By I. Innostian. Wilberforce University.

In acid–base titrations order femara 2.5 mg without a prescription, a suitable acid–base indicator is used to detect the endpoint from the change of colour of the indicator used order femara 2.5mg on line. The following table contains the names and the pH range of some commonly used acid–base indicators. Atoms are a collection of various subatomic particles containing negatively charged electrons, positively charged protons and neutral particles called neutrons. Electrons move around the nucleus, and are arranged in shells at increasing distances from the nucleus. These shells represent different energy levels, the outermost shell being the highest energy level. Chemistry for Pharmacy Students Satyajit D Sarker and Lutfun Nahar # 2007 John Wiley & Sons, Ltd. The total number of protons and neutrons in the nucleus of an atom is known as the mass number. For example, a carbon atom containing six protons and six neutrons has a mass number of 12. Mass number (Number of protons + number of neutrons) 12 6C Atomic symbol Atomic number (Number of protons) Elements are substances containing atoms of one type only, e. Compounds are substances formed when atoms of two or more elements join together, e. Although 109 elements exist naturally, some of them are extremely rare (check out the periodic table). Electrons do not move freely in the space around the nucleus but are confined to regions 2 of space called shells. Therefore, electron shells are identified by the principal quantum number, n ¼ 1, 2, 3 and so on. Shell Total number of shell electrons Relative energies of shell electrons 4 32 Higher 3 2 8 1 2 Lower The electronic configuration of an atom describes the number of electrons that an atom possesses, and the orbitals in which these electrons are placed. The arrangements of electrons in orbitals, subshells and shells are called electronic configurations. Electronic configurations can be repre- sented by using noble gas symbols to show some of the inner electrons, or by using Lewis structures in which the valence electrons are represented by dots. Valence is the number of electrons an atom must lose or gain to attain the nearest noble gas or inert gas electronic configuration. The ground-state electronic configuration isthelowestenergy,andthe excited-state electronic configuration is the highest energy orbital. If energy is applied to an atom in the ground state, one or more electrons can jump into a higher energy orbital. Thus, it takes a greater energy to remove an electron from the first shell of an atom than from any other shells. Therefore, to attain thestableconfiguration,theNaatom must lose one electron from its outermost shell and become the nearest noble gas configuration, i. At the far end on the right hand side of the periodic table, let us take another example, chlorine, which has the electronic configuration of two, eight and seven, and the nearest noble gas is argon, which has the electronic configuration of two, eight and eight. Since all other elements of Group 7A in the periodic table have seven electrons in their outermost shells and they can gain one electron, we can say that the Group 7A elements have a valence of 1. We are here only concerned with the ground-state electronic configuration, which has the lowest energy. The ground-state electronic configuration of an atom can be determined by the following three principles. The Aufbau principle states that the orbitals fill in order of increasing energy, from lowest to highest. Because a 1s orbital is closer to the nucleus it is lower in energy than a 2s orbital, which is lower in energy than a 3s orbital. The Pauli exclusion principle states that no more than two electrons can occupy each orbital, and if two electrons are present, their spins must be paired. For example, the two electrons of a helium atom must occupy the 1s orbital in opposite spins. Hund’s rule explains that when degenerate orbitals (orbitals that have same energy) are present but not enough electrons are available to fill all the shell completely, then a single electron will occupy an empty orbital first before it will pair up with another electron. Therefore, the six electrons in the carbon atom are filled as follows: the first four electrons will go to the 1s and 2s orbitals, a fifth electron goes to the 2px, the sixth electron to the 2py orbital and the 2pz orbital will remain empty. The ground-state electronic configurations for elements 1–18 are listed below (electrons are listed by symbol, atomic number and ground-state electronic configuration). First period Second period Third period H s1 Li 3 [He] 2s1 Na 11 [Ne] 3s1 He 2 1s2 Be 4 [He] 2s2 Mg 12 [Ne] 3s2 2 1 2 1 B 5 [He] 2s 2p Al 13 [Ne] 3s 3p C 6 [He] 2s2 2p2 Si 14 [Ne] 3s2 3p2 7 [He] 2s2 2p3 P 15 [Ne] 3s2 3p3 8 [He] 2s2 2p4 S 16 [Ne] 3s2 3p4 2 5 2 5 9 [He] 2s 2p Cl 17 [Ne] 3s 3p 10 [He] 2s2 2p6 Ar 18 [Ne] 3s2 3p6 2. Oxygen has the atomic number 8, and the ground-state 2 2 2 1 1 electronic configuration for oxygen can be written as 1s 2s 2px 2py 2pz. Similarly, we can write the others as follows: 2 2 2 2 2 2 2 2 1 Chlorine (atomic number 17): 1s 2s 2px 2py 2pz 3s 3px 3py 3pz 2 2 1 1 1 Nitrogen (atomic number 7): 1s 2s 2px 2py 2pz 2 2 2 2 2 2 2 1 1 Sulphur (atomic number 16): 1s 2s 2px 2py 2pz 3s 3px 3py 3pz 2 2 1 1 0 Carbon (atomic number 6): 1s 2s 2px 2py 2pz 2. All noble gases are inert, because their atoms have a stable electronic configuration in which they have eight electrons in the outer shell except helium (two electrons). One of the driving forces behind the bonding in an atom is to obtain a stable valence electron configuration.

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There is a greater likelihood of unwanted side effects with combined herbal preparations buy generic femara 2.5mg on-line. Table 23-1 lists information about common herbal remedies femara 2.5 mg with mastercard, with possible implications for psychiatric/mental health nursing. Toxic in large doses, Extracts from the causing dizziness, nausea, roots are thought to headaches, stiffness, and have action similar trembling. Cascara sagrada Relief of constipation Generally recognized (Rhamnus as safe; sold as purshiana) over-the-counter drug in the U. Echinacea Stimulates the immune Considered safe in reason- (Echinacea system; may have able doses. Fennel Used to ease stomach- Generally recognized as (Foeniculum aches and to aid safe when consumed in vulgare or digestion. Foeniculum a tea or in extracts officinale) to stimulate the appetites of people with anorexia (1-2 tsp. Effective ence the adverse effect in either the fresh of temporary mouth leaf or freeze-dried ulcers. Hops Used in cases of ner- Generally recognized as (Humulus vousness, mild anxi- safe when consumed in lupulus) ety, and insomnia. Kava-Kava Used to reduce anxiety Scaly skin rash may occur (Piper while promoting when taken at high methylsticum) mental acuity. Peppermint Used as a tea to relieve Considered to be safe when (Mentha upset stomachs and consumed in designated piperita) headaches and as a therapeutic dosages. Oil of pep- permint is also used for inflammation of the mouth, pharynx, and bronchus. Psyllium Psyllium seeds are a Approved as an (Plantago popular bulk laxative over-the-counter ovata) commonly used for drug in the U. Scullcap Used as a sedative for Considered safe in reason- (Scutellaria mild anxiety and able amounts. John’s Wort Used in the treatment Generally recognized as (Hypericum of mild to moderate safe when taken at recom- perforatum) depression. Taking doses higher to make a tea, or than recommended may capsules are avail- result in severe headache, able in a variety of nausea, morning grog- dosages. Acupressure and Acupuncture Acupressure and acupuncture are healing techniques based on the ancient philosophies of traditional Chinese medicine dating back to 3000 b. The main concept behind Chinese medicine is that healing energy (qi) flows through the body along specific pathways called meridians. It is believed that these meridians of qi connect various parts of the body in a way similar to the way in which lines on a road map link various locations. There- fore, it is possible to treat a part of the body distant to another because they are linked by a meridian. Trivieri and Anderson (2002) have stated, “The proper flow of qi along energy channels (meridians) within the body is crucial to a person’s health and vitality. This pressure is thought to dissolve any obstructions in the flow of healing energy and to restore the body to a healthier functioning. In acupuncture, hair-thin, sterile, disposable, stainless-steel needles are inserted into acupoints to dissolve the obstructions along the meridians. The needles may be left in place for a specified length of time, they may be rotated, or a mild electric current may be applied. Complementary Therapies ● 377 The Western medical philosophy regarding acupressure and acupuncture is that they stimulate the body’s own painkilling chemicals—the morphine-like substances known as endorphins. Recent studies suggest that acupuncture may aid in the treatment of cocaine dependence and chronic daily headaches (Avants et al. Acupuncture is gaining wide acceptance is the United States by both patients and physicians. This treatment can be admin- istered at the same time other techniques are being used, such as conventional Western techniques, although it is essential that all health-care providers have knowledge of all treatments being received. Acupuncture should be administered by a physician or an acupuncturist who is licensed by the state in which the service is provided. Typical training for licensed acupuncturists, doctors of oriental medicine, and acupuncture physicians is a 3- or 4-year program of 2500 to 3500 hours. Diet and Nutrition The value of nutrition in the healing process has long been un- derrated. Lutz and Przytulski (2006) stated: Today many diseases are linked to lifestyle behaviors such as smok- ing, lack of adequate physical activity, and poor nutritional habits. Healthcare providers emphasize the relationship between lifestyle and the risk of disease. Many people, at least in industrial- ized countries, are increasingly managing their health problems and making personal commitments to lead healthier lives. Individuals select the foods they eat based on a number of fac- tors, not the least of which is enjoyment. Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intakes of fat, cholesterol, added sug- ars, salt, and alcohol.

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Lens : The area of the eyeball that contains cells that are sensitive to light is the b purchase 2.5mg femara with amex. They reshape the lens by contracting and relaxing as needed to bring things into focus 2.5 mg femara free shipping. The structure in the eye that responds to the ciliary muscles during focusing is the b. Otherwise known as the eardrum, this membrane sometimes bursts or tears as a result of infection or trauma. Hairs in this structure are what ultimately send the signal down the auditory nerve. These little endolymph- filled sacs have hairs and chunks of calcium carbonate that detect changes in gravitational forces. Pinna Chapter 16 Raging Hormones: The Endocrine System In This Chapter Absorbing what endocrine glands do Checking out the ringmasters: Pituitary and hypothalamus glands Surveying the supporting glands Understanding how the body balances under stress he human body has two separate command and control systems that work in harmony Tmost of the time but also work in very different ways. Designed for instant response, the nervous system cracks its cellular whip using electrical signals that make entire systems hop to their tasks with no delay (refer to Chapter 15). By contrast, the endocrine system’s glands use chemical signals called hormones that behave like the steering mechanism on a large, fully loaded ocean tanker; small changes can have big impacts, but it takes quite a bit of time for any evidence of the change to make itself known. At times, parts of the nervous system stimulate or inhibit the secretion of hormones, and some hormones are capable of stimulating or inhibiting the flow of nerve impulses. The word “hormone” originates from the Greek word hormao, which literally translates as “I excite. Each chemical signal stimulates some specific part of the body, known as target tissues or target cells. The body needs a constant supply of hormonal signals to grow, maintain homeostasis, reproduce, and conduct myriad processes. In this chapter, we go over which glands do what and where, as well as review the types of chemical signals that play various roles in the body. You also get to practice discerning what the endocrine system does, how it does it, and why the body responds like it does. No Bland Glands Technically, there are ten or so primary endocrine glands with various other hormone- secreting tissues scattered throughout the body. Unlike exocrine glands (such as mammary glands and sweat glands), endocrine glands have no ducts to convey their secretions. Instead, hormones move directly into extracellular spaces surrounding the gland and from there move into capillaries and the greater bloodstream. Although they spread throughout the body in the bloodstream, hormones are uniquely tagged by their chemical composition. Thus they have separate identities and stimulate specific receptors on target cells so that usually only the intended cells or tissues respond to their signals. All of the many hormones can be classified either as steroid (derived from cholesterol) or nonsteroid (derived from amino acids and other proteins). The steroid hormones — which include testosterone, estrogen, progesterone, and cortisol — are the ones most closely Part V: Mission Control: All Systems Go 266 associated with emotional outbursts and mood swings. Steroidal hormones, which are nonpolar (see Chapter 2 for details on cell diffusion), penetrate cell membranes easily and initiate protein production at the nucleus. Nonsteroid hormones are divided among four classifications: Some are derived from modified amino acids, including such things as epineph- rine and norepinephrine, as well as melatonin. Protein-based nonsteroid hormones include such crucial substances as insulin and growth hormone as well as prolactin and parathyroid hormone. Hormone functions include controlling the body’s internal environment by regulating its chemical composition and volume, activating responses to changes in environmen- tal conditions to help the body cope, influencing growth and development, enabling several key steps in reproduction, regulating components of the immune system, and regulating organic metabolism. Glands that secrete their product into the interstitial fluid, which flows into the blood, are a. Rickets cells Chapter 16: Raging Hormones: The Endocrine System 267 Mastering the Ringmasters The key glands of the endocrine system include the pituitary (also called the hypophy- sis), adrenal (also referred to as suprarenal), thyroid, parathyroid, thymus, pineal, islets of Langerhans (within the pancreas), and gonads (testes in the male and ovaries in the female). But of all these, it’s the pituitary working in concert with the hypothalamus in the brain that really keeps things rolling (see Figure 16-1). The hypothalamus is the unsung hero linking the body’s two primary control systems — the endocrine system and the nervous system. Part of the brain and part of the endocrine system, the hypothalamus is connected to the pituitary via a narrow stalk called the infundibulum that carries regular system status reports to the pituitary. In its supervisory role, the hypothalamus provides neurohormones to control the pituitary gland and influences food and fluid intake as well as weight control, body heat, and the sleep cycle. The hypothalamus sits just above the pituitary gland, which is nestled in the middle of the human head in a depression of the skull’s sphenoid bone called the sella turcica. The pituitary’s anterior lobe, also called the adenohypophysis or pars distalis, is some- times called the “master gland” because of its role in regulating and maintaining the other endocrine glands. Hormones that act on other endocrine glands are called tropic hormones; all the hormones produced in the anterior lobe are polypeptides. Two capil- lary beds connected by venules make up the hypophyseal portal system, which connect the anterior lobe with the hypothalamus. Hypothalamus Anterior pituitary gland Adrenocortico- tropic hormone Thyroid- stimulating hormone Figure 16-1: The working Level of thyroxin relationship has control over anterior Thyroid pituitary gland and of the hypo- gland hypothalamus thalamus and the pituitary gland.

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And usually the chatter predicts purchase 2.5 mg femara, judges buy 2.5mg femara with mastercard, and evaluates in harsh or frightening ways. Think of part of your mind as a chatter machine that produces a stream of toxic verbiage, including: I’m not good enough. In the left-hand column of Worksheet 8-4, write down the comments that you hear over and over. Change your mind chatter to a statement about your friend, and write that statement in the right-hand column. For example, change “Pretty soon, people will know I’m a phony” to “Pretty soon, people will know you’re a phony, Richard. Imagine what it would feel like to express this mind chatter to your friend, and record your reflections in Worksheet 8-5. Chapter 8: Managing Mindfulness and Achieving Acceptance 121 Worksheet 8-4 Mind Chatter Turned on Its Head Mind Chatter Mind Chatter Said to a Friend Worksheet 8-5 My Reflections Consider treating yourself as well as your friend better, and stop being so mean to yourself. When your mind chatters, remind yourself that you want to be a friend to yourself. Playing with your mind chatter In Chapters 5, 6, and 7, we show you how thoughts and beliefs that run through your mind contribute to emotional distress. These thoughts are almost always distorted and built on a foundation of sand (that is, they are based on flimsy evidence or outright distortions). Flip back to those chapters for a review of how you can wage war against unhelpful thoughts and beliefs. You can certainly wage war on your unhelpful thoughts, but sometimes a warrior needs a break or a change in tactics. Tell your mind how creative it’s being (yes, this involves more than a hint of sarcasm). He hates his job and hopes that getting a counseling degree will allow him to change careers. After reading about thanking his mind, he comes up with the responses shown in Worksheet 8-6. Worksheet 8-6 Joseph’s Thank You Mind Exercise Mind Chatter Playful Response I’ll never be able to finish Thanks, mind. Follow these instructions to complete the exercise in Worksheet 8-7, and then record your overall reflections in Worksheet 8-8. Worksheet 8-7 My Thank You Mind Exercise Mind Chatter Playful Response Chapter 8: Managing Mindfulness and Achieving Acceptance 123 Just for fun, consider trying out some other ways of playing with your mind’s chatter. Try singing the negative thoughts to the tune of “Happy Birthday to You” or “Row, Row, Row Your Boat. When you sing or say your self- downing thoughts in a humorous manner, it’s much harder to take them seriously. Worksheet 8-8 My Reflections Arriving at Acceptance Once or twice each winter, we take a drive up to the crest of New Mexico’s Sandia Mountains, elevation 10,000 feet. The parking lot at the crest is usually plowed, but the last time we went, we managed to get stuck in a snowbank. As the wheels began spinning uselessly, I (Charles) uttered a few choice words of frustration. Laura reminded me that we had written about this very subject (getting stuck in the snow) in our last book, Depression For Dummies. She said, “Remember, you have to accept where you’re at to get where you want to go. I gently applied the gas again until the tires started to spin, and once again, I took my foot off the accelerator. Rather, the message here is that in order to move forward, it’s important to ease up and accept where you’re at for a moment. Recognizing and accepting those feelings is important because if you absolutely can’t stand to be worried or down, then you’ll inevitably feel more upset when you experience these normal feelings. But as far as we know, the only humans who don’t feel some anxiety or sadness are, well. To accurately express the expe- rience, you need to acquire a dispassionate understanding of the essence of your emotions. Whether you’re depressed or anxious, accepting the emo- tional angst dispassionately will help you handle your bad feelings without becoming more upset. Read through the following example, and try out the exercise when you’re feeling troubled. Kelsey needs to renew her driver’s license, so she runs over to the Motor Vehicles Depart- ment on her lunch hour. Although there’s only one clerk on duty, she’s pleased to see only four people ahead of her. As the discussion at the front of the line drags on, Kelsey looks at her watch and starts to worry about getting back to work on time. She recalls the Accepting Angst Dispassionately exercise (see Worksheet 8-9) and runs through it in her mind. Now that I’m paying attention, I can see that these feelings go up and down every few minutes; they aren’t constant.