you, who has questions and wants to discuss a test she can pay privately for, which may have significant benefit to her. There is the duty to act as a health advocate, promoting the health of your patients and community by taking efforts to change practices or policies. Physicians may wish to consider the principles of informed choice, of offering information that is relevant to a patient’s needs to make a decision about a particular intervention. Informed decision-making can promote autonomous decision-making, and supports a woman to make a choice that is consistent with her values. Some have suggested that these factors may lessen the gravity of the decision to test. If it is used according to professional guidelines, it will be offered only to women who have been previously identified as having a higher risk for fetal aneuploidy, potentially after earlier screening has returned a positive result. In this situation, physicians may wish to consider whether most of the counselling should take place before or after the test. In practice, we know that pre-test counselling about screening tests is often very brief, with more detailed counselling in the event of a positive screening result. Post-test counselling may address the meaning of results, conditions screened for, and potential options available to the woman. This question will be addressed further in the "Public/Private Resources" section of this case. After the test, physicians should counsel those who have received a negative result about false negative results, that further invasive diagnostic testing is an option, and that a second trimester ultrasound will still be carried out. For women who receive a positive test, physicians are advised to ensure there is sufficient time for counselling and asking questions, and should cover topics such as the meaning of risk statistics, the option of invasive testing, details about what the test will diagnose, risks of invasive diagnostic testing, the option of pregnancy termination, that further investigation is not contingent upon a desire to terminate the pregnancy, that consultation and support will be available no matter what choice she makes. Post-test counselling may also include more information about the condition detected, including health implications and long-term outcomes for people with this condition. Position statement from the aneuploidy screening committee on behalf of the board of the international society for prenatal diagnosis, April 2013. Multicenter study of first trimester screening for trisomy 21 in 75 821 pregnancies: results and estimation of the potential impact of individual riskorientated twostage firsttrimester screening. Noninvasive prenatal testing/Noninvasive prenatal diagnosis: the position of the National Society of Genetic Counselors. Immediate adverse events after second trimester medical termination of pregnancy: results of a nationwide registry study. Psychological outcome in women undergoing termination of pregnancy for ultrasound-detected fetal anomaly in the first and second trimesters: a pilot study. Ottawa, Canada: the Royal College of Physicians and Surgeons of Canada, 2005 Contract No. Exploring informed choice in the context of prenatal testing: findings from a qualitative study. Should non-invasiveness change informed consent procedures for prenatal diagnosis Will the introduction of non-invasive prenatal diagnostic testing erode informed choices Short Author Biographies Meredith Vanstone is an Assistant Professor in the Department of Clinical Epidemiology and Biostatistics and a member of the Centre for Health Economics and Policy Analysis at McMaster University. Her research interests include social and ethical aspects of health technology policy, reproductive and genetic technologies, and the use of technology in health professional education and practice. Meredith approaches research from a socio cultural perspective, using qualitative methods to analyze both primary and secondary data. Mita Giacomini is a Professor in Clinical Epidemiology and Biostatistics at McMaster University, and a member of the Centre for Health Economics and Policy Analysis. She holds graduate degrees in health services and policy analysis, history of medicine and public health. Her publications have addressed topics including health policy ethics, political reasoning in health technology assessment, health resource allocation, values in evaluation and policy-making, interdisciplinarity, and uses of qualitative evidence in health care. Current research projects focus on the roles of evidence and theory in health policy arguments, values and ethics in Canadian health policy, and the social and ethical dimensions of health technology assessment. Giacomini has provided consultation and service to local, provincial, national and international health agencies in related areas. Giacomini teaches in the areas of health policy, philosophy of science, and research methodology. Jeff Nisker is a Professor of Obstetrics-Gynaecology at the Schulich School Medicine & Dentistry, Western University, and Scientist, Children’s Health Research Institute. Jeff has written or co-written over 150 scientific articles and book chapters, as well as seven plays. His plays have been performed throughout Canada, as well as in the United States, the United Kingdom, Australia and South Africa. Funding Acknowledgement Support for this work was received from the Canadian Institutes of Health Research. Meredith Vanstone’s salary is supported by the Ontario Ministry of Health and Long Term Care through a Health Systems Research Fund grant entitled “Harnessing Evidence and Values for Health System Excellence”. The views expressed in this document are the views of the authors and should not be taken to represent the views of the Ministry of Health and Long Term Care. The Clinical Review Criteria only apply to Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. Use of the Clinical Review Criteria or any Kaiser Permanente entity name, logo, trade name, trademark, or service mark for marketing or publicity purposes, including on any website, or in any press release or promotional material, is strictly prohibited. Kaiser Permanente Clinical Review Criteria are developed to assist in administering plan benefits. If requesting this service, please send the following documentation to support medical necessity: • Any genetic counseling notes if applicable • Results of prior genetic testing • Last 6 months of specialist notes of that is being reviewed. However, on an individual member basis, Kaiser Permanente can share a copy of the specific criteria document used to make a utilization management decision. If one of your patients is being reviewed using these criteria, you may request a copy of the criteria by calling the Kaiser Permanente Clinical Review staff at 1-800-289-1363. Back to Top Criteria | Codes | Revision History the following information was used in the development of this document and is provided as background only. It is provided for historical purposes and does not necessarily reflect the most current published literature. Background Fetal chromosomal abnormalities occur in approximately 1 in 160 live births. Most fetal chromosomal abnormalities are aneuploidies, defined as an abnormal number of chromosomes. The approximate risk of a trisomy 21 (T21; Down syndrome)affected birth is 1 in 1100 at age 25 to 29. The risk of a fetus with T21 (at 16 weeks of gestation) is about 1 in 250 at age 35 and 1 in 75 at age 40.
Rather they focused more on the protection of in operation diabetic quiche recipes glucotrol xl 10 mg without a prescription, with some companies providing a detailed the consumer in terms of validity of information diabetes symptoms but normal glucose purchase glucotrol xl 10mg without prescription, consent and analysis of the results while others release raw data back to managing diabetes 7 day menu generic 10mg glucotrol xl amex data management diabetes untreated symptoms glucotrol xl 10 mg on line, and access to qualified counselling if so the consumer, who can subsequently analyse them through required (depending on the nature of the test performed). In addition, some companies will have counsellors available to support their Regulation of Genetic Tests customers while others do not provide this service. The regulations focus Individual Consumers on assessing the safety and accuracy of a device rather Consumers may find interpretation of genetic test results than the benefits or indirect risks to the consumer. For example, details of a company’s policies on data the current lack of requirement for clinical evidence of may be hidden in lengthy terms of service agreements or the strength of the link between a particular gene privacy policies making it difficult for consumers to make sequence and a claimed clinical significance. The model recommended that genetic testing firms should make advocates for classification of all genetic tests as medium risk, and the inclusion of Pre-Market Approval. Some suggest that this cannot be information about their data policies prominently available to 9,10,11 done, because of differential levels of risk between tests being potential consumers in lay language. Alternative models for ‘appropriate’ regulation of this market will have to ensure adequate levels of protection, as well as the accuracy and usefulness of tests, while not stifling Healthcare Providers Model innovation and the potential benefits to consumers from As the cost of gene sequencing continues to fall, genomics accessing new technology. While the sharing of such 9 data for research purposes is widespread throughout the from low to medium risk. It suggested that tests should be classified according to the degree of predictiveness of the world, such projects include safeguards such as consent test and the ability of the consumer to act upon the and anonymisation of datasets as standard practice. For further information on this subject, please contact the co-author, Dr Peter Border. With this in mind, is Huntington’s disease caused by a dominant or recessive trait The pedigree to the right shows a family’s pedigree **half-shaded = carrier of disease for colorblindness. The symbols used for a pedigree are: female, unaffected male, unaffected female, affected male, affected Siblings are placed in birth order from left to right and are labeled with numbers. Phone number: 34-91-3941450 this article has been accepted for publication and undergone full scientific peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Alzheimer’s © 2012 the Authors British Journal of Clinical Pharmacology © 2012 the British Pharmacological Society 4 disease, stroke and multiple sclerosis, has also been investigated in studies that have yielded some positive results [27-33]. This phytocannabinoid has been found to display a wide range of actions in vitro some at concentrations in the submicromolar range, and others at concentrations between 1 and 10 µM or above 10 µM. Its pharmacological targets include a number of receptors, ion channels, enzymes and cellular uptake processes (summarized in Table 1). Energy failure during ischemia provokes the dysfunction of ionic pumps in neurons, leading to accumulation of ions and excitotoxic substances such as glutamate. The consequent increase in intracellular calcium content aggravates the neuron dysfunction and activates different enzymes, starting different processes of immediate and programmed cell death. During post-ischemic reperfusion, inflammation and oxidative stress aggravate and amplify such responses, increasing and spreading neuron and glial cell damage. These neuroprotective effects are not only free from side effects but also associated with some beneficial cardiac, hemodynamic and ventilatory effects [84]. Major symptoms include hyperkinesia (chorea) and cognitive deficits (see [87] for review). Thus, even though a few compounds have produced encouraging effects in preclinical studies. It is possible, however, that this antioxidant/neuroprotective effect of phytocannabinoids involves the activation of signaling pathways implicated in the control of redox balance. As presented above, its actions are channeled through several biochemical mechanisms and yet it causes essentially no undesirable side effects and its toxicity is negligible [2]. Thus, because the mechanisms that underlie its anti-inflammatory effects are different from those of prescribed drugs, it could well prove to be of considerable benefit to a large number of patients, who for various reasons are not sufficiently helped by existing drugs. Its neuroprotective effects are extremely valuable as no drugs exist that have similar properties. The authors are indebted to all colleagues who contributed in this experimental work and to Yolanda Garcia-Movellan for administrative support. A comparative study on some chemical and biological characteristics of various samples of cannabis resin. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Oral anti inflammatory activity of cannabidiol, a non-psychoactive constituent of cannabis, in acute carrageenan-induced inflammation in the rat paw. Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Potential therapeutical effects of cannabidiol in children with pharmacoresistant epilepsy. Murillo-Rodriguez E, Millan-Aldaco D, Palomero-Rivero M, Mechoulam R, Drucker Colin R. Antitumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma. The non psychoactive cannabidiol triggers caspase activation and oxidative stress in human glioma cells. Different effects of nabilone and cannabidiol on binocular depth inversion in Man. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Cannabis with high cannabidiol content is associated with fewer psychotic experiences. Hayakawa K, Mishima K, Nozako M, Ogata A, Hazekawa M, Liu A-X, Fujioka M, Abe K, Hasebe N, Egashira N, Iwasaki K, Fujiwara M. Repeated treatment with cannabidiol 9 but not -tetrahydrocannabinol has a neuroprotective effect without the development of tolerance. Cannabidiol prevents cerebral infarction via a serotonergic 5-hydroxytryptamine1A receptor-dependent mechanism. Post-ischemic treatment with cannabidiol prevents electroencephalographic flattening, hyperlocomotion and neuronal injury in gerbils. Kozela E, Lev N, Kaushansky N, Eilam R, Rimmerman N, Levy R, Ben-Nun A, Juknat A, Vogel Z. Inhibition of an equilibrative nucleoside transporter by cannabidiol: a mechanism of cannabinoid immunosuppression. Cannabinoid activation of peroxisome proliferator-activated receptors: potential for modulation of inflammatory disease. The nonpsychoactive cannabinoid cannabidiol inhibits 5-hydroxytryptamine3A receptor mediated currents in Xenopus laevis oocytes. Inhibition of recombinant human T-type calcium 9 channels by -tetrahydrocannabinol and cannabidiol. Ahrens J, Demir R, Leuwer M, de la Roche J, Krampfl K, Foadi N, Karst M, Haeseler G. The nonpsychotropic cannabinoid cannabidiol modulates and directly activates alpha-1 and alpha-1-beta glycine receptor function. Differential inhibition of human cytochrome P450 2A6 and 2B6 by major phytocannabinoids. Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Cannabinoids attenuate norepinephrine-induced melatonin biosynthesis in the rat pineal gland by reducing arylalkylamine N-acetyltransferase activity without involvement of cannabinoid receptors. Generation of reactive oxygen species during mouse hepatic microsomal metabolism of cannabidiol and cannabidiol hydroxy-quinone. Watanabe K, Motoya E, Matsuzawa N, Funahashi T, Kimura T, Matsunaga T, Arizono K, Yamamoto I. In vitro inhibitory effects of cannabinoids on progesterone 17 hydroxylase activity in rat testis microsomes. Characterization of P-glycoprotein inhibition by major cannabinoids from marijuana. Induction of apoptosis by cannabinoids in prostate and colon cancer cells is phosphatase dependent. Maione S, Piscitelli F, Gatta L, Vita D, De Petrocellis L, Palazzo E, de Novellis V, Di Marzo V. Non-psychoactive cannabinoids modulate the descending pathway of © 2012 the Authors British Journal of Clinical Pharmacology © 2012 the British Pharmacological Society 19 antinociception in anaesthetized rats through several mechanisms of action.