Question

1- Understand the purpose of HAART Therapy in the treatment of AIDS.

2- Know albuterol and inhaled corticosteroids used to treat asthma, and their teaching points.

3- Antihistamines mechanism of action. Difference between generation one and two.

4- Mechanism of action for Colace, Lomotil, Pancrelipase, and Carafate.

5- Understand why we vomit, and the receptors targeted in anti-emetic therapy (treatment of nausea)

6-Understand what COPD is and what causes it.

7-Mechanism of action of antacids (Tums, Mylanta) and PPIs.

8-Medications for nasal congestion (allergic rhinitis), and cough.

9- Know lipid vs water soluble vitamins.

Answer 1

9.Fat-soluble vitamins are soluble in fats. They are absorbed by fat globules that travel through the small intestines and into the general blood circulation within the body.

Water-soluble vitamins travel freely through the body, and excess amounts usually are excreted by the kidneys. The body needs water-soluble vitamins in frequent, small doses. These vitamins are not as likely as fat-soluble vitamins to reach toxic levels.

Vitamins are classified as either fat soluble (vitamins A, D, E and K) or water soluble (vitamins B and C).

8)

Hay fever, or allergic rhinitis, symptoms are similar to the symptoms of a common cold. Some common symptoms include sneezing, congestion, coughing, sinus pressure, itchy watery eyes, and itchy nose, mouth, and throat, and fatigue.

Antihistamines. The second-generation oral anti-histamines (e.g., desloratadine [Aerius], fexofenadine [Allegra], loratadine [Claritin], cetirizine [Reactine]) are the first-line pharmacological treatments recommended for all patients with allergic rhinitis.

Decongestants cut down on the fluid in the lining of your nose. That relieves swollen nasal passages and congestion.

You can take these by mouth in pills or liquids, like pseudoephedrine. Decongestants also come in nasal sprays, including oxymetazoline and phenylephrine.

Decongestants can also cause side effects, such as:

Nervousness

Sleeplessness

Increased heart rate

Increased blood pressure.

COUGH_

There are 2 types of OTC cough medicines: antitussives and expectorants. A common antitussive is dextromethorphan (some brand names: Triaminic Cold and Cough, Robitussin Cough, Vicks 44 Cough and Cold). The only expectorant available in OTC products is guaifenesin (2 brand names: Mucinex, Robitussin Chest Congestion)

Medications used to treat chronic cough may include:

Antihistamines, corticosteroids and decongestants. These drugs are standard treatment for allergies and postnasal drip.

Inhaled asthma drugs. ...

Antibiotics. ...

Acid blockers.

7)

Antacids can be used to treat symptoms of excess stomach acid, such as:

acid reflux, which can include regurgitation, bitter taste, persistent dry cough, pain when lying down, and trouble swallowing

heartburn, which is a burning sensation in your chest or throat caused by acid reflux

indigestion, which is pain in your upper gut that can feel like gas or bloating

Types of antacids

Antacids usually come in the following drug forms:

liquid

chewable gummy or tablet

tablet that you dissolve in water to drink.

The antacids act by neutralizing the acid in the stomach and by inhibiting pepsin, which is a proteolytic enzyme. Each of these cationic salts has a characteristic pharmacological property that determines its clinical use.

Popular antacid brands include:

Alka-Seltzer

Maalox

Mylanta

Rolaids

Tums.

Proton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid. Acid is necessary for the formation of most ulcers in the esophaguProton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid. Acid is necessary for the formation of most ulcers in the esophagus ,stomach, and duodenum, and the reduction of acid with PPIs prevents ulcers and allows any ulcers that exist in the esophagus, stomach, and duodenum to heal.

PPIs work by inhibiting certain stomach cells from "pumping" acid into the stomach. When taken 30 to 60 minutes before a meal, PPIs can prevent or reduce heartburn.

Proton pump inhibitor (PPI). Esomeprazole inhibits gastric acid secretion by inhibiting the K+/H+ pump (potassium pump) located on the apical membrane of the gastric parietal cell, inhibiting secretion of H+ into the stomach.

6)

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing.

COPD, the airways of the lungs (bronchial tubes) become inflamed and narrowed. They tend to collapse when you breathe out and can become clogged with mucus. This reduces airflow through the bronchial tubes, a condition called airway obstruction, making it difficult to move air in and out of the lungs.

The cause of COPD is usually long-term exposure to irritants that damage your lungs and airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause COPD, especially if you inhale them. Exposure to other inhaled irritants can contribute to COPD.

Causes of airway obstruction include:

Emphysema. This lung disease causes destruction of the fragile walls and elastic fibers of the alveoli. Small airways collapse when you exhale, impairing airflow out of your lungs.

Chronic bronchitis. In this condition, your bronchial tubes become inflamed and narrowed and your lungs produce more mucus, which can further block the narrowed tubes. You develop a chronic cough trying to clear your airways.

1)

HAART prevents the HIV virus from making copies of itself and limits how much virus is in the body. The level of virus in the blood is called 'viral load'. When the viral load is low or “undetectable”, there is less harm to the body's immune system and fewer complications of HIV infection.

primary goals of antiretroviral therapy are to maintain maximal suppression of the viral load (i.e., fewer than 50 copies per mL), restore or preserve immunologic function, improve quality of life and reduce HIV-related morbidity and mortality.

Standard antiretroviral therapy (ART) consists of the combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease. ART also prevents onward transmission of HIV.

Pharmacologic drug classes include:

Nucleoside reverse transcriptase inhibitors (NRTIs)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Protease inhibitors (PIs)

Integrase inhibitors (INSTIs)

Fusion inhibitors (FIs)

Chemokine receptor antagonists (CCR5 antagonists)

5)

The timing of the nausea or vomiting can indicate the cause. When appearing shortly after a meal, nausea or vomiting may be caused by food poisoning, gastritis (inflammation of the stomach lining), an ulcer, or bulimia. Nausea or vomiting one to eight hours after a meal may also indicate food poisoning.When the stomach sensors detect something bad, they send a signal to the nervous system, which then sends a signal to your brain. The command to throw up actually comes from your brain, not your stomach.

Antiemetic drugs are medicines that ease nausea or vomiting.

Medicines that treat nausea and vomiting are called antiemetics. Several OTC medicines are used as antiemetics. These include: Bismuth subsalicylate(2 brand names: Kaopectate, Pepto-Bismol)

motion sickness

viral or bacterial infections, such as those responsible for the stomach flu

pregnancy

the effects of surgery

other medications, such as chemotherapy

These medications work by blocking chemical messengers called neurotransmitters, which send information about nausea to the brain. Blocking their signals can keep a person from feeling nauseous and vomiting..

3)

Antihistamines suppress the histamine-induced wheal response (swelling) and flare response (vasodilation) by blocking the binding of histamine to its receptors or reducing histamine receptor activity on nerves, vascular smooth muscle, glandular cells, endothelium, and mast cells.Antihistamines block the effects of a substance called histamine in your body. Histamine is normally released when your body detects something harmful, such as an infection. It causes blood vessels to expand and the skin to swell, which helps protect the body.

First-generation antihistamines block both histaminic and muscarinic receptors as well as passing the blood-brain barrier. Second-generation antihistamines mainly block histaminic receptors and do not pass the blood-brain barrier.

First-generation antihistamines cross the blood-brain barrier into the central nervous system and antagonize H-1 receptors, which leads to a different therapeutic and adverse effect profile in contrast to second-generation antihistamines, which only bind to peripheral histamine receptors.

4)

Docusate is an anionic surfactant (i.e., a surface-active agent). It lowers the surface tension at the oil-water interface of the feces, allowing water and lipids to penetrate the stool. This helps to hydrate and soften the fecal material, facilitating natural defecation.Colace generally produces bowel movement in 12 to 72 hours. Call your doctor if your symptoms do not improve after 72 hours. You should not use this medicine for longer than 1 week, unless your doctor tells you to.

Lomotil is a prescription medicine used to treat the symptoms of diarrhea. Lomotil may be used alone or with other medications. Lomotil belongs to a class of drugs called Antidiarrheals.This medication is used to treat diarrhea. It helps to decrease the number and frequency of bowel movements. It works by slowing the movement of the intestines. Diphenoxylate is similar to opioid pain relievers, but it acts mainly to slow the gut.Diphenoxylate is an opioid agonist that acts on the presynaptic opioid receptors (predominantly mu receptors) in the enteric nervous system. The enteric nervous system comprises of two components- myenteric plexus and submucosal plexus.

Mechanism of action. Pancrelipase is a combination of lipases, proteases, and amylases derived from porcine pancreas. It acts to replace the normal endogenous pancreatic enzymes. – Enteric-coated microspheres in capsules withstand gastric acid and disintegrate at pH > 6.

Pancrelipase delayed-release capsules (Creon, Pancreaze, Pertzye, Ultresa, Zenpep) are used to improve digestion of food in children and adults who do not have enough pancreatic enzymes (substances needed to break down food so it can be digested) because they have a condition that affects the pancreas .

Sucralfate is a complex of aluminium hydroxide and sucrose octasulfate. It dissociates in the acid environment of the stomach to its anionic form, which binds to the ulcer base. This creates a protective barrier to pepsin and bile and inhibits the diffusion of gastric acid.Carafate (sucralfate) is an anti-ulcer medication. Carafate is not greatly absorbed into the body through the digestive tract. It works mainly in the lining of the stomach by sticking to ulcer sites and protecting them from acids, enzymes, and bile salts. Carafate is used to treat an active duodenal ulcer.