Case: You are working in a remote community health clinic. John is a 65-year-old male who comes to your clinic complaining of stomach pain, especially after eating. He thinks he might have a stomach ulcer. He also states that he is always feeling tired, sometimes gets dizzy and he finds it difficult to breathe. John also tells you that he is often constipated. On further questioning John tells you that he suffers from osteoarthritis in his knees and in addition, he was in a car accident several years ago and suffers from chronic back pain. John regularly smokes cigarettes and is a regular heavy drinker of alcohol, John tells you that he takes the following medications consistently for his medical conditions: . Aspirin 300 mg every 4-6 hours as required. . Morphine 30 mg twice daily as required John has also been drinking at least 6-8 heavy strength beers every night as he claims it helps with his pain. You consider that John's symptoms could be related to several new medical conditions however, they have been ruled out. Even though John is taking his medications within recommended dosage guidelines, you now suspect that John's symptoms could be related to his medications and alcohol intake. Questions: Q1. Detail the pharmacological mechanism of action (MOA) of aspirin and morphine. MOA needs to be explained in depth at the receptor and cellular level and needs to include how the MOA results in a therapeutic effect. Also, explain how this mechanism affects the action potential of the cell. Q2. Look at Johns presenting complaints. Explain which medication (aspirin and morphine) could be responsible for each of John's complaints and why (stomach pain, especially after eating, stomach ulcer, feeling tired, dizzy, difficult to breathe, and constipated). Explain in depth, at the receptor and cellular level, the mechanism of action of the medication and how it could cause the symptoms that John is experiencing. Q3. A) What is the mechanism of actions (MOAs) of alcohol? You need to describe these MOA's in detail at the receptor and cellular level. B) Describe any interactions between John's medications (aspirin and morphine) and any other substances (alcohol and tobacco smoking) that John consumes? Explain pharmacologically how these substances interact with John's medicines (aspirin and morphine) at the receptor and cellular level and what could be the consequences of these interactions. Q4. A) Based on your answer to Q2, what immediate actions would you recommend to John in order to prevent further complications with his ulcer? B) John goes to the doctor to treat his ulcer. Using knowledge of pharmacology, what recommendations might the doctor make regarding managing the side effects that John has experienced due to interactions with his pain medications? Your recommendations must be in line with current therapeutic guidelines and recommendations must be supported with current evidence from the literature. · Please label each question answered. E.g. Q1., etc. Answer each question separately. . Do not answer in essay form. . Please use referenced evidence to support all your answers to the above questions. (e.g. Journal articles, textbooks, valid medical websites with authors etc). . Include 8-10 relevant references less than 10 years old giving evidence of research. . Use Intext citations for all relevant material and reference list in APA7. . Length: 800 words, excluding references

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