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The Health Science Module of the Science & Technology Curriculum Learning and Teaching Resources Theme: Diseases and Community Health Topic: Treatment, Common Drugs & Antibiotics The purpose of this set of teaching resources is to provide teachers with some teaching ideas and updated information on individual themes. The content of the topics is built on those in the S1-3 Science Curriculum. It is not expected that every detail in this set of materials is to be covered in class teaching, as some of the materials only serve as references/enrichment for teachers. To enhance the effectiveness of learning and teaching, teachers may need to modify the resources to suit the needs, abilities and interests of their students. Teachers also have to note that the materials included are by no means exhaustive, and should feel free to employ other resources if appropriate. Table of Contents Page Introduction 1 Learning Objectives 1 Scheme of Work 2-6 Lesson Plans 7-14 Teacher’s Notes Period 1 Period 2 Period 3 Period 4 Medical service outlets Medical consultation process 15-16 Treatment methods 16-18 Other technologies 19 Analgesics (Pain Killers) Anesthesia 21 Medical drugs 22 Methods of administration drugs Legal control on the sale of medicine Registration of medicines Antimicrobial agent 26 Antibiotic 26 Story of Penicillin 26-27 Why are antibiotics used 27-28 How antibiotics work Broad and narrow spectrum antibiotics Characteristics of a useful antibiotic 29 How are antibiotic drug used 29 Antibacterial agents 30 Drug resistance of antibiotics 30-31 Tuberculosis and drug resistance 31-33 Antiviral drugs 33 Common cold 34-35 Coughing 35 Other therapeutic methods 36 15 20-21 22-23 23 23-25 28 28-29 Suggested Activities 37 Review Questions/quizzes/food for thought 38 Handout and question sheets 39-49 Treatment, Common Drugs & Antibiotics Introduction We live in a dangerous world, where an infection in one country can spread within the time frame of a ‘plane journey from one country to another for the price of a ticket. New diseases and conditions emerge, old ones re-surface to join the numerous health threats already present. To help combat these diseases and health problems, a broad range of medical services, drug therapies and allied services are available. As the disease patterns change, medical researchers seek new treatments. To maximize the effects of these treatments and services, we need to have a broad understanding of the common types of drugs and antibiotics and their use and misuse. We also need to understand the role of the individual in medical care and how the actions of individuals combine to impact the system and the health of the community as a whole. Learning Objectives: After this series of classes, the students will be able to 1. understand the possible outlets where medical services may be obtained. 2. understand the basic process of medical consultation. 3. obtain a general understanding of the various forms of medical treatment 4. 5. 6. 7. 8. and examples of utilization of modern medical technologies. obtain a general understanding of anesthesia for minor or major operations. appreciate the complex organization of a general or teaching hospital. understand the use of drugs: what they are; how they work; how they are used; how they are controlled and supplied. understand the use of antibiotics and antibacterials: what they are, how they work and the development of drug resistance, with penicillin and anti-tuberculosis treatments cited as examples, and the use of anti-viral infection drugs. understand the Patients’ Rights and Responsibilities. 1 Scheme of work for Treatment of Diseases Scheme of work for Treatment of Diseases Scheme of work for Treatment, Common Drugs & Antibiotics (Diseases and Community Health Theme – Health Science Module) (40 mins) Topic Time Learning Objectives Suggested Activities Resources Treatment of Period 1 1. Identify medical service outlets and Q and A (Period 1 Sheet 1) - Handout: Sheet 1 Diseases state their functions. Split students into three - Teacher notes groups – group 1 to consider - Blackboard 2. Understand the medical consultation what information a doctor process. - Web resources for might need to make a homework assignment (1) 3. Know common treatment methods. diagnosis and prescribe http://www.psycom.net/depr treatment. Group 2 to ession.central.ect.html 4. Outline other healthcare technologies. consider the composition of - http://www.actualizations.c 2 5. Homework (to expand on the information given in “healthcare technologies”). This homework calls for students to do independent research as these two medical technologies are not covered. the physical examination the doctor may perform. Group 3 to consider what sorts of investigations may be called for and why (20 minutes) Discuss other medical technologies Students to write on one of the following topics: (1) Mentally ill patients sometimes need electroconvulsive therapy (ECT) to help them recover. Discuss what ECT is, how it works and why it is controversial. OR (2) Define a prosthetic device. Discuss artificial limbs, stating when they might be needed, they help the people using them and how other people might react to these people? . 3 om/ect.htm - Web resources for assignment (2) - http://www.amputee-coaliti on.org/nllic_faq.html (limb loss) http://www.mossresourcen et.org/amputa.htm (amputation fact sheet) - http://www.amputee-coaliti on.org/inmotion/mar_apr_9 8/pros_primer/page1.html (prosthetics for amputees) - Students will also find information in any public library. Scheme of work for Treatment of Diseases Scheme of work for Treatment, Common Drugs & Antibiotics (Diseases and Community Health Theme – Health Science Module) (40 mins) Topic Time Learning Objectives Suggested Activities Resources Treatment of Period 2 1. Define pain. Ask students to fill in Period 2 - Period 2 Sheet 1 Diseases Sheet 1.”What is Pain?” - Teacher notes Review their comments. - Web resources: 2. Differentiate between opioids and Ask students to define an non-opoioids. - http://www.painforum. analgesic and an anaesthetic, com/en/1/nuroguide.html 3. Know the difference between an and state when would they be analgesic and an anaesthetic. used. 4. Name and describe three types of Ask students, “How can aneasthesia. medical drugs be given?” 5. Name and describe the three types of Write answers on the medical drugs. blackboard and complete the 6. List methods of administration of list. drugs. . 4 Scheme of work for Treatment of Diseases Scheme of work for Treatment, Common Drugs & Antibiotics (Diseases and Community Health Theme – Health Science Module) (40 mins) Topic Time Learning Objectives Suggested Activities Resources Treatment of Period 3 1. Define infection. Ask students (1) what kinds of - Teacher notes Diseases infections they have had? (2) - Blackboard what they think these - Student handout 1 2. Outline the four main types of infections have in common infection, viral, bacterial, fungal and - http://www.nuigalway.ie/ba and (3) to try and define parasitic. c/fungal_infection.htm infection. Review answers 3. State what types of drugs are used to (fungal infections) and hand out Student Sheet 1 - http://www.neb.com/neb/pr combat infection (antibiotics, Ask students “How will an antivirals, antifungals and antiparasitic oducts/drug_discovery/Par antibiotic cure your sore drugs). asitic.html and throat?” 4. Define “antibiotic” and know the two http://www.bartleby.com/65 types. /ta/tapeworm.html (parasitic infections) 5. Know the two types of antibiotics, how - http://www.bbc.co.uk/educ they work, how they are administered. ation/medicine/nonint/indu st/dt/indtbi2.shtml (history of medicine) 5 Scheme of work for Treatment of Diseases Scheme of work for Treatment, Common Drugs & Antibiotics (Diseases and Community Health Theme – Health Science Module) (40 mins) Topic Time Learning Objectives Suggested Activities Resources Treatment of Period 4 1. List common infections by type and Review Homework table with - Teacher notes Diseases treatment. students, asking them to - Blackboard supply answers. - Homework handout 2. Describe and give examples of Quick question ”What is antibacterial agents. from period 3. another name for an - Sheet 1 Period 4 3. Analyze the problem of antibiotic drug Antibacterial agent?” resistance. (Answer, antibiotic) 4. Understand tuberculosis and the Ask a student how long variations are infection rate over time. he/she thinks a course of antibiotics lasts. Another student can recap how antibiotics are administered. Students to complete question sheet 1 for period 4 6 Lesson Plan for Treatment of Diseases Lesson Plans for Treatment, Common Drugs & Antibiotics (Diseases and Community Health Theme – Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 1: Sequence Motivation (40 min) Content and Activity Resources Ask students to complete the Q and A sheet and pass to their Q and A sheet 1 neighbour for marking. Teacher goes through the sheet, explaining the answers. Pen and paper Students are divided into 3 groups to consider what information a Blackboard doctor might need to make a diagnosis and prescribe treatment, the composition of the medical examination the doctor may perform and the investigations that may be ordered. Each group presents their findings and teacher supplements and corrects where needed. Lesson Plan forTeacher Treatment ofand Diseases Theme teaching Teacher outlines other medical technologies notes blackboard Homework Students to write on either: (1) Mentally ill patients sometimes need Web resources assignment electroconvulsive therapy (ECT) to help them recover. Discuss what Public library ECT is, how it works and why it is controversial. OR (2) Define a prosthetic device. Discuss artificial limbs, stating when they might be needed, they help the people using them and how other people might react to these people? Consolidation Ask students to briefly recount the role of the GP and the medical specialist, say where patients would get help and what sort of treatments are available. 7 Time 5’ 20’ 5’ 5’ 5’ Lesson Plan for Treatment of Diseases Lesson Plans for Community Health Services (Diseases and Community Health Theme – Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 2: Sequence Motivation (40 min) Theme teaching Homework assignment Content and Activity Resources Time Define and understand pain. Students to fill in sheet 2 and Period 2 Sheet 1 10’ teacher to review (The point of the exercise is to expose Teacher notes students to the idea that pain is always caused, i.e. that it is the result of action on or within the body and that the experience of pain is very individual). Ask students to define (1) analgesic and (2) anaesthetic and review their definitions. Student question, “How can medical drugs be given?” Write answers on the blackboard and complete the list Teacher to describe opioids and non-opioids, giving examples of Teacher notes 15’ each. Teacher to introduce the three types of anesthesiaLesson Plan for Treatment of Diseases Teacher to introduce the three types of medical drugs (A) In the following situations, write down what type of Teacher notes 5’ medication would be needed (1.e. anaesthetic or analgesic and Web resources: what route): http://www.geocities.com/c 1) Surgery to mend a broken leg heeaungroup2001/ 2) Child birth (deficiency diseases) 3) A filling at the dentist http://www.healingwithnutri 4) Muscle pain tion.com/adisease/arthritis/ 5) Mild headache rheumatoidarthritis.html (B) Describe either (i) a deficiency disease and its treatment or (arthritis) (ii) the inflammatory condition, rheumatoid arthritis and its treatment. 8 Consolidation Ask students what they can tell you about pain and its treatment and about what may cause pain. 9 5’ Lesson Plan for Treatment of Diseases Lesson Plans for Community Health Services(Diseases and Community Health Theme – Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 3: Sequence Motivation (40 min) Theme teaching Homework assignment Consolidation Content and Activity Resources Time Define and understand infection. Students discuss what kinds of Teacher notes 10’ infections they have had, what they think these infections have Blackboard in common. Students try and define infection. Teacher will hand Student handout 1 out Student sheet 1. Ask students “How will an antibiotic cure your sore throat?” Note the importance of establishing that antibiotics will only work if the infection is bacterial. Teacher will describe the four main types of infection (These will Teacher notes 20’ receive further attention in Period 4). Blackboard After students have tried to list drugs for treating infections, Student handout 2 teacher will review and expand as needed, handing out Sheet http://www.micro.msb.le.ac. Lesson Plan2.for Treatment of Diseases Teacher to describe the action and administration of antibiotics. uk./224/224/Antivirials.html (details of antiviral drugs) 1) (To prepare for the next lesson) Use the internet or your library to fill in the blanks on table 1. 2) Write a paragraph about one of these pioneers. What was his/her major achievement? How did it affect mankind? (a) Alexander Fleming (b) Edward Jenner. Information available on the BBC Medicine site. Teacher to re-cap on the main types of infection and their treatment. 10 http://www.bbc.co.uk/educa 5’ tion/medicine/nonint/indust/ dt/indtbi2.shtml Table 1 handout Teacher notes Blackboard 5’ Lesson Plan for Treatment of Diseases Lesson Plans for Community Health Services (Diseases and Community Health Theme – Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 4: Sequence Motivation (40 min) Theme teaching Homework assignment Consolidation Content and Activity Use homework table from period 3 to provide background for period 4. List common infections by type and treatment Quick question ”What is another name for an Antibacterial agent?” (Answer, antibiotic) Teacher will provide information on antibiotics. Students asked to consider the length of a course of antibiotics and the methods of administration. Teacher gives details, to be expanded into the theme of Antibiotic resistance. Students complete question sheet on TB, followed by teacher review and information Resources Teacher notes Blackboard Table from Period 3 Teacher notes Blackboard Question Sheet 1 Period 4 Time 5’ 25’ 1) Describe the condition known as “gas gangrene”, giving the http://xtramsn.co.nz/health/ 5’ causative agent, signs and symptoms of the disease and its 0,,8065-1669854,00.html treatment. What happens if treatment fails? (gas gangrene) 2) What is Pott’s disease? Give it’s causative agent, signs and http://www.nlm.nih.gov/med symptoms of the disease and its treatment. What happens if lineplus/ency/article/000417. Lesson Plan for of Diseases treatment fails htmTreatment (Potts disease) Ask the students – What advice would you give to a relative who had a recurrent sore throat and who had been to three different doctors, never completing a course of treatment? 11 Teacher notes 5’ Teacher’s Notes for Treatment of Diseases PERIOD ONE Treatment of Diseases Medical service outlets Hong Kong health care services are provided under a dual Health Care Delivery System that involves both public and the private sectors. The public sector services are provided by the Hospital Authority and Department of Health. In the private sector, services are provided by private hospitals and private practitioners Primary Medical Care: General Practitioners in the public and private sectors. Secondary Medical Care: Specialist service either directly through the Hospital Accident and Emergency Department for emergencies or through referrals from doctors at the Primary Medical Care level. Doctors will decide the specialty for referral, e.g. surgery, gynecology or orthopedics. Unless the patient’s condition is urgent or critical (when urgent admission would be necessary) the patient is seen at specialist out patients clinics. At the specialist clinics, medical assessment, investigation, diagnosis and treatment are provided. The specialists decide when a patient needs to be admitted to hospital. Tertiary Medical or Extended Care: Hospital specialists arrange for rehabilitation care when necessary. Medical consultation process Medical History: Doctors obtain essential information from patients about their occupation; past health history; family history, life style behaviors, e.g. smoking habit, alcohol and medication history; and present complaints or medical problems Medical Examination: Patient’s basic vital signs (e.g. blood pressure, pulse rate and body temperature); Inspection (visual observation of the patient’s physical condition); Palpation (physical examination on parts of the body); Percussion; Auscultation (usually with the aid of stethoscope) 12 Teacher’s Notes for Treatment of Diseases Investigations: Common examples are x-ray examination; blood, urine tests; ultra-sound, and endoscopy Treatment: (See below for Methods of Treatment) Treatment methods Self Care: Some minor ailments, e.g. common cold can be relieved with medication obtained directly from local pharmacies. (For more detailed information, you can cross references to “Over the Counter”, and “Common Cold- Self Help”) Medical treatment: Broadly speaking, this refers to the use of drug therapy in the treatment of medical conditions. (For more detailed information, you can cross references to ‘Action of Drugs’) Surgical treatment: General practitioners decide on the advisability of certain minor surgical conditions that can be performed in their clinics, e.g. sebaceous cyst excision, wart removal, abscess drainage etc. Similarly, surgical specialists perform operations either in an outpatient setting or in hospital operating theatres. Radiotherapy Since the discovery of x-rays over one hundred years ago, radiation has been used increasingly in medicine, both to help with diagnosis by taking pictures with x-rays (radiodiagnosis) and also as treatment (radiotherapy) especially of various forms of cancers. Physiotherapy, The primary aim of physiotherapy is the restoration of body function or minimising dysfunction after disease or injury. Physiotherapists assess and diagnose the problem, then plan and administer treatment programs. They apply a combination of manual therapy, movement training and physical and electrophysical agents. This 13 Teacher’s Notes for Treatment of Diseases may be by stretching, strengthening, re-learning movement patterns, manipulation, massage or by using some electrotherapeutic modalities such as ultrasound. Advice will be given about the use of various supports, braces etc needed by some conditions as well as ergonomic advice for both work, home and sporting environment. Physiotherapy may be appropriate in the following situations: sprains or strains of any joint; neck or back pain; following fractures; and following surgery, including joint replacement. Occupational Therapy Occupational therapy aims at using self-care, work, and play activities as a form of therapy to increase patients’ independent function, enhance development, and prevent disability. This form of therapy may include adaptation of task or environment to achieve maximum independence and to enhance quality of life. Occupational therapists provide their service to any individual who has an injury, illness, cognitive impairment, psychosocial dysfunction, mental illness, developmental or learning disability, physical disability, or other disorder or condition. Speech Therapy Speech Therapists can help to evaluate and treat individuals with communicative, hearing, cognitive or swallowing disorders. Speech therapists offer treatment for patients with speech impairment as a result of stroke, dementia, Parkinson's disease or multiple sclerosis; speaking and listening, or cognitive and memory problems following head injury; voice disorders resulting from disease or misuse of the voice; speech disorders; swallowing disorders (dyshagia) and developmental delays. They work across a range of sites in the community as well as in hospitals, depending on their clients' needs. Community settings may include health centres, day nurseries, schools and colleges, training centres, as well as people's homes. Hospital departments typically provide services to clients on an in-patient and out-patient basis, with an increasing focus on outreach and intermediate care. 14 Teacher’s Notes for Treatment of Diseases Psychotherapy Psychotherapy is a broad term which encompasses all forms of treatment which use psychological methods such as talking, rather than physical methods such as drugs. There are many different types of psychotherapy, having different aims, using different methods and based on different theories of mental functioning. Clinical Psychologist Service Clinical Psychology is a professional field of practice that deals with human functioning; either human problems and their solution, or ways of promoting physical, mental, and social well-being. Clinical Psychologists are involved in a wide range of activities for treating their clients. For example, psychologists treat depression, anxiety and stress, major mental disorders, learning disabilities, drug and substance abuse problems, marital/ relationship problems, and problems stemming from physical and sexual abuse. Generally, Clinical Psychologists conduct psychological assessment and treatment of individual adults or children, couples, families, and groups. Palliative care/treatment (multi-disciplinary approach) (For more detailed information, you can cross references to Community Health Services – Hospice Service) Palliative care is directed at providing relief to a terminally-ill person through symptom management and pain management. The goal is not to cure, but to provide comfort and maintain the highest possible quality of life for as long as life remains. Palliative care programs also address mental health and spiritual needs. The focus is on compassionate specialized care for the living. Palliative care is well-suited to an interdisciplinary team model that provides support for the whole person and family. Palliative care may be delivered in hospice and home care settings or in hospitals. Many people who are terminally ill may choose to enter a home-like alternative care setting such as a hospice. 15 Teacher’s Notes for Treatment of Diseases Other technologies. Examples: 1. Endoscopic surgery: an endoscope is made up of a tiny camera with a bright light fitted on the end of a long tube, and a viewing screen or television monitor to display a magnified image from the camera. The surgeon moves the endoscope into the body through a very tiny cut when performing the surgery and watches the screen. Other surgical instruments such as knives (scalpels), scissors, or forceps may be inserted to assist as necessary in the completion of the procedure. Endoscopic surgery results in a small scar wound, causing less trauma to the body and offering quicker recovery time. Endoscopic surgery can be applied in surgery to the chest and abdomen e.g. gall stones, joints e.g. the knees and shoulder injuries. 2. Laser Surgery: A laser is a special light beam, which can be used to treat tissues of the body by heating the targeted cells until they “burst”. Laser Surgery uses a laser light source to remove diseased tissues or treat bleeding blood vessels. This procedure can be used to remove tumours, warts, and moles. Laser surgery may also be used for cosmetic purposes including removal of wrinkles, tattoos, or birthmarks. 16 Teacher’s Notes for Treatment of Diseases PERIOD TWO Analgesics (Pain Killers) Pain (for example, headache) is a symptom and is not a disease. Pain can be relieved with the use of pain relieving medications. However, if the pain symptom is a long-term problem, its relief depends on treatment of the underlying cause. For example, toothache can be relieved with the use of a medication, but can be cured by appropriate dental treatment. Pain relieving drugs can be divided into the non-opioids and the opioids (which have properties similar to drugs derived from opium, such as morphine and codeine) groups. Examples of the non-opoids include drugs like paracetamol and aspirin. Non-opioids are less powerful as pain reliever than opoids. Some drugs such as paracetamol and aspirin, can be obtained over-the-counter. If the pain cannot be relieved with these common medications, we should seek medical advice. Paracetamol can be used for everyday aches and pains, such as headaches, toothache, and joint pains. It is the most widely used pain relieving drug, and it is a safe drug to use when taken correctly. Paracetamol can also reduce fever. It does not treat the cause of the pain or fever, and it is not effective as an anti-inflammation medication. Paracetamol is used either alone or in combination in many over-the-counter and prescription medications such as panadol, tylenol. Aspirin (which is one the groups of drugs called non-steroidal anti-inflammatory drugs or NSAIDs) has been used for many years to relieve pain and reduce fever. It is useful for headaches, toothaches, discomfort caused by feverish illnesses. Given regularly, it can also relieve the pain and inflammation of chronic rheumatoid arthritis. Aspirin is not recommended for children aged under 12 years because it use has been linked to a rare but potentially fatal liver and brain disorder (called the Reye’s syndrome). Mild opioids, such as codeine, are often found in combination proparations with non-opioids such as paracetamol. These mixtures may increase the effect of pain relief. Codeine is an effective drug for relieving mild to 17 Teacher’s Notes for Treatment of Diseases moderate pain. When pain is not severe, it is usual to start using paracetamol or a drug with action like aspirin. If they do not provide adequate pain relief, they may be combined. A mild opioid may be used. If the less powerful drugs are ineffective, a strong opioid such as morphine may be given. Anesthesia Anesthesia is the medical process that uses drugs and medical gases to ensure render patients unconscious and/or pain free during surgery. There are several forms of anesthesia General Anesthesia: during general anesthesia the patient undergoing an operation is carefully kept in a state of controlled unconsciousness by a medical specialist using a mixture of very potent drugs, so that the operation is painless. During the process, all the patient’s bodily functions are carefully controlled and monitored. Regional Anesthesia (or nerve block): involves injecting drugs at places in the body close to the nerves supplying the parts of the body involved in the operation. The drugs temporarily stop the targeted nerves from working, so that no sensation or movement in that area of the body occurs. Examples: Spinal anesthesia used to anaesthetize the abdomen and legs. The effect of the drugs lasts for different times and is tailored to the operation and the individual patient. The patients can remain completely awake or become relaxed and drowsy with drugs. Local Anesthesia: refers to temporarily numbing a small area by injecting drugs locally into the skin so that minor procedures like stitching cut wounds can be done painlessly 18 Teacher’s Notes for Treatment of Diseases Medical Drugs Medical drugs scan be used to cure disease and / or alleviate symptoms. Their actions generally fall into one of 3 categories: 1. Replacing chemicals that are deficient. The body requires sufficient levels of certain chemical substances to function normally. These substances include vitamins, and minerals, which the body obtains from food. Other deficiency diseases arise from a lack of various hormones. 2. Interfering with cell function. Many drugs can change the way cells work by stimulating or reducing the normal level of activity. Inflammation, for example, is due to the action on blood vessels and blood cells of certain natural hormones or other chemicals. Anti-inflammatory drugs block the action of the hormones or slow their production. Drugs that act in a similar way are used in the treatment of a variety of conditions such as hormone disorders, blood clotting problems, and heart and kidney diseases. 3. Acting against invading organisms or abnormal cells. Infections are caused by viruses, bacteria, protozoa, and fungi invading the body. Some drugs are used to destroy these microorganisms, either by halting their multiplication or by killing them directly. Other drugs treat disease by killing abnormal cells produced by the human body – cancer cells, for example. Methods of Administration of Drugs The majority of drugs must be absorbed into the bloodstream in order to reach the site where their effects are needed. The method of administering a drug determines the route it takes to get into the bloodstream and the speed at which it is absorbed into the blood. The routes of administration are as follows: Through the mouth or rectum (oral or anal routes) By injection through the muscle (intramuscular), blood vessels (intravenous), or the skin (subcutaneous). 19 Teacher’s Notes for Treatment of Diseases By inhalation (breathing in), or By implanting under the skin (for slow release of the drug). By topical application: when it is unnecessary or undesirable for a drug to enter the bloodstream in large amounts, it may be applied topically on the skin or mucous membrane, in the forms of cream, sprays, drops or suppositories, pessaries (suppositories administered via the anal route, pessaries by the vaginal route) Legal Control on the Sale of Medicines (Teacher References Only) In Hong Kong, the sale of medicines is regulated under the Pharmacy and Poisons Ordinance. In addition, the sale and distribution of antibiotics is controlled under the Antibiotics Ordinance, and narcotics under the Dangerous Drugs Ordinance. Registration of medicines (Teacher References Only) The Pharmacy and Poisons Ordinance requires that all medicines for sale in Hong Kong must be registered with the Pharmacy and Poisons Board. This registration process aims to protect the local community from medicines that are ineffective, substandard, or unsafe. Products that make exaggerated claims are also targeted, to prevent them from getting onto the market. All medicines on sale required to be labeled with essential information to enable their safe use by the consumers. All medicines before they are allowed to be sold to the general public, they are required to be labeled with the following particulars: a) Name of the product (in English or Chinese) b) c) d) e) Name and quantity of each active ingredient Dosage instruction (in both English and Chinese) Lot number and expiry date Name and address of manufacturer If certain precautions or warnings are needed to ensure the safe use of the product, the registration authority would ensure that precautions / warnings of suitable wording are added before approval for sale is given. 20 Teacher’s Notes for Treatment of Diseases Medicines are classified according to the following scale, as their potency and potential for harm increases. (Teacher References Only) Non-poisons Common, relatively mild medicines are available to the general public without restriction through retail outlets such as supermarkets, chain stores, medicine companies, etc. Part II poisons More potent medicines are available through medicine companies licensed as “Listed Sellers”, and outlets licensed to supply medicines subject to a higher level of control. Community pharmacies Registered Pharmacists are available to advise the consumer on the use of the medicines. These Pharmacies are recognized by a special sign in the shop front showing the letter Rx against a red cross. Part I SI poisons They require the Pharmacist to be on hand to advise the consumer on their use. To ensure that this is done and to prevent abuse of these medicines by the consumer, the law requires that certain details be recorded before the customer purchases the product. Prescription-only drugs Because of the special nature of these medicines (Poisons), their high potency, or their abuse potential, these medicines should only be used under the guidance of a medical doctor. For this reason, they can only be legally obtained through a medical doctor, or from a Pharmacy according to a prescription written by a medical doctor. Over-the-counter (OTC) products There is no agreed definition of “Over-the-Counter” Products, and this term is subject to different interpretations. However, in general, it is taken to mean medicines that can be legally obtained without a prescription to treat common ailments. While this is a convenient, and low-cost method of seeking relief from a mild complaint, patient education and awareness is 21 essential for their safe use. You must read the directions on the label and follow them carefully; particularly those advising on dosage and under what Teacher’s Notes for Treatment of Diseases circumstances a doctor should be consulted. If possible, the free advice from a Pharmacist in the Community Pharmacy should be sought to increase the effectiveness of such self-medication. If the condition has not improved within a day or two, the advice of a medical doctor should be sought. Proprietary medicines There is no general agreement on the meaning of this term. It could be taken as synonymous as “Over-the-counter “ medicine, and could include western medicine, traditional Chinese medicine, and a mixture of the two. Patent medicines These are newly discovered products, and the patent confers the marketing rights for a defined period of time for the benefit of the company which made the discovery Generic medicines These are medicines not subject to patent protection, and may be produced by any licensed manufacturer of medicine. 22 Teacher’s Notes for Treatment of Diseases PERIOD THREE Antibiotics/Antibacterial agents Antimicrobial agents Antimicrobial agents are drugs, chemicals, or other substances that either kill or slow the growth of microbes. Among the antimicrobial agents in use today are antibacterial drugs (which kill bacteria), antiviral agents (which kill viruses), antifungal agents (which kill fungi), and antiparisitic drugs (which kill parasites). Antibiotic Antibiotic is the type of antimicrobial agent made from a mold or a bacterium that kills, or slows the growth of other microbes, specifically bacteria. Examples include penicillin and streptomycin. These drugs are used to fight many infections caused by bacteria. Antibiotics work only against infections that are caused by bacteria. Some antibiotics are effective against only certain types of bacteria; others can effectively fight a wide range of bacteria. Bacterial infections include throat, most (but not all) ear infections, and some sinus, bladder, and lung infections. Most common infections (such as colds, bronchitis and sore throats) are caused by viruses. Antibiotics should not be used for these viral infections because they don't help, they may cause side effects, and overuse of antibiotics contributes to the growing problem of bacterial resistance Antibiotics are used for the treatment of bacterial disorders ranging from minor infections, like conjunctivitis, to life-threatening diseases like pneumonia, meningitis and septicemia. Since 1941, when the first antibiotic, penicillin, was introduced, many different classes of antibiotics have been developed. Each one has a different chemical composition and is effective against a particular range of bacteria. Story of Penicillin Penicillin was originally discovered by a French medical student, named Duchesne. In 1929, penicillin was re-discovered by a Scottish researcher, Sir Alexander Fleming. It was not until 1941 in England, that an Australian, Howard Florey and an Englishman, Ernst Chain developed commercial 23 Teacher’s Notes for Treatment of Diseases methods to produce penicillin for human use. At that time World War II was in progress, and there was a major effort to produce penicillin for all British, U.S. and other allied soldiers. The entire manufacturing process was moved to the United States for economic and military reasons. (It is for this reason primarily that the pharmaceutical industry became so well-established in the U.S.) Initially, only military personnel were allowed access to this life-saving drug. Towards the end of World War II, penicillin was made available to the general public. (See: http://www.tallpoppies,net.au/florey/researcher/story/72re.html ) The overwhelming majority of antibiotic substances are natural products that certain bacteria and fungi (moulds) produce and send outside of their cells. About 90% of the antibiotics in use today are isolated from bacteria. There are a few antibiotics, however, which are completely synthetic, that is, are made from scratch in the laboratory. (Semi-synthetic antibiotics are those antibiotics where some things from the original structure are added or removed, and produce an altered form of the original material for better benefits to the body – example: ampicillin). The development of drugs that prevent and cure bacterial infections (use of antibiotics and immunization procedures) is one of the twentieth century’s major contributions to human longevity and quality of life. Antibiotics are not effective against viral infections such as influenza, hepatitis, dengue fever, etc. Why are antibiotics used? We are surrounded by bacteria – in the air we breathe, on the mucous membranes of our mouth and nose, on our skin, and in our intestines – but we are protected, most of the time, by our immunological defenses. When these defenses break down, or when bacteria already present move to a vulnerable new site, or when harmful bacteria not usually present invade the body, infection sets in. Doctors prescribe antibiotic therapy to remove the bacteria causing the infection and cure the patient’s illness. Confronted with a sick person and suspecting a bacterial infection, doctors should identify the organism causing the disease before prescribing any 24 Teacher’s Notes for Treatment of Diseases drug. However, tests to analyze the blood, sputum, urine, stool or pus usually take 1 day or more. In the meantime, especially if the person is in discomfort or pain, doctors usually make a preliminary drug choice, sometimes of an educated guess as to the causative organism. How antibiotics work? Antibiotics are either bactericidal (killing) or bacteriostatic (inhibitory). Bactericidal antibiotics kill organisms directly. Penicillin destroys bacteria by preventing them from making normal bacterial cell walls. Bacteriostatic antibiotics halt the multiplication of bacteria and enable the body’s natural defense to overcome the remaining infection. Most antibiotics act inside the bacteria, by interfering with the chemical activities essential to their life cycle. Disintegrating Cell Wall Bacterium Bactericidal antibiotics Cell Wall Drug Example: Penicillin. They interfere with the chemicals needed by bacteria to form normal cell walls. The bacteria’s cell wall disintegrates and they die. Bacteriostatic antibiotics They alter the chemical activity inside the bacteria and interfere with the bacteria’s ability to multiply (and also the ability to survive) Cell Protein Unformed Protein 25 Teacher’s Notes for Treatment of Diseases Broad and narrow spectrum antibiotics The range of bacteria or other microorganisms that is affected by a certain antibiotic is expressed as its ‘spectrum of action’. Antibiotics that are effective against a wide range of bacteria are said to be ‘broad spectrum’. Antibiotics that are effective mainly against a particular group of bacteria are referred to as ‘narrow spectrum’. If they are effective against a single organism or disease, they are referred to as ‘limited spectrum'. Characteristics of a useful antibiotic: should have a wide spectrum of activity with the ability to destroy or inhibit many different species of pathogenic organisms should be able to reach the part of the human body where the infection is occurring should be chemically stable should be non-toxic to the patient and without undesirable side effects. should be also non-allergenic to the patients. should be inexpensive and easy to produce. antibiotic resistance is uncommon and unlikely to develop. How are antibiotic drugs used? When taking an antibiotic, it is very important to strictly follow all instructions from the physician and pharmacist. At the proper dosage, most antibiotics will not hurt us; however, if you exceed the upper dosage limit, harmful side effects will occurred. Some people are allergic to a given antibiotic. Allergies to penicillin or its derivatives are relatively more common. Sometimes certain types of antibiotics can cause other symptoms such as nausea and vomiting, diarrhea, developing a rash or a ringing sound in the ears (tinnitis). It is important to complete the course of medication as it has been prescribed by your doctor, even if all your symptoms have disappeared. Failure to do this or if the antibiotic is not taken regularly can lead to a resurgence of the infection in the antibiotic-resistant form. 26 Teacher’s Notes for Treatment of Diseases PERIOD FOUR Antibiotics/Antibacterial agents Antibacterial Agents Antibacterial Drugs are similar to antibiotics in function but dissimilar in origin. Antibacterial drugs were developed from chemicals. Sulfonamides were the first drugs to be given for the treatment of bacterial infections and provided the mainstay of the treatment of infection before penicillin (the first antibiotic) became generally available. Increasing bacterial resistance and the development of antibiotics that are more effective and less toxic have reduced the use of sulphonamides . Other antibacterials are used for treatment of tuberculosis, protozoal infections, microbials, and treatment of urinary tract infection. Drug resistance of antibiotics Some bacteria are naturally resistant to certain types of antibiotics. However, bacteria may also become resistant by genetic mutation or by acquiring resistance from another bacterium. Resistance to penicillin for some strains of bacteria (Staphylococci) was recognized almost immediately after introduction of the drug. Today resistance to penicillin occurs in as many as 80% of all strains of the same bacteria. Some strains are even resistant to virtually all clinically available antibiotics. Because of this problem, significant efforts are underway to find new natural sources of antibiotics, or to make completely synthetic ones in the laboratory. The development of drug resistant strains of the bacteria causing Tuberculosis are threatening to break through in one of the world’s most prevalent infectious diseases. The bacteria may develop mechanisms of growth and reproduction that are not disrupted by the effects of the antibiotics. The bacteria may also produce enzymes that neutralize the antibiotics. 27 Teacher’s Notes for Treatment of Diseases Antibiotic resistance may develop in a person during prolonged treatment or sometimes because the antibiotic was not taken regularly. The resistant strain of bacteria is able to multiply, thereby prolonging the illness. The increasing use of antibiotics in the treatment of infection over the past half century has led to the development of resistance in certain types of bacteria to the effects of particular antibiotics. Indiscriminate use of antibiotics also aggravates this problem Antibiotics resistance also enhances the spread of infection within a community. Environmentally, antibiotic resistance spreads as bacteria themselves move from place to place; bacteria can travel via airplane, water and wind. People can pass the resistant bacteria to others; for example, by coughing or contact with unwashed hands. Tuberculosis (TB) and Drug Resistance Tuberculosis Tuberculosis is a bacterial infection most commonly affecting the lungs. The bacteria can also cause infection in other parts of the body, including the lymph nodes, bones, joints, vertebral spine, brain, and kidneys. Transmission usually takes place through the airborne spread of droplets produced by patients with infectious tuberculosis. In Hong Kong, the morbidity and mortality rates of tuberculosis in 2001 were 108 and 23.58 per 100,000 population respectively. Compared with the early 90s, the prevalence of tuberculosis was decreased drastically. For more detailed information, you can go to the Department of Health website at: http://www.info.gov.hk/dh/publicat/web/tb/tb4700e.htm to look up more statistical data about the Notification and Death Rate of Tuberculosis from 1947 to 2001. 28 Teacher’s Notes for Treatment of Diseases Chemotherapy is the most important component of tuberculosis control. The success in the treatment of tuberculosis depends on the doctor prescribing an adequate drug regimen and on the patient taking the multiple medications regularly for the total period of time required. Medication is given under direct observation of health-care staff. This treatment regimen has greatly improved the compliance of patients in taking chemotherapy. In the past, chemotherapy had to be taken for one or two years. Current regimens can affect a cure in only 6 months. The development of effective anti-TB drug therapies has drastically improved the world TB situation with drop in both incidence rates and death rates. However, due to various reasons since late 1980's, there has been a resurgence of TB in various parts of the world. In industrialized countries, the steady drop in Tuberculosis incidence began to level off in the mid-1980s and then stagnated or even began to increase. Much of this rise can be at least partially attributed to a high rate of immigration from places with a high incidence of Tuberculosis. In Hong Kong, recent immigrants from Mainland China did not appear to be at excess risk of Tuberculosis in comparison with the local population. Thus, changing demography, increasing prevalence of chronic degenerative disease, high population density and rapid population movement are challenges to those responsible for the control of Tuberculosis. Drug resistance of tuberculosis The epidemic of drug-resistant strains in certain places has made control of the disease more difficult. Drug-resistant tuberculosis can be largely prevented by adherence to the principles of sound therapy. The use of ‘Directly Observed Treatment’ (DOT) for treatment of Tuberculosis has been introduced in Hong Kong since the 1960/1970s in response to low treatment completion and mounting resistance at that time. DOT work with community acceptance, a committed team of staff and measures to promote adherence by convenient location convenient hours, education, counseling, rapid defaulter identification and exhaustive defaulter tracing. (See: http://www.info.gov.hk/tb_chest/doc/Annrpt2000.pdf ) 29 Teacher’s Notes for Treatment of Diseases Antiviral drugs (Teacher References Only) Viruses are simpler and smaller entity than bacteria and are less able to sustain themselves. There are many types of virus, and viral infection causes illnesses with various symptoms and degrees of severity. Common viral infections include: Common cold Influenza Flu-like illness Cold scores Childhood diseases, such as chickenpox and mumps The natural defenses of the body are usually strong enough to overcome infections, and medications are required for relief of pain and fever. Some viral infections such as poliomyelitis, rubella, and hepatitis can be prevented by vaccination. Antiviral drugs should be given early in the course of a serious viral infection such as herpes zoster (shingles). Some antiviral drugs are applied topically. 30 Teacher’s Notes for Treatment of Diseases Common cold – self help The common cold is a contagious viral infection of the upper respiratory passage and usually takes 3-7 days until the symptoms subside. No medicine can cure the virus. Symptoms 1. Nasal congestion and runny nose 2. A tickle in the throat or soreness 3. Cough 4. Headache and some facial discomfort over the cheek bones or above the eyes or even watery eyes (This is due to involvement of the sinuses) 5. Fatigue 6. Slight fever for one or two days 7. May have loose stools or vomiting Self-care principles Keep warm (but not hot) Rest and go to bed early Drink plenty of fluids (hot drinks to soothe the irritation in the throat) Use a vaporizer or cool mist humidifier to relieve nasal congestion Eat normal meals (with fruit and vegetables) Cut down the workload a little, rest as needed Avoid going to crowded public places (to reduce infection risk to others) Non-prescription drugs such as “Panadol” (paracetamol) for relief of headache and antihistamines based products such as “Coldrex, Coltalin” etc to relieve symptoms of runny nose, sore throat, etc. can be taken. Should I see a doctor? Consult a doctor if: Fever persists for more than 2 days or if it exceeds 390C (1020F) Greenish or yellowish sputum is present. There is trouble in breathing. Symptoms persist for 14 days. 31 Teacher’s Notes for Treatment of Diseases For young children, the elderly and others with heart disease or chronic chest ailments, medical advice should be sought. A number of over-the-counter medicines are prepared for children. Many other medicines have labels that give both adults’ and children’s dosages. (For the purposes of drug labeling, anyone 12 years of age or under is considered a child.) When giving OTC medicines to children, you should always follow the instructions on the label exactly and under no circumstances exceed the dosage recommended for a child. Never give a child even a small proportion of a medicine intended for adult use without the advice of your doctor, for example: do not give aspirin to children which may cause Reyes syndrome (a rare brain and liver disorder.) Coughing Coughing is a natural response to irritation of the lungs and air passages, designed to expel harmful substances from the respiratory tract. Common causes of coughing include infection of the respiratory tract (such as bronchitis, pneumonia), asthma or exposure to certain irritant substances such as smoke or chemical fumes. Coughing can be dry or productive of phlegm. As most coughing is a helpful process that would dispel excess phlegm or irritating substances in the respiratory tract, suppressing the cough may actually delay recover. However, persistent coughing can be distressing, and may actually increase irritation of the air passages and medication to ease the cough may be necessary. There is a large variety of over-the-counter medications available for treating coughs. Most consist of syrup containing a number of active ingredients and flavourings. It is best to choose a preparation with a single active ingredient appropriate for the type of cough. Seek medical advice for any cough that persists for longer than a few days or if a cough is accompanied by additional symptoms such as fever or blood in the phlegm. Many preparations are available over-the-counter to treat different symptoms of the common cold. The main ingredient in most preparations is a mild pain relieving drug such as paracetamol or aspirin, accompanied by a decongestant, an antihistamine and sometimes caffeine. 32 Teacher’s Notes for Treatment of Diseases Other therapeutic methods Traditional Chinese Medicine: The practice is based on the dichotomy of Ying and Yang, female and male hot and cold, which is applied to symptoms, diet and treatments, such as acupuncture and Chinese herbal medicine. Alternative medical practice It offers therapies based on cultural views of health and disease alongside conventional health services, e.g. Chiropractic 33 Suggested Activities 1. To conduct a project to clarify what exactly are Chinese Medicine practice, and whether people in Hong Kong have a clear idea when they should consult Chinese Medicine practitioners. 2. To study the changes in disease pattern, and top killer diseases in Hong Kong over the past 5 decades, and explains why there are changes. 3. To find out what diseases are classified by law as notifiable diseases and for what purposes? 4. Why is Hong Kong continuously under the threat of the introduction of some forms of communicable diseases? 34 Review Questions/Quizzes/Food for Thought 1. Should and could Chinese medicine and Western medicine be integrated and how? 2. Is it true that environment health improvements saves more lives than advances in medical practice; with reference to Hong Kong or in rural China. 35 Handout and question sheets Period 1 Question and Answer Sheet 1 Answer the following questions by placing a in the correct square. Only one answer is correct. 1. Where are you most likely to go when you have a bad cough and a fever? (a) Your local accident and emergency department (b) The local doctor’s office (c) The gym – you can sweat it out there 2. Your uncle suddenly grips his chest, complaining of severe paint here and down his arm. He is very pale and breaks out into a cold sweat. Where do you take him? (a) Back to the doctor for more of his white tablets. (b) Home for a rest (c) Your local accident and emergency department 3. Your aunt has been complaining about her back for months and has been to several doctors. Her latest doctor decides that she needs further investigations and specialist help. Where will the doctor be most likely to send your aunt? (a) A chiropractor (b) An outpatient clinic specializing in orthopedic or back pain problems (c) A physiotherapist 4. Your aunt’s back problem is quite serious. Who decides whether she should have surgery? (a) Your Aunt – it’s her back! (b) The specialist from the outpatient clinic (c) Her own doctor and the specialist together, after a meeting 36 Handout and question sheets 5. Your aunt’s operation was a success and she is about to be discharged from the hospital. What is most likely to happen next? (a) She will be sent home with an out patient appointment for the specialist to check her progress and appointments for any follow-up care. (b) She will be sent home with a letter for her doctor so that arrangements for physiotherapy can be made (c) The operation was a success – she can rest up for a while and then get on with her life. 37 Handout and question sheets Period 1 Question and Answer Sheet 1 – Answers 1. Where are you most likely to go when you have a bad cough and a fever? Correct answer is (b) the local doctor’s office. Attending the Accident and Emergency departments wastes resources that are better spent on patients needing urgent and life saving help. Going to the gym could be dangerous, especially if you have a fever, and would increase the spread of the virus in the community. 2. Your uncle suddenly grips his chest, complaining of severe paint here and down his arm. He is very pale and breaks out into a cold sweat. Where do you take him? Correct answer is (c), the local accident and emergency department. These are classic signs of angina, a condition where not enough blood is flowing into the heart muscle. Angina can lead to a “heart attack” (myocardial infarction), where part of the muscle dies because of the lack of blood flow. This is a potentially life-threatening condition requiring urgent attention. Your uncle may be having a severe angina attack or a heart attack – either way, he needs to be taken to a hospital immediately. 3. Your aunt’s back problem is quite serious. Who decides whether she should have surgery? Correct answer is (b) The consultant will decide whether surgery is needed. Your aunt has the right to accept or refuse the treatment offered, and if she decides to accept, she will sign a form, called a “consent” form giving the surgeon permission to carry out the procedure. The GP will no longer be involved in decision-making. 38 Handout and question sheets 4. Your aunt’s operation is a success and she is about to be discharged from the hospital. What is most likely to happen next? Correct answer is (a) She will be sent home with an out patient appointment for the specialist to check her progress and appointments for any follow-up care. This may include physiotherapy, medication and routine visits to the outpatient clinic to check her progress. The decision on when to resume normal activities will be based on her progress in consultation with her medical care team. 5. Your aunt’s operation is a success and she is about to be discharged from the hospital. What is most likely to happen next? Correct answer is (a) She will be sent home with an out patient appointment for the specialist to check her progress and appointments for any follow-up care. This may include physiotherapy, medication and routine visits to the outpatient clinic to check her progress. The decision on when to resume normal activities will be based on her progress in consultation with her medical care team. 39 Handout and question sheets Period 2 Sheet 1 What is Pain? Pain is described in Merrium Webster’s Dictionary as: - physical suffering associated with disease, injury, or other bodily disorder - a basic bodily sensation . . . caused by something harmful - physical discomfort (pricking, throbbing, or aching) - mental distress Pain can be graded into mild, moderate and severe pain, but the grading of pain is not so much determined by the cause of the pain as by the individual sufferer. Some people have a “high pain threshold” which means that they are very resistant to pain, whilst others are more sensitive. List some illnesses or conditions that are likely to cause: (a) mild pain (b) moderate pain (c) severe pain 40 Handout and question sheets Period 2 Teacher Sheet Some examples of painful conditions and illnesses (for teacher) Headache, Influenza, Earache Dental pain, Common cold Neck pain Period pain, Fractures Pain of childbirth Back pain, Sprains Pain following surgery Muscular aches and Inflammation Constipation pains Sports injury Burn pain fall off bike 41 Handout and question sheets Period 3 Student Sheet 1 (Page 1) What is an infection? An infection happens when a microorganism begins to grow and multiply in the body. We all have millions of microorganisms on and in our bodies. There are many bacteria (microorganisms that can live independently) on our skin, and even more in our intestines and mouths. These bacteria are mostly harmless and many perform useful functions, such as aiding digestion, within the body. However, there are many bacteria that will make you sick. Some are usually not found in the healthy body, whereas others, normally harmless or helpful bacteria may overgrow or invade parts of the body where they are not supposed to be. There are also viruses, particles that cannot live by themselves but which can invade your body's cells, take over those cells' growth machinery, and make the cells start producing more virus particles. (adapted from “Infections and Immunizations” http://www.drreddy.com/shots/index.html#infectwhat ) _____________________________________________________________ Broad Outline – drug types used to treat infections Antibiotics An antibiotic is the type of antimicrobial agent made from a mold or a bacterium that kills, or slows the growth of other microbes, specifically bacteria. Examples include penicillin and streptomycin. Antibiotics work only against infections that are caused by bacteria. Some antibiotics are effective against only certain types of bacteria, whilst others can effectively fight a broad range. Antibiotics are of no use in the treatment of viral infections. Since 1941, when the first antibiotic, penicillin, was introduced, many different classes of antibiotics have been developed. Each one has a 42 different chemical composition and is effective against a particular range of bacteria. 43 Handout and question sheets Student Sheet 2 Types of Infection – A brief outline Bacterial Infection See sheet 1 for description of bacteria. Bacteria cause disease and infection when they are able to gain access to more vulnerable parts of our bodies and multiply rapidly. Bacteria can infect almost any part of the body. Viral Infection The successful invasion, establishment and growth of viruses in the tissues of the host. [Viruses are ultra-microscopic parasitic micro-organisms within living cells They contain genetic instructions concerning viral reproduction protected by a protein coat. They destroy the cells they live in and when the cells break up, the newly formed viruses are released]. Fungal Infection Fungi are very different from bacteria and fungal cells have a very different genetic structure and cell wall. They can be divided into two groups, yeasts and moulds. Yeasts are single cell fungi and moulds are multi-cellular with a complex reproductive process involving specialized structures that release spores. Fungi can cause infection in people who appear otherwise healthy. These people can then develop progressive disease over a period of many years since the primary infection. Parasitic Infection A parasitic infection is simply infection by a parasite or “A successful invasion of a host by an organism that uses the host for food and shelter” There are around 30,00 parasites known to infect humans. The one that will immediately spring to mind is the malarial mosquito, which injects its eggs into humans when it stings, causing malaria. Onother one, the tapeworm infects the intestines after infected raw or undercooked meat is eaten.. Once in the intestine the worm feeds off the host’s digested food. Adult tape worms can reach a length of more than 15 feet. 44 Handout and question sheets Homework sheet for Period 3 (Complete and bring along to Period 4) Fill in the blanks Type of infection Bacterial Example Type of drug used Example Penicillin Streptomycin Vancomysin “Cold Sore” Antiviral (Herpes simplex) Fungal Athlete’s Foot Tapeworm Niclosamide Iodoquinol Chloroquine Suggested websites to help in your research http://www.cellsalive.com/pen.htm http://www.nuigalway.ie/bac/fungal_infection.htm http://www.neb.com/neb/products/drug_discovery/Parasitic.html http://www.merck.com/mrkshared/mmanual_home/sec17/186.jsp 45 Handout and question sheets Period 3 homework Sample answer sheet for teachers Type of infection Example Type of drug used Bacterial Boils Antibiotic Example Penicillin Streptomycin Vancomysin Viral Fungal “Cold Sore” Antiviral Acyclovir (Herpes Ribavirin simplex) Amantadine Athlete’s Foot Antifungal Clotrimazole Amphocil Nystatin Parasitic Tapeworm Anti-parasitic Niclosamide Iodoquinol Chloroquine Information available on: http://www.cellsalive.com/pen.htm http://www.nuigalway.ie/bac/fungal_infection.htm http://www.neb.com/neb/products/drug_discovery/Parasitic.html http://www.merck.com/mrkshared/mmanual_home/sec17/186.jsp 46 Handout and question sheets Period 4 Sheet 1 Tuberculosis 1. What type of infection is TB? 2. Which parts of our body can it affect? 3. Which part of the body does it most often attack? 4. How is the infection transmitted? 5. How do you test for TB 6. How is it treated? 7. Do you think TB is a common disease? 47