There are several Ethical models for behavior. The virtues model

is often reflected in professional or corporate codes.

balances the rights of different parties in a business transaction.

is always limited to a few elements.

Phil Anderson didn't inform his client about all the risks and costs of the financial product he sold. This kind of unethical behavior is mostly trigged by

the result controls of the company, including the rewards for achieving sales targets.

the code of conduct of the company.

the aggressive sales training of employees.

the lack of action controls around sales.

An effective way of spreading good ethics during the start up stage of a company, is

the use of detailed rules and procedures.

Why are 'too good' controls like surveillance cameras sometimes unethical?

It's a violation of the right to autonomy and privacy of employees.

This gelt only if the camera images are kept too long.

It's too expensive, so its costs shareholders money.

It may lead to manager's myopia.

In which case is creating of budget slack unethical?

When the manager's intent in creating budget slack reflects only self-interest.

When the amount of slack is not material.

When budget targets are flexible and targets are adapted to the circumstances.

When the superiors of the manager are aware of the budget slack.

Management control related ethical issues

Administrative jobs involve performing administrative roles that support workers in the agriculture industry. b. Engineering jobs involve using high-level science and math to solve complex problems. Professionals, evaluate, design, test and install agricultural equipment and systems. c. Labor jobs require workers to perform manual tasks such as planting, harvesting, caring for animals and maintaining equipment Sales jobs are performed by professionals who are responsible for selling materials and products to customers. e. Science jobs are those of scientists who work in agriculture and specialize in crops, livestock or food production. Agricultural Jobs: a. Farm workers perform essential manual labor tasks under the supervision of farmers and ranchers. They harvest or inspect crops, assist in watering the plants, applying fertilizer and pesticides to control weeds and insects. b. Growers are responsible for taking care and raising crops that involves proper management of the growing plants and its environment to keep the crops/plants healthy. c. Grain Elevator operators assist in maintaining essential quality standards of grains by properly storing, shipping and purchasing grains. They receive incoming grain deliveries, store the grain safely and they may assist in preparing outgoing shipments, drying grain and blending different grain types. d. Agricultural equipment technicians maintain, install and repair machines and implements. They perform preventive maintenance, which may involve refueling machines, replacing batteries, changing the oil and lubricating moving parts. When they detect a malfunctioning equipment, they perform diagnostic tests and conduct necessary repairs. e. Purchasing agents are responsible for buying agricultural products and raw materials at wholesale for processing and reuse. These professionals often have to meet specific purchasing quotas for processors. They work with several farming clients, who serve as suppliers of grain, milk and other agricultural products. f. Farm warehouse managers are responsible for overseeing all activities related to storing, shipping and receiving agricultural materials. They send and receive shipments, including loading and unloading products and materials Agriculture specialists perform administrative support and clerical tasks that focus on a certain aspect of farming. Some agriculture specialists focus on storage, which requires them to work with farmers to develop high-performing crop and grain storage and inventory systems. h. Sales representatives sell materials and products to businesses and government agencies. They seek out prospective customers by attending trade shows, reviewing customer lists and following leads from existing clients. They determine customers' needs, explain how their products meet clients' needs and create packages that meet customers' budgetary and timeline needs. i. Crop managers oversee the many steps in the crop production process. They supervise seed sourcing, planting processes and scheduling as well as fertilizing, irrigation and harvesting. j. Environmental engineers use science and engineering principles to design and apply solutions to problems that occur on agricultural sites. They assess environmental conditions—including testing soil and analyzing drainage capabilities—and develop improvements. k. Feed mill managers supervise the production and storage of animal feed. They are responsible for monitoring inventory levels, scheduling feed production and inspecting the quality of the grain. These professionals set and maintain quality standards, assess and improve operating procedures and track customer complaints. l. Research scientists who specialize in agriculture often work as food scientists, who research and develop processes for manufacturing, storing and packaging food. They are responsible for developing or improving products, but some specialize in detecting contaminants or administering government regulations

New Trends in Agriculture Extension approaches Extension has been, and still is, under attack from a wide spectrum of politicians and economists over its cost and financing. As a result, Extension Systems have had to make changes, by restating the system’s mission, developing a new vision for the future, and formulating plans for the necessary transition to achieve the desired change. 1. Privatization of Agricultural Extension Service Privatization: Process of funding and delivering the extension services by private individual or organization is called Private Extension. Concept: Privatization of extension refers to services rendered in rural area & allied aspects of extension personnel working in private agencies or organization for which farmers are expected to pay a fee & it can be viewed as supplementary or alternative to public extension services (Sarvanan & Shivalinge 1980). Privatization approaches ➢ Share cropping system ➢ Village extension contract system ➢ Public extension through private delivery ➢ Service for vouchers Strengths of Private Extension System ➢ More demand - driven rather than supply – driven ➢ High quality of services in terms of satisfying information needs of clientele, trained manpower, sustained finances and resource allocation ➢ Provides for an information mix and choices available to farmers ➢ Enhanced efficiency of staff ➢ Assure continuous supply and quality agricultural products ➢ More effective because farmer can select an adviser who is the best able to help ➢ Healthy competition among service provider will lead to better quality and lower costs for service Weakness of Private Extension System ➢ Concentrate on area having favorable physical environment ➢ More face-to-face contacts (person oriented) ➢ Increased dependence of farmers and hence exploitation ➢ No education role ➢ Deprivation of small farmers ➢ Hamper the free flow of information 2. Cyber Extension or e-extension Concepts Cyber space: it is the imaginary or virtual space of computers connected with each other on Networks, across the Globe. Cyber extension: it means 'using the power of online networks, computer communications and digital interactive multimedia to facilitate dissemination of agriculture technology. Cyber Extension thus can be defined as the extension over cyber space. Important tools of cyber extension E-Mail, Telnet, File Transfer Protocol (FTP), Gopher, Archie and World Wide Web (WWW) Strengths of Cyber Extension ➢ Access to the astounding information and continuously available ➢ Information rich and instantaneously available of information ➢ Interactive communication ➢ The information is available from any point on the globe ➢ Communication is dynamic ➢ Cut steps from traditional process ➢ Save money, time and effort ➢ Multiplicity of purpose Issues and Concerns of Cyber Extension ➢ Lack of Reliable Telecom Infrastructure in Rural Areas ➢ Erratic or no Power Supply ➢ Lack of ICT Trained manpower (willing to serve) in Rural Areas ➢ Lack of content (locally relevant and in local languages) ➢ Lack of Information Services to Rural Clientele ➢ Low Purchasing power of the Rural communities ➢ Lack of Holistic Approaches ➢ Issues of Sustainability Application of cyber extension ➢ Village information shops Dr. M.S. SwaminathanResearch Foundation, Chennai ➢ Information villagers MANAGE in Ranga Reddy District in Andhra pradesh ➢ Gyandoot net initiative of District Dhar, Madhya Pradesh. ➢ Warna wired village of National Informatics Center (NIC) in Kolhapur- Sangli Districts of Maharashtra 3. Market-Led-Extension (MLE) Concepts Market: A congregation of prospective buyers & sellers with a common motive of trading a particular commodity. Extension: It is the spreading/reaching out to the mass Market-led-extension: Agriculture & economics coupled with extension is the perfect blend for reaching at the door steps of common man with the help of technology. Dimensions of market-led extension ➢ Marketing mix: A planned mix of the controllable elements of a product's marketing plan commonly termed as 4Ps: product, price, place, and promotion. These four elements are adjusted until the right combination is found that serves the needs of the product's customers, while generating optimum income. ➢ Marketing plan: A marketing plan is a comprehensive document that outlines a business and marketing efforts for the coming year. It describes business activities involved in accomplishing specific marketing objectives within a set time frame. A marketing plan also includes a description of the current marketing position of a business, a discussion of the target market and a description of the marketing mix that a business will use to achieve their marketing goals. ➢ Market Intelligence: It is the information relevant to a company’s markets, gathered and analyzed specifically for the purpose of accurate and confident decision making. Market intelligence includes the process of gathering data from the company’s external environment, whereas the business intelligence process is primarily based on internal recorded events – such as sales, shipments and purchases. ➢ Market oriented production ➢ Use of Technology Strengths of market-led extension ➢ SWOT analysis of the market ➢ Organization of Farmers’ Interest Groups (FIGs) ➢ Enhancing the interactive and communication skills of the farmers ➢ Establishing marketing and agro-processing linkages ➢ Advice on product planning ➢ Educating the farming community ➢ Direct marketing ➢ Acquiring complete market intelligence ➢ Publication of agricultural market information Production of video films of success stories ➢ Challenges to market-led extension ➢ Gigantic size of extension system ➢ Information technology Diverse conditions ➢ Market intelligence ➢ Reforms in agricultural extension system Government Initiatives ➢ Central warehousing Corporation-1965 ➢ MSP by Commission for Agricultural Cost and Price (CACP) ➢ Food Corporation of India ➢ Then some others as: Cotton Corporation of India (CCI), Jute Corporation of India (JCI), National Dairy Development Board (NDDB), Agriculture and Processed food Export Development Authority (APEDA) etc. 4. Farmer--Led-Extension (FLE) Farmer--led-extension is defined as 'the provision of training by farmers to farmers, often through the creation of a structure of farmer promoters and farmer trainers' (Scarborough et al., 1997). Philosophy and principles ➢ Farmers and local institutions (e.g. producer organizations or village leaders) should play a key role in selecting farmer-trainers and monitoring and evaluating them. This helps make the programmes more accountable to the community or groups that they serve. ➢ Farmer-trainers are ‘of the community’; they communicate in local languages and are more sensitive to local cultures, mannerisms, farming practices, and farmers’ needs. ➢ Farmer-trainers should be selected on the basis of their skills and interest in sharing information, not just on their farming expertise. ➢ Farmer-trainers need strong linkages with and support from development agents (whether government, non-government organization (NGO), or private), the people who train and backstop them. Farmer-trainers generally serve as a complement to existing extension systems, rather than being a substitute for them. ➢ Facilitating organizations and local institutions need to be proactive in ensuring that women as well as men become farmer-trainers. ➢ Simple and appropriate reference materials should be made available to the farmer trainers. Essential Elements of Farmer--led-extension ➢ The group ➢ The Field ➢ The Facilitator ➢ The curriculum ➢ Programme leader ➢ Financing Special features of Farmer--led-extension ➢ All learning is field based & it is primary venue for learning ➢ FLE group learning constantly over the experimentation period ➢ FLE promotes healthy decisions & quality decisions ➢ Farmers conduct their own field studies with comparisons or treatments ➢ Facilitates Farmer-to-Farmer communication ➢ Field staff serve as facilitators ➢ FLE is a unique way to educate farmers ➢ It is an effective platform for sharing of experiences and collectively solving agriculture related problems. 5. Expert system Expert system is an intelligent computer program that uses knowledge and inferences procedures to solve problems (Daniel Hunt, 1986). Objectives of developing expert system ➢ To enhance the performance of agricultural extension personnel and farmer ➢ To make farming more efficient and profitable ➢ To reduce the time required in solving the problems ➢ To maintain the expert system by continuously upgrading the database Advantages of expert system ➢ Solves critical problems by making logical deductions without taking much time ➢ It combines experimental and conventional knowledge with the reasoning skills of specialists ➢ To enhance the performance of average worker to the level of an expert Limitations of expert system ➢ Expensive computer program ➢ Mostly developed not in regional languages ➢ Requires AC power and internet connection all the time ➢ Complex software requires computer skilled personnel Modules of expert system in agriculture ➢ COMAX: Integrated crop management in cotton ➢ SOYEX: Soybean oil extraction expert system ➢ PLANT/ds: Diagnosis of soybean diseases ➢ MAIZE: Maize expert system for field crop management ➢ SEMAGI: Weed control decision making in sunflowers ➢ Rice Crop Doctor: Developed by National Institute of Agricultural Extension Management (MANAGE) Difference between conventional and expert system of extension Conventional Extension ➢ Universal approachability of same information is a problem ➢ Information is given whatever is available without considering needs and resources ➢ No Cost benefit analysis ➢ Information flow depends on availability of agent ➢ Require users to draw their own conclusion from facts Expert System of Extension ➢ Universal approachability of same information is possible ➢ Information is chosen based on their needs and resources ➢ Cost benefit analysis ➢ Information through Cyber Cafe at any place at any time ➢ Conclusion is drawn based on the decision given by the expert

Abstract The main focus of this research is to discuss the perspective of the teamwork and its impaction organizational performance and success. Also highlight the Meanings of Team and its work sprit towards batter organizational performance and specific to its impact on the success of organization that provided the basis for this research study. In this research study a thoroughly focus was on organization and teamwork. The aim of this research is to deliver a participative view of teamwork in the organization, and also discourses the major issues and emphases on the recent work that opens the basis to move research onward. There is much worth in taking a more focus on the essential areas of teamwork. The team signifies the spirit and working capacity of the employees as team to bring organization to the success. The various explanations, definitions, processes, dimensions, team size and benefits etc. regarding the above topic teamwork and organizational success is highlighted. Keywords: Teamwork, Success, Organization, Performance, Work Groups, Employees Introduction It is indeed human beings have learned in their beginning of life to work together as (Team) that have made such a remarkable developments as unique specie. Human beings have experience throughout their social history, lived, loved, grow younger to older and worked together in groups said West M.A. (2012).The mutual social knowledge of living and functioning together creates connection among people, society and families. When work is done cooperatively as a team it can achieve extremely extra work than individually. Team can be defined as in the human society to live, to work and to play and to cooperate with others for particular task. According to John W. Newstrom et al (1993) “team is the process of assessing performance of workers, passing information and exploring methods to increase performance”. If observe closely, one can discover the instances of The Government: Research Journal of Political Science Supplementary Edition Vol. III 88 The Government social (teams) they are functioning either effectively or ineffectively everywhere; organizations, schools, work place, home etc. “Coordinating the events of people is like sand house, making by using a sole particles of sand” expressed Belbin, R. M.(2010). Moreover it is one of the general myths that the skill of team member is more important than their vigor, attention and determination for the tasks. Another widespread myth is that the team members are not alone accountable for the achievements or failures of their tasks the truth is that the members are the small parts in the teams and their individual abilities effect on the various results in team. The working relationships exist among team that might sight these relationships at different levels of involvement or relationships among the members as they move towards the degree of communication, integration and commitment increases. Terry L.G. et al (1980) expressed that “The skills are essential if members have to work together efficiently in complex situations, only development of skills and relationships, involvement on the task regarding the particular task might be selected for reaching at target that is considered as a definition of a team”. Team often perform higher when they work together with sprit that enable them to achieve a collective goal at the workplace, it is not only benefits to the organization also affects the workers confidence and success. Cooperating on various tasks reduces workloads for all team members and enables them to share duties or ideas. Work as a team is the part of everyone's life, as one is a member of a family team, staff team, school team, and community teams etc., so as to understand how to work effectively as a team member. Especially there is a need when task is threatened with increasingly many problems for example; the energy problem has effects on organization, family life, and social development and the multi-dimensional nature of many problems require a scientific skill based problem solving approach. Terry L.G, et al (1980) expressed that “The skills, competencies and efforts of team by setting priorities the team can have better impact on the problems solving such efforts can reduce work load, work duplication, and produce a result better than separate efforts”. There are some processes of teamwork by adopting those the objectives can be achieved easily. Le Pine, et al, (2008) identified10 teamwork processes that fall in three categories following are those. TEAMWORK PROCESSES TRANSITION PROCESSES •Mission analysis •Goal specification •Strategy formulation ACTION PROCESSES •Monitoring progress toward goals •Systems monitoring •Team monitoring and backup behavior •Coordination INTERPERSONAL PROCESSES •Conflict management •Motivation and confidence building •Affect management Team Work 89 Teamwork process reduces the work stress on every member which permits members to complete given important task of organization; teamwork offers members an opening to pledge with each other. Also it develops relations between the members who start a teamwork they usually sense appreciated on productive accomplishment of task. It may be cited one of the best instances of surgical team; where surgeon is assisted by his team; nurses, anesthetist and experts etc., everyone knows that their success depends upon the teamwork. In addition they are devoted to the aim that is human life it is easy to succeed with best teamwork. The important role of manager is the team building, trust building, confidence building, in the team to achieve the task. In the Situation where all team members contribute the task, it develops the positive relationship in the team that improves the trust of team members.“Functions effectively members of team must be flexible, committed, trusting each other and help to each other’s in the progress and the achievement of goals” Expressed Plamínek (2008). The accountability of every member in the team must be increased so that they do not let each other down therefore they do their best for the achievements of their teams. In contrast, working alone on a task the pressure is generally high in team in those cases of small confidence impacts fewer on members. Team consists on members who always vary from each other’s in skills, knowledge and abilities but working together that is an opportunity for them to gain skills and knowledge from each other’s that they had never before. Working alone on a task is a challenge and using the ideas of each other brings them to come up with a mutual resolution and the achievement of the task. Nowadays theoretical development and research has rested largely a new trend that is emerging within the organizations as an essential process of teamwork. Teamwork has brought a new move in the research and development to the inputs and outputs that bound, constrain and impact on the team processes within organizations said Ilgen, D.R. (1999). The world is changes fast, any one set of instructions can’t be sufficient, changes needs flexible members, teams and organizations so as to be effective on task. This paper suggests that in teams members must use the exclusive human abilities. Cannon B.et al (1995) has précised dimensions of teams into three categories: Team dimensions 1-Cognitions: include associations, task team-mate characteristics, team mission, objectives, norms, and resources, team role interaction patterns, skills, roles, and team orientation. 2-Skills: consist on adaptability, shared situational awareness and mutual concept to conflict resolution. 90 The Government 3-Attitudes: symbolize motivation, collective potency, shared vision, team cohesion, mutual trust, collective orientation and importance of. Teamsize Researchers have given different approvals about the best size of team as Katzenbachetet al (1993) suggested that the teams should comprise on a dozen or so members which are enough to achieve a task. Although seven is the best size of the team in the organizational practices said Scharf, A. (1989). Several views of researchers are expressed in the literatures and it is difficult to decide which better is because their opinions are based on their own observations. The team size matters in the proper output and performance however from an empirical research it is also difficult to decide the suitable team size and what to accept. This study suggests that team size has a practical link with efficacy such as few or many member shave impact on the performance but size matters. Proper size of team improves the performance maximum stated Campion M. A et al (1996).These different results are expected due to the fact that appropriate team size is required for task, environment and situation where team works. However, larger teams can also experience coordination problems that delay performance. Sheppard, J. A. (1993) expressed that the question of best team’s size is a complex one; more research is required on this topic to explain the impact of team size on given definite task. Literature Review Across many different organizations and industries teamwork is focused to increase the performance of employees’ their unity and also create work culture. Organizations those regularly develop new ideas or products using a project-based approach and assemble teams in order to focus responsibilities to achieve the object. Researchers have given dissimilar meanings of “teams”. Dyer W.G. (2007) said that “teams are groups of people who trust in cooperation, if members are expert the success of goal is more possible”. It is essential due to the problemsolving cooperation added from many minds of team members working on a resolution of problems. Team members contribute their thoughts together to make exclusive plans for dealing with problems and this unity enhance the result due to interaction, trust and teamwork. Teamwork means a "work done by several companions with each doing a part but all subordinating personal prominence to the efficiency of the whole" Merriam, (2012). In addition combined employees are expected less hostile to each other and accepting more of each other’s decisions. Unity of employees can increase the flow of work in organization. When employee’s working together as a team, they learn from each other that awareness is based on their personal experiences and from coworkers; Team Work 91 employees from different departments may acquire knowledge from each other. The main object for organizations is to hold the team effort to achieve output and quality; team is a key to achieve quality productivity. According to Maddux et al (2003) “some of the organizations have major benefits from the use of teamwork which are showed in the following chart: Benefits of Teamwork 1 Improving quality of work life for employees 2 Reducing absenteeism and increasing turnover 3 Increasing innovation and change 4 Improving organizational adaptability and flexibility A real team is mostly one where members are allowed to take decisions that how to complete task. That authority enables them to control the work process, decreases the outside control and increases the sense of duty for work. Team always feels superiority on workplace and they rely on each other’s being there. Plamínek (2008) said that “affiliation with teamwork gives member a sense of belonging, interaction and recognition of success”. These actions support to remove the sense of loneliness of team member in organization. Effective teams can also improve efficacy through communication and trust between the team members, quality of work and decrease in absenteeism contribute to positive impact on team. Involving employees in teamwork helps the organization remain open to new ideas.“The world of organizations is shifting individualism is out and collectivism is in, power is out, empowerment is in.” stated G. M. Parker (1998). This study discovers the experiences and difficulties of teamwork that employees and organizations are facing nowadays due to big transformation and enlarged globalization. In recent years a remarkable amendment has been emerged in the belief of team working organizations. The modern study has explored that the scope of teamwork have been appeared in system rooted in belief, and employees accept changes that denoting a modern organizational system. The organizations which are responsive to the changes appear to achieve greater satisfaction. Although it may be suggested that, the managers should assess the values and beliefs of their employees to play more dedicated role in the development of organization by making sprit to face the modern challenges. Organizational cultural is much significant and it has the excessive impact on the performance of organization and employees’ but it is quiet arguable topic that the culture of teamwork can be developed according to the requirement. It is difficult to specify the relationships and to assess the reliable set of values to use as they believed symbol across the entire organizations. This review study focus that 92 The Government there is a great influence of organizational culture on the assumptions, values, and beliefs on the individuals’ considerations, actions and performances and so is vice versa, through learning, and training process. However the researchers believe that the organizational setup aids to unite employees of diverse cultures and dissimilar social backgrounds, traditions and have their own beliefs to work. Creating a positive teamwork culture it has several diverse aspects are goal setting, conflict resolution, empowerment, ability to accomplish tasks, measuring output and consideration for other teamwork cultures stated Pack L, et al April 27, (2012). Team work in the organization delivers employees the wisdom of unity; understand to each other’s, and reducing conflict. In addition teamwork in organization inspires employee for impartiality by affirming that no one is ignored in the organization and all treated equally. It is known that a team in organization is bound and sincere to work with dedication to bring the success. If the employees are committed and recognize the teamwork values and its benefits, as a part of the organization they can contribute a lot to the achievement of organization. One can finds the informal instances of team at these level, family, society, community, tribe and work groups etc., and formally team appears at the level of departments, functional groups, and other organizational units. The employees feel a greater sense of achievement for being a part of an organization, if they attain team work, having freedom to work not forced. The system gives best performance to achieve recognition and credit from their managers and it will increase their effort that helps them to contribute the organizational performance. Each team batter knows about their role and how to achieve tasks. The true spirit of teamwork gives benefit to organization in maintaining its standard by which it becomes identified. The team defines its specialty, and the way it is doing task that is perceived by the organization as well as its managers and it is secured by appreciation. Employees identify what they believe; that exist in their belief system and those understandings call them to change their views to develop and raise attention towards batter performance. The literature contains sufficient definitions of teamwork and the word team is used to denote a set of generally developed as to learn collective values, attitudes and cooperation to work. The study praises that the teamwork is mostly related with the team success for instance, Wagner (1995) described that “in the team individual is less valued and group is more valued, with”. It is found in the study that individualismcollectivism both regulates the relationships between team size, standing, and cooperation that have better effects on the cooperation of individualists rather than the cooperation of collectivists. Team Work 93 Conclusion The main concentration of this research paper is to examine more in-depth the fundamental of teamwork and its effectiveness to achieve the organizational goals. Teamwork provides vast amounts of knowledge and information, cultural differences each of these building a culture of teamwork and the skill to make the valuable solutions of the problems. To work efficiently, team members need a good understanding of how to do their job, to achieve goal and for that a basic way to ensure understanding is training, then they have to be motivated to do a job. Team is a vital activity of organization, when organization desires to perform sound it has to be confident that team functions effectively. Consequently it is compulsory to know how team performs, what manners within a team happen, and how they make decisions. If there is knowhow of teamwork events, it can be effective for the tasks that they have to accomplish. Organizations build up their own culture through tradition, history and structure these values can be accepted by team workers of an organization. The values and assumptions are the vital tools of organizations and are used as guidance for team. These have to do mostly with the basic dignity and worth of all members of team and the ability, necessity for them to solve the problems and work for the positive change. Through this review study is concluded that there is a good impact of teamwork on the organizations doings and success. Subsequently in recently developed literature there is a great focus amongst the social scientists and scholars’ in their discussion on the above topic teamwork. The above study is also an evidence of little effort to assess the significance of teamwork in organizations success. teams in organiz

Introduction to Hedging Instruments: Forwards, Futures, Options, and Swaps Hedging instruments are financial tools used by businesses and investors to mitigate risk. These instruments help protect against adverse price movements in assets such as commodities, currencies, interest rates, or securities. The four main hedging instruments are forwards, futures, options, and swaps. 1. Forwards A forward contract is a customised agreement between two parties to buy or sell an asset at a predetermined price on a specified future date. Key Characteristics: Over-the-counter (OTC): Traded directly between parties, not on an exchange. Customisation: Can be tailored to suit the needs of the parties involved. Settlement: Occurs at the end of the contract, which may involve physical delivery or cash settlement. Risk: Forwards carry counter-party risk, as there is a possibility one party may default. Example: A company that needs to import raw materials in six months may enter into a forward contract to lock in the current price, avoiding the risk of price increases. 2. Futures A futures contract is similar to a forward, but it is standardised and traded on an exchange. This standardisation eliminates counter-party risk. Key Characteristics: Standardised: Contract size, expiration, and other terms are fixed by the exchange. Mark-to-market: Gains and losses are settled daily. Liquidity: Futures are highly liquid because they are traded on exchanges. Regulation: As they are traded on formal exchanges, they are more regulated than forwards. Example: A wheat farmer may sell futures contracts to hedge against a possible decline in wheat prices before harvest. 3. Options Options provide the right, but not the obligation, to buy or sell an asset at a specified price on or before a certain date. There are two types of options: call options and put options. Call Option: Gives the holder the right to buy an asset at a predetermined price. Put Option: Gives the holder the right to sell an asset at a predetermined price. Key Characteristics: Premium: The buyer pays a premium upfront to obtain the option. Limited Risk: The maximum loss is limited to the premium paid. Flexibility: Options can be used for speculative or hedging purposes. Example: An investor holding stocks may buy a put option to protect against potential declines in the stock's price. 4. Swaps A swap is a contract in which two parties agree to exchange cash flows or liabilities over a specific period. The most common types are interest rate swaps and currency swaps. Key Characteristics: Customizable: Like forwards, swaps are often tailored to meet the needs of the parties involved. Counterparty Risk: Swaps are typically OTC instruments, exposing parties to default risk. Common Uses: Used to manage interest rate risk or currency risk. Example: A company with a variablerate loan may enter into an interest rate swap to exchange its variable payments for fixedrate payments, thus locking in stable costs. Hedging instruments are essential for managing financial risk in volatile markets. Each instrument serves different purposes, with varying levels of complexity, risk, and customization. Whether through forwards, futures, options, or swaps, businesses can better plan for the future by reducing exposure to uncertain price fluctuations. Hedging Strategies for Market Risk, Credit Risk, and Currency Risk 1. Hedging Strategies for Market Risk Market risk (also known as systematic risk) arises from fluctuations in asset prices, such as stocks, bonds, commodities, and interest rates, due to economic factors or market volatility. Key Hedging Instruments for Market Risk: Derivatives (Options, Futures, and Forwards): These instruments allow investors to hedge against unfavorable price movements in stocks, commodities, or interest rates. Example: An investor holding a large stock portfolio might buy a put option to protect against a potential market downturn. If the market declines, the put option increases in value, offsetting losses in the portfolio. Short Selling: Investors can sell borrowed assets with the expectation of buying them back at a lower price, profiting from the decline. Example: A fund manager expecting a market decline may short sell stocks to hedge a portfolio against losses. Common Hedging Strategies: Portfolio Diversification: Reducing market risk by spreading investments across various asset classes (stocks, bonds, commodities) and sectors. Using Index Futures: Large portfolios can be hedged using index futures that track the performance of the overall market. If the market declines, profits from the short position in the futures contract will offset losses in the portfolio. Risk Parity: Allocating assets based on the level of risk rather than the dollar amount invested, balancing risk exposure across asset classes. 2. Hedging Strategies for Credit Risk Credit risk refers to the possibility that a borrower will default on a debt obligation. This is especially important for banks, lenders, and institutions dealing with bonds and loans. Key Hedging Instruments for Credit Risk: Credit Default Swaps (CDS): A financial derivative where the buyer of a CDS pays a premium to the seller in exchange for protection against a default on a loan or bond. Example: A bank holding corporate bonds can buy a CDS to ensure they are compensated if the issuing company defaults. Collateralised Debt Obligations (CDOs): These instruments pool together various debt instruments and allow risk to be distributed among multiple investors. Credit Insurance: Companies may use insurance to protect against the risk of a customer defaulting on payments. Common Hedging Strategies: Diversification of Loan Portfolio: Spreading out credit exposures across various industries, geographies, and borrower profiles reduces the overall risk of default. Tightening Lending Standards: Limiting exposure to highrisk borrowers by implementing stringent credit assessments. AssetBacked Securities: Banks can sell loans or bonds packaged as assetbacked securities to reduce their exposure to credit risk. 3. Hedging Strategies for Currency Risk Currency risk (or exchange rate risk) arises from fluctuations in foreign exchange rates, which can affect companies involved in international trade or with investments in foreign countries. Key Hedging Instruments for Currency Risk: Forward Contracts: A firm agrees to exchange a specified amount of currency at a predetermined exchange rate on a future date. Example: A U.S. exporter expecting payment in euros might enter into a forward contract to sell euros and lock in a favorable exchange rate. Currency Options: These give the right, but not the obligation, to buy or sell currency at a specific price. Example: A U.S.based company buying goods from Japan might buy a call option on the yen to hedge against the risk of yen appreciation. Currency Swaps: Two parties exchange interest payments and principal in different currencies to hedge against exchange rate fluctuations. Common Hedging Strategies: Natural Hedging: Companies can offset currency risk by balancing foreign revenue with costs in the same currency. For example, if a company generates revenue in euros, it can also incur expenses in euros, reducing exposure to exchange rate fluctuations. Multi-Currency Invoicing: Firms can invoice in their home currency, shifting the currency risk to the buyer. Currency Diversification: Holding a diversified basket of currencies can reduce exposure to large fluctuations in any one currency. Effective hedging strategies are crucial for managing various types of risks in financial markets. Market risk can be managed using instruments like futures and options, while credit risk can be mitigated through diversification and credit derivatives. Currency risk, often faced by multinational firms, can be hedged using forward contracts, options, or swaps. Each strategy helps firms and investors protect their portfolios, ensure financial stability, and reduce the impact of adverse movements in the financial markets. Portfolio Risk Management Techniques: Diversification, Asset Allocation, and Risk Budgeting Managing risk is a fundamental aspect of portfolio management. Investors use various techniques to control and reduce the risks inherent in investing. Three key techniques used in portfolio risk management are diversification, asset allocation, and risk budgeting. Each of these techniques helps in mitigating potential losses while aiming to achieve the desired return. 1. Diversification Diversification is a risk management strategy that involves spreading investments across different assets, sectors, or geographic regions to reduce exposure to any single risk. The idea is that different assets perform differently under various market conditions, so losses in one investment can be offset by gains in others. Key Benefits of Diversification: Reduction of Unsystematic Risk: Unsystematic risk, which is unique to a specific company or industry, can be reduced by holding a variety of investments that respond differently to market conditions. Improved Stability: A diversified portfolio is less volatile, as the negative performance of one asset can be balanced by the positive performance of others. Methods of Diversification: Across Asset Classes: Investing in a mix of asset classes such as stocks, bonds, commodities, and real estate. Example: A portfolio with 60% equities, 30% bonds, and 10% commodities is more diversified than one solely consisting of stocks. Within Asset Classes: Diversifying within a single asset class (e.g., holding stocks from different sectors like technology, healthcare, and energy). Geographic Diversification: Investing in assets across various countries or regions to mitigate country-specific risks. Example: Holding U.S. stocks along with emerging market equities can reduce risks related to a downturn in one country's economy. 2. Asset Allocation Asset allocation refers to the process of dividing investments among different asset classes (such as stocks, bonds, and cash) to align with an investor's risk tolerance, time horizon, and financial goals. Asset allocation plays a crucial role in portfolio risk management by determining the overall risk-return profile of the portfolio. Key Elements of Asset Allocation: Strategic Asset Allocation: A longterm approach that involves setting target allocations for different asset classes based on financial goals and risk tolerance. Example: A young investor with a longterm horizon might allocate 70% to stocks, 20% to bonds, and 10% to cash. Tactical Asset Allocation: A more active approach that involves adjusting the asset mix in response to short-term market conditions. Example: If the investor expects an economic downturn, they might temporarily reduce exposure to equities and increase exposure to bonds. Types of Asset Allocation Models: Conservative: Focuses on preserving capital with a larger allocation to bonds and cash (e.g., 20% stocks, 80% bonds). Balanced: A moderate risk approach with an equal focus on growth and income (e.g., 50% stocks, 50% bonds). Aggressive: Targets higher returns by investing predominantly in equities, accepting higher risk (e.g., 80% stocks, 20% bonds). Example of Asset Allocation: A 40 year old investor with moderate risk tolerance may allocate their portfolio as follows: 50% equities, 40% bonds, and 10% in alternative investments such as real estate or commodities. The equities provide growth potential, while the bonds and alternative assets offer stability and income. 3. Risk Budgeting Risk budgeting is a method of allocating risk across different components of a portfolio, rather than focusing solely on returns. The goal is to optimise the portfolio’s risk-return profile by distributing risk in a way that aligns with the investor’s objectives and risk tolerance. Key Concepts of Risk Budgeting: Risk Contribution: Each asset class or investment in the portfolio contributes a certain amount of risk (measured by metrics such as volatility or Value at Risk). Risk budgeting ensures that no single asset class dominates the overall risk of the portfolio. Example: A portfolio may contain 60% stocks and 40% bonds, but if the stocks are highly volatile, they may contribute 90% of the portfolio's risk. Target Risk: Investors set a maximum acceptable level of risk (e.g., a portfolio volatility of 10%) and allocate investments so that the total risk remains within this target. Techniques in Risk Budgeting: Risk Parity: Allocates risk evenly across asset classes, rather than allocating capital based solely on return expectations. Example: In a risk-parity portfolio, both bonds and stocks might be balanced in such a way that they contribute equally to the overall portfolio risk, even though the dollar investment in bonds may be larger due to their lower volatility. Value at Risk (VaR): This technique measures the potential loss in a portfolio over a specific time period, under normal market conditions, at a given confidence level. The risk budget ensures that the potential loss stays within acceptable limits. Example of Risk Budgeting: An investor targets an overall portfolio risk of 8% volatility. After analyzing the risk contribution of each asset class, they determine that equities, which currently make up 60% of the portfolio, contribute 70% of the risk. To adhere to the risk budget, the investor may reduce their equity exposure and increase their allocation to bonds or other less volatile assets. Diversification, asset allocation, and risk budgeting are complementary techniques used in portfolio risk management. Diversification reduces unsystematic risk by spreading investments across various assets. Asset allocation ensures that investments align with an investor's goals and risk tolerance. Risk budgeting focuses on managing the contribution of risk from each asset class to create a balanced and efficient portfolio. Together, these strategies help investors achieve a balance between risk and return, ensuring longterm portfolio stability. Risk Mitigation Through Insurance, Securitisation, and Other Financial Engineering Techniques Risk mitigation is a core objective in financial management, and various strategies can be employed to reduce or manage risks. Three major approaches are insurance, securitisation, and financial engineering techniques. Each of these methods helps firms and individuals transfer, reduce, or eliminate certain financial risks. 1. Insurance as a Risk Mitigation Tool Insurance is a traditional risk transfer method that protects against financial losses by shifting the risk to an insurance company in exchange for premium payments. It is widely used to mitigate various forms of risk, such as operational, liability, and property risks. Key Aspects of Insurance for Risk Mitigation: Risk Transfer: The insurer takes on the risk in exchange for a premium, thus protecting the insured party from unexpected financial losses. Indemnity: In the event of a loss, the insurance policy compensates the insured based on the terms of the contract. Customisable Coverage: Insurance policies can be tailored to address specific risks, such as property damage, business interruption, liability, or cyber risks. Types of Insurance for Businesses: Property and Casualty Insurance: Covers physical assets like buildings, machinery, and inventory from risks like fire, theft, or natural disasters. Liability Insurance: Protects businesses against legal liabilities arising from accidents, negligence, or professional errors. Business Interruption Insurance: Compensates for lost income if a business has to halt operations due to unforeseen events. Credit Insurance: Shields companies from losses due to the nonpayment of trade receivables. 2. Securitisation as a Risk Mitigation Technique Securitisation is a financial engineering process that involves pooling various financial assets (such as loans, mortgages, or receivables) and converting them into marketable securities. This process allows firms to transfer risk to investors, thereby reducing their exposure. Key Elements of Securitisation: Risk Transfer: By securitising assets, companies can transfer the risk of default or nonpayment to investors who purchase the securities. Liquidity Creation: Securitisation converts illiquid assets (like mortgages or loans) into liquid, tradeable securities, improving cash flow for the originating firm. Diversification of Risk: Pooling assets with different risk profiles reduces the impact of individual defaults, spreading the risk across multiple investors. Common Forms of Securitisation: MortgageBacked Securities (MBS): Pools of mortgages are bundled and sold as securities to investors, transferring the risk of mortgage defaults. Example: A bank that issues home loans can bundle those loans into MBS and sell them to investors, transferring the credit risk of potential defaults. Asset-Backed Securities (ABS): Similar to MBS, but backed by other types of assets like credit card receivables, auto loans, or student loans. Collateralised Debt Obligations (CDOs): Structured financial products that pool different types of debt, such as loans and bonds, and sell them as securities with varying risk levels. Example: A bank may issue a portfolio of auto loans and then pool these loans into an assetbacked security (ABS). The ABS is sold to investors, who take on the risk of loan defaults. By securitising the loans, the bank reduces its exposure to credit risk and generates immediate cash flow. 3. Financial Engineering Techniques for Risk Mitigation Financial engineering involves the use of complex financial instruments, derivatives, and structured products to manage or mitigate financial risks. These techniques allow firms to hedge against specific risks, optimize capital structure, and improve financial stability. Common Financial Engineering Techniques: Derivatives: Financial instruments like futures, forwards, options, and swaps are used to hedge against price fluctuations, interest rate changes, or currency movements. Example: A company with significant foreign exchange exposure may use currency forwards or options to hedge against exchange rate fluctuations, ensuring predictable cash flows. Options and Futures: Options: Provides the right (but not the obligation) to buy or sell an asset at a predetermined price, allowing firms to hedge against unfavorable price movements. Example: An airline company can buy options on jet fuel to hedge against rising fuel prices. Futures: Standardized contracts to buy or sell an asset at a set price on a future date, commonly used to hedge commodities or financial assets. Example: A wheat producer may use futures contracts to lock in a favorable price for its crop, hedging against a potential price drop. Swaps: These involve the exchange of cash flows between two parties, often used to manage interest rate risk or currency risk. Interest Rate Swaps: Firms can exchange floatingrate interest payments for fixedrate payments to hedge against rising interest rates. Currency Swaps: Used to hedge exchange rate risk in crossborder transactions by exchanging principal and interest payments in different currencies. Example: A company with a variablerate loan may enter into an interest rate swap to exchange its variable payments for fixedrate payments, locking in stable costs. Structured Products: These are customised financial instruments designed to achieve specific riskreturn objectives. They often combine derivatives with other securities to create tailored risk exposures. Example: A structured note that combines a bond with an embedded option, offering downside protection while allowing for potential upside linked to the performance of an equity index. Credit Derivatives: Tools like credit default swaps (CDS) allow investors to transfer credit risk to other parties. Example: A bondholder worried about a company’s potential default may purchase a CDS, which pays out in case of a default event. Example: A company may issue a bond with an embedded call option, allowing it to repurchase the bond if interest rates decline. This financial engineering tool enables the company to mitigate the risk of rising interest rates, reducing future borrowing costs. Risk mitigation through insurance, securitisation, and financial engineering offers businesses a variety of tools to manage and transfer risks. Insurance allows for the direct transfer of risk to an insurer, while securitisation helps companies offload risk by packaging and selling assets as securities. Financial engineering techniques, including derivatives, swaps, and structured products, provide sophisticated ways to hedge market, interest rate, and currency risks. Each approach helps organizations improve financial stability, enhance liquidity, and manage potential losses in a volatile market environment.

Chapter 7 - Review Data and Decision Making *Glow bus due at midnight, name and student number: answer questions using content in class People have created wonderful things for centuries, and management Management can be traced as far back as 500 bc when the ancient Sumerians used written records to improve government and business activities Why is it important to lean from the past Not to repeat our mistakes Classical management approaches Scientific management Administrative Principles Bureaucratic organisation Behavioural Management Approaches Follett’s Organizations as communities The Hawthorne studies Maslow’s theory of human needs Mcgregor’s Theory x and Theory Y Argyris Personality and organisation Modern Management foundations Organises as systems Contingency thinking Quality management Quantitative and analysis and tools Evidence-based management Contributions Frederick Taylor - Father of Scientific management He noticed that workers often did their jobs with wasted motions and without a constant approach. His resulted in inefficiency and low performance He believed the problem could be fixed if workers were taught to do their jobs in the best ways and ten were helped and guided by supervisors Four guiding principles of scientific management Rules of motion, standardized work and proper working conditions Select workers with the right abilities Train workers and give them incentives Support workers by planning and smoothing the way as they do their work Frank and Lillian Gilbreth Pioneered use of motitono studies as a management tool In one famous case, the gilbreaths cut down the number of motions used by bricklayers adn tripled their productivity Contributions from scientific management Make results-based compensation a performance incentive Carefully design jobs with efficient work methods Carefully select workers with the ability to perform the job Trian workers to execute activities to the best of their abilities Train supervisors to support workers so they can perform jobs to the best of their abilities Classical Management Adiminstative principle (Henro Fayol) 1919, after a career in French industry, Henri F published “adminisration Industrielle et Generale” (General and industrial management) in which we out like his views on the management of organiztion and workers Rules and duties in management Foresight - to complete a plan of action for the future Organization - To provide and mobilize resources to implement the plan Common- to lead, select and evaluate workers to get the best work toward the plan Coordination- to fit diverse efforts together and ensure information is shared and problems solved Control- to make sure things happen according to plan and to take necessary corrective action Classical management Bureacratic organiztion (Max Weber) Max weber (Bureaucrativ organization) - late 19th century German political economist who had a major impact in the fields of management and sociology Bureaucratic Organization An ideal, intentionally rational adn very efficient form of organization Based on the principles of logic, order and legitimate authority Characteristics of BO Clear division of labour Clear hierarchy of authority Formal rules and procedure Impersonality Careers based on merit What are some disadvantages of bureaucracy Takes a long time for problems to become solved bec there are procedures and there is a chain of people in command Having the power Rules have to follow Excessive paperwork or “red tape” Slowness in handling problems Rigidity in the face of shifting needs Resistance to change Employee apathy Behavioural Management Approaches (focus on understanding the elements that affect human behaviour in organisations) Follett’s Organizations as communites Mary park follett contributed to the transition from classical thinking inot behavioural management Groups and human cooperation Groups allow individuales too combine their talents for a greater good Organizations are cooperating “communites” of managers adn workers Managers job is to help people copperate and achive an integration of goals and intrests Forward-looking managment insight: Making every emploee an owner creates a sense of collective responsibility Prescursor of employrr ownership, profit sharing and gain sharing Buniess problems invovle a varity of inter realted factors Prescursor of systems thinking Private profits realtive to public good Precursor of managerial ethics and social respinsibility Hawthorne studies Took place at western electric chicago plan, a tran led by Harvards Elton Mayo set out to learn how econmic incentives and workplace conditions affected workers output Maing objective Intial study examined how ecomoin incentives adn physical conditions affected worker output (productivity) No consistent relationship found During experientmetn they had 2 groups The expertiant groups (impoved wokring ocnditions ) The control group ( no changes to original working conidtions) No consitant relationship found, perfomance in both groups increased even after removing incentives Social setting and human relations Concluded New “social setting” led workers to do good job Good “Human relations” = higher productivity The contect - The Great Depression (1929-1940) Employee attitudes and groups processes Osme thinsf satisifed some workers but not others People resticited output to adhere to groups norms (Avoid layoffs) Lessons from he hawthrone stufirs Social and human concerns are keys to prductivity Hawthrone effect - People who are singled out for special attention perform as expected Maslow’s Theory of human needs Human needs The work of psychologist Abraham Maslow in the area if human “needs,” also has had a major impact in the behavioual apporach to management Maslow’s hierarchy of human needs Self actualization needs Higherst level: need foe self fulfillment to grow and use abilites to fullest and most creative extent Esteem needs Needs fro esteem in eyes of others need for respect, prestige, recognition; need for self esteem, personal sense of competence, mastery Social needs Need for love, affection, sense of belongingness in ones relationship either other people Safett needs Need for security, protection and stability in teh events of day to day life Physiological needs Most basic of all human needs: need for biological maintence; food, water and phydical well being Principles Defict principle: A satidifed need is not a motivator of behaviour Progress principles: A need becomes a motivator once the preceding lower-level need is satisfied Both principles cease to operate at self actulilzation level McGregor’s Theories Thepry x assumes that workers; Dislike work Lack ambition Are irresponsible Resist change Prefer to be led Theoyry y assumes that workers are Willing to work Willing to accept responsibility Capable of self control Capable of self direction Imaginative and creative According to McGregor, Managers create: Self fulfilling prophecies Implications of Theory x and y Theory x managers: Create situations where workers become dependent, passive and reluctant Theory y managers create situations where workers respond with initiative and high performance Central to notions of empowerment and self management Argyris’s theory of adult personality Classical management principles and practices inhibit worker maturation and are inconsistent with the mature adult personality Management practices should accommodate the mature personality: Increasing task responsibility Increasing task variety Using participative decision making Modern Management Foundation Quantitative analysis and Tools Analytics: the use of large data bases and mathematics to solve problems and make informed decision using systematic analysis Organization as systems System Collection of interrelated parts that function together to achieve a common purpose Subsystem A smaller component of a larger system Open systems Organisations that interact with their environment Contingency thinking Tires to maths managerial responses with problem (situation) No “one best way” to manage The “appropriate way to to manage depends on the situations Quality management Qality anc competitive advantafe are linked Total quality managment (TQM) Comprehensive approach to contiou impovment on teh entire organization ISO certification Gloval quality management standards Refine and upgrade quality to meet ISO requirments Evidednce Based Managment Making management decision on “hard facts” about what really works

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)

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