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week 2 tutorial on quiz prep PART 1 — Transcript

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0:00Well, hello everyone and welcome to our
0:03week two tutorial that aims to make sure
0:06that all of the students attending this
0:08tutorial are going to do well in the
0:11week two quiz.
0:13Obviously, you're going to need to go
0:15through the module one in order to do
0:18well, but this tutorial is going to give
0:20you a really good idea of the kind of
0:23questions and some exact questions that
0:26you'll see in the quiz.
0:28And just a reminder about the details of
0:30the quiz so that you know exactly what's
0:33happening.
0:35The quiz is this coming Friday and it's
0:38worth 20% of your grade in the unit.
0:42You will need to access the quiz in
0:45assessment on the side panel there in
0:47our Blackboard site. Assessment,
0:49assessment tests and submission.
0:52Assessment one, go down to assessment
0:55one and then you'll be looking at a
0:58folder that starts giving you prompts
1:01and agreements to certain conditions
1:04that you'll have to make sure to abide
1:07by.
1:08They're academic integrity issues for
1:10the most part. Okay, so sorry in advance
1:12for this next bit, but I do have to tell
1:14you the rules of the quiz right now.
1:17Some of the terms and conditions that
1:19you'll agree to include that you will
1:22not use artificial intelligence. There
1:25are no screenshots or photos of the quiz
1:28allowed at all. So even if you have a
1:31question about the quiz and you want to
1:32show me what's happening to your screen,
1:35you will have to email me or explain it
1:38in an email. You will not be able to
1:40take a picture of the screen or a
1:43screenshot of the screen. That's
1:45strictly forbidden.
1:47And you're not allowed to communicate
1:50with anybody about the quiz, not during
1:52the quiz time at all. So from 6:00 a.m.
1:56to the next day
1:58and you're not allowed to give a copy of
2:00the quiz to a future student. So, all of
2:03those are academic integrity issues and
2:06you will have to agree to those before
2:08you actually get the to the quiz. If you
2:11don't agree to them, then you don't
2:13actually get to the quiz.
2:15And another important condition of the
2:18quiz is that if you are not at one of
2:21the SCU campuses. Now,
2:23this means that if you are at one of the
2:26SCU campuses taking the quiz, then this
2:29condition does not exist. But, if you
2:31are not at one of the SCU campuses,
2:34you'll need to agree that you have a
2:37backup computer or some sort of a device
2:40that you can take the quiz. So, you have
2:42to have two different devices to take
2:44the quiz. One is your primary and second
2:47one is your your backup. And then you
2:50have to have a backup internet
2:51connection. So, what are you going to do
2:54in case? You have to have a backup plan.
2:57So, once you start the quiz, you'll need
3:00to finish it in the 90 minutes allowed.
3:03Those are the rules that have been
3:05agreed to by the board of assessors. So,
3:08we do need to abide by the rules.
3:11Once you go through those that series of
3:15folders, you will have 60 minutes to
3:19take the quiz. The quiz itself contains
3:2232 multiple-choice questions and each of
3:26those are worth 0.5%
3:29of your grade. That all adds up to 16
3:32points or 16% of your grade. And then
3:35there will be two two-point questions
3:38that I basically give you in this
3:40tutorial. So, all together, 20 points or
3:4420% of your grade in the unit.
3:48So, with that as an overview to the
3:51actual quiz, let's talk about what we
3:53will find in today's tutorial and why
3:55it's so important in doing well in the
3:57quiz.
3:58Today, we're going to discuss a number
4:00of multiple choice quiz questions, and
4:02for those, I'll discuss the question,
4:05and I will discuss the answers that you
4:07should actually give in order to be
4:09successful in each one of those
4:11questions. Each one of those questions
4:13will have five different choices. In
4:15most instances, the PowerPoints and the
4:17PowerPoint notes don't have all five
4:20choices in those, but I will give you
4:23the other choices, and you'll just have
4:25to add to your study notes. The
4:27university doesn't allow me to post the
4:29notes that can be used in the quiz to
4:31directly give students additional credit
4:34because everybody would just download
4:36the notes and not bother with the
4:37mandatory tutorial. But, I've got an
4:40easy solution. I suggest that you print
4:42out the PowerPoint notes,
4:45and as we go through this tutorial here,
4:47you can fill in the blanks.
4:49Then, your study notes are going to
4:51become invaluable
4:52if you don't remember the answers off
4:54the top of your head. The other thing
4:56that we'll be looking at today will be
4:58two two-point short answer questions,
5:01and importantly, those two short answer
5:02questions will be questions that you
5:04absolutely cannot get the answer to
5:06anywhere else but this tutorial. So, for
5:08instance, I may ask name the four most
5:11important side effects of ACE inhibitors
5:13in the order in which they were
5:14presented in week five tutorial.
5:17Uh that's not one of the questions, but
5:18anyway, that's the kind of question. So,
5:20that is a very specific answer that
5:22you'll have to give in order to get the
5:24credit for the two points.
5:26And every student who decides not to go
5:29to this tutorial or to watch the video
5:31tutorial series is going to complain
5:33about that, but those are the rules, and
5:35um
5:36you, uh for instance, will thank me for
5:38it because you will have the notes that
5:41um gives you the answers to a good
5:43portion of your questions in the quiz.
5:46So, that's good news for each of you who
5:48are here today, and unless you have any
5:50questions about the process, I think
5:52it's probably Does anybody have any
5:54questions?
5:55Okay, nothing's coming in. Uh let's
5:57start writing up our cheat sheet for the
6:00quiz.
6:01And the first thing I want to remind you
6:03about is that module O, so the
6:06orientation module has three short
6:08lessons that were included, and there
6:10will be at least one question from those
6:13three in the quiz. The topics were
6:15drugs, and if you recall schedules 2, 3,
6:19and 4. Four is prescription only. Uh 8
6:22is a controlled drug. Uh those are the
6:26most important ones, and if there's a
6:28question on those, it'll be have to do
6:29with those. Uh schedules 2, 3, 4, and 8.
6:33Medicinal formulations was another
6:35topic, and one thing that always comes
6:37up in a quiz about medicinal
6:39formulations has to do with enteric
6:41coated drugs. So, enteric coating is a
6:44coating that is put on the drug
6:47in order for the drug to get straight
6:49through the stomach all the way into the
6:51small intestines before it actually
6:53dissolves. And that would be because of
6:55the fact that uh perhaps uh the drug
6:57exposed to the acidic environment of the
6:59stomach would degrade really rapidly or
7:01for whatever reason. It might be a drug
7:03that's really hard on the stomach wall.
7:06So, for whatever reason, they'll put an
7:08enteric coating on the medication, and
7:11when there is a enteric coating, the
7:13question that always comes up in quizzes
7:16is you know, can it be chewed or
7:18swallowed? Can it be uh
7:20crushed? Uh definitely never crush or
7:23chew
7:24an enteric coated medication.
7:27And that would almost inevitably result
7:28in a diminished efficacy of the drug,
7:31and then in some cases, it would
7:33actually uh result in damage to the
7:35stomach wall.
7:37So, that's probably the most important,
7:38but then you can find the list of
7:41medicine formulations in a module uh O
7:45and uh there was a a pretty much a
7:47handout that you would be able to
7:49download. So, I've simplified an entire
7:51chapter by uh putting it into a table
7:54and all of the most important
7:56information about medicinal formulations
7:58is in that table.
8:00Okay, and the other quick lesson, so
8:03that was two quick lessons in the
8:04orientation module and the other one had
8:06to do with pregnancy categories.
8:09The most important thing that you need
8:10to remember about pregnancy categories
8:12is that the uh drugs get a bit more
8:14problematic as they go from pregnancy
8:17category A to pregnancy category C to D
8:20to X. A is the safest and it's been
8:23taken by a large number of pregnant
8:25women, while uh pregnancy category D is
8:28likely to result in harm to the fetus
8:30and uh pregnancy category X is
8:33teratogenic. So, it will cause birth
8:35defects. But, the pregnancy category B
8:39drugs is the one that is not strictly
8:41hierarchical. In other words, there is
8:44not enough information about pregnancy
8:45category B drugs to know for certain
8:48whether they will eventually be a
8:50pregnancy category A drug or pregnancy
8:53category C or D. Uh the other thing
8:56about the pregnancy categories has to do
8:57with the fact that you need to know that
8:59you're looking at the Australian
9:01pregnancy uh categories. So, make sure
9:04that it's an Australian pregnancy
9:06category in order for it to be relevant
9:08to Australia.
9:09If the source says, for instance, FDA
9:13uh regulates this drug as a pregnancy
9:15category B or for for instance, that has
9:17to do with America. It's it doesn't have
9:19to do with the B drugs in Australia. So,
9:22uh please make sure that when you're
9:23looking at the pregnancy categories, you
9:26are using an Australian source.
9:30Okay, so those were the three uh little
9:34lessons that we had in the orientation
9:36module. And as we move to the material
9:39presented in the weekly modules, one of
9:41the questions that will definitely be in
9:43the quiz will have to do with half-life.
9:46Now, for this one, I may not give you
9:48this exact one, but as I present this, I
9:51definitely I guarantee that if you
9:53listen to this, you will get the answer
9:56to the question that I do choose for the
9:58quiz, okay? So, listen carefully to what
10:01I have to say about the half-life in in
10:03this question. And as you go through
10:05that, you'll know the answer to that
10:08type of question, that half-life
10:09question that's in the quiz.
10:12So, at 12:00 noon,
10:15Mr. SM has 8 mg of drug in his system.
10:18The drug has a half-life of 1 hour.
10:20Uh when is it anticipated that he will
10:23have about 0.5 mg of drug in his system?
10:27So, that's uh going to have a number of
10:29choices if this is the exact question
10:31that I'm going to choose for being in
10:33the quiz. So, around 4:00, around 2:00,
10:363:00, 6:00 p.m., and 5:00 p.m. So, in
10:40order to really fully understand this,
10:42what we need to do is take a look at
10:43this graph.
10:44So, here's the 8 mg at 12:00 noon, and
10:50it is a and it has a 1-hour half-life.
10:54So, in the first half-life, it goes from
10:568 mg down to 4. Everybody Everybody's
10:59going to understand that one.
11:00Now, a lot of people at this point will
11:02think that in the second half-life,
11:04it'll go down four more milligrams, and
11:06it'll be out of the system completely in
11:08two half-lives. But that is incorrect.
11:11You need to look at this graph right
11:13here and just get your head around the
11:15fact that the second half-life is going
11:17to basically begin the clock ticking
11:19again. At
11:211:00, there's 4 mg in his system, and
11:24that's going to go down to 2 mg at 2:00.
11:28So, just note the fact that it's not a
11:30linear thing, not with the standard way
11:33that we excrete medications,
11:35which is uh the first order of kinetics.
11:38And uh the next half-life is going to
11:40take it down to 1 mg uh and that's going
11:42to be at 3:00. The fourth half-life
11:45takes it down to 0.5 mg. And take this
11:48down because the point at which there's
11:51only 5% remaining in the system is 4.5
11:55half-lives. The average time that it
11:57takes to eliminate uh 95% of the drug
12:01from the system is 4.5 half-lives.
12:05So, does everybody understand that it's
12:07not a linear thing? If it was a linear
12:09thing, it would take only 2 hours to
12:10eliminate the drug, but basically it
12:12gets harder and harder to eliminate the
12:14drugs when we have less of the drug in
12:16our system.
12:18So, hopefully you have understood that
12:21with respect to half-life, and we can go
12:24on to another question, which is likely
12:27to be in the final quiz. So, the next
12:30question has to do with linear dose
12:32response versus a normal response curve.
12:37And the question that will be seen in
12:38the quiz has to do with, you know, which
12:40of the following exhibits a linear dose
12:43response. And the answers that I'm
12:46showing here on the PowerPoint are
12:47calcium antacids, uh paracetamol, beta
12:50blockers, and the two that are not seen
12:53on the PowerPoint notes are opioids, and
12:57uh the last one is none of the drug
12:59choices in this list exhibit a linear
13:02dose response.
13:04So, take some time to write down those
13:06two additional choices, opioids, and
13:09none of the drug choices in this list
13:11exhibit a linear dose response.
13:14In order to understand the dose response
13:17curves, we should first take the normal
13:20dose response. So, normally the response
13:23goes something like this graph, where
13:25the dose is on the x-axis, right here
13:28and the response is on the y-axis.
13:31So, if we took paracetamol as an
13:33example, because this is a really
13:34important one. This is something that
13:37clients will always
13:39uh have the wrong assumption about and
13:41it's really a an important uh safety
13:45issue. If we take paracetamol as an
13:46example, the normal dose is going to be
13:49in this range here.
13:51But, it's a weak analgesic. So, you're
13:55not going to get more analgesic effects
13:57by taking more than the normal dose.
14:00This is one of the reasons that uh you
14:01know, people are overdosing so much on
14:03paracetamol. Paracetamol is one of it
14:05well, it's the number one cause of acute
14:07liver failure because of the fact that
14:09people think that the more you take, the
14:12greater the effect. But, all you do when
14:14you take more paracetamol is that you
14:17actually get into this time right here
14:20where you're going to experience more
14:22side effects and not more, for instance,
14:25analgesic effects.
14:27Now, a linear dose response is
14:29demonstrated with this graph. The
14:31example that we used in the modules in
14:34module one was the osmotic laxatives.
14:37Osmotic laxatives, very simplistically
14:39speaking, pull water into the small
14:41intestine from the blood. It's an
14:43osmotically active particle. It pulls
14:45basically basically pulls it into the
14:47intestines and then
14:49uh the person has diarrhea or has looser
14:52stools or you know, depending on how
14:54much they take and where they started
14:55from.
14:56But, if you take too much, the major
14:58side effect is going to be diarrhea and
15:00also even dehydration if you take too
15:02much. Uh and then even electrolyte
15:04imbalances from that dehydration.
15:07Uh because basically there's uh too many
15:09electrolytes in your blood for the
15:10amount of fluid that's left. If you're
15:12actually, you know, pulling just think
15:13about, you know, pulling all of that
15:15water, all of that fluid out of the
15:17blood and into the GIT, well, you wind
15:21up with um diarrhea uh in the uh GIT and
15:24in the system, you wind up with
15:26dehydration and electrolyte imbalances.
15:29So, uh
15:30yes, so that one is an example of the
15:33rare time in which we have a linear dose
15:36response. The more you take, the more
15:40uh the greater the the effect.
15:42Uh other examples of drugs that have a
15:44linear dose response are mainly those
15:47drugs that are attempting to kill
15:48pathogens or cancer cells. So, for
15:51instance, radiation therapy exhibits a
15:53linear dose response. But, of course,
15:56you have to be really careful because if
15:57you're killing 100% of the cancer cells,
16:00then you're probably going to kill the
16:02patient as well.
16:03Uh so, let's go back to the question and
16:06which one of the following exhibits a
16:07linear dose response? Can anybody tell
16:09me? Uh calcium antacids? Do do those do
16:12do paracetamol? Does uh
16:15beta blockers or opioids?
16:18Okay, yeah, correct. And none of those
16:20will actually exhibit a linear dose
16:22response. Uh if there was, for instance,
16:26uh radiation therapy or
16:29osmotic laxatives in that group of
16:31medications, then you would choose
16:33those.
16:34Okay, so does everybody understand that?
16:38Good. Well done. Uh so, at this point,
16:41what I'm going to do is uh sneak in the
16:43one of the two-point questions.
16:45And so, the next question is about
16:47rebound effects of medications, and it's
16:50going to be that question, one of the
16:52two two-point questions that we'll take
16:53today.
16:54And once again, the only way you'll know
16:56how to answer this question is to listen
16:58to it right here. The question's going
17:00to be worded, "In the tutorial, we
17:01discussed the rebound effect that is
17:03seen in some medications. Using the
17:05example that was given in the compulsory
17:07tutorial, explain the rebound effect and
17:09why it occurs."
17:14Okay, yeah, I will post that in the chat
17:17board and
17:18uh it's posted right now. So, in the uh
17:20tutorial we discussed the rebound effect
17:23that is seen in some medications. Using
17:25the example that was given in the
17:27tutorial, explain the rebound effect and
17:29why it occurs.
17:31And for this one, I would just want you
17:33to use the example that we used in
17:35module one. Let's just be consistent and
17:38you've already been exposed to this uh
17:39example. We're looking at various and we
17:42were looking at various antacids and we
17:45were saying that each one of them
17:46resulted in a rebound effect. Uh that
17:49each one of those actually resulted in a
17:51bit of hyperacidity. If you take an
17:52antacid, it's good, you know, because it
17:56uh relieves the uh the the heartburn and
17:58that kind of thing for a short period of
17:59time, but then there's a little bit of a
18:00hyperacidity. But do you recall which
18:03one was the worst of those?
18:05Yes, exactly. It was the calcium uh
18:08antacids. So, they have the greatest
18:12uh neutralization of stomach acid, but
18:15they are also the ones that exhibit the
18:17very strongest rebound effect. So, as
18:20soon as you're uh kind of feeling like
18:22your the the stomach is neutralizing,
18:24what's happening there is that the the
18:27parietal cells detect the fact that the
18:30stomach has a neutral environment and it
18:32wants to hypersecrete acid so it gets
18:36the pH more acidic as quickly as
18:39possible.
18:41So, in answer to that question, what
18:43you're going to say is something
18:44something to the effect of the
18:45calcium-based antacids are an example of
18:48a drug that exhibits a strong rebound
18:50effect. It occurs because the neutral
18:52environment in the stomach is detected
18:55and the body attempts to maintain
18:57homeostasis through a hypersecretion of
19:00acid.
19:03Yep. Yeah, I do.
19:05I I I don't want you to use my words
19:08exactly. What I'd I'd like you to do is
19:09understand what what we're what we're
19:12talking about. So,
19:13what I said was the calcium-based
19:15antacids are an example of a drug that
19:17exhibits a very strong rebound effect.
19:19It occurs because the neutral
19:21environment of the stomach is detected
19:23by the parietal cells and the body
19:25attempts to maintain homeostasis through
19:27a hypersecretion of acid.
19:30So, the main thing is that you realize
19:32that a lot of drugs result in that kind
19:35of rebound effect. There's uh for
19:37instance, opioid analgesics and
19:39antidepressants and benzodiazepines. You
19:41know, when you take a benzodiazepine,
19:43what is going to happen is that, you
19:45know, you get really relaxed. And those
19:46are like Xanax and uh Valium and and
19:49that kind of thing. You You get really
19:50relaxed and and all anxieties are, you
19:52know, diminished and that kind of thing.
19:54But then there's a bit of a um
19:57a rebound effect where you're actually a
19:59bit more anxious afterwards. Stimulants
20:01do that. Um nasal decongestant
20:04decongestants do that a lot of times.
20:06Beta-blockers, corticosteroids, there's
20:08a lot of medications that
20:11have this type of rebound effect. And
20:14it's really because of the fact that the
20:16body is trying to maintain homeostasis.
20:19So, it's trying to get back to that
20:21norm. And uh and yeah, that's one of the
20:24reasons that a lot of our medications
20:27aren't going to be tolerated very well.
20:29But the one that you use in the quiz,
20:32the example that you use in the quiz is
20:33definitely the calcium-based antacids.
20:35The reason is because it neutralizes the
20:37stomach acids and then the parietal
20:39cells go overtime trying to get the
20:42stomach acid back to normal. And
20:44inevitably, that results in a short-term
20:46hyperacidity.
20:49Okay, yeah. Just make sure that you
20:50mention calcium-based antacids and
20:52homeostasis and you're about
20:54three-quarters of the way there for that
20:56question.

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