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Definition of a fraction A fraction is part of a whole number or one number divided by another pyridium 200mg with visa. Thus in the above example discount pyridium 200 mg free shipping, the whole has been divided into 5 equal parts and you are dealing with 2 parts of the whole buy pyridium 200mg without prescription. To reduce a fraction cheap pyridium 200mg fast delivery, choose any number that divides exactly into the numerator (number on the top) and the denominator (number on the bottom). A fraction is said to have been reduced to its lowest terms when it is no longer possible to divide the numerator and denominator by the same number. This process of converting or reducing fractions to their simplest form is called cancellation. Remember – reducing or simplifying a fraction to its lowest terms does not change the value of the fraction. If you have a calculator, then there is no need to reduce fractions to their lowest terms: the calculator does all the hard work for you! Equivalent fractions Consider the following fractions: 1 3 4 12 2 6 8 24 Each of the above fractions has the same value: they are called equivalent fractions. If you reduce them to their simplest forms, you will notice that each is exactly a half. Now consider the following fractions: 1 1 1 3 4 6 If you want to convert them to equivalent fractions with the same denominator, you have to find a common number that is divisible by all the individual denominators. For each fraction, multiply the numbers above and below the line by the common multiple. So for Fractions and decimals 27 the first fraction, multiply the numbers above and below the line by 4; for the second multiply them by 3; and the third multiply them by 2. So the fractions become: 1 4 4 1 3 3 1 2 2 × and and 3 4 12 3 4 12 6 2 12 1 1 1 4 3 2 , and equal , and , respectively. For example: 14 7 4 14 +7 – 4 17 + – = 32 32 32 32 32 To add (or subtract) fractions with the different denominators, first convert them to equivalent fractions with the same denominator, then add (or subtract) the numerators and place the result over the common denominator as before. For example: 1 1 1 3 2 4 3– 2 + 5 – += – + = = 4 6 3 12 12 12 12 12 Multiplying fractions It is quite easy to multiply fractions. You simply multiply all the numbers ‘above the line’ (the numerators) together and then the numbers ‘below the line’ (the denominators). For example: 2 3 2 ×3 6 × = 5 7 ×7 35 However, it may be possible to ‘simplify’ the fraction before multiplying, e. You can sometimes ‘reduce’ both fractions by dividing diagonally by a common number, e. You will probably encounter fractions expressed or written like this: 2 5 2 3 whichisthesameas ÷ 3 5 7 7 In this case, you simply invert the second fraction (or the bottom one) and multiply, i. A decimal number consists of a decimal point and numbers both to the left and right of that decimal point. Multiplying decimals Decimals are multiplied in the same way as whole numbers except there is the decimal point to worry about. If you are not using a calculator, don’t forget to put the decimal point in the correct place in the answer. At first, it looks a bit daunting with the decimal points, but the principles covered earlier with long multiplication also apply here. The decimal point is placed as many places to the left as there are numbers after it in the sum. This is particularly true in infusion rate calculations, as it is impossible to give a part of a drop or a millilitre (mL) when setting an infusion rate. If the number after the decimal point is 5 or more, then add 1 to the whole number, i. Converting decimals to fractions It is unlikely that you would want to convert a decimal to a fraction in any calculation, but this is included here just in case. The value of this multiple of 10 is determined by how many places to the right the decimal point has moved, i.

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As alluded to in chapter 2 200 mg pyridium overnight delivery, pragmatic approaches will start with an explo- ration of the potential for creating a clear harm reduction gradient purchase 200mg pyridium overnight delivery. This will demand the differential application of regulation purchase 200 mg pyridium fast delivery, along key risk vectors order 200 mg pyridium with amex. It is proposed this could involve a tiered regulatory system: * Some highly potent, short-acting synthetic or semi-synthetic 159 1 2 3 Introduction Five models for regulating drug supply The practical detail of regulation opiates, such as fentanyl (and its various analogues), would remain prohibited under all circumstances for non-medical supply and use. Whilst many of these drugs have occasionally appeared within opiate using populations (usually as diverted medical supplies) such use is primarily a refection of the lack of access to alternatives. If greater access to and choice of other opiates were available, it is assumed that the demand for more niche medical opiates would largely disappear. These would be available on a medical prescription basis, where specifc criteria were met. Opiate prescribing models have a long history in a number of countries and are well established. As discussed in chapter 2, various models exist that can include access that is condi- tional on supervised use in a clinical setting. These would potentially be in combination with licensed premises for supply and consumption, or membership based clubs/venues. Specifc levels of regulation for particular products would be determined by risk assessment of individual prepa- rations. These would be combined with an assessment of local demand, patterns of use and risk behaviours. Some more potent/risky products would not be available, and would remain restricted for medical use only. Some non-injectable pharmaceu- tical opiates (including methadone) would also be available on prescription under certain circumstances. These could be subject to tighter restrictions including, for example, a requirement for supervised consumption. The aim of making opium subject to less restrictive availability controls, would be to reverse the trend towards more concentrated opiate products that has unfolded over the last century of prohibition. Lower risk opium preparations could absorb an increasingly large share of the demand for opiates currently met from illicit sales and diverted medical supplies of higher risk opiates. Availability for consumption in regulated venues would allow for a range of controls, peer support, risk reduction and targeting of public health information and services. It is notable that whilst the conventions draw very strict lines in terms of movement in one direction along the policy continuum, few barriers or parameters exist for movement in the opposite direction, towards increasing strictness, although the 1988 convention notes that this is ‘subject always’ to human rights law. This is in stark contrast to its frequent and vocal protestations at even the most minor shifts in the opposite direction. The challenge: allowing increased fexibility without undermining the whole system. The challenge in reforming the international drug control infrastructure is to institute reforms that remove the barriers to individual or groups of states exploring models for the legal regulation and supply of some currently illicit drugs, without destroying the entire international drug control infrastructure, much of which is unquestionably benefcial. The system of control and regulation of the pharmaceutical trade is vitally important. The consensus and shared purpose that the conventions represent—behind the need to address the problems associated with drugs—holds great potential to develop and implement more effective responses at an international level, guided by the principles and norms of the United Nations. These are the 1961 Single Convention on Narcotic Drugs, as amended by the 1972 Protocol, the 1971 Convention on Psychotropic Substances and the 1988 Convention against Illicit 108 R. As of March 2008, 183 states reconsidered’ and recommended are parties to all three conventions. The thirteen countries involved all sought to curb the opium trade (albeit for a range of different cultural, geo-political and economic reasons). The Hague convention that emerged in 1912 established the model for international drug control that continues to this day, binding parties to limit production, supply and use of opium to medical contexts, coor- dinate international efforts to enforce restrictions on non-medical use including closure of ‘opium dens’, and specifcally to penalise unauthor- ised possession. It is interesting to note that drug control demonstrates a reversed evolutionary pattern of development to much of contempo- rary social, criminal or public health policy, in that it actually began with a top-down international approach that was then consolidated into 112 domestic policy and law at a later stage.

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The drugs are divided into fourteen main groups (1st level) purchase pyridium 200 mg otc, with pharmacological/therapeutic subgroups (2nd level) generic pyridium 200 mg on line. The 3rd and 4th levels are chemical/pharmacological/therapeutic subgroups and the 5th level is the chemical substance 200mg pyridium with mastercard. The 2nd buy 200 mg pyridium free shipping, 3rd and 4th levels are often used to identify pharmacological subgroups when that is considered more appropriate than therapeutic or chemical subgroups. The complete classification of metformin illustrates the structure of the code: A Alimentary tract and metabolism (1st level, anatomical main group) A10 Drugs used in diabetes (2nd level, therapeutic subgroup) A10B Blood glucose lowering drugs, excl. A major reason why a substance is not included is that no request has been received. Remaining dosage forms/strengths are classified under G03 - Sex hormones and modulators of the genital system. Such drugs are usually only given one code, the main indication being decided on the basis of the available literature. Cross- references will be given in the guidelines to indicate the various uses of such drugs. Subdivision on the mechanism of action will, however, often be rather broad, since a too detailed classification according to mode of action often will result in having one substance per subgroup which as far as possible is avoided (e. To avoid a situation of several 4th levels with only one single substance in each, new 4th levels are as a general rule only established when at least two substances with marketing authorisations fit in the group. In addition, a new 4th level should be regarded a benefit for drug utilization research. New and innovative medicinal products will therefore often be classified in an X group and such groups could be established for only one single substance. Classification of plain products Plain products are defined as: - Preparations containing one active component (including stereoisomeric mixtures). Classification of combination products Products containing two or more active ingredients are regarded as combination products. Packages comprising two or more different medicinal products marketed under a common brand name are also considered as combination products. There are some exceptions to the main rules and these are explained in the guidelines. A medicinal product containing an analgesic and a tranquillizer, and used primarily to ease pain, should be classified as an analgesic. Likewise, combinations of analgesics and antispasmodics will be classified in A03 Drugs for functional gastrointestinal disorders if the antispasmodic effect of the product is considered most important. Similar examples are described in detail in the guidelines for the relevant drug groups. This ranking shows which drug takes precedence over others when the classification is decided. The harmonisation process was initiated in order to minimise the confusion of having two very similar classification systems. It should be emphasised that the defined daily dose is a unit of measurement and does not necessarily reflect the recommended or Prescribed Daily Dose (see page 31). For the optimal use of drugs, it is important to recognise that genetic polymorphism due to ethnic differences can result in variations in pharmacokinetics of drugs. Plain products Plain products contain one single active ingredient (including stereoisomeric mixtures). When the recommended dose refers to body weight, an adult is considered to be a person of 70 kg. It should be emphasised that even special pharmaceutical forms mainly intended for children (e. Other factors a) Fixed dose groups For some groups of products, it has been considered most appropriate to estimate the average use for products within a group instead of establishing accurate doses for every product, e. For the multivitamins the composition of various products may differ, but the average recommended dose is usually the same. For eye drops used in glaucoma therapy (S01E), a fixed dose regardless of strength has been established in the different subgroups. This is based on the assumption that, per dosage given, only one drop is applied in each eye, regardless of strength.

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