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Absorption Process o The process in which a drug moves from administration site into the blood stream. Determines how quickly a drug enters the blood stream. o Two other terms associated with absorption are chemical equivalence and bioavailability. o Factors affecting Absorption: ▪ Rate of Dissolution of the Drug ▪ Before a drug can be absorbed it must first dissolve. The rate of dissolution helps determine the rate of absorption. ▪ Different formularies: immediate releas...

Chapter 5 FDA & QT Interval Drugs o Prolong the QT interval and serious risk for dysrhythmias. Torsade’s de pontes. o FDA requires all new drugs be tested for ability to cause QT prolongation Boxed Warnings o Strongest safety warning a drug can carry while still on the market. Text inside box with black border, FDA requires on drugs with serious or life-threatening risks Boxed Warnings: Drug Examples o Promethazine is contradicted in pt less than 2 d/t respiratory depression ...

Chapter 6 Individual Variation in Drug Responses • Metabolic influence on drug administration o Age: infants and older adults are sensitive to drugs o Body and weight: body surface area o Kidney function o Liver function: if liver metabolism declines, rate of metabolism declines causing drug levels to climb o Acid-base imbalances: if there is a difference in PH on two sides of a membrane, a drug will accumulate on the side where the PH most favors its ionization. o Because ...

Reasons for medication non-adherence: Multiple factors underlie nonadherence to the prescribed regimen. Among these are forgetfulness; failure to comprehend instructions (because of intellectual, visual, or auditory impairment); inability to pay for medications; and use of complex regimens (several drugs taken several times a day). All of these factors can contribute to unintentional nonadherence. However, in most cases (about 75%), nonadherence among older adults is intentional. The p...

Week 4 • Most appropriate treatment approach for OA: asymptomatic patients are usually not treated. Mild pain can be managed with analgesics and anti-inflammatory agents. When the disease is more severe, a bisphosphonate is the treatment of choice. Benefits derive from suppressing bone resorption. o Pharmacological and non-pharmacological • Gout o Complications of untreated gout: Untreated gout may cause erosion and irreversible joint damage, renal damage, and tophi. o Trea...

Self-Directed Plan for Improvement Using Resources Chamberlain’s Chamberlain Care services offer many resources for psychosocial health and economic stability, such as mindfulness skills courses, stress management webinars, and Chamberlain Scholarships and Grants. Chamberlain Care provides emotional and well-being support that can help me stay grounded while managing stress and personal challenges. I also plan to utilize the Student Assistance Program more often. The financial well...

Boxed warnings ○ Most serious FDA safety warnings ○ Indicate → Risk of death or Serious injury ○ Require heightened monitoring or restricted use ○ Key Concept ■ Boxed warnings indicate risk of serious injury or death ■ Require avoidance, strict monitoring, or special precautions ○ Drugs with Critical Boxed Warnings ■ Acetaminophen ● Severe hepatotoxicity ● Risk increased with overdose, alcohol use, liver disease ■ Warfarin ● Major bleeding ● ...

CARDIOVASCULAR PATHOLOGIES Coronary Artery Disease (CAD) Pathophysiology • Atherosclerosis → plaque formation • Endothelial injury → LDL oxidation → foam cells → fibrous cap • Plaque rupture → thrombosis → MI Risk Factors Modifiable • HTN • Smoking • Diabetes • Hyperlipidemia • Obesity

(10 points) Compute the line integral Ω I xdy − y dx Γ ∫ f (x, y) dx dy where Γ is the counterclockwise oriented boundary of the domain defined by the inequalities x2 − 2x + y2 ≥ 3; x2 − 2x + y2 ≤ 8; y ≥ 0 1

Damage causes: • Visual field loss • Difficulty recognizing objects by sight Example symptom: Patient has normal eyes but cannot identify objects visually. Parietal lobe Keeps us alert to what is going on around us Damage may cause: • Difficulty recognizing objects by touch • Problems with spatial awareness • Difficulty copying drawings or writing Example symptom: Inability to copy a drawing or word → parietal lobe dysfunction. Sensory Cortex Pain, heat, a...

Level 1- Systemic review of randomized clinical trial studies- strongest- minimized bias Level 2- Single, well designed, randomized clinical trial Level 3- Well designed controlled trials without randomization Level 4- Well designed case- control or cohort studies Level 5- Systemic reviews of descriptive and qualitative studies Level 6- Single descriptive or qualitative studies Level 7- Opinion of authorities and or reports of expert committees 6. Sensitivity/Specificity Sensitiv...

10. Let Find f'(1) + g'(1). • A. -27 • B. -29 • C. 0 • D. -10 • E. None of the above. Answer B. f (x) = 5 − 2x, g(x) = x3 + 9 x3

Week 2: CARDIOVASCULAR PHARM ● Htn tx ○ Indication ■ Pt with high bp or stage 1 htn ○ Rx selection ■ Thiazide diuretics, ace, arbs, ccbs (first line) ■ Betablocks, loop diuretics, aldosterone antagonists ● Beta blockers ○ Indications: HF, Post MI, Angina, Arrhythmias, HTN, Migraine, tremo, hyperthyroidism ○ Moa: block b receptors which slows heart, lowers bp, and reduces heart workload ○ Adverse effects: bradycardia, hypotn, fatigue, bronchospasm, cold e...

WEEK 3 – PAIN & OPIOIDS Tramadol: CNS depression, seizures, serotonin syndrome Methadone: QT prolongation, respiratory depression, accumulation OUD treatment: Methadone (full), Buprenorphine (partial, safer) Opioid safety: Lowest dose, shortest duration, avoid CNS depressants Naloxone: opioid reversal, repeat dosing may be needed Cannabis adverse effects: cognition , coordination , anxiety, sedation

CARDIOVASCULAR PATHOLOGIES 1. Coronary Artery Disease (CAD) - Pathophysiology: Atherosclerotic plaque buildup → endothelial injury → lipid accumulation → inflammatory cytokines (IL-1, TNF) → narrowing and ischemia. - Risk factors: - Modifiable: smoking, hypertension, diabetes, obesity, hyperlipidemia, sedentary lifestyle. - Nonmodifiable: age, male sex, family history. - Diagnostics: Lipid panel, ECG, cardiac biomarkers, stress testing. - Treatment: Lifestyle changes, statins, aspiri...

Alpha-1 blockers: Relax smooth muscle in prostate and bladder neck; may cause orthostatic hypotension. Week 4 – Urinary Conditions Bethanechol: Muscarinic agonist used to stimulate bladder contraction. Oxybutynin: Antimuscarinic used to treat overactive bladder. Cinacalcet: Calcimimetic used to treat secondary hyperparathyroidism in chronic kidney disease.

Renal drug excretion ○ Primary route of elimination ○ Reduced renal function leads to: ■ Drug accumulation ■ Increased adverse effects ○ Dose adjustment often required ● Agonists and antagonists ○ Agonists: activate receptors ○ Antagonists: block receptors ○ Partial agonists: weaker activation ○ Key properties: ■ Affinity ■ Efficacy ■ Potency ● Drug interactions ○ Types:

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D: hear you:' she - Answer~C. A comma is necessary if an attribution is going to be made. They hopped down off the table; and went to go pick up the napkins. A: off the table; and went B: off the table: and went C: off the table, went D: off the table and went - Answer~D. There is no need for punctuation to separate these two continuous actions. 'I'm not sure about that,' he said. 'I can't really remember.'