How would ancient people have crossed from Asia to North America?

Would travel on canoes through the ocean

Sailed on boats and crossed the sea

Developed air crafts to be able to cross to North America

How did people learn to use fire? What type of tools

Archaeologists believe early humans produced fire by friction

They were able to ask the gods the believed in to create fire

They had a Dragon who started the fires for them

History 6 (1-2) | Quizalize

World History Ch. 6-1&2

6th Grade Science Test 2.1-2.6 Review

Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we won’t talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined α and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic DrugAlpha1 Blockers (we’ve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an α1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic DrugsAlpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels → lowers peripheral resistance → Results in decreased BP So ….Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesn’t everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitorsaka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion  less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patient’s chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-life Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers(ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect  Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia… Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTNTreatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)

THE SOAR SYSTEM A solar system is a group of planets and other celestial bodies that revolve around a star. A solar nebula- a vast cloud of gas and dust, mostly hydrogen and helium. How the Solar System Form • COLLAPSE AND SPINNING DISK FORMATION - Gravity pulls material inward. The cloud flattens into a spinning disk due to conservation of angular momentum. • PROTOSTAR FORMATION- (BIRTH OF THE SUN). Material collects at the center, and begun to heat up. When it reaches to 10 million KELVIN, nuclear fusion begins. thus, SUN is born. • PLANETESIMALS AND PROTOPLANETS. Dust and gas in the disk stick together via static and gravitational forces. These form planetesimals, which grow into protoplanets collision and accretion. • PLANET FORMATION. Inner disk: too hot for gas rocky planets form Mercury, Venus, Earth, Mars. • PLANET FORMATION. Outer disk: gas and ice giants. Jupiter, Saturn, Uranus, Neptune • LEFTOVER DEBRIS. Remaining materials forms moon, asteroids, comets and dwarf planets. DIFFERENT HYPOTHESIS IN THE FORMATION OF SOLAR SYSTEM. 1. NEBULAR HYPOTHESIS- The Solar system formed from a rotating cloud of Gas and Dust (solar nebula). As it rotates conservation of angular momentum caused the cloud to flatten into a disk. the Sun formed at the center (DISK) while planets formed from the surrounding materials through acceleration. thus, it explains the coplanar and nearly circular orbit of the planets all planets orbits around the sun on the same flat, disk shaped plane. Proposed by Immanuel Kant in 1755 and Modified by Pierre Simon Laplace in 1756. PROTOPLANET HYPOTHESIS. The Solar system formed from a rotating cloud of Gas and Dust (solar nebula). As it rotates conservation of angular momentum caused the cloud to flatten into a disk. 2. Protoplanet hypothesis. Builds on the nebular model but focuses more on the role of planetesimals which then form into full planets. PROCESS: - Small solid particles stick together through collisions. As collisions takes place, it grows into kilometer-sized planetesimals. Gravitational interactions lead to the formation of planets. Lead to formation of steroids belts and varying planet sizes 3. Encounter hypothesis. States that the sun encountered a rogue star. The encounter led to the removal of hot gas from both stars due to their gravitational interaction. The hot gas then accumulated and formed the planets. The materials from the less dense rogue star formed the other planets, while that from the sun formed the inner planets. 4. TIDAL HYPOTHESIS. (also called the Tidal Theory) is an early scientific idea about how the solar system might have formed. Proposed by James Jeans and Harold Jeffreys. A massive star passed very close to the early Sun. The hot gas then accumulated and formed the planets. The materials from the less dense rogue star formed the other planets, while that from the sun formed the inner planets. Streams of hot gas were drawn out from the Sun in elongated shape. These streams eventually condensed and cooled, forming planets, moons, and other bodies in the solar system. 5. Not accepted theory. Later studies showed the streams of hot gas would disperse too quickly into space instead of condensing into planets. The theory also couldn’t explain the specific orbital patterns and compositions we see today. Modern science favors the Nebular Hypothesis, which explains solar system formation through the collapse of a rotating gas cloud. Earth as the only habitable planet 1. Right Distance from the Sun (The Goldilocks Zone). Not too hot, not too cold — just right for liquid water to exist. 2. Atmosphere with Oxygen. Earth has a mix of gases, especially oxygen, which most living things need to survive. 3. Liquid Water. Earth has oceans, rivers, and rain — water is essential for all life. 4. Magnetic Field. Earth’s magnetic field protects us from harmful solar radiation. 5. Stable Climate. The atmosphere and natural cycles keep temperatures and weather mostly stable over time. 6. Rich Resources. Earth has soil for growing food, minerals, and energy sources that support life and technology. Solar explorations 1. AUGUST 6, 2014. First space craft to orbit a comet (ROSETTA PROBE). Captures the comet photograph. -Comets have coma and tail as it approaches to the sun. 2. JULY 14, 2015. NASA’s New Horizons spacecraft made history by becoming the first spacecraft to fly by Pluto, giving us our first close-up look at the dwarf planet. First time visiting Pluto. Before this, Pluto was just a blurry dot in telescope images. Revealed a surprising world New Horizons showed mountains of ice, smooth plains, and a heart-shaped region called Tombaugh Regio. Changed what we knew. Scientists thought Pluto would be dull and frozen — instead, it turned out to be geologically active and incredibly complex. 3. SEPTEMBER 8, 2016. NASA launched OSIRIS-REx, the first U.S. mission to collect a sample from an asteroid and return it to Earth. Changed what we knew. Scientists thought Pluto would be dull and frozen — instead, it turned out to be geologically active and incredibly complex. OSIRIS-REx stands for: Origins, Spectral Interpretation, Resource Identification, Security–Regolith Explorer It was sent to study the asteroid Bennu, a near-Earth asteroid about 500 meters wide. Mission Goals: Collect a sample of surface material from Bennu Study the asteroid’s omposition, structure, and history. Mission Goals: Help scientists understand the origins of the solar system. Learn more about asteroids that could impact Earth. 4. August 12, 2018: Launch of NASA’s Parker Solar Probe, the first spacecraft to "touch" the Sun by flying through its outer atmosphere, called the corona. Mission Goal: To study the Sun up close and help scientists understand: How the solar wind (a stream of charged particles) is formed. Why the Sun’s corona is hotter than its surface. What causes solar storms that can affect Earth’s satellites and power grids. 5. November 26, 2018: NASA’s Insight Lander Touches Down on Mars. Its mission was focused on studying the interior of the Red Planet (crust, mantle, and core of the planet). Why the Sun’s corona is hotter than its surface. What causes solar storms that can affect Earth’s satellites and power grids 6. November 26, 2018: NASA’s Insight Lander Touches Down on Mars. Its mission was focused on studying the interior of the Red Planet (crust, mantle, and core of the planet) 7. JULY 30, 2020 PERSEVERANCE PROBE. Perseverance rover as part of the Mars 2020 mission aboard an Atlas V-541 rocket This marked a major step in Mars exploration. 8. DECEMBER 25, 2021-JAMES WEBB SPACE TELESCOPE. Investigate exoplanets’ atmospheres for signs of habitability. Observe the first galaxies formed after the Big Bang. Study the formation of stars and planetary systems. Look deeper into the infrared universe than ever before. RESULTS OF EXPLORATION • Evidence of Ancient Life-friendly Environment. • Sedimentary rocks formed in water-rich environments. • Signs of clay and carbonate minerals, which can preserve biosignatures (traces of past life). • Evidence of Ancient Life-friendly Environment. • Sedimentary rocks formed in water-rich environments. • Signs of clay and carbonate minerals, which can preserve biosignatures (traces of past life). • Evidence of Ancient Life-friendly Environment. • Sedimentary rocks formed in water-rich environments. • Signs of clay and carbonate minerals, which can preserve biosignatures (traces of past life).

NEW-SC.8.N.1.1-1. Students will evaluate a scientific investigation using evidence of scientific thinking and/or problem solving. 2. Students will identify test variables (independent variables) and outcome variables (dependent variables) in a given scientific investigation. 3. Students will identify and/or analyze data to make predictions and/or defend conclusions. 4. Students will explain how hypotheses are valuable. 5. Students will compare methods and/or results obtained in a scientific investigation. 6. Students will explain that scientific knowledge may change as new evidence is discovered or new scientific interpretations are formed. 7. Students will identify instances in the history of science in which scientific knowledge has changed as a result of new evidence.

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