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Phase-non-specific drugs are cytotoxic at any point in the cell cycle and may be toxic to cancer cells in the resting phase. However, most cancer drugs are effective in the S phase of dividing cells, preventing normal DNA synthesis so that the cells go into apoptosis. Drug therapy aims to prevent cell division or cause cell death in the tumour without damaging normal healthy cells. Cancer cells are similar to normal cells, so this is often impossible and explains many of the side effects of chemotherapy. Cytotoxic drugs affect normal dividing cells producing unwanted adverse effects on bone marrow and the cells produced there; reduced healing; loss of hair due to damage to hair producing cells in hair follicles; damage to the gastrointestinal lining; reduced growth in children; sterility; and damage to the foetus.

Pneumonia can result from infection by bacteria, viruses or fungi. Bacterial pneumonia is treated with antibiotics; viral pneumonia may not need specific drug treatment, but in serious cases antiviral drugs can be used. Fungal pneumonia usually only occurs in immunocompromized patients and must be treated with oral antifungal drugs. Tuberculosis is a serious lung disease that can be difficult to treat. Successful therapy requires the prolonged use of a combination of at least three different antibiotics. Treatment of other lung diseases, for example lung cancer, is beyond the scope of this book.

Oxygen in the air that is breathed into the lungs diffuses from the alveoli across their thin walls into tissue fluid and then into the blood capillaries. Diffusion of oxygen happens efficiently because there is a concentration gradient from air in the alveoli to blood in the capillaries; the distance through the alveoli walls, tissue fluid and capillary walls is small; and the total surface area of all the alveoli is large. For the same reasons, carbon dioxide diffuses in the opposite direction. Air moves in and out of the lungs due to changes in volume and pressure inside the chest cavity. Inspiration is brought about by contraction of the diaphragm and the external intercostal muscles. The diaphragm flattens and the ribs are pulled upwards and outwards increasing the volume of the chest cavity.

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