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Reply to a letter written by a local prescriber by considering the clinical issue of patient and using an academic writing (UK style). Use BNF, SPCs on medicines.org.uk, national guidance and medical journals as reference. (at least 2 pages) Dear Pharmacist, Can you help me treat my patient, Ms. RH, who is 78 years old. She came to clinic for relief of a chest infection yesterday but has subsequently informed me that she is going out of the area for some time. I am currently treating her atrial fibrillation with Warfarin, however, she does not wish to continue on this treatment due to the monitoring constraints. She has had erratic INRs over the last few months so is being monitored on a weekly basis. Last INR reading was taken yesterday and was 3.2 (target of 2.5). She also suffers from stage 3 CKD, she has had a stroke in the past and has mild hypertension and No Known Drug Allergies. Current medicines: Zocor 40mg on Warfarin od as per INR Lansoprazole 30mg om Amlodipine 10mg om Ramipril 7.5mg om Ferrous sulphate 200mg TDS Sodium Bicarbonate 500mg TDS Augmentin 625mg TDS 1/52 Clarithromycin 500mg bd 1/52 I am looking for your advice regarding which anticoagulant would be most appropriate for this patient and when is safest to initiate treatment. Dr Matt
What is the probability that their child will be stricken with the disease? show the probability with a punnett square.
During interphase the DNA is not visible through a microscope; it only becomes visible as chromosomes during mitosis. Why isn't the DNA visible during interphase and why would this be the case?
Why can glucogenic amino acids be used to make glucose, while ketogenic ones cannot?
Calculate the net ATP yield (ATP equivalents) for the combined complete oxidation of 1 molecule of serine and 1 molecule of alanine to CO2 in the liver, taking into consideration the energy cost of nitrogen excretion as urea.
Describe the mechanism of action of eicosanoids. Give examples of eicosanoids used to treat bronchoconstriction and inflammatory cell infiltration of the bronchi.
when flavoprotein transfers electrons directly to the final electron acceptor hydrogen peroxide is produced. What other consequences might result from electron carriers in the ETC being bypassed?
Determine the concentration of the various ionic species in a 0.01 M solution of glutamatic acid at pH = 5.
In smurfs, tall (T) is dominant to dwarf (t), blue (B) isdominant to pink (b) and happy (H) is dominant to sad (h). Tall,blue, sad females were mated to dwarf, blue, happy males. Theprogeny generation consisted of 74 tall blue happy, 69 dwarf blue..
What colors are the butterflies and What colors are the flowers? Do the colors you see correspond to those selected in Box 1 of the Settings panel at the top of the simulation? Explain
When evolution occurs we would expect different regions with similar enviornments to all contain the same mix of plants and animals.
what is the function of the casparian strip and what cheif function do the cells in the cortex serve and how do you know this?
a. compare the structure of the fetal pig heart and sheep heart. how are they similar? how are they different?b. why
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