What is the primary purpose of protecting the drug activity within a drug product?

To ensure the efficacy and safety of the drug

To improve the taste of the drug

To enhance packaging aesthetics

What role do excipients play in the protection of drug activity within a drug product?

They can stabilize the active ingredients and enhance drug delivery.

They provide no function and are just fillers.

They are used to increase the drug's cost.

They are solely for flavoring the drug.

What is the significance of the pH level in maintaining the protection of drug activity in a formulation?

It can influence the stability and solubility of the active ingredient.

It determines the dosage form type.

It only affects the color of the drug.

It has no effect on drug formulation.

What is a common method to prevent oxidation of drug compounds within a formulation?

Incorporating antioxidants into the formulation.

Why is it important to control light exposure for drug products?

To prevent photodegradation of the active pharmaceutical ingredients.

It allows for easier manufacturing processes.

It decreases the overall cost of the drug.

It helps to enhance the flavor of the drug.

Which of the following practices can help to prolong the shelf life of drug products?

Storing them in a cool, dry place.

Leaving them open to air exposure.

Storing them in high humidity environments.

Keeping them in direct sunlight.

Protection of the drug activity within the drug product

The endoplasmic reticulum (EN-doh-PLAZ-mik ri-TIK-yuh-luhm), abbre- viated ER, is a system of membranous tubes and sacs, called cisternae (sis-TUHR-nee). The ER functions primarily as an intracellu- lar highway, a path along which molecules move from one part of the cell to another. The amount of ER inside a cell fluctuates, depending on the cell’s activity. There are two types of ER: rough and smooth. The two types of ER are thought to be continuous. Rough Endoplasmic Reticulum The rough endoplasmic reticulum is a system of interconnected, flattened sacs covered with ribosomes, as shown in Figure 4-15. The rough ER produces phospholipids and proteins. Certain types of proteins are made on the rough ER’s ribosomes. These proteins are later exported from the cell or inserted into one of the cell’s own membranes. For example, ribosomes on the rough ER make digestive enzymes, which accumulate inside the endoplasmic retic- ulum. Little sacs or vesicles then pinch off from the ends of the rough ER and store the digestive enzymes until they are released from the cell. Rough ER is most abundant in cells that produce large amounts of protein for export, such as cells in digestive glands and antibody-producing cells. Smooth Endoplasmic Reticulum The smooth ER lacks ribosomes and thus has a smooth appear- ance. Most cells contain very little smooth ER. Smooth ER builds lipids such as cholesterol. In the ovaries and testes, smooth ER produces the steroid hormones estrogen and testosterone. In skeletal and heart muscle cells, smooth ER releases calcium, which stimulates contraction. Smooth ER is also abundant in liver and kidney cells, where it helps detoxify drugs and poisons. Long-term abuse of alcohol and other drugs causes these cells to produce more smooth ER. Increased amounts of smooth ER in liver cells is one of the factors that can lead to drug tolerance. As Figure 4-15 shows, rough ER and smooth ER form an interconnected network. Copyright © by Holt, Rinehart and Winston. All rights reserved. reticulum from the Latin rete, meaning “net”; reticulum means “little net” Word Roots and Origins The endoplasmic reticulum (ER) serves as a site of synthesis for proteins, lipids, and other materials. The dark lines in the photo represent the membranes of the ER, and the narrow lighter areas between the dark lines show the channels and spaces (cisternae) inside the ER. FIGURE 4-15 Smooth ER Ribosomes Rough ER Cisternae 82 CHAPTER 4 GOLGI APPARATUS The Golgi apparatus, shown in Figure 4-16, is another system of flattened, membranous sacs. The sacs nearest the nucleus receive vesicles from the ER containing newly made proteins or lipids. Vesicles travel from one part of the Golgi apparatus to the next and transport substances as they go. The stacked membranes modify the vesicle contents as they move along. The proteins get “address labels” that direct them to various other parts of the cell. During this modification, the Golgi apparatus can add carbohydrate labels to proteins or alter new lipids in various ways. VESICLES Cells contain several types of vesicles, which perform various roles. Vesicles are small, spherically shaped sacs that are surrounded by a single membrane and that are classified by their contents. Vesicles often migrate to and merge with the plasma membrane. As they do, they release their contents to the outside of the cell. Lysosomes Lysosomes (LIE-suh-SOHMZ) are vesicles that bud from the Golgi appa- ratus and that contain digestive enzymes. These enzymes can break down large molecules, such as proteins, nucleic acids, car- bohydrates, and phospholipids. In the liver, lysosomes break down glycogen in order to release glucose into the bloodstream. Certain white blood cells use lysosomes to break down bacteria. Within a cell, lysosomes digest worn-out organelles in a process called autophagy (aw-TAHF-uh-jee). Lysosomes are also responsible for breaking down cells when it is time for the cells to die. The digestion of damaged or extra cells by the enzymes of their own lysosomes is called autolysis (aw-TAHL-uh-sis). Lysosomes play a very important role in maintaining an organism’s health by destroying cells that are no longer functioning properly. Copyright © by Holt, Rinehart and Winston. All rights reserved. The Golgi apparatus modifies many cellular products and prepares them for export. FIGURE 4-16 CELL STRUCTURE AND FUNCTION 83 Peroxisomes Peroxisomes are similar to lysosomes but contain different enzymes and are not produced by the Golgi apparatus. Peroxisomes are abundant in liver and kidney cells, where they neutralize free radicals (oxygen ions that can damage cells) and detoxify alcohol and other drugs. Peroxisomes are named for the hydrogen peroxide, H2O2, they produce when breaking down alco- hol and killing bacteria. Peroxisomes also break down fatty acids, which the mitochondria can then use as an energy source. Other Vesicles Specialized peroxisomes, called glyoxysomes, can be found in the seeds of some plants. They break down stored fats to provide energy for the developing plant embryo. Some cells engulf material by surrounding it with plasma membrane. The resulting pocket buds off to become a vesicle inside the cell. This vesicle is called an endosome. Lysosomes fuse with endosomes and digest the engulfed material. Food vacuoles are vesicles that store nutrients for a cell. Contractile vacuoles are vesicles that can contract and dispose of excess water inside a cell. Protein Synthesis One of the major functions of a cell is the production of protein. The path some proteins take from synthesis to export can be seen in Figure 4-17. In step , proteins are assembled by ribosomes on the rough ER. Then, in step , vesicles transport proteins to the Golgi apparatus. In step , the Golgi modifies proteins and pack- ages them in new vesicles. In step , vesicles release proteins that have destinations outside the cell. In step , vesicles containing enzymes remain inside the cell as lysosomes, peroxisomes, endo- somes, or other types of vesicles. 5 4 3 2 1 Copyright © by Holt, Rinehart and Winston. All rights reserved. Proteins are assembled by ribosomes on the rough ER. Vesicles carry proteins from the rough ER to the Golgi apparatus. Proteins are modified in the Golgi apparatus and enter new vesicles. Some vesicles release their proteins outside the cell. Other vesicles remain in the cell and become lysosomes and other vesicles. Nucleus

Health 11/12 Review for Final Exam Core Concepts - Mental and Emotional Health, Substance Abuse Prevention, Safety and Violence Prevention, Family Life and Human Sexuality, Disease Prevention and Control, Healthy Eating Health Education Skills - goal setting, decision making, accessing information/resources, analyzing influences, communication, self-management, advocacy DIMENSIONS of Wellness - social, spiritual, emotional/mental, environmental, financial, intellectual, multicultural, occupational, physical, sexual RISK factors - anything that increases the risk of disease, injury, or illness. PROTECTIVE factors - anything that decreases the risk of disease, injury, or illness. INTERNAL health factors - health factors that can be either hereditary and genetic or acquired elements -- include smoking and personal diet or eating habits. Example – a genetic predisposition to an illness. EXTERNAL health factors - health factors that are part of the direct outer environment, the geographical location, micro-organisms, socio-economic elements that could affect an individual's health. Example – being unable to afford mental health services. Unit 1- Managing Personal and Community Wellness Explain Maslow’s Hierarchy of Needs in your own words using the image provided. Explain how each Social Determinant of Health may impact a person’s health. Levels of Disease Prevention • PRIMARY The goal is to avoid conditions altogether. • SECONDARY The goal is early detection. • TERTIARY The goal is to minimize the damage (manage). Define the following terms. Fads/Trends Sleep hygiene Driver safety Unit 2- Investigating Social Ecological Factors on Well-Being Socio-Ecological Model – The SEM examines how health behaviors form based on characteristics of individuals, communities, nations and levels in between. Each level overlaps with other levels signifying how the best public health strategies are those that encompass and target a wide range of perspectives. Interpersonal (personal) health vs. intrapersonal (relationship) health Health INEQUITY - systemic, ingrained and unjust barriers that prevent segments of the population from having the opportunity of health leading to health disparity. IMPLICIT BIAS - a form of bias that occurs automatically and unintentionally, that nevertheless affects judgments, decisions, and behaviors. Research has shown implicit bias can contribute to unequal access to quality healthcare, negative patient-provider relationships and interactions; and create mistrust in the healthcare system and practitioners among patients. This can contribute to health disparities. Health DISPARITY - represents a difference in health between populations. It is often used to describe disease burden and other negative health outcomes socially disadvantaged groups may face. Health EQUITY - The opposite of health inequity. It describes a system that supports a high standard of health and healthcare for all people. Racism - Beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of phenotypic characteristics or ethnic group affiliation. DISCRIMINATION - An unjust differential treatment of a person or a group. PRIVILEGE- The unearned access to resources and social power that are only available to some because of their membership within certain social groups. OPPRESSION is the act of taking away choices from others and can be defined as a system that maintains advantage and disadvantage based on social identities and that acts on multiple levels from interpersonal to institutional and societal. (internalized, interpersonal, institutional, structural) Systematic Oppression - Intentional disadvantage of groups of people based on their identity while advantaging members of dominant group (race, gender, sexual orientation, language, size, ability, etc.). Intersectionality - The complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism) combine, overlap, or intersect especially in the experiences of marginalized individuals or groups Unit 3- Accessing Resources and Communicating to Support Mental and Emotional Health What is anger? What is anxiety? What is stress? STRESSORS are the things that cause stress. Stressors can be internal and external. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. INTERNAL Stressors - are made by your belief system and the way you evaluate yourself. Examples include pessimistic attitude, negative self-talk, deep need to be perfect, low self-esteem or body image, unhealthy standards for self. EXTERNAL Stressors - are stressful things that happen in your surroundings and/or in your environment. Examples include busy schedules, work problems, family issues, financial trouble, social problems, injury, unforeseen circumstances. Socio-economic issues are also a part of external stressors such as poverty, violence, and racism. Define the following mental health conditions. Depression Eating disorders NSSI Non-suicidal self-injury Grief/Loss Suicide prevention A.C.T. • ACKNOWLEDGE- Tell them in a caring way that you recognize that they are having a problem • CARE- You can show you care by actively listening - put away anything else you are doing, make eye contact, sit down, ask questions. • TELL-(call 988 for additional help and support) - Tell them it is important that they speak with a trusted adult. Help them figure out who this may be and offer to go with your friend. A social norm is an unwritten, informal rule meant to guide behavior among the of society. It distinguishes between acceptable and unacceptable, good and bad, and so on. Social norms can influence a person with emotional or mental health disorders, access to care and stigmatize their situation. STIGMA- a mark of disgrace associated with a particular circumstance, quality, or person. • Self-stigma - This describes the internalized stigma that people with mental health conditions feel about themselves. • Public stigma - This refers to the negative attitudes around mental health from people in society. • Institutional stigma - This is a type of systemic stigma that arises from corporations, governments, and other institutions. Unit 4- Evaluating Risks of Substance Use and Abuse Harm Reduction - a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Explain how each level of the Social Ecological Model is impacted by addiction. Individual Relationship Community Society SEM Level Contributing/Risk Factors to substance use Preventative/Protective Factors for substance use Individual Interpersonal/Relationship Community Society Unit 5- Analyzing Influences to Examine Ways to Increase Safety and Reduce Violence HATE CRIME - a crime, usually violent, motivated by prejudice or intolerance toward an individual’s national origin, ethnicity, color, religion, gender, gender identity, sexual orientation, or disability. Explain how the media influences violence in society. The Pyramid of Hate Explain the escalation of hate using the Pyramid of Hate visual. List several hate crime motivators. Example: age HEALTHY Relationship Signs - comfortable pace, trust, honesty, independence, respect, equality, kindness, taking responsibility, healthy conflict, fun UNHEALTHY Relationship Signs - intensity, possessiveness, manipulation, isolation, sabotage, belittling, guilting, volatility, deflecting responsibility, betrayal Sexual Assault is a sexual behavior WITHOUT consent. Human trafficking - the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, using force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. Sex trafficking - commercial sex act induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age. Trafficking happens using… • Force - using violence to control someone. • Fraud - using lies to control someone. • Coercion - using threats to control someone. Unit 6- Family Life and Human Sexuality Agency - A belief about yourself and the extent to which you can act on that belief. • The ability to choose freely one’s own narrative. • To embrace the idea that I am the cause (or agent) of my own thoughts and actions. • Personal agency is a personal responsibility for who we are, what we experience, what we do about that experience, and how we shape our world to give us more of the experiences we want. SEXUAL Agency • The ability to choose your own interests and desires vs. what we see in the media or others’ perceptions • The ability to identify, communicate, and negotiate one’s sexual needs • The ability to initiate behaviors that allow for the satisfaction of those needs Sexually Explicit Material - photographs, videos, films, magazines, and books whose primary themes, topics, or depictions involve sexuality that may cause sexual arousal. Sexual scripts - thoughts, patterns, or behavior that a person has about themselves in a romantic or sexual context. It is how people picture themselves or want to project themselves in front of others. Reproductive Rights of Teens - In Maryland, teens have the right to an abortion, keep their child, obtain and use birth control, paternity tests, adoption, give up custody of their child within 10 days of birth (Safe Haven Law). • REPRODUCTIVE RIGHTS- legal rights and the freedom of the individual to control decisions regarding contraception, abortion, sterilization and childbirth. • SAFE HAVEN LAW- a distressed parent who is unable or unwilling to care for their infant can safely give up custody of their baby, no questions asked. CONSENT is an agreement between participants to engage in sexual activity. • It is clearly and freely communicated, verbal, and affirmative. Consent CANNOT be given if… • A person is underage, one or both partners is intoxicated or incapacitated by drugs or alcohol, one partner is asleep or unconscious, one partner feels pressured, threatened or intimidated, or one partner holds a position of power or authority over the other. Unit 7- Advocating for Enhanced Nutrition, Food Systems, and Health Outcomes Dietary Guidelines for Americans Guideline 1: Follow a Healthy Dietary Pattern at Every Life Stage Guideline 2: Customize and Enjoy Food and Beverage Choices to Reflect Personal Preferences, Cultural Traditions, and Budgetary Considerations Guideline 3: Focus on Meeting Food Group Needs with Nutrient-Dense Foods and Beverages, and Stay Within Calorie Limits Guideline 4: Limit Foods and Beverages Higher in Added Sugars, Saturated Fat, and Sodium, and Limit Alcoholic Beverages FOOD DESERT- a neighborhood where there is little or limited access to healthy and affordable food such as fruits, vegetables, whole grains, low-fat milk and other foods that make up the full range of a healthy diet. FOOD INSEQURITY lack of access to a sufficient amount of food because of limited funds. More than 49 million American households are considered food insecure and are vulnerable to poor health as a result. PROCCESED FOODS- any raw agricultural commodities that have been washed, cleaned, milled, cut, chopped, heated, pasteurized, blanched, cooked, canned, frozen, dried, dehydrated, mixed or packaged — anything done to them that alters their natural state.

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)

Grace Hopper (1906-1992): An American computer scientist and U.S. Navy rear admiral. She was a pioneer in computer programming and developed the first compiler for a computer programming language, laying the groundwork for cobol. Garrett Augustus Morgan Sr. (1877-1963): An African American inventor who patented the traffic signal and the safety hood, a precursor to the modern gas mask. Hedy Lamarr (1914-2000): An Austrian-American actress and inventor who co-invented an early technique for spread spectrum communications, a key to modern wifi and bluetooth technology. Otis Boykin (1920-1982): An African American inventor who patented over 25 electronic devices, including a control unit for the pacemaker that is widely used today. Stephanie Kwolek (1923-2014): An American chemist who invented the synthetic fiber Kevlar, which is used in bulletproof vests and other protective equipment. Gladys West (b. 1930): An African American mathematician who played a crucial role in the development of the GPS technology we use today. Shirley Ann Jackson (b. 1946): An African American physicist who was the first African American woman to receive a doctorate at MIT and her work laid the foundations for the touch-tone telephone, caller ID, and call waiting. Tu Youyou (b. 1930): A Chinese pharmaceutical chemist who discovered artemisinin, a drug therapy that has significantly reduced the mortality rates for malaria, for which she was awarded the Nobel Prize in Physiology or Medicine in 2015. Chien-Shiung Wu (1912-1997): A Chinese-American physicist who made significant contributions to the Manhattan Project and disproved the hypothetical law of conservation of parity, for which her male colleagues received the Nobel Prize (she did not). Mária Telkes (1900-1995): A Hungarian-American biophysicist and architect dubbed the "Sun Queen" for her pioneering work in solar energy, including the development of the first solar-powered house. Percy Lavon Julian (1899-1975): An African American chemist and pioneer in the chemical synthesis of medicinal drugs from plants. Charles Ginsburg (1925-1992): An American engineer who led the team that developed the first commercial videotape recorder. Philo Farnsworth (1906-1971): An American inventor who developed an electronic television system and made major contributions to early television technology. María Montoya Martínez (1887-1980): A Native American (Tewa) potter from San Ildefonso Pueblo, New Mexico, who helped revive the traditional black-on-black pottery style and is considered one of the most influential Pueblo potters of the 20th century. Satya Nadella (b. 1967): An Indian-American business executive who has been the chief executive officer of Microsoft since 2014, overseeing the company's transformation into a cloud computing powerhouse. Junko Tabei (1939-2016): A Japanese mountaineer who in 1975 became the first woman to reach the summit of Mount Everest, and the first woman to ascend the Seven Summits, climbing the highest peaks on each continent. Mildred Dresselhaus (1930-2017): An American physicist and engineer, known as the "Queen of Carbon Science," who made groundbreaking contributions to the study of carbon materials like graphite and carbon nanotubes. Ellen Ochoa (b. 1958): An American engineer and former astronaut. In 1993, she became the first Hispanic woman to go to space when she flew on the Space Shuttle Discovery. Françoise Barré-Sinoussi (b. 1947): A French virologist who co-discovered HIV as the cause of AIDS, for which she was awarded the Nobel Prize in Physiology or Medicine in 2008. Esther Lederberg (1922-2006): An American microbiologist who made significant contributions to genetics and microbiology, including the discovery of the bacterial virus lambda, but whose work was often overshadowed by her husband's Nobel Prize-winning accomplishments.

Protection of the embryo

07i. Protection of the CNS

The Revolt of the Northern Earls (1569) Most people in the North remained loyal to the Catholic noble families who controlled the north and their Catholic faith. When Elizabeth came to power, she promoted ‘new men’ (Protestants) from the gentry and the powerful Catholic nobles lost their power and influence. This led them to organise the most serious rebellion of Elizabeth’s reign in 1569. Why did the Northern Earl’s revolt? The Earls had lost their power when Elizabeth became Queen (and wanted it back). They wanted Catholicism restored in England (and felt that ordinary Catholics would support it). Elizabeth was refusing to marry or to name an heir, causing uncertainty about England’s future. Mary Queen of Scots (if freed from prison) could replace Elizabeth and solve all these problems Who were the key players in the Revolt? Earl of Northumberland • A Catholic who had held an important position under Mary I. • He lost a lot of influence under Elizabeth (as she favoured Protestant gentry) • Elizabeth also took the rights to a valuable copper mine found on his lands Earl of Westmorland • From a rich Catholic family in the north Also the Duke of Norfolk’s brother in law Duke of Norfolk • England’s most senior Protestant noble, but he had very close links to old northern Catholic families, & was sympathetic to them & greedy for power. • He hated William Cecil & Robert Dudley, Earl of Leicester (Elizabeth’s favourite) who were Protestant and from the gentry • He planned to marry Mary QS, but later backed down and urged the earls to call off the rebellion. Mary also supported the plan to marry him What role did religion play? (7/10 – but only because it was linked to power) • Most northerners held onto their Catholic beliefs & although Elizabeth didn’t persecute them, they knew that she wanted their religion to gradually die out, so they supported the revolt. • In 1561 Elizabeth hired a strict Protestant as archbishop of Durham to promote Protestantism in the north, but he was unpopular & turned many northerners against the Protestant religion. What role did politics/power play? (9/10 – this was the most important cause of the revolt) • The Northern Earls lost a lot of their power/influence (even jobs/money under Elizabeth) • Northumberland was jealous of new Protestant families being given top jobs in the North • William Cecil & Robert Dudley were not from ancient noble families, but were very close to the Queen, so the northern Earls resented them getting top jobs in her Government • Elizabeth also confiscated large areas of land & the profits from their copper mines • It is possible, that had Elizabeth allowed the Catholic Northern Earls to keep their jobs, money and influence at court, they may have ‘tolerated’ her as a Protestant Queen (greedy/selfish). What role did Mary Queen of Scots and the Succession play? • Elizabeth was refusing to name an heir and it was becoming clear that she would not marry • If Mary Queen of Scots married the Duke of Norfolk, England would have an heir and England would be Catholic again. The country would be stable without people competing for power. • However, some of Elizabeth’s courtiers got worried that it might not work and that it might lead to charges of treason (punishable by death) • So by September 1569, Robert Dudley (Earl of Leicester) decided to tell Elizabeth about the plot. By this time it was much more serious than simply marrying Norfolk to Mary. • Mary QS had secretly asked Spain to send troops to help the rebellion & overthrow Elizabeth Plan for the Revolt of the Northern Earls (1569) • The Earls of Northumberland & Westmorland will raise rebel troops from their lands in the north and take control of Durham. • The rebels will then march south towards London to join with the Duke of Norfolk • 1000s of Spanish troops will land in England to support the rebel forces • The Duke of Norfolk & rebel forces will seize control of Government & overthrow Elizabeth • Mary Queen of Scots is to be freed, ready to marry the Duke of Norfolk Key Events of the Revolt • Once Elizabeth knew of the plot, Norfolk was arrested and sent to the Tower of London • The Northern Earls were worried they would be executed for their involvement and in a desperate attempt to avoid punishment, pushed ahead with the revolt • They raised an army of ordinary Catholics and took control of Durham cathedral • Catholic mass was celebrated across the north for 2 weeks. • They then headed south, to try and free Mary • Mary QSs was moved south to Coventry on the orders of Elizabeth, so she couldn’t escape • The rebellion failed as Spanish troops never arrived • Elizabeth’s friend (Earl of Sussex) had raised an army of 7,000 men to defend her throne. Results: • The rebellion was a serious threat to Elizabeth • She executed 450 rebels in the north • Northumberland was executed in 1572 & his head was put on a spike on the city gate • The Privy Council called for the Duke of Norfolk’s execution too, but Elizabeth released him. • Mary Queen of Scots was kept in prison for the next 14 years. • The failed plot also led the Pope to take action against Elizabeth • In 1570 he excommunicated Elizabeth from the Catholic Church • He also issued a Papal Bull (order) calling on all loyal Catholics to overthrow her hoping it would encourage another rebellion. • In 1571 Elizabeth called parliament to pass an Act making it treason to claim that she was not the rightful Queen and to bring in/print papal bulls in England. The Significance of the Revolt of the Northern Earls • It was the first and most serious rebellion by English Catholics against Elizabeth • Treason laws were made much harsher • It ended the influence of the powerful Catholic Earls in the North • It led to harsher treatment of Catholics, e.g. 1572 Elizabeth sent the Earl of Huntingdon (strict Protestant) to the north to carry out laws against Catholics (and suppress Catholicism). • Although Elizabeth’s brutal revenge on the rebels show how serious a threat it was, most Catholics in the north stayed loyal, but the Pope’s Papal Bull now put their loyalty in doubt There was little support for the revolt among the rest of the Catholic nobility and ordinary people. When faced with a choice between Elizabeth and their religion, most Catholics chose to support the Queen. 1569, was the last time English Catholics tried to remove Elizabeth by force. The future plots against her were always uncovered by Cecil & Walsingham, before they had a chance to get any public support. Despite this, the Northern Revolt & Papal Bull changed Elizabeth’s attitude towards Catholics who were now seen as potential traitors. From 1570, Elizabeth became less tolerant of recusants (people refusing to attend her church) & took increasingly tough measures against Catholics. The Ridolfi, Throckmorton & Babington plots • In the 1870s-80s, there were 3 Catholic plots to assassinate Elizabeth & replace her with Mary. • The plots were supported by France, Spain, the Pope and some Catholic nobles. • They reinforced the form Mary & from Catholics at home and abroad. Also the threat from Spain. The Ridolfi Plot (1571) • Ridolfi was an Italian banker living in England and a spy for the Pope. • He organised a plot to murder Eliz, marry Mary QS to the Duke of Norfolk & make her Queen. • The Pope & King Philip supported the plot & Philip told the Duke of Alba in the Netherlands to prepare 10,000 troops (but to only invade AFTER the English had overthrown Elizabeth). • The plot failed because Sir William Cecil intercepted coded letters & Norfolk was executed. • Mary was kept under closer watch. • Ridolfi was abroad when the plot was discovered and never returned to England. 1574: Catholic Priests and Priest Holes • From 1574 Catholic priests were smuggled into England to keep the religion alive. • They stayed with rich Catholic families, so Catholic families were kept under surveillance. • Catholic homes were raided – to find ‘priest holes’ where Catholic priests were hiding. • Catholic priests who were found could be hung, drawn and quartered (although not all were) • In 1581, Parliament also passed 2 new tougher laws against Catholics: • Recusants would be fined £20 (which would bankrupt most families) • Trying to convert people to Catholicism was now treason (punishable by death) The Throckmorton Plot (1583) • It aimed to assassinate Elizabeth and replace her with Mary. The French Duke of Guise (Mary’s cousin) would invade England with an army, funded by King Philip (Pope also supported it). • An Englishman, Throckmorton carried messages between Mary & Catholic plotters abroad. • Sir Walsingham (Secretary of State) uncovered the plot after his agents found the plans for the plot in Throckmorton’s house. Throckmorton confessed under torture and was executed. Significance: • The plots showed that Mary’s presence in England posed a serious threat • It also showed that France & Spain were a serious threat (& could invade) • Throckmorton’s papers showed a list of Catholic supporters in England, so the threat from English Catholics was also real • 1,000s of Catholics were imprisoned or kept under surveillance/house arrest • In 1585 another Act was passed to make helping Catholic priests punishable by death. • The Bond of Association was signed by the English nobles & gentry & forced them to promise to execute anyone who tried to overthrow the Queen. Weaknesses of the Plots The plots lacked public support & were uncovered by informers & spies before they had the chance to work King Philip was reluctant to destroy his alliance with Elizabeth (France was still a bigger rival) so is support for the plots was half-hearted, he rarely followed through on his promises to help the plotters or send an army The Babington Plot (1586) In 1586, Walsingham used his spy network to PROVE that Mary supported the Babington plot. His evidence persuaded Elizabeth to put Mary on trial & execute her for treason. • This was a plot to murder Elizabeth and put Mary on the throne • France would invade England with 60,000 men and Spain would also send an army • Babington was passing coded letters between Mary & her supporters in England & Europe. • But all of her letters were being intercepted and read by Walsingham. • Walsingham used his spies to follow every stage of the plot & had the letters decoded • One of Mary’s letters approved plans to murder the Queen and free Mary from prison • They also contained the names of 6 Catholics who planned to kill Elizabeth • They were arrested, hung, drawn and quartered for treason. • Mary had been implicated in plots before, but Elizabeth was always reluctant to execute her • But the proof found by Walsingham finally persuaded her to put Mary on trial • In October 1586, Mary was found guilty & was sentenced to death • But Elizabeth still hesitated, and did not sign the death warrant until February 1587. Significance 1) This plot was very significant because by 1585 England was effectively at war with Spain since Elizabeth had sent her army to help the Dutch Protestants fight the Spanish 2) This meant that Elizabeth’ situation was more dangerous than during previous plots. 3) Elizabeth’s government also became more determined to crush Catholicism 4) 1000s of recusants were arrested & 31 priests were executed 5) Mary’s execution removed the Catholic threat at home 6) English Catholics had no one to rally around, & lost hope of overthrowing Elizabeth 7) But Mary’s death increased the threat of a foreign invasion as England was at war with Spain and King Philip had been preparing an attack on England since 1585 8) Mary’s death made Philip even more determined to invade, Mary had left her claim to the English throne to King Philip upon her death Why was Mary Queen of Scots finally executed? 1 • A new Act in 1585 stated that in the event of Elizabeth’s assassination, Mary could be executed as long as she had been proved guilty & Walsingham had provided hard proof. 2 • Another reason was that by 1587, it was clear that Philip was planning to invade England • There were rumours that Spanish ships had landed in Wales & that Mary had escaped. This convinced Elizabeth that Mary had to be executed if she wanted to keep her throne. Walsingham’s Spy Network: • Walsingham (Secretary of State from 1573) had a network of spies all over England & abroad. He had spies in every English town, some were normal people paid to spy on neighbours. • He also had agents and spies in Spain, France, Germany and Italy • He hired mathematicians to crack written codes and people to open/seal letters secretly • He also pressured captured Catholic priests to spy on others for him in return for a pardon. • He used double agents to infiltrate Catholic networks - to help him discover traitors • But he only used torture against Catholic priests caught in England in the most serious cases • But 130 priests and 60 of their supporters were still executed during Elizabeth’s reign. Why did Relations with Spain get worse (1569-1588) • England had tried to stay on good terms with Spain, because Eliz wanted to avoid an expensive war that could lead to her being overthrown (English Catholics could support it) • But by the 1570s, Elizabeth wanted to have an empire of her own. • She also needed to make more money to defend her country and throne (by improving trade) • This religious, political and economic rivalry led to growing tensions between England & Spain Political and Religious Rivalry 1) Land abroad, gave countries wealth/power. By the 1580s, Eliz wanted an empire to rival Spain’s (especially as Spain had supported the Catholic plots against Eliz – even if it was half-hearted) 2) Religion was another cause of conflict. Philip opposed Elizabeth’s religious settlement 1559 3) Luckily for Elizabeth, in the 1550s Spain & France were competing to be the greatest European power and both wanted England as an ally against the other. 4) But from 1567, Spanish ships were sailing to the Netherlands with money for the Alba’s army 5) This alarmed English Protestants and Elizabeth’s Privy Council who put more and more pressure on her to send an army to help the Dutch Protestant rebels (in the Netherlands). Economic (commercial) Rivalry: The New World, privateers and Sir Francis Drake • Under Elizabeth, English merchants wanted to make big profits in the New World (Americas). • However, trading in the New World was difficult because of Spain’s power 1) Spain controlled most of the New World where there were huge profits to be made and anyone who wanted to trade there needed a licence from Spain (which it would not give): 2) But the Americas had valuable crops like tobacco, sugar, and also silver and gold 3) Elizabeth secretly encouraged privateers to trade illegally & raid Spanish ports & ships 4) At first Elizabeth denied responsibility for their actions, which delaye war with Spain Sir Francis Drake: Elizabeth sends Drake to rob Spanish colonies and ships (which infuriates Spain) 1) Spain’s support for the Ridolfi plot (1571) made her more willing to support Drake • In 1572 Eliz hired Drake to sail to the New World & steal £40,000 of Spanish silver • In 1577 she sent Drake back again with a secret mission to rob Spain’s colonies/ships • Drake brought back £400,000 of Spanish treasure & claimed an area of California in Elizabeth’s name (New Albion). He gave a lot of this money to Elizabeth • He boosted England’s finances at a time of growing concern over Spain’s threat • He became famous as the first Englishman to circumnavigate the globe. • Eliz knighted Drake as a reward, which infuriated Philip (as he saw Drake as a pirate) • Drake’s actions & his claim to California made it clear that England did not accept Spain’s domination of the New World. Elizabeth’s Support for the Dutch Rebels led to War with Spain (1585-88) • By the 1580s, tension between England & Spain had reached boiling point • At first, Eliz refused to send her army to help the Dutch rebels, because she wanted to avoid a war with Spain. So she tried to get the Spanish to leave the Netherlands in other INDIRECT ways: 1) By allowing Drake (& other English privateers) to attack and rob Spanish ships and colonies 2) By encouraging others (the French heir/mercenaries) to fight the Spanish in the Netherlands • In the 1570s, Elizabeth promised to marry the heir to the French throne (the Duke of Alencon) so that he would take an army to fight the Spanish in the Netherlands The Spanish Fury (1576) and the Pacification of Ghent (1576) • By 1576, the Spanish Govt in the Netherlands was bankrupt (the war was expensive) • After months without pay, Spain’s soldiers violently robbed Dutch towns in the “Spanish Fury” Spanish troops rebelling and robbing cities in the Netherlands in 1576. This united the Dutch Protestants & Catholics against Spain. They drew up the ‘Pacification of Ghent’ (demanding that): • Spanish troops leave the Netherlands • Spain allows the Dutch to rule themselves • The persecution of Dutch Protestants stops What did Elizabeth do? • Elizabeth sent £100,000 to help the Dutch rebels • In 1577 King Philip’s brother, Don Juan agreed to the rebels demands (but this was a trick) as just 6 months later Philip sent an even bigger army to attack the Dutch. • Elizabeth then hired a mercenary army of 6000 English & Scottish volunteers to help the Dutch. • But her plan backfired because the mercenaries destroyed Dutch Catholic churches, which caused the Catholics to make peace with Spain. • In 1578, her Privy Council urged Eliz to send her official army to help the Dutch, but she refused. The Dutch were disappointed & turned to France for help. The French Duke of Alencon arrived with an army to fight the Spanish, but by 1579 Spain had taken control again. • In 1580 Spain got even stronger after Philip won control of Portugal & its empire. • So Elizabeth gave the Duke of Alencon £70,000 to help him fight the Spanish • In 1582, Alencon took his army the Netherlands but failed to defeat Spain. • Elizabeth’s foreign policy in the Netherlands had failed & she had only managed to annoy Spain 1585: Why did Eliz finally decide to send her army to the Netherlands? (she lost her 2 main allies) • 1584 the Duke of Alencon died (so he could no longer fight the Spanish in the Netherlands) • 1 month later, William of Orange, the leader of the Dutch Protestant rebels was assassinated. • In 1585, Spain signed the Treaty of Joinville with France, agreeing to stamp out Protestantism in France/Europe meaning France & Spain were now allies against Protestantism • Elizabeth now felt she had no choice but to send her official army to the Netherlands • She signed the Treaty of Nonsuch with the Dutch rebels which promised them military help 1585: Robert Dudley’s campaign in the Netherlands was unsuccessful She sent 7,400 man army to the Netherlands led by Dudley. But he accepted the title of ‘Governor General’. Eliz was angry as it suggested that she had deposed King Philip so she told Dudley to resign this position. His army was defeated by the bigger Spanish Army as Eliz had not provided him with enough money to win. In 1587 Dudley resigned and returned to England. At the same time, Eliz had sent Drake to raid Spanish colonies in the New World to disrupt King Philip’s flow of money. Philip was furious and told the Pope he planned to invade England at the end of 1585. Drake singes the King of Spain’s beard 1587 • In 1587 Elizabeth ordered Drake to attack Spain’s most important port Cadiz • He destroyed 30 ships in 3 days – known as the ‘Singeing of the King of Spain’s Beard’ • He also stole lots of wood, meaning the Armada did not have quality barrels for food/water • Drake’s disruption delayed the Armada by a year (& meant that its food rotted in 1588). • This bought England more time to prepare for war. The Spanish Armada (1588) The Plan • By 1588, the Spanish Armada was ready to invade England • It had 130 ships with 8000 sailors & 18,000 soldiers • The Duke of Medina Sidonia would lead the Armada, but he had little experience at sea and didn’t want the job • The Armada would collect Parma’s army from France & sail to England under the protection of the Armada’s warships • Parma would march to London to depose Elizabeth & impose a Catholic government in England. 1) The Armada reached the English Channel The Armada set out in May 1588, but was delayed for a few weeks by bad weather In July the Armada was near England & signal fires were lit to warn Elizabeth English ships set sail to meet the Armada The Armada sailed up the channel in a crescent (half moon) formation, to use the large armed galleons to protect the weaker supply and army ships The English navy carried out a few minor raids, but did not inflict much damage Only 2 Spanish ships were lost (by accident) 2) The English attack the Spanish at Calais (with fire ships) and at Gravelines The Armada sailed up the English channel & anchored at Calais to wait for Parma’s army But Parma’s men didn't reach the coast in time (news had reached them too late) At midnight, the English sent 8 fireships into the Spanish ships causing panic They cut their anchors, broke formation & headed for the open sea (without Parma) The Spanish ships sailed to Gravelines, but bad weather stopped them returning to Calais The English attacked and the battle lasted many hours (5 Spanish ships were sunk) The rest were forced to sail away from France towards Scotland The English ships followed them to make sure they didn’t come back to collect Parma’s army 3) The Armada’s Journey back to Spain around Ireland was a disaster The Spanish called off the attack and returned to Spain around Scotland & Ireland Bad storms sank many ships and wrecked more on the Irish coast Many sailors died from starvation & disease – less than half the men made it back to Spain How did England defeat the Spanish Armada? !) Faster Ships • Years before the battle, England had started building smaller, faster ships (galleons) that could fire canon balls quicker & further than Spanish ships • Spanish ships were huge and slow to change direction. 2) Bad Planning & Communication (Spanish) • Philip’s plan to join with the Duke of Parma’s army in France was risky. • Parma had lots of small ships which took 48 hours to load, man and set sail. • It took too long (a week) for word to reach Parma that Medina was in the English Channel, by which time Medina had set sail to Calais. • Parma was not ready to set sail & the English were already ready to attack (leaving Medina with very little back up when anchored in France). 2) English Tactics were more effective • Spanish ships aimed to come alongside the English ones, jump on board & fight the enemy. But the English ships were faster & kept a safe distance. • They chased the Armada down the Channel, with heavy cannon fire, which forced the Spanish to arrive in France before Parma’s army was ready • As the Armada was waiting, the English sent fireships into the Spanish fleet. • This caused the Armada to panic, cut their anchors & sail away to the north • When the Spanish ships regrouped, the English attacked them in the Battle of Gravelines & the Armada was forced to sail north, chased by faster ships. 5) Bad Weather • Strong winds made it impossible for the Armada to return & pick up Parma’s army and storms wrecked or sunk Spanish ships as they tried to return home along the Scottish-Irish coasts. 2) Spanish Supplies • The Armada was not well supplied with food/weapons. Drake’s attack on Cadiz port in 1587 had destroyed food barrels. Delays in setting sail meant that by the time the English attacked the Armada it had been at sea for 10 weeks and had rotting food. 1000s died from starvation/disease. The consequences of the English victory? • Victory over the Spanish Armada gave Elizabeth a great propaganda victory • A new portrait was made, and a medal was made to commemorate her victory, it said “God blew and they were scattered”. • Elizabeth claimed that God was on the side of Protestantism • This led to a feeling of English pride and encouraged the Dutch rebels to renew their fight against the Spanish • The defeat of the Armada showed the strength of the English navy and gave England the confidence to trade and explore more widely at sea • Although Philip did not give up and continued the war for the rest of Elizabeth’s reign, the defeat had cost Spain dearly, both financially and in terms of its power • The Armada marked the start of a long decline in Spain’s power and fortunes. • English ships were sent on voyages of discovery and set up valuable new trade routes • By the end of Elizabeth’s reign, the navy was also trying to set up a new colony in Virginia • The English victory boosted Elizabeth’s popularity & strengthened the Protestant cause

Related quizzes

Related quizzes