Comparative Drug Review Gastrointestinal Therapies Tagamet And Nexium Biology Essay

Comparative Drug Review Gastrointestinal Therapies Tagamet And Nexium Biology Essay Tagamet and Nexium have been two of the many common drugs these days, both of which are widely used in the medical treatment of major gastric acid-related disorders like peptic ulcer disease (PUD) and gastro-esophageal reflux disease (GERD), with their respective active ingredient being cimetidine and esomerprazole. In view of their similar uses in gastrointestinal therapies, this review addresses various major characteristics possessed by the two drugs and in an attempt to make a vivid comparison between them in accordance to their active ingredients, for providing information optimizing the selection of gastric acid-related drugs at different clinical conditions. Mechanism Both cimetidine and esomeprazole serve to cure gastrointestinal disorders by reducing the secretion of gastric acid, however, with different drug targets to be acted on and mechanisms to bring about their actions. Cimetidine, being a histamine H2 receptor competitive antagonist (H2RA), reversibly binds to the histamine H2 receptor on the acid-secreting parietal cell of the stomach and lead to the production of second messenger cAMP which can ultimately trigger the H+/K+-ATPase to pump more acid out of the cell. Thus, the binding of histamine released by Enterochromaffin-like (ECL) cells in the stomach to the receptors, which in turn stimulates gastric acid secretion, is inhibited. At the same time, with the blockage of the histamine H2 receptors by cimetidine, the effect of both gastrin- and acetylcholine-stimulated acid secretion would be reduced. All these result in the lowering of acidity in the stomach. Esomeprazole, being a proton pump inhibitor (PPI), acts by an entirely different mechanism. Esomerprazole is a weak-base prodrug and it accumulates in the unique, highly acidic canalicular space of the active parietal cell, where the pH is less than 2.0. At this pH, it is converted to the active form of the drug, which then covalently binds to one or more cysteines that are accessed from the luminal surface of the gastric proton pump in gastric parietal cells, the H+/K+ ATPase enzyme, the target of which esomeprazole acts on. As a result, this irreversibly inhibits the H+/K+ ATPase enzyme, whose activity is involved in the final step of gastric acid secretion Therapeutic Effectiveness Owing to their different mechanisms of action, the gastric acid-suppressive effect produced by them varies, thus leading to variation in their effectiveness for treating related diseases. In general, PPIs (e.g. esomerprazole) are more potent than H2RAs (e.g. cimetidine) because the former inhibits the H+/K+ ATPase enzyme involved in the final step of acid secretion[1], as the latter only inhibits one of the pathways involved in acid secretion. The superior acid-suppressive effect of PPI over an H2RA has been verified by comparative studies. [2-5] Because of the different mechanism of these two drugs, esomeprazole has a longer duration than cimetidine. After converted to the active form, Esomeprazole can bind reversibly to the H+/K+-ATPase. As a result, esomeprazole will not be easily enzymatically metabolized and the major factor that leading to loss of effect of esomeprazole is largely dependent on the production of new H+/K+-ATPase. This is reason why esomeprazole has a rather long duration of effect on inhibition of acid secretion. In terms of therapeutic outcomes, it has been shown that higher efficacy is found in PPI treatments than in H2RA treatments for a wide range of diseases such as peptic ulcer disease, gastroesophageal reflux disease, GI damage caused by non-steroidal anti-inflammatory drugs, and Zollinger-Ellison syndrome. [6 V13], as revealed by many studies. One of these aimed to investigate oesophagitis in which a meta-analysis of 43 therapeutic trials was conducted in patients with moderate or severe oesophagitis. The proportion of patients successfully treated was almost doubled with PPIs, and the rapidity of healing and symptom relief were about twice that with H2RAs. [14] Thus, It had confirmed the advantage of PPIs over H2RAs. [15] To sum up, up to the present stage, esomerprazole seems to be more effective and a more preferable choice than cimetidine for the treatment of most gastric acid-related diseases. Safety In fact, both cimetidine and esomeprazole are quite safe and they rarely have adverse effects that may be lethal. In a meta-analysis of 24 double-blind placebo-controlled studies, it shows negligible difference of incidence of side effects between cimetidine and placebo. The most commonly reported adverse effects are diarrhea, other gastrointestinal disturbances, dizziness, tiredness, rashes and headache. Furthermore, most adverse effects of cimetidine are dose-related and as the length of treatment increases, the risk is decreased which means Cimetidine is rather secure for patients who require long-term treatment. Also, Cimetidine has significant anti-androgen effects in patient receiving high dose and this puts some male patients in fear. Adverse effects of Esomeprazole are infrequent as Cimetidine, but some of its common side effects like headache, diarrhea and skin rashes can be severe and may need to resolve on drug discontinuation. Moreover, recognized increases in the prevalence of pneumonia and Campylobacter enteritis as well as a doubling of the risk of infection with Clostridium difficile should not be overlooked due to the role of esomeprazole as a first-line drug. What should emphasize is that patients still need health care professionals careful indication as if both drugs are safe. Since esomeprazole is one of the most frequently prescribed medicine and 63% , 33% and 67% of hospital inpatients in Austria, Ireland and the United Kingdom did not meet the criteria for taking esomeprazole or other proton pump inhibitors. As a result, it is pharmacoeconomically unfavorable and improved clinical pharmaceutical care can be achieved by detailed indication by the cooperation of pharmacist and health care professionals. What is more, these two drugs are placed in the same Pregnancy Category by the US FDA and they are not advised for the pregnant women. Because of their inhibition of parietal cells, secretion of intrinsic factor is reduced. As a result, both drugs can lead to mal-absorption of Vitamin B12 which is important for maturation of Erythrocytes and DNA synthesis and thus Vitamin B12 therapy may be needed. Drug interactions They interact with a wide variety of drugs except that they both reduce absorption of acid-dependent drugs due to their effect of lowering of the stomach pH, but in fact only drugs with a narrow therapeutic index have clinical significance. The majority of interactions is due to binding of cimetidine to cytochrome P450 isoenzymes in the liver with subsequent inhibition of microsomal oxidative metabolism and increased bioavailability or plasma concentrations of drugs metabolised by these enzymes. These drugs are anticoagulants, phenytoin, theophylline, benzodiazepines, betal-blockers, lidocaine, Procainamide, ketoconazole and itraconazole. Similarly, Esomeprazole interferes with the elimination of drugs metabolized by isoenzyme CYP2C19 and to a smaller extent by CYP3A4. Therefore, it increases the plasma level of clarithromycin, amoxicillin, diazepam, phenytoin, and warfarin. In addition, esomeprazole has a potential interaction with atazanavir which is a HIV-Protease Inhibitor to treat HIV by substantially reducing the concentration of atazanavir. Conclusion Summarizing all the above mentioned features, Nexium is seemingly a better drug in terms of its potency, therapeutic effects as well as its range of application in clinical conditions, comparing to Tagamet. However, its benefits and drawbacks may be revealed in the future by research works, which should be always aware of.

Civic league :: essays research papers

Civic League   Ã‚  Ã‚  Ã‚  Ã‚  Helen Sykes, a resident of the Norfolk area, feels that the tight community neighborhood is drastically decreasing. She is among many home owners whom feel this way. In order to restore our community we must work from every angle including those areas that may be less fortunate. Many of the children in this area have no where to go after school therefore they are becoming latch-key children because their parents have to work long hours. We all must work together to better this community not just our specific neighborhood. In order to bring that tight knit community we have to live and work together in harmony. Now many to disagree like John Mitts, who feels that helping the minority neighborhoods is just a lost cause and we can not help them unless they help themselves.   Ã‚  Ã‚  Ã‚  Ã‚  Jim English, President of the Wards Corner Civic League, feels that rebuilding the community will appeal to everyone in every neighborhood. We will be helping those less fortunate then us to have a nicer and safer place to live. At the same time the neighborhood’s real estate value will increase because of the new appeal. If the neighborhood does not pull together and want this change then no one can benefit. Think about how you would feel if you were in a home were there is constant drugs and violence and you don’t even feel safe letting your children outside to play. No one can begin to imagine how bad these people really need our help and at the same time you are helping to reshape your neighborhood as well.   Ã‚  Ã‚  Ã‚  Ã‚  Everyone must do their part in order to change the outlook of the neighborhood. This change will take time but the end result will be amazing. We will be constructing and shaping the lives of our future generations who will live here after us. I am a strong believer in second chances and I feel that is exactly what this neighborhood needs. We should be able to go back to the time when everyone would sit on their porches and talk for hours and children would play until their little bodies became to weak. Those were the good times and we can all make them into the great times. All we need is a little team work.   Ã‚  Ã‚  Ã‚  Ã‚  Many will disagree to restoring the community for various reasons. Some just feel that we should move and let the neighborhood be taken over by the crime and filth of some other areas.

Handling information Essay

1. Understand requirements for handling information in health and social care setting 1.1 identify legislation and codes of practice that relate to handling information in health and social care: All of the staff need to make sure that confidentiality is paramount. Staff have to read and understand the Data Protection Act of 1998. We have to make sure that we are clear about our standards of conduct, that we are expected to meet. We are encouraged to use the codes of conduct to maintain our own practice is good and we need to look at any area’s that we can improve on. When it comes to Medication, staff have to make sure that all stock is listed on the MAR sheet. The Human Rights Act 1998 details the right to a private life. There is also the GSCC code of practice for social care workers, which provides a clear guide for all those who work in social work, setting out the standards of practice and conduct workers and their employers should meet with regards the handling of information. There is also Caldecott standards which govern the sharing of information based on the Data protection Act. 1.2 summarise the main points of legal requirements and codes of practice for handling information in health and social care. The 8 Principles of the Data Protection Act 1998 states the personal data must be: Processed fairly and lawfully Processed only for one or more specified and lawful purpose Adequate, relevant and not excessive for the purpose Accurate and kept up to date Kept for no longer than is necessary Processed in line with the rights of the individual Secure against accidental loss, destruction or damage and against unauthorized / unlawful processing Not transferred to countries outside the European economic area The six main points of the gscc code of practice states that health and social care workers must provide the following: Protect the rights and promote the interests of service users and carers. Strive to establish and maintain the trust and confidence of service users and carers. Promote the independence of service users while protecting them as far as possible from danger or harm. Respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people. Uphold public trust and confidence in social care services. Be accountable for the quality of your work and take responsibility for maintaining and improving your knowledge and skills. 1.3. describe features of manual and electronic information storage systems that help ensure security Manual systems inevitably mean paper type records (text, photos, X-Ray, hand written notes or comments, etc.) These require to be out of general view when in use and locked away when not in use or attended. Lockable filing cabinets, locked rooms (by key or number pad), locked briefcase (when in transit) and special vaults and safes. Electronic records can be protected by password access to the computer, to the folder, to the file. Some systems allow access (to anything electronic) by only authorised personnel based on employee number or similar. Some computers are not connected to the internet to avoid the risk of intervention. Movement of data should require that the data is first encrypted so if intercepted cannot be viewed.

Pascual Orozco, Early Leader of the Mexican Revolution

Pascual Orozco, Early Leader of the Mexican Revolution Pascual Orozco (January 28, 1882–August 30, 1915) was a Mexican muleteer, warlord, and revolutionary who participated in the early parts of the Mexican Revolution (1910–1920). More of an opportunist than an idealist, Orozco and his army fought in many key battles between 1910 and 1914 before he â€Å"backed the wrong horse,† said General Victoriano Huerta, whose brief presidency lasted from 1913 to 1914. Exiled, Orozco was captured and executed by Texas Rangers. Fast Facts: Pascual Orozco Known For: Mexican revolutionaryBorn: January 28, 1882 in Santa Inà ©s,  Chihuahua, MexicoParents: Pascual Orozco Sr. and Amanda Orozco y VzquezaDied: August 30, 1915 in the Van Horn Mountains, MexicoNotable Quote: â€Å"Here are the wrappers: send more tamales.† Early Life Pascual Orozco was born on January 28, 1882, in Santa Inà ©s,  Chihuahua, Mexico. Before the Mexican Revolution broke out, he was a small-time entrepreneur, storekeeper, and muleteer. He came from a lower-middle-class family in the northern state of Chihuahua and by working hard and saving money, he was able to acquire a respectable amount of wealth. As a self-starter who made his own fortune, he became disenchanted with the corrupt regime of Porfirio Dà ­az, who tended to favor old money and those with connections, neither of which Orozco had. Orozco became involved with the Flores Magà ³n brothers, Mexican dissidents trying to stir up rebellion from safety in the United States. Orozco and Madero In 1910, opposition presidential candidate Francisco I. Madero, who lost due to election fraud, called for a revolution against the crooked Dà ­az. Orozco organized a small force in the Guerrero area of Chihuahua and quickly won a series of skirmishes against federal forces. His force grew with every victory, swelled by local peasants who were drawn by patriotism, greed, or both. By the time Madero returned to Mexico from exile in the United States, Orozco commanded a force of several thousand men. Madero promoted him first to colonel and then general, even though Orozco had no military background. Early Victories While Emiliano Zapatas army kept Dà ­az federal forces busy in the south, Orozco and his armies took over the north. The uneasy alliance of Orozco, Madero, and Pancho Villa captured several key towns in Northern Mexico, including Ciudad Juarez, which Madero made his provisional capital. Orozco maintained his businesses during his time as general. On one occasion, his first action upon capturing a town was to sack the home of a business rival. Orozco was a cruel and ruthless commander. He once sent the uniforms of dead federal soldiers back to Dà ­az with a note: â€Å"Here are the wrappers: send more tamales.† Revolt Against Madero The armies of the north drove Dà ­az from Mexico in May 1911 and Madero took over. Madero saw Orozco as a violent bumpkin, useful to the war effort but out of his depth in government. Orozco, who was unlike Villa in that he was fighting not for idealism but under the assumption that he would be made at least a state governor, was outraged. Orozco had accepted the post of general, but he resigned it when he refused to fight Zapata, who had rebelled against Madero for not implementing land reform. In March 1912 Orozco and his men, called Orozquistas or Colorados, once again took to the field. Orozco in 1912–1913 Fighting Zapata to the south and Orozco to the north, Madero turned to two generals: Victoriano Huerta, a relic left over from the days of Dà ­az, and Pancho Villa, who still supported him. Huerta and Villa were able to rout Orozco in several key battles. Orozcos poor control of his men contributed to his losses: he allowed them to sack and loot captured towns, which turned the locals against him. Orozco fled to the United States but returned when Huerta overthrew and assassinated Madero in February 1913. President Huerta, in need of allies, offered him a generalship and Orozco accepted. Huertas Downfall Orozco was once again fighting Pancho Villa, who was outraged by Huertas murder of Madero. Two more generals appeared on the scene: Alvaro Obregà ³n and Venustiano Carranza, both at the head of huge armies in Sonora. Villa, Zapata, Obregà ³n, and Carranza were united by their hatred of Huerta, and their combined might was far too much for the new president, even with Orozco and his colorados on his side. When Villa crushed the federales at the battle of Zacatecas in June 1914, Huerta fled the country. Orozco fought on for a while but he was seriously outgunned and he, too, went into exile in 1914. Death After the fall of Huerta, Villa, Carranza, Obregà ³n, and Zapata began slugging it out among themselves. Seeing an opportunity, Orozco and Huerta met up in New Mexico and began planning a new revolt. They were captured by American forces and charged with conspiracy. Huerta died in prison. Orozco escaped and was later shot and killed by Texas Rangers on August 30, 1915. According to the Texas version, he and his men tried to steal some horses and were tracked down and killed in the ensuing gunfight. According to the Mexicans, Orozco and his men were defending themselves from greedy Texas ranchers, who wanted their horses. Legacy Today, Orozco is considered a minor figure in the Mexican Revolution. He never reached the presidency and modern historians and readers prefer the flair of Villa or the idealism of Zapata. It should not be forgotten, however, that at the time of Maderos return to Mexico, Orozco commanded the largest and most powerful of the revolutionary armies and that he won several key battles in the early days of the revolution. Although it has been asserted by some that Orozco was an opportunist who coldly used the revolution to his own gain, that does not change the fact that if not for Orozco, Dà ­az may well have crushed Madero in 1911. Sources McLynn, Frank. Villa and Zapata: A History of the Mexican Revolution. New York: Carroll and Graf, 2000.Pascual Orozco, Jr. (1882–1915).  Encyclopedia of Latin American History and Culture, Encyclopedia.com, 2019.

4 Reasons You Need Volunteer Work On Your Resume

4 Reasons You Need Volunteer Work On Your Resume We all know volunteering experience can really jazz up a resume. But it’s hard to find the time to balance that sort of extracurricular pursuit with acquiring all the skills and knowledge needed in your field. It’s hard to tell when volunteering would actually, specifically, directly help you in your job search. Here are four situations where some volunteer work on your resume would be a major asset:1. You’ve just graduatedYour only relevant experience is academic, perhaps with an internship or two. Volunteering at this stage in your career can be fabulous for building your network and helping you find jobs, and also for padding your resume to help you get one. Try to find an opportunity that complements your chosen career path and you’ll be well on your way.2. You’re unemployed and have been (or will be) for a whileKeep yourself current and prove that, even though you may not have found a suitable job opportunity in the interval, you’ve kept yourself busy and motivated and have kept your skills sharp. It’s also a great way to make new connections. You never know who might help you find your next job.3. You want to change careersWhile you start to build up skills and expertise in the new career you’re angling to change into, volunteering can be a great way to get your feet wet and break into that world. It shows your passion for your field, and will start helping you to make valuable networking connections, plus learning things that will serve you in the course of your career switch.4. You don’t know what you want to doIt’s okay to come out of school and not know exactly what you want to be when you grow up. Volunteer work is a great way to try out different fields and get a feel for what rewards you and challenges you most. Play around. Worst case scenario? You haven’t wasted time, you’ve helped to make a difference.

Pick any topic from the instruction Essay Example | Topics and Well Written Essays - 1250 words

Pick any topic from the instruction - Essay Example If free will is a gift from God, then it is part of that same open system that God set in motion to follow its own course. There is the possibility that what atheistic existentialists take to be an accident is actually the seeming chaos of a free system, created by an entity, animated - not governed - by free will. The idea that theism can be compatible with non-theological concepts has gained currency in recent years. The Episcopal Church, for example, has adopted the idea that the rational can help aid one’s understanding of what God is because reason itself is a gift from God. Name 2 One need not cancel out the possibility of the other. Faith doesn’t have to be the only resource because man has other gifts, other intrinsic capabilities that he can use in concert with others. The theistic philosopher Henry Rogers wrote, â€Å"The truth is, that both Reason and Faith are coeval with the nature of man, and were designed to dwell in his heart together. They are†¦re ciprocally complementary; - neither can exclude the other† (Rogers, 339). ... ng answers, to looking beyond the suppositions of existentialism, Kierkegaard’s tendency was to fall back on his Lutheran background, Pascal from an Augustinian system of belief and Sartre and Nietzsche from the humanist school, of which they were to a large extent the product (Tillich, 25). For Kierkegaard, the search for answers was a striving for transcendence, which resulted from the realization that one is responsible for one’s own condition. Personal freedom lies at the heart of this position. One has the freedom to choose despair or strive for self-actualization. â€Å"Either possibility requires that the self moves toward transcendence, reliance on God’s help, according to Kierkegaard† (Gray, 279). As such, the subject engages in a kind of selection, a choosing of salvation or of a personal fall. The subject â€Å"comes to renounce its Name 3 immediate self and choose its eternal self. It accepts the paradox of the God-man, and through this qualit ative leap free itself from despair and reach salvation† (Stewart, 138). For Kierkegaard, theism is the vehicle through which the individual arrives, subjectively, at the fullness of his meaning as a human being. The individual works through this alone as the sole possessor of his own ethical and aesthetic reality, ultimately leading him to a state of grace. Kierkegaard and many of those who followed his precepts believed that Christianity, and other monotheistic religions, were expressions of hypocrisy that taught pure love but practiced a creed that seemed to believe this purity was the special reserve of a privileged few; specifically, of the wealthy and powerful. The Christianity they observed around them drew from a shallow moral well, one that provided dubious spiritual sustenance from its manifesto (the

International business law Assignment Example | Topics and Well Written Essays - 2500 words

International business law - Assignment Example In civil proceedings the wronged party has the sole discretion to pursue his rights, make a compromise or, if he so wishes, fail to bring proceedings or even discontinue proceedings in the course of the trial of a case. The case of Donoghue v Stevenson which falls under the law of torts and is part of civil law is a good illustration that civil law is meant to uphold the rights of individuals. A friend of Mrs Donoghue ordered an opaque bottle of ginger beer (intended for the consumption of Mrs Donoghue) in a cafe in Paisley. Having consumed half of it, Mrs Donoghue poured the remainder into a tumbler. The decomposing remains of a snail floated out. She claimed to have suffered from shock, fell ill with gastroenteritis and sued the manufacturer for carelessly allowing the drink to be contaminated. The House of Lords decided that the manufacturer was liable for Mrs Donoghue's illness. Criminal proceedings, on the other hand, are meant to enforce law and order in the interests of the co mmunity (Brody et al 2000), generally by punishing the offender. Proceedings are usually undertaken by the Crown, although private prosecutions are possible but very rare, and once started can be discontinued only by the Attorney-General. On the face of it, a civil offence is a wrong against an individual, whereas a criminal offence is a wrong against the community, but such a line is difficult to draw. The intention of the criminal law is to ensure that every citizen knows the boundaries of acceptable conduct in the UK, for example it is clearly unacceptable conduct to steal from another individual – thereby it is necessary to have the criminal law of theft under the Theft Act 1968. This clearly applies to other criminal offences such as murder and rape. The wrong is against the society. A breach of the criminal laws imposed by society will be seen as a wrong against society as a whole. Therefore if the boundaries of acceptable conduct in the UK have been exceeded by an indi vidual and that individual has been caught they will face prosecution by the state and will receive appropriate punishment such as a fine, imprisonment or a community sentence. References Brody, David C.; Acker, James R.; Logan, Wayne A. (2000). "Introduction to the Study of Criminal Law". Criminal Law. Jones & Bartlett Publishers. ISBNÂ  0-8342-1083-5 Donoghue v Stevenson ([1932] A.C. 532, 1932 S.C. (H.L.) 31, [1932] All ER Rep 1 Evaluate the role of common law and legislation within the English Legal System Common law Common law is based largely on judge-made law (law developed through decisions by judges necessary to decide cases brought before them or case-law) The development of case-law still remains an important source of law. A statement of law made by a judge in a case can become binding on later judges and can in this way become the law for everyone to follow. Whether or not a particular pronouncement (technically called a precedent) by a judge sitting in court when decid ing a case does become binding (according to the doctrine of "stare decisis" - stand by what has previously been decided) on later judges depends on two main factors: The pronouncement must be made by a court of sufficient seniority. Basically, judges at the lowest tiers of decision making (often called courts of first instance), are not allowed to issue binding precedents. The pronouncement