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Uses of Alcohols
Quiz by Soni Manuel
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Acetic acid – a chemical substance with an inhibiting effect on the growth of microorganisms and which is present in vinegar.Acetic Acid Fermentation Fermentation preserves food through the metabolic activities of selected groups of microorganisms. During the process, compounds such as lactic acid, acetic acid and alcohol are developed and result in a more or less stable food form. It makes food more nutritious as dietary source of proteins, vitamins and minerals.Vinegar is an example of the product of acetic acid fermentation which also undergoes alcoholic fermentation to complete the process.Filter – is a device, substance (like paper or charcoal), or process that separates unwanted components from a fluid Cheesecloth-is a loose-woven, gauze-like cotton fabric used for straining liquids from solids.Decant- gradually pour (liquid, typically wine or a solution) from one container into another, especially without disturbing the sediment. Sediment-is solid material (like sand, silt, clay, rocks, organic matter) broken down by weathering, transported by wind, water, or ice, and deposited in a new location, settling at the bottom of water bodies or on land.How to make vinegar? 1.Grind or crash the fruit, then boil in water of the same amount as the ground flesh, peels and cores. Boil until soft, and then strain the juice through a cheesecloth2.Add ¼ (one-fourth) pound of sugar for every liter of juice extracted from fruit peels and cores. Do not add sugar when using ripe fruit.3.Add ¼ of a cake of fresh yeast that has been well-broken up, for every liter of juice. Stir very well, and then place in glass jars. Cover with a clean cloth and let the mixture stand for about two weeks .4. After two weeks, separate the clear liquid from the sediment. Prepare fresh, unpasteurized vinegar also called “mother vinegar” which is the white gummy mass that usually forms in vinegar. Add this to the liquid and mix very well. Over the container with cloth, then allow to stand in a warm place until it has acquired a flavor strong enough to use.5.Filter the clear liquids, then pour in a bottle and cover tightly.USES OF VINEGAR1. Insect salve and repellent. 2. Kill weeds and remove ants. 3. Enhance bricks. 4.Open a tight jar. 5.Clean scissors. 6.Remove smoke odors. 7. Remove pit stains. 8. Make hair shine. 9. Fruit fly trap. 10. Car care. 1 .Sand soil • Has course/ large particles • they are larger than those of clay • Loses water quickly • Has less organic matter • Has good aeration • Allows good root penetration • Leaching of nutrients is more in sand soil. • Does not stick when wet 2. Clay soil • Has very fine particles which are closely packed • The soil is sticky when wet and can be moulded into any shape • It holds more water than sand and loam • It has poor drainage • It cracks when dry • It has poor aeration • It does not allow good root penetration 2 .Loam soil • Is a mixture of sand and clay particles • It half clay half sand • It can be easily moulded into a shape but easily crumbles • Holds water for a longer time than sand • It sticks on the hands when wet • It has good drainage • It has good aeration • It allows good root penetration • Loam is the best soil Soil Fertility • When soil has enough plant nutrients it is fertile • Soil fertility is the presence of nutrients in the soil • A farmer can add nutrients to the soil to make it fertile • This is done by applying fertilizers and compost. • A fertiliser is a substance that is added to the soil to increase fertility • Nutrients found in the soil include Nitrogen, Phosphorus and Potassium ( NPK ) • They are called major nutrients or macro nutrients because they are needed in large quantities Minor nutrients • Minor nutrients are needed in smaller quantities • Minor nutrients are also called micro nutrients or trace elements • Examples of minor nutrients are boron, iron, zinc, manganese, magnesium and molybdenum Soil erosion • Is the washing away of top soil by agents such as Water Wind Animals Humans 1. Water: • Water washes away soil when it rains. • Loose soil is washed away into dams and rivers. • Steep slopes also lead to soil erosion. • Ploughing 2 . Wind • The blowing away of soil by wind causes soil erosion. • When people cut down trees wind erosion easily takes place. • Type of soil also leads to wind erosion. Which soil type is easily eroded by wind? 3 . Animals • Animal cause soil erosion by overgrazing. • Overgrazing is when animals eat plant or vegetation leaving the ground surface bare. • Animals walking on the same pathway for a long time make the soil loose. • Animals that live underground also burrow loosening the soil. • This makes soil break easily and get washed away. WATER WATER CONSERVATION Water • Water is important in agriculture • It is used to: Clean farm tools Mould bricks Wash milking equipment Cool machines Provide homes(habitat) for fish Give animals drinking and bathing water Sources of Water Natural sources 1. Natural rains: • rain water from the clouds is a primary source of water. • It is used to water crops such as maize, millet, sorghum and so on during the rainy season. • Rain water that collects into the rivers and dams is used by animals and people for drinking. 2 . Rivers : • Rivers are some of the major sources of water for different activities such as fishing, boat cruising and irrigation. 3 . Streams : • A stream is a small river. • Streams supply water for irrigating garden crops especially in rural areas. • They are also a source of water for animals to drink and bath. Sources of Water 4 . Springs : • Springs are usually found on hilly areas. • They result from pressure of underground streams. • The pressure forces water underground to form a channel to the surface of the soil and flow above the ground. Sources of Water Man made sources Man discovered that water for agriculture was not enough during the rain and cool dry seasons. They decided to make structures which would harvest or collect and store water for future use. 1.Protected well: • Wells are dug in the ground by hand. • They are often lined with bricks and concrete so that they do not cave in. • Protected wells are covered, therefore are safe to drink from. 2 . borehole : • They are deep holes made by drilling machines. • Drilling can be done up to 70 metres deep. • Water is pumped using an electric pump or hand pump. Sources of Water 3 . Dams : • A dam is a large wall or barrier built to hold water to save it for future use. 4 . Weir : • A weir is made by construction a cement brick wall or concrete wall across a river to trap water and eroded soil. • water flows over the wall when the river is inflood. 5 .Water tank : • Is a temporary manmade water source. • Water from a water tank is usually harvested from roof tops or it works along a borehole or protected well as temporary storage. • Water is pumped from the borehole or protected well into the water tank. 6 . reservoir : • A large natural or manmade lake used as a source of water. PLANTS Uses of plants • Fibre for making clothes • Oil for cooking, making paint and chemicals • Sugar for tea • Wood for timber • Refreshing drinks and alcohol • Food for people and animals • Protect the soil from erosion • Plants supply us with fresh oxygen for breathing. • Some plant parts are used as medicine.Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we won’t talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined α and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic Drug Alpha1 Blockers (we’ve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an α1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic Drugs Alpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels → lowers peripheral resistance → Results in decreased BP So ….Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesn’t everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitors aka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patient’s chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-life Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers (ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia… Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTN Treatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)CELLULAR RESPIRATION CELLULAR RESPIRATION What is it? Cellular respiration is the process by which cells break down glucose (a simple sugar) and other organic molecules to release energy in the form of ATP (adenosine triphosphate), which powers cell activities. Overall equation: C6H12O6 + 6O2 ⟶ 6CO2 + 6H2O + ATP (energy) Stages of Cellular Respiration 1. Glycolysis (in the cytoplasm) • Where it happens: Cytoplasm (outside mitochondria) • What happens: o One molecule of glucose (6 carbons) is split into two molecules of pyruvate (3 carbons each). o 2 ATP are used to start the process. o 4 ATP are produced (net gain = 2 ATP). o 2 NADH (electron carriers) are also produced. Summary of glycolysis products per glucose: • 2 ATP (net gain) • 2 NADH • 2 Pyruvate 2. Krebs Cycle (Citric Acid Cycle) (in the mitochondrial matrix) • Where it happens: Mitochondrial matrix • What happens: o Each pyruvate (3C) is converted to acetyl-CoA (2C) before entering the cycle. o Acetyl-CoA combines with oxaloacetate (4C) to form citric acid (6C). o Through a series of enzyme-controlled reactions, citric acid is broken down, releasing CO₂, ATP, NADH, and FADH₂. Summary of Krebs Cycle products (per 2 pyruvates): • 2 ATP • 6 NADH • 2 FADH₂ • 4 CO₂ (exhaled as waste) 3. Electron Transport Chain (ETC) & Oxidative Phosphorylation (in the inner mitochondrial membrane) • Where it happens: Inner mitochondrial membrane (cristae) • What happens: o NADH and FADH₂ donate high-energy electrons to proteins in the ETC. o As electrons move through the chain, protons (H⁺) are pumped across the membrane, creating a proton gradient. o This gradient powers ATP synthase, which makes lots of ATP (like a turbine powered by flowing water). o Oxygen acts as the final electron acceptor, combining with electrons and hydrogen to form water (H₂O). Summary of ETC products: • About 34 ATP • H₂O Total Energy Yield from One Glucose (Aerobic Respiration) • Glycolysis → 2 ATP • Krebs Cycle → 2 ATP • ETC → ~34 ATP Total: ~38 ATP (usually 36 in eukaryotes due to energy costs) Anaerobic Respiration (When Oxygen is Absent) If oxygen is not available, cells switch to fermentation: • Alcoholic Fermentation (yeast & some bacteria): pyruvate → ethanol + CO₂ • Lactic Acid Fermentation (muscles & some bacteria): pyruvate → lactic acid These processes only make 2 ATP per glucose, much less efficient than aerobic respiration. Key Takeaway: Cellular respiration is like the cell’s power plant: glycolysis breaks glucose into smaller pieces, the Krebs cycle extracts more high-energy electrons, and the ETC uses those electrons to generate the bulk of ATP. Oxygen is essential for the final step, which is why we need to breathe to stay alive.Uses of Energy and Functions of ObjectsUses of radiationUses of EmbryosUses of energy