Video -drugs and prescription http://www.youtube.com/watch?v=6v1HxdnLVLo Intro to Pharmacology Pharmacology Definition Pharmacology is the study of the nature, uses, and effects of drugs Drugs affect the body and the body affects the drugs • Vocabulary of pharmacology • How drugs interact with the body and how they pass through the body • Common classifications of drugs and their characteristics • Concepts of proper drug administration - concentrations, dosage, frequency Bell Work Thursday March 6 1. Pharmacology is the study of________________________. 2. Drugs affect ________________. 3. The body affects _____________. (Pharmacodynamics and Pharmacokinetics) A drug is a chemical compound that is used as an aid in diagnosis, treatment, prevention of disease or other abnormal conditions, for the relief of pain and suffering, or to control or improve any physiologic or pathologic condition. A poison is a substance that may cause structural damage or functional disturbance Pharmaceutical vs Nutraceutical OTC / Over the counter drugs Prescription Drugs Control Drugs Narcotic Drugs used in food animals Over the Counter drugs •Can be bought without a prescription •Can be bought at multiple places (stores) •Regulated by FDA which monitors what are acceptable ingredients, doses, formulations, and labeling for OTC drugs. OTC Drugs Tylenol Triple- antibiotic cream Peptobismol Benadryl/ antihistamines Robitussin Aspirin Prescription •Prescribed by a doctor •Purchased at a pharmacy •Prescribed for and intended for only one person / not general use •Regulated by the FDA: includes all animal and human data and analyses of the data, as well as information about how the drug behaves in the body and how it is manufactured… Prescription Drugs Amoxicillin Propranolol Prednisone Metronidazole Enacard Tylenol 3 Legend Drugs Prescription drugs are also called legend drugs (they bear one of the following legends) Caution: Federal law restricts this drug to be use by or on the order of a licensed veterinarian Rx symbol denotes drog product as a legend drug can be used instead of the caution statement Labels on Veterinary Prescription medications Basic Information on Labels Name, address, and telephone number of veterinary practice Name of client Identification of animal(s) treated species and numbers of animals treated, when possible Date of dispensing of drug Today’s date Name of prescribing veterinarian Name, active ingredient, strength, and quantity of the drug dispensed Dosage and duration Route of administration / adequate directions Number of refills Number of authorized refills, expiration date Cautionary statements, as needed Slaughter withdrawal and/or milk withholding times, if applicable Other… Ultimate responsibility for any medication dispensed through a veterinary practice lies with the authorizing veterinarian All medications dispensed must be approved by the veterinarian Federal law requires pharamacists and physicians to dispense medication in childproof containers. AVMA recommends the same for veterinary medications! Example of Drug Withdrawal Time Label Drugs in Food Animals Drug Withdrawal Time (FDA and USDA) The time needed after drug administration for drug residue to leave a marketable animal used for meats, eggs, milk, organs, or other edible products. Drug residues-what is leftover of the drug or chemical components Each feed or drug manufactured for animal use must carry a label: Withdrawal time = the length of time the animal must have been off the product for all residues to have worked their way through and out of the animal’s body. Adherence to all stated withdrawal times before marketing the animal’s meat or any products (such as milk or eggs), you will help keep the human food supply safe. FOOD ANIMALS On drugs dispensed and used in animals that will be used for food Drug Withdrawl Times must be listed on the label. Any drug given to a food animal can potentially be transferred to people through ingestion of animal products (meat, milk, organs). Example Drug Withdrawal Times Agri-Cillin™ …AgriLabs… Beef Cattle… I.M… 10days Amoxi-Inject® … Pfizer Animal Health …Beef Cattle… I.M., S.C…. 25days Ivermectin Injection for Cattle and Swine… Durvet… Beef Cattle… S.C…. 35days Ivermectin Pour-On…Durvet… Beef Cattle… Topical… 48days Vira Shield® 2… Novartis (Farm Animal)… Beef Cattle… I.M., S.C… 60days Vitamin A D B12 Injection… Vedco… Beef Cattle… I.M. …60days Blood Stop Powder… AgriLabs… Beef Cattle… Topical Note: Not for use on animals intended for food purposes Control Drugs •Drugs that have the potential to be abused •Drugs that have the potential to be addictive •These drugs are classified by the Drug Enforcement Administration according to abuse potential •Use and distribution of control drugs are controlled and monitored, special forms called schedules are filled out which document the arrival of the drug and it’s departure from the facility. Control Drug Classification C-I C-II C-III C-IV C-V •Lower number indicates higher potential for abuse •Controlling these drugs through intensive documentation is very effective in reducing abuse, misuse, and diversion of controlled drugs. Bell Work Tuesday March 18 What are some of the differences between Over The Counter drugs and Prescription drugs? Purchase Directions Safety Factor how they are regulated by the FDA What 2 major characteristics define a control drug? C-I Schedule I or C-I drugs • Drugs with a high abuse risk or highly addictive. These drugs have NO safe, accepted medical use in the United States. Some examples are heroin, LSD, PCP, and crack cocaine •Most likely will not find a C-I controlled drug in a medical facility and most likely will be an illegal drug C-II Schedule II or C-II drugs • Drugs with a high abuse risk, but also have safe and accepted medical uses in the United States. These drugs can cause severe psychological or physical dependence. Schedule II drugs include certain narcotic, stimulant, and depressant drugs. Some examples are morphine, cocaine, oxycodone (Percodan®), methylphenidate (Ritalin), Pentobarbital Overdose of many of these drugs is fatal C-III, IV, V C-III-V Drugs with an abuse risk less than Schedule II. These drugs also have safe and accepted medical uses in the United States. Schedule III, IV, or V drugs include those containing smaller amounts of certain narcotic and non-narcotic drugs, anti-anxiety drugs, tranquilizers, sedatives, stimulants, and non-narcotic analgesics. Some examples are acetaminophen with codeine (Tylenol® No.3), hydrocodone with acetaminophen (Vicodin®), diazepam (Valium®), alprazolam (Xanax®), propoxyphene (Darvon®). Narcotic Definition: a drug (codeine, methadone, or morphine) that in moderate doses dulls the senses, relieves pain, and induces profound sleep but in excessive doses causes stupor, coma, or convulsions, death …derived from opium or compounds similar to opium. Such drugs are potent pain relievers and can affect mood and behavior. Longterm use of narcotics can lead to dependence and tolerance Opiods •Opiod • is the preferred medical term for narcotic drugs due to abuse and illegal use associated with these drugs. •Opiods are derived from opium or are synthetically produced. • Examples: Morphine, oxymorphone, fentanyl, methadone, tobutrol/torbugesic, hydromorphone, codeine (agonists-moderate to severe pain) • butorphanol (agonist-antagonist –mild to moderate pain, short acting), bupreorphine (partial agonist-long acting analgesic) (apomorphine) •Used medically for analgesia • Other medical effects: deep sleep, depress respiration or cough reflex, constrict pupils, cause smooth muscle spasm, decreased peristatlsis, emesis •How they work: bind to opiate receptors in the central nervous system (CNS) •Antagonists: Naloxone • Displaces opiates fromCNS receptor sites Parmacokinetics-body works on the drug Absorption - the process of a substance entering the blood circulation. Distribution- the dispersion or dissemination of substances throughout the fluids and tissues of the body. Metabolization (or biotransformation, or inactivation) – the recognition by the organism that a foreign substance is present and the irreversible transformation of parent compounds into daughter metabolites. Excretion - the removal of the substances from the body. In rare cases, some drugs irreversibly accumulate in body tissue Pharmokinetics -how the body acts upon drugs Absorption – Enteral Gastrointestinal Tract Drugs that are taken orally - Parenteral IM and IV by -passing the GI system no absorption through intestines…directly to blood stream - Transdermal “patches” absorbed through the skin - Respiratory droplets inhaler, nebulizer Distribution Bioavailability – usable by the body - is based upon: -how much of the drug is available for absorption -how much of the drug is extracted – usable by the body *Parenteral dosing by IV route has 100 % because absorption and extraction are bypassed Not limited in absorption Metabolismmodify drug from active to inactive metabolites (result of breaking up the drug/metabolization) (drugs are molecules=therefore drugs interacting with body = chemical reactions between molecules) Occurs in the LIVER Chemical changes to the drug are caused by the liver ***First Pass Effect - the liver encounters drug before it enters the system*** (Enteral drugs) absorption from small intestine, enters blood circulation, specifically small intestine to hepatic to heart to body (systemic circulation)…reduces bioavailability Elimination metabolites (by products of metabolizing the drug) are eliminated through excretion • kidney – urine • GI – feces Sometimes the metabolites are toxic to the animals kidneys If liver or kidneys are damaged drugs may not be eliminated efficiently Some oral drugs are not absorbed and pass right through the intestines unchanged and are excreted in feces (anthelmintics) Absorption may follow the flow of blood circulation From the digestive system/ intestine, to the liver (portal shunt) to veinous circulation, to the (right side) heart, to the pulminary arteries through the lungs, to the (left side) heart, to the aorta (arterial circulation) How drugs can be administered (Routes of administration-how the drug enters body) Intramuscular (IM) Subcutaneous (SQ) Transdermal Intradermal Intraosseus Orally (PO) Sublingual Sub mucosal Intravenous (IV) Rectal Topical Intranasal Remember: Intra- refers to within (or inside) You would not use inter- because that means between! Routes of Administration Orally – will pass through liver (first pass effect) IV – enter directly into vein IM – enter blood stream slower than directly into vein Rectally – enters quicker than oral SQ-absorption is slower because subcutaneous tissue is less vascular than muscle Intestine, Liver, Veinous, Left Side Heart, Lungs, Right Side Heart, Artery, arterial circulation to tissue (target cells or receptors) http://www.youtube.com/watch?v=CtnKuLWFpQ4 How do drugs work video… Pharmacodynamics -Drug works on the body Relationship between drug concentration and resulting effect •Potency of drug = maximum effect of a drug •Therapeutic range below the range = no benefit above the range = toxic •Time duration of effect of drug Physiological effects of drugs Drug needs to bind with a receptor -on neurons (CNS) -cardiac muscle -within bacteria Variations in ADME (pharmacokinetics) can affect effectivenes of drug very young, very old very thin, obese other medications disease (kidney, liver) MATH (Oh no!) Math is used to help understand how medications are absorbed into the body, what happens when medications are there, and how your body gets rid of them …because absorption is happening elimination is happening time is happening So, you have variables and differentials (change in function y=f(x) with respect to independent variables) This is calculus…I cannot even begin to explain the relationship between the formula above and the graph. Just know that there are many variables with respect to the function of time. Calculus is the math that allows a pharmacist or a drug researcher/ manufacturer to predict at what point a drug might be most effective! We can see in the graph the portion where the concentration increases (up to around t = 3) and levels off. The concentration then decreases to almost zero at t = 24. Drugs and Medications Name of the drug – generic name based upon the chemical structure of the drug Trade name or “brand” Grouping of drugs within their classification Classification or categories of drugs according to the effect they have on the body Routes of administration Species drug is approved for Categories of Drugs Antibiotics Analgesics and sedatives Anesthetics (general anesthetic, conscious sedation, regional and local anesthetics) Cardiovascular Respiratory Gastrointestinal Anthelmintic Hormones and endocrine Vaccines (biologicals) Topical Oncological Euthanizing agents Antibiotics How antibiotics work: • toxic to bacteria • least resistant (weaker) bacteria die first…if full course is not given, the more resistant bacteria survive and reproduce • bacteriocidal vs bacteriostatic • Classes ( “How” they work): aminoglycoside, penicllin, cephalosporin, chloramphenicol,quinolone, macrolide, antifungal, antiprotozoal, sulfonamide, tetracycline Aminoglycosides • Bacteriocidal make their way into the bacteria, attach to ribosomes which are responsible for making proteins, which kills the cell (bacteria is cellular) amikacin gentamicin Penicillins • Bacteriocidal destroys cell wall amoxicillin ampicillin amoxicillin/clavulanate penicillin G Polymixins/Polypeptides • Bacteriocidal Changes the permeability of cell wall so the cell dies Bacitracin Polymixin B Tetracylcines, Chloramphenicol, Macrolides, Lincosamides • Bacteriostatic Prevent protein synthesis so cell doesn’t reproduce Tetracycline Doxycycline Oxytetracycline (Terramycin) Chloramphenicol Azithromycin Erythromycin Clindamycin Cephalosporins • Bacteriocidal affects bacterial cell wall Cefazolin Cefalexin Sulfonamides • Bacteriostatic Prevents nuceic acids from building dna and rna/ cells can’t reproduce Trimethoprim-Sulfamethoxazole (Co-trimoxazole) (TMP-SMX) (SMZ-TMP) Sulfa drugs Sulfasalazine Creates light sensitivity, also possible kidney failure Quinolones/Fluoroquinalones Bacteriostatic interference with DNA or RNA enrofloxacin (Baytril) ciprofloxacin levofloxacin orbifloxacin (Orbax) marbofloxacin (Zeniquin) Can cause birth defects, retinal myopathy in cats, CNS (if CNS already affected), usually not used in very young Metronidazole, Grisofulvin, Ketoconazole Bacteriostatic Metronidazole -Produces toxic free radicals that disrupt DNA and proteins. This non-specific mechanism is responsible for its activity against a variety of bacteria, amoebae, and protozoa. • Bacteriostatic: Interference with DNA and RNA Griseofulvicin anti fungal Ketoconazole antifungal Clotrimazole antifungal • Bell Work Monday March 24 How do antibiotics work? Bacteriocidal Bacteriostatic What is the reason for telling the client that their pet needs to take all of the antiobiotics prescribed for that pet? •Anesthesia is a state of unconsciousness induced in an animal. The three components of anesthesia are analgesia (pain relief), amnesia (loss of memory) and immobilization. • Often multiple analgesic and sedative drugs are combined to induce the state of anesthesia • • • • (cocktail) Classes : Inhalant, dissociative, opiate, barbiturate, sedative/hypnotic Overdose of some general anesthetics are used for euthanasia Any general anesthetic can be fatal if overdose occurs Anesthesia involving state of induced unconsciousness is often referred to as general anethesia Analgesics, Sedatives, Anesthetics •Analgesia is the relief of pain. •Sedation provides skeletal muscle relaxation, anxiolysis (antianxiety), and amnesia. They have no direct analgesic properties. Classes of analgesics and sedatives: Tranquilizers, NSAIDS, Opiods, alpha 2 agonist (produce sedative and analgesic properties), corticosteroids An agonist-activates the neuronal receptor that it attaches to (can stimulate or inhibit within CNS) An antagonist- deactivates receptor (reverses) Morphine-> Naloxone Xylazine-> Yohimbine Anesthetic agents (Injectibles) 1. Barbituates 1. 2. 3. Phenobarbital Pentobarbital (Nembutal) Thiopental Pentothal Slow onset, long duration (long to “wear off ”) of some barbituates Sedative, hypnotic, control seizures CNS depression resulting in mild sedation – surgical plane of anesthesia No analgesic properties Barbituates do cross placenta barrier and will affect in utero Anesthetic agents (Injectibles) 1. Dissociative anesthetics 1. 2. Ketamine Tiletamine (Telazol) Cataleptic state (lack of response, muscular rigidity) CNS stimulant (not depressant) Analgesia, immobility, dissociation from environment, amnesia Anesthetic agents (Injectibles) Propofol (Rapinovet, Propoflo) causes CNS depression by decreasing brain activity Rapid onset, rapid recovery potent respiratory depressant safe particularly for C-sections Anesthetic agents (Inhalent) Halothane- 1950s, general CNS depressant, crosses the placenta Isoflurane – 1970s, general CNS depressant, crosses the placenta Sevoflurane-1990s, CNS depressant, Very small amount of drug is metabolized by liver in Iso and Sevo Analgesics, Sedatives, Anesthetics •Analgesia is the relief of pain. •Sedation provides skeletal muscle relaxation, anxiolysis (antianxiety), and amnesia. They have no direct analgesic properties. •Classes of analgesics and sedatives: Tranquilizers – Acepromazine, Diazepam (Valium), Midazolam (Versed) • • Muscle relaxing, calming, low sedation • NSAIDS – Flunixin meglumine (Banamine), Carprofen (Rimadyl), Ketoprofen • Opiods- morphine, hydromorphone, codeine, etc • alpha 2 agonist (produce sedative and analgesic properties)-xylazine (rompun),medetomidine (domitor), detomidine (dormosedan) • corticosteroids (act as analgesics by reducing tissue swelling) Dexamethasone, Prednisone • local anesthetics (block nerve sensation)-lidocaine, marcaine, bupivicaine An agonist-activates the neuronal receptor that it attaches to (can stimulate or inhibit within CNS) An antagonist- deactivates receptor (reverses) Morphine-> Naloxone Xylazine-> Yohimbine Bell Work Tuesday March 25 Match the following classification of drugs to their definition: Anesthetic Drugs Analgesic Drugs Sedatives relaxes, calms the patient produces a state of unconsciousness relieve pain Why do medical professionals often combine drugs when placing a patient under anesthesia? Cardiovascular, Respiratory, Gastrointestinal Drugs •Cardiovascular Antiarrhythmics, Diuretics, Positive Inotropes and Catecholamines (increase the strength of contractions), Vasodilators •Respiratory Antitussives, Expectorants, Bronchodilators, Antihistamines •Gastrointestinal Emetics, Antiemetics, Antidiarrheal, Laxatives, Antacids, Antiulcer Anthelmintics Anthelmintics kill or inactivate parasites-external and internal •Fenbendazole (Panacur) •Ivermectin (Ivomec, Heartguard)) •Melarsomine (Immiticide) •Metronidazole (Flagyl) •Praziquantal (Droncit, Droncit •plus) •Pyrantel Pamoate (Nemex) (Pyrantel Tartrate=Strongid) •Pyrethrins (chrysanthemum) and Permethrins (synthetic) (Many topical OTC products) Measuring and Calculating Drugs When talking about Weight (Mass) Kilogram - Kg Gram – G (x1000) = 1 Kilogram Milligrams - Mg (x1000) = 1 Gram One of the most common conversions in medicine is pounds to kilograms Example: 50 lb dog = 22.7 kg 23.3 pounds = 11 lb cat = 5 kg 79.5 pounds = 860 lb horse = 390.9 kg 220.1 pound= So here’s where I got stuck… 0.90 kg = how many grams Remember 1000…1 kilogram is 1000g (1 x 1000= 1000) 1 gram is 1000mg .9 kg is 900g (.9 x 1000= 900) .45 kg is 450 g (.45 x 1000 = 450) .258 kg is 258 g .035 kg is 35 g Small weights Really small animals! Increments under a pound as decimal or as ounces .5 pound rat = .227kg Math: .5 lb / 2.2 =0.227kg 8 oz rat=.227 kg Math: 8 oz/ 16=.5lb, then .5 lb/ 2.2=.227kg 4 oz puppy = .114 kg (which = 114 grams) 1 lb pocket pet = .453 kg ( 453 grams) 1 ounce = .028kg (028 grams) (you don’t really write the zero) Examples 1.My Australian Shepherd weighs 32 pounds. How much does she weigh in kilograms? 2. The Chihuahua weighs 13 pounds…how many kilograms? 3. A newborn puppy weighs 3 ounces…how many kilograms 4. My friend has a rat that weighs 2 kg. How much does it weigh in pounds? Dose Need to know the weight of an animal in order to know how much of a drug to give it. Many dosages for oral drugs are given in mg/ kg Example: Carprofen (Rimadyl) Dose is listed as 4.4mg of drug/kg =? Cefalexin Dose is listed as 10 – 25 mg of drug/ kg every 8-12 hours =? Diphenhydramine (Benadryl) Dose is listed as 2 mg/ kg of drug every 6-8 hours=? Pills Pills (any oral form of medication except liquid) tablets, capsules, caplets Pills are available in premeasured doses Example Carprofen is available in 25mg, 75 mg, 100mg Cefalexin is available in 250 mg and 500 mg Diphenhydramine is available in 25 mg Furosemide is available in 12.5mg, 20mg, 40mg, 50mg, 80mg •If the tablet is “scored” you may break in half for more accurate dosing •The mg in a drug is actual weight of the drug in that tablet. How many pills?? Dog weighs 46 pounds Dose of drug is listed as 6 mg/kg every 12 hours Drug is available in 75 mg, 125 mg, and 300mg •46 pounds/2.2 = 20.90kg •20.90 kg x 6 mg/kg = 125.4 mg •Will give the dog 1 125mg tablet every 12 hours More examples •15 pound dog Dose 2 mg/kg Available as 25 mg, 50mg, and 100 mg scored tablets •56 pound dog 1mg/kg Available as 12.5 mg, 30 mg, 75mg •67 pound dog Dose 25- 30 mg/kg Available as 150, 300, 500 mg Bell Work Tuesday April 1 •27 pound dog Dose 9 mg/kg every twelve hours Available as 12.5 mg, 30 mg, 75mg How many tablets of which size? If you are sending home 1 weeks worth of medication, how many tablets will you send home? If the drug is administered every 8 hours? Bell Work Wednesday April 2 Dog weighs 20 lbs Amoxicillin is 11 mg/ kg every 12 hours. Available in 50 mg, 100mg, 200mg, 400 mg unscored tablets. There is no 100mg Amoxilcillin on the shelf due to manufacture backorder. How mg should this dog receive? Which size tablet is your best choice and why? You need to send home 10 days worth of medication. How many tablets will you send home? Activity Part 1 Take one bottle per group of 3-4 students Find the Dosage according to the label Strip of paper with weight of animal and how many sizes available Find out how many tablets of this medication (per 24 hours) should be prescribed for the animal. THEN find out how many pills for a 10 day course of this medication. Vials for medications A dram is a pharmacy unit of measure and is used in sizing prescription vials. 1 dram equals approximately 18 oz. Common sizes are: 6 dram 8 dram 13 dram 16 dram 20 dram 30 dram 40 dram 60 dram Same drug - different strengths (use the three check system every time!) Counting and Dispensing Pills 3 Check system 1-Look at drug name and concentration or strength as you pull the bottle off the shelf 2-Look again as empty pills onto tableau 3-Look again when putting back on shelf Activity Part 2 Counting Accuracy Counting pills Bottles will be filled with Skittles Count…check accuracy Place in proper vial #14 #30 #90 #120 #180 Liquid, oral medications 1 mL = 1 cc Sometimes medications are only available in a liquid, or often, smaller doses are available as liquid (usually called a suspension), more accurate dosing. Dosed similar to pills, except instead of using weight of drug (mg) placed in a solid tablet you will use weight of a drug placed in a volume of liquid (mL or cc) Example Amoxicillin in liquid form (also available in 50 mg, 100 mg, 250 mg, 400 mg tablets) Dose is 15 mg/kg As a liquid it is available as 50mg /mL 9 pound Maltese poodle mix 1. Weight is 9/2.2=4.09kg 2. Dose is 15 mg/kg 3. 4.09kg x 15 mg/kg =61.35 mg 4. Now what? Divide by 50… 61.35mg / 50 mg/ml =1.23 mls Measuring liquid with syringes Bell Work Monday April 7 Dog weighs 98 pounds Dose of drug is 12mg/kg 1. How much does this dog get (Dose)? Available as liquid 250 mg/ ml 2. How many mLs of this drug do you need to give this dog? Bell Work Wednesday April 9 1. 5 pound puppy 1. 2. 3. 4. Liquid Amoxicillan 50mg / mL Dose is 15 mg/ kg every twelve hours How much liquid Amoxicillin will you give the puppy Sending home two weeks worth of medicine. How many mLs will you send home? Activity Cups of water to practice pulling up various amount in various syringes. First practice drawing up measured amounts. Figure out dosing instructions Draw up correct amount. Fluids and Liquids When talking about liquids (volume) Milliliter – mL Liter – L There are 1000 mL in 1 Liter 1 cc is exactly the same as 1 mL Used interchangeably Examples: Half a liter is how many mLs? How many cc’s in a half liter? Each number on a bag of fluids is 100 cc Intravenous Fluids Bags of fluids for dogs and cats come in 1Liter size bags, also 500 mL and in some cases 250 mL. The amount of fluids given to an animal can help or harm it so the correct amount given over the course of time is very important! Simple IV Fluid calculations You have decided to put Fluffy on what is called maintainance IV fluid therapy as part of your treatment plan. Fluffy weighs 18 pounds. The amount of IV fluids Fluffy will get is based upon the following “doseage” of 30 mL/ kg. (This is just what you use as a general rule of thumb for mainainance.) This amount will be given over a period of 24 hours. The IV pump is programmed by putting the amount of fluids per hour Fluffy should receive. liquid drug preparations 1. creams, and ointments are expressed as percentage concentrations 2. a certain quantity of the drug is contained in the final quantity of the product a. 1 % hydrocortisone cream contains 1 g of hydrocortisone in 100 g final product (the actual drug plus the cream) b. 5% sodium chloride solution contains 5 g sodium chloride in 100 ml final product ( NaCl and distilled water) c. 1 gram in 100 grams or 1/100 equal to 0.01, or 1% d. 5 grams in 100 milliliters equal to 5/100 or 0.05, or 5%