Question1: Nitroglycerin mechanism of action
Nitroglycerinis a drug that is commonly used in the treatment of angina because ofits perceived effectiveness. It has a complex mechanism of actionwhere its nitrogenous component known as glyceryl trinitrate (GTN) isdenitrated. The process of denitration leads to the production of anactive metabolite referred to as nitric oxide (NO) (Ferreira &Rosen, 2012). The groups of nitrates that undergo denitration arereferred to as nitrovasodilators. Although the process through whichnitrates undergo denitration is still disputed, it is widely acceptedthat nitrates generates nitric oxide by reacting with a compoundknown as sulfhydry groups. Alternatively, nitrates may react withcytochrome P450 or glutathione S-transferases, where both of them aresignificant sources of glyceryl trinitrate bioactivation. Nitricoxide activates guanylate, which increases the level of guanosine3’5’ monophosphate in the smooth muscles. Guanosine 3’5’monophosphate controls the contractile state of the affected smoothmuscles, resulting in vasodilatation. Vasodilatation facilitates aninstant pain relief among the patients suffering from angina.
Nitroglycerin,which is an old drug, is preferred over other drugs for the treatmentof angina for several reasons. First, the drug is known to be veryfast and it reduces the chest pain within a few minutes (Katzung,Masters, & Trevor, 2012). The ability to act faster makes thedrug more important to angina patients, which suffer from a sharppain. Secondly, the drug is still preferred to-date because it isrelatively cheap, which makes it accessible to many patients,including those from the low-income households. Third, nitroglycerinis produced in the form of tablets, which makes it easy to use.Lastly, nitroglycerin has fewer side effects compared to itsalternatives and they rarely occur.
Question2: Controlling blood pressure
Controllingblood pressure is significant because it reduces the risk ofsuffering from different medical conditions. Many people sufferingfrom high blood pressure lead a normal and only discover the medicalcondition when they suffer from other illnesses, such ascardiovascular diseases. High blood pressure has been shown to be themajor cause of heart diseases and mortality, especially among olderadults (British Hypertension Society, 2016). Controlling a high bloodpressure help people discover the possibility of contractingdifferent diseases or notice diseases before they develop to chronicstages.
Hypertensionis treated using drugs from different classes, including calciumchannel blockers (CCB), diuretics, and ACE inhibitors. Calciumchannel blockers function by promoting vasodilator activity. Thispromotion is achieved by reducing the calcium influx to the cells ofvascular smooth muscles. These drugs interrupt the calcium channelsthat are operated by voltage in the cell membrane (BHS, 2016). Aninterference with the intracellular calcium influx results in theblockage of calcium channels, which occurs during the plateau phaseof the heart’s action. This lowers the heart rate and the bloodpressure. Examples of CCB include Amlodipine, felodine, andnicardipine.
Thiazideis an example of diuretic used to treat hypertension. The diureticfunctions by acting on nephron, where it targets the proximalsections of the distal tubule. An interference with the transfer ofsubstances across the cell membrane increases the urine volume andsodium excretion (BHS, 2016). This results in a reduction in thevolume of blood, but changes in extracellular fluid and cardiacoutput are transient in the long-term. The main haemodynamic impactof the drug is a reduction in peripheral resistance as a result ofsubtle alterations in contractile responses that occur in thevascular smooth muscles.
ACEinhibitors act by inhibiting the activity of ACE, prevents thedevelopment of active octapeptide from angiotensin I. The processtakes place in the tissues (such as heart and kidney) and blood.Angiotensin promotes the release of aldosterone, which supportssympathetic activity (BHS, 2016). This activity facilitatesvasodilation and a decline in the level of blood pressure. Examplesof ACE inhibitors include captopril, fosinopril, and ramipril.
Question3: Combination therapy
Combinationtherapy refers to a treatment process that requires the use more thanone drug to treat a single medical condition. The primary objectiveof using this type of therapy is to increase the chances as well asthe pace of recovery. However, health care providers are required ofprescribed a combination of drugs, which combination cannot result inadverse reactions (Foster, 2013). Combination therapy is alsorecommended when the health care providers intend to reduce the riskof drug resistance.
Thereare two major medical conditions that are currently treated using acombination therapy. The first condition is HIV, where Highly ActiveAntiretroviral Therapy is prescribed (Foster, 2013). HAART refers toa combination of six different drugs that target the same type ofvirus. Each of the drugs included in HAART attack and act on HIVthrough a different mechanism. The intention of using different drugsis to disrupt and slow down the process of HIV cells` replicationthrough different mechanisms. For example, entry inhibitors preventthe HIV cells from attach to receptors that are located on the wallsof the healthy cells while integrase inhibitors play the role ofblocking the integrase enzyme (Foster, 2013). A combination of thesix drugs benefit patients by limiting the rate at which HIV canmultiply, thus keeping the virus within their manageable levels.
Secondly,a combination therapy is used in the treatment of metastaticadenocarcinoma that affects the pancreases. This disease is treatedby combining Abraxane and gemcitabine (Foster, 2013). Abraxane actsby inhibiting microtubule, which prevent cancer cells from growing.Gemcitabine function by replacing different segments of the DNA inorder to force apoptosis. Similar to HAART, this combination therapybenefit clients by fighting the same cancer cells using differentmechanisms, thus controlling the rapid reproduction and spread.
Question4: Selective toxicity
Theterm selective toxicity is used to describe the process in which adrug destroys certain cells without causing any harm to others. Inmost cases, drugs with the property of selective toxicity target sitethat are more essential to the survival of the microorganisms thatthe drug is designed to kill than the host. Some specific sites mayinclude bacterial ribosomal, specific bacterial enzymes thatsynthesize the cell wall (El-kattan & Varma, 2012). Selectivetoxicity is attributed to differences that exist between the cells ofthe pathogen and human cells.
Penicillin,oseltamivir, and imidazoles are examples of drugs with the propertyof selective toxicity. Penicillin is used in the treatment ofstreptococci and staphylococci. It has a beta-lactam ring and itkills the bacteria by binding its ring to DD-transpeptidase. Thisresults in the inhibition of its cross-linking activity followed byprevention of the formation of new cell wall (El-kattan & Varma,2012). The absence of cell wall subject the bacteria to molecularpressure and outside water, which eventually kills it withoutaffecting the surrounding human cells.
Oseltamiviris a pro-drug that used in the treatment of influenza. Oseltamivir isnot an antiviral, but it undergoes some reaction to release itsactive component. This reaction occurs in the liver, whereoseltamivir is hydrolyzed to release carboxylate (El-kattan &Varma, 2012). This active compound acts by competing with the viralneuraminidase enzyme for sialic acid that is found on glycoprotein inthe normal cell. This prevents the release of new viral particles,thus reducing the concentration of the virus without causing harm tothe host cells.
Imidazolesacts by altering the permeability of the cell membrane of susceptiblefungi and yeast. This is accomplished by blocking the process ofergosterol synthesis. The drug-induced changes in peroxidative andoxidative enzyme activities result in the intracellular concentrationof hydrogen peroxide to toxic levels (El-kattan & Varma, 2012).This toxicity destroys internal organelle and the cell membrane,leading the death of the cell of the fungi.
Question5: Over-the counter drugs for different medical conditions
Theprocess of selecting the right over-the-counter drug requires thepatient to understand how the drug works and the limitationsinvolves. Ibuprofen is an over-the-counter drug that can berecommended for a person with dental pain. It is a non-steroid painkiller, but it also functions as an anti-inflammatory product (Drugs,2016). It is recommended for dental pain because inflammation is oneof the key outcomes of dental aches.
A1 % hydrocortisone is a smearing cream that can be accessedover-the-counter for the treatment of moderate poison ivy exposure.Hydrocortisone is recommended because it suppresses the itching andprevents urushiol from penetrating deep into the skin (Drugs, 2016).Therefore, the cream plays the treatment and prevention roles at thesame time. It is also easy to apply at home.
Alka-Seltzeris an anti-acid that can be obtained over-the-counter for thetreatment of heartburn. This anti-acid is recommended because it iscommon knowledge that heartburn takes place when acid backs into theesophagus from the stomach, which implies that an anti-acid can offeran immediate and effective relief (Drugs, 2016). In addition, theanti-acid does not have side-effects that can worry the patient.
Bismuthsubsalicylate is a drug that can be bought over-the-counter in orderto treat traveler’s diarrhea (Drugs, 2016). The drug is recommendedbecause its function is well known where it functions by reducing thefrequency of stools. In addition, the drug is produced in the form oftablets that are easy to carry and administer.
Acetaminophenis recommended for the treatment of fever in children. The drugreduces fever and pain that may be associated with the illness at thesame time. Acetaminophen is manufactured in the form of tablets orliquid, which increase the level of convenience in the process ofadministration (Drugs, 2016).
Question6: Herbal medicine
Theterm herbal medicine is used to describe different therapeuticproducts that are obtained from plant materials, such as leaves,seeds, and barks, among others. Herbal drugs are considered to besafer than the formal drugs for different reasons. For example, thefact that these herbal drugs are derived from plants implies thatthey have not undergone significant chemical changes (Katzung,Masters, & Trevor, 2012). Their active components retain theirnatural status, which makes the fear of overdosing herbal drugslesser compared to traditional medicines. This is confirmed by thefact that some of the herbal drugs (such as Echinacea) arerecommended for pregnant women, while the majority of the rest ofdrugs are taken with a lot of consciousness during pregnancy.
Inaddition, herbal drugs are classified as supplements, which implythat they are administered as products intended to boost other drugs.The term supplements mean that herbal drugs are less strong comparedto formal pharmaceutical products. Ginkgo is one of the keysupplements that are administered as supplements. Ginkgo is used totreat a wide range of disorders, including the loss of memory andcirculatory disorders (Katzung, Masters, & Trevor, 2012). Ginkgohas been proven to be safe.
Althoughmost of the herbal drugs are considered to be safe and gentle topatients, some of them contain components that can harm patients,especially when they are taken in the wrong dosages, but children, orpregnant women. For example, Echinacea is recommended for treatmentof cold among adults, but it can be harmful to children (Katzung,Masters, & Trevor, 2012). Therefore, herbal drugs are safercompared to other pharmaceutical drugs, but they should be taken withcare.
Question7: Dietary vitamin supplements
Supplementationinvolves the administration essential vitamins that are missing inone’s body. Different medical conditions require the use ofdifferent vitamin supplements. For example, vitamin D supplements arerecommended for patients who are suffering from none and teethproblems (Health Unit Organization, 2016). It is also recommended forpregnant and breastfeeding women. Vitamin D is recommended underthese conditions because it facilitates the absorption of calciumthat is responsible for the strength and the overall development ofbones as well as teeth.
Acombination of vitamin A, C, and D are recommended for kids who areaged between five months and five years. These vitamins arerecommended because children do not get enough of them from ordinarymeals (Health Unit Organization, 2016). This makes it necessary tosupply additional vitamins in the form of supplements. During thisage kid’s immune system and their entire body is developing at afaster rate, which increase the demand for vitamins to an extent thatthe food that they eat may not supply adequate quantities of vitaminA, C, and D.
Somevitamins may be recommended for serious medical conditions. Forexample, vitamin B12 is administered to patients suffering fromatrophic gastritis, alcoholism, Cohn’s disease, pernicious anemia,and intestinal bacterial overgrowth, among other conditions (HealthUnit Organization, 2016). These conditions are associated with adecline in the rate of absorption of vitamin B12, thus creating theneed for supplementation.
Althoughsupplementation involves the administration of vitamins that are thatare ordinarily found in foods, they should only be taken with therecommendation of the qualified health care professional. This isbecause they may lead to side effects, especially when they areoverdosed. In addition, there is a risk of taking more vitamins thanthe body requires.
Question8: Impact of oral contraceptives on the modern society
Oralcontraceptives have four major impacts on the modern society. First,the pills have empowered women by giving them control over birthrate. For example, oral contraceptives are easy to administer andwomen can take them from home. This has allowed families to givebirth to the number of children that they want (Djerassi, 2015). Inaddition, oral contraceptives have enabled women to space theirchildren to their desired number of years.
Secondly,oral contraceptives have empowered women economically by giving themthe opportunity to pursue their higher education and career withoutthe fear of unwanted pregnancies (Djerassi, 2015). This isaccomplished by allowing women to distinguish between procreation andsex, where they can continue with their sex life without gettingpregnant.
Third,oral contraceptives have enhanced the overall quality of life offamilies. By allowing families to determine when they want to havechildren, oral contraceptives facilitate budgeting and planning. Forexample, couples can decide to give birth to children only afterenhancing their financial strength (Djerassi, 2015). Similarly,single women who consider pregnancy to be costly can enjoy their sexlife without the fear of unexpected financial constraints. Therefore,people who use oral contraceptives can improve their quality of lifeby giving birth to a manageable number of children.
Finally,oral contraceptives have numerous side effects, which mean that theyhave increased the risk of suffering from different diseases anddiscomfort among the users. For example, oral pills are associatedwith the risk of irregular periods, hirsutism, endometriosis, andcancer, among other medical conditions (Djerassi, 2015). These healthissues may limit the gains that users of oral contraceptives get fromthem.
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