Discussion Cases 1 Leon

While biological causes for the difference between whites and blacks’ biological mechanisms regarding blood pressure have been speculated as being the cause of higher rates of hypertension among blacks in America, the fact that African Americans as opposed to Africans have higher rates of hypertension suggests that environment has more to do with it than biology (Fuchs, 2011). Environmental factors and daily living habits of African Americans are more than likely the main contributing variables to higher hypertension rates in this population. Environmental factors can include stress and anxiety stemming from racial tension in the U.S. that leads to high blood pressure for blacks in the country. Lifestyle habits can also impact the health of this population: diet and lack of exercise can contribute to hypertension as well (Lindhorst, Alexander, Blignaut & Raynor, 2007). Many diets in America are high in sodium, which can increase blood pressure, and an African American like Leon who likes to consume nachos and hot dogs and undoubtedly other salty foods regularly is bound to have higher blood pressure.

The significance of an elevated systolic pressure, even in the absence of diastolic hypertension, is that it means the patient has a higher risk of suffering from cardiovascular disease. A higher systolic pressure has been associated with hypertrophy in the left ventricle of the heart and a need for more oxygen in the heart muscle, which, if untreated, can lead ultimately to heart failure. So a high systolic pressure is not acceptable even if diastolic hypertension is not present—it is still a troubling sign that needs to be adequately addressed. Other problems that could arise from high systolic pressure include atherosclerosis and a possible aneurysm.

The mechanism of action of the two classes of drugs Leon was prescribed for the management of his hypertension—diuretics and an ACE inhibitor—focus on getting the sodium out of the body and limiting the body’s ability to constrict blood vessels, respectively. The diuretics flush the system by triggering the body’s renal secretion of water and sodium. The ACE inhibitor blocks the body from turning angiotensin I into angiotensin II. As there is less angiotensin...

Thus, the diuretics stimulate the body to release water and sodium, while the ACE inhibitor blocks the body from releasing stimulants that would constrict the blood vessels.
2 Emmanuel

The corticosteroid inhaler uses steroids to reduce swelling of the airways to help the patient breathe better. As Lim et al. (1998) point out, these types of inhalers work well because they “increase interleukin-10 but reduce macrophage inflammatory protein-1 ?, granulocyte-macrophage colony-stimulating factor, and interfere on-? release from alveolar macrophages in asthma” (p. 256). In other words, stimulate anti-inflammatory cytokine while prohibiting pro-inflammatory cytokines.

The action of the corticosteroid inhaler is different from a beta-2 agonist inhalant in that the latter provides short term relief by promoting dilation of the bronchial passage and relaxing the uterine muscle, while releasing insulin into the body. Vasodilation occurs in the muscles and liver of the patient to trigger these latter actions. Inhaled steroids are the recommended course of action for treating asthma, but beta-2 agonists are also helpful for smoothing the airways and helping the patient to gain better control of the breathing process (Erdinc, 2011). It is this type of treatment that Emmanuel most likely would benefit from during an asthma attack so that he does not become panic-stricken over the initial inability to catch his breath while waiting for the steroid to take effect when using the corticosteroid inhaler.

Someone with severe asthma becomes physically fatigued during a prolonged attack because the individual is not getting the oxygen the body needs to maintain proper functions and thus the body is working overtime or twice as hard just to keep up with its routine maintenance jobs while the individual tries to cope with the stress of struggling to breathe. Hypercapnia results, which is what happens when more carbon dioxide is in the blood than should be, and it can cause fatigue and the body to become flush. The body also becomes tense from the stress, and the muscles…