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week 2 tutorial on quiz prep PART 1c

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This tutorial aims to prepare students for a significant quiz by reviewing key concepts from Module 1 and the orientation module, including specific question formats and academic integrity rules.

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Well, hello everyone and welcome to our

week 2 tutorial that aims to make sure

that all of the students attending this

tutorial are going to do well in the

week 2 quiz. Obviously, you're going to

need to go through the module one in

order to do well, but this tutorial is

going to give you a really good idea of

the kind of questions and some exact

questions that you'll see in the quiz.

And just a reminder about the details of

the quiz uh so that you know exactly

what's happening. The quiz is this

coming Friday and it's worth 20% of your

grade in the unit. You will need to

access the quiz in assessment on the

side panel there in our Blackboard site.

Assessment assessment tests and

submission assessment one. go down to

assessment one and then you'll be uh

looking at a folder that uh starts

giving you prompts and agreements to

certain conditions that you'll have to

make sure to abide by. They're academic

integrity issues for the most part.

Okay, so sorry in advance for this next

bit, but I do have to tell you the rules

of the quiz right now. Some of the terms

and conditions that you'll agree to

include that you will not use artificial

intelligence. There are no screenshots

or photos of the quiz allowed at all. So

even if you have a question about the

quiz and you want to show me what's

happening to your screen, you will have

to email me or explain it in an email.

You will not be able to take a picture

of the screen or a screenshot of the

screen. That's uh strictly forbidden.

And uh you're not allowed to communicate

with anybody about the quiz, not during

the quiz time at all. So from 6:00 a.m.

to the next day, and you're not allowed

to give a copy of the quiz to a future

student. So all of those are academic

integrity issues, and you will have to

agree to those before you actually get

the to the quiz. If you don't agree to

them, then you don't actually get to the

quiz. And another important condition of

the quiz is that if you are not at one

of the SCU campuses, now this means that

if you are at one of the SCU campuses

taking the quiz, then this condition

does not exist. But if you are not at

one of the SCU campuses, you'll need to

agree that you have a backup computer or

some sort of a device that you can take

the quiz. So you have to have two

different devices to take the quiz. one

is your primary and second one is your

your backup and then you have to have a

backup internet connection. So what are

you going to do in case you have to have

a backup plan? So once you start the

quiz, you'll need to finish it in the 90

minutes allowed. Those are the rules

that have been agreed to by the board of

assessors. So, we do need to abide by the

the

rules. Once you go through those uh that

series of folders, uh you will have 60

minutes to take the quiz. The quiz

itself contains 32 multiplechoice

questions and each of those are worth

0.5% of your grade. That all adds up to

16 points or 16% of your grade. And then

there will be two twopoint questions

that I basically give you in this

tutorial. So altogether 20 points or 20%

of your grade in the

unit. So with that as an overview to the

actual quiz, let's talk about what we

will find in today's tutorial and why

it's so important in doing well in the

quiz. Today we're going to discuss a

number of multiplechoice quiz questions.

And for those I'll discuss the question

and I will discuss the answers that you

should actually give in order to be

successful in each one of those

questions. Each one of those questions

will have five different choices. In

most instances, the PowerPoints and the

PowerPoint notes don't have all five

choices in those. But uh I will give you

the other choices and you'll just have

to add to your study notes. The

university doesn't allow me to post in

notes that can be used in the quiz to

directly give students additional credit

because everybody would just download

the notes and not bother with the

mandatory tutorial. But I've got an easy

solution. I suggest that you print out

the PowerPoint notes and as we go

through the tutorial here, you can fill

in the blanks. Then your study notes are

going to become invaluable if you don't

remember the answers off the top of your

head. The other thing that we'll be

looking at today will be two twopoint

short answer questions. And importantly,

those two short answer questions will be

questions that you absolutely cannot get

the answer to anywhere else but this

tutorial. So for instance, I may ask

name the four most important side

effects of ACE inhibitors in the order

in which they were presented in week

five tutorial. Uh that's not one of the

questions, but anyway, that's the kind

of question. So that is a very specific

answer that you'll have to give in order

to get the credit for the two

points. And every student who decides

not to go to this tutorial or to watch

the video tutorial series is going to

complain about that. But those are the

rules and um you for instance will thank

me for it because you will have the

notes that um gives you the answers to a

good portion of your questions in the

quiz. So that's good news for each of

you who are here today. And unless you

have any questions about the process, I

think it's probably Does anybody have

any questions? Okay, nothing's coming

in. Let's start writing up our cheat

sheet for the

quiz. The first thing I want to remind

you about is that module O, so the

orientation module has three short

lessons that were included and there

will be at least one question from those

three in the quiz. The topics were

scheduling of drugs and if you recall

schedules two, three and four, four is

prescription only. Uh eight is a

controlled drug. Uh those are the most

important ones and if there's a question

on those, it'll have to do with those

schedules 2, three, four, and eight.

Medicinal formulations was another

topic. And one thing that always comes

up in a quiz about medicinal

formulations has to do with intericcoded

drugs. So interic coating is a coating

that is put on the drug in order for the

drug to get straight through the stomach

all the way into the small intestines

before it actually dissolves. And that

would be because of the fact that

perhaps the drug exposed to the acidic

environment of the stomach would degrade

really rapidly or for whatever reason it

might be a drug that's really hard on

the stomach wall. So for whatever reason

they'll put an entic coating on the

medication and when there is a interic

coating the question that always comes

up in quizzes is you know can it be

chewed or swallowed? Can it be uh

crushed? uh definitely never crush or

chew an intericcoated medication and

that would almost inevitably result in a

diminished efficacy of the drug and then

in some cases it would actually uh

result in damage to the stomach wall. So

that's probably the most important but

then you can find the list of med

medicine formulations in a module O and

there was a pretty much a handout that

you would be able to download. So I've

simplified an entire chapter by putting

it into a table and all that the most

important information about medicinal

formulations is in that

table. Okay. And the other quick lesson.

So that was two quick lessons in the

orientation module and the other one had

to do with pregnancy categories. The

most important thing that you need to

remember about pregnancy categories is

that the uh drugs get a bit more

problematic as they go from pregnancy

category A to pregnancy category C to D

to X. A is the safest and it's been

taken by a large number of pregnant

women. While pregnancy category D is

likely to result in harm to the fus and

pregnancy category X is togenic. So it

will cause birth defects. But the

pregnancy category B drugs is the one

that is not strictly hierarchical. In

other words, there's not enough

information about pregnancy category B

drugs to know for certain whether they

will eventually be a pregnancy category

A drug or pregnancy category C or D. The

other thing about the pregnancy

categories has to do with the fact that

you need to know that you're looking at

the Australian pregnancy categories. So

make sure that it's an Australian

pregnancy category in order for it to be

relevant to Australia. If the source

says for instance

FDA regulates this drug as pregnancy

category B or for for instance that has

to do with America. It doesn't have to

do with the B drugs in Australia. So uh

please make sure that when you're

looking at the pregnancy categories you

are using an Australian

source. Okay. So those were the three

little lessons that we had in the

orientation module and as we move to the

material presented in the weekly

modules. One of the questions that will

definitely be in the quiz will have to

do with

halflife. Now for this one and may not

give you this exact one but as I present

this I definitely I guarantee that if

you listen to this you will get the

answer to the question that I do choose

for the quiz. Okay. So listen carefully

to what I have to say about the

half-life and in this question and as

you go through that you'll know the

answer to that uh type of question that

half-life question that's in the quiz.

So at 12:00 noon Mr. SM has 8 milligrams

of drug in his system. The drug has a

halflife of 1 hour. Uh when is it

anticipated that he will have about 0.5

milligrams of drug in his system? So

that's uh going to have a number of

choices if this is the exact question

that I'm going to choose for being in

the quiz. So around 4:00, around 2:00,

3:00, 6:00 p.m., and 5:00 p.m. So in

order to really fully understand this,

what we need to do is take a look at

this graph. So here's the 8 mgram at 12

noon, and it is a and it has a 1 hour

halflife. So in the first halfife it

goes from eight milligrams down to four.

Everybody everybody's going to

understand that one. Now a lot of people

at this point will think that in the

second halfife it'll go down four more

milligrams and it'll be out of the

system completely in two half lives. But

that is incorrect. You need to look at

this graph right here and just get your

head around the fact that the second

halfife is going to basically begin the

clock ticking again. at 1:00 there's 4

milligrams in a system and that's going

to go down to 2 milligrams at 2:00. So

just note the fact that it's not a

linear thing, not with the standard way

that we excrete

medications, which is uh the first order

of kinetics. And the next halfife is

going to take it down to 1 milligram. Uh

and that's going to be at 3:00. The

fourth halfife takes it down to 0.5 mg.

and take this down because the point at

which there's only 5% remaining in the

system is 4.5 half- livives. The average

time that it takes to eliminate uh 95%

of the drug from the system is 4.5 half-

livives. So, does everybody understand

that it's not a linear thing? If it was

a linear thing, it would take only two

hours to eliminate the drug. But

basically it gets harder and harder to

eliminate the drugs when we have less of

the drug in our

system. So hopefully you have understood

that with respect to half-life and we

can go on to another question which is

likely to be in the final quiz. So the

next question has to do with linear dose

response versus a normal response curve.

And the question that will be seen in

the quiz has to do with you which of the

following exhibits a linear dose

response. And the answers that I'm

showing here on the PowerPoint are

calcium antacids, paracetamol, beta

blockers. And the two that are not seen

on the PowerPoint notes are opioids and

uh the last one is none of the drug

choices in this list exhibit a linear

dose response. So take some time to

write down those two additional choices.

Opioids and none of the drug choices in

this list exhibit a linear dose

response. In order to understand the

dose response curves, we should first

take the normal dose response. So

normally the response goes something

like this graph where the dose is on the

x axis right here and the response is on

the y- axis.

So if we took paracetamol as an example

because this is a really important one.

This is something that clients will

always uh have the wrong assumption

about and it's really a an important uh

safety issue. If we take paracetamol as

an example, the normal dose is going to

be in this range

here. But it's a weak analesic. So

you're not going to get more analesic

effects by taking more than the normal

dose. This is one of the reasons that um

you know people are overdosing so much

on paracetamol. Paracetamol is one of

well it's the number one cause of acute

liver failure because of the fact that

people think that the more you take the

greater the effect. But all you do when

you take more paracetamol is that you

actually get into this time right here

where you're going to experience more

side effects and not more for instance

analesic effects.

Now a linear dose response is

demonstrated with this graph. The

example that we used in the modules in

module one was the osmotic laxatives.

Osmotic laxatives very simplistically

speaking pull water into the small

intestine from the blood. It's an

osmotically active particle. It pulls

basic basically pulls it into the

intestines and then uh the person has

diarrhea or has looser stools or you

know depending on how much they take and

where they started from. But if you take

too much, the major side effect is going

to be diarrhea and also even dehydration

if you take too much. Uh and then even

electrolyte imbalances from that

dehydration because basically there's

too many electrolytes in your blood for

the amount of fluid that's left. If

you're actually, you know, pulling, just

think about, you know, pulling all of

that water, all of that fluid out of the

blood and into the git, well, you wind

up with diarrhea in the uh git and in

the system. you wind up with dehydration

and electrolyte imbalances. So, uh yes.

So, that one is an example of the rare

time in which we have a linear dose

response. The more you take, the more uh

the greater the the effect. Uh other

examples of drugs that have a linear

dose response are mainly those drugs

that are attempting to kill pathogens or

cancer cells. So for instance, radiation

therapy exhibits a linear dose response.

But of course, you have to be really

careful because if you're killing 100%

of the cancer cells, then you're

probably going to kill the patient as

well. Uh so let's go back to the

question and which one of the following

exhibits a linear dose response. Can

anybody tell me uh calcium antacids? Do

do those does paracetamol? Does uh beta

blockers or

opioids? Okay. Yeah, correct. None of

those will actually exhibit a linear

dose response. Uh if there was for

instance uh radiation therapy or osmotic

laxatives in that group of medications

then you would choose those. Okay. So

does everybody understand

that? Good. Well done. Uh so at this

point what I'm going to do is uh sneak

in the one of the twopoint questions.

So, the next question is about rebound

effects of medications. And it's going

to be that two-point question, one of

the two twop two-point questions that

we'll take today. And once again, the

only way you'll know how to answer this

question is to listen to it right here.

The question is going to be worded in

the tutorial. We discussed the rebound

effect that is seen in some medications

using the example that was given in the

compulsory tutorial. Explain the rebound

occurs. Okay. Yeah, I will post that in

the chat board and uh it's posted right

now. So in the tutorial we discussed the

rebound effect that is seen in some

medications using the example that was

given in the tutorial. Explain the

rebound effect and why it

occurs. And for this one I would just

want you to use the example that we used

in module one. Let's just be consistent

and you've already been exposed to this

example. We're looking at various we

were looking at various ant acids and we

were saying that each one of them

resulted in a rebound effect. Uh that

each one of those actually resulted in a

bit of hyper acidity. If you take an ant

acid, it's good, you know, because it

relieves the uh the heartburn and that

kind of thing for a short period of

time, but then there's a little bit of a

hyper acidity. But do you recall which

one was the worst of those? Yes,

exactly. It was the calcium uh ant

acids. So they have the

greatest neutralization of stomach acid,

but they are also the ones that exhibit

the very strongest rebound effect. So as

soon as you're kind of feeling like

you're the stomach is neutralizing,

what's happening there is that the the

parietal cells detect the fact that the

stomach has a neutral environment and it

wants to hyper secrete acid. So it gets

the pH more acidic as quickly as possible.

possible.

So in answer to that question, what

you're going to say is something

something to the effect of the calcium

based antacids are an example of a drug

that exhibits a strong rebound effect.

It occurs because the neutral

environment in the stomach is detected

and the body attempts to maintain

homeostasis through a hypers secretion of

acid. Yeah. Yeah. I do I I I don't want

you to use my words exactly. What I' I'd

like you to do is understand what what

we're what we're talking about. So what

I said was the calcium based antacids

are an example of a drug that exhibits a

very strong rebound effect. It occurs

because the neutral environment of the

stomach is detected by the parietal

cells and the body attempts to maintain

homeostasis through a hypers secretion

of acid. So the main thing is that you

realize that a lot of drugs result in

that kind of rebound effect. There's for

instance opioid analesics and

anti-depressants and benzoazipines. You

know when you take a bzzoazipene what is

going to happen is that you know you get

really relaxed. Those are like Xanax and

Valium and and that kind of thing. You

you get really relaxed and and all

anxieties are you know diminished and

that kind of thing but then there's a

bit of a um a rebound effect where

you're actually a bit more anxious

afterwards. Stimulants do that. um nasal

decongest decongestants do that a lot of

times. Beta blockers, cortosteroids,

there's a lot of medications that have

this type of rebound effect and it's

really because of the fact that the body

is trying to maintain homeostasis. So,

it's trying to get back to that norm and

uh and yeah, that's one of the reasons

that a lot of our medications aren't

going to be tolerated very well. But the

one that you use in the quiz, the

example that you use in the quiz is

definitely the calcium based ant acids.

And the reason is because it neutralizes

the stomach acids and then the parietal

cells go overtime trying to get the

stomach acid back to normal and

inevitably that results in a short-term hyper

hyper

acidity. Okay. Yeah. Just make sure that

you mention calcium based antacids and

homeostasis and you're about

threequarters of the way there for that question.

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YouTube Transcript:week 2 tutorial on quiz prep PART 1c