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IT 3rd General Revision - Switching
Quiz by Sayed Mohammed
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Whichis from following is the First Boot sequence for the Switch?
Power On Self-Test (POST)
Locates and loads a default IOS operating system
Locates and loads the configuration file
Initializes the flash file system
Which type of cable you need to configure cisco switch from first time
Console Cable
Power Cable
Aux Cable
Straight-through Cable
Whichis from following is the First Boot sequence for the Switch?
Which type of cable you need to configure cisco switch from first time
Which of the following is one of the best practices to ensure the security of the network?
What is the default VLAN of a Cisco switch?
Which command you will use to set violation mode for the port to ‘shutdown’?switch(config)#interface range f0/1-6
switch(config-if)# …………………………
Which of the following port security commands allows only TWO devices to connect at same port?
Which of the following IOS command is used to enable port security on the interface?
Which of the following IOS command is used to enter interface configuration mode forthe SVI?
What is the default VTP Mode configuration of Cisco Switches?
A switching protocol that allows a network manager to configure a switch so that it will propagate VLAN configurations to other switches across the network.
The VTP server distributes and
synchronizes VLAN information to VTP-enabled switches(Clients).
What VTP mode allows you to change VLAN information on the switch?
Which of the following best describes a VLAN?
Which of the following statements is true about VTP?
Which statement is correct to describe the Benefit of VLAN?
What switchport mode will you use for a switch-to-switch connection in VLANs?
What switchport mode will you use for End-Devices at VLAN’s Network?
Which of the following commands sets a trunk port on a switch?
Which command displays VTP information?
A VLAN trunk carries only one VLAN
Which type of VLANs used to separate the network into groups of users or devices?
A type of VLAN that is configured to access the management capabilities of a switch.
Which series of command is used to verify the port-security on interface f0/19?
Which statement is correct based on FIGURE below?
Which series of command secures a switch froma remote connection?
What is the outcome of the commands below?
Switch (config)# line vty 0 4
Switch (config-line)# password check123
Switch (config-line)# login
Which command best secures a switch privilege mode?
Which of the following prompt tells that a Switch is in interface configuration mode?
Which of the following prompt tells that a switch is in privileged mode?
Which command allows a user to change a switch name?
Which command enables a user to configure a switch?
As a network administrator, you are tasked to improve network performance by increasing the bandwidth available to hosts and limit the size of the broadcast domains. Which of the following options will achieve this goal?
Which of the following is NOT a switch port security violation mode
By default, the dynamic port security is?
What is the default file used by Cisco switches to store VLAN configurations in the VLAN
database?
What IOS command is used to re-enable the port or interface?
You can view the list of commands that you have entered before with the show history command
Which command is used to display the layout and contents of a Flash memory file system
Which command is used to displays the configuration of the system hardware, the software version, the names and sources of configuration files, and the boot image
IT 3rd General Revision - RoutingIT 3rd Year General Revision -IP AddressingYaama I'm Jack Evans and you're watching BTN. Here's what's coming up. We uncover the story behind this famous photo, learn about First Nations seasons and find out the history of Book Week. What is Statehood? Reporter: Tatenda Chibika INTRO: But first, the Prime Minister Anthony Albanese has announced that Australia will join other countries in recognising Palestine as an independent state. So, what does that mean? Tatenda found out. Anthony Albanese, Prime Minister: Australia will recognise the state of Palestine. Australia will recognise the right of the Palestinian people to a state of their own. We will work with the international community to make this right a reality. Tatenda Chibika, Reporter: That's the moment our Prime Minister said Australia would recognise Palestine as an independent state at the upcoming United Nations General assembly next month. It's something other countries, including France and Canada, have said they'll be doing too. So, what does that mean exactly? To be considered an independent state under international law a place needs to have its own land or territories with defined borders, it needs to have people who permanently live there, have a working government and it has to be able to talk and make deals with other countries. Once a place meets all those rules, it can ask to be recognised by other independent states and countries. But a big step in becoming an independent state is being fully recognised by the United Nations. To do that you first need to get approval from at least nine members of the UN's Security Council. That's a group of countries responsible for maintaining international peace and security. But even then, that tick of approval can still be blocked by one of the Security Council's five permanent members Russia, China, the UK, the US and France. If the Security Council approves, the decision then goes to the UN's General Assembly where at least two thirds of the UN's 193 members have to agree to make it official. Yeah, it's a pretty complex process which is why we've only seen a handful of countries recognised by the UN in recent years like South Sudan and Montenegro. Others like Kosovo are only 'partially' recognised which means they have some recognition but not enough to become a full member state at the UN. Right now, Palestine is recognised by more than 140 countries — that's more than two thirds of the UN General Assembly. So, why hasn't it become a UN member state yet? Well, it came pretty close last year when 12 members of the Security Council voted in favour of it. VANESSA FRAZIER, AMBASSADOR OF MALTA, APRIL 2024 UNSC PRESIDENT: I shall now put the draft resolution to the vote. But the US, a close ally to Israel, used its special powers to block Palestine from becoming a member state. VANESSA FRAZIER: Those against? At the time, the U.S said Palestine and Israel needed to come to an agreement on their own first. Throughout the years, there have been attempts to figure out a way for both Palestine and Israel to exist peacefully alongside each other but that hasn't happened yet. And now Israel has said that recognising Palestine as an independent state would be rewarding Hamas the group in charge of Gaza which was responsible for the terror attacks on October 7th, 2023. But the Palestinian Authority which governs parts of the West Bank says Hamas won't have a role in any future state of Palestine which will exist peacefully alongside Israel. Australia, like the US, had previously said that it wanted Israel and Palestine to figure out things by themselves first but because of how the war has been going the Australian government is worried that if it continues to wait, there might not be a Palestinian state to recognise. ANTHONY ALBANESE, PRIME MINISTER: There has been too many lives lost, both Israeli's and Palestinians and the world is saying we need a solution to this conflict, we need to end the cycle of violence and the way to do that is to have a two-state solution. News Quiz Russia's President Vladimir Putin stepped foot on American Soil for the first time in a decade to meet with US President Donald Trump. What state did they meet in? Alabama, Alaska or Arizona?It's Alaska. The two leaders met to discuss a way to end the war in Ukraine but weren't able to make any final agreements. DONALD TRUMP, US PRESIDENT: There were many, many points that we agreed on. Most of them, I would say, a couple of big ones, that we haven't quite got there, but we've made some headway. There's no deal until there's a deal. A lot of people criticised the two world leaders for not including Ukraine's president Volodymyr Zelenskyy in the meeting. But that didn't seem to worry Mr Trump who said the meeting was a success and Mr Putin even invited the US President to meet up again in Russia. DONALD TRUMP: We'll see you again very soon. Thank you very much, Vladimir. VLADIMIR PUTIN, RUSSIAN PRESIDENT: Next time in Moscow. DONALD TRUMP: Oh, that's an interesting one. No, no, no. I'll get a little heat on that one. Last week thousands of people marked the 80th anniversary of VJ Day. What does VJ Day commemorate? The victory of Allied forces in Europe, the surrender of Japan and the end of World War II or the dropping of the first atomic bomb? VJ Day or Victory over Japan day commemorates the surrender of Japan and the end of World War II on the 15th of August 1945. Around the world, and here in Australia, people marked the anniversary with ceremonies remembering those who fought in the war. REPORTER: Who will you be remembering today? VETERAN: Oh, a lot of fellows that I knew that never made it home. Scientists in the UK have created toothpaste that includes which of these ingredients? Hair, eye lashes or fingernails? Yeah, they're all a bit random and gross but the answer is hair. According to scientists from King's College in London, hair could be the key to good oral health because it contains a protein called Keratin which they say when mixed with saliva forms a crystal-like protective coating similar to enamel. And Swifties rejoice because Taylor Swift has announced her 12th Studio album. It's called life of a show what? Is it show pony, show girl or show bag? It's Life of a Showgirl and it'll be released October 3rd. Vincent Lingiari Reporter: Joseph Baronio INTRO: Now to this very famous photograph. It was taken 50 years ago and depicts a really significant moment in Australian history. Joe found out about the story behind it. On the 16th of August 1975, this famous photo was taken. It shows the former Prime Minister Gough Whitlam pouring sand into the hand of Aboriginal leader Vincent Lingiari. A simple gesture that symbolised handing the land at Wave Hill in the Northern Territory back to the Gurindji people. But the journey to get there was far from simple. It started back in the 1960s. At the time, Wave Hill was the biggest cattle station in the world, controlled by British landowner Lord Vestey. The Gurindji people, who had lived on the land for generations, worked for Vestey, but they weren't paid fairly, and conditions were tough. NEWS REPORTER: The station's 100 aboriginal stockmen, with their 100 dependents, are camped in the dry bed of the Victoria River with little shade from 90-degree heat, dust and flies. Eventually, Gurindji leader Vincent Lingiari said it was time to act. VINCENT LINGIARI: I said, "What was it before Lord Vestey born and I was born?" It was blackfella country. So, on August 23rd, 1966, Mr Lingiari and his fellow Aboriginal workers went on strike. It became known as the Wave Hill Walk Off. They moved their camp away from the Wave Hill station to a sacred site called Daguragu on Wattie Creek. They wanted to set up their own cattle station, and said they wouldn't move until their land was returned to them. For years, petitions and negotiations went on between the Gurindji people, the NT Administration, and the Australian Government in Canberra. CLAPPERS: 31. 32. 33. DAVID QUINN, ABSCOL: Well, it's basic justice that their land is recognised. PROTESTORS: Equal rights! As the news spread across the country, thousands of Aussies joined the campaign, including the leader of the Labor Party, Gough Whitlam, who made this promise during his 1972 election campaign. GOUGH WHITLAM: We will legislate to give Aborigines land rights. Not just because their case is beyond argument, but because all of us as Australians are diminished, while the Aborigines are denied their rightful place in this nation. Later that year, Gough Whitlam became Prime Minister. (Song From Little Things Big Things Grow, Song by Kev Carmody and Paul Kelly, 1993) From little things big things grow,from little things big things grow… But it wasn't until 1975, 9 years after the Wave Hill Walk Off started, that he followed through with his promise. Eight years went by, eight long years of waiting'Til one day a tall stranger appeared in the landAnd he came with lawyers and he came with great ceremony GOUGH WHITLAM: I solemnly hand to you these deeds as proof in Australian law that these lands belong to the Gurindji people. And through Vincent's fingers poured a handful of sandFrom little things big things grow 50 years on, and The Wave Hill Walk Off is seen as a pivotal moment in Australia's history. It led to significant legal and social changes for First Nations people, which is something many agree is worth celebrating. First Nations Seasons Reporter: Saskia Mortarotti INTRO: Recently, Melbourne's Lord Mayor suggested ditching the four-season calendar that most of us are familiar with and adopting a six-season Wurundjeri calendar instead saying it gives a better description of what the weather's actually like there. Sas found out more about the different seasonal calendars used by First Nations people. SASKIA MORTAROTTI, REPORTER: Right now, in most of the country, it's pretty cold. COLD GIRL: Think of somewhere warm. What? It's 32 degrees in Darwin in the middle of winter? But ah, yeah. There are some places where it's, well, quite warm. Which makes you wonder whether the weather actually matches the seasons. You see, Australia is pretty big, and we have lots of different weather patterns. Which is something First Nations people have tracked for thousands of years with their own seasonal calendars. KARL WINDA TELFER, CULTURAL CREATIVE KANYANYAPILLA: Why have we got four seasons when you know that don't make any sense here. It doesn't relate to the country here. This is Karl Telfer. He's an artist and storyteller who produced the Kuri Kurru exhibition at the Museum of Discovery in Adelaide that explores the 6 different seasons of the Kaurna Meyunna. SASKIA MORTAROTTI: So, how do you know when you're in one of those six seasons? KARL WINDA TELFER: Well, there are stars that rise. So, you know, there are certain stars, like in Parnatti, for example. There's a star called Parna, and we know what that star is. So, that talks to us about, okay, the time now is going to be cold on the ground. First Nations calendars like the Kaurna one don't just tell us what's happening with the weather; they're also used to track when certain plants and animals are around. KARL WINDA TELFER: It teaches you about what plants you can, you know, what you can eat what you can't and all that what is ready certain times a year and fruit everything, bird shows you the right time to eat the fruit, perfect time, if you try and go get them the next week they're gone. Karl says we can also use these calendars to see how the environment has changed over time. KARL WINDA TELFER: Kudlilla is the season we're in now and Kudlilla that talks about like the rain but we're not having enough rain these days, well, these times. And this is due to climate and the climate changing. There are many different First Nations seasonal calendars around the country. Like Ngan'gi calendar from the Northern Territory which has 13 seasons that follow the life cycle of the native spear grass. Or the Wurundjeri Calendar in Victoria which has 6 seasons. And recently, Melbourne's Lord Mayor, Nicholas Reece, said Melbourne, or Naarm, would be better off adopting the Wurundjeri calendar because it's more in tune to what's happening with the weather. Something many, including Karl, think we should be doing right across the country. KARL WINDA TELFER: I'm talking about the English four seasons. So, this is totally different systems that we're talking about and weather patterns and currents and all sorts of different things, because it's the sea country too. So, my question is, well, why do we have that? If that doesn't work, you know? Quiz How many seasons are there in the Tiwi Island Calendar? 1, 2 or 3? It's 3, although they also have 13 minor seasons. Book Week Reporter: Wren Gillett INTRO: This week, kids across Australia have been dressing up as their favourite characters to celebrate Book Week. Wren finds out why Book Week began 80 years ago and why it's still important today for getting young Aussies into reading. STUDENT: I read an hour every night, maybe even two hours some nights. STUDENT: My favourite book series are the Harry Potter series and the Keeper of the Lost City series. STUDENT: Probably Bad Guys and Weirdo. STUDENT: I like the Amulet, I've been reading that. STUDENT: I love reading Dork Diaries and Exploding Endings. Whether it's Fantasy, mystery, history — whatever you're into. Book week is a time to celebrate, well, books. STUDENT: Me and my friends are dressing up as Inside Out. STUDENT: I was thinking SpongeBob. STUDENT: I'm dressing up as Winnie the Pooh and it's just a fun way to express what kind of books you like. And guess what, book week has actually been a thing for many, many years. WREN GILLETT, REPORTER: Once upon a time, in a land not so far away, literacy lovers noticed a problem. The year was 1945. The second World War had just ended, and kids were mainly reading books from overseas, in particular the UK. Because, at the time, there weren't many Aussie authors writing books for children. WREN GILLETT: So, a group of passionate teachers, librarians, booksellers, publishers, and book-loving volunteers, decided to create what we now know as The Children's Book Council of Australia. Familiar logo, right? Together, they launched book week, all in an effort to get Aussie kids' reading more. And it seemed to work. The 1960s saw a boom in Australian children's books being published. REPORTER: How many books do you read a week? STUDENT: Well, it really depends on the week. If there's exams, I might read only one or two. But if there's no exams and if I've got plenty of time, I might read up to five or six. WREN GILLETT: But today, it's a slightly different story. Studies show that less than one in five eight to 18-year-olds are reading in their free time, and that only one in three actually enjoy reading for fun. WREN GILLETT: Why do you reckon we're seeing this trend? STUDENT: People are getting sucked into screens and they're like spending hours just scrolling through TikTok and stuff, and they're getting so attached to it that they don't feel the need to pick up books and read them. Yeah, there's a lot of different things competing for our attention these days, but many think books are still worth our time. PETER HELLIER, AUSSIE COMEDIAN AND AUTHOR: Books are the exact opposite of boring. And if you think they're boring, I'm sorry, but you're wrong. This is Peter Hellier, he's a pretty famous Aussie comedian, actor, and the author behind these books. And he's just released another one called Detective Galileo, about a trail horse who dreams of solving crimes. PETER HELLIER: He joins the police force and quickly finds out that the horses don't actually solve the crimes, it's the police officers who solve the crime. So he promptly gets thrown out of the force and begins his own detective agency, which I'm reliably told is the only detective agency in the world run by a horse. Peter actually started writing books when he was a kid. PETER HELLIER: I started writing when I was six, seven, eight years old. In fact, I started my own publishing company called Better Books. And I would write these books, and then I would get a parent or one of my parents or teachers to type them up. And I would read them in front of the class. And, you see, each has the logo, the Better Books logo, there it is — the famous Better Books logo. WREN GILLETT: You weren't mucking around. PETER HELLIER: There all on all of them. There we go. There we go. Many, Including Peter, say there's plenty to get from a good book. They help us learn new words and phrases, get a better understanding of the world around us, and strengthen our imaginations. PETER HELLIER: Books can take you absolutely anywhere. They can take you to countries that you never dreamed about going. Countries that exist, countries that don't exist. Reading just makes the world a much bigger place. It's why for the past 80 years, schools around the country have been taking part in book week. STUDENT: Reading is a place where you can have your own world just to yourself. STUDENT: It's like watching a movie inside your head, but you can choose how it goes. STUDENT: Picking up a book is a good idea, maybe you should start with something that you're interested with and then you can start exploring from there. Quiz What is the title of the book that took out this year's Book of the year Award for younger readers? It's Laughter is the Best Endingby Maryam Master. Some other winners included I'm not really here by Gary Loneborough which took out book of the year for older readers and best picture book went to The Truck Cat, by Deborah Frenkel. Sport Australia's men's national basketball team — the Boomers — have won their third Asia Cup in a row, with an epically narrow victory over China. COMMENTATOR: It is Australia who are celebrating! China started strong, leading 25-17 at quarter time. But Aussie Xavier Cooks led a fierce comeback, shooting 30 points and collecting nine rebounds, earning him the title of MVP. And there seriously couldn't have been a tighter finish. Just as the final buzzer went off, China missed a shot that would have won them the game, leaving Australia with a 90-89 victory. COMMENTATOR: An unbelievable finish. The 2025 AFLW season kicked off last week, and so did a new trick. Yeah, 19-year-old Ash Centra from Collingwood, pulled out this move in the warm-up before their season-opener to Carlton, and since then, a lot of people have been trying to do it, with some success, kind of? FOOTY PLAYER: No, I'm not doing it on camera. But despite the epic warmup, Carlton did end up beating Collingwood by 24 points. Now, the moves from these athletes in China weren't quite so graceful but give 'em a break, okay, they're robots. For the first time ever, humanoid robots from all over the world, competed in their very own games, which featured, soccer, boxing, running, and ahh, lots of falling over. Lots. Luckily though, they did bring their own cheer squad. Young Rapper Reporter: Rylie INTRO: Finally, we're going to meet another winner of this year's Heywire competition — which asks young people in regional areas to share their stories. Rylie's going to tell us how music helped to transform his life. Check it out. Mum and I were homeless. We lived at a caravan park, in motels and tents around Warrnambool. It wasn't pretty. I'm First Nations, and I remember feeling like, my own country is failing me right now. So, we camped right along here. I remember pitching a tent right here and this was actually around the same time I started to get into music which was a good way for me to have something to look forward to. I was raised by the SoundCloud era, listening to a lot of trap music. When I was in school, I'd rap along to songs by Juice World, then I started to make my own. My first track was recorded on my phone. It was bad but a lot of fun to make. Some kids in my school heard it and shamed me. That put me off music for the next couple of years, until a friend of mine bought a microphone and encouraged me to give it another go. There was something about that mic and the energy of the crew around me that gave me confidence. It lit a fire in me. Over time, I was able to focus my flow. My songs are about escapism, living the life, being a success. I rap about stuff that takes me to a better place in my head. I'm manifesting my future. My stage name is Hundo Milli, it's short for hundreds of millions. Money's not really the end goal; it's more about having the freedom to dream big. Mum taught me to never stop believing. Even when times were tough, she kept pushing for us to get housing and eventually we did. We're some of the lucky ones. Today, I'm in a Melbourne studio recording my next single. I remember living in my tent dreaming about this very moment and now I'm here, doing what I love. Ain't nothing going to stop me. Closer Well, that's all we've got for you today, but we'll be back before you know it. In the meantime, you can head to our website, there's plenty to see and do. You can also catch Newsbreak every weeknight and there's BTN High for all you highschoolers out there. Have an awesome week and I'll see you next time. Bye.Chore a household task, such as washing dishes; often assigned to children by their parents livestock farm animals rasp to make a rough, grating sound hope a wish for something to happen the way you want it to lard soft fat from a pig that is used for cooking neigh a soft, low sound made by a horse ribs the bones that protect your heart and lungs wheat the grain from grass that is used to make bread point of view the perspective from which a story is told first, second, third person the type of perspective (1st - I, me; 2nd - you; 3rd - he, she, they) narrator the person telling a story hurricane a large, powerful storm that starts over the ocean and brings in heavy rain and high winds to the land last resort a final chance to go for help levee a long wall built along a river to stop flooding; can be made of soil, rocks or concrete shelter a place where people can get food and a place to sleep when a storm threatens their home frond a large, long leaf Chinatown a part of a city that was historically home to Chinese immigrants conflict a serious disagreement society people living together in a community chaos a state of complete confusion; actions and events are out of control deport to force someone to leave a country because the person is not a citizen mass a large number of people resident someone who lives in a place status the position of a person according to the law informative a text that gives facts about something opinion a view of something based on feelings, not facts chart a visual that gives information about a topic aloft in the air plains a large area of flat land without trees researcher a person who gathers facts about a topic scale a range of numbers used as a system to measure or compare things twister another name for a tornado; a storm in which wind forms a tube that moves along the ground at high speeds and often causes damageSure! Here's a solid list of **AP English Literature vocabulary**—terms that often come up in class, essays, and the AP exam. I'll break it down into categories to make it easier to study. --- ### 📚 **Literary Devices & Techniques** 1. **Alliteration** – Repetition of initial consonant sounds 2. **Allusion** – A reference to another text, event, or figure 3. **Anaphora** – Repetition of a word or phrase at the beginning of successive clauses 4. **Antithesis** – Contrast of ideas in a balanced or parallel construction 5. **Apostrophe** – Addressing someone absent, dead, or nonhuman as if present and able to respond 6. **Assonance** – Repetition of vowel sounds within nearby words 7. **Asyndeton** – Omission of conjunctions between parts of a sentence 8. **Consonance** – Repetition of consonant sounds, often at the end of words 9. **Diction** – Word choice (formal, informal, colloquial, etc.) 10. **Enjambment** – Continuation of a sentence without pause beyond the end of a line in poetry --- ### 🧠 **Figurative Language** 1. **Hyperbole** – Extreme exaggeration 2. **Imagery** – Descriptive language that appeals to the senses 3. **Irony** - *Verbal*: Saying the opposite of what’s meant - *Situational*: When the outcome is the opposite of what's expected - *Dramatic*: Audience knows something characters don’t 4. **Metaphor** – A direct comparison without using "like" or "as" 5. **Metonymy** – Substituting the name of one thing with something closely related (e.g. "The crown" for royalty) 6. **Synecdoche** – A part representing the whole (e.g. "All hands on deck") 7. **Personification** – Giving human traits to nonhuman things 8. **Simile** – A comparison using "like" or "as" 9. **Symbol** – An object, character, or color that represents something beyond itself --- ### ✍️ **Poetic & Rhetorical Terms** 1. **Caesura** – A pause in a line of poetry, often marked by punctuation 2. **Couplet** – Two lines of poetry that usually rhyme 3. **Iambic Pentameter** – A line with five iambs (unstressed-stressed syllables) 4. **Blank Verse** – Unrhymed iambic pentameter 5. **Free Verse** – Poetry with no fixed meter or rhyme 6. **Elegy** – A mournful poem, often for the dead 7. **Ode** – A lyric poem expressing emotion, often in honor of something 8. **Sonnet** – A 14-line poem with a specific rhyme scheme (Shakespearean or Petrarchan) --- ### 📖 **Narrative & Structure Terms** 1. **Tone** – The author's attitude toward the subject 2. **Mood** – The feeling or atmosphere the reader experiences 3. **Theme** – The central idea or message in a work 4. **Motif** – A recurring element that has symbolic significance 5. **Foil** – A character who contrasts with another character to highlight traits 6. **Foreshadowing** – Clues or hints about what will happen later 7. **Juxtaposition** – Placing two elements side by side to present a contrast 8. **Point of View** – Perspective from which the story is told (1st, 2nd, 3rd person) 9. **Stream of Consciousness** – Narrative style that mimics thoughts and feelings 10. **Frame Narrative** – A story within a story --- Want me to make flashcards, a quiz, or a PDF study guide with these? Or need help using them in a literary analysis essay?Early society and accomplishments Origins Knowledge of the early prehistory of Southeast Asia has undergone exceptionally rapid change as a result of archaeological discoveries made since the 1960s, although the interpretation of these findings has remained the subject of extensive debate. Nevertheless, it seems clear that the region has been inhabited from the earliest times. Hominid fossil remains date from approximately 1,500,000 years ago and those of Homo sapiens from approximately 40,000 years ago. Furthermore, until about 7000 bce the seas were some 150 feet (50 metres) lower than they are now, and the area west of Makassar Strait consisted of a web of watered plains that sometimes is called Sundaland. These land connections perhaps account for the coherence of early human development observed in the Hoabinhian culture, which lasted from about 13,000 to 5000 or 4000 bce. The stone tools used by hunting and gathering societies across Southeast Asia during this period show a remarkable degree of similarity in design and development. When the sea level rose to approximately its present level about 6000 bce, conditions were created for a more variegated environment and, therefore, for more extensive differentiation in human development. While migration from outside the region may have taken place, it did not do so in a massive or clearly punctuated fashion; local evolutionary processes and the circulation of peoples were far more powerful forces in shaping the region’s cultural landscape. Technological developments and population expansion Perhaps because of a particular combination of geophysical and climatic factors, early Southeast Asia did not develop uniformly in the direction of increasingly complex societies. Not only have significant hunting and gathering populations continued to exist into the 21st century, but the familiar cultural sequences triggered by such events as the discovery of agriculture or metallurgy do not seem to apply. This is not to say that the technological capabilities of early Southeast Asian peoples were negligible, for sophisticated metalworking (bronze) and agriculture (rice) were being practiced by the end of the 3rd millennium bce in northeastern Thailand and northern Vietnam, and sailing vessels of advanced design and sophisticated navigational skills were spread over a wider area by the same time or earlier. Significantly, these technologies do not appear to have been borrowed from elsewhere but were indigenous and distinctive in character. Austronesian languages Austronesian languagesMajor divisions of the Austronesian languages. These technological changes may partially account for two crucial developments in Southeast Asia’s later prehistory. The first is the extraordinary seaborne expansion of speakers of Proto-Austronesian languages and their descendants, speakers of Austronesian (or Malayo-Polynesian) languages, which occurred over a period of 5,000 years or more and came to encompass a vast area and to stretch nearly half the circumference of Earth at the Equator. This outward movement of people and culture was evolutionary rather than revolutionary, the result of societal preference for small groups and a tendency of groups to hive off once a certain population size had been reached. It began as early as 4000 bce, when Taiwan was populated from the Asian mainland, and subsequently it continued southward through the northern Philippines (3rd millennium bce), central Indonesia (2nd millennium bce), and western and eastern Indonesia (2nd and 1st millennia bce). From approximately 1000 bce on the expansion continued both eastward into the Pacific, where that immense region was populated in a process continuing to about 1000 ce as voyagers reached the Hawaiian Islands and New Zealand, and westward, where Malay peoples reached and settled the island of Madagascar sometime between 500 and 700 ce, bringing with them (among other things) bananas, which are native to Southeast Asia. Thus, for a considerable period of time, the Southeast Asian region contributed to world cultural history, rather than merely accepting outside influences, as frequently has been suggested. The second development, which began possibly as early as 1000 bce, centred on the production of fine bronze and the fashioning of bronze-and-iron objects, particularly as they have been found at the site in northern Vietnam known as Dong Son. The earliest objects consisted of socketed plowshares and axes, shaft-hole sickles, spearheads, and such small items as fishhooks and personal ornaments. By about 500 bce the Dong Son culture had begun producing the bronze drums for which it is known. The drums are large objects (some weigh more than 150 pounds [70 kg]), and they were produced by the difficult lost-wax casting process and decorated with fine geometric shapes and depictions of animals and humans. This metal industry was not derived from similar industries in China or India. Rather, the Dong Son period offers one of the most powerful—though not necessarily the only or earliest—examples of Southeast Asian societies transforming themselves into more densely populated, hierarchical, and centralized communities. Since typical drums, either originals or local renditions, have been found throughout Southeast Asia and since they are associated with a rich trade in exotics and other goods, the Dong Son culture also suggests that the region as a whole consisted not of isolated, primitive niches of human settlement but of a variety of societies and cultures tied together by broad and long-extant trading patterns. Although none of these societies possessed writing, some displayed considerable sophistication and technological skill, and, although none appears to have constituted a territorial centralized state, new and more complex polities were forming.Hi, I'm John Green, this is Crash Course U.S. History, and today, we're going to talk about slavery, which is not funny. 0:06 Yeah, so we put a lei on the eagle to try and cheer you up, but let's face it, this is going to be depressing. 0:10 With slavery, every time you think, like, "Aw, it couldn't have been that bad," it turns out to have been much worse. 0:14 Mr. Green, Mr. Green! But what about – 0:15 Yeah, Me from the Past, I'm going to stop you right there, because you're going to embarrass yourself. Slavery was hugely important to America. 0:20 I mean, it led to a civil war and it also lasted what, at least in U.S. history, counts as a long-ass time, from 1619 to 1865. 0:29 And yes, I know there's a 1200-year-old church in your neighborhood in Denmark, but we're not talking about Denmark! 0:35 But slavery is most important because we still struggle with its legacy. 0:38 So, yes, today's episode will probably not be funny, but it will be important. 0:42 [Theme Music] North & South economic ties 0:51 So the slave-based economy in the South is sometimes characterized as having been separate from the Market Revolution, but that's not really the case. 0:57 Without southern cotton, the North wouldn't have been able to industrialize, at least not as quickly, because cotton textiles were one of the first industrially products. 1:04 And the most important commodity in world trade by the nineteenth century, and 3/4 of the world's cotton came from the American South. 1:11 And speaking of cotton, why has no one mentioned to me that my collar has been half popped this entire episode, like I'm trying to recreate the Flying Nun's hat. 1:18 And although there were increasingly fewer slaves in the North as northern states outlawed slavery, cotton shipments overseas made northern merchants rich. 1:26 Northern bankers financed the purchase of land for plantations. 1:29 Northern insurance companies insured slaves who were, after all, considered property, and very valuable property. 1:35 And in addition to turning cotton into cloth for sale overseas, northern manufacturers sold cloth back to the South, where it was used to clothe the very slaves who had cultivated it. 1:45 But certainly the most prominent effects of the slave-based economy were seen in the South. Slave-based agriculture in the South 1:49 The profitability of slaved-based agriculture, especially King Cotton, meant that the South would remain largely agricultural and rural. 1:56 Slave states were home to a few cities, like St. Louis and Baltimore, but with the exception of New Orleans, 2:00 almost all southern urbanization took place in the upper South, further away from the large cotton plantations. 2:06 And slave-based agriculture was so profitable that it siphoned money away from other economic endeavors. 2:11 Like, there was very little industry in the South. 2:13 It produced only 10% of the nation's manufactured goods. 2:16 And, as most of the capital was being plowed into the purchase of slaves, there was very little room for technological innovation, like, for instance, railroads. 2:23 This lack of industry and railroads would eventually make the South suck at the Civil War, thankfully. 2:27 In short, slavery dominated the South, shaping it both economically and culturally, and slavery wasn't a minor aspect of American society. Popular attitudes concerning slavery 2:35 By 1860, there were four million slaves in the U.S., and in the South, they made up one third of the total population. 2:42 Although in the popular imagination, most plantations were these sprawling affairs with hundreds of slaves, 2:47 in reality, the majority of slaveholders owned five or fewer slaves. 2:51 And, of course, most white people in the South owned no slaves at all, though, if they could afford to, they would sometimes rent slaves to help with their work. 2:57 These were the so-called yeoman farmers who lived self-sufficiently, raised their own food, and purchased very little in the Market Economy. 3:04 They worked the poorest land and, as a result, were mostly pretty poor themselves. 3:08 But even they largely supported slavery, partly, perhaps, for aspirational reasons, and partly because the racism inherent to the system gave even the poorest whites legal and social status. 3:18 And southern intellectuals worked hard to encourage these ideas of white solidarity and to make the case for slavery. 3:23 Many of the founders, a bunch of whom you'll remember, held slaves, saw slavery as a necessary evil. 3:29 Jefferson once wrote, quote, "As it is, we have the wolf by the ear, and we can neither hold him, nor safely let him go. 3:37 Justice is on one scale, and self-preservation in the other." 3:41 The belief that justice and self-preservation couldn't sit on the same side of the scale was really opposed to the American idea, 3:47 and, in the end, it would make the Civil War inevitable. 3:50 But as slavery became more entrenched in these ideas of liberty and political equality were embraced by more people, 3:55 some southerners began to make the case that slavery wasn't just a necessary evil. 3:59 They argued, for instance, that slaves benefited from slavery. 4:03 Because, you know, because their masters fed them and clothed them and took care of them in their old age. 4:07 You still hear this argument today, astonishingly. 4:09 In fact, you'll probably see asshats in the comments saying that in the comments. 4:12 I will remind you, it's not cursing if you are referring to an actual ass. 4:15 This paternalism allowed masters to see themselves as benevolent and to contrast their family-oriented slavery with the cold, mercenary Capitalism of the free-labor North. 4:26 So yeah, in the face of rising criticism of slavery, some southerners began to argue that the institution was actually good for the social order. 4:33 One of the best-known proponents of this view was John C. Calhoun, who, in 1837, said this in a speech on the Senate floor: 4:40 "I hold that, in the present state of civilization, 4:43 where two races of different origin and distinguished by color and other physical differences as well as intellectual, are brought together, 4:51 the relation now existing in the slave-holding states between the two is, instead of an evil, a good. A positive good." 4:59 Now, of course, John C. Calhoun was a fringe politician, and nobody took his views particularly seriously. 5:04 Stan: Well, he was Secretary of State from 1844 to 1845. 5:07 John: Well, I mean, who really cares about the Secretary of State, Stan? 5:10 Danica: Eh, he was also Secretary of War from 1817 to 1825. 5:13 John: All right, but we don't even have a Secretary of War anymore, so... 5:16 Meredith: And he was Vice President from 1825 to 1832. 5:19 John: Oh my god, were we insane?! 5:21 We were, of course, but we justified the insanity with Biblical passages and with the examples of the Greeks and Romans, 5:28 and with outright racism, arguing that black people were inherently inferior to whites. 5:33 And that not to keep them in slavery would upset the natural order of things. 5:37 A worldview popularized millennia ago by my nemesis, Aristotle. God, I hate Aristotle. 5:42 You know what defenders of Aristotle always say? 5:44 "He was the first person to identify dolphins." 5:47 Well, ok, dolphin identifier. 5:50 Yes, that is what he should be remembered for, but he's a terrible philosopher! Lives & experiences of enslaved people 5:53 Here's the truth about slavery: 5:55 It was coerced labor that relied upon intimidation and brutality and dehumanization. 6:00 And this wasn't just a cultural system, it was a legal one. 6:03 I mean, Louisiana law proclaimed that a slave "owes his master... a respect without bounds, and an absolute obedience." 6:09 The signal feature of slaves' lives was work. 6:12 I mean, conditions and tasks varied, but all slaves labored, usually from sunup to sundown, and almost always without any pay. 6:20 Most slaves worked in agriculture on plantations, and conditions were different, depending on which crops are grown. 6:25 Like, slaves on the rice plantations of South Carolina had terrible working conditions, 6:29 but they labored under the task system, which meant that once they had completed their allotted daily work, they would have time to do other things. 6:36 But lest you imagine this is like how we have work and leisure time, bear in mind that they were owned and treated as property. 6:42 On cotton plantations, most slaves worked in gangs, usually under the control of an overseer, or another slave who was called a "driver." 6:49 This was back-breaking work done in the southern sun and humidity, and so it's not surprising that whippings – or the threat of them – were often necessary to get slaves to work. 6:58 It's easy enough to talk about the brutality of slave discipline, but it can be difficult to internalize it. 7:03 Like, you look at these pictures, but because you've seen them over and over again, they don't have the power they once might have. 7:09 The pictures can tell a story about cruelty, but they don't necessarily communicate how arbitrary it all was. 7:14 As, for example, in this story, told by a woman who was a slave as a young girl: 7:18 "[The] overseer... went to my father one morning and said, "Bob, I'm gonna whip you this morning." 7:22 Daddy said, "I ain't done nothing," and he said, "I know it, I'm going to whip you to keep you from doing nothing," 7:28 and he hit him with that cowhide – you know it would cut the blood out of you with every lick if they hit you hard." 7:33 That brutality – the whippings, the brandings, the rape – was real, and it was intentional, because, in order for slavery to function, slaves had to be dehumanized. 7:43 This enabled slaveholders to rationalize what they were doing, and it was hoped to reduce slaves to the animal property that is implied by the term "chattel slavery." 7:51 So the idea was that slaveholders wouldn't think of their slaves as human, and slaves wouldn't think of themselves as human. 7:57 But it didn't work. Let's go to the Thought Bubble. 7:59 Slaves' resistance to their dehumanization took many forms, but the primary way was by forming families. Family, love, & religion of enslaved people 8:05 Family was a refuge for slaves and a source of dignity that masters recognized and sought to stifle. 8:10 A paternalistic slave owner named Bennet H. Barrow wrote in his rules for the Highland Plantation: 8:15 "No rule that I have stated is of more importance than that relating to Negroes marrying outside of the plantation... It creates a feeling of independence." 8:23 Most slaves did marry, usually for life, and, when possible, slaves grew up in two-parent households. 8:28 Single-parent households were common, though, as a result of one parent being sold. 8:32 In the upper South, where the economy was shifting from tobacco to different, less labor-intensive cash crops, the sale of slaves was common. 8:40 Perhaps one-third of slave marriages in states like Virginia were broken up by sale. 8:45 Religion was also an important part of life in slavery. 8:47 While masters wanted their slaves to learn the parts of the Bible that talked about being happy in bondage, 8:52 slave worship tended to focus on the stories of Exodus, where Moses brought the slaves out of bondage, 8:57 or Biblical heroes, who overcame great odds, like Daniel and David. 9:01 And, although most slaves were forbidden to learn to read and write, many did anyway. And some became preachers. 9:07 Slave preachers were often very charismatic leaders, and they roused the suspicion of slave owners, and not without reason. 9:13 Two of the most important slave uprisings in the South were led by preachers. 9:16 Thanks, Thought Bubble. 9:17 Oh, it's time for the Mystery Document? Mystery Document 9:19 We're doing two set pieces in a row? All right. [buzzing noise] [music] 9:24 The rules here are simple. 9:26 I wanted to re-shoot that, but Stan said no. 9:29 I guess the author of the Mystery Document. 9:30 If I am wrong, I get shocked with the shock pen. 9:33 "Since I have been in the Queen's dominions I have been well contented, yes well contented for sure, man is as God intended he should be. 9:40 That is, all are born free and equal. 9:43 This is a wholesome law, not like the southern laws which puts man made in the image of God on level with brutes. 9:49 O, what will become of the people, and where will they stand in the day of judgment. 9:53 Would that the 5th verse of the 3rd chapter of Malachi were written as with a bar of iron, 9:59 and the point of a diamond upon every oppressor's heart that they might repent of this evil, and let the oppressed go free..." 10:06 All right, it's definitely a preacher, because only preachers have read Malachi. 10:10 Probably African American, probably not someone from the South. 10:13 I'm going to guess that it is Richard Allen, the founder of the African Methodist Episcopal Church? 10:18 [buzzing noise] DAAAH, DANG IT! 10:19 It's Joseph Taper, and Stan just pointed out to me that I should have known it was Joseph Taper because it starts out, 10:24 "Since I have been in the Queen's dominions..." 10:27 He was in Canada. He escaped slavery to Canada. The Queen's dominions! 10:31 All right, Canadians, I blame you for this, although, thank you for abolishing slavery decades before we did. 10:36 [electric sounds] AHHH! How people resisted & escaped slavery 10:37 So, the Mystery Document shows one of the primary ways that slaves resisted their oppression: by running away. 10:42 Although some slaves like Joseph Taper escaped for good by running away to northern free states, 10:47 or even to Canada, where they wouldn't have to worry about fugitive slave laws, even more slaves ran away temporarily, hiding out in the woods or the swamps, and eventually returning. 10:55 No one knows exactly how many slaves escaped to freedom, but the best estimate is that a thousand or so a year made the journey northward. 11:01 Most fugitive slaves were young men, but the most famous runaway has been hanging out behind me all day long: Harriet Tubman. 11:07 Harriet Tubman escaped to Philadelphia at the age of 29, and over the course of her life, she made about 20 trips back to Maryland to help friends and relatives make the journey north on the Underground Railroad. 11:17 But a more dramatic form of resistance to slavery was actual, armed rebellion, which was attempted. 11:22 Now, individuals sometimes took matters into their own hands and beat or even killed their white overseers or masters. 11:27 Like Bob, the guy who received the arbitrary beating, responded to it by killing his overseer with a hoe. 11:33 But that said, large-scale slave uprisings were relatively rare. 11:36 The four most famous ones all took place in a 35-year period at the beginning of the 19th century. Slave rebellions 11:41 Gabriel's Rebellion in 1800 – which we've talked about before – was discovered before he was able to carry out his plot. 11:45 Then, in 1811, a group of slaves upriver from New Orleans seized cane, knives, and guns, and marched on the city before militia stopped them. 11:52 And in 1822, Denmark Vesey, a former slave who had purchased his freedom, may have organized a plot to destroy Charleston, South Carolina. 11:59 I say "may have" because the evidence against him is disputed and comes from a trial that was not fair. 12:05 But regardless, the end result of that trial was that he was executed, as were 34 slaves. Nat Turner's Rebellion 12:09 But the most successful slave rebellion, at least in the sense that they actually killed some people, was Nat Turner's in August 1831. 12:15 Turner was a preacher, and with a group of about 80 slaves, he marched from farm to farm in South Hampton County, Virginia, 12:21 killing the inhabitants, most of whom were women and children, because the men were attending a religious revival meeting in North Carolina. 12:27 Turner and 17 other rebels were captured and executed, but not before they struck terror into the hearts of whites all across the American South. 12:34 Virginia's response was to make slavery worse, passing even harsher laws that forbade slaves from preaching, and prohibited teaching them to read. 12:42 Other slave states followed Virginia's lead and, by the 1830s, slavery had grown, if anything, more harsh. 12:47 So, this shows that large-scaled armed resistance was – Django Unchained aside – not just suicidal, but also a threat to loved ones and, really, to all slaves. How enslaved people resisted their oppression & why it matters 12:55 But, it is hugely important to emphasize that slaves did resist their oppression. 12:59 Sometimes this meant taking up arms, but usually it meant more subtle forms of resistance, 13:03 like intentional work slowdowns or sabotaging equipment, or pretending not to understand instructions. 13:08 And, most importantly, in the face of systematic legal and cultural degradation, they re-affirmed their humanity through family and through faith. 13:16 Why is this so important? 13:17 Because too often in America, we still talk about slaves as if they failed to rise up, 13:21 when, in fact, rising up would not have made life better for them or for their families. 13:26 The truth is, sometimes carving out an identity as a human being in a social order that is constantly seeking to dehumanize you, is the most powerful form of resistance. 13:34 Refusing to become the chattel that their masters believed them to be is what made slavery untenable and the Civil War inevitable, so make no mistake, slaves fought back. 13:45 And in the end, they won. I'll see you next week. Credits 13:48 Crash Course is produced and directed by Stan Muller. 13:50 The script supervisor is Meredith Danko. 13:52 Our associate producer is Danica Johnson. 13:54 The show is written by my high school history teacher Raoul Meyer and myself. 13:57 And our graphics team is Thought Cafe. 13:58 Every week, there's a new caption to the Libertage, but today's episode was so sad that we couldn't fit a Libertage in... 14:04 UNTIL NOW! [Libertage Rock Music] 14:08 Suggest Libertage caption in comments, where you can also ask questions about today's video that will be answered by our team of historians. 14:13 Thanks for watching Crash Course, and as we say in my home town, don't forget to be abolitionist.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 Drug Alpha1 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 Drugs Alpha 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 Inhibitors aka 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 HTN Treatment 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)