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The major ones are the Medicines Act plus associated Schedules, Orders, Regulations and European Directives. These Acts of Parliament deal with substances that are known as medicinal products within the meaning of the Act(s). The Medicines Act and then sets out exemptions that allow, for example the manufacture and sale of medicinal products under licence. The Act exempts various activities of professionals, thus allowing doctors to prescribe and pharmacists to dispense.

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During exercise preload increases and therefore cardiac output increases. Cardiac output also depends on end systolic volume, which in turn depends on afterload. Afterload is a function of total peripheral vascular resistance and blood pressure. If afterload becomes greater, ESV increases and cardiac output is reduced.

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Lidocaine is probably the most commonly used local anaesthetic. Qualified, registered podiatrists are allowed to access and administer lidocaine, bupivacaine, prilocaine, mepivacaine, levobupivacaine and ropivacaine. Analgesia can be achieved by peripherally acting and centrally acting analgesics. The most commonly used peripherally acting analgesics are paracetamol and aspirin for mild to moderate pain. For moderate to severe pain morphine is commonly used. Peripherally acting analgesics work by inhibiting the enzyme necessary for prostaglandin synthesis.

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The phases of a cardiac action potential are shown in Figure change in resting membrane potential of cardiac muscle cells from This is due to influx of sodium ions followed by influx of calcium ions. Contraction of the myocardium follows depolarization. The refractory period is the time interval when a second contraction cannot occur and repolarization is the recovery of the resting potential due to efflux of potassium ions. After this the cycle repeats itself. A typical ECG is shown in Figure and contraction; the QRST complex corresponds to atrial repolarization and relaxation and the onset of ventricular depolarization and contraction; and the T wave represents ventricular repolarization and relaxation. Analysis of the size and shape of the waves can indicate abnormalities of the heart.