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Based on the information that the patient reported, the following actions could be recommended to address MRPs: I: START prescription for nitroglycerin SL tabs, 0.4 mg, one tab at onset of chest pain prn, can repeat every 5 min (max 3 doses), call 911 if no relief after first dose E: INCREASE Trulicity to 1.5 mg once weekly Note: other recommendations could be made, but this one would minimize medication burden since not starting a new med AND maximize cadiovascular benefit of GLP-1 A sulfonylurea would not be a particularly good option due to lack of CV benefit, risk of hypoglyecmia, and other factors S: (none applicable) – of note, you may have mentioned the drug interaction (atorvastatin/gemfibrozil) here, but since gemfibrozil is no longer an active medication, the interaction is not relevant A: RESTART / pickup refill for atorvastatin 80 mg daily and ensure taking daily (education provided to patient)     ****NOTES REGARDING BETA BLOCKER AND ACE-I: This patient should remain on the beta blocker and ACE inhibitor since they had a recent MI. Compared to patients with HF, there is less evidence for titrating the beta blocker to any specific HR in patients who are post-MI. You could consider increasing the dose to maximize beta blocker post-MI, but you would need to do so cautiously to ensure tolerability (BP may decrease and is already well within the goal range). The benefit of beta blockers post-MI is greatest within the first 1-3 years after the MI (this patient is still within the one year time frame). The ACE inhibitor also has benefit in patients with diabetes if the patient has an elevated albumin-to-creatinine ratio (preserving renal function), although we do not know if that is the case since we cannot see labs in this community setting. ***NOTE REGARDING CLOPIDOGREL / DUAL ANTI-PLATELET THERAPY: Clopidogrel should NOT be discontinued based on the information available. While the MINIMUM duration of dual anti-platelet therapy is 6 months, the IDEAL length is AT LEAST one year unless the patient is high risk for bleeding, which we have no information to suggest from this case. Often, we need information that we do not have in order to make a risk/benefit call like this. 

What structure is covered by many blood vessels and adheres tightly to the surface of the brain?  

I understand that past due assignments, quizzes, and tests will have a 1% grade deduction per hour.

Which of the following would cause the account Cash to increase

Subtraction is defined as adding a negative.

Accounts receivable

  The typical result of monopoly is __________ prices and __________ output than we find in a competitive market.  

Choose the correct answer. The choices will be used more than once.

What final grade is required to take the next highest math class (MTH 112, MTH 231, MTH 265, or BUS 271)? Select all that apply.

The following patient profile will be important for the remainder of this exercise. Please read it carefully before proceeding. Imagine that you are meeting with the patient below today (10/1/2024) for a Comprehensive Medication Review (CMR): Setting: Primary Care Physician’s Office (Ambulatory Care) Patient: Charles Robinson DOB: 8/8/1984 (40 years old) Race: Black Allergies: Lisinopril (angioedema)   Immunization History Date(s) Administered Hepatitis B (Recombivax HB) 5/4/18, 6/5/18, 11/7/18 Influenza (Fluzone Quadrivaent) 9/15/22, 10/01/24, 9/28/24 Tdap (Boostrix) 8/21/2020 COVID-19 (Moderna) 6/21/21, 7/19/21, 1/8/22, 6/9/24   The electronic medical record at your clinic links to the patients fill history at his community pharmacy; therefore you are able to verify the following medications on his dispense report over the past year: Medication Profile (from past one year): Medication Date Filled Directions Quant Refill Left Prescriber Amlodipine 10 mg tablet 9/6/24 Take 1 tablet by mouth once daily 90 3 M. Edwards Levetiracetam 500 mg tablet 9/6/24 Take 1 tablet by mouth twice daily 90 1 J. Lewis Simvastatin 40 mg tablet 9/6/24 Take 1 tablet by mouth once daily 90 1 M. Edwards Albuterol 90 mcg/actuation 8/15/24 Inhale 1-2 puffs every 4 to 6 hours as needed for shortness of breath 8.5 g 1 M. Edwards Amlodipine 5 mg tablet 6/8/24 Take 1 tablet by mouth once daily 90 3 M. Edwards Levetiracetam 500 mg tablet 6/7/24 Take 1 tablet by mouth twice daily 90 2 J. Lewis Simvastatin 40 mg tablet 6/7/24 Take 1 tablet by mouth once daily 90 2 M. Edwards Spiriva Respimat 2.5 mcg/actuation 6/5/24 Take 2 puffs by mouth once daily 4 g 2 M. Edwards Lisinopril 10 mg tablet 5/28/24 Take 1 tablet by mouth once daily 90 3 M. Edwards Chantix Starting Month Pak 4/21/24 On days 1 to 3 take 0.5 mg once daily, then on days 4 to 7 take 0.5 mg twice daily, then starting on day 8 take 1 mg twice daily 53 0 M. Edwards Levetiracetam 500 mg tablet 3/8/24 Take 1 tablet by mouth twice daily 90 3 J. Lewis Simvastatin 40 mg tablet 3/8/24 Take 1 tablet by mouth once daily 90 3 M. Edwards Albuterol 90 mcg/actuation 3/4/24 Inhale 1-2 puffs every 4 to 6 hours as needed for shortness of breath 8.5 g 2 M. Edwards Spiriva Respimat 2.5 mcg/actuation 2/6/24 Take 2 puffs by mouth once daily 4 g 3 M. Edwards Levetiracetam 500 mg tablet 12/5/23 Take 1 tablet by mouth twice daily 90 0 J. Lewis Simvastatin 40 mg tablet 12/5/23 Take 1 tablet by mouth once daily 90 0 M. Edwards