Results for "acetic acid"

BIOC 503 - Fatty Acids

Neutralization: Sodium Bicarbonate + Acetic Acid

ASSESSMENT OF THE LIVER Anatomic and Physiologic Overview The liver, the largest gland of the body and a major organ, can be considered a chemical factory that manufactures, stores, alters, and excretes a large number of substances involved in metabolism (Hammer & McPhee, 2019; Sanyal, Boyer, Terrault, et al., 2018). The location of the liver is essential because it receives nutrient-rich blood directly from the gastrointestinal (GI) tract and then either stores or transforms these nutrients into chemicals that are used elsewhere in the body for metabolic needs. The liver is especially important in the regulation of glucose and protein metabolism. The liver manufactures and secretes bile, which has a major role in the digestion and absorption of fats in the GI tract. The liver removes waste products from the bloodstream and secretes them into the bile. The bile produced by the liver is stored temporarily in the gallbladder until it is needed for digestion, at which time the gallbladder empties and bile enters the intestine (see Fig. 43-1). Anatomy of the Liver The liver is a large, highly vascular organ located behind the ribs in the upper right portion of the abdominal cavity. It weighs between 1200 and 1500 g in the average adult and is divided into four lobes. A thin layer of connective tissue surrounds each lobe, extending into the lobe itself and dividing the liver mass into small, functional units called lobules (Barrett, Barman, Brooks, et al., 2019; Hammer & McPhee, 2019). The circulation of the blood into and out of the liver is of major importance to liver function. The blood that perfuses the liver comes from two sources. Approximately 80% of the blood supply comes from the portal vein, which drains the GI tract and is rich in nutrients but lacks oxygen. The remainder of the blood supply enters by way of the hepatic artery and is rich in oxygen. Terminal branches of these two blood vessels join to form common capillary beds, which constitute the sinusoids of the liver (see Fig. 43-2). Thus, a mixture of venous and arterial blood bathes the hepatocytes (liver cells). The sinusoids empty into venules that occupy the center of each liver lobule and are called the central veins. The central veins join to form the hepatic vein, which constitutes the venous drainage from the liver and empties into the inferior vena cava, close to the diaphragm (Barrett et al., 2019; Hammer & McPhee, 2019; Sanyal et al., 2018). In addition to hepatocytes, phagocytic cells belonging to the reticuloendothelial system are present in the liver. Other organs that contain reticuloendothelial cells are the spleen, bone marrow, lymph nodes, and lungs. In the liver, these cells are called Kupffer cells (Barrett et al., 2019; Hammer & McPhee, 2019). As the most common phagocyte in the human body, their main function is to engulf particulate matter (e.g., bacteria) that enters the liver through the portal blood. The smallest bile ducts, called canaliculi, are located between the lobules of the liver. The canaliculi receive secretions from the hepatocytes and carry them to larger bile ducts, which eventually form the hepatic duct. The hepatic duct from the liver and the cystic duct from the gallbladder join to form the common bile duct, which empties into the small intestine. The sphincter of Oddi, located at the junction where the common bile duct enters the duodenum, controls the flow of bile into the intestine. Figure 43-1 • The liver and biliary system, including the gallbladder and bile ducts. Reprinted with permission from Norris, T. L. (2019). Porth’s pathophysiology: Concepts of altered health states (10th ed., Fig. 38.1). Philadelphia, PA: Wolters Kluwer. Figure 43-2 • A section of liver lobule showing the location of hepatic veins, hepatic cells, liver sinusoids, and branches of the portal vein and hepatic artery. Functions of the Liver Glucose Metabolism The liver plays a major role in the metabolism of glucose and the regulation of blood glucose concentration. After a meal, glucose is taken up from the portal venous blood by the liver and converted into glycogen, which is stored in the hepatocytes. Subsequently, the glycogen is converted back to glucose through a process called glycogenolysis and is released as needed into the bloodstream to maintain normal levels of blood glucose. However, this process provides a limited amount of glucose. Additional glucose can be synthesized by the liver through a process called gluconeogenesis. For this process, the liver uses amino acids from protein breakdown or lactate produced by exercising muscles. This process occurs in response to hypoglycemia (Barrett et al., 2019; Hammer & McPhee, 2019). Ammonia Conversion The use of amino acids from protein for gluconeogenesis results in the formation of ammonia as a by-product. The liver converts this metabolically generated ammonia into urea. Ammonia produced by bacteria in the intestines is also removed from portal blood for urea synthesis. In this way, the liver converts ammonia, a potential toxin, into urea, a compound that is excreted in the urine (Barrett et al., 2019; Hammer & McPhee, 2019). Protein Metabolism The liver also plays an important role in protein metabolism. It synthesizes almost all of the plasma proteins (except gamma-globulin), including albumin, alpha-globulins and beta-globulins, blood clotting factors, specific transport proteins, and most of the plasma lipoproteins. Vitamin K is required by the liver for synthesis of prothrombin and some of the other clotting factors. Amino acids are used by the liver for protein synthesis (Barrett et al., 2019; Hammer & McPhee, 2019). Fat Metabolism The liver is also active in fat metabolism. Fatty acids can be broken down for the production of energy and ketone bodies (acetoacetic acid, beta-hydroxybutyric acid, and acetone). Ketone bodies are small compounds that can enter the bloodstream and provide a source of energy for muscles and other tissues. Breakdown of fatty acids into ketone bodies occurs primarily when the availability of glucose for metabolism is limited, as in starvation or in uncontrolled diabetes. Fatty acids and their metabolic products are also used for the synthesis of cholesterol, lecithin, lipoproteins, and other complex lipids (Hammer & McPhee, 2019; Sanyal et al., 2018). Vitamin and Iron Storage Vitamins A, B, and D and several of the B-complex vitamins are stored in large amounts in the liver. Certain substances, such as iron and copper, are also stored in the liver. Bile Formation Bile is continuously formed by the hepatocytes and collected in the canaliculi and bile ducts. It is composed mainly of water and electrolytes such as sodium, potassium, calcium, chloride, and bicarbonate, and it also contains significant amounts of lecithin, fatty acids, cholesterol, bilirubin, and bile salts. Bile is collected and stored in the gallbladder and is emptied into the intestine as needed for digestion. The functions of bile are excretory, as in the excretion of bilirubin; bile also serves as an aid to digestion through the emulsification of fats by bile salts. Bile salts are synthesized by the hepatocytes from cholesterol. After conjugation or binding with amino acids (taurine and glycine), bile salts are excreted into the bile. The bile salts, together with cholesterol and lecithin, are required for emulsification of fats in the intestine, which is necessary for efficient digestion and absorption. Bile salts are then reabsorbed, primarily in the distal ileum, into portal blood for return to the liver and are again excreted into the bile. This pathway from hepatocytes to bile to intestine and back to the hepatocytes is called the enterohepatic circulation. Because of the enterohepatic circulation, only a small fraction of the bile salts that enter the intestine are excreted in the feces. This decreases the need for active synthesis of bile salts by the liver cells (Hammer & McPhee, 2019). Bilirubin Excretion Bilirubin is a pigment derived from the breakdown of hemoglobin by cells of the reticuloendothelial system, including the Kupffer cells of the liver. Hepatocytes remove bilirubin from the blood and chemically modify it through conjugation to glucuronic acid, which makes the bilirubin more soluble in aqueous solutions. The conjugated bilirubin is secreted by the hepatocytes into the adjacent bile canaliculi and is eventually carried in the bile into the duodenum. p. 1366 p. 1367 In the small intestine, bilirubin is converted into urobilinogen, which is partially excreted in the feces and partially absorbed through the intestinal mucosa into the portal blood. Much of this reabsorbed urobilinogen is removed by the hepatocytes and secreted into the bile once again (enterohepatic circulation). Some of the urobilinogen enters the systemic circulation and is excreted by the kidneys in the urine. Elimination of bilirubin in the bile represents the major route of its excretion. Drug Metabolism The liver metabolizes many medications, such as barbiturates, opioids, sedatives, anesthetics, and amphetamines (Goldman & Schafer, 2019; Hammer & McPhee, 2019; Sanyal et al., 2018). Metabolism generally results in drug inactivation, although activation may also occur. One of the important pathways for medication metabolism involves conjugation (binding) of the medication with a variety of compounds, such as glucuronic acid or acetic acid, to form more soluble substances. These substances may be excreted in the feces or urine, similar to bilirubin excretion. Bioavailability is the fraction of the given medication that actually reaches the systemic circulation. The bioavailability of an oral medication (absorbed from the GI tract) can be decreased if the medication is metabolized to a great extent by the liver before it reaches the systemic circulation; this is known as first-pass effect. Some medications have such a large first-pass effect that their use is essentially limited to the parenteral route, or oral doses must be substantially larger than parenteral doses to achieve the same effect. Gerontologic Considerations Chart 43-1 summarizes age-related changes in the liver. In the older adult, the most common change in the liver is a decrease in size and weight, accompanied by a decrease in total hepatic blood flow. However, in general, these decreases are proportional to the decreases in body size and weight seen in normal aging. Results of liver function tests do not normally change with age; abnormal results in older patients indicate abnormal liver function and are not a result of the aging process itself. Chart 43-1 Age-Related Changes of the Hepatobiliary System •Atypical clinical presentation of biliary disease •Decreases in the following: •Clearance of hepatitis B surface antigen •Drug metabolism and clearance capabilities •Intestinal and portal vein blood flow •Gallbladder contraction after a meal •Rate of replacement and or repair of liver cells after injury •Size and weight of the liver, particularly in women •Increased prevalence of gallstones due to the increase in cholesterol secretion in bile •More rapid progression of hepatitis C infection and lower response rate to therapy •More severe complications of biliary tract disease Adapted from Townsend, C. M., Beauchamp, R. D., Evers, B. M., et al. (2016). Sabiston’s textbook of surgery: The biological basis of modern surgical practice. Philadelphia, PA: Elsevier. Metabolism of medications by the liver decreases in the older adult, but such changes are usually accompanied by changes in intestinal absorption, renal excretion, and altered body distribution of some medications secondary to changes in fat deposition. These alterations necessitate careful medication administration and monitoring; if appropriate, reduced dosages may be needed to prevent medication toxicity

CNS Stimulants ADHD Medications Amphetamine (Adderall, Dexedrine) Mechanism of Action: Stimulates excitatory neurons, increases dopamine & norepinephrine. Indications: ADHD, narcolepsy. Adverse Effects: Increased HR/BP, anxiety, tremor, insomnia, headache, decreased appetite, GI distress, dry mouth. Contraindications: Cardiac abnormalities, hypertension, anxiety, agitation, glaucoma, MAOI use (within 14 days). Nursing Implications: Administer 4-6 hours before bedtime. Take on an empty stomach. Monitor BP, pulse, weight, growth patterns in children. Avoid abrupt withdrawal. Methylphenidate (Ritalin, Concerta) Mechanism of Action: CNS stimulant affecting dopamine reuptake. Indications: ADHD, narcolepsy. Adverse Effects: Same as amphetamines. Nursing Implications: Same as amphetamines. Lisdexamfetamine (Vyvanse) Mechanism of Action: Converted into dextroamphetamine. Indications: ADHD, binge-eating disorder. Nursing Implications: Similar to amphetamines. Atomoxetine (Strattera) Mechanism of Action: Selective norepinephrine reuptake inhibitor. Indications: ADHD (children >6 and adults). Adverse Effects: Lower abuse potential, less insomnia, but Black Box Warning for suicidal thoughts. Nursing Implications: Monitor mental health for suicidal ideation. Narcolepsy Medications Modafinil (Provigil) Mechanism of Action: Low abuse potential stimulant. Indications: Narcolepsy, shift work sleep disorder. Nursing Implications: Monitor BP & mental health. Antimigraine Medications Rizatriptan (Maxalt), Sumatriptan (Imitrex) Mechanism of Action: Serotonin receptor agonist, causing vasoconstriction. Indications: Acute migraine treatment. Adverse Effects: Tingling, flushing, chest tightness, rebound headaches if overused. Contraindications: Cardiovascular disease, hypertension, glaucoma. Nursing Implications: Administer at first sign of migraine. Avoid triggers. Monitor cardiac history. Endocrine Medications Pituitary Medications Somatropin (Humotrope) Mechanism of Action: Growth hormone replacement. Indications: Growth failure (hypopituitarism, HIV wasting). Adverse Effects: Hyperglycemia, hypothyroidism, injection site reactions. Nursing Implications: Monitor growth, motor skills, thyroid, and glucose levels. Rotate injection sites. Octreotide (Sandostatin) Mechanism of Action: GH antagonist. Indications: Acromegaly, GH-producing tumors. Adverse Effects: GI distress, glucose changes, cardiac conduction issues. Nursing Implications: Monitor glucose, EKG, growth. ADH Medications Vasopressin (Pitressin) & Desmopressin (DDAVP) Mechanism of Action: Mimics ADH. Indications: Vasopressin: Hypotension, hemorrhage. Desmopressin: Diabetes insipidus, bedwetting. Adverse Effects: Increased BP, headache, GI distress. Nursing Implications: Monitor VS, urine output, cardiac status. Thyroid Medications Levothyroxine (Synthroid) Mechanism of Action: Synthetic T4. Indications: Hypothyroidism. Adverse Effects: Hyperthyroid symptoms. Nursing Implications: Administer before breakfast on an empty stomach. Monitor thyroid labs (TSH, T3, T4). Avoid iodine-rich foods, iron/calcium supplements. Propylthiouracil (PTU) Mechanism of Action: Inhibits thyroid hormone production. Indications: Hyperthyroidism, thyroid storm. Adverse Effects: GI distress, bone marrow suppression. Nursing Implications: Monitor thyroid levels & CBC. Avoid iodine-rich foods. Radioactive Iodine (I-131) Mechanism of Action: Destroys thyroid tissue. Indications: Hyperthyroidism, thyroid cancer. Adverse Effects: Radiation sickness, Pregnancy Category X. Nursing Implications: Radiation precautions: Avoid close contact, use separate utensils, increase fluids. Adrenal Medications Glucocorticoids Hydrocortisone (Solu-Cortef), Prednisone (Deltasone), Dexamethasone (Decadron), Methylprednisolone (Solu-Medrol) Mechanism of Action: Anti-inflammatory, immunosuppressant. Indications: Adrenal insufficiency, inflammatory/autoimmune diseases. Adverse Effects: Metabolic: Hyperglycemia, weight gain, Cushing’s syndrome. Musculoskeletal: Osteoporosis, muscle wasting. CV: Hypertension, edema. Neuro: Mood swings, insomnia. Nursing Implications: Administer in the morning with food. Taper off slowly to prevent adrenal crisis. Monitor glucose levels with long-term use. Avoid sick contacts due to immune suppression. Mineralocorticoids Fludrocortisone (Florinef) Mechanism of Action: Mimics aldosterone (Na & water retention). Indications: Addison’s disease, adrenal insufficiency. Adverse Effects: Hypertension, hypokalemia, edema. Nursing Implications: Monitor BP, electrolytes (Na, K). Immunosuppressants Cyclosporine (Sandimmune), Tacrolimus (Prograf) Mechanism of Action: Suppresses immune response. Indications: Organ transplant, autoimmune diseases. Adverse Effects: Increased risk for infections, nephrotoxicity, diabetes. Nursing Implications: Strict dosing schedule (same time every day). Avoid grapefruit juice & styrofoam cups. No live vaccines (MMR, Varicella, Smallpox). Report any signs of infection immediately. Lifespan Considerations Pediatrics: Monitor growth in children using ADHD meds & growth hormones. Pregnancy: Avoid radioactive iodine (I-131) & immunosuppressants. Elderly: Caution with stimulants & corticosteroids (risk of cardiac issues, osteoporosis). Patient Teaching CNS Stimulants: Avoid abrupt withdrawal. Monitor growth (children). Thyroid Meds: Take levothyroxine on an empty stomach. Avoid iodine-rich foods if on PTU. Corticosteroids: Taper off gradually. Monitor glucose, avoid infections. Immunosuppressants: No live vaccines. Strict dosing schedule. Insulins Rapid-acting Insulins (Insulin lispro - Humalog, Insulin aspart - Novolog) Mechanism of Action: Fast-acting insulin that mimics natural insulin secretion in response to meals. Indications: Type 1 or Type 2 Diabetes. Adverse Effects: Hypoglycemia, weight gain, lipodystrophy at injection sites. Nursing Implications: Must eat a meal after injection. Administer subcutaneously (SQ) or via infusion pump. Clear, colorless solution. Short-acting Insulin (Regular insulin - Humulin R) Mechanism of Action: Provides short-term glucose control. Indications: Type 1 & Type 2 Diabetes. Adverse Effects: Hypoglycemia, weight gain. Nursing Implications: Onset: 30-60 min, Peak: 2.5 hr, Duration: 6-10 hr. Can be administered IV, IM, or SQ. Clear, colorless solution. Intermediate-acting Insulin (NPH - Isophane insulin suspension) Mechanism of Action: Delayed onset but prolonged glucose control. Indications: Often combined with regular insulin for Type 1 & Type 2 Diabetes. Adverse Effects: Hypoglycemia, weight gain. Nursing Implications: Onset: 1-2 hr, Peak: 4-8 hr, Duration: 10-18 hr. Cloudy suspension, administered SQ. Usually given twice daily before meals. Long-acting Insulins (Insulin glargine - Lantus, Insulin detemir - Levemir) Mechanism of Action: Provides basal insulin coverage with no peak effect. Indications: Type 1 & Type 2 Diabetes. Adverse Effects: Hypoglycemia (less risk), weight gain. Nursing Implications: Onset: 1-2 hr, No peak, Duration: 24 hr. DO NOT mix with other insulins. Clear, colorless solution. Oral Antidiabetics Biguanides (Metformin - Glucophage) Mechanism of Action: Decreases hepatic glucose production & increases insulin sensitivity. Indications: First-line treatment for Type 2 Diabetes. Adverse Effects: GI discomfort, diarrhea, metallic taste, reduced B12 levels. Black Box Warning: Risk of lactic acidosis (especially in renal failure). Nursing Implications: Administer 30 min before meals. Hold if contrast dye is used (renal failure risk). Sulfonylureas (Glipizide - Glucotrol) Mechanism of Action: Stimulates pancreatic insulin release. Indications: Type 2 Diabetes (early stages). Adverse Effects: Hypoglycemia, weight gain, nausea. Contraindications: Sulfa allergy. Nursing Implications: Give 30 min before meals. Monitor for hypoglycemia. Glinides (Repaglinide - Prandin) Mechanism of Action: Increases insulin secretion from beta cells. Indications: Type 2 Diabetes (postprandial glucose control). Adverse Effects: Hypoglycemia, weight gain. Black Box Warning: May exacerbate heart failure. Nursing Implications: Take with each meal, skip if meal is skipped. Glitazones (Pioglitazone - Actos) Mechanism of Action: Improves insulin sensitivity. Indications: Type 2 Diabetes (often combined with metformin or sulfonylureas). Adverse Effects: Fluid retention, weight gain, fractures. Black Box Warning: May exacerbate heart failure. Nursing Implications: Weigh daily. Monitor for heart failure signs. Alpha-glucosidase Inhibitors (Acarbose - Precose) Mechanism of Action: Delays carbohydrate absorption. Indications: Type 2 Diabetes (postprandial glucose control). Adverse Effects: GI issues (flatulence, diarrhea). Contraindications: GI disorders (IBD, malabsorption). Nursing Implications: Take with first bite of meal. DPP-4 Inhibitors (Gliptins) (Sitagliptin - Januvia) Mechanism of Action: Enhances incretin hormone function. Indications: Adjunct to diet/exercise in Type 2 Diabetes. Adverse Effects: URI, headache, diarrhea. Nursing Implications: Take once daily, with or without food. SGLT-2 Inhibitors (Canagliflozin - Invokana) Mechanism of Action: Inhibits glucose reabsorption in kidneys. Indications: Type 2 Diabetes (weight loss benefit). Adverse Effects: UTIs, yeast infections, dehydration, ketoacidosis. Nursing Implications: Take once daily before breakfast. Injectable Non-Insulin Medications Amylin Agonists (Pramlintide - Symlin) Mechanism of Action: Slows gastric emptying, suppresses glucagon. Indications: Type 1 & Type 2 Diabetes. Adverse Effects: Nausea, vomiting, anorexia. Contraindications: Gastroparesis. Nursing Implications: Inject before meals. Take at least 1 hr before oral meds. Incretin Mimetics (Exenatide - Byetta) Mechanism of Action: Enhances insulin secretion. Indications: Type 2 Diabetes (used when oral meds fail). Adverse Effects: GI symptoms, weight loss, thyroid tumors (Black Box Warning). Nursing Implications: Administer SQ 1 hr before meals. Glucose-Elevating Agents Glucagon Indications: Severe hypoglycemia. Adverse Effects: Vomiting (turn patient on side). Nursing Implications: Used when patient cannot take oral glucose. Dextrose 50% in Water (D50W) Indications: Emergency treatment of hypoglycemia. Nursing Implications: Administer IV. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Salicylates (Aspirin - ASA) Mechanism of Action: COX-1 & COX-2 inhibitor, antiplatelet. Indications: Pain, fever, inflammation, CV prevention. Adverse Effects: GI bleeding, Reye’s syndrome in children. Nursing Implications: Do not give to children with viral infections. Acetic Acid Derivative (Ketorolac - Toradol) Indications: Short-term pain management (up to 5 days). Adverse Effects: Renal impairment, GI distress. COX-2 Inhibitor (Celecoxib - Celebrex) Indications: Osteoarthritis, rheumatoid arthritis. Adverse Effects: CV risk (Black Box Warning). Contraindications: Sulfa allergy. Propionic Acid Derivatives (Ibuprofen, Naproxen) Indications: Pain, inflammation, fever. Adverse Effects: GI distress, bleeding risk. Antigout Medications Allopurinol (Zyloprim) Mechanism of Action: Reduces uric acid production. Indications: Chronic gout prevention. Adverse Effects: Stevens-Johnson syndrome. Nursing Implications: Take with food. Colchicine (Colcrys) Mechanism of Action: Reduces inflammatory response. Indications: Acute gout attack. Adverse Effects: GI distress, bleeding risk. Nursing Implications: Hydration (3L/day). Immunizations Active Immunizing Drugs Mechanism of Action: Stimulate the immune system to produce antibodies against specific pathogens, offering long-term immunity. Indications: Prevention of infectious diseases. Adverse Effects: Common: Soreness, fever, mild rash. Severe: Fever >103°F, encephalitis, convulsions, anaphylaxis. Contraindications: Immunocompromised patients, pregnancy (some vaccines), active infections. Nursing Implications: Assess medical history, immune status, and pregnancy. Administer vaccines at appropriate sites: Infants: Mid-lateral thigh. Older children/adults: Deltoid muscle. Use warm compresses, Tylenol for mild reactions. Report severe reactions to VAERS (Vaccine Adverse Event Reporting System). Examples of Active Immunizations: Diphtheria, tetanus toxoids, acellular pertussis (DTaP, Td): Prevents diphtheria, tetanus, and pertussis. Haemophilus influenzae type B (Hib): Prevents bacterial infections, especially in children. Hepatitis B vaccine: Prevents Hep B infection. Influenza vaccine: Annual vaccine for flu prevention. Measles, mumps, rubella (MMR): Prevents viral infections. Pneumococcal vaccine: Protects against pneumococcal infections (pneumonia, meningitis). Poliovirus vaccine (IPV): Prevents poliomyelitis. Rabies vaccine: Given for rabies exposure or pre-exposure prophylaxis. Human papillomavirus (HPV - Gardasil): Prevents HPV-related cancers. Herpes zoster (Zostavax, Shingrix): Protects against shingles. Varicella vaccine: Prevents chickenpox. Passive Immunizing Drugs Mechanism of Action: Provides preformed antibodies for immediate protection; temporary immunity. Indications: Post-exposure prophylaxis in high-risk patients. Examples: Hepatitis B immunoglobulin: Post-exposure protection for Hepatitis B. Immunoglobulin: General immune support. Rabies immunoglobulin: Post-exposure prophylaxis after animal bites. Tetanus immunoglobulin: Used in unvaccinated individuals exposed to tetanus. Dermatologic Medications Antibacterials Bacitracin Mechanism of Action: Inhibits bacterial cell wall synthesis. Indications: Minor skin infections. Adverse Effects: Burning, itching. Neomycin & Polymyxin B (Neosporin) Mechanism of Action: Broad-spectrum antibacterial. Indications: Minor wounds. Adverse Effects: Local irritation. Mupirocin (Bactroban) Indications: Topical: Treats impetigo (Staphylococcus, Streptococcus infections). Intranasal: Used for MRSA colonization. Adverse Effects: Burning, itching. Silver Sulfadiazine (Silvadene) Mechanism of Action: Acts on bacterial cell wall. Indications: Burn treatment (prevention of infection). Adverse Effects: Pain, burning, contraindicated in sulfa allergy. Antiacne Medications Benzoyl Peroxide Mechanism of Action: Releases oxygen, killing acne bacteria. Indications: Mild to moderate acne. Adverse Effects: Red, peeling skin, warmth. Tretinoin (Retin-A) Mechanism of Action: Vitamin A derivative, stimulates cell turnover. Indications: Acne, UV damage. Adverse Effects: Skin peeling, severe sunburn risk (use sunscreen). Isotretinoin (Accutane) Mechanism of Action: Sebaceous gland suppression. Indications: Severe cystic acne. Adverse Effects: Teratogenic (Pregnancy Category X), liver toxicity, mood changes. Black Box Warning: IPLEDGE Program (2 contraceptive methods required). Antifungals Clotrimazole (Lotrimin) Mechanism of Action: Inhibits fungal growth. Indications: Athlete’s foot, ringworm, yeast infections. Adverse Effects: Local irritation. Miconazole (Monistat) Mechanism of Action: Antifungal, some Gram-positive action. Indications: Yeast infections, jock itch, athlete’s foot. Adverse Effects: Burning, itching, pelvic cramps. Antivirals Acyclovir (Zovirax) Mechanism of Action: Inhibits viral DNA replication. Indications: Herpes simplex (HSV-1 & HSV-2), shingles. Adverse Effects: Stinging, rash. Miscellaneous Dermatologics Permethrin (Elimite) Mechanism of Action: Neurotoxic to lice/scabies. Indications: Head lice, scabies. Adverse Effects: Itching, burning. Ophthalmic Medications Cholinergic Drugs (Miotics) Acetylcholine (Miochol-E) Indications: Induces miosis (pupil constriction) during surgery. Adverse Effects: Eye discomfort, blurred vision. Pilocarpine (Pilocar) Mechanism of Action: Stimulates cholinergic receptors, reduces intraocular pressure. Indications: Glaucoma, ocular surgery. Adverse Effects: Blurred vision, tearing, reduced night vision. Beta-Adrenergic Blockers Timolol (Timoptic) Mechanism of Action: Reduces aqueous humor production & increases outflow. Indications: Glaucoma, ocular hypertension. Adverse Effects: Eye irritation, systemic effects possible (bradycardia, hypotension). Otic Medications Ofloxacin (Floxin Otic) Mechanism of Action: Fluoroquinolone antibiotic (bacterial DNA disruption). Indications: Otitis externa & media. Adverse Effects: Mild itching/pain. Carbamide Peroxide (Debrox) Mechanism of Action: Softens & breaks down earwax. Indications: Earwax removal. Adverse Effects: Ear irritation. Nursing Considerations Lifespan Considerations Pediatrics: Infants: Thigh for vaccines, avoid aspirin (Reye’s syndrome risk). Monitor growth with long-term corticosteroids. Pregnancy: Avoid live vaccines (MMR, varicella, HPV, Zoster). Avoid isotretinoin (teratogenic). Elderly: Caution with ophthalmic beta-blockers (can cause systemic effects). Monitor renal function with fluoroquinolones (ototoxicity risk). Patient Teaching Vaccines: Keep records, report reactions. Use Tylenol, not aspirin for fever. Dermatologics: Apply with gloves, wash hands before & after. Sunscreen required with tretinoin & isotretinoin. Ophthalmic/Otic: Apply pressure to inner canthus after eye drops (reduce systemic absorption). Hold ear up & back (adults), down & back (children) for otic drops

9: Acid-Base Titrations: Analyzing Acetic Acid in Vinegar

Pre-lab 6 : pKa of acetic acid. Acidic rain.

Acetic Acid (Vinegar) Fermentation

Sulfuric Acid Fertilizer, processing metals and petroleum - Propylene plastics - Sodium Hydroxide Petroleum, plastics - Sodium Carbonate Glass, bricks, dye/fabrics, cleaners Ammonia Fertilizer - Benzene Intermediate to produce other chemicals Acetic Acid Foods, plastics Ethylene Oxide antifreeze

Pharmacology Basics a. What types of assessments and evaluations are important to do before and after giving a medication? -Vital signs -Modified head to toe exam -Pt allergies -Labs - Med history -Speci drug data -Pt understand of drugs - Age related concerns -Liver failure? Malabsorption syndrome? Renal disease? -Pt home drugs? - When intended effect will happen - Urine outpit - Lung sounds - Monitoring (desired outcome obtained? What was drug response? Any adverse effects? Any toxic effects?) b. What are the 9 rights you must consider before giving a medication? - Right pt - Right drug - Right dose - Right route - Right time - Right indication - Right documentation - Right response - Right to refuse c. What drugs are considered to be controlled substances and why? - Schedule 1-5 drugs due to the high abuse potential d. What are black box warnings? - Highest safety-related warning for meds that are assigned by FDA. This warning is intended to bring the consumer and the nurses attention to the major risk of the drug. e. Why do you have to know the generic name of a drug? - This is the name used on the NCLEX and the DR can call/prescribe it by either name. f. What is Pharmaceutics? - Developing a chemical to be used as a drug. g. What are enteral drugs? - PO drugs, it has to pass through intestines/ be absorbed in GI tract h. What are parenteral drugs? -Drug given by injection (passing outside the intestines) i. What is Pharmacokinetics? - Study of what happens to the drug while it is in the body j. Why do we consider the absorption of the drug? - Absorption affects the speed and concentration at which a drug may arrive at its desired location of effectg - k. What factors affect the absorption of a drug? - CYP450= enzyme in liver responsible for breaking down drugs and making them bioavailable l. What is the First Pass phenomenon? m. Which route of administration will be absorbed fastest and slowest? - IV/ parentral drugs are absorbed faster. - n. Why do we consider the distribution of the drug? • -Distribution describes how a substance is spread throughout the body. To be effective, a medication must reach its designated compartmental destination, described by the volume of distribution, and not be protein-bound in order to be active. o. What factors affect the distribution of a drug? - biochemical properties of the drug as well as the physiology of the individual taking that medication, ; protein bound drugs, if it has protein bound to it, it makes it harder to reach the site. p. What is a drug to drug interaction and why does this occur? - Drug- drug interaction occurs when taking more than one medication together. q. What is the importance of drug metabolism? - Metabolism changed drug to inactive metabolite to more soluble form, to a more potent active metabolite. Affecting the liver. r. What are the cytochrome P-450 enzymes and why are they so important to medication administration? - This is an active enzyme used to break down the drug; there are multiple enzymes used to break down drugs by PY450 is common; if that enzyme is already in use for a drug the enzyme may not be effective for another drug taken at the same time requiring the action of that enzyme. s. What organ is responsible for most drug metabolism? - Liver t. What labs do we monitor to make sure that organ is not damaged from metabolizing the drugs? - Liver labs u. What factors affect the metabolism of drugs? - The enzymes. Certain enzymes might make a drug more effective potentially causing toxicity and some enzymes can impede a drugs effectiveness. v. What organ is most frequently responsible for excretion of drugs? - Kidneys w. What labs do we monitor to make sure that organ is not damaged excreting the drugs? -Kidney function x. What is the onset of action of a drug? - Time required for drug to take effect y. What is the peak level of a drug? - Time required for drug to reach its maximum therapeutic response. z. What is the half-life of a drug - Time required for 50% of the drug to be eliminated from the body. aa. What is the duration of action of a drug? - Length of time that drug concentration is sufficient enough to elicit a therapeutic response. bb. How do these time factors affect the way we nurses administer and evaluate drug affects? - If a drug has a long half-life then we have to delay or put more time in between giving another dose. cc. What are the common ways that drugs exert their actions? - Through receptors, by effecting enzymes, nonselective interactions (will bind to multiple receptors because we haven’t been able to target just the one area which is why we have side effects) dd. What is acute drug therapy used for? - Antibiotics, given for a short amount of time to get rid of something specific ee. What is maintenance drug therapy used for? - BP meds, taken for a long time to maintain a function ff. What is palliative drug therapy used for? - Given to make someone more comfortable at end of life. gg. What is prophylactic drug therapy used for? - Given to prevent something hh. What are adverse effects or adverse reactions to drugs and why are they important for nurses to recognize? - Adverse effects are basically negative effects or responses to the drug from external sources; ie grapefruit garlic don’t react well with certain meds ii. What is important to consider when giving a drug to a pregnant woman? - What trimester pt is in and category drug jj. What is important to consider when giving a drug to a pediatric patient? - Pt weight kk. What is important to consider when giving a drug to a geriatric patient? - Polypharmy, other drugs taken, physiologic issues, financial issues ll. Why are drugs categorized related to pregnancy? - To determine the potential effects to the fetus mm. What are some cultural or genetic factors you must consider when administering drugs? - Speak different languages, may use herbal remedies that you need to ask about, how thee culture handles illness, be considerate of religious belief because some could affect care , how they feel about the treatment nn. Why is it important to educate patients about their prescribed medications? - So they will know what is happening and how it is happening oo. What are some factors that will improve the patient’s ability to learn about their medications? - Pt age, language barrier, cognitive abilities, literacy level, emotional status, environment at home, barriers of learning, any physical/psych/cognitive limitations pp. What are the different routes of medication administration? - PO, IM, IV, subcutaneous, topical, inhalation, nebulized, rectal, sublingual, intrathecal (epidural/spinal, transdermal qq. Why are drugs ordered to be administered using different routes? - Maybe poor liver, can’t swallow, needs to act quicker rr. What are common causes of drug administration errors? - Abbreviation, misinterpretation, drugs with similar spelling or pronunciation, staff nurse “work around”, high alert medication have more sever consequences w. error, not doing med reconciliation w/ new pt, given to wrong pt, wrong route and time ss. How can we prevent drug administration errors? - 3 checks of the 9 routes, limit telephone orders, multiple systems of checks and balances, be aware of look alike- sound alike drugs, any doubt CALL THE PHARMACIST. tt. What should you do if you make a medication administration error? - Be honest, follow the institutions policies and procedure, complete incident report, stay with pt to monitor for adverse reaction, document accurately thoroughly and objectively include info 2. Pain Medications a. Opioids i. How do you assess pain? - Onset - Location - Duration - Character - Aggravating/ - Relieving Factors - Timing - Severity ii. What are the different types of pain? iii. What are the receptors in the central nervous system that are responsible for pain transmission? -Mu, kappa, and delta -Mu has most side effects/ targeted effects iv. What does an agonist drug do in the body? -Acute, chronic, somatic, vascular, superficial, deep, visceral, neuropathic, referred, phantom, and cancer pain -Binds to receptor, alters function of receptor, and triggers physiologic response for that receptor. (ex: opiates) v. What does an antagonist drug do in the body? - Binds to receptor, but fails to activate physiologic response, vi. What happens when an opioid agonist binds to a Mu receptor? - You get all the effects of the Mu receptor (gi motility, euphoria, respiratory depression, etc) lots of side effects vii. What are the generic names of the frequently prescribed opioids? - Morphine and Fentanyl viii. What is drug potency? - How much drug is needed to produce the effect you need ix. What are the indications for the use of opioids? - Moderate to severe pain, cough suppression, anti diarrhea, local anesthesia, x. What are the adverse reactions that are frequently seen with the use of opioids? - Respiratory depression, CNS depression (sedation, mental clouding, coma), constipation, n/v, itching, rash, wheal formation, orthostatic hypotension, - Zofran reduces nausea when taking opiates xi. When evaluating the effects of an opioid, what body system must the nurse assess? - Respiratory and cardiac xii. What are the signs and symptoms of opioid overdose or toxicity? - Respiratory depression, CNS depression (sedation, mental clouding, coma), miosis xiii. What should the nurse do if there is a suspected opioid overdose? - Notify provider, use naloxone (antagonist for opiate) xiv. What does it mean to be opioid naïve? - First time user xv. What is drug tolerance and how does it affect a patient? - Larger dose is required to produce the same response, xvi. What is drug dependance and how does it affect a patient? - If you take the drug away they will freak out. xvii. What education should you provide to a patient taking an opioid? - Don’t increase your dose without talking to your doctor - Don’t stop abruptly - Don’t crush or chew ER or controlled release tablets - Can cause drowsiness, don’t partake in hazardous activities while using med - If become light headed or dizzy, sit down; change position slowly - Don’t drink alcohol or other CNS depressants while taking opiods xviii. When is the onset of action of morphine? - 5-10minutes xix. When is the peak action of morphine? Onset : 5-10 Peak: 30 minutes xx. How do we give morphine in the hospital? - IV, PO xxi. How quickly do you push IV drugs? - Slow push xxii. What are appropriate indications (what is it used for) for the use of Fentanyl? - Chronic pain, xxiii. What education should you provide to a patient who has a prescription for a Fentanyl patch? - Shave area and clean, don’t apply heat, flush down toilet, remove old patch first, keep away from children, change patch q72hrs, periodically check that oatch has not fallen off xxiv. What is Naloxone used for? - Opioid antagonist xxv. How should you educate a person or the family of a person that might need to use Naloxone? - After giving it to the step back, call provider/911, be prepared to give second dose if they relapse b. NSAIDS i. What are the main classes of NSAIDS? - Salicylate ( Asprin_ ) ii. What are the three main indications for NSAIDS? - Pain/ fever/ inflammation iii. How do NSAIDs work? - Blocks COX 1&2 enzymes - COX 2 is given for arthritis and causes less GI upset iv. What is the difference between “Protective Prostaglandins” and “Pathologic Prostaglandins”? - Protective goes through GI system (saves liver and kidney) by vaso constricting of dilating, increase clotting factors, v. What are the names of 9 different NSAID drugs? - Aspirin - Diflunisal - Indomethacin - Ketorolac (Toradol) - Diclofenac (Voltaren) - Celecoxib(Celebrex - Ibuprofen (Motrin, Advil) - Naproxen (Aleve) - Oxaprozin (Daypro) - Acetic acid derivatives - Cox 2 - Enclic acid derivatives - Proprionic acid derivatives (Ibuprofen/ Naproxen vi. What are 3 major contraindications for using NSAIDs? - Never in 3rd trimester of pregnancy - Not to be given to pts going to surgery (stop one week prior) - ASA or salicylates not to be given to children with viral illness or fever ages 4-12 vii. What is the major adverse effect that nurses should monitor for in patients taking NSAIDs? - GI Bleed - Reyes Syndrome - Acute renal failure viii. What is Reyes Syndrome and why is understanding this syndrome important? -brain swell and your liver lose function after a viral illness or infection like flu or chickenpox. Common among children who take aspirin to treat symptoms during a viral infection or illness - Don’t give children under 12 asprin ix. What is the Black Box Warning for NSAIDs? - Be aware that patient may be at increased risk for CV events, GI bleed, renal insufficiency; monitor accordingly, don’t give to 3rd trimester x. What are drugs and herbs that will interact with NSAIDs? - Garlic (increases bleeding), fish oil, ginger ginko, feverfew, alcohol, anticoagulants, ulcerogenic drugs, diuretics, lithium xi. What are important considerations for enteric coated or sustain released pills? - Don’t crush or chew xii. What are important patient education points the nurse should provide to patients taking NSAIDs? -don’t crush or chew, take with meal xiii. What is the most common reason a patient will take 81 mg of aspirin? - Cardiovascular issues, preventing thrombosis xiv. What are the signs and symptoms of aspirin toxicity in adults? - Tinnitus (ringing in ears), hearing loss xv. What are the signs and symptoms of aspirin toxicity in children? - Dizziness, increased breathing, coma, confusion, tachypnea xvi. What treatment should the nurse expect to be used for patients with aspirin toxicity? - xvii. What is Ketorolac? - xviii. How long should a patient be taking Ketorolac? - Can’t take for more than 5 days xix. What are common indications for Ketorolac? - Post op surgery/ pain control xx. How is Celecoxib different than other NSAIDS? -Blocks COX 2 and has more anti inflammatory properties, used for joint pains xxi. What are the indications for Acetaminophen use? - Preferred antipyretic med for children and adolescents due to Reye’s Syndrome xxii. What patients should be careful when using Acetaminophen? xxiii. What are the potential adverse effects of Acetaminophen? - N/V, liver toxicity xxiv. What is the antidote for Acetaminophen toxicity? - Acetylcysteine (Give within 10 hours of overdose) xxv. What is the recommended daily dose for Acetaminophen? -3,000mg xxvi. What is the recommended daily dose of Acetaminophen for patients with liver disease? - Less than 2,000 xxvii. What is Tramadol? - Used for seizures and constipation, moderatre to severe pain (adverse effects similar to opiods, no more than 400mg per day xxviii. What are the most common indications for the use of Tramadol? - Alleviate pain xxix. What are the names of 3 drugs used to treat Gout? - NSAIDS - Allopurinol - Colchicine xxx. What is Allopurinol and how does it work to treat gout? - Purine inhibitor, maintenance for gout xxxi. What are potential adverse effects of Allopurinol? - Steven Johnson Syndrom, flu like symptom, xxxii. What is Steven Johnson Syndrome? - eruption of mucous membrane leading to bleed out xxxiii. What is Colchicine and how does it work to treat gout? - NSAID xxxiv. What are potential adverse effects of Colchicine? - Don’t give to pregnant in 3rd trimester, GI/GU bleed, Drugs Used for Anesthesia a. What is the goal of Balanced General anesthesia? - b. What are the classes of drugs used in Balanced General anesthesia? - Benzo, analgesics, anasthetics, muscle relaxants c. What are 3 IV general anesthetics? - Dexmedetomidine - Ketamine - IV - Propofol d. What are 3 inhaled general anesthetics? - Sevoflurane - Suprane - Nitrous oxide e. What is malignant hyperthermia? - disease that causes a fast rise in body temperature and severe muscle contractions when someone receives general anesthesia with one or more of the following drugs: halothane, isoflurane, sevoflurane, desflurane or succinylcholine f. What are the signs and symptoms of malignant hyperthermia? - Cramping, seizure, lockjaw, increase temperature, sweating g. What drug should be given if a patient experiences malignant hyperthermia? - Dantrolene (2mg/kg) repeat every 5mins till stable h. What are other nursing interventions that are useful in patients who have malignant hyperthermia? - Chill them, hydrate, critical care meds i. What is Moderate sedation? - Medication that numbs them, but they are awake and alert. j. What are neuromuscular blocking drugs use for? - Muscle relaxant k. What is the name of a neuromuscular blocking drug used in surgery? - succinylcholine l. What is the black box warning for neuromuscular blocking drugs? -cardiac arrest -arrythmia m. What is local anesthesia? - Targeted to numb just that area. n. What is the most commonly used local anesthetic? - Lidocaine - Procaine - Bupivacaine o. What is Local Anesthetic Systemic Toxicity and how does it occur? - Local anestheic doesn’t leave spot, prolonged numbess; too much of the anesthetic. p. What is a spinal headache? - When anesthetic goes into blood stream, cause change in pressure of cebreal spinal fluid, increase ICP, (Pt needs to lay don flat on their back for 5 minutes - q. Why is Epinephrine added to Lidocaine for local anesthesia? - To control bleeding SALYSISM is aspirin poisoning, treat with bicarbonate

NSAIDS - Acetic Acid Derivatives/Indomethacin and Ketorolac

POLICE PHOTOGRAPHY A. DEFINITION OF TERMS: 1. Photography = Derived from the Greek word “Phos” or “Photos” which means “light” and “Grapho” means “Writing” or “Graphia” meaning “to Draw”. Sir John F. W. Herschel coined the word photography when he first wrote a letter to Henry Fox Talbot. = Is the art and science of reproducing image by means of light through some sensitized material with the aid of a camera, Lens and its accessories and the chemical process required in order to produced a photograph. 2. Forensic = Derived from the Latin word “Forum” which means “a market place” where people gathered for public discussion. = When used in conjunction with other science it connotes a relationship to the administration of justice. It is sometimes used interchangeably with the word legal. 3. Police Photography = Is the application of the principles of photography is relation to the police work and in the administration of justice. 4. Photograph = Is the mechanical and chemical result of Photography. Picture and photograph are not the same for a picture is a generic term is refers to all kinds of formed image while a photograph is an image that can only be a product of photography. B. USES OF PHOTOGRAPHY 1. Personal Identification = Personal Identification is considered to be the first application of photography is police work. Alphonse Bertillion was the first police who utilized photography in police work as a supplementary identification in his Anthropometry system. 2. For Communication = Photograph is considered to be one of the most universal methods of communication considering that no other language can be known universally than photograph. 3. For Record Purposes = Considered to be the utmost used of photography in police work. Different Views in photographing a. General View = taking an over-all view of the scene of the crime. It shows direction and location of the crime scene. b. Medium View = Is the taking of the photograph of the scene of the crime by dividing it into section. This view will best view the nature of the crime. c. Close-up View = Is the taking of individual photograph of the evidence at the scene of the crime. It is design to show the details of the crime. d. Extreme Close-up View = Commonly designed in laboratory photographing using some magnification such as Photomacrography and photomicrography. 4. For Preservation = Crime scene and other physical evidence requires photograph for preservation purposes. Crime scene cannot be retain as is for a long period of time but through photograph the initial condition of the scene of the crime can be preserved properly. 5. For Discovering and Proving = Photography can extend human vision in discovering and proving things such as: a. The use of Magnification Photomicrography = Taking a magnified photograph of small object through attaching a camera to the ocular of a compound microscope so as to show a minute details of the physical evidence. Photomacrogaphy = Taking a magnified (enlarged) photograph of small object by attaching an extended tube lens (macro lens) to the camera. Microphotography = is the process of reducing into a small strips of film a scenario. It is first used in filmmaking. Macrophotography = used synonymously with photomacrogaphy. Telephotography = Is the process of taking photograph of a far object with the aid of a long focus and Telephoto lens. b. Used of Artificial Light such as X-ray, Ultra-violet and Infra-red rays to show something which may not be visible with the aid of human eye alone. 6. For Court Exhibits = Almost all evidence presented in court before formally be accepted requires that they satisfy the basic requirements for admissibility which is relevancy and competency. A question of relevancy is usually proved by proving the origin of the evidence and its relation to the case and this is usually supplemented by photograph of the evidence giving reference as to where it came from. Evidence presented in court once accepted became known as Exhibit. Either Exhibit 1,2,3 etc. for the defense or Exhibit A, B, C etc for the prosecution. 7. Crime Prevention = with the used of video camera (hidden camera) and other advanced photographic equipment crimes are being detected more easily and even to the extent of preventing them from initially occurring. 8. Police Training = Modern facilities are now being used as instructional material not only in police training as well as in other agencies. 9. Reproducing and Copying = With the use of photography any number of reproduction of the evidence can be made those giving unlimited opportunity for its examination and even allow other experts or person to examine the specimen without compromising the original. C. ESSENTIALS OF PHOTOGRAPHY 1. Light = is an electromagnetic energy that travels in a form of a wave with the speed of 186, 000 miles per second. 2. Camera = a light tight box designed to block unwanted or unnecessary light from reaching the sensitized material. 3. Lens = is the light gathering mechanism of the camera that collect the reflected light coming from the object to form the image. 4. Sensitized material = composed of a highly sensitized chemical compound which is capable of being transformed into an image through the action of light and with some chemical processes. ( Film and Photo Paper). 5. Chemical Process = is the process necessary for reducing silver halides into a form so as a latent image and a positive image be made resulting to what we called Photograph. D. THEORIES OF LIGHT 1. The WAVE Theory (Huygens) = It is the theory that was transcribed from the motion of the water that if we observe a piece of log floating in the ocean and with the force of the air would naturally will make the log move up and down. 2. Corpuscular theory (Newton) = this later opposed the wave theory stating that light has its effect by the motion of very small particles such as electrons. 3. Modified Wave theory (Maxwell and hertz) = Based on electromagnetics. All these theories are still considered to be of little lacking that law enforcement need not to be very focus on this but rather go along with the accepted conclusion that light is a form of energy, which is electromagnetic in form. E. LIGHT: ITS NATURE, CHARACTERISTICS, SOURCES AND CLASSIFICATION Light is defined as an electromagnetic energy with the speed of 186,00 miles per second. Its wave travel is said to be characterized in certain extent based on velocity, wavelength and frequency of the number of vibration of the wave per second. Light wavelength is the distance measured between two (2) successive crest or through of wave and it is expressed in either Millimicron (nanometer) or Angstrom. Millimicron is the units of light wavelength which is equivalent to one-millionth part of a millimeter which the Angstrom is relatively smaller for it has an equivalent measurement of ten (10) millionth part of a millimeter. Once light hits a certain medium, its action can be characterized as either: Reflected, Transmitted or Absorbed (RAT). Reflected once the light hits a mirror and it bounce back. Transmitted when the light hits a transparent glass which would allow the light to pass through its medium and Absorbed when the light hits a dark colored object and prevents it from either bouncing or passing through. Isaac Newton in 1666 proved that the light which men see as white light is actually a mixture of all colors of the spectrum. This is produced when we allow light to hit a glass prism (Sharp Edge of the Glass). A rainbow array will then be shown with colors red, orange, yellow, green, blue and violet colors (from top to bottom). The visible light is also said of have a wavelength of between 400-700 millimicron or nanometer. 1. Types of Light Lights can largely be classified into visible and invisible light. a. Visible Light = Is the type of light that produces different sensation when reach the human eye. It is the type of light, which is capable of exciting the retina of the human eye. b. Invisible Light = lights in which their wavelength are either too short or too long to excite the retina of the human eye i.e. X-ray, Ultrat-violet and Infra-red lights. 2. Photographic Rays a. X-ray =Light with the wavelength between .01 to 30 millimicrons. It is produced by passing an electric current through a special type of vacuum tube. It was incidentally discovered by Conrad Welhelm Roentgen. This type of light works in the principle of shadow photography. b. Ultra-violet ray (Before the violet) = Radiation having a wavelength of 30 to 400 nanometers designed to photograph fingerprints in multi colored background, documents that are altered, decipherment of erase writing and developing invisible writing. It is commercially known as “black Light”. c. Visible Light = It refers to the type of radiation having a wavelength of 400 to 700 millimicrons designed for ordinary photographing purposes. d. Infra-red (Beyond the Red) = Considered as the photographic rays with the longest wavelength ranging from 700 to 1000 millimicrons. It is designed to take photograph of over-written documents, obliterated writing, and charred documents or for black out photography. It is sometimes referred to as heat rays). 3. Light Source A. Natural Light= are those light which come to existence without the intervention of man e.i. Sunlight, moonlight and starlight. 1. Bright Sunlight = object in an open space casts a deep and uniform shadow and the object appears glossy. 2. Hazy Sunlight = object in an open space casts a transparent or bluish shadow. This is due to thin clouds that cover the sun. 3. Dull Sunlight = object in an open space cast no shadow due to thick clouds covering the sun. Daylight may still be classified as: open space bright sunlight, under shade bright sunlight, hazy sunlight, cloudy sunlight and cloudy dull sunlight. These conditions and their colors affect the appearance of the object being photograph. Factors such as atmospheric vapor, atmospheric dust and quality of the reflected light coming and not coming from the source should likewise be considered. B. Artificial Light = otherwise known as man-made light e.g. fluorescent bulb, incandescent bulb and photoflood lamp. 1. Continuous radiation Photoflood lamp= is likewise known as Reflectorized light or Spot light. It is a light with a reflector at the back which focus the light to the object the common wattages of this lamp is 500 watts. Flourescent Lamp = are tube lamps in which the walls are coated with fluorescent powders with both ends is mounted with a holder that serves as the reflector. This is commonly used by everybody more than it is used in photographing. Incandescent bulb = are bulb with a wire filament connecting two wires which sustain the electrical charge that produces the light. Everybody likewise commonly uses this although it is more expensive in terms of electrical consumptions. Infra-red Lamp Ultra-violet Lamp 2. Short Duration type Flash bulb = are chemical lamps, as it generate lights by the rapid combination of metal in oxygen. The bulb can be used only once as the bulb is busted when fired electrically. There are thin filaments inside the bulb with two electrical contacts. When the current flows through the filament, it becomes incandescent and ignites the explosive primer that ignites the aluminum foil that burns, giving flash of tense light. Electronic Flash = produces light by an instantaneous electrical in charges between two electrodes in a gas filled glass bulbs. The electrical energy for the discharge is kept in capacitor or condenser. It usually ranges from 1/300 second and 1/5000 second, and because of this, subject in fast motion can be arrested or stopped in the photographs. 4. SENSITIZED MATERIAL = It refers to the film and photographic paper that basically composed of emulsion containing Silver Halides suspended in gelatin and coated on a transparent or reflective support. Parts of the Sensitized Material 1. Emulsion = is that part of the film or photographic paper which contains the silver grains which is the one sensitive to light. In a colored film this emulsion surface can be composed of three layers (Blue, Green and Red) with filters intervening. 2. Anti Halation Backing = is the one designed to hold back the light and prevents halation. 3. Base = Support the emulsion I. Types of Film A. According to Use 1. Black and White Film = usually represented by a prefix or a suffix “Pan” or “Ortho” and generally used in black and white photography. Examples are Ortholith film, Tri X-Pan and Pan X-plus. 2. Colored Film = can be divided into two: the Negative type and the reversal type of colored film. The former is usually having names ending in color while the word chrome represents the latter. e.g. Blue sensitive film, Ultra-violet film, Infra-red film, Orthochromatic film and Panchromatic film. B. According to Spectral Sensitivity Spectral sensitivity = is the responsiveness of the film emulsion to the different wavelength of the light course. 1. Blue – Sensitive film = sensitive to U.V. light and Blue Color. 2. Orthochromatic Film = Sensitive to U.V. Light up to the green. ( popular in the marker as KODALITH FILM) 3. Panchromatic film = Sensitive to U.V. Light up to red (sensitive to all colors of the visible light) 3.1. Process Panchromatic film = permit short exposures under average lighting condition and has the advantage of the grain structure. 3.2. Grain Panchromatic film 3.3. High Speed Panchromatic film designed originally for photographing object under adverse lighting condition. 4. Infra-red Film = Sensitive to all colors and to infra-red light. FILM SPEED (Emulsion Speed) This refers to the degree of sensitivity of the film to light. 1. ASA (American Standards Association) = this is expressed in arithmetic value system. The bigger the number the more sensitive the film is. ASA 10, 20 , 30 , 40,50, 100, 200, 400, 800, 1000 2. DIN ( Deutche Industre Normen) = expressed in Logarithmic value system. Used in the same principle as the ASA. Din 12, 15, 18, 21, 24, 27, 30, 33 etc. 3. ISO (International Standard Organization) expressed as combination of ASA and DIN rating. II. Photographic Paper It is that sensitized material that will record the visible image in the final development and become the photograph. Types of Photographic Papers A. According to Emulsion Used (Silver halides content) 1. Silver Chloride paper = used for contact printing, the size of the positive print is the same as the size of the negative used. Sensitivity to light is low and give blue-black tones when properly developed. 2. Silver Bromide paper = used projection, printing and enlarging process. This is one of the most ideal photo paper used for police photography. Will give a black tone when properly developed. 3. Silver Chlorobromide paper = used both for projection and contact printing. Slow emulsion. 4. Variable contract paper = combines the contrast range in one paper it uses a special chlorobromide emulsion that produces varying contrast responses upon exposure to different colors of light. B. According to Physical Characteristics b.1. Weight 1. Light weight = designed for high flexibility and when paper thickness is not of consideration. Intended for purposes, which involves folding. 2. Single Weight = papers used for small prints or which are need to be mounted on solid and fine details necessary in the production. Used in ordinary photographic purposes. 3. Double weight = generally used for large prints because they stand up under rough treatment. b.2. Surface Texture a. Glossy paper =designed for fine details and brillant image formation. b. Semi-mate paper = obscure the fine details c. Rough papers = used for large prints or where breath rather than detail is necessary. b.3. Color a. White = better used in police photography. b. Cream = preferred for pictorial effect, portraits, landscape or when warmth effect is desired. c. Buff papers = prepare for tone prints C. According to Contrast (grade) 1. Velox No. 0 = used for printing extremely contrast negative or extremely exposed film. 2. Velox No. 1 = used for high contrast negative (over exposed film) 3. Velox No. 2 = used for normal exposed film 4. Velox No. 3 = used for negative with weak contrast (under exposed) 5. Velox No. 4 = used to provide sufficient contrast to compensate for very thin or weak negatives. It is useful imprinting which high contrast is desired. 6. Velox No. 5 = for flat negative that are unprintable. 5. CAMERA Is a light tight box with light gathering device and a means of blocking unwanted or unnecessary light from reaching the sensitized material. Basically, camera can produce image with its four-(4) basic parts such as light tight box, lens, and shutter, Holder of sensitized material. Essential Parts of a Camera 1. Light Tight Box – a box designed to keep light out and serve as a frame to hold other parts. 2. Lens – designed to collect or to focus the reflected light from an object to form an image on the film. 3. Shutter – designed to control the time during which the light reaches the film 4. Holder of the sensitized material – located at the opposite side of the lens designed to hold firmly the sensitized material to prevent the formation of the multiple or blurred image 5. View finder – designed to determine the field of view of the camera or the extent of the coverage of the given lens OTHER PARTS OF A CAMERA A. Viewing System Is that part of the camera which provides the means of showing to the photographer the entire scene coverage that can be recorded in the sensitized material. B. Film Advancer (film advance lever or knob) =designed to transfer the exposed film to the other side or to the take up spool and the unexposed film will be the opposite side of the lens for another exposure. C. Shutter speed = is that part of the camera which regulates the time exposure of the film thus, affecting the amount of light reaching the sensitized material. It is usually expressed in a fraction of a second. 1/1 1/2 1/4 1/8 1/15 1/30 1/60 1/125 1/250 1/500 etc. The speed number in the left is always two times powerful in terms of light gathering than that of the right number Using a fast shutter speed the photographer can stop or “freeze” the action of a person provided that necessary adjustment on the lens opening be made in order to maintain normal exposure. D. Lens Aperture = the ratio between the diameter of the whole lens in relation to the focal length of the lens. It is the light gathering power of the lens. Otherwise known as lens opening or relative aperture and it is expressed in F-number. f 2.8 f-4 f-5.6 f-8 f-11 f-16 The lower the f-number, the bigger the lens opening and the bigger the lens opening the greater the volume of air that will passed through the lends and reach the sensitized material. If the objective of a photographer is obtain the widest possible coverage of the lens in which objects are all sharp, It will be advisable to used a smaller lens opening. E. Focusing = is that mechanism of a camera designed to control the degree of sharpness of the object to be photograph. It is usually obtained by estimating the distance from the camera and that of the object that will make a sharp or clear image. Types of focusing device: 1. Range finder (Either coincidence or split image type) Coincidence otherwise known as superimposed image focusing. In this type of focusing a single object will appeared double once the object is not in focus, but moving the focusing adjustment this double image will coincide or superimposed to form a single object. Split Image focusing on the other hand will show an image in split or two parts once the object in not in focus once the two parts of the image has been united then the object is already focused 2. Ground Glass This is observed from the viewing system of the camera, once the object is not in focused the object will be viewed to be blurred and will turn sharp and clear once adjusted. 3. Scale Bed Estimating the distance of the object and adjusting the camera control based on his estimation do this. TYPES OF THE CAMERA 1. View Finder Type – it is considered as the smallest and the simplest type of camera 2. Single Lens Reflex Camera – it is a type of camera best suited for police work due to its interchangeability of the lens 3. Twin Lens Reflex Camera – A type of camera with dual lens, one for focusing and the other for forming the image. 4. View or Press type – is considered the biggest and expensive type of camera, used for movie making 5. LENS = It is the image-forming device of the lens that actually has a greater effect on the quality of the image to be formed. = a medium or system which converge or diverge light rays passing through it to form an image. = Can be a glass or transparent material, which permit light to pass through and change the direction of light. Daniel Barbaro = first to introduce the use of lens in the camera. CLASSIFICATION OF LENSES 1. According to the type of image to be produced a. Positive or Convex Lens (Converging Lens) Characterized by the fact that it is thicker at the center and thinner at the side which is capable of bending the light together and forms the image inversely. b. Negative or Concave Lens (diverging Lens) Characterized by the fact that it is thinner at the center and thicker at the side and forms the virtual image on the same side of the lens. 2. According to Degree of Corrections a. Meniscus Lens = lens that has no correction. b. Rapid Rectilinear Lens – lens corrected of distortion c. Anastigmat Lens – correcting astigmatism d. Achromatic Lens – correcting chromatic aberration e. Apochromatic Lens – correcting both astigmatism and chromatic aberration INHERRRENT LENS DEFECTS 1. Spherical Aberration= Inability of the lens to focus light passing the side of the lens producing an image that is sharp in the center and blurred at the side. 2. Coma = (Also known as lateral aberration) = Inability of the lens to focus light that travels straight or lateral, thus making it blurred while the light reaching the lens oblique is the one the is transmitted sharp. 3. Curvature of Field = the relation of the images of the different point are incorrect with respect to one another. 4. Distortion = Is a defect in shape not in sharpness. It can either be Pincushion distortion (curving inward) or Barrel (curving outward). 5. Chromatic Aberration = Inability of the lens to focus light of varying wavelength. The lens refracts rays of short wavelength more strongly than those of longer wavelength and therefore bringing blue rays to a shorter focus than the red. 6. Astigmatism= is a form of lens defects in which the horizontal and vertical axis are not equally magnified. Inability of the lens to focus both horizontal and vertical lines. 7. Chromatic Difference of Magnification 8. Flares = condition of the lens producing multiple images. LENS CHARACTERISTICS 1. Focal Length – is the distance measured from the optical center of the lens is set to focus at infinite position. As according to focal lenses may be classified as: a. Wide Angle or Short Focus = with focal length not longer than the diagonal half of the negative. Useful in taking photograph at short distance with wider area coverage. b. Normal or Medium Focus = with focal length approximately equal but not longer than twice the diagonal half of the negative. c. Long or Telephoto Lens = with focal length longer than twice the diagonal half of the negative. Best used in long distance photographing but with narrow area coverage. d. ZOOM lens = lens with variable focal length or that which can be adjusted continuously by the movement of one or more elements in the lens system. 2. Relative Aperture – the light gathering power of the lens expressed in F-number a. Depth of Field – is the distance measured from the nearest to the farthest object in apparent sharp focus when the lens b. Hyperfocal distance = Is the nearest distance at which when a lens is focused with a given particular diaphragm opening will gives the maximum depth of field. 3. Focusing = is the setting of the proper distance in order to form a sharp image. The one that controls the degree of sharpness of the object. 6. CHEMICAL PROCESS The process of making the latent image visible and permanent. a. Development (Use of either D-76, Dektol or Universal Solution) = Is the process necessary for reducing the silver halides to form the image. Elon, Hydroquenone = used as main developing agents b. Stop bath = normally composed of water with little amount of dilute acetic acid that serves as a means to prevent contamination between the developer and the acid fixer. c. Fixation = Is the process by which all unexposed silver halides are dissolved or removed from the emulsion surface and making the image more permanent. Sodium Thiosulfate (hypo) is the main fixing agent that dissolves unexposed silver halides. Other chemicals used: Acetic Acid and Boric acid = serves as neutralizer Sodium Sulfate = serves as the preservative Potassium Bromide = restrainer or hardener Sodium bicarbonate and borax powder = serves as accelerator Dodging = is the process of eliminating unwanted portion of the negative during enlarging. Cropping = is the process of omitting an object during the process of enlarging and printing. Vignetting = is the gradual fading of the image towards the side through skillful adjustment on the dodging board. Dye toning = is the process designed in changing the color tone of the photograph. Burning-In = refers to additional exposure on a desired portion of the negative used for purposes of making a balance exposure.