1. Goofice ขนาดยาเริ่มต้นในผู้ใหญ่ที่แนะนำคือ?

5 mg ครั้งละ 2เม็ด วันละ 1 ครั้ง ก่อนอาหาร

5 mg ครั้งละ 1เม็ด วันละ 1 ครั้ง ก่อนอาหาร

5 mg ครั้งละ 1เม็ด วันละ 2 ครั้ง ก่อนอาหาร

5 mg ครั้งละ 1เม็ด วันละ 3 ครั้ง ก่อนหรือหลังอาหารก็ได้

6. คนไข้ตัดถุงน้ำดีมาสามารถรับประทานยาGooficeได้ไหม?

รับประทานได้ในคนไข้ที่ตัดถุงน้ำดีมาแล้วนานกว่า6เดือน

ไม่แนะนำให้รับประทานเนื่องจากประสิทธิภาพของยาอาจะลดลง

ไม่มั่นใจยังไม่มีข้อมูลการศึกษาในคนไข้ตัดถุงน้ำดี

ไม่รู้ PMช่วยด้วย

7. คนไข้ไตบกพร่องเรื้อรังระดับใดที่ไม่สามารถใช้ยาGooficeได้โดยไม่ต้องปรับขนาดยาลง

สามารถใช้ได้ทุกระยะโดยไม่ต้องปรับขนาดยาลง

ระยะที่ 3aeGFP 45-59 mL/min/1.73m

ระยะที่ 3beGFP 30-44 mL/min/1.73m

ระยะที่ 4eGFP 15-29 mL/min/1.73m

ระยะที่ 5eGFP <15 mL/min/1.73m

8. คนไข้ตับบกพร่องระดับรุนแรงเมื่อรับประทานยากูฟิซ อาจส่งผลต่อเรื่องใด

Efficacy อาจจะมีประสิทธิภาพลดลงได้

Safety น้อยลง อาจเกิด ADRมากกว่าคนทั่วไป

Efficacyของยาเพิ่มขึ้นควรเริ่มยาที่ขนาดต่ำก่อน

ส่งผลให้ภาวะตับบกพร่องรุนแรงขึ้นไม่แนะนำให้ใช้ในคนไข้กลุ่มนี้

9. ข้อใดไม่ใช่หนึ่งในอาการที่ตรงกับเกณฑ์การวินิจฉัยCICตาม RomeIV criteria

Sensation of incomplete evacuation (≥25%)

10. ข้อใดไม่ถูกต้องเกี่ยวกับDrug interactionของยากูฟิซ

เพิ่มplasmalevelของยา midazolam

เพิ่มplasmalevelของยาdabigatran

ลดประสิทธิภาพของยาbile acid preparations (ursodeoxycholic acid)

เพิ่มplasmalevelของยาdigoxin

GOF refreshment Feb2024

Inferring meanin g of idiomatic expressions

A solution is a mixture in which one or more substances are uniformly distributed in another substance. Solutions can be mixtures of liquids, solids, or gases. For example, plasma, the liquid part of blood, is a very complex solution. It is composed of many types of ions and large molecules, as well as gases, that are dissolved in water. A solute (SAHL-YOOT) is a substance dissolved in the solvent. The particles that compose a solute may be ions, atoms, or molecules. The solvent is the substance in which the solute is dissolved. For example, when sugar, a solute, and water, a solvent, are mixed, a solution of sugar water results. Though the sugar dissolves in the water, neither the sugar molecules nor the water molecules are altered chemically. If the water is boiled away, the sugar molecules remain and are unchanged. Solutions can be composed of various proportions of a given solute in a given solvent. Thus, solutions can vary in concentra- tion. The concentration of a solution is the amount of solute dis- solved in a fixed amount of the solution. For example, a 2 percent saltwater solution contains 2 g of salt dissolved in enough water to make 100 mL of solution. The more solute dissolved, the greater is the concentration of the solution. A saturated solution is one in which no more solute can dissolve. Aqueous (AY-kwee-uhs) solutions—solutions in which water is the solvent—are universally important to living things. Marine microorganisms spend their lives immersed in the sea, an aqueous solution. Most nutrients that plants need are in aqueous solutions in moist soil. Body cells exist in an aqueous solution of intercellu- lar fluid and are themselves filled with fluid; in fact, most chemical reactions that occur in the body occur in aqueous solutions. Copyright © by Holt, Rinehart and Winston. All rights reserved. Liquid water Solid water Ice (solid water) is less dense than liquid water because of the structure of ice crystals. The water molecules in ice are bonded to each other in a way that creates large amounts of open space between the molecules, relative to liquid water. FIGURE 2-12 solvent from the Latin solvere, meaning “to loosen” Word Roots and Origins CHEMISTRY OF LIFE 43 ACIDS AND BASES One of the most important aspects of a living system is the degree of its acidity or alkalinity. What do we mean when we use the terms acid and base? Ionization of Water As water molecules move about, they bump into one another. Some of these collisions are strong enough to result in a chemical change: one water molecule loses a proton (a hydrogen nucleus), and the other gains this proton. This reaction really occurs in two steps. First, one molecule of water pulls apart another water molecule, or dissociates, into two ions of opposite charge: H2O ∏ H OH The OH ion is known as the hydroxide ion. The free H ion can react with another water molecule, as shown in the equation below. H H2O ∏ H3O The H3O ion is known as the hydronium ion. Acidity or alkalin- ity is a measure of the relative amounts of hydronium ions and hydroxide ions dissolved in a solution. If the number of hydronium ions in a solution equals the number of hydroxide ions, the solution is said to be neutral. Pure water contains equal numbers of hydro- nium ions and hydroxide ions and is therefore a neutral solution. Acids If the number of hydronium ions in a solution is greater than the number of hydroxide ions, the solution is an acid. For example, when hydrogen chloride gas, HCl, is dissolved in water, its mol- ecules dissociate to form hydrogen ions, H, and chloride ions, Cl, as is shown in the equation below. HCl ∏ H Cl These free hydrogen ions combine with water molecules to form hydronium ions, H3O. This aqueous solution contains many more hydronium ions than it does hydroxide ions, making it an acidic solution. Acids tend to have a sour taste; how- ever, never taste a substance to test it for acidity. In concentrated forms, they are highly corrosive to some materials, as you can see in Figure 2-13. Bases If sodium hydroxide, NaOH, a solid, is dissolved in water, it dissociates to form sodium ions, Na, and hydroxide ions, OH, as shown in the equation below. NaOH ∏ Na OH Copyright © by Holt, Rinehart and Winston. All rights reserved. Eco Connection onnection Acid Precipitation Acid precipitation, more commonly called acid rain, describes rain, snow, sleet, or fog that contains high levels of sulfuric and nitric acids. These acids form when sulfur dioxide gas, SO2, and nitrogen oxide gas, NO, react with water in the atmosphere to produce sulfuric acid, H2SO4, and nitric acid, HNO3. Acid precipitation makes soil and bodies of water, such as lakes, more acidic than normal. These high acid levels can harm plant and animal life directly. A high level of acid in a lake may kill mollusks, fish, and amphibians. Even in a lake that does not have a very elevated level of acid, acid precipitation may leach aluminum and magnesium from soils, poisoning water- dwelling species. Reducing fossil-fuel consump- tion, such as occurs in gasoline engines and coal-burning power plants, should reduce high acid levels in precipitation. Sulfur dioxide, SO2, which is produced when fossil fuels are burned, reacts with water in the atmosphere to produce acid precipitation. Acid precipitation, or acid rain, can make lakes and rivers too acidic to support life and can even corrode stone, such as the face of this statue. FIGURE 2-13 44 CHAPTER 2 This solution then contains more hydroxide ions than hydronium ions and is therefore defined as a base. The adjective alkaline refers to bases. Bases have a bitter taste; however, never taste a substance to test for alkalinity. They tend to feel slippery because the OH ions react with the oil on our skin to form a soap. In fact, commercial soap is the product of a reaction between a base and a fat. pH Scientists have developed a scale for comparing the relative con- centrations of hydronium ions and hydroxide ions in a solution. This scale is called the pH scale, and it ranges from 0 to 14, as shown in Figure 2-14. A solution with a pH of 0 is very acidic, a solution with a pH of 7 is neutral, and a solution with a pH of 14 is very basic. A solution’s pH is measured on a logarithmic scale. That is, the change of one pH unit reflects a 10-fold change in the acidity or alkalinity. For example, urine has 10 times the H3O ions at a pH of 6 than water does at a pH of 7. Vinegar, has 1,000 times more H3O ions at a pH of 3 than urine at a pH of 6, and 10,000 times more H3O ions than water at a pH of 7. The pH of a solution can be measured with litmus paper or with some other chemical indicator that changes color at various pH levels. Buffers The control of pH is important for living systems. Enzymes can function only within a very narrow pH range. The control of pH in organisms is often accomplished with buffers. Buffers are chemi- cal substances that neutralize small amounts of either an acid or a base added to a solution. As Figure 2-14 shows, the composition of your internal environment—in terms of acidity and alkalinity— varies greatly. Some of your body fluids, such as stomach acid and urine, are acidic. Others, such as intestinal fluid and blood, are

110.31.b.17.C

Topic: Reading/Vocabulary Development

STAAR English II High School 2014 - Past Paper

110.31.b.1.B

STAAR English I High School 2017 - Past Paper

110.32.b.15.A

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