Hypertension, Diabetes, Cancer, Drug addiction and drug abuse

1. Rajkumari Lodhi
Assistant Professor
Department of Pharmacology
Bhopal Madhya Pradesh
Hypertension, Diabetes, Cancer,
Drug addiction and drug abuse
Subject:-Social and preventive pharmacy
Semester:- 8th

2. Hypertension
 Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-
term medical condition in which the blood pressure in the arteries is persistently
elevated.
 High blood pressure typically does not cause symptoms.
 Long-term high blood pressure, however, is a major risk factor for coronary artery
disease, stroke, heart
failure, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.
High blood pressure is classified as ..
primary (essential) hypertension :
• primary hypertension
• secondary hypertension.
.

3. primary hypertension, About 90–95% of cases are primary, defined as high blood pressure due to nonspecific
lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body
weight, smoking, and alcohol use. the world’s leading risk factor is expected to cause more than half of the
estimated 17 million deaths per year. resulting from cardiovascular disease (CVD) worldwide.
secondary hypertension:
The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure
due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine
disorder, or the use of birth control pills.
The underlying causes of secondary hypertension include:
1.narrowing of the arteries that supply blood to your kidneys
2. adrenal gland disease
3. side effects of somemedications, including birth control pills, diet aids, stimulants,
Antidepressants etc.
4. hormone abnormalities
5. thyroid abnormalities
6. constriction of the aorta

4. Blood pressure is expressed by two measurements,
1.systolic pressures
2.diastolic pressures,
which are the maximum and minimum pressures, respectively.
 For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg)
systolic
 and 60–80 mmHg diastolic
 For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80
or 140/90 mmHg.
Symptoms of Severe High Blood Pressure
If your blood pressure is extremely high, there may be certain symptoms to look out for,
including:
1. Severe headaches
2. Nosebleed
3. Fatigue or confusion
4. Vision problems
5. Chest pain
6. Difficulty breathing
7. Irregular heartbeat
8. Blood in the urine

5. People sometimes feel that other symptoms may be related to high blood pressure, but they may not be:
1. Dizziness
2. Nervousness
3. Sweating
4. Trouble sleeping
5. Facial flushing
6. Blood spots in eyes
Risk Factors:
The risk factors includes age, Race, Family history or genes, obesity, lack of physical activity, chewing or
smoking tobacco, too much salt in diet, not enough potassium in diet, alcohol, stress, kidney disease, diabetes
and sleep apnea.
Prevention:
The 2004 British Hypertension Society guidelines proposed lifestyle changes consistent with those outlined by
the US National High BP Education Program in 2002 for the primary prevention of hypertension:
•maintain normal body weight for adults
•reduce dietary sodium intake
•limit alcohol consumption
•consume a diet rich in fruit and vegetables

6. Diabetes
Diabetes is a number of diseases that involve problems with the hormone insulin. Normally, the
pancreas (an organ behind the stomach) releases insulin to help your body store and use the sugar and
fat from the food you eat. Diabetes can occur when the pancreas produces very little or no insulin, or
when the body does not respond appropriately to insulin.
There are a few different types of diabetes:
1. Type 1 diabetes is an autoimmune disease. The immune system attacks and destroys cells
in the pancreas, where insulin is made. It’s unclear what causes this attack. About 10
percent of people with diabetes have this type.
2. Type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels.
About 90-95% of people with diabetes have type 2.
3. Prediabetes occurs when your blood sugar is higher than normal, but it’s not high enough
for a diagnosis of type 2 diabetes.
4. Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones
produced by the placenta cause this type of diabetes.

7. Some Key Aspects of Diabetes
a. Diabetes is a long-term condition that causes high blood sugar levels.
b. In 2013 it was estimated that over 382 million people throughout the world had diabetes.
c. Type 1 Diabetes - the body does not produce insulin. Approximately 10% of all diabetes cases
are type 1.
d. Type 2 Diabetes - the body does not produce enough insulin for proper function.
Approximately 90% of all cases of diabetes worldwide are of this type.
e. Gestational Diabetes - this type affects females
g. If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin,
you can lead a normal life.
h. Type 2 patients need to eat healthily, be physically active, and test their blood glucose. They
may also need to take oral medication, and/or insulin to control blood glucose levels.

8. SIGNS AND SYMPTOMS
1. Increased thirst
2. Frequent urination
3. Extreme hungera
4. Unexplained weight loss
5. Fatigue
6. Blurred vision
7. Slow-healing sores
8. Frequent infections, such as gums or skin infections and vaginal infections
Type 1 diabetes can develop at any age.
Type 2 diabetes, the more common type, can develop at any age, more common in
people older than 40.

9. Risk factors
Risk factors for diabetes depend on the type of diabetes. Risk factors for
include:
1.Family history. Your risk increases if a parent or sibling has type 1 diabetes.
2.Family history. Your risk increases if a parent or sibling has type 2 diabetes
3. The more fatty tissue you have, the more resistant your cells become to insulin.
4.Inactivity. The less active you are, the greater your risk. Physical activity helps you
control
your weight, uses up glucose as energy and makes your cells more sensitive to insulin.

10. Complications
Long-term complications of diabetes develop gradually. The longer you have diabetes — and
the
less controlled your blood sugar — the higher the risk of complications.
1.Cardiovascular disease. Diabetes increases the risk of various cardiovascular
problems, including coronary artery disease with chest pain (angina), heart attack, stroke and
narrowing of arteries .
2.Nerve damage . Excess sugar can injure the walls of the blood vessels(capillaries) that
nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or
pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
3.Kidney damage : The kidneys contain millions of tiny blood vessel clusters
(glomeruli) that filter waste from your blood.
4.Eye damage :Diabetes can damage the blood vessels of the retina, potentially leading to
blindness. Diabetes also increases the risk of other serious vision conditions.

11. CANCER
Cancer is the uncontrolled growth of abnormal cells in the body. Cancer develops when
the body’s normal control mechanism stops working. Old cells do not die and instead
grow out of control, forming new, abnormal cells. These extra cells may form a mass of
tissue, called a tumor.
Over 100 types of cancers affect humans.
Tobacco use is the cause of about 22% of cancer deaths.
 Another 10% are due to obesity, poor diet, lack of physical activity or excessive
drinking of alcohol.
Other factors include certain infections, exposure to ionizing radiation, and
environmental pollutants.
In the developing world, 15% of cancers are due to infections such as Helicobacter
pylori, hepatitis B, hepatitis C, human papillomavirus infection, and human
immunodeficiency virus (HIV).

12. Classification:
There are five main categories of cancer:
Carcinomas begin in the skin or tissues that line the internal organs. include nearly all
those in the breast, prostate, lung, pancreas and colon.
Sarcomas develop in the bone, cartilage, fat, muscle or other connective tissues.
Leukemia begins in the blood and bone marrow.
Lymphomas start in the immune system.
Central nervous system cancers develop in the brain and spinal cord

13.  Worldwide approximately 18% of cancer deaths are related to infectious diseases.
 This proportion ranges from a high of 25% in Africa to less than
 10% in the developed world.
 Viruses are the usual infectious agents that cause cancer but cancer
Bacteria and Parasites may also play a role.
 include human papillomavirus (cervical cancer),
 Epstein–Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), sarcoma
herpesvirus sarcoma and primary effusion lymphomas),
Hepatitis B and
Hepatitis C viruses (hepatocellular carcinoma) and
Human T-cell leukemia virus-1 (T-cell leukemias).
Management of cancer and oncology :-
Many treatment options for cancer exist. The primary ones include
surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy and palliative care. Which treatments
are used depends on the type, location and grade of the cancer as well as the patient health and preferences.

14. Chemotherapy
Chemotherapy is the treatment of cancer with one or more cytotoxic anti-
neoplastic drugs (chemotherapeutic agents) as part of a standardized regimen.
Radiation
Radiation therapy involves the use of ionizing radiation in an attempt to either cure or
improve symptoms. It works by damaging the DNA of cancerous tissue, killing it.
Surgery
Surgery is the primary method of treatment for most isolated, solid cancers and may play a
role in prolongation of survival
Vaccination
Vaccines have been developed that prevent infection by some carcinogenic viruses. Human
papillomavirus vaccine (Gardasil and Cervarix ) decrease the risk of developing cervical
cancer.
The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases
the risk of liver cancer.

15. Drug addiction and drug abuse
Drug addiction and drug abuse, chronic or habitual use of any chemical substance to alter states of body or
mind for other than medically warranted purposes. – physical dependence – withdrawal
• Addiction: Compulsive nature of the drug use despite physical and/or psychological harm to the user and
society and includes both licit and illicit drugs.
• Substance abuse: Frequently used broad range of substances (including alcohol and inhalants) that can fit the
addictive profile.
Drug addiction and drug abuse
• Dependence: – Psychological dependence is the subjective feeling that the user needs the drug to maintain a
feeling of well-being. Eg: cocaine – Physical dependence is characterized by tolerance (the need for increasingly
larger doses in order to achieve the initial effect) and withdrawal symptoms when the user is abstinent.
• addiction to morphine (reward pathway) • dependence to morphine (thalamus and brainstem)

16. Drug use terms and descriptions
• Drug:
In medicine, it refers to any substance with the potential to prevent or cure disease or enhance
physical or mental well-being. In pharmacology, drug refers to any agent that alters the
biochemical or physiological processes of tissue or organism.
• Street drug:
Drug that is taken for non-medicinal reasons (usually for mind-altering effects); drug abuse
can lead to physical and mental damage and (with some substances) dependence and
addiction. Eg: Alcohol, heroin, methamphetamine, crack, cocaine and marijuana (Cannabis).
Drug use terms and descriptions
• Adulterants: drugs that are added to mimic or enhance the effects of the drug being offered.
Example, sometimes amphetamines have been cut with caffeine or ephedrine
• Diluents: Compounds such as sugars or baking soda that are used to increase the bulk of the
drug sample.

17. Types of Abused Substances
Legal Substances – Legal substances, approved by law for sale over the counter or by
doctor's prescription, include caffeine, alcoholic beverages, nicotine, and inhalants (nail
polish, glue, inhalers, gasoline). – Prescription drugs such as tranquilizers, amphetamines,
benzodiazepines, barbiturates, steroids, and analgesics can be knowingly or unknowingly
overprescribed or otherwise used improperly.
Types of Abused Substances
Illegal Substances – Prescription drugs are considered illegal when diverted from proper
use. – Morphine, and synthetic opiates, such as fentanyl, are most often abused by people in
the medical professions, who have easier access to these drugs. – Other illegal substances
include cocaine and crack, marijuana and hashish, heroin, hallucinogenic drugs such as
lysergic acid diethylamide, phencycline or "angel dust", "designer drugs" such as MDMA
(Ecstasy), and "party drugs" such as GHB (gamma hydroxybutyrate).

18. Motivations for Drug Use
• People take drugs for many reasons, and they may take stimulants to keep alert, or cocaine for the feeling of
excitement it produces. – peer pressure – relief of stress – increased energy – to relax – to relieve pain – to escape
reality – to feel more self-esteem, and for recreation.
• Athletes and bodybuilders may take anabolic steroids to increase muscle mass
Effects of Substance Abuse
• The effects of substance abuse can be on many levels: – on the individual, – on friends and family, – on society.
Effects of Substance Abuse- on individual
• Around 10000 death causes by drug abuse in USA every year.
• Many drug users engage in criminal activity, such as burglary and prostitution, to raise the money to buy drugs,
and some drugs, especially alcohol, are associated with violent behavior.
• Cocaine: anxiety, fatigue, depression, and an acute desire.
• Marijuana and alcohol interfere with motor control and are factors in many automobile accidents.
• Users of marijuana and hallucinogenic drugs may experience flashbacks, unwanted recurrences of the drug's
effects weeks or months after use.

19. Symptoms
 Recurrent drug use may result in a failure to fulfill major role obligations at work, school, or home.
 Repeated absences, tardiness, poor performance, suspensions, or neglect of duties in major life domains
suggests drug abuse.
 Recurrent drug use in situations in which it is physically hazardous is a sign of abuse.
 Operating machinery, driving a car, swimming, or walking in a dangerous area while under the influence
indicates drug abuse.
 Recurrent drug-related legal problems, such as arrests for disorderly conduct or for driving under the influence,
are indicative of abuse.
 Recurrent use despite having persistent or recurrent social or interpersonal problems, caused or exacerbated by
the effects of the drug, is indicative of abuse.
Treatment
• Treatment of substance abusers depends upon the severity and nature of the addiction, motivation, and the
availability of services.
• Pharmacological treatment
• Fighting Substance Abuse
• Supply Reduction
• Reduction of demand for drugs
• Legalization and decriminalization

20. Treatment-Pharmacotherapy
• Both pharmacological and behavioral treatments are used, often augmented by
educational and vocational services. Treatment may include detoxification, therapy, and
support groups, such as the 12-step groups Alcoholics Anonymous, Narcotics
Anonymous, and Cocaine.
Anonymous. – Disulfiram is a medicine used in the treatment of alcoholism. –
methadone or buprenorphine maintenance programs for heroin addiction.

21. thankyou