Art Is Not Considered An Academic - 1775 Words

Although art is not considered an â€Å"academic† subject by some, I am certain that art is important to all students’ education because it promotes creative thoughts, teaches students to celebrate individual uniqueness and gives historical and cultural perspective. I myself, being a student, have always enjoyed my art classes more than any other, and sometimes it is my only reason for going to school at all. Even though I am not very skilled at it, I remember asking myself, why are we not able to attend these classes more than once a week? And although I may enjoy it because it feels like a break from all the other rigorous learning in other classes, I only recently realized how much I was still learning from it. With the growing minds of†¦show more content†¦All of which are extremely valuable skills that we as humans want every generation to have more of. As most everyone knows, the brain has a left and a right side that is responsible for controlling differ ent things, and each person uses a different amount of each side. (Which is what creates personality). The left brain deals with logic, analysis, sequencing, math, language, facts, computation and much more. The right brain deals with creativity, imagination, holistic thinking, intuition, tune of songs, visualization, feelings, etc. (Citation)http://www.livescience.com/32935-whats-the-difference-between-the-right-brain-and-left-brain.html But there is a common misconception that creative thinking is exclusive to the right side of your brain, when in reality it involves using both hemispheres of your brain working together. When humans go through life using the left hemisphere more than the right, they are more likely to end up with degenerative brain diseases, such as Alzheimer Disease. That is one of the reasons that it is so critical to stimulate both sides of the brain, which encourages our neurons to establish new connections in the process. Doing so will allow to the brain to act with a much improved ability to be accurate and precise, and our capacity to be wholesome thinkers will progress. (CITATION)

Plastic Surgery Ethics Essay - 1605 Words

Plastic surgery is a rapidly evolving field spread around the world. Plastic surgery deals with human appearance and is becoming a more profitable business throughout the years. It is divided into two sections, reconstructive and cosmetic surgery. An ethical dilemma that corresponds to plastic surgery is the loss of human values patients encounter once they undergo surgery. Also, individuals that depend on cosmetic surgery detract from patients that are in urgent need of these procedures. The replacement of misleading values, pride and, joy through surgery creates unrealistic dreams for patients. The patient and doctor relationship created under these circumstances is viewed as a therapeutic purpose due to the feeling of being â€Å"healed†Ã¢â‚¬ ¦show more content†¦The abuse of plastic surgery over the years has gotten out of control. Due to the high demand for fillers, laser, and Botox, physicians perform cosmetic procedures that are non-surgical with no training. Societ y has unofficially banned wrinkles, fat deposits, and sun-damaged skin. An ethical concern for patients and healthcare providers is that these so-called problems should be enhanced and dealt with rather than result in aesthetic surgery. Although body image is important to certain people, the outer image does not define a human being. â€Å"The real value of a person cannot be reduced to his/her appearance, and medicine as an art, should feel the obligation to resist these modern ideologies and should attempt to help people get a more authentic attitude about themselves.† (Mousavi, 2010) If a person is unhappy with himself or herself, they should rely on a more natural solution. Aesthetic surgery should only be an option for people that have suffered an accident or born with a deformity. Having small lips, tiny wrinkles, beauty marks, or dark hair is not a deformity, they’re simply things the body produces over the years. AnShow MoreRelatedThe, Beauty, And Beauty1573 Wo rds   |  7 Pagesindividual looks like. But, is remarkably debated and should be abnegated from preponderant cases: The craft of plastic surgery. In a candid notion, plastic surgery can be delineated as, a procedure of rejuvenating or refurbishing distinctive segments of the body by delegating tissues either in the treatment of a laceration or for cosmetic dialectics. Cosmetic surgery is an element of plastic surgery that alters and revamps a personage’s appearance to make them glean an augmented look. People of every raceRead MoreCosmetic surgery is a globally well-known term, which is undertaken to alter and enhance human1000 Words   |  4 PagesCosmetic surgery is a globally well-known term, which is undertaken to alter and enhance human self-imageand esteem.Cosmetic surgery is different from all other forms of surgeries and is a treatment for â€Å"want† rather than for â€Å"need†. Along with gaining popularity due to social obsession, it also creates health risks due to invasive surgery. This essay will argue for government control of cosmetic surgery in the areas of advertisement, medical malpract ices and human welfare. Media advertising industryRead MoreThe Ethics Of Cosmetic Surgery1264 Words   |  6 PagesThe Ethics of Cosmetic Surgery Cosmetic surgery, a type of elective surgery undertaken to alter a person’s appearance for reasons beyond injury, illness, or disease, has become increasingly pervasive in society in the past few decades despite sparking controversial debates. (Coleman, 171) While reconstructive surgery is condoned, cosmetic surgery occupies a gray area where physicians â€Å"dedicated to saving lives, healing, and promoting health† perform â€Å"invasive surgical operations on healthy bodiesRead MorePhotographic Truth in the Digital Era Essay774 Words   |  4 PagesDigital Era Description of the Research Area (this should be no less than 500 words): According to James Brooks, â€Å"the manipulation of meaning to assure an audience would destroy the reality of the work and debase the concept of communication.† The essay will examine how images are used nowadays in media to influence people’s opinions rather than only for artistic purposes. We are constantly surrounded by advertising. The main power of the images is prominent in advertising where experts changeRead MoreTransgender Discrimination1615 Words   |  7 PagesDiscrimination of Transsexuals For many years, members of the gay, lesbian and transgender communities have been persecuted because of their sexual orientation. The group that will be the focused on in this essay is transsexuals. Transgender is a term that describes transvestites and transsexuals, which is gender identification not sexual orientation. Transgender are individuals whose gender identities or gender expressions contrast with traditional social norms and expectations. Gender identityRead MoreArgument Against The Claim That Business Is Not A Profession Essay1020 Words   |  5 Pagesnormal to think of business as a profession. If business were to be considered not a profession, there are many factors to be considered. A profession involves a formal education, and training as well as providing a service that is in need. In this essay, I will debunk Pritchard’s argument against the claim that business is not a profession. First I will discuss how business is a profession because it involves forma l education of knowledge and skills that a client acquires. Then I will show that theRead MoreThe Inethical Reporting of Michael Jackson1282 Words   |  5 Pagesthe individual or group upon which they are reporting and this includes ‘celebrities’. However, people may argue that ethics in journalism are not mandatory. Journalism has power that should not be misused or abused, yet there are journalists with the field that do not embrace these ethics because loyalty is voluntary. The Society of Professional Journalists has a Code of Ethics that is adopted voluntarily and adhered to by many journalists. Although it does not seem to be a code that is enforcedRead MoreTechnology Impact On Health Care1295 Words   |  6 Pagesin 1980 for their ground-breaking DNA sequencing approach that is utilized commonly in modern times. According to Felder (2015),† Biochips are small, wafer-like components manufactured from substrates such as silicon, fused quartz, soda glass and plastic(Para. 2). Biotechnology Dealing with Cancer in Healthcare In today’s western world cancer is the second most common cause of death. According to The U.S Department of Energy’s Argonne National Laboratory; they have created a biochip that can saveRead MoreA Critique Of The Administration Of Intravenous Medication Administration Errors1474 Words   |  6 PagesThe aim of this essay is to provide a critique of two articles. The first article is, â€Å"Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience† conducted in Australia by Johanna Westbrook, Marilyn Rob, Amanda Woods and Dave Parry published on the 20th of June 2011. The second article is â€Å"Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study†, conducted in theRead More Essay on Euthanasia and Doctor-Assisted Suicide1175 Words   |  5 Pagesmore popular points of interest involved with the euthanasia-assisted s uicide discussion. There are less than a dozen questions which would come to mind in the case of the average individual who has a mild interest in this debate, and the following essay presents information which would satisfy that individuals curiosity on these points of common interest.    Euthanasia and assisted suicide are legal in the state of Oregon and in the country of the Netherlands; these are the only two jurisdictions

The Invention Of A Flint Lock - 1377 Words

From the iconic AK-47 to the lesser know guns have been with man since the 10th century when the Chinese invented the fire lance (â€Å"Jeff Harder†). A simple hollow tube made of bamboo or metal loaded with gunpowder and shrapnel that would be fired. Later on in the 13th century the first cannons were in production and used by European countries (â€Å"Jeff Harder†). Following the invention of a flint lock in the 15th century guns similar to those used in the French and Indian Wars were produced (â€Å"Jeff Harder†). Theses firearms began to replace the older weapons such as swords, bows or spears because of it was more economic. It costed lots of money to train a soldier to use a sword or a bow and arrow. As guns became more and more popular as a weapon of choice, guns began to rapidly develop in the 16th century into the guns we see and use today. In modern day America there is about 89 guns for every 100 people in the U.S. (â€Å"Gun Control†). The U.S . population is approximately 321,418,820 that means that there are approximately 286,062,750 firearms in the hands of the people (â€Å"U.S. Census†). In this controversy the second amendment is constantly brought up but what is the second amendment? The second amendment is in the Bill of Rights and it gives the people the right to bear arms (â€Å"The Constitution†). The Bill of Rights were a part of the Constitution which was ratified and in effect on June 28, 1788. The 2nd Amendment states â€Å"A well regulated militia, being necessary to the securityShow MoreRelatedThe World War I Ended1256 Words   |  6 Pagessome ways. Flintlock rifles were the weapon of choice during the revolutionary war. They weren’t very accurate but if you were hit by the solid lead ball that was projected at you, it would cause serious damage. They also used sabers or swords, flint lock pistols, and cannons. During these wars, they used very different strategies than those used in World War 1 to present day wars. The tactics used in the revolutionary war were kind crazy. Most battles were fought in open fields with very minimalRead MoreThe Evolution of Gunsmithing Firearms have been used for centuries to alter history. Without the2100 Words   |  9 Pagesrecorded use of this kind of firearm was in 1364 according to the timeline from PBS history deceives website. A century after the matchlock was first recorded there was another incredible breakthrough in the field of Gunsmithing it was the wheel lock. This was a true innovation in firearm history this is the first firearm with rifling to increase accuracy. How this gun worked is when the trigger is pulled it spins a wheel that has rough steel and at the same time a hammer is lowered on to the spinningRead MoreThe Physics of Firearms1626 Words   |  7 PagesThe gun is based on one simple concept: You apply explosive pressure behind a projectile to launch it down a barrel. The earliest, and simplest, applications of this idea were cannons. It wasn’t until the turn of the fourteenth century when the invention of the firing pin on a gun called a matchlock was made for the creation of the first functioning hand gun. The first functioning hand gun developed by the French was called an Arquebus, a short-barrelled firearm held at the shoulder and small enoughRead MoreThe Rebellion Of The Un ited States1763 Words   |  8 Pagestheir advanced and expert training. Compared to the Americans’ lack of skill with a weapon, this simple fact alone should have been enough for Great Britain to crush this revolution with ease. With the invention of the flintlock musket, all battlefield tactics changed drastically. Since the invention of the smokeless weapon was a century away, American soldiers were trained to fire at an area not a target. With this training, soldiers were put into linear formations instead of the larger blockedRead MoreOffice Computerized Equipment Borrowing System6949 Words   |  28 Pagestechnological object (such as a device or an appliance) that has a particular function, but is often thought of as a novelty. Gadgets are invariably considered to be more unusually or cleverly designed than normal technological objects at the time of their invention. Gadgets are sometimes also referred to as gizmos. †¢ Reservation – a term used for future acquiring of an item or equipment to be used. †¢ Borrowing – a method of acquiring the usage of an item yet to be returned after use. 1.6.2 TechnicalRead MoreArgumentative Essay on Telivision Is the Leading Cause of Violence in Todays Society9353 Words   |  38 Pagescultures, actual weights were not uniform throughout the area. The weights and measures later used in Kautilyas Arthashastra (4th century BCE) are the same as those used in Lothal.[36] Unique Harappan inventions include an instrument which was used to measure whole sections of the horizon and the tidal lock. In addition, Harappans evolved some new techniques in metallurgy and produced copper, bronze, lead, and tin. The engineering skill of the Harappans was remarkable, especially in building docks afterRead MoreThe Incredible And Sad Tale Of Innocent Erendira And Her Heartless Grandmother16345 Words   |  40 Pagesorgandy bow that looked like a butterfly on her head. You look awful, she admitted, but it s better that way: men are quite stupid when it comes to female matters. Long before they saw them they both recognized the sound of two mules walking on the flint of the desert. At a command from her grandmother, Erendira lay down on the mat the way an amateur actress might have done at the moment when the curtain was about to go up. Leaning on her bishop s crosier, the grandmother went out of the shelter andRead MoreCrossing the Chasm76808 Words   |  308 PagesLotus, or Excel, that is the adoption category, just as it is browsers, not Navigator or Explorer. In the early days products and categories were synonymous because technologies were on their first cycles. But today we have multiple decades of invention to build on, and a new offer is no longer quite as new or unprecedented as it used to be. The marketplace is therefore able to absorb this notquite-so-new technology in gulps, for a while letting one company come to the fore, but substituting anotherRead MoreMonsanto: Better Living Through Genetic Engineering96204 Words   |  385 PagesSteger, ‘The DaimlerChrysler Merger: The Involvement of the Boards’, Case no. IMD3-0771, for detailed corporate governance issues during the merger negotiations in 1998. The present case only covers the developments after the deal had taken place. J. Flint, 1997, ‘Company of the Year: Chrysler’, Forbes, 13 January: 82 ff. 1998, ‘Merger Details, from â€Å"Autonomy† to â€Å"Zetsche†Ã¢â‚¬â„¢, Automotive News, 5 October, 73(5787): 41 ff. R. Kisiel, 1999, ‘Gale: D/C won’t share platforms’, Automotive News, 4 October, 74(5841):Read MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesexperiencing fear or extreme stress is forced to choose one of these behaviors. Any sane manager wants none of them. Imagine supervi sing Chris, who flees work when fearful or stressed, Sanjay, who fights with others when he feels cornered, and Mercedes, who locks up whenever she is chastised. Does effective management mean eliciting these behaviors? One workplace expert noted, â€Å"Fear motivation always results in inner anger and resentment against the person using the fear tactics . . . Fear motivation is the

The Economic Case For Raising The Minimum Wage - 927 Words

The Economic Case for Raising the Minimum Wage The United States is recognized for its economic opportunities. Thousands come to this country for the chance to improve economic stability and climb the social ladder – opportunities usually not available in their home countries. However, there has been increasing concern regarding American wages compared to the rise in the cost of living. Many of the lowest paid workers receive wages that is far much below the federal minimum provision as stipulated in the Fair Labor Standard Act (FLSA). At the same time, costs to cover only the basic of necessities are rising at a much faster rate. Currently, only ten states that have raised their minimum wage rate above the federal minimum wage rate to match the increasing cost of living. The federal minimum wage is listed as ($7.25) per hour. Most low-wage earning workers do not received benefits such as vacation and the family medical leave. Economists believe raising the minimum wage will combat poverty and improve the economy while opponents argue that raising the minimum wage will weaken job creation in an economy still climbing out of a recent recession. Raising the minimum wage is necessary and will have the following three outcomes; Increase economic spending thus reducing economic recovery time, improve overall living for families, decrease the need for social programs such as Temporary Aid to Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP). SupposeShow MoreRelatedMinimum Wage During The Great Depression1419 Words   |  6 PagesThe Minimum Wage Battle In the United States, the minimum wage was passed during the Great Depression in 1938 to protect the buying power of normal workers in a period in which the â€Å"unemployment rate was still a very high 19 percent† (Sklar, 2009, p. 1). Since that time, there has been significant debate about the controversial topic of raising the federal minimum wage. The federal minimum wage law was created to eliminate unfair practices of sweat shops and manufacturing companies during this timeRead MoreThe Minimum Wage Change 1151 Words   |  5 Pagesthe topic of minimum wage. With president Obama’s increase in the minimum wage to 10.10$ per hour people, both economists and politicians alike, have been debating whether raising the bar is a smart idea. At a time when the country the country’s inflation continues to rise at a steady pace and Americans are constantly working to feed their families, some economists know that a raise in the minimum wage would help elevate some of the difficulty. The last time the federal minimum wage was raised wasRead MoreThe Benefits Of Raising The Minimum Wage706 Words   |  3 Pages Minimum wage is a difficult number to decide on because it affects different income earning citizens in different ways. According to Principles of Microeconomics, by N. Gregory Mankiw, minimum wage is a law that establishes the lowest price for labor that and employer may pay (Mankiw 6-1b). Currently, the minimum wage in the United States is $7.25 per hour. For many years politicians and citizens have argued on what should be the minimum wage that would benefit the economy and society in generalRead MoreMinimum Wage And The Wage1639 Words   |  7 PagesMinimum wage is one of the many microeconomic policies that serve to correct imbalance in the economy. It is defined as the lowest amount of remuneration required of an employer to pay his employees during a given period of work. There exist different laws in different states that can fix the minimum wage policy. A current economic issue is minimum wage, or specifically, its pertinence to social inequality. Many sectors of society w ould be affected by changes in this policy. Minimum wage relies onRead MoreA Brief Note On Raising The Minimum Wage1503 Words   |  7 PagesWage War Alternatives to Raising the Minimum Wage Minimum wage is a topic of considerable controversy and a significant source of economic stratification. Essentially, the minimum wage policy is what defines the baseline income of â€Å"low level† or â€Å"starting positions.† Here in the U.S. most individuals will at some point in their life hold a minimum wage position. According to the U.S. Bureau of Labor Statistics, about 58.5% of U.S. citizens were paid at hourly rates, and about 2.6 million workersRead MorePros And Cons Of Raising The Minimum Wage1122 Words   |  5 PagesSince 2009, the federal minimum wage rate for employees has been $7.25 per hour. In retrospect, this is hardly enough pay to take care of one’s self-- let alone a family with children. If a person were to add up the average cost of living for one week and then compare it to the average amount of money earned in minimum wage for that week, it would be apparent that there is little to no extra money for emergency situations. Increasing t he minimum wage has been a major controversial issue; DemocratsRead MoreThe Case For A Higher Minimum Wage1659 Words   |  7 PagesRachel Dorf The Case for a Higher Minimum Wage In 1938, the Federal Government established a minimum wage through the Fair Labor Standards Act, during the Great Depression. Its stated purpose was to keep American workers out of poverty and increase consumer purchasing power to help stimulate the economy. President Franklin Roosevelt, understood that the minimum wage should be a living wage, he stated â€Å"by living wages, I mean more than a bare subsistence level — I mean the wages of a decent livingRead More America Must Create Jobs Essay1475 Words   |  6 PagesPrices everywhere are on the rise as wages are declining drastically. Class division has never been more distinct. Of those lucky enough to have secured the multiple jobs needed in order to maintain their subsistent existences, most make only a minimum wage, established by their state’s laws, which is then harshly taxed upon. Life is hard enough in our dying superpower of a nation, but even worse for the work force of America that must survive on minimu m wage. It is an offending disappointment thatRead MoreIf Minimum Wage Raise Up945 Words   |  4 PagesIf Minimum Wage Raise up In many cases in the U.S. people are suffering from the very low hourly wages. According to David Cooper: â€Å"As wages go down, the percentage of workers relying on public assistance gets higher: 60 percent of workers earning less than $7.42—only slightly higher than the $7.25 federal minimum wage—receive some form of means-tested public assistance.† Because the minimum wage is so low, many people are forced into programs, such as Medicaid, food stamps and the Earned IncomeRead MorePersuasive Speech Outline For Non Rising Of Minimum Wage Essay1228 Words   |  5 Pagessupport the non-rising of minimum wage. ___________________________________________________________________________ Introduction Attention getter (teaser): How many of you believe we in the state of California should have a higher minimum wage? Well we shouldn’t and I’m going to tell you why. Significance (why important to them?): A lot of people believe that because you re getting paid a higher minimum wage that it’s benefiting you but in reality that’s not the case. The purpose of my speech

International Business †Midterm Review Free Essays

string(159) " Reasons to Invest Abroad: – market seeking – efficiency/cost seeking – resource seeking – knowledge seeking Why Internationalize\? 1\." AFM 333 Midterm Review Module 1: – Fall of Berlin Wall 1989 – Two Trends altering global market: globalization of markets and technological advances – Globalization: interconnectedness of national economies, growing interdependence of buyers, producers and suppliers in different countries G6 economies: US, UK, Japan, Germany, France, Italy – Account for half of global consumption with only 1/10 of population – B6 economies: China, India, Russia, Brazil, Mexico, South Korea – China is the biggest market for phones, TVs, and cars in 2007 – China and India have more middle class households than all of the households in the United States – Growth in B6 more than 3x the growth in G6 economies 62 Multinationals in Fortune Global 500 20 of these multinationals are in China 12 from South Korea 6 from India 5 from Mexico and 5 from Russia B6 have three times the labour force of G6 countries 33 million university-educated young professionals in developing world compared to 14 million in the developed world 00 000 IT Engineers in India vs. 50 K in US In the decade to 2020, the working-age population of emerging economies is expected to increase by more than 500 million, compared with an increase of only 3. 7 million in developed economies. We will write a custom essay sample on International Business – Midterm Review or any similar topic only for you Order Now Drivers of Market Globalization – 1. Reduction of trade and investment barriers – 2. Market Liberalization: move to market based economies + adopt free trade in China + Soviet Union etc. – 3. Industrialization + Modernization + developing economies creating higher value adding products – 4. Integration of World Financial Markets: international banks, globalization of finance – 5. Advances in Technology: reduces cost and time, improves coordination and communication, facilitates development, helps share information/marketing, virtual space removes distance Dimensions of Market Globalization – integration/interdependence of global economies – increase regional economic integration bloc – growth of global investment – convergence of buyer lifestyles/preferences – globalization of production activities Social Concequences – loss of national soverignity offshoring/outsourcing jobs – effects on the poor, the natural environment and national culture Firm-level consequences – new business opportunities – new risks and rivalries – more demanding buyers (less bargaining power to supplier) – international value chains Phases of Globalization 1. 1830-1880: Introduction of railway and ocean transport (trains and ships) + phone and telegraph invented 2. 1900-1930: increased steel and electricity production + Western Europe most industrialized country so established first multinational subs through colonization (Nestle, Shell, BP) 3. 948-1970: Form general agreement on tariff and trade + high demand for consumer products and input goods to rebuild after the war 4. 1980- now: radical advances in IT, communication, manufacturing, consultation, and privatization. Caused by: †¢Commercialization of the personal computer. †¢Arrival of the Internet and the web browser. †¢Advances in communication and manufacturing technologies. †¢Collapse of the Soviet Union and ensuing market liberalization in central and Eastern Europe. †¢Substantial industrialization and modernization efforts of the East Asian economies including China. GDP growth rates highest in developing economies who emphasize global integration Information travels faster now than ever before (ships/carraiges, steamships/cars, motor vehicles/aircraft, internet (speed of light)). Firm Level Consequences of Globalization – international value chain – demanding buyers – increased rivalry and competition – increased opportunity for business – Management must change focus – Must partner and outsource better – look for productivity and operational efficiency gains – find and measure key global strategic assets of org. International Business trade and investment activities of firms across borders Globalization – economic integration and growing interdependency worldwide Theories of Trade – mercantilism – national prosperity = positive balance of trade (trade surplus) – absolute advantage principle – produce only products for which your country/region has an abso lute advantage – comparative advantage principle – both countries produce even if one has absolute advantage in all products, relative efficiency matters, specialize in what you produce best and trade for the rest you can use scarce resources more efficiently National Comparative Advantages – China low cost labour – India – IT workers in Bangalore – Ireland – service economy – Dubai – knowledge based economy Comparative Advantage = superior features with unique benefits in global market either naturally endowed or put in place through national policy – NATIONAL Competitive Advantage = distinctive competencies of a firm from cost, size, innovation that are difficult for competitors to replicate – FIRM Factor Proportions/Endowments Theory = produce and export products that use abundant factors of production and import goods that use scarce resources Limitations of Early Trade Theories – they don’t account for cost of international transportation – tariffs and import restrictions distort trade flows – economies of scale bring about additional efficiencies – low cost capital now available on global markets How do Nations Enhance Competitive Advantage – governments can proactively implement policies to subsidize and stimulate the economy outside of natural endowments – create national economic advantage through: innovation stimulus, target industries for development, provide incentives and low cost capital National Industrial Policy – economic development plan by public sector to nurture and support promising industries through: tax incentives, monetary/fiscal policy, rigorous educational systems, investment in national infrastructure, strong legal and regulatory systems – Example Ireland: fiscal, monetary and tax consolidation, partnership of gov with unions, emphasis on high value add industry like pharma, biotech and IT, membership in EU, investment in education – improved GDP, Unemployment and National Debt 3x by 2003 from 1987 Porter’s Diamond Model: Firm Strategy, Structure and Rivalry – strong competitors in country serves as national competitive advantage – clusters ? Factor Conditions – labour, natural resources, capital, technology, knowledge and entrepreneurship ? Demand Conditions – strengths and sophistication of consumer demand ? Related and Supporting Industries – availability of clusters and complementary fi rms in the value chain Industrial Clusters: – concentration of suppliers and supporting firms in the same regional area – ex. silicon valley, Switzerland pharma, fashion in italy/paris, IT in Bangalore – export platform for the nation Classical Theories – International Product Cycle Theory: introduction, growth and maturity of each product and its associated manufacturing – INTRO: inventor country enjoys a monopoly in manufacturing and exports – GROWTH: other countries enter the global market place with more standard manufacturing – MATURITY: original innovator becomes net importer of product – Now – hard for innovator to maintain a lead because there is a short product life cycle – New Trade Theory: economies of scale important for international performance in some industries. Ex. high fixed costs = high volume sales to breakeven Reasons to Invest Abroad: – market seeking – efficiency/cost seeking – resource seeking – knowledge seeking Why Internationalize? 1. You read "International Business – Midterm Review" in category "Essay examples" opp for growth through diversification of market 2. higher profit margins 3. new PS ideas and business methods 4. serve customers who have relocated abroad (increase/maintain market) 5. closer to supply sources, use global sourcing advantages, flexibility in sourcing products 6. access to lower cost/better value factors of production 7. evelop economies of scale in sourcing, production, marketing, economies of scale 8. confront international competitors 9. invest in relationship with a foreign partner Nature of International Business – value adding activities can be done internationally (source, manufacture, market) – cross border trade not limited to raw materials, include capital, tech, knowledge, products, services etc. – Internationalize through: Export, FDI, Licence, Franchise and JV FDI – longterm acquisition of productive assets like capital, tech, labour PE etc – large commitment used to manufacture products in low labour cost countries MNE – big company with lots of resources, subs and affiliates in many countries (US, Japan, Germany, France, Britain) SME – small to medium size enterprise, 500 or fewer employees Born Global Firm – young company that initiates business on the global market Risks in International Business: 1. Commercial Risk – weak partnerships, bad timing of entry, high competition, poor execution of strategy, operational problems 2. Currency Risk – tax, inflation, asset valuation, transfer pricing, currency exposure 3. Country Risk – protectionism/gov intervention, bureaucracy, lack of legal safeguards/poor leagal system, social/political unrest 4. Cross-Cultural Risk – cultural differences, negotiation, different decision making styles, different ethical practices MNE Avenues for Involvement: ? Import/Export ? Licencing/Franchising ? Joing Venture ? FDI – get progressively more risky, higher investment, higher potential benefit, higher commitment Intermediaries Include: – Distributor – extension of firm, takes goods under their name to sell – Manufacturer Rep – under contract of exporter to rep and sell merch – Retailer – bypass wholesaler/distributer and sell to retailer to sell to customers – IKEA, WALMART – Trading Company – based in home country, high volume, low margin resellers. – Export Management Company – US, export agent who secures contracts to export goods – usually specialize in industries and areas – Agent – works on commission Licensor – Focal firm grants the right to the foreign partner to use certain intellectual property in exchange for royalties – Franchisor – grant right to use a business system for fees and royalties – ICV – share cost and risk fo new venture with another company – JV – create a jointly owned new entitiy with foreign partners – Project B ased Venture – collaboration with a timeline without creating a new entity, common with RD intensive ventures Facilitator – provide services for cross border transactions: Bank, Lawyers, Freight, Consultants, ad agency, custom brokers, insurance companies, tax accountants, Turnkey Contractor: Provide engineering, design, and architectural services in the construction of airports, hospitals, oil refineries, and other types of infrastructure. †¢These projects are typically awarded on the basis of open bidding by the sponsor. †¢Examples- European Channel Tunnel, the Three Gorges Dam in China, Delhi Metro Rail Ltd. and the Hong Kong Airport. †¢Build-own-transfer venture- an increasingly popular type of turnkey contract in the developing economies where contractors acquire an ownership in the facility for a period of time until it is turned over to the client. MODULE 3 [pic] Advanced economies are post-industrial countries characterized by high per capita income, highly competitive industries, and well-developed commercial infrastructure. †¢Examples- world’s richest countries and include Australia, Canada, Japan, New Zealand, the United States, and Western European countries. Developing economies are low-income countries characterized by limited industrialization and stagnant economies. †¢Examples- low-income countries, with limited industrialization and stagnant economies- e. g. Bangladesh, Nicaragua and Zaire. Emerging market economies are a subset of former developing economies that have achieved substantial industrialization, modernization, improved living standards and remarkable economic growth. †¢Examples- some 27 countries in East and South Asia, Latin America, Middle East and Eastern Europe- including Brazil, Russia, India, China (so called BRIC countries). [pic] Advanced Economies – 2 – 4% growth rates – mature industrial development – moved from manufacturing to service based economies – typically democratic political systems and capital economic systems – host worlds biggest MNEs – Emerging Economies – 7 – 10% growth rates 40% of world GDP – 30% of exports – 20% of FDI – low cost labour and capital, knowledgeable workers, gov support – fastest growth rate – attractive: growing middle class, manufacturing bases, sourcing destinations – market potential: percapita income, s ize of middle class, GNI, use adjusted GDP for PPP – middle class has some economic independence and discretionary income Hong Kong, Isreal, Saudi Arabia The EMPI combines factors that provide firms with a realistic measure of export market potential: †¢Market Size: the country’s population, especially urban population †¢Market Growth Rate: the country’s real GDP growth rate Market Intensity: private consumption and GNI represent discretionary expenditures of citizens †¢Market Consumption Capacity: The percentage share of income held by the country’s middle class †¢Commercial Infrastructure: characteristics such as number of mobile phone subscribers, density of telephone lines, number of PCs, density of paved roads, and population per retail outlet †¢Economic Freedom: the degree of government intervention †¢Market Receptivity: the particular country’s inclination to trade with the exporter’s country as estimated by the volume of imports †¢Country Risk: the degree of political risk Challenges of doing business with Ems – political stability – hard to forecast in uncertain conditions – beauraucracy/lack of transparency – weak IP rights – availability of good partners – presence of family conglomerates †¢Regional economic integration, refers to the growing economic interdependence that results when countries within a geographic region form an alliance aimed at reducing barriers to trade and investment. †¢40% of world trade today is under some bloc preferential trade agreement. Premise- mutual advantages for cooperating nations within a common geography, history, culture, language, economics, and/or politics †¢Free trade that results from economic integration helps nations attain higher living standards by encouraging specialization, lower prices, greater choices, increased productivity, and more efficient use of resources. 1. Market access. Tariffs and most non-tariff barriers have been eliminated for trade in products and services, and rules of origin favor manufacturing that uses parts and other inputs produced in the EU. . Common market. The EU removed barriers to the cross-national movement of production factors—labor, capital, and technology. 3. Trade rules. The member countries have largely eliminated customs procedures and regulations, which streamlines transportation and logistics within Europe. 4. Standards harmonization. The EU is harmonizing technical standards, regulations, and enforcement procedures that relate to products, services, and commercial activities. 5. Common fiscal, monetary, taxation, and social welfare policies in the long run. The euro (common currency since 2002): †¢Simplified the process of cross-border trade and enhanced Europe’s international competitiveness. †¢Eliminated exchange rate risk in much of the bloc and forced member countries to improve their fiscal and monetary policies. †¢Unified consumers and businesses to think of Europe as a single market †¢Forced national governments to relinquish monetary power to the European Central Bank, in Luxembourg, which oversees EU monetary functions. †¢NAFTA passage (1994) was facilitated by the maquiladora program – U. S. firms locate manufacturing facilities just south of the U. S. order and access low-cost labor without having to pay significant tariffs. NAFTA has: †¢Eliminated tariffs and most nontariff barriers for products/services. †¢Initiated bidding for government contracts by member country firms †¢Established trade rules and uniform customs procedures. †¢Prohibited standards/technical regu lations to be used as trade barriers. †¢Instituted rules for investment and intellectual property rights. †¢Provided for dispute settlement for investment, unfair pricing, labor issues, and the environment. †¢Trade among the members has more than tripled and now exceeds $1 trillion per year. In the early 1980s, Mexico’s tariffs averaged 100% and gradually disappeared under NAFTA. †¢Member countries now trade more with each other than with former trading partners outside the NAFTA zone. †¢Both Canada and Mexico now have some 80% of their trade with, and 60% of their FDI stocks in the United States. †¢Mexican exports to the U. S. grew from $50 billion to over $160 billion per year. †¢Access to Canada and the U. S. helped launch numerous Mexican firms in industries such as electronics, automobiles, textiles, medical products, and services. †¢Annual U. S. nd Canadian investment in Mexico rose from $4 billion in 1993 to nearly $20 billion by 2006. †¢Mexico’s per capita income rose to about $11,000 in 2007, making Mexico the wealthiest country in Latin America. †¢By increasing Mexico’s attractiveness as a manufacturing location, firms like Gap Inc. and Liz Claiborne moved their factories from Asia to Mexico during the 1990s. †¢IBM shifted much of its production of computer parts from Singapore to Mexico. ASEAN – Brunei, Cambodia, Indonesia, Laos, Malaysia APEC – Asia Pacific Economic Coop – Australia, Canada, Chile, US, China, Japan, Mexico CER – Aussie and New Zealand – removed 80% of tarriffs Why Nations Expand? 1. Expand market size  §Regional integration greatly increases the scale of the marketplace for firms inside the economic bloc.  §Example- Belgium has a population of just 10 million; the EU gives Belgian firms easier access to a total market of roughly 490 million. 2. Achieve scale economies and enhanced productivity  §Expansion of market size within an economic bloc gives member country firms the opportunity to gain economies of scale in production and marketing.  §Internationalization inside the bloc helps firms learn to compete more effectively outside the bloc as well. Labor and other inputs are allocated more efficiently among the member countries- leading to lower prices for consumers. 3. Attract direct investment from outside the bloc  §Compared to investing in stand-alone countries, foreign firms prefer to invest in countries that are part of an economic bloc as they receive preferential treatment for exports to other member countries.  §Examp les- General Mills, Samsung, and Tata- have invested heavily in the EU to take advantage of Europe’s economic integration.  §By establishing operations in a single EU country, these firms gain free trade access to the entire EU market. 4. Acquire stronger defensive and political posture  §Provide member countries with a stronger defensive posture relative to other nations and world regions- this was one of the motives for the initial creation of the European Community (precursor to the EU). †¢The value chain can be thought of as the complete business system of the focal firm. It comprises all of the activities that the focal firm performs. †¢The focal firm may retain core activities such as production and marketing, and outsource distribution and customer service responsibilities to foreign-market based distributors, thus the global reconfiguration of the value chain. Dell makes a variety of products, each with its own value chain. The total supply chain for a notebook computer, including multiple tiers of suppliers, involves about 400 companies, primarily in Asia, but also in Europe and the Americas. †¢On a typical day, Dell processes orders for 150,000 computers, which are distributed to customers a round the world, with non-U. S. sales accounting for 40 percent. †¢Shipping is handled via air transport, e. g. from the Dell Malaysia factory to the U. S. Dell charters a China Airlines 747 hat flies to Nashville, Tennessee six days a week, with each jet carries 25,000 Dell notebooks that weigh a total of 110,000 kilograms, or 242,500 pounds. †¢One of the hallmarks of Dell’s value chain is collaboration. CEO Michael Dell and his team constantly work with their suppliers to make process improvements in Dell’s value chain. [pic] Automotive Industry †¢Manufacturing of the Chevrolet Malibu illustrates national and geographic diversity of suppliers that provide content for an automobile, a truly global value chain. †¢Suppliers are headquartered in Germany, Japan, France, Korea, and United Kingdom, and the U. S. , and the components they sell to General Motors are manufactured in typically low-cost countries and then shipped to the General Motors plant in Fairfax, Kansas. †¢The German automaker BMW employs 70,000 factory personnel at 23 sites in 13 countries to manufacture its vehicles. †¢Workers at the Munich plant build the BMW 3 Series and supply engines and key body components to other BMW factories abroad. †¢In the U. S. , BMW has a plant in South Carolina, which makes over 500 vehicles daily for the world market. †¢In Northeast China, BMW makes cars in a joint venture with Brilliance China Automotive Holdings Ltd. In India, BMW has a manufacturing presence to serve the needs of the rapidly growing South Asia market. †¢BMW must configure sourcing at the best locations worldwide, in order to minimize costs (e. g. , by producing in China), access skilled personnel (by producing in Germany), remain close to key markets (by producing in China, India and the U. S. ). †¢Global sourcing is the procurement of products or services from suppliers or company-owned subsidiaries located abroad for consumption in the home country or a third country. Technological advances, including instant Internet connectivity and broadband availability TECHNOLOGY †¢Declining communication and transportation costs †¢Widespread access to vast information including growing connectivity between suppliers and the customers that they serve; and SUPPLY CHAIN †¢Entrepreneurship and rapid economic transformation in emerging markets. GLOBALIZATION †¢Managers must decide between internalization and externalization — whether each value-adding activity should be conducted in-house or by an independent supplier. This is known as the ‘make or buy’ decision: â€Å"Should we make a product or conduct a particular value-chain activity ourselves, or should we source it from an outside contractor? † †¢Firms usually internalize those value-chain activities they consider a part of their core competence, or which involve the use of proprietary knowledge and trade secrets that they want to control. †¢Configuration of value-adding activity: The pattern or geographic arrangement of locations where the firm carries out value-chain activities. Instead of concentrating value-adding activities in the home country, many firms configure these activities across the world to save money, reduce delivery time, access factors of production, and extract maximal advantages relative to competitors. †¢This helps explain the migration of traditional industries from Europe, Japan, and the U. S. to emerging markets in Asia, Latin America, and Eastern Europe. [pic] †¢Outsourcing refers to the procurement of selected value-adding activities, including production of intermediate goods or finished products, from independent suppliers. This practice of externalizing a particular value-adding activity to outside contrac tors is known as outsourcing. †¢Firms outsource because they generally are not superior at performing all primary and support activities. Most value-adding activities — from manufacturing to marketing to after-sales service — are candidates for outsourcing. †¢Business Process Outsourcing (BPO). The outsourcing of business functions to independent suppliers such as accounting, payroll, and human resource functions, IT services, customer service, and technical support. BPO includes:  §Back-office activities, which includes internal, upstream business functions such as payroll and billing, and  §Front-office activities, which includes downstream, customer-related services such as marketing or technical support. †¢Offshoring is a natural extension of global sourcing. It refers to the relocation of a business process or entire manufacturing facility to a foreign country. †¢MNEs are particularly active in shifting production facilities or business pro cesses to foreign countries to enhance their competitive advantages. Offshoring is especially common in the service sector, including banking, software code writing, legal services, and customer-service activities. †¢E. g. , large legal hubs have emerged in India that provide services such as drafting contracts and patent applications, conducting research and negotiations, as well as performing paralegal work on behalf of Western clients. With lawyers in N. America and Europe costing $300 an hour or more, Indian firms can cut legal bills by 75 percent. Best Jobs for Offshoring: Large-scale manufacturing industries whose primary competitive advantage is efficiency and low cost; †¢Industries such as automobiles that have uniform customer needs and highly standardized processes in production and other value-chain activities; †¢Service industries that are highly labor intensive, e. g. , call centers and legal transcription; †¢Information-based industries whose functi ons and activities can be easily transmitted via the Internet, e. g. , accounting, billing, and payroll; and †¢Industries such as software preparation whose outputs are easy to codify and transmit over the Internet or by telephone, e. g. routine technical support and customer service activities. [pic] †¢Cost efficiency is the traditional rationale for sourcing abroad. The firm takes advantage of ‘labor arbitrage’ – the large wage gap between advanced economies and emerging markets. †¢One study found that firms expect to save an average of more than 40% off baseline costs as a result of offshoring. These savings tend to occur particularly in RD, product design activities, and back-office operations such as accounting and data processing. Benefits of Outsourcing: †¢Faster corporate growth. †¢Access to qualified personnel abroad. †¢Improved productivity and service. Business process redesign. †¢Increased speed to market. †¢Acc ess to new markets. †¢Technological flexibility. Improved agility by shedding unnecessary overhead. Disadvantages to Outsourcing: †¢Vulnerability to exchange rate fluctuations †¢Partner selection, qualification, and monitoring costs †¢Increased complexity of managing a worldwide network of production locations and partners †¢Complexity of managing global supply chain †¢Limited influence over the manufacturing processes of the supplier †¢Potential vulnerability to opportunistic behavior or actions in bad faith by suppliers †¢Constrained ability to safeguard intellectual assets Risks in Global Sourcing: 1. Less-than-expected cost savings. Conflicts and misunderstandings arise because of differences in the national and organizational cultures between the focal firm and foreign supplier. Such factors give rise to cost-savings that are less than originally anticipated. 2. Environmental factors. Numerous environmental challenges confront focal firms including: exchange rate fluctuations, labor strikes, adverse macro-economic events, high tariffs and other trade barriers, and high energy and transportation costs. 3. Weak legal environment. Many popular locations for global outsourcing have weak laws and enforcement regarding intellectual property, which can lead to erosion of key strategic assets. 4. Risk of creating competitors. As the focal firm shares its intellectual property and business-process knowledge with foreign suppliers, it also runs the risk of creating future rivals (e. g. , Schwinn). 5. Inadequate or low-skilled workers. Some foreign suppliers may be staffed by employees who lack appropriate knowledge about the tasks with which they are charged. Other suppliers suffer rapid turnover of skilled employees. 6. Over-reliance on suppliers. Unreliable suppliers may put earlier work aside when they gain a more important client. Suppliers occasionally encounter financial difficulties or are acquired by other firms with different priorities and procedures. Over-reliance can shift control of key activities too much in favor of the supplier. 7. Erosion of morale and commitment among home-country employees. Global sourcing can create a situation in which employees are caught in the middle between their employer and their employer’s clients. At the extreme, workers find themselves in a psychological limbo, unclear about who their employer really is. How to cite International Business – Midterm Review, Essay examples

Pharmacokinetics Parameters of Amikacin Drugs Samples for Students

Question: Discuss about the Clinical Pharmacokinetics. Answer: Introduction The field of pharmacokinetics has significant implication in the drug development process. Before any new drugs come in the market, its role and mechanism of action is evaluated on the basis of pharmacokinetics and pharmacodynamic parameters. Some of the important parameters in the drug development process includes clearance, concentration range, extent of availability, toxic concentration, extent of protein binding and volume distribution. Secondly, pharmacokinetics also studies the process of drug absorption, distribution and metabolism of drugs. Knowledge of these actions of drugs and the core principles of pharmacokinetics promotes effective therapeutic management of the drugs in patients (1). This drug report particularly discusses the pharmacokinetics parameters of Amikacin drugs to understand its therapeutic benefits in particular group of patients and the precautions needed while administering the drug to patients. Pharmacology (mechanism of action, toxicieties/adverse effect) Amikacin is an aminoglycoside antibiotic used in the treatment of serious bacterial infections particularly gram-negative bacterial strains like Escherichia coli, Pseudomonas species, Acinetobacter species and Enterobacter and other species. It is mainly involved in inhibiting the production of bacterial proteins consequently leading to bacterial cell death. Amikacin is a semi-synthetic antibiotic derived from Kanimycin A and it binds to the 30S ribosome of infectious organism to disrupt and inhibit bacterial protein synthesis. The binding of the aminoglycoside antibiotic to bacterial 30S ribosomal unit causes misreading of the t-RNA. The inhibition of translocation prohibits the ability of the bacteria to synthesize vital proteins necessary for its growth. This action of the drugs lead to the production of the non-functional or toxic peptides that contributes to the bactericidal effect of the drug (2). The resulting bactericidal activity is fatal for aerobic gram-negative bacilli. Use of Amikacin drug is often associated with serious side effects such as shortness of breath, rashes, swollen lips and tongue causes due to allergic reaction, dizziness, diarrhoea, skin tingling and muscle twitching. Use of aminoglycoside drugs like Amikacin has the potential to cause auditory, renal, vestibular toxicity and neuromuscular blockade (3). Another study also suggested Amikacin-induced liver toxicity seen due to ultrastructural changes in liver. Hence, patients with chronic liver disease has the risk of nephrotoxicity. Dosage consideration may help to lessen risk in vulnerable people (4). The following are the toxicity of the drug in different areas- Renal- The nephrotoxicity of the drug is associated with renal function changes such as increase in serum creatinine, albuminuria and red and white blood cells. Nephrotoxicity is high in patients with impaired renal function who receive prolonged treatment. Other manifestations of neurotoxicity includes numbness, skin tingling, convulsion and muscle twitching (5). Nervous- Rare adverse effects include tremor and headache. Other adverse outcome of the drug include neuromuscular blockade, toxic effect on eights cranial nerves, loss of balance, hearing problem and vertigo. This indicates possibility ototoxicity due to cochlear hair cell damage which is often irreversible. Often the drug is used with diuretics, however it should be avoided because diuretics may also cause ototoxicity (3). Respiratory- In very rare case, respiratory paralysis or apnea is observed due to neuromuscular blockade after parenteral injection of the drug. These adverse symptoms should be checked in patients who have to take neuroblocking agents like tubocurarine (3). Clinical uses Amikacin is mainly given in the form of injection for the short term treatment of serious infection caused due to different strains of gram negative bacteria. Clinical studies reveal the efficacy of the drug in treating bacterial septicaemia and infection in the respiratory tracts, bones and central nervous system (6). Its clinical indication is also seen in treating post operative infections and peritonise caused due to intra-abdominal infection (7). In some case, Amikacin sulphate injection is also given to patients with urinary tract infection when causative organism is not affected by antibiotics having less toxicity (8). While proceeding with the treatment, it is necessary that susceptibility testing is done to identify the susceptibility of the drug to different causative organisms. In the initial phase, the therapy may continue and the decision to continue the drug should depend upon the susceptibility test, response of the drug in patient, severity of the infection and adverse effect of the drug (9). Dosage/ formulations available The calculation of correct dosage is dependent on body weight of patients before treatment. Secondly, renal function assessment should be done to measure creatinine concentration. Amikacin concentration in serum is also necessary to check that they are not at excessive level. During the therapy, the peak concentration after injection above 35mcg/ml and trough concentration (concentration before next dosage) above 10mcg/ml should be avoided (10). The following is the dosage information for Amikacin drugs in different patients- For treating bactermia, initial dose should be 1.5g/day and the dose should be adjusted later based on desired serum level. In case of nosocomial pneumonia, 20mg/kg/day IV is necessary by dividing it into 3 dose for one day. The duration of the treatment should be kept to 7 days to reduce the risk of infection from resistant organism (11). Chemical structure related to pharmacokinetic parameters The physicochemical nature of drugs determines their pharmacokinetic properties such as metabolism, absorption, distribution and drug clearance. Amikacin is a broad spectrum antibiotic with aliphatic heteromonocyclic structure. The chemical nature of the drugs is highly soluble in water, low plasma protein binding and great clearance (12). The molecular feature of Amikacin determine the interaction with enzyme and predict feature that might lead to enzymatic degradation of the drugs. Secondly, the route of clearance is also dependent on molecular properties of Amikacin such as charge, atomicity, molecular size and its hydrogen bond acceptors. The molecular weight of Amikacin is 683.68g/mol. The renal excretion is inversely related to level of plasma protein binding too (23). Interesting pharmacokinetic parameters and clinical implications Amikacin is highly water soluble drug, has low plasma protein binding and more than 95% excreted by the kidney (12). Amikacin belongs to the class of aminoglycoside drugs derived from Kanamycin A. Its molecular formula is C22H43N5O132H2SO4 (13). The following is the detail regarding pharmacokinetics parameters of Amikacin drugs- ADME Absorption-The drug is generally taken as intravenous or intrasmuscular route because amikacin is not absorbed orally. In case of adults with normal renal function who are given a single dose of 7.5mg/kg, the peak plasma amikavin concentration is achieved within 45 minutes to 2 hours. It indicates that the drug is rapidly absorbed after the intramuscular administration. Its injection mainly consist of sulphate salts as shown below- Figure1: Structure of Amikacin (13) Distribution- Following the administration of the required dosage of the drug, the drug is distributed into bile, bronchial secretions, pleural and synovial fluids and interstitial fluid. This indicates that Amikacin remains in the extracellular fluid space of patients. Metabolism- After the distribution of the drug, peak serum level demonstrates the efficacy of the drug and the trough serum level determines the toxicity of Amikacin. In patients taking multiple dose per day, peak serum level is 15-30mcg/ml and trough serum level is 1-4 mcg/ml. Aminoglycosides are efficient if the peak concentration is more than the minimum inhibitory concentration of the microorganism. Elimination- In adults with normal renal function, the plasma elimination half life of amikacin is 2-3 hours and this increases by 30-86 hours in patients with chronic renal impairment. The clearance of the drug is severely low in patients with renal impairment with decrease in clearance along with the increase in severity of impairment (13). Volume of distribution (Vd)-The volume of distribution of Amikacin drug is 0.21 0.08 L/kg (14). The volume of distribution is related to the extracellular fluid content of the body and maintaining fluid balance will be important when estimating the volume of distribution of the drug in patients. Amikacin is given as 250mg/ml injection and in new borns of different weights, the recommended dose is 7.5mg/kg. This volume of distribution of the drug indicates that aminogylcosides like amikacin remains in the extracellular fluid space of neonates. In normal adults, it is rapidly absorbed after intramuscular administration and peak serum concentration after 1 hour is 12 mcg/mL for 250mg single dose (15). Total clearance (CL)- The total clearance rate of Amikacin drug is 78.6 12.1 mL/min/kg and this based on the creatinine clearance. The mean serum clearance rate is about 100mL/min and renal clearance rate is 94 mL/min in patients in normal renal function (14). The creatinine clearance calculation is dependent on age, weight, sex and amount of serum creatinine in the body of patients. The serum creatine values have relation with aminoglycoside half-lives in patients and dose schedule should be adjusted according to clinical observation of patients. Half-life (t1/2)- The estimated half life value of Amikacin is 1.4 0.41 hours. It indicates that elimination occurs within 2-3 hours. Serum half lives correlates inversely with post-natal age and renal clearance of amikacin. In normal adults, half life is slightly above 2 hours and average volume of distribution of about 24 liters. In case of patients with renal impairment, the serum half life is prolonged due to the slower excretion of the drug. Therefore, before giving the drug to patients with renal impairment, renal function should be observed carefully and dose should be adjusted accordingly (14). Combination of subactam and amikacin therapy helps to reduce haematological disease and complications. Secondly, serum concentration of the drug also determines its use for different clinical purposes (16). Requirement for therapeutic drug monitoring (TDM) Therapeutic drug monitoring is the analysis of the drug concentration in the blood. This analysis is important to improve the outcome in special group of patients by the adjustment of the dose of the drugs. The drug concentration data can be interpreted by means of time, route, dose given to patients, validity of the pharmacokinetic parameters and the handling and storage consideration of the drug (17). The antibactericidal activity of the drug is seen after peak concentration is reached after drug injection. Clinical recovery of patient is achieved when the peak concentration of the drug is greater than the minimal inhibitory concentration of the pathogen. However, conditions like sepsis alter the pharmacokinetic property of the drug. Secondly, conditions like renal impairment also results in accumulation of the drug. In such case, use of higher than recommended dose cause elevated trough concentration and consequently increase in toxicity (18). Hence, in different clinical context and condition of patients, the daily dose of drugs needs to be adjusted to achieve optimal drug concentration. Considerations for the drug to be used in special population One research study has showed that the pharmacokinetic property of Amikacin drug is changes in patient with sepsis and in such case dose adjustment is necessary (18). This is also required in patients with renal or hepatic impairment. This is because of high nephrotoxicity of the drug. While giving the drug to renally impaired patient, it is necessary to adjust dose based on creatinine clearance calculation. However, this is difficult in acute renal impairment where patients renal function changes rapidly. While initiating therapy in such patient, it is necessary to treat the infection aggressively for first 24 hour and then reduce the dose after monitoring the renal function of patients from time to time (19). This is the reason why dosage formulation of the drug changes in patient with urinary tract infection, hospital acquired pneumonia and renal impairment (22). The dose modifications for renal impairment according to age and creatinine clearance (CrCl) are as follows- CrCl greater than 90 mL/min and age more than 60 years- q8 hrsCrCl between 60-90 mL/min and age less than 60 years- q12hrsCrCl of 25-60mL/min- q 24hrsCrCl of 10-25 mL/mim- q 48 hrs (20) Just like patients with renal impairment, dose adjustment is also necessary in patients with hepatic impairment. As there is no marker for hepatic clearance, drug dosing consideration becomes difficult. Hence, to predict the kinetic behavior of drugs in cirrhotic patients, drugs should be used according to level of hepatic extraction. The higher the hepatic extraction of the drug, the higher the bioavailability in patients. On this basis, the dose is adjusted irrespective of the route of administration (21). Conclusion The drug report on Amikacin summarized the therapeutic efficacy of the drugs in the treatment of severe bacterial infection. The pharmacological study of the drug revealed it function in binding to the bacterial proteins and thus inhibiting its growth. This property lends the drug its bactericidal effect. However, the clinical usage and dose formulation suggest the action of the drug changes in specific population group. In such instance, therapeutic drug monitoring is an essential technique to understand the pharamacokinetic properties of the drug and this will help to alter and change the dose formulation of drug in patients with renal and hepatic impairment. Reference Yacobi A, Skelly JP, Shah VP, Benet LZ, editors. Integration of pharmacokinetics, pharmacodynamics, and toxicokinetics in rational drug development. Springer Science Business Media; 2013 Nov 11. Wilson DN. Ribosome-targeting antibiotics and mechanisms of bacterial resistance. Nature Reviews Microbiology. 2014 Jan 1;12(1):35-48. Amikacin Side Effects in Detail - Drugs.com [Internet]. Drugs.com. 2017 [cited 1 May 2017]. Available from: https://www.drugs.com/sfx/amikacin-side-effects.html#refs Martines G, Butturini L, Menozzi I, Restori G, Boiardi L, Bemardi S, Baldassarri P. Amikacin-induced liver toxicity: correlations between biochemical indexes and ultrastructural features in an experimental model. Revista de Medicina de la Universidad de Navarra. 2017 Mar 23:41. Sweileh WM. A prospective comparative study of gentamicin?and amikacin?induced nephrotoxicity in patients with normal baseline renal function. Fundamental clinical pharmacology. 2009 Aug 1;23(4):515-20. Jenkins A, Thomson AH, Brown NM, Semple Y, Sluman C, MacGowan A, Lovering AM, Wiffen PJ. Amikacin use and therapeutic drug monitoring in adults: do dose regimens and drug exposures affect either outcome or adverse events? A systematic review. Journal of Antimicrobial Chemotherapy. 2016 Jul 11:dkw250. Syue LS, Chen YH, Ko WC, Hsueh PR. New drugs for the treatment of complicated intra-abdominal infections in the era of increasing antimicrobial resistance. International journal of antimicrobial agents. 2016 Apr 30;47(4):250-8. Venkatesh RK, Prabhu MM, Nandakumar K, RPai KS. Urinary tract infection treatment pattern of elderly patients in a tertiary hospital setup in South India: A prospective study. Journal of Young Pharmacists. 2016 Apr 1;8(2):108. Brown-Elliott BA, Nash KA, Wallace RJ. Antimicrobial susceptibility testing, drug resistance mechanisms, and therapy of infections with nontuberculous mycobacteria. Clinical microbiology reviews. 2012 Jul 1;25(3):545-82. Nevin RL, Leoutsakos JM. Amikacin has been one of the important antimicrobial agents against Gram-negative pathogens. However, there is discrepancy regarding the amikacin initial dosage, with some reports recently recommending 25 mg/kg and others the conventional dosage (1520 mg/kg). Hence, we evaluated the optimal initial dosing regimen of amikacin. Pharmacokinetic (PK) parameters were estimated using a population PK analysis... Drugs in RD. 2017;17(1):177-87. Amikacin Pharmacodynamics and Mechanism of Action [Internet]. Medipub.blogspot.in. 2017 [cited 1 May 2017]. Available from: https://medipub.blogspot.in/2011/04/amikacin-pharmacodynamics-and-mechanism_24.html Panomvana D, Kiatjaroensin SA, Phiboonbanakit D. Correlation of the pharmacokinetic parameters of amikacin and ceftazidime. Clinical pharmacokinetics. 2007 Oct 1;46(10):859-66. amikacin | C22H43N5O13 - PubChem [Internet]. Pubchem.ncbi.nlm.nih.gov. 2017 [cited 1 May 2017]. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/amikacin#section=Top Amikacin [Internet]. Antimicrobe.org. 2017 [cited 1 May 2017]. Available from: https://www.antimicrobe.org/drugpopup/Amikacin.htm Rughoo L, Bourguignon L, Maire P, Ducher M. Study of relationship between volume of distribution and body weight application to amikacin. European journal of drug metabolism and pharmacokinetics. 2014 Jun 1;39(2):87-91. Blackburn LM, Tverdek FP, Hernandez M, Bruno JJ. First-dose pharmacokinetics of aminoglycosides in critically ill haematological malignancy patients. International journal of antimicrobial agents. 2015 Jan 31;45(1):46-53. Roberts JA, Norris R, Paterson DL, Martin JH. Therapeutic drug monitoring of antimicrobials. British journal of clinical pharmacology. 2012 Jan 1;73(1):27-36. Duszynska W, Taccone FS, Hurkacz M, Kowalska-Krochmal B, Wiela-Hoje?ska A, Kbler A. Therapeutic drug monitoring of amikacin in septic patients. Critical Care. 2013 Jul 25;17(4):R165. Amikacin: Dose adjustment for renal impairment - GHNHSFT [Internet]. Gloshospitals.nhs.uk. 2017 [cited 1 May 2017]. Available from: https://www.gloshospitals.nhs.uk/en/Trust-Staff/Antibiotic-Guidelines/Renal/Amikacin-renal/ Amikin (amikacin) dosing, indications, interactions, adverse effects, and more [Internet]. Reference.medscape.com. 2017 [cited 1 May 2017]. Available from: https://reference.medscape.com/drug/amikin-amikacin-342516 Lewis JH, Stine JG. Review article: prescribing medications in patients with cirrhosisa practical guide. Alimentary pharmacology therapeutics. 2013 Jun 1;37(12):1132-56. How Physicochemical Properties of Drugs Affect Their Metabolism and Clearance 2017 [cited 1 May 2017]. Available from: https://How Physicochemical Properties of Drugs Affect Their Metabolism and Clearance