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# Case Study 1 (5 marks total) A hypothetical medication, called MedG, contains 200 mg of its active ingredient in an intestinesolvent capsule. The active ingredient is effectively transported across...

Answered 1 days After May 22, 2023

## Solution

Dr Insiyah R. answered on May 23 2023
Case study 1    1
Case Study 2    3
Case Study 3    4
Case Study 4    6
Case Study 5    7
Case Study 6    9
Case Study 7    10
Case study 1
To calculate MedG's bioavailability, we must first find the amount of drug abso
ed into the portal circulation and then the amount of drug remaining after first-pass metabolism in the liver.
1. Amount of drug abso
ed = 200 mg (Total drug) * 0.85 (Absorption rate) = 170 mg
2. Amount of drug remaining after first-pass metabolism = 170 mg * (1 - 0.55) = 170 mg * 0.45 = 76.5 mg
Finally, calculate the bioavailability (F) by dividing the remaining amount of drug by the initial amount and multiply by 100 to get a percentage:
Bioavailability (F) = (76.5 mg / 200 mg) * 100 = 38.25%
When MedG and MedA are administered together, they compete for the binding sites on the plasma albumin. Since MedA has a higher affinity for the binding sites than MedG, MedA will displace MedG from the protein. This results in an increased plasma concentration of the unbound fraction of MedG. The unbound fraction of MedG can then exert its pharmacological effect or be eliminated by the body faste
The type of drug interaction that has occu
ed between MedG and MedA is a competitive binding interaction. The rationale for this is that both drugs have an affinity for the same target (plasma albumin), and they compete for binding sites on the protein. Since MedA has a higher affinity for these binding sites, it displaces MedG, causing an increase in unbound MedG in the plasma. This interaction can potentially alter the pharmacokinetics and pharmacodynamics of both drugs, leading to either an increased or decreased effectiveness and/or increased risk for side effects.
Case Study 2
The most likely aetiology of Sharon's osteoporosis is age-related and hormonal factors. Postmenopausal women have decreased estrogen levels, which lead to an imbalance in bone resorption and formation. The pathogenesis of osteoporosis involves excessive bone resorption by osteoclasts versus bone formation by osteoblasts, leading to a decrease in bone mass and deterioration of bone microarchitecture. This deterioration renders the bones fragile and prone to fractures.
Sharon's osteoporosis may have contributed to her hip fracture by weakening her bone structure, making it more susceptible to fractures from even minor trauma like a fall. With the low bone mass and compromised bone quality, the force from the fall was enough to cause a fracture in her hip.
To help prevent the development of osteoporosis, Sharon can advise her daughter and granddaughter to consider the following strategies:
1. Maintain a balanced diet rich in calcium and vitamin D to support bone health.
2. Engage in regular weight-bearing and resistance exercise to stimulate bone formation and strengthen muscles, which can help improve balance and prevent falls.
3. Maintain a healthy body weight to ensure adequate bone mass is maintained.
4. Limit alcohol intake
Case Study 3
The risk factors from Chantal's case that may have contributed to her advanced atherosclerosis include:
1. Mild obesity
2. Type 2 diabetes
3. Hyperlipidemia
4. Smoking history
5. Family history of hypertension (father)
6. Age (65 years old)
I agree with the medical student's diagnosis of unstable (crescendo) angina. My rationale is based on Chantal's symptoms of chest tightness that occu
ed during physical activity and resolved upon stopping the activity, and her severe atherosclerosis that was identified in the clinical examination. These factors all support the diagnosis of unstable angina.
Glyceryl trinitrate (GTN) is a nitrate that acts as a vasodilator. Its mechanism of action primarily involves the release of nitric oxide (NO) in vascular smooth muscle cells, leading to the activation of guanylate cyclase, which increases the production of cyclic guanosine monophosphate (cGMP). Elevated cGMP levels cause the relaxation of vascular smooth muscles, primarily in veins, resulting in venous dilation. This reduces venous return to the heart, decreases cardiac
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