A drug fitting a one-compartment model was found to be eliminated from the plasma by the following pathways with the corresponding elimination rate constants. Metabolism: km = 0.200 h- 1
a. What is the elimination half-life of this drug?
b. What would be the half-life of this drug if biliary secretion was completely blocked?
c. What would be the half-life of this drug if drug excretion through the kidney was completely impaired?
d. If drug-metabolizing enzymes were induced so that the rate of metabolism of this drug doubled, what would be the new elimination half-life?

One hospital ceo insists on including performance data in the hospital’s annual report. “we do very well on most measures, except for one or two, but we put those in anyway,” she says. “we want to hold ourselves accountable.” does this practice demonstrate effective or ineffective leadership?

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A46-year-old man with a history of hypertension and hypercholesterolemia visits the physician for a routine followup. the patient's job involves a lot of travelling, and he admits to occasionally forgetting to take his medications with him when he travels. he complains of several episodes of chest pain in the past few months. the pain is sharp in nature, mainly over his lower chest and epigastrium, and tends to come on when walking. he believes these episodes are due to indigestion and has been taking antacids. there is a family history of heart disease, and his father died of a heart attack at age 48. on physical examination, his blood pressure is 150/80 mmhg and heart rate is 86/min. his lungs are clear to auscultation. cardiac auscultation reveals normal rate and rhythm, without rubs, gallops, or murmurs. there is no pedal oedema. he is sent for an exercise stress test. five minutes into the test, he develops st depression of 3mm in leads v1-v5. the st segment depression is greater than 0.12 seconds in duration and the stress test is stopped. which of the following is the most appropriate next step in management? - coronary angiography- holter monitor- no further tests are required- repeat stress test with thallium- upper gastrointestinal endoscopy