Methadone is a powerful analgesic that is used to suppress withdrawal symptoms in the rehabilitation of heroin addicts. Identify the major product that is obtained when methadone is subjected to a Hofmann elimination.

Cj is a 53 year old african american female presenting to pharmacy for first-time certification and cmr so that she may start getting her medications at no cost. cj states that her main concern about her health is her diabetes. pmh: t2dm, htn, hyperlipidemia sh: denies tobacco and illicit drug use, occasional alcohol use (1-2 drinks/month) fh: unknown allergies: penicillin (unknown reaction; had reaction when young). medications: lisinopril 5 mg daily aspirin 81 mg daily simvastatin 20 mg daily wt 231 lbs (105 kg), ht 5’6”, bmi 37.3 (obese), ibw 59.3 kg, bp 145/80, hr 98, random blood glucose 395, a1c 11.2%, estimated 10-year ascvd risk 9.5% drug-related problems: 1. uncontrolled t2dm 2. uncontrolled htn 3. suboptimal statin intensity 1) identify two pieces of objective data included in this case: 2) what kind of monitoring needs performed for the new prescription for this patient? 3) based on your case how would you counsel the patient on the new prescription medication? provide examples of specific aspects you would include in your patient education. 4) review your patient case. identify any medications that do not have a corresponding disease state. 5) review your patient case. identify any disease states are not treated by current medications. 6) what otc (over the counter) product would you recommend for this patient (based on the patient request for an otc product? include dose, frequency of administration, route of administration, and critical counseling points.