Lecture 9 PCL201 Drug Distribution
|
|
- Adela Snow
- 6 years ago
- Views:
Transcription
1 Lecture 9 PCL201 Drug Distributin Where d drugs distribute? Drug distributin (and ptentially cncentratin) will depend n bld flw and the physichemical prperties f the chemical Lipid and water slubility Inizatin Size (fr hydrphilic) Play a rle in distributin, ability t crss membranes Bld flw t tissues Cardiac Output Tissue vlume What is vlume f distributin? Vlume f Distributin (Actual) Anatmical vlume accessible t the drug E.g. Charged cmpund (ECF can t diffuse acrss membrane) vs. uncharger nnplar cmpund (can distribute t different areas, TBW) ECF vs TBW = 12L vs 42L Vlume f Distributin (Apparent) The hypthetical vlume necessary t cntain hmgenus cncentratin in bld, plasma, r water. Vd can be measure and calculated fllwing IV injectin f knwn cmpunds. Large Vd nt cncentrated (lw MW, hydrphlic (lipid sluble), access t mre thrugh diffusin thrugh membranes) Intermediate Vd cncentrated in a smaller area ECF (can t readily crss membranes) Small Vd quite cncentrated Drug is cncentrated in plasma cmpartment Vd prvides infrmatin n where a drug will be fund and where it wn t be fund. Why is Vd imprtant? Knwing the Vd f a drug allws us t calculate the dse required t achieve a desired plasma cncentratin. In practice: Wrks with respect t calculating drug cncentratins Des nt prvide nfrmatin n if the drug is effective Hw can we calculate Vd? Iv injectin fllwed by measuring drug cncentratins at specific time pints. Use semilg plt, extraplate t t=0 (remember t use anti-lg) What infrmatin des Vd prvides? Increased Vd, nt cncentrated, drug equilibrating t ther places utside f plasma, nt fund in plasma t a great extent. Vd nt necessarily a measure f physical vlume, rati f drug in cmpartments utside plasma relative t plasma, allws fr dse estimatin
2 Increased Vd, lw cncentratin fund in plasma cmpartment, increased Vd, decreased cncentratin fund in plasma, make it t prly accessible regins. Drugs with very large Vd have higher cncentratins in extravascular tissue than in vascular cmpartments (plasma) and are NOT hmgenusly distributed. Drugs that are cmpletely retained within vascular cmpartments have very lw Vd equal t r less than bld cmpnent distributed in vascular fluid. Lw Vd, in plasma, large, hydrphbic, bund t prteins in plasma Drug Distributin in ECF ECF = plasma (intravasular and ISF) Many cmpunds are permeable t capillary membranes and act at cell surface and are inactive inside the cell. Many cmpunds d NOT gain access t inside the cell Mannitl can be used t measure ECF mpartment: High Vd, High cncentratin in extravascular tissues relative t plasma, nt hmgenusly distributed. Drug Distributin in Bld Plasma cmpnent (intravascular) where cmpunds are disslved in water Plasma prtein bund cmpunds becme bund thrugh nncvalent interatin α-glycprtein (binds t weakly basic drugs), albumin(binds t weakly acidic drugs), and lipprteins Drug ncentratins measure in plasma/serum and usually will be dependent n the hematcrit. Hematcrit - & packed erythrcytes: amunt f frmed bld cells. Average cunt: Men ~50, Wmen ~40 It is imprtant t knw if drug is in plasma knw if drug can reach target get dsing infrmatin need t be in plasma t be excreted Plasma Plasma prtein bund drugs, high drug cncentratins in plasma s Vd small ECF Large water sluble drugs TBW Small drugs, rapid equilibratin between all cmpartments Tissue cncentratin drugs that bind tssue Factrs affecting Vd 1. Intravascular a. Plasma prteins 2. Extravascular a. Cellular prteins, tissue, bne, muscle 3. Adipse a. Lean vs. bsess bdy weight b. Female vs. Male (% bdy fat) 4. Enterhepatic Circulatin (bld vessels that feed liver can extend duratin f actin)
3 5. Redestributin Plasma Prtein binding Nt all drugs disslve in plasma water sme assciate with bld cmpnents: albumin, glbulins, lipprteins and erythrcytes, acid glycprteins Evans blue IV injectin binds strngly t plasma albumin, s entire dse in plasma. Causes misleading small Vd because nly want t measure unbund drug which will equilibrate t rest f bdy. Plasma prtein binding must be taken int accunt when cnsidering Vd. Alters drug-plasma cncentratin Alters effective drug cncentratin fr target Will nt necessarily elimated as readily Unbund Drug can g t Site f actin: capillary walls, cell membrane, intracellular site, still in plasma t bind t prtein, decrease free disslved drug able t crss membrane Site f eliminatin: glmerular filtratin, renal tube secretin, hepatic bitransfrmatin, bilary secretin % Free drug depends n 1. Kd f drug (affinity) 2. Ttal drug cncentratin 3. albumin cncentratin If lw Kd, at lw drug cncentratins, mstly bund e.g. phenylbutzne 100 times greater inttal plasma than in plasma water and ECF. It is bund t prteins, very little freely flating in plasma water. As drug cncentratins increase, prtein becmes saturated and free drug cncentratin increases. Tw imprtant plasma prteins fr drug binding Albumin Negatively charged s binds t weak acids (but cnsidered nn-specific) Albumin levels are generally lwer in disease states, therefre lwer ttal drug cncentratin, increased free drug cncentratin Orsmucid (α1-acid glycprtein) Psitively charged, s binds t weak bases Increased levels during perids f acute inflammatin Plasma prtein binding is mre imprtant fr drugs highly bund at lw cncentratin (high affinity) Pharmacdynamically imprtant Decrease cncentratin available t act Saturatin f binding ccurs as drug cncentratin increases, therefre prprtin f unbund drug cncentratin increases with higher dses
4 Extend duratin f actin May play a rle with drug interactins Fr drugs that are bund at high drug cncentratins, free drug cncentratins increases less rapidly than dsing rate suggests, until prtein binding appraches saturatin Takes mre drug befre binding t plasma prtein As a result f prtein binding Smaller cncentratin available fr drug target Drug efficacy effected Eliminatin slwed when passive diffusin slwed (active transprt, enzyme mediated functins nt altered) Duratin f actin can be extended Unbund drug cncentratin can be affected by ther drugs that bind prteins with higher affinity (displaced) Unless explicitly stated plasma cncentratins are a measure f bund and unbund drug. Lwer Vd, higher cncentratin in ttal plasma, but lwer cncentratin in plasma water. Is it clinically relevant? Article published suggest the rle f plasma-prtein binding is nt as significant in clinical practice as it is in lab thery Open system with eliminatin f unbund drug 5% increase f unbund drug distributes thrughut bdy vlume As unbund drug cncentratin increases, rate f eliminatin increases Plasma prtein binding mst imprtant When drug A is displaced by drug B When Drug A has a narrw TI Drug Tissue Binding Extravascular prtein reservir (bind t prtein utside plasma) Lwer cncentratin in plasma, therefre higher Vd Prlngs duratin f actin r t ½ Drugs binding t cytplasmic prteins Lwers plasma cncentratin, therefre increases Vd Many anti-bacterials Quinlnes, flurquinne Lead (replaces Ca++ at many sites in bnd frmatin) Methtrexate Many drugs targets are intracellular prteins Anticancer Might be respnsible fr txicity assciated with sme drugs
5 FAT as a reservir Chrnic expsure t lipid-sluble drugs can cause accumulatin Lwer plasma cncentratin, therefre increases Vd Lwer perfusin rate, therefre increased time t equilibrate between plasma and fat. Increased time t accumulate, increased time fr remval Can increase duratin f actin Can act as strage site May result in acute pisning (DDT) Examples: Diazepm, THC, chlrinated hydrcarbns, thipental readily assciate with adipse Adipse pr circulatin, takes lng time t reach adipse, remve frm adipse. Enterhepatic Circulatin Drugs may mre may nt betransfrmed in cycle Drugs recycle therefre lwers plasma cncentratin and increases Vd Prlng duratin f actin Examples: Imipramine, Mrphine A nte n drug residues in fd animals Drug reservirs and sites f prlnged sequestratin is a majr cncern in fd animals. Residues an be fund in muscle, milk, eggs, liver, etc. Many drugs are nt apprved fr use in fd animals. Drug will nt be apprved fr use in milking dairy cattle if drug residues can be detected fr lnger than 96 hurs in milk. Other factrs affecting drug distributin Bld flw heart, lungs, liver, kidney, brain PH trapping inside cells Disease: Edema increases water, affects Vd The rate at which a drug is released frm a reservir is gverned by the same factrs as thse described fr its distributin Reservirs can be useful in achieving a prlnged effect with an therwise shrt acting drug Reservirs extent t ½ Mre drug may be required t reach therapeutic cncentratins Redistributin IV dse drug in small vlume f bld will mve thrugh pulmnary y and then systemic circuit Cncentratin decreases as drug mixes with larger bld vlume Frm capillaries, drug mves int ECF and equilibrated ~15 minutes Perfusin f different rgans )at rest vs. during exercise)
6 Due t differences in tissue perfusin rates, drugs reach equilibrium in sme tissues faster than thers. In Halethane, exercise reduces bld flw at GI tract 3 types f tissues (depends n amunt f bld flw) Rapid uptake phase: liver, brain, heart Vessel rich grup (VRG) Intermediate phase uptake: muscles Muscle Grup (MG) Slw phase: fat, skin, bne, ligament, teeth, hair Vessel pr grup (VPG), ptentially acts as reservirs When drug administratin stps remval f drug in 3 phases prprtinal t distributin rates. VRG mves ut fast. The vessel rich grup (VRG) tissues are mre ften target fr drug therapy Very rapid nset but within tissue, redistributin time may vary. e.g. gray matter perfusin 4 x greater than white matter Redistributin ccurs t t differences in time-curse f perfusin VRG rapid distributin and clearance In General Oral absrptin and distributin takes ~2hrs Digitxin takes up t 6 hrs after last dse t distribute, binds t muscle Lithium takes clse t 24 hrs (charged mlecule) Aminglycsides (gentamycin) are quite rapid 1h3 Bld sample at half way pint f dsing interval will clsely apprximate stead state cncentratin (based n Absrptin, distributin, and clearance) In Summary Vlume f distributin can be calculated Vd = D/C and represents the vlume that a drug is distributed Vd prvides infrmatin t calculate dsing TBW, plasma, ECF, ther Vs~plasma cmpartment (4% Distributin/Eliminatin will be affected by bld flw
INTRODUCTION TO THE CIRCULATORY SYSTEM
INTRODUCTION TO THE CIRCULATORY SYSTEM What des bld d? 5. What makes this pssible? : In rder fr there t be an efficient exchange f xygen, waste and nutrients there must be a high surface area between the
More informationBIOLOGY 101. CHAPTER 7: Membrane Structure and Function: Life at the Edge
BIOLOGY 101 CHAPTER 7: Membrane Structure and Functin: Life at the Edge Membrane Structure and Functin: Life at the Edge CONCEPTS: 7.1 Cellular membranes are fluid msaics f lipids and prteins 7.2 Membrane
More informationTest 3 Study Guide: Photosynthesis, Respiration, and the Cell Membrane
Name Blck Date Test 3 Study Guide: Phtsynthesis, Respiratin, and the Cell Membrane Test Dates: December 13 (1 st and 7 th blck) and 12 (6 th blck) SOL: BIO.2d, 3d-e Related Ntes Phtsynthesis Respiratin
More informationChem 464 Biochemistry Third Hour Exam
Name: Chem 464 Bichemistry Third Hur Exam Multiple chice (5 pints apiece): 1. Which f the fllwing statements cncerning fatty acids is crrect? A) One is the precursr f prstaglandins. B) Phsphatidic acid
More informationName: Date: Period: Notes: The Blood and Lymphatic System
Name: Date: Perid: Cmpsitin f Bld and their Functins Red Bld Cells (aka ) Structure Ntes: The Bld and Lymphatic System D nt have a like ther cells d Cntain a specialized prtein called Hemglbin cntains
More informationAnemia. There are three types of Anemia that effect EB patients. They are Iron Deficiency, Chronic Inflammatory and Nutritional.
Anemia Mst patients with Recessive Dystrphic Epidermlysis Bullsa are als Anemic. Anemia in EB is caused by many factrs and can becme very severe if nt treated. Anemia means nt having enugh red cells and
More informationUrine Alkalinization. Passawat Na Nakorn, MD. R 3 Emergency Medicine
Urine Alkalinizatin Passawat Na Nakrn, MD. R 3 Emergency Medicine H + secretin HCO 3 - reabsrptin Mechanism Alkalinizatin f the urine increases urinary excretin f weak acids different frms f the acid have
More informationUSING THE POLARITY CHARACTERISTICS OF A DRUG S FUNCTIONAL GROUPS TO ESTIMATE SOLUBILITY CHARACTERISTICS
USING THE POLARITY CHARACTERISTICS OF A DRUG S FUNCTIONAL GROUPS TO ESTIMATE SOLUBILITY CHARACTERISTICS Lessn Objectives 1. Understand what is meant by lgp; knw the difference between MlgP and ClgP 2.
More informationCellular Neurophysiology Membrane Ionic Gradients Concentration gradients and diffusion Membrane transport:
Cellular Neurphysilgy Membrane Inic Gradients Fluid-msaic mdel f plasma membrane: lipid bilayer separating intracellular and extracellular fluids Biplar phsphlipids Hydrphilic head grups and hydrphbic
More informationAnnex III. Amendments to relevant sections of the Product Information
Changes t the Prduct infrmatin as apprved by the CHMP n 13 Octber 2016, pending endrsement by the Eurpean Cmmissin Annex III Amendments t relevant sectins f the Prduct Infrmatin Nte: These amendments t
More informationIntravenous Vancomycin Use in Adults Intermittent (Pulsed) Infusion
Intravenus Vancmycin Use in Adults Intermittent (Pulsed) Infusin Backgrund This plicy cvers the use f intravenus vancmycin prescribed as an intermittent (pulsed) infusin. This can be used fr treatment
More informationIntravenous Vancomycin Use in Adults Intermittent (Pulsed) Infusion
Backgrund This plicy cvers the use f intravenus vancmycin prescribed as an intermittent (pulsed) infusin. This can be used fr treatment r prphylaxis. Evidence supprting this guidance is detailed belw.
More informationThe Excretory System. 4 The Excretory System.notebook. May 24, 2017
4 The Excretry System.ntebk The Excretry System OSMOREGULATION (WATER BALANCE) Mst marine invertebrates are smcnfrmers, meaning the cncentratin f slutes in their bdy fluid is equal t that f their envirnment.
More informationChapter 20 The Heart
Chapter 20 The Heart ANATOMY OF THE HEART The adult heart is apprximately the size f. The heart is lcated in the cavity, between. Base is directed, and the apex is directed. The membrane surrunding and
More informationSOLUBLE URANIUM DEFINITION FOR REGULATORY COMPLIANCE
SOLUBLE URANIUM DEFINITION FOR REGULATORY COMPLIANCE Rland Benke, Ph.D., CHP (Center fr Nuclear Waste Regulatry Analyses) Tanya Oxenberg, Ph.D. (U.S. Nuclear Regulatry Cmmissin) James Webb (U.S. Nuclear
More informationNFS284 Lecture 3. How much of a nutrient is required to maintain health? Types and amounts of foods to maintain health
NFS284 Lecture 3 Chapter 2: Nutritin: Guidelines: Applying the Science f Nutritin 2.1 Nutritin Recmmendatin fr the Canadian Diet Nutrient-based apprach Hw much f a nutrient is required t maintain health?
More informationThe Cell Cycle & Cellular Division
The Cell Cycle & Cellular Divisin Name: Perid: Date: I. Cell Divisin: All are derived frm preexisting cells (Cell Thery) is the prcess by which cells prduce new cells Cells grw in number, NOT in Smaller
More informationChapter 18 The Urinary System Renal Function
Chapter 18 The Urinary System Renal Functin Chapter Outline Functins f the Urinary System Anatmy f the Urinary System Basic Renal Exchange Prcesses Reginal Specializatin f the Renal Tubules Excretin 18.1.
More informationA Phase I Study of CEP-701 in Patients with Refractory Neuroblastoma NANT (01-03) A New Approaches to Neuroblastoma Therapy (NANT) treatment protocol.
SAMPLE INFORMED CONSENT A Phase I Study f CEP-701 in Patients with Refractry Neurblastma NANT (01-03) A New Appraches t Neurblastma Therapy (NANT) treatment prtcl. The wrd yu used thrughut this dcument
More informationFrequently Asked Questions: IS RT-Q-PCR Testing
Questins 1. What is chrnic myelid leukemia (CML)? 2. Hw des smene knw if they have CML? 3. Hw is smene diagnsed with CML? Frequently Asked Questins: IS RT-Q-PCR Testing Answers CML is a cancer f the bld
More informationBRCA1 and BRCA2 Mutations
BRCA1 and BRCA2 Mutatins ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM v Cancer is a cmplex disease
More informationGlaucoma Interviews: Due Tuesday, May 22 nd
Glaucma Interviews: Due Tuesday, May 22 nd 1) Read the glaucma article well! It will explain what it is, plus tell yu sme symptms and risk factrs. Yu may want t use a highlighter r pen t mark imprtant
More informationUnderstanding Your Total-Cholesterol-to-HDL Ratio
Understanding Yur Ttal-Chlesterl-t-HDL Rati Yur ttal-chlesterl-t-hdl rati is measured during a bld test called a lipid prfile. This wrksheet will help yu learn mre abut this rati. It will als help yu:
More informationModule 2. Chapter 4 Anatomy of the Cell
Mdule 2 Chapter 4 Anatmy f the Cell The Prkarytic and Eukarytic Cells Prkarytic cells and eukarytic cells Cmpsed f carbhydrates, prteins, nucleic acids, lipids Perfrm f chemical reactins Differences are
More informationRisk factors in health and disease
Risk factrs in health and disease Index 1 Intrductin 2 Types f risk factrs 2.1 Behaviural risk factrs 2.2 Psychlgical risk factrs 2.3 Demgraphic risk factrs 2.4 Envirnmental risk factrs 2.5 Genetic risk
More informationSwindon Joint Strategic Needs Assessment Bulletin
Swindn Jint Strategic Needs Assessment Bulletin Swindn Diabetes 2017 Key Pints: This JSNA gives health facts abut peple with diabetes r peple wh might get diabetes in Swindn. This helps us t plan fr medical
More informationVirginia Western Community College BIO 142 Human Anatomy and Physiology II
Virginia Western Cmmunity Cllege BIO 142 Human Anatmy and Physilgy II Prerequisites BIO 141 r equivalent: an ENG 111 placement recmmendatin, c-enrllment in ENF 3/ENG 111, r successful cmpletin f all develpmental
More informationTick fever is a cattle disease caused by any one of the following blood parasites:
Tick fever Tick fever is a cattle disease caused by any ne f the fllwing bld parasites: Babesia bvis Babesia bigemina Anaplasma marginale These parasites are all transmitted by the cattle tick (Bphilus
More informationCELLS TO ORGANISMS LECTURE NOTES.! BIOL1040 University of Queensland
CELLS TO ORGANISMS LECTURE NOTES BIOL1040 University f Queensland BIOL1040 Cells t rganisms Lecture Ntes Cntents Mdule 1 Principles f Cell Functin... 2 Lecture 1: Membrane Structure and Functin 1... 2
More informationCDC Influenza Division Key Points MMWR Updates February 20, 2014
CDC Influenza Divisin Key Pints MMWR Updates In this dcument: Summary Key Messages Seasnal Influenza Vaccine Effectiveness: Interim Adjusted Estimates Influenza Surveillance Update: September 29, 2013-February
More informationMetabolism: Oxidative Phosphorylation
Metablism: Oxidative Phsphrylatin Hand-ut fr the CBT versin April 2012 1. On average, hw much ATP is needed each day by ur bdy? 2. Which f the fllwing ccurs during cellular respiratin? Bisynthesis f glycgen
More informationPharmacokinetics. What the body does with the drug
Pharmaclgy 203 Windward Cmmunity Cllege Pharmackinetics What the bdy des with the drug Ever wndered why different peple have different reactins t the same drug? Hw des genetics play int therapeutics? What
More information1A Human Biology Food, Digestion and Associated Body Systems
1A Human Bilgy Fd, Digestin and Assciated Bdy Systems Human Bilgy Fd, Digestin and Assciated Bdy Systems Fd Fd is ne f the basic human needs and the digestive system enables the bdy t cnvert it int a frm
More informationHuman papillomavirus (HPV) refers to a group of more than 150 related viruses.
HUMAN PAPILLOMAVIRUS This infrmatin may help answer sme f yur questins and help yu think f ther questins that yu may want t ask yur cancer care team; it is nt intended t replace advice r discussin between
More informationAP Biology Immune System. Pathogens: agents that cause disease Immunity: the ability to avoid disease when invaded by a pathogen
AP Bilgy Pathgens: agents that cause disease Immunity: the ability t avid disease when invaded by a pathgen Innate Immunity: nnspecific First line f defense Barriers such as skin Hard fr bacteria t penetrate
More informationOHlympia: becoming the PRODIGY. A Special Thanks to Cary K for giving me the opportunity to do this!
OHlympia: becming the PRODIGY A Special Thanks t Cary K fr giving me the pprtunity t d this! Prdigy defined by Webster is a nun described as a persn f unusual talent r marvelus talents, r anything that
More informationnumber Done by Corrected by Doctor Nafeth Abu Tarbosh
number 1 Dne by Crrected by Dctr Nafeth Abu Tarbsh 1 P a g e Abut this Curse: In this curse, we will study structure-functin relatinship, plasma prteins and energy metablism with dr Nafith, carbs metablism
More informationMaterials Dissecting pan, dissecting kit, safety glasses, lab apron, pig heart, & gloves
Heart Dissectin Intrductin Mammals have fur-chambered hearts and duble circulatin. The heart f a bird r mammal has tw atria and tw cmpletely separated ventricles. The dublelp circulatin is similar t amphibians
More informationOsteoporosis Fast Facts
Osteprsis Fast Facts Fast Facts n Osteprsis Definitin Osteprsis, r prus bne, is a disease characterized by lw bne mass and structural deteriratin f bne tissue, leading t bne fragility and an increased
More informationProkaryotic cells are placed in two taxonomic domains: o Bacteria o Archaea o
AP Bilgy Ch. 4 Cellular Structure and Functin 4.1Cellular Level f Organizatin Cell Thery: Name Cell Size Large cells - Small cells EK 2.A.3b: Surface area- t- vlume ratis affect a bilgical system s ability
More informationBiology 30S Unit Test Review: Digestion
Bilgy 30S Unit Test Review: Digestin Test utline: Multiple Chice: 10 Questins, 1 mark each. Shrt Answer: 5 Questins (answer 3 f them), 5 marks each. Lng Answer: 2 Lng Answer Questins, 10 marks each. Tasks
More informationVITAPRO. Detoxification properties of Apple pectin formulation, PROPECTIN. CENTRE D ETUDE ET DE VALORISATION DES ALGUES FINAL REPORT.
CENTRE D ETUDE & DE VALORISATION DES ALGUES 2400 Detxificatin prperties f Apple pectin frmulatin, PROPECTIN. VITAPRO FINAL REPORT PrPectin July 2015 CENTRE D ETUDE ET DE VALORISATION DES ALGUES PRESQU
More informationFDA Dietary Supplement cgmp
FDA Dietary Supplement cgmp FEBRUARY 2009 OVERVIEW Summary The Fd and Drug Administratin (FDA) has issued a final rule regarding current gd manufacturing practices (cgmp) fr dietary supplements that establishes
More information3903 Fair Ridge Drive, Suite 209, Fairfax, VA Harry Byrd Hwy, Suite 285, Ashburn, VA *How did you hear about our program?
3903 Fair Ridge Drive, Suite 209, Fairfax, VA 22033 44121 Harry Byrd Hwy, Suite 285, Ashburn, VA 220147 *Hw did yu hear abut ur prgram? Patient Histry Patient Name: First Middle: Last: Address: City: State:
More informationScience. Human Biology. New Jersey Quality Single Accountability Continuum (NJQSAC) Department: Course Title
New Jersey Quality Single Accuntability Cntinuum (NJQSAC) Department: Curse Title Human Bilgy Textbk(s): Fundamentals f Anatmy and Physilgy Essential Questin(s): Cntent Unit 1, September 1. What are Anatmy
More informationImaging tests allow the cancer care team to check for cancer and other problems inside the body.
IMAGING TESTS This infrmatin may help answer sme f yur questins and help yu think f ther questins that yu may want t ask yur cancer care team; it is nt intended t replace advice r discussin between yu
More informationPercutaneous Nephrolithotomy (PCNL)
Percutaneus Nephrlithtmy (PCNL) What is a percutaneus nephrlithtmy? is the mst effective f the cmmnly perfrmed prcedures fr kidney stnes. It is the best prcedure fr large and cmplex stnes. T perfrm this
More informationPennsylvania Guidelines on the Use of Opioids to Treat Chronic Noncancer Pain
Pennsylvania Guidelines n the Use f Opiids t Treat Chrnic Nncancer Pain Chrnic pain is a majr health prblem in the United States, ccurring with a pintprevalence f abut ne-third f the US ppulatin.(1) Mre
More informationTopic 11: Nervous System
Tpic 11: Nervus System Functin: Imprtant Definitins Neurns: Stimulus: anything that causes a nerve impulse t be sent Ex: Receptrs: sense rgans that detect Impulse: change alng the neurn Effectrs: any structure
More informationCARDIOVASCULAR SYSTEM: OVERVIEW & ANATOMY Cathy Proenza
CV 03-20-17 08AM CVPR Overview-Anatmy - Prenza CARDIOVASCULAR SYSTEM: OVERVIEW & ANATOMY Cathy Prenza catherine.prenza@ucdenver.edu Recmmended Reading Lilly p 1-12 Other learning resurces: http://www.cvphysilgy.cm/
More informationRoActemra (tocilizumab) for Giant Cell Arteritis (GCA) subcutaneous (SC) formulation
RActemra (tcilizumab) fr Giant Cell Arteritis (GCA) subcutaneus (SC) frmulatin What yu shuld knw abut RActemra This brchure prvides key infrmatin t assist in the patient s understanding f the benefits
More information* Manuscript received August 25, t Horticultural Research Section, CSIRO, Glen Osmond, South Australia.
SUCROSE BREAKDOWN AND SYNTHESIS IN THE RIPENING GRAPE BERRY* By P. J. HARDyt Sucrse is the majr translcated sugar in the grapevine (Swansn and EIShishiny 1958), but in the berry glucse and fructse tgether
More informationCONSENT FOR KYBELLA INJECTABLE FAT REDUCTION
CONSENT FOR KYBELLA INJECTABLE FAT REDUCTION INSTRUCTIONS This is an infrmed cnsent dcument which has been prepared t help yur Dctr infrm yu cncerning fat reductin with an injectable medicatin, its risks,
More informationPackage leaflet: Information for the user. Fragmin 10,000 IU/1 ml and 10,000 IU/4 ml Solution for injection dalteparin sodium
Package leaflet: Infrmatin fr the user Fragmin 10,000 IU/1 ml and 10,000 IU/4 ml Slutin fr injectin dalteparin sdium Read all f this leaflet carefully befre yu start using this medicine because it cntains
More informationPackage leaflet: Information for the user. Fragmin Graduated Syringe 10,000 IU/ml Solution for Injection dalteparin sodium
Package leaflet: Infrmatin fr the user Fragmin Graduated Syringe 10,000 IU/ml Slutin fr Injectin dalteparin sdium Read all f this leaflet carefully befre yu start using this medicine because it cntains
More informationThe Digestive System. May 16, The Digestive System.notebook
3 The Digestive System.ntebk The Digestive System THE BASIC CONCEPTS Animals btain energy by breaking fd mlecules int smaller pieces. The basic fuel mlecules are amin acids, lipids and carbhydrates. The
More informationIron and Iron Deficiency
Irn and Irn Deficiency Irn and why we need it Irn is a mineral needed by ur bdies. Irn is a part f all cells and des many things in ur bdies. Fr example, irn (as part f the prtein hemglbin) carries xygen
More informationDATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 2016 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS
DATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 216 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS This briefing has been specifically prepared fr the Ministry f Health t prvide infrmatin frm this
More informationCancer Association of South Africa (CANSA)
Cancer Assciatin f Suth Africa (CANSA) Fact Sheet and Psitin Statement n Cannabis in Suth Africa Intrductin Cannabis is a drug that cmes frm Indian hemp plants such as Cannabis sativa and Cannabis indica.
More informationSURGICAL NOTE. Surgical Recommendations to Optimize Femoral/Iliac Artery Cannulation
SURGICAL NOTE Surgical Recmmendatins t Optimize Femral/Iliac Artery Cannulatin Due t its size, lcatin, and ease f access, the femral artery is frequently used fr bld pressure catheter placement. Less frequently,
More informationTopic 1: Cell Biology (Student) Essential Idea: Eukaryotes have a much more complex cell structure that prokaryotes.
Tpic 1: Cell Bilgy (Student) 1.2 Essential Idea: Eukarytes have a much mre cmplex cell structure that prkarytes. 1.2 Intrductin t Cells i. Prkarytes have a simple cell structure withut cmpartmentalizatin.
More informationYou may have a higher risk of bleeding if you take warfarin sodium tablets and:
MEDICATION GUIDE Warfarin (WAR-far-in) Sdium (SO-dee-um) Tablets USP The 7.5 mg tablets cntain FD&C Yellw N. 5 (tartrazine), which may cause allergic-type reactins (including brnchial asthma) in certain
More informationMedication Guide ABSTRAL (AB-stral) CII (fentanyl) Sublingual tablets
Medicatin Guide ABSTRAL (AB-stral) CII (fentanyl) Sublingual tablets IMPORTANT: D nt use ABSTRAL unless yu are regularly using anther piid pain medicine arund-the-clck fr at least ne week r lnger fr yur
More informationA fake medicine that passes itself off as a real, authorised medicine. (1)
Falsified medicines Index 1 Intrductin 2 Types f falsified medicines 3 Eurpean regulatin n falsified medicines 4 Risks f falsified medicines 5 Buying medicine nline safely 6 References 7 Further resurces
More informationPart 1. Saturated and Branched-Chain Fatty Acids
Mass spectra f DMX derivatives. Part 1. Saturated and branched-chain fatty acids MASS SPECTRA F DMX DERIVATIVES Part 1. Saturated and Branched-Chain Fatty Acids a 4,4-Dimethylxazline (DMX) derivatives
More informationMEMBRANES. Overview of membranes. The chemical components of membranes
MEMBRANES This text is divided int seven majr sectins: Overview f membranes The chemical cmpnents f membranes Membrane structure Membranes and cmpartmentalizatin Membrane receptrs Sme receptrs invlve secnd
More informationMEDICATION GUIDE. (Interferon alfa-2b)
MEDICATION GUIDE INTRON A (In-trn-aye) (Interfern alfa-2b) Read this Medicatin Guide befre yu start taking INTRON A, and each time yu get a refill. There may be new infrmatin. This infrmatin des nt take
More informationForensic Science: Fundamentals & Investigations, 2e Chapter 9. All rights Reserved Cengage/NGL/South-Western 2016
1 Frensic Science: Fundamentals & Investigatins, 2e Cengage/NGL/Suth-Western 2016 Frensic Txiclgy By the end f this chapter yu will be able t: 9.1 Prvide examples f drugs, pisns, and txins. 9.2 List factrs
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study Synpsis fr Public Disclsure This clinical study synpsis is prvided in line with Behringer Ingelheim s Plicy n Transparency and Publicatin f Clinical Study Data. The synpsis which is
More informationFad diets Ask the Dietitian Michele Lucas RD CDE
Fad diets Ask the Dietitian Michele Lucas RD CDE WHAT YOU SHOULD KNOW: Weighing t much is nt gd fr yur health. Being verweight increases yur risk f health prblems, like heart prblems, high bld pressure,
More informationChapter 6: Impact Indicators
Overview Chapter 6: Impact Indicatrs The best measure f the lng-term impact f all HIV preventin activities is the HIV incidence rate, namely the number f new cases f HIV infectin per year divided by the
More informationPILI Lifestyle Program Facilitator s Guide
Update: Octber 13, 2006 Page 1 f 12 PILI Lifestyle Prgram Facilitatr s Guide Sessin 3: Lwering Fat & Getting a Mve n Questin/Tpic Script Reminder/Activity Page Welcme back! Alha and welcme t the third
More informationMEDICATION GUIDE Pioglitazone and Metformin Hydrochloride (PYE o GLI ta zone and met FOR min HYE-droe- KLOR-ide)Tablets, USP
MEDICATION GUIDE Piglitazne and Metfrmin Hydrchlride (PYE GLI ta zne and met FOR min HYE-dre- KLOR-ide)Tablets, USP Read this Medicatin Guide carefully befre yu start taking piglitazne and metfrmin hydrchlride
More informationWHAT IS HEAD AND NECK CANCER FACT SHEET
WHAT IS HEAD AND NECK CANCER FACT SHEET This infrmatin may help answer sme f yur questins and help yu think f ther questins that yu may want t ask yur cancer care team; it is nt intended t replace advice
More informationTalking to Patients About Recreational Cannabis
Talking t Patients Abut Recreatinal Cannabis With the upcming legalizatin f recreatinal cannabis, yu may find that mre patients want t talk t yu abut its use. This can be apprached similar t cnversatins
More informationPain relief after surgery
Pain relief after surgery Imprtant infrmatin fr patients www.mchft.nhs.uk We care because yu matter This leaflet is designed t help yu cntrl any pain yu may have at hme fllwing yur peratin. Please read
More informationI am having a Rotator Cuff Repair
I am having a Rtatr Cuff Repair A rtatr cuff repair is surgery t repair a trn tendn in the shulder. The rtatr cuff is a grup f muscles and tendns that frm a cuff ver the shulder jint. The muscles and tendns
More informationChapter 26: The Urinary System. An Overview of the Urinary System, p The Kidneys, p. 952
Chapter 26: The Urinary System An Overview f the Urinary System, p. 952 Objective 1. Identify the cmpnents f the urinary system and describe the functins it perfrms. Figure 26-1 The urinary system has
More informationDownloaded from
POINTS TO REMEMBER : Dwnladed frm www.studiestday.cm 19. Excretry Prducts and Their Eliminatin Ammntelic: eliminatin f nitrgenus waste in the frm f ammnia.(fish) Uretelic: eliminatin f nitrgenus waste
More informationFrequently asked questions: Influenza A (H1N1)v
July 30 th 2009 V1.0 Frequently asked questins: Influenza A (H1N1)v (Swine Flu) infrmatin fr parents The fllwing advice is fr parents f children in all educatinal institutins, including crèches, childcare,
More informationMEDICATION GUIDE Pioglitazone (pie-oh-glit-ah-zohn) and Metformin (met-fore-min) Hydrochloride Tablets USP
MEDICATION GUIDE Piglitazne (pie-h-glit-ah-zhn) and Metfrmin (met-fore-min) Hydrchlride Tablets USP Read this Medicatin Guide carefully befre yu start taking piglitazne and metfrmin hydrchlride tablets
More informationCancer Association of South Africa (CANSA) Fact Sheet on Essential Thrombocythaemia
Cancer Assciatin f Suth Africa (CANSA) Fact Sheet n Essential Thrmbcythaemia Intrductin Essential thrmbcythaemia (ET) is nt a type f bld cancer as there are n cancerus cells. It is cnsidered a chrnic haematlgical
More informationMy Symptoms and Medical History for Adult Chronic Immune Thrombocytopenia (ITP)
My Symptms and Medical Histry fr Adult Chrnic Immune Thrmbcytpenia (ITP) Call t talk t a registered nurse 1-855-7Nplate (1-855-767-5283), Mnday Friday, 9:00 AM 9:00 PM ET Indicatin Nplate is a man-made
More informationChapter 7 Membrane Structure and Function
Chapter 7 Membrane Structure and Functin Overview: Life at the Edge The plasma membrane separates the living cell frm its surrundings. This thin barrier, 8 nm thick, cntrls traffic int and ut f the cell.
More informationNeonatal Jaundice Guideline
Nenatal Jaundice Guideline Guideline Number: 663 Supersedes: Classificatin Clinical Versin N: Date f EqIA: Apprved by: Date Apprved: Date made active: Review Date: 1 Obstetric Written Dcumentatin Review
More informationChronic Fatigue Syndrome
Chrnic Fatigue Syndrme (Als knwn as Myalgic encephalmyelitis/encephalmyelpathy) What is CFS/ME? CFS/ME cmprises a range f symptms that include fatigue, malaise, headaches, sleep disturbances, difficulties
More informationSchool Medication Authorization Form. School Grade Teacher. Emergency Phone No: To be completed by the student's physician: Name of Medication:
Schl Medicatin Authrizatin Frm Student's Name Address Birth Date Hme Phne Schl Grade Teacher Emergency Phne N: T be cmpleted by the student's physician: Name f Medicatin: Dsage Frequency Time t be given
More informationM.R.C.Path. causes to the raised plasma urea in patients admitted
Pstgradcuate Medical Jurnal (January 1979) 55, 1-14 The cause f the raised plasma urea f acute heart failure R D THOMAS MRCP D B MORGAN MRCPath ALISON NWILL AIMLS Departments f Cardilgy and Chemical Pathlgy,
More informationTopic 12: Endocrine System. Function: Group of glands that produces regulatory chemicals ( )
Tpic 12: Endcrine System Functin: Grup f glands that prduces regulatry chemicals ( ) Hrmnes: Chemical messengers released directly int the bldstream that regulate: *May have wide-spread effects r nly affect
More informationARLA FOOD FOR HEALTH 4 th ANNUAL CALL FOR EXPRESSIONS OF INTEREST
ARLA FOOD FOR HEALTH 4 th ANNUAL CALL FOR EXPRESSIONS OF INTEREST 7 th July 2017 Cntent 1 Intrductin 2 Tpics fr EOI in the 4 th call 3 The applicatin prcess and imprtant dates 4 Guideline fr EOIs Deadline
More informationBiology 12 Review sheet Urinary and Reproductive Systems ANSWERS
Bilgy 12 Review sheet Urinary and Reprductive Systems ANSWERS 1. What is the main excretry rgan? Kidneys 2. What are the functins f the kidney? helps maintain hmestasis thrugh regulatin f H 2O and ins
More informationMedication Guide MORPHINE SULFATE (mor-pheen) Oral Solution (CII)
Medicatin Guide MORPHINE SULFATE (mr-pheen) Oral Slutin (CII) IMPORTANT: Keep Mrphine Sulfate Oral Slutin in a safe place away frm children. Accidental use by a child is a medical emergency and can cause
More informationExercise Physiology CardioRespiratory Trimester 2. Exercise Physiology Cardiorespiratory Study Guide
Exercise Physilgy CardiRespiratry Trimester 2 Cardivascular System Exercise Physilgy Cardirespiratry Study Guide 1. Be able t label the structures f the heart (chambers, vessels, valves) and the pattern
More informationEndocrine glands secrete hormones that mediate slower, but longerlasting. Endocrine system functions more as a regulatory than a command system
The Endcrine System 1 Tpics Types f cell signalling Fur types f cell signalling (majr) Fur types f hrmnes (majr) Types f hrmnes Hrmne receptrs Majr endcrine glands Majr hrmnes The hypthalamus and pituitary
More informationCode of employment practice on infant feeding
Cde f emplyment practice n infant feeding An Emplyer s guide t: Sectin 69Y f the Emplyment Relatins Act 2000 Frewrd As Minister f Labur, I am pleased t publish the Cde f Emplyment Practice n Infant Feeding.
More informationProtocol. Preparation Protocol for the Non-Targeted Vevo MicroMarker Contrast Agent
Prtcl Preparatin Prtcl fr the Nn-Targeted Vev MicrMarker Cntrast Agent System Cmpatibility: This guide cntains instructins and suggestins fr wrk n the Vev2100, VevLAZR, Vev 3100 systems and transducers
More informationALCAT FREQUENTLY ASKED QUESTIONS
1. Is fasting required befre taking the Alcat Test? N. It is recmmended t drink water and t avid stimulants like caffeine prir t the test. 2. With regard t testing children, must a child be a certain age
More informationMembrane Structure and Function
Chapter 7 Membrane Structure and Functin Lecture Outline Overview: Life at the Edge The plasma membrane separates the living cell frm its surrundings. This thin barrier, 8 nm thick, cntrls traffic int
More informationChapter 21: Carboxylic Acid Derivatives: Nucleophilic Acyl Substitution Reactions
Chapter 21: Carbxylic Acid Derivatives: Nuclephilic Acyl Substitutin Reactins 21.1 Naming Carbxylic Acid Derivatives Naming Acid Halides, RCOX Naming Acid Anhydrides, RCO 2COR Naming Esters, RCO 2R 1.
More informationFood information to consumers - Commission proposal - COM (2008) 40 final 2008/0028 (COD) The European Heart Network s position in a nutshell
Fd infrmatin t cnsumers - Cmmissin prpsal - COM (2008) 40 final 2008/0028 (COD) The Eurpean Heart Netwrk s psitin in a nutshell Summary On 30 January 2008 the Eurpean Cmmissin published its prpsal fr a
More information