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formation in hypercoaguable states (e.g. in cancer). Aspirin is a PROSTAGLANDIN inhibitor and this accounts for the wide range of its actions.

INDICATIONS

Aspirin, as with many older drugs, has proven to be useful in many conditions. Despite its well-known toxicity it is widely used, since physicians are familiar with its properties. Indications for its use include: fever, pain (especially useful for some forms of arthritis, and chronic pain), migraine, rheumatic fever, coronary artery disease, acute myocardial infarction.

In addition, aspirin is recommended (low dose, 75-81 mg daily) for the prevention of: myocardial infarction — in patients with either documented coronary artery disease or at elevated risk of cardiovascular disease. Women may possibly benefit less from aspirin than men. Stroke is as secondary prevention (i.e. to prevent recurrence)

DOSAGE

For adults doses of 300 to 1000 mg are generally taken four times a day for fever or arthritis, with a maximum dose of 8000 mg a day. The correct dose of aspirin depends on the disease process that is being treated. For those under 12 years of age, the dose previously varied with the age, but aspirin is no longer routinely used in children due to the association with Reye's syndrome; paracetamol (acetaminophen) or other NSAIDs, such as Ibuprofen, are now being used instead.

HOW SHOULD THIS MEDICINE BE USED?

Prescription aspirin comes as an extended-release tablet (tablet that releases medication slowly over a period of time). Nonprescription aspirin comes as a regular tablet, a delayed-release tablet (tablet that first begins to release medication some time after it is taken), a chewable tablet, and a gum to take by mouth and a suppository to use rectally.

Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take aspirin exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.

Swallow the extended-release tablets whole with a full glass of water. Do not break, crush, or chew them.

Chewable aspirin tablets may be chewed, crushed, or swallowed whole. Drink a full glass of water, immediately after taking these tablets.

CONTRAINDICATIONS AND WARNINGS

Aspirin should be avoided by those known to be allergic to ibuprofen or naproxen.

Caution should be exercised in those with asthma.

It is generally recommended that one seek medical help if symptoms do not improve after a few days of therapy.

Caution should be taken in patients with kidney disease, peptic ulcers, mild diabetes, gout or gastritis; manufacturers recommend talking to one's doctor before using this medicine.

Taking aspirin with alcohol increases the chance of gastrointestinal hemorrhage (stomach bleeding).

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Children, including teenagers, are discouraged from using aspirin in cold or flu symptoms as this has been linked with Reye's syndrome.

Patients with hemophilia or other bleeding tendencies should not take salicylates.

COMMON SIDE-EFFECTS

Aspirin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: nausea, vomiting, stomach pain, heartburn.Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: hives, rash, swelling of the eyes, face, lips, tongue, or throat, wheezing or difficulty breathing, hoarseness, fast heartbeat, fast breathing, cold, clammy skin, ringing in the ears, loss of hearing, bloody vomit, vomiting material that looks like coffee grounds, bright red blood in stools, black or tarry stools Aspirin may cause other side effects. Call your doctor if you experience any unusual problems while you are taking this medication.

UNDERSTANDING DETAILS AND DISCUSSION …

Task 2 Based on the context, work out the meaning of the underlined words and terms. Refer to a dictionary, if necessary to the correct meaning.

Task 3 Use the underlined words and terms and in the sentences of your own to show you understand them.

Task 4 Scan the summary of the medicine to find the information:

-about indications;

-dosage;

-how Aspirin is used. Discuss it with classmates.

Task 5 Scan the summary of Aspirin again to say about contraindications and warnings. Work with your partner.

Use prompts: It’s been my case/experience that … , When you’ve … disease … , To my mind … , In my opinion … .

Task 6 Comment on the analysis of side effects of the medicine Aspirin. Think about … , if you’ve had any trouble case with Aspirin. Share your information with your classmates.

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GOING BEYOND THE TEXT …

Task 7 Show all the ‘pros’ and ‘cons’ of the medicine Aspirin. Try to convince your partner in your views.

Task 8 Add the following discussion:

Aspirin, as an analgetic drug, is used to … Aspirin, as an antipyretic drug, is applied to …

As an antiplatelet means, Aspirin is widely used to …

The dosage of Aspirin varies with the client age. For adults, the average dose should be …, while for children under 12, should be

…

Task 9 Write a presentation of the summary of the medicine Aspirin according to the scheme: formula, indications, dosage, contraindications, warnings and common side-effects.

Present it in the next class period.

Text B.

‘ AN ASPIRIN A DAY’ – JUST ANOTHER CLICHÉ?

Skim through the text to obtain additional information how Aspirin is prescribed today. Also interesting to find out a controversary surrounding of the use of Aspirin in the viewpoints of different scientists.

Today, aspirin is actually prescribed under its various generic and name brands for its heart-healthy effects.

In fact, of the 80 million aspirin tablets Americans take each day, most are taken not for everyday aches and pains but to reduce the risk of heart disease.

As summarized in the update professional labelling for aspirin, the 100-plus- year-old drug has been shown to reduce the risk of the following medical problems:

stroke in those who have had a previous stroke or who have had a warning sign called a transient ischemic attack (mini-stroke)

heart attack in those who have had a previous heart attack or experience angina (chest pain)

death or complications from a heart attack if the drug is taken at the first signs of a heart attack

recurrent blockage for those who have had heart bypass surgery or other procedures to clear blocked arteries, such as balloon angioplasty or carotid

endarterectomy.

Scientists believe that aspirin’s ability to reduce the body’s production of hormone-like “prostaglandins” is the reason for both its effectiveness in relieving pain and reducing inflammation and its protective effects against heart attacks and strokes.

Aspirin is a great drug: effective, cheap, and relatively safe. The drug has been used by just about everybody, so it may not have the sex appeal of newer drugs,

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but it can have a huge beneficial impact if used properly. Looking at aspirin’s impact, on heart attacks for example, it may be equal to or better than some drug therapies that cost thousands of dollars.

Although aspirin is a familiar and readily available drug, people shouldn’t take it for its cardiovascular benefits without discussing the risked of long-term use with a doctor.

The same quality that gives aspirin its potential benefit-its ability to inhibit clotting of the blood-may increase the risk of excessive bleeding, including the possibility of bleeding in the brain.

Some other possible risks are:

Stomach irritation. Aspirin can irritate the stomach lining and cause heartburn, pain, nausea, vomiting, and, over time, more serious consequences such as internal bleeding, ulcers, and holes in the stomach or intestines. Chronic alcohol users may be at increased risk of stomach bleeding, as well as liver damage, from aspirin use.

Ringing in the ears. At high doses, aspirin may cause temporary ringing in the ears and hearing loss, which usually disappear when the dose is lowered.

Allergy. Facial swelling and sometimes an asthma attack may occur in the two out of 1, 000 people who are allergic to aspirin, according to the Mayo Clinic in Rochester, Minn.

In children, Reye syndrome.

Because of its risks, aspirin is not approved for decreasing the risk of heart attack in healthy individuals.

More potential medical uses for aspirin are still under study – everything from treating migraines and colon, ovarian and breast cancer to improving brain function. Could an aspirin a day help you retain your memory as you age by preventing clogging of the arteries in the brain? It remains to be proven, but early studies suggest it’s possible.

Text C.

HISTORY OF ASPIRIN

Scan the text and work out the meaning of the unfamiliar words. Refer to a dictinary, if necessary.

Hippocrates, a Greek physician, wrote in the 5th century BC about a bitter powder extracted from willow bark that could ease aches and pains and reduce fevers. This remedy is also mentioned in texts from ancient Lebanon, and Assyria. The Cherokee and other Native Americans used an infusion of the bark for fever and other medicinal purposes for centuries. The medicinal part of the plant is the inner bark and was used as a pain reliever for a variety of ailments. The Reverend Edward Stone, a vicar from Chipping Norton, Oxfordshire, England, noted in 1763 that the bark of the willow was effective in reducing a fever.

The active extract of the bark, called salicin, after the Latin name for the white willow, was isolated to its crystalline form in 1828 by Henri Leroux, a French pharmacist, and Raffaele Piria, an Italian chemist. Piria was able to convert the

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substance into a sugar and a second component, which on oxidation becomes salicylic acid.

In 1897 Felix Hoffmann a chemist at Friedrich Bayer & Co. obtained acetylsalicylic acid by a reaction of salicylic acid and acetic anhydride. This synthesis served as the basis for Bayer claims to discovery of aspirin. According to a legend publicized by Bayer, Hoffmann made some of the formula and gave it to his father, who was suffering from the pain of arthritis and could not stand the sideeffects of salicylic acid. On March 6, 1899 the BAYER company of Germany registered it as a trademark. However, the German company lost the right to use the trademark in many countries because the Allies seized and resold its foreign assets after World War I.

Bayer began marketing aspirin in July 1899. It was marketed alongside another of Hoffmann's products, an acetylated derivative of morphine called 'Heroin' that he invented 11 days after aspirin

Heroin was initially the more successful of the two painkillers and it was common belief that it was healthier than aspirin. But, as heroin's shortcoming of addictiveness became more obvious, aspirin stepped to the forefront. Aspirin was originally sold as a powder (still the preferred form in many European countries) and was an instant success; in 1914, Bayer introduced aspirin tablets.

READING COMPREHENSION

Text D.

A “LUCKY” WOMAN

Skim through the text and follow the surgery case of heart disease recovery. Give the best answer in Topic quiz.

It was a normal night. Jim and Linda Carson had just finished dinner and were in the living room watching TV. Suddenly, Linda fell to the floor crying out that she had severe pain in her chest and arms. Scared at what was happening, Jim jumped up, phoned the emergency 911 number, and asked for an ambulance to come to the house. The ambulance arrived soon after and drove Linda to the hospital where she was taken to the emergency room.

Dr. Craig examined her while the nurse wrote down everything on a chart. He checked her lungs, and noticed that her breathing was erratic. While checking her heart, he noticed her pulse was fluctuating. Besides these symptoms, her vision was not clear. After taking some more tests, Dr. Craig concluded that Linda had very serious heart disease and needed to undergo immediate surgery. He gave her an injection to relax her, and admitted her into the hospital intensive care unit. Then he notified Dr. Peters, a heart surgeon. Dr. Peters arrived and immediately prepared for surgery while the nurses prepared Linda.

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While Linda was having her surgery, Jim stayed in the waiting room. He was nervous and worried. From time to time, one of the nurses came out to assure him that the surgery was going well and everything would be okay.

The operation was finished after about 2 hours, and Linda was taken to the recovery room where several machines were attached to monitor her breathing and heartbeat. She was still carefully watched her and the machines. She was in stable condition. Meanwhile, Dr. Peters talked to Jim and convinced him that Linda would pull through and that he should go home for the rest of the night—there was nothing else Jim could do for Linda tonight.

For the next week, Linda remained in the hospital to recover from the surgery. She became stronger and healthier every day. Dr. Peters told her she was a lucky woman. She gave Linda some problems in the future. She said to be careful about her diet and not eat certain foods, to exercise regularly, and to quit smoking. Linda assured her she would follow the advice. She dismissed Linda from the hospital, and Linda went home to begin her new life-style.

Topic Quiz

Choose the best answer a, b or c.

1.What was Linda doing when she fell?

a.eating dinner

b.watching TV

c.telephoning someone

2.What did Jim do immediately after Linda fell?

a.drove Linda to the hospital

b.called an ambulance

c.picked her up from the floor

3.When did Dr. Craig decide that Linda needed surgery?

a.after taking more tests

b.after checking her lungs

c.after checking her pulse

4.Who performed the surgery?

a.Dr. Peters

b.Dr. Craig

c.the nurses

5.Where did they take Linda after the operation?

a.the intensive care unit

b.the emergency room

c.the recovery room

6.Why did Linda fall to the floor?

a.She was having a heart attack.

b.She fainted from weakness.

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c.She had stepped on something slippery.

7.Why did the nurse write everything on a chart?

a.to keep an accurate record of Linda’s condition

b.to write an article for the newspaper

c.to total the emergency room bill

8.Why were machines attached to Linda after surgery?

a.to help her recover from the operation

b.to see if any problems developed from the operation

c.to communicate with the doctors

9.What kind of advice did Dr. Peters give Linda?

a.change her way of living

b.follow her normal routine as before

c.continue to eat what she wants, but reduce smoking

10.Why was Linda a “lucky” woman?

a.She pulled through the surgery.

b.She had a heart attack.

c.The ambulance brought her to the hospital on time

GIVING VIEWPOINT OR OPINION …

ASSIGNMENT … Use additional material from the Internet to prepare a project about Aspirin focusing on the controversary surrounding of the use of Aspirin. Show ‘pros’ and ‘cons’ of this medicine in the viewpoints of different scientists. Use the questions as a prompt.

1.Do you agree or disagree with their views? Why? / Why not?

2.Prove your point of view and convince the others in the next class period.

3.What’s your attitude to Aspirin?

4.What are the advantageous sides of Aspirin as a painkiller, to your mind?

5.What do you think the most obvious negative sides are?

6.Should Aspirin be reduced in its use just to a certain extend, or totally banned?

7.Are you extremely radical or quite moderate in your views?

Remember your arguments should be well-grounded.

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UNIT 6

DIAZEPAM

Task 1 Read the summery of the medicine and get ready to discuss it.

TEXT .

DIAZEPAM

Pharmacology

Anxiolytic - Sedative - Muscle Relaxant

Diazepam is a benzodiazepine with CNS depressant properties and a somewhat flatter dose-response slope than the sedative-hypnotic drugs. In laboratory animals, it produces, in varying doses, taming, disinhibitory, sedative, anticonvulsant, muscle relaxant, ataxic and hypnotic effects.

Indications

The short-term symptomatic management of mild to moderate degrees of anxiety in conditions dominated by tension, excitation, agitation, fear or aggressiveness, such as may occur in psychoneurosis, anxiety reactions due to stress conditions and anxiety states with somatic expression.

Contraindications

Myasthenia gravis, known hypersensitivity to benzodiazepines. Not recommended for children under 6 months of age.

Warnings

Pregnancy:

Several studies have suggested an increased risk of congenital malformations associated with the use of diazepam, chlordiazepoxide and meprobamate during the first trimester of pregnancy. Therefore, the administration of diazepam is rarely justified in women of childbearing potential. If the drug is prescribed for a woman of childbearing potential, she should be warned to contact her physician regarding discontinuation of the drug if she intends to become or suspects that she is pregnant.

Precautions

Geriatrics:

Elderly and debilitated patients or those with organic brain disorders have been found to be prone to CNS depression following even low doses. For these patients it is recommended that the dosage be limited to the smallest effective amount to preclude development of ataxia, oversedation or other possible adverse effects.

Drug dependence:

Abrupt cessation of large doses of diazepam after prolonged periods may precipitate acute withdrawal symptoms and, in these cases, the drug should be discontinued gradually. Caution should be exercised when it is considered necessary to administer diazepam to addiction prone individuals.

Occupational Hazards:

Patients receiving diazepam should be advised to proceed cautiously whenever mental alertness and physical coordination are required.

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Adverse Effects

The most common adverse effects reported are drowsiness and ataxia. Other reactions noted less frequently are fatigue, dizziness, nausea, blurred vision, diplopia, vertigo, headache, slurred speech, tremors, hypoactivity, dysarthria, euphoria, impairment of memory, confusion, depression, incontinence or urinary retention, constipation, skin rash, generalized exfoliative dermatitis, hypotension, changes in libido.

The more serious adverse reactions occasionally reported are leukopenia, jaundice, hypersensitivity and paradoxical reactions.

Minor changes in EEG patterns have been observed in patients on diazepam therapy. These changes consist of low to moderate voltage fast activity, 20 to 30 cycles/second and are of no known significance.

Overdose

Symptoms:

Drowsiness, oversedation and ataxia. When the effects of drug overdosage begin to wear off, the patient exhibits some jitteriness and overstimulation. The cardinal manifestations of overdosage are drowsiness and confusion, reduced reflexes and coma. There are minimum effects on respiration, pulse and blood pressure unless the overdosage is extreme.

Dosage

Must be individualized according to diagnosis, severity of symptoms and degree of response.

Adults

Symptomatic relief of anxiety and tension in psychoneurosis and anxiety reactions: 2 to 10 mg, 2 to 4 times daily depending upon severity of symptoms.

Elderly and debilitated patients, or in the presence of debilitating disease:

2 mg, 1 or 2 times daily initially; increase gradually as needed and tolerated.

Children (Because of varied responses, initiate therapy with lowest dose and increase as required. Not for use in children under 6 months):

1 to 2.5 mg, 3 or 4 times daily initially; increase gradually as needed and tolerated.

Supplied

2 mg:

Each white cylindrical, biplane tablet with edges bevelled, single scored on one side and engraved {ROCHEover2} on unscored side contains: Diazepam 2 mg.

5 mg:

Each yellow cylindrical, biplane tablet with edges bevelled, single scored on one side engraved ROCHE above and C below the score line and engraved {VALIUMover5} on unscored side contains: Diazepam 5 mg.

10 mg:

Each light blue cylindrical, biplane tablet with edges bevelled, single scored on one side and engraved {ROCHEover10} on unscored side contains: Diazepam 10 mg. Store between 15 and 30°C. Keep in a tightly closed, light-resistant container.

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UNDERSTANDING DETAILS AND DISCUSSION …

Task 2 Skim through the summary of the medicine Diazepam to pick up main medical and pharmaceutical terms. Underline them and use a dictionary to find their meanings.

Task 3 Use the new terms in the sentences of your own. Show your partner that you understand the context.

Task 4 Think about and discuss with your classmates the summary according to the plan: brand name, indications contraindications, warnings, precautions dosage, supplied.

Task 5 Comment on the most common and less frequent adverse effects reported. Mention minor changes observed in patients on diazepam therapy.

GOING BEYOND THE TEXT. DISSCUSSION…

Task 6 Keep talking … Use the summary clues to discuss the average symptoms and treatment of this medication.

UNIT 7

Task 1 Read the summary of the drug detailed information and be prepared to discuss it in class. Refer to a dictionary, if necessary.

TEXT A.

DICYNONE

Properties/Effects

Etamsylate is a synthetic antihaemorrhagic and angioprotective drug acting on the first step of haemostasis (endothelium-platelet interaction). By improving platelet adhesiveness and restoring capillary resistance, it is able to reduce bleeding time and blood losses.

Etamsylate has no vasoconstrictor action; it does not influence fibrinolysis nor modify the plasma coagulation factors.

Composition

Active principle: etamsylate

Tablet: etamsylate 500 mg. Antiox. (E 221), excipients for tablet. Tablet: etamsylate 250 mg. Antiox. (E 221), excipients for tablet. Ampoule: etamsylate 250 mg. Antiox. (E 223) 0.8 mg, water for

injection q.s.p 2 ml.

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