1. Unit 5: Tasks Readings –Chapter 26: Respiratory System Disorders medication –Chapter 27: Circulatory System medication Discussion Board Seminar Assignment

2. Respiratory System

3. Lung Air Exchange Purves et al., Life: The Science of Biology, 4th Edition, by Sinauer Associates

4. Drugs for Nasal Congestion: Antihistamines Antihistamines – tx for allergies! These block the H1 receptor sites, preventing histamine’s action during allergic rhinitis (see p 527 of text) Drug tolerance may occur –1 st Generation: -- sedating, short acting examples -chlorpheniramine (ChlorTrimeton) -diphenhydramine (Benadryl) –2 nd Generation: -less, or NON-sedating, and much longer duration of action Give me an example of a non-sedating antihistamine

5. Drugs for Nasal Congestion: Decongestants Reduce congestion by shrinking swollen mucous membranes of the nasal passage due to the common cold (see p 529-530). Often combined with an antihistamine Oral and nasal preparation are available Phenylephrine – most widely used, less elevation of blood pressure, no METH link! Pseudoephedrine(e.g.,Sudafed) – stimulates the CNS causing elevated BP, insomnia, agitation … used in Crystal-Meth production!

6. Glucocorticoids (steroids) Nasal Glucocorticoids (Flonase, Nasacort) Most effective meds for prolonged seasonal or year-round allergic rhinitis Excellent relief of symptoms such as: *congestion, *runny nose, *sneezing, *itching What is the suffix for nasal steroids? (page 532):

7. What is an antitussive? (page 533)

8. What is a Mucolytic? Give me an example. (page 536)

9. Asthma medications Inflammation (edema and mucous plugs) Constriction of bronchioles Drugs for prevention of symptoms –Inhaled steroids (what is the suffix p. 540) –Singular, cromolyn Drugs to treat acute symptoms –Epinephrine –Beta-adrenergic drugs What is the difference between albuterol and salmeterol (page 539)?

10. Class exercise Sandy has asthma, and she has needed to use her albuterol inhaler more often. What questions would you ask her to get more information?

11. Circulatory system

12. Diseases of the Heart & Vessels Coronary Artery Disease (CAD)  decreased blood flow through coronary arteries from … –Atherosclerosis  hardening/narrowing of blood vessels –Statins are especially useful Angina  spasms of the cardiac muscle as a result of ischemia (oxygen deprivation) –Nitrates are pivotal in treatment Myocardial Infarction (MI, heart attack)  heart is deprived of blood supply and tissues become necrotic Hypertension (increased blood pressure)  >140/90; >120/80 = pre-hypertension –Silent Killer: increased blood flow damages the artery walls and more likely for plaque formation to occur

13. ACE inhibitors Drugs used to treat high blood pressure and heart failure. They stop the body’s ability to produce angiotensin II, a natural substance that causes blood vessels to tighten (contract). Relax and expand (dilate) blood vessels, allowing blood to flow more easily. Why does vasodialation lower blood pressure?

14. Ace Inhibitors What is the common suffix of generic ACE inhibitors? What are some brand names of ACE Inhibitors?

15. Beta blockers This specific class of drugs work to block the binding sites for epinephrine and norepinephrine on the adrenergic receptors (β1 and β2) found primarily on myocardial tissue- although they have other uses. By blocking the binding sites of these catecholamines, the overall effect is leads to reduced heart rate, along with increased vasodilation of blood vessels resulting in a lowering of blood pressure in the body What is the suffix for generic B-blockers?

16. Calcium Channel Blockers for HTN, angina Interfere with influx of calcium in vascular and smooth muscle Reduce ability of vessels to constrict – result is decreased blood pressure What is an example of a Calcium channel blocker? (page 572)

17. Hyperlipidemia We all need cholesterol and triglycerides (fats) to form cell membrane and nervous tissue! Excessive lipids in circulation leads to hyperlipidemia and potential for atherosclerosis (plaques which accumulate and harden the artery walls) HDL(‘good cholesterol’) - high density lipoproteins carry cholesterol out of blood stream and into liver for storage; LDL(‘bad’ cholesterol) - low density lipoproteins carry cholesterol from the liver to the blood stream

20. HMG-CoA reductase inhibitors Give me an example of a Statin (page 574) What is the common suffix? Most effective agents to lower TOTAL cholesterol and LDL levels Must be continued for life to reduce the progression of Coronary Artery Disease (CAD) Major side effect: rhabdomyolysis (muscle breakdown, symptom is muscle-aches) Other SE’s: Headache, cramping

21. Which suffix is frequently used in the generic names of a beta-blocker? A. -olol B. -ipine C. -statin D. -pril

22. Class exercise: Working in a medical office Turn to page 580 in your textbook Let’s review the Scenario presented in the book. Questions?