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  • Q1:1. Identify main metabolic enzymes involved in elimination of clozapine. a) Tabulate median clozapine maximal plasma concentrations (Cmax), area under plasma concentration-time curve (AUC) and clearance (Dose/AUC) in non-smokers vs. heavy smokers (>20 cigarettes/day). Assess percent change in these parameters in smoker vs. non-smoker patients. Explain reasons for potential differences in parameters between smokers and non-smokers. b) Comment whether you would recommend a change in clozapine dose in heavy smokers and why.See Answer
  • Q2:2. Define parameter half-life. Calculate clozapine half-life in non-smoker and smoker patient groups using clearance values calculated in question 1 (see PKPD Table). Assume volume of distribution and corresponding average body weight (BW) of each of the patient group as listed below: a) Non-smokers: V= 5.5 L/kg, average BW= 75 kg b) Smokers: V = 6 L/kg, average BW = 67 kgSee Answer
  • Q3:3. Explain whether you expect clozapine Cmax to change following the initiation of smoking cessation and whether there would be any consequences of smoking cessation on the patient's safety and efficacy of this drug. What effect would nicotine replacement therapy have on clozapine metabolism?See Answer
  • Q4:4. Identify another drug example where pharmacokinetics of a drug differs between smokers and non- smokers. List either clearance, AUC or t1/2 for that drug in smokers vs. non-smokers, explain reasons for these differences and include relevant reference. Comment on any therapeutic implications/ clinical action for that drug example for i) the patient starting smoking and for ii) the patient stopping smoking.See Answer
  • Q5:Patient Female, 45 year old. Chief Complaint While eating, she bit down on something hard and immediately experienced a sharp shooting pain on the left side that persisted even after she stopped chewing. She had increased sensitivity in her lower left molar to hot and cold foods or drinks. Background and/or Patient History The patient had been in your office for many years and practiced good oral hygiene and reported annually for examination and prophylactic cleaning. Current Findings Upon examination you diagnosed a crack in the dental restoration in the lower left first. Case I. Local Anesthesia for Controlling Dental Pain. Understanding why your local anesthetic is "smart enough" to know how to block the pain efficiently and selectively Drs. H. Cohen and R. Shirokov. Images are courtesy of Dr. P. Duda Cook-Walte Lidocaine HCI 2% and Epinephrine 1:100,000 Injection (lidocaine hydrochloride and epinephrine injection, USP) Marked by Canestream Heath, inc To block the pain in the lower left molar, you injected the left inferior alveolar nerve with a cartridge of 2% lidocaine/epinephrine 1:100,000. After several minutes she reported the area was "numb" and that she had no feeling of the previous pain. She was able to open her mouth and position her jaw so you could complete her tooth restoration with no difficulty. 1. The patient felt numb but could touch and feel her face, teeth, and mouth after she was injected. Describe the basic neuron anatomy and physiology of how these impulse sensations are conducted along the nerve fiber. a) What types of nerve fibers are involved affecting her tooth pain and other aspects, such as sensitivity to touch and jaw movement? b) How are action potentials conducted through these fibers? Describe the differences. c) What are the principal factors determining conduction velocity in different types of nerve fibers?See Answer
  • Q6:(1) The research words assigned to our group were 'Pharmaceuticals' and 'Circular Economy'. A circular economy aims to reduce waste and pollution by recycling, reusing, and repairing products to keep them in circulation for as long as possible and maximize their useful life.See Answer
  • Q7: 3. What would you want to see on an antimicrobial prescription?See Answer
  • Q8: 1. What is the role of community pharmacy in patient education?See Answer
  • Q9: 2. Which should the actions of the pharmacist be if they suspect apatient has sepsis?See Answer

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