EX III - " mm m=fimfi PIIPR 315 A Em #3 FEBRUARY...

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Unformatted text preview: " mm m=fimfi PIIPR 315 A Em #3 FEBRUARY 23, ENE: Grnup Name E?) L I Participants; rinth Name Signature 930.11 Caulk. .5 fl I'M erlu PJ'MJru'nclumJ; {CS Wail-Ir frfl— Earn. J E— MJUIL 533%!“me fimmw - a)" a. tag-Ne ‘ amines {rainy THIS EXAM IS WORTH 151'] POINTS! r. PHARMACIST'S PATIENT DATA BASE FORM Pharmacist Julie Esterhrook Patienrwame LL Location Address Race aim Warm 63k Dccu peticn Date cf Admisssicn i lhmel ‘u'rst Alle - ice I ADRS FRIORITIZED MEDICAL PROBLEM LIST MEDICATION PROFILE ru Reaction ‘1. D‘u'T—Il't te veneus clct from vehcus calf to iliac vein er nhncwn cirt recent hi sure and FH—fsther died cf stroke, and oral contraceticn acetaminchen 500 5 4h rn - and inade uate rch laxis for D‘H'T BU 4flUm - h m r _ fishasiIEB _ Date of Birth 42 i IUDXEIII'IE 20m er'n aria ts - MWP DE:- bid r W 8x Hm. PMH. FH. 5H: are. mum HPli Ftwmlains Dilefi ls swellinr am for enuxaparin 40m 50 da -in harsh 1 d3 _ Had tctsi hi relacementgda 5 ac. cli'c cefezclin—1 N -. after 4 d3 3- Cflntinued kneei'efi '6 ain '10 dUCUSEIE-ifl hflfiital IIIIIIIII J3. uiccdin. Pain scale sric —h sical there '1 mcrhr'ne PEA um--in hcsitsl “5‘; 5=BP139iBEPWE R12 T311 _i .1 . EENT, neurc. skin: nl . heat» menstrsl ricds ' hes-t breath sounds —I H tac rdic, RR, co m rmurs. rubs 5. IDES I ' . nc tad: sci‘t. n , _ - D e rt _ 4m? GU ni ehric exam nctcurrentl menstretin c fl-ITI : hi 3 IEI I'I CE LI 1 M WU fer-arm "need renanc test at: sutc accident. anemia. Hx cf LITi. hes ' —"IEECI siler JADRs 'mental health rablems’? SH: Married tc-r 1+3 .mcnemcus; 2 health ccmliance with dru there ? children. he tchsccc. nc iiticici dru use occasional EtOH use F H. father died of stroke ae EB, mcther alive and well as 59 _ Vital Signs , leaorstor].r Data. Diagnostic test results EEE-——_____——_—_ ___—____—___ —_—____— EI_—______— HEE—_______ _—_——___ ———————————-—_ fl_—___________ K 3-9 _—_____—__—— 102 __———_—__— ___—__———___ n————__—————— m—_————_————— __—_____—__— E_——____——__— 11.1mm ___——_______ _—__———_____ “__________—— 212.012»? _——______—__ _____——————_ ____——_—____ __—_—___—_—— _fl____—__—__ ____________ “__—_—___——_— mum-__———_————__ E]_-II___————_____ ——-————————— _—_—__—_____ “________—_—_ _—"—_—_—_——___ Do Ior ultrasoundrrt I 4 mi; lit | - venous oiot oflondin from mid I:an to start of iiiao vein - I'uris - I . 'n flaunt? J. mb— _.___ mm—fl' _ 015,1, :Mlmhm (53¢ Mm“ 4 “d” 1")“ DRUG THERAPY PRUBLEM WURKSHEET TYPE OF PROBLEM PC! In E P E T H T . _ _ h.‘ we “a H! J, Each-In DE(nn J'jm Ila-I) Cambium Mitt-m cm 11mm Drug: wimm- mm medic-II indiulinns-——-—-——-' i lu m Wm 15H - ‘3" I i" “T . A I ma volumin- and nwzljsalpmhlmts Mncljmfims minimum in“ L, a I .h “.m‘;ufl F," a; Mummmlmdium .».—»-————--— FWT .r finm'ar ' H?“ “M3 .- H'H HT” " _--- TF5 53%;}, “phi”. J a: Fc‘ cwrkfl‘t Hand for ultlititml drug tl'lctlppr New medical :mditlun requiring new Elma therapy Chronic disulfiu' [Whig amtinued drug lhetapy_._..-—-—-'—‘ heaw ‘i Candida] has: treated with combination drug li'lmpj' May during new media] Milan wime mphylmtic ,_ V 1 I an, H; .19.; {a PE or P'tmmu'vc Elmlp‘t' or medication—_— "—— '_ " L ' Prim—i . .“hifl __ in“?! Mifnm‘fih’ whim. H, “Mic-ch "a— Unnacmn'dmgfllmm' Medzicatjun will! no valid imidnlljun- -— --—-—-h—-—-—-- - - “'— Cmdilim fllflfii by accidnun] at inme hagcstim aftnxic nmoml ul‘ drug or chemical . Hadimi [unblnmfilhsmillud with molwwiththml "fill- APA P _.p I W 1' “3°” hM“ Ermalwholjmgurtmcm— — ——"_'_ "‘5"- a"; swim is berm treated with nmdrug Lima Taking multipludrugs “Msmgleagm fitment-'42.- _... ____. _..— Apfl‘ .p J F g“, [with Pd..- Pun Taking druggle to train an avoidable nth-rem: rotation from Inulhcr mudjmum n Ammlt drug “inflict: Cm ragimcn ml um.tu as cfimfiw a: _. , _ _..-. . ---- -- ' A “A P 1' I Eu“ PM P“ {7 mm ‘L. “mini 3 (- uthu'chfl'im ____ +W Pm” .- ch Flint-1| huclrrv Current regimen not usually as safe as _ .. __—-—---r~ -- - —- ~-—-- 0&th chem Thu-am.- m individmltmd tn patient Wm dang Malia] mum rm which an]; is null. cilia-iv: {r i . bug. | Patimt has nsk [intact-s that cat-imitation: Lu: ul'dJ‘nghn—ur-J—"F l Palimt has mfmlim 'wilh mgmisrtu maijm to chug Pilicnt rcfnctury t:- ctn-rmt chug Ilia-upg- "flung tn :1 h ' r m - a mprédgmw mmsimtm awe?" Hike“ a“ will? In rum maul-mm - lhm‘jfi. I'M- F‘J'fl' Drug Ragimcn PEN in: no! IpFlupantc for umbddljun-—_ ——---- " Rout: Dfndmjnislnljm’doaugc farmhnudu uradnmiuuatim Muppwpnut: I'm amtnmdju'm _ - Imgflturmfirmpj' mllpp'ap‘rillb—_.. — ---—'-"— ' ' I D I} I I II ‘3‘“; V' min Dug dmpylhnu‘l withnl ndnqmtr Il'icnpmllctrial F-l “5* Mullen-n! flexibciJity mapp'opu'ilut . IE'JU [mu-ohm- anqtmiawtnflodmdflimdw - afiufi 3'? APAP ’ fiathizplljentu— - -- ' [DE £1 “6' 5mm drug level below desired [limp-cutie :1 Timing. nfunfimju'nbul prophylaxis not appthinte Mndiualim nut alum-l properly Mudjmliuu error TYPE OF PROBLEM Dos-I: inn high Thmwgruliir. thrpficfltmn Ding enemy-immerse dt'I-I-fl. matte luteneiiem {mm drug- dimei: m-nmnmt. drtutv lalxntmjv test) Feiltu'e te renew: flan-spy.- Financiai imrfltfl Patient mutedge el' thug fluently PROBLEM Ll T NDTES m “3% -- letter-P in“ in. ka'jh/pr.%wt tar alcohol: We PDSSIBLE CA SE5 mwfiequmey too In: this patient -—a— — — " 3mm: drug level about the desired therein-emit: range Dos: miflltfl toe quieka lhsuinterwl flexibility net appwptiete Fm this pmimt Mudiwtim mm it'll-PM.- Ii'ninrmr-ew-l" APAP , |Eu M JDB' P“ Ream-i ring multiple agents Withmit fiddled benefit- . ——— —' Histnq.‘ fr‘F allergy m" ADE in eunmt tut chemically-Maw 35M fliiflgj'ilfil-JE histmy' not in medical recon]: Patient not U3ng alert fiat" sin-en: allergyme _ I [ Syml'lmtmt nr medial pmblm'is that may be dnig-indueeii—f" "— ' ' D VT ' 1y“. PM? J Drug administered too rapidly Medication mm: mutual tn petenh'ei A we 9— shrub-I c allth “5" Emmudfl J, T Waging. lye-bl: Hm t war in“ i :t‘u: 4‘ 1M“ “i 9”“ . .- «xiv- ‘3 b‘wiltt’ “a hrfihfxledrfi r3 Mtwp'ch-kt ate I'll‘a‘ H _ f -' tempt 1‘ r“ “E “5" - t h W” In} Gk Pita“! m, {L eflnflL‘l’fiN‘: filmy?" Effect of drug aimed rim: to meg-1m: ind‘untiml'inhibitinn from another ting patiml is taking Effect ei'thug altered due te protein binding alterations FFIIIFI'l mother drug patient is taking. i EITeet et'tlnigeltered this: to phemteeedrnemie change from I [- NHL pied-Lev? net-1W“; firin in amther drug patient is taking Eimwflebiiity et‘dnLg altered due Ie mmfitlm with amthur drug at feed Effect et'dmg uttered due to substance in feed l Fau'mt’s laboralm'jr' test uttered due to m1erferenee from a I drug 111: patient is taking. i i Pnu'ent did not ldhfl‘e win: the drug flflimW—"' -- at Drug net given due to medieetleu: error 'I Patient did net lake due in high drug mka nf'insumriee Lam: flit“, bled-4 *3. Patient unable to like oral medic-tint A E w ' ‘9' F W med' Li a ' _ , Patienthesm] eeeeeeer mean M“! W HIE-L Ngmnjwuflwfi’ «43‘ Drugpmduetnetamilaht: - M I M h“; n I HTH ill-{5W pfl'lmf-J flirt-,1 qua W filth-lit: but: i II" will“ willi- i'llll-flfl‘fi W111, tuba. "Vitamin mt ilk-u.“ {1b.- lap-n The emenl regimen is not fit: most wet-effeuti‘i'e Patient unable to purines: medieatimsu‘ne instn-enee Patient tie-cs nnt undernmud the tame. dire-auntie er Wantinl side effects DI ti'il: drug regimm Cline-m regimen nest misialmt with the paiieni's heaith remix H_ Pitt-mt imitate" WM" ’ imp.” we WW‘j“ tact Mitt” WWW" ——~ } D i3 Patient ID Number Pharmacist Julie Esterbrook Location Date 1i'3‘l f2 6 sq _ \Cs wit-Ki: PHARMACEUHCAL case PLAN . "i 1' Therapeutic . Medical Currerit drug drug Therapy Therapeutic gualsmfijmd therapeutic munflufing palm! adumtinn problem list reglmen problems recommen straps and 0mm alternatives Dv'T—see Triphasil cause”?I ‘l dic triphasil because aPTT=62—94. lNFt:2 1. dic triphasil baseline aF'TT. educate on which meds are being attached sheet Inadequate possibly 'I 3. eliminate D'v'l'. because possiny PTiltht. CBC. die and why. Explain the for rationale prophylaxis? causei'exa te D prevent causeiexacerbate platelets importance of compliance with and risk factors 1ii'v'hen warfarin 2. W UFH reoccurance. El'v'T aP‘l‘r gEh until warfarin regimen. consistency of started die APAP bolus then ~ prevent 2. enoxapan‘n 2 consecutive diet [especiain vitamin K rich foods like leafy vegetables} and herbels {ginseng and garlic} and OTC drugs. Educate on signs of bleeding such as bleeding gums. GI bleed—dark. tarry stoolse bruising. Educate on D‘v'T preventions such as ambulating and physical therapy compliance. Explain what warfarin does. risks of clotting and that she will need to take it for a while. and dangers of pregnancy while on werfarin--must avoid pregnancy by using non- and SMMMF DS. and caution to be consistent for garli and ginseng development of PE. reduceieliminate Sx ofclot{leg pain. swelling}. and 50mg SC {11 2h— values we did not choose [between 62- this as primary QAJIhen aF'TI‘ therapy because o‘lEh until it is not as easy to discharge monitor. INR in 3deys. expensive; see #4 adjust warfarin for di'c dose according instructions to Lil'vlC 3. warfarin 5mg protocol. pc dd for Edeys re'c k INR in recheck IMF! in 3 1week. u at days. adjust dose wartarin ' ' . TT=62-Q4 [range is 1.5—2.5‘hi} because easy to monitor. cost effective prevent other 3. warfarin 5mg po od complications of for adays recheck INR ov'r such as time in 3 days. adjust dose loss according to |NR=2—3 using UMC protocol. this is standard starting dose for D'v'T for anticoagulaticn after discharge to prevent according to hormonal contraception because future reocurrance INFt=2—3 using of an increased risk for D'v'T with 4. dc heparin after 4.5 UMC protocol. hormonal therapy, Explain days of wartarin AND |NR=2-3 for two consecutive measurements this is standard starting dose or D‘v’T for anticoagulation impedance of warfarin clinic visits and why F'TilNFt must be monitored. Discuss interrection of warfan'ri with EtEiH and advise to avoid EtCIH. Counsel pt to pay attention to different colors of warfarin tablets—be sure to take the right strength in case of dose changes. Advise it she misses a dose. do not double up--miss the dose. Tell any health care car-0L "moot 5M war-Cousin dtswfib all"; W we no pom-massi- ‘i't-II “NBC-AC Fer- fol-mt- prevent future reocurrance 4. dc enoxeperin after 4-5 days of warfarin AND lNFt=2a3 for hire Patient Location medical Current drug problem list regimen anemia —Fe deficiency violate deficiency 4312 deficiency? Possibly due to heavy men stratio and aubseq uent‘l‘ loss of bioodfi Sign that she I that she has anemia include tachycardia. low serum folate. low iron. high TIElC. low HiH. Pt could also be losing blood from El. but hemoccult was neg my“... . _ of m *1 [D Number Date drug Therapy problems IBU. APAF‘. Therapeutic recommendations FeSCid po 325mg tid for Serum Fe=5fl- enoxapan‘n. gensing. 3 months then reasess 1titimcgidL garlic cause bleed? {see n'ionitoring} and di'c it iron stores are 3 more months no added benefits and oral is less expensive and less invasive and will need to be on drug for at least 3 EM - folio acid 1mg did to 4 months. after 4 months reevaluate anemia status and consider dic totate or adjust dose according to anemia status. Using po folic acid because cheaper and easier for outpatient and pt shows no sign of malabsorption. Confirm that not B12 deficient. If deficient. cobalamin 2mg po gd for 1 week then 1mg gd. reasess in Ewks. work up for IF deficiency. Reasess for B12 status and adjust flittirdi n Therapeutic goalsidesired and oints TI n n_n nn '3 fin I IUD—L UU'QUU HtH=12—15t3§—44 repletednit not continue Mcv=sd1oc FeSDd po 325mg lid for alleviate signs and symptoms of use oral because I‘v' has anemia serum folate=3- 12ngi’dL B12=1tlu-EiutlpgidL I "a Pharmacist Julie Esterbroolc PHARMACEUTICAL CARE PLAN therapeutic alternatives monitoring patient ed ucstion HiH with retic in Fe is oonstlpatlng, better 5-? days. absorbed on empty stomach. but his Fe gluconate Iv 12st in 1ccmL ttStSflmin Ftasval it no toad dwmases Gt upset. watch for 3 doses. reticutocytosis for dark tarry stools. Don't take Fteasess anemia in Swita. Serum iron with tea. eggs. coffee. milk. status and folate. 512. cereal. or dietary fibers. No consider do it Hil-I serum iron. antacids or stomach acid altering is nl; if E512 TIBC. MCV. dmgs {PPI and H2 blocker}. Keep deficient. BBC in 5 days iron away from kids. and eat a well alternative is if then :1 month. balanced diet. If UTl develops neurologic Sit adjust doses use ipro 250mg bid for ? days develop accordineg inst d of SMWP cyanooobalamln mesmcg 1M do for 1 week. then {1 ' weekfor1 month a 4/) then q month until " Sx resolve. then 1. po cobalamin; if malabsorption (J present. then 5mg ‘lr If tolate po for 4 "j months. reevaluate anemia status and consider dc folate or adjust dose accordingly Patient ID Number Pharmacist Location Date PHARMACEUTICAL CARE PLAN . Therapeutic . Medical Curretlt drug drug There'th Therapeutic Enamel“in therapettttt: manitming Patient education problem list regimen problems recommendations and in“; altematwes post‘hip APAP, iEIU? interractions of refer to pain specialist no pain, improye per pain specialist per pain physical therapy compliance. replacement APAP with warfarin quality of life and specialist recommend a pain specialist. talk therapyiu ncontr mobility, preyent to pharmacist about any net-ir pain Heavy menstral trlphasil? refer to DBIGYN nl menstration, no see anemia pen'ocis anemia. no complications “33 see 103 list on med prob list 15E 3, (vam‘nfl ig’rfmulfi’ Ham 9%, Shé'fl’ar (WT: Posswfecaufifii Tm {L'ysptl ‘r‘SUf QTY 01" HP $730M 1C1 (Hx’ O‘C- OLL'LTIdE‘M LLJ/rtrmtfb %be-¢'O%Err s-g'b‘r Rafi bean mafia“ NT"? fi‘flmfl Cam-ff; rm; rip it? uses] {MO} :31. .-S"0 &33fl"~<g P109, P {DH}: .13. CG.¢": ’Pfi-‘St‘ictjfi‘n LEUEL- I 34 "Hacmrea val-we pt __hc\r-4 StquKE $8018 r‘nQi'O-{ffifl CH? 1'11? pf 7th1‘ §CJ ‘fl’Lfiifly‘E’Fy. ‘26 Ian?mi}?HUCQTIGFU'COLIH? 59. K}: b1: *Toxcto a” Cl"; pt had m of CLUE M3 [mm/51‘ch 1cm; gig-)7 bewaeit‘ C”; {it}! 0. “155' I hk.ec’"1t<€d. rf'ikf E: 1,...Q died :39 ca stcmce, ¥ HQJET%}1€ Pt ES i'.--' F"; ‘ .. > “a; I' Iii {‘13 {J (Li ; tWL Wch sites cumming warfarin infnrmminn: htt :a’e'wwwdru rdi raster I DDIDVl-IHJscsffl 3915 "I135 Warfarin Ufl.html [pan of wwwdrugdi gesmgg afler Searching for warfarin} htlpflclmeme.mmfclutcarefabnutwarfarinflsgx [part (If hugza’fclotcarexom after sm‘rching for warfarin] I'.I1:t[;:a".If WJJ-Llismum! druga’d nIg-3949- Warfarin+ Oral .asgx‘?drugid=3 9493cdmgnamc=w arfarin+0ral (pan of www.mlichum afier searching fur warfarin and selecting the oral product} 0 "E5 5&0“ {Effie fitflitf’d pf 01*? E.ch Qdaysfifl ‘ PSMJE l: INK L‘i ll I? bke 9’: came, an Ear” monitor: U33th {in INK 05-“ f."f(b€{0m tkafclpeag {I}? 9*3) EFQ lsf pfiafity WOmid ?' be ta: atha' mace in¥ccmatian arrow t'ke Paf. nt: in (Q‘THHS bi: tkeioflowfnafl 5“ H516 she filed her COESUHIPtT-Qfi I 0? EtOH?’ IS? Sflxit may alfer' her INPJQOQHSEI war: On Eonftha-l l Cw? amidin EtOH as muck as firgcvsc‘ilijtézi a it: COP: magi? xiihef ,I pic-lgiemg qf, {pelt 1' 93* Hag her diet: @301,1 0? has 34%": 1| beep. unabLe EC} K86 H: swag? 4| Dales she fealiae E e TmPGFtQFKfi i 05} dietaw censisfanckf? 119 not} 3 0i {1% he: diet mo bean Inconsfiiafii, COLmBBl R9,? in (E: Qfd‘j to this. 1 .. f-t’xCuLGle in fg'CLfd-S to Vitamin E “CF mods aw; 5L5 afEen 'r kemxf vegembtes. ! gflgk Heb Gbflut he? mé’dwflfim LLSQ~ has 5M: be, (An thkSTn CL medicine that m be (liaififij 1H8? w&{¥flf’ih (EH; L SHCECIS i harmonal c.0nt€aCep£Iues,etc. I? go comma 1y. the. maixqfim, D/C’in tke medicati- mch Jasmin Rec" 4: importance a? tam-c»? 1 "1+, COnSB’CfintLy. E w— s i q) 'Agic Her 3‘} 9L? hfiS been {again-w. H1? Loaf€af'rn consifit‘antl_x/-I$ no} "hfif‘ld £0 Edufflfi.’ EEC abOmf Boo: qmvartant this is Raf five mamas C)? Mfr £"n.ei&p\{, [EFFWHQU J I; t,th Pt denies [Lei if“ dwelt, i;ch usamedrmmcm maefqnd 1? She (“Appetle to be darn-nglfant,u>e need 1:0 £1 Rec" Loafimm dose. (I? a}? Kid £1 h "m dEEZfir EbOH, rhEd use; : (Jag pom Compliance, we L063qu comma | he: (land 10980 HE? on em: same dose, and 1—-..OLuQ hen? _ COmE? Earth In one? meat ._ $0? Cm IR??? to 3:366 H: H“): In”: . entéfi'ed Geilijpegfifi yamcfi'}; IQ WK? olecl‘dai mm+ that? Logs | m ailfoblEW-S Of £65 with #1913}?! we, mantel incfeflié‘ he: mufaim ‘ @038 {:20 7.5m three t'me-E UL. week Cm man, ed, Guild. RI, and I Brno) (“an the cit-{Rev dang monitor INR In Imi- | QO‘fbuSt dab-SE: VF hEEdCd; dECi'E’ClSE INKfixc-n'ifoo‘n Hf: mommy Once {31c kkercxpeut'lc €an 2;. @8855, | Q Emmafi €06 Poss”;th ma: arcane“. I "tuation 31'. INF? ‘1 S DOD a th‘gkm OLSEET-E-fflfifit and Intermgw pt. {D 58E. 1‘? fihg 15,. umfiEr-c‘m any ! abnormal bteedm (bteeolfmg 13mg, .J‘A‘l bfpfiSifi , ELOGOW €121.56, Rite—BEEF??? EH“.-=5Itbi¥ifl, ' -“ F Eider: tth Pt on. Fe “Wm tkga’gpy MEIER may fifegt' EtfiriflerF ' 900.5 fiesfiamS' 'HEGOiinq. ‘ Ive We" ' q H; vitamin. 14..) and how warfiafin x m ('1‘ fl 9/ Z r'r m n O :1 ,— fix Qdaqs. moniffif Irons: mm), [find QLoSEIy monitor EDJC ‘FGF bLfi’fidT (Onwpifcatmrm We repeat defied? Miran-"m PC and or frest €7’éozem GIRO‘AH-G. I? bLEER-Ci ': 11 CODJCmu-S'g “kc; Ems: Ct Pfi'MiEm, {TSP-2'ng {i—-c~fibflommj begow decidirz mhfi’t 6511513129 qegéflfF Loaflm‘i $3 *EJLOH m5? £15m 1., 11C E'EC‘H COU-fl‘iei “nee— ii I in Srtufiitimn LEE. Mir-:15 the be} On EEOH OLUDEdmnCE. {ELF-OK {eaten-at LeQQCorin at pr Fan? 5 may {is-3:2, monitor INR {1&6 '1 mm, Omk’uei £1039 in? neceg'm‘y; decrease. NR monmmm- to ' monfihh maze 112??) thcupemt‘g rem <2 or f; twain. 4{OFF—1t 0L3 TD 1&1 in STfMQHom Onel’I? dfet was hfobivfimiffic’ fegtflflc ‘3 m5 (DON? CHM Omd WDnEfT-‘rf‘ OLE fibOuE. JkDrug fntEfOLCt'FCJfiE 03.3 M i? 3 abovef' Efiqenematty da‘u ‘3 Jam: mm to Wherease MOISTQTIO Efiedg 5MP“ ‘33 ENE/TIME Hwfixefinefi ibugmfen, PHDH‘P] iflfific I O.Fd.%1fi5€fi . I? (.1 dim was. HE pmhfifm; D/C 0r [3 It 1? 55751153; H3 (P’c is Gin to tke pi‘obiéfm (I'LL , Leap tQKTfia damage mafia in dose ’33 QMSm mom, Load, Fri} and 5mg the alt-ix dxch. mon?for IJUR in CARE: LOEEEL and 0059?: dose H1“ needed, matter I.an {if} Mme. I %Make fluc’e pt wfli HLUCWH" was i toxin LuOfifflfi 1r- -:'E.('ec:te ' H‘- gke 1 0133 {Cami-x ’cc; mum'le COL-miet G"? PM? INPUTi-fyn E’ 01-? S'TICI‘ Cflwplfflfiifi {Pamrr m- Pa-zov @1089. and rhOrnIfor‘" IN E1 (123 olfhcscmged pEPuI-IOLLSiyx | | | 1‘? (pf not expef'ierwcm Esteem“ 1 0L0 MOT {we Uitamm L0? pm a. ‘ HOfld U004? fir. dose {—‘Qr gudays (Mid ('Qgtafifi uih'icw‘owj ENE, CfHefiQ Caz-bvua, 11: moms a? ‘che' aboxle wag 13M; Gauge 0? war mac'eaged HURJ than 2 decrearsa 1mm aka-Sea to 35m? mom}, i med,» Fir-r“: Omd S m {:5er ether: g; 1 f€=ci~wect WE: $54.5 {MQE‘E-J flfljfiz amaze and ("TWODJW'FIFWCEj SEC'QCtut'my as; GbOuQ; ...
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EX III - &amp;quot; mm m=fimfi PIIPR 315 A Em #3 FEBRUARY...

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