II. Combine the sentences using Gerundial Complexes.

Model: The newborn’s reflexes were normal. The doctor was pleased with it. –

The doctor was pleased with the newborn’s reflexes being normal.

1. Nick is an excellent cardiologist. His father is proud of it.

2. She will have a healthy baby. I am sure of it.

3. The physician has withheld Atorvastatin. We are surprised at it.

4. The doctor will come in time. We are sure of it.

5. The patient goes in for sports. The doctor agreed to it.

6. The intern made a correct diagnosis after the first examination of the cardiac patient. The doctor is pleased with it.

7. The patient’s condition has been caused by heavy smoking. I am sure of it.

Lesson 6 Gastrointestinal Drugs

Text: Gastrointestinal Drugs

Grammar: Verbals (Review)

I. Active Vocabulary

motility anti-diarrhoeal kaolin aluminium silicate laxative constipation saline purgative bulk laxative faeces liquid paraffin anthraquinone cascara senna phenolphthalein ricinoleic acid methylcellulose tragacanth psyllium emetic to vomit ipecac syrup motion sickness peptic ulcer proton pump inhibitor antacid

[mqV'tIlqtI] ["xntI"daIq'rJql] ['keIqlIn] ["xlq'mInIqm 'sIlIkeIt] ['lxksqtIv] ["kPnstI'peISn] ['seIlaIn 'pE:gqtIv] ['bAlk 'lxksqtIv] ['fJsJz] ['pxrqfIn] ["xnTrq'kwInqVn] [kx'skRq] ['senq] ["fJnPl'TxlJn] ["rIsInqV'lJIk] ["mJTaIl'seljVlqVs] ['trxgqkxnT] ['sIlIqm] [I'metIk] ['vPmIt] ['Ipq"kxk] ['mqVSn 'sIknIs] ['peptIk 'Alsq] ['prqVtPn 'pAmp In'hIbItq] [xn'txsId]

моторика протипроносний засіб каолін силікат алюмінію проносний засіб закреп проносний засіб на сольовій основі проносний засіб, що збільшує вміст кишківника випорожнення, кал вазелінова олія антрахінон каскара, лікарський засіб з кори крушини сенна фенолфталеїн (пурген) рицинолева кислота метилцелюлоза трагакант псиліум, подорожник рвотний засіб блювати сироп іпекакуани закачування в транспорті пептична виразка інгібітор протонової помпи засіб, що нейтралізує кислоту

II. Read the following text. Gastrointestinal Drugs

Drugs may act on the digestive system either by affecting the actions of the involuntary muscle (motility) and thus altering movement or by altering the secretion of digestive juices or gastric emptying.

Anti-diarrhoeal drugs. In the treatment of diarrhoea, kaolin powder is the most widely used adsorbent powder. Kaolin is a naturally occurring hydrated aluminium silicate, which is prepared for medicinal use as a fine powder. It is not harmful, and it is effective in many cases. Morphine, codeine and the synthetic opioids have a constipating action (morphine was used for this effect long before it was used as a painkiller). The dangers of dependency and addiction clearly prevent the use of certain opioids (e.g., morphine, meperidine) as a treatment for diarrhoea. Other opioids (codeine and the synthetic analogs diphenoxylate and loperamide) produce little dependence, however, and they have been used successfully in the treatment of the condition.

Laxatives. There are four kinds of medication available for relief of constipation: saline purgatives, faecal softeners, contact purgatives, and bulk laxatives. Saline purgatives are salts containing highly charged ions that do not readily cross cell membranes and therefore remain inside the lumen, or passageway, of the bowel. Some commonly used salts are magnesium sulphate, magnesium hydroxide, sodium sulphate, and potassium sodium tartrate. Faecal softeners are not absorbed from the gastrointestinal tract and act to increase the bulk of the faeces. Liquid paraffin (mineral oil) can be used either as the oil itself or as a white emulsion. Contact purgatives include the anthraquinone derivatives (cascara, aloe, senna, and rhubarb), phenolphthalein, and ricinoleic acid (castor oil). Although their exact mechanism of action is unknown, these drugs irritate the lining of the bowel, which may account for their effect. After regular use, their effect tends to lessen, so that larger and more frequent doses are necessary until finally they cease to be effective. Bulk laxatives act by increasing the size of the faeces, in part because of their capacity to attract water. This group includes methylcellulose and carboxymethylcellulose, the gums agar and tragacanth, psyllium (plantago) seed, and dietary fibre.

Emetics produce nausea and vomiting, and their use is limited to the treatment of poisoning with certain toxins that have been swallowed. The most commonly used drug for this purpose is ipecac syrup, prepared from the dried roots of Cephaelis ipecacuanha, a plant indigenous to Brazil and Central America.

Antiemetic medications reduce the urge to vomit. One of the most effective of these medications is the phenothiazine derivative prochlorperazine. This medication acts on the vomiting center in the brain. It is often administered rectally and usually alleviates nausea and vomiting within a few minutes to an hour. Other drugs that are used to combat nausea and vomiting include dolasetron, granisetron, and ondansetron. Antihistamines are also often used to prevent nausea and vomiting, especially when these problems are caused by motion sickness. This type of medication may also work on the vomiting center in the brain.

Antiulcer medications are prescribed to relieve the symptoms and promote the healing of peptic ulcers as well as to treat acid-reflux disease, which can cause severe heartburn pain in some people. Histamine (H-2) blockers, including cimetidine, famotidine, nizatidine, and ranitidine, work by preventing histamine from attaching to receptors on acid-secreting cells, thus keeping the histamine from triggering the secretion of stomach acid.

Another group of antiulcer drugs are the proton pump inhibitors (PPIs); they limit stomach-acid secretion by shutting down the acid pumps in the acid-secreting cells themselves. PPIs, which include omeprazole, pantoprazole, and lansoprazole, are commonly prescribed to treat and prevent many stomach problems.

Antacids. Excess acid may be neutralized in the stomach with antacid tablets. The main constituents of antacids are aluminum and magnesium hydroxides. There are three side effects of antacid therapy, which depend on the compound used. First, many have an action on the bowel: some have a mild laxative effect, and some are constipating. Second, if the positively charged compounds are absorbed, the blood may be made alkaline. Third, antacids may affect the absorption of other drugs by binding with them in the gastrointestinal tract.

Answer the following questions on the text.

1. In what way do drugs act on the digestive system?

2. What is the most widely used medication in the treatment of diarrhea?

3. Why are certain opioids rarely used for diarrhea?

4. What medications available for relief of constipation do you know?

5. In what cases are emetics used?

6. What is the action of prochlorperazine?

7. Antihistamines are often used to prevent nausea and vomiting, aren’t they?

8. What drugs are prescribed in case of peptic ulcer?

9. What do PPIs include?

10. What may excess acid be neutralized by in the stomach?

11. Do antacids have any side effects?

III. Vocabulary and Speech Exercises

I. Read the following transcriptions. Write them in words and give their Ukrainian equivalents.

[me'perIdJn], ["dIfe'nPksIleIt], [lqV'perqmaId], ["fJnqV'TaIqzJn], ["prqVklLr'perqzJn], [dP'lxstqrPn], [grx'nIsqtrPn], [Pn'dxnsqtrPn], [saI'metIdJn], [fq'mtIdJn], [nI'zxtIdJn], [rx'nItIdJn], [P'meprqzqVl], [pxn'tqVprqzqVl], [lxn'sqVprqzql].

II. Give English equivalents of the following words and word combinations.

Травна система; адсорбент; дрібний порошок; закріплююча дія; небезпека звикання; синтетичний аналог; високозарядні іони; тартарат калію-натрію; мінеральна олія; ревінь; касторова олія; клітковина; загоювання пептичних виразок; кислотний рефлюкс; печія; секреція шлункової кислоти; лужний.

III. Read the following drug information and discuss it with your group-mates.

Drug class and mechanism: Omeprazole is in a class of drugs called proton pump inhibitors (PPI) that block the production of acid by the stomach.

Preparations: Capsules: 10, 20 and 40 mg. Tablets: 20 mg (Prilosec OTC). Powder for oral suspension: 20 and 40 mg

Storage: Capsules should be stored at 15 to 30 C and tablets at 20 to 25 C. They should be kept away from moisture and light.

Prescribed for: Omeprazole is used for treating acid-induced inflammation and ulcers of the stomach and duodenum; gastroesophageal reflux disease (GERD), heartburn; prevention of upper gastrointestinal bleeding in critically ill patients. It also is used in combination with antibiotics for eradicating H. pylori infection of the stomach.

Dosing: For ulcers, GERD, erosive esophagitis and eradication of H. pylori the recommended dose for adults is 20-40 mg daily. Ulcer healing usually occurs within 4-8 weeks.

H. pylori infections are treated for 10-28 days.

The usual dose for prevention of upper gastrointestinal bleeding in critically ill patients is 40 mg daily for 14 days.

Drug interactions: Omeprazole potentially can increase the concentrations in blood of diazepam, warfarin, phenytoin by decreasing the elimination of these drugs by the liver. The absorption of certain drugs may be affected by stomach acidity. Therefore, omeprazole as well as other PPIs reduce the absorption and concentration in blood of ketokonazole and increase the absorption and concentration in blood of digoxin. This may reduce the effectiveness of ketoconazole or increase digoxin toxicity.