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world of drugs


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when did ideas concerning the link between germs and diseases develop
100 years ago
major method of disease detection way back when
uroscopy: the study of urine (diagnosis by urine colour)
life expectancy at the end of the last century in NA(1890s)
47 yrs for men
present life expectancy for men and women
80 yrs
country with the highest life expectancy
Andorra in eastern europe
country with the lowest life expectancy
swaziland in africa
world average life expectancy
what percent of the population will be above 65 years old in 2020
old person alive
edna parker 114
oldest person ever
jeanne Calment 122
top causes of death in the modern world
repiratory disease kill 5 million ppl/yr diarrheal diseases kill 3 million/yr and HIV/AIDS also kills 3 million people a year
largest disease epidemic known in history
1918 Influenze Pandemic (Spanish Flu) 30-50 million deaths
prevention methods for spread of the influenza epidemic
face masks, sneeze sheets, isolation
what did people use during the 1911 flu epidemic
kemps Balsam (alcohol and plant substances)
This man discovered a diary of a boy written during the 1911 flu epidemic that turned out to be his father
Dr. Harpp
what was the cause of most deaths in the 1918 flu
bacterial pnumonia
cause of pneumonia
caused when virus wiped out bronchial cells in the lungs, where bacteria from nose and mouth could invade and multiply
what famous person died of smallpox which is now eradicated
Queen Mary II of England
this disease is nearly eradicated
Leprosy is also known as
Hansen's Disease
this disease involves the ingestion of the nematode larvae (worm)
Guinea Worm Disease
this disease is caused by the "kissing bug" and a parasite and can be prevented using insecticides, symptoms can occur 10-20 yrs following the bite
Chagas Disease
used to widen the esophagus
Balloon Angioplasty or a "Roto-Router Treatment"
in order to widen the esophagus, these drugs are used as sedatives
Librium and Valium
This person was faculty of Mcgill Medicine in 1874 and was instrumental in the development of the tools of diagnosis
Sir William Osler
definition of a drug
a chemical agent that affects living matter or any preparation which in a person's mind has a beneficial effect on his or hers well being.
what is the market for perscription drugs in NA/yr
300 Billion Dollar market
market for OTC drugs/yr in NA?
25 Billion dollars
how many beer recipes did the sumerians (2200 BC) have?
This person tried to exclude superstition and invented a cure of night blindness using Ox Liver (since liver contains lots of vitamin A) and also believed that poppy juice and excrement of flies was useful in calming babies
Hippocrates (460-370 BC)
this person worked with gladiators
Galen (131 AD in greece)
does the placebo effect typically opose or support drug studies demonstrating the usefulness of a drug?
what percent of individuals taking a placebo during a drug trial will improve in health
he wrote De MateriaMedica, a large tome with information about plants and their pharmaceutical effects
Dioscorides (40-90AD)
some of the plants described in De MateriaMedica
opium, wormwood (used in Absinthe, Arum dioscordies (used as an expectorant), Saffron (to pass urine)
use of iodine and alcohol
kill bacteria on open cuts
use of smelling salts
ammonium carbonate--ammonia causes one to wake up
pharmacy present in ancient times
doctors in the 1135-1204 period who were well known for writing about the practice of medicine (hospital named after one of them in montreal)
Avicenna and Maimonides(has statue and hospital)
these people brought the methods of medicine back to spain in the year 700
the moors
why was doctor Paracelcus (1493-1541) famous?
wrote about medicine, was against the Doctrine of Humors, suggested that proof comes from experiment and reasoning, introduced chemical treatments for disease but was against use of multiple drugs at once, known for notion of poison vs. potion, believed all drugs are poisons and only the right dosage stopped them from being a poison
mandrake root thought to have great powers because
it resembles a human body
this technique was generally a failure because blood types had not yet been discovered
blood transfusions
what did the doctrine of humors say?
body consisted of blood, phlegm, black and yellow bile, and each element correpsonded to earth elements such as air, water, earth, and fire respectively
what did the doctrine of signatures say?
god marked everything he created with a sign eg. walnuts good for the brain since they look like little brains
who put forth the doctrine of signatures and which philosphers did his philosophy influence
german shoemaker jakob Bohm (1575-1624), influenced Hegel and Schopenhauer
in middle ages, thought to be a cure for the black plague
bezoar stone
these were added to wine and were thought to be good for the blood
this is an emetic, meaning it iduced vommitting istantaneously
poison used by romeo
this technique allowed the patient to get rid of fluid that may have been causing the disease
blood letting
this assisted in the condition once known as Dropsy where one would drop to their knees due to fluid accumulation (such that the heart can not cirrculate blood properly (now known as congestive heart failure)
foxglove plant
this drug is used to treat failing heart and is derived from the foxglove plant
Lanoxin (Digoxin)
published information about foxglove first written by
william withering
this man was competitor of william withering and insisted his grandson ______ recieve credit for foxglove discovery
Erasmus Darwin and charles Darwin
cure of malaria that is extracted from this plant
quinine extracted from the cinchona plant
number of species of anopheline mosquitoe and number of species that actually transmit malaria causing parasite
380 and 60
quinine or cinchona (not sure) named after who?
wife of spanish viceroy to Peru because she was treated with it
first people to efficiently purify Quinine from bark
pelletier and Caventou
contains quinine
tonic water
used in the 1940s to combat malaria
why is DDT banned
causes shells of bird eggs to crack permaturely--hampers bird reproduction
used to prevent spread of malaria
insecticide treated nets
prof Jeff Sachs of columbia university does not believe in use of nets but rather use of_____
plague spread by
flea pulexirritans
the great pox 1945
morphine discovered by
Friedrich Serturner in 1805
what did dr. joseph lister do
popularized phenol as an atiseptic, washing of hands and rubber gloves could prevent sepsis
antisepsis introduced in Canada by
Thomas Roddick
1950 listerine used for
dandruff control
listerine no longer contains phenol but
thymol (a related molecule)
Phenol is also known as
carbolic acid
use of anisthetics began in
first anesthetic was ____discovered by ______
nitrous oxide discovered by Sir Humphrey Davy (also known as laughing gas)
____introduced as an anesthetic by ____in 1800s
ether, william morton
first surgeon that used ether
John Collins warren
two main surgeries before modern era
amputations and surface tumors
similar structure to NaCL
Potassium Bromide , KBr
the patent medicine era was between
1850 and 1906
"proper drug era" between
1906 and present
_____ won the nobel prize in 1908 for compound_____which is used to treat______
paul erlich, Salversan (compound 606), syphilis
____ ivented in 1800s by Bayer company used to
Aspirin, suppress coughs
this made it stricter to sell drugs, required drugs to have proof of safety, regulated cosmetics of product, updated food standards
1938 federal, food drug and cosmetic act
this drug originally used to treat morning sickness causes mutations in babies
thalidomide is a ____ and this person was affected by it
teratogen, thomas quasthoff, german first class singer
______ discovered the effects of thalidomide and won award
Dr. Francis Kelsey
Thalidomide is useful for treating
Leprosy, Hansen's Disease, certain cancers
____ is extracted from spanish flies, thought to be an aphrodisiac but known to be an irritant
periwinkle flower yields____ a widely used chemotherapeutic agent
witch doctor with good understanding of specific herbs and remedies
fragment based lead discovery technique
largest drug sales in US from
lipitor and Zocor (cholesterol drugs)
also big money makers are
stomach acid reduction drugs prevacid and nexium
pharmaceutical company with largest volume of sales
Pfizer Inc
top selling drugs world wide
Lipitor (cholesterol) Plavix (blood clotting) nexium (stomach acid) seretide (asthma)
sales of perscription drugs increasing by ___% a yr
FDA catalogues drugs by chemical type but also by
new molecular entity, new derivative, new formation, new combintation, already marketed 9expired patent)new use for a drug
this druge was originally researched for high blood pressure but is now used for increased hair growth
excipients are
materials in the pill that are not medicine such as fillers binds anti foaming agents, emulsifiers etc
this drug removed from the market because of its negative side effects
Vioxx (Merck)
risk factors
not the disease, contribute to probability that a certain disease will effect and individual
5 most popular OTC drugs (with revenue) are
cough cold represents (4 billion) pain relievers (most popular but 2.7 billion) antacids (1.4 billion) oral antiseptics (0.8 billion)laxatives (0.7 billion)
how much is spent on OTC drugs compared with prescription in NA
25$ billion on OTC and 300$ billion spent on perscription
do we use more OTC or perscription drugs
Arielle Newman died in 2007 by taking this topical pain reliever
Methyl Salicylate
16th century one way to treat headaches was
puting your head in an ovrn and letting the evil spirits come out
aspirin is associated with the ___ that belongs to the ____ family
willow tree, salix family
these are part of the salix family
polar, beech, wintergreen, and the meadowsweet
_____ are extracted from plants from the salix family
methyl salicylate is also known as
oil of wintergreen
sumerians used willow leaves to help
joint pains
egyptians used willow leaves to lessen
wound inflammation
to treat baldness egyptians used
fat from snakes lions and hippopotami
medication applied to scalp to increase hair growth
pill taken to increase hair growth
used bark of willow tree to get rid of pain from child birth
hippocrates (400 BC)
rediscovered potential of willow tree in 1763
reverand edward stone
doctrine of signature states
if there is some form of association between a disease and a plant or animal then the plant or animal should be successful in treating that disease
quinine was extracted from bark in
he extracted salicin from willow bark in 1829
henri leroux
1838 he purified salicin making salycylic acid
rafaelle Piria
salycylic acid has the following properties
analgesic (pain relieving), antipyretic (lowers fevers), anti-inflammatory
side effects of salicylic acid
bittern tasting, upsets stomach
salycilic acid also used in ____
compound W, wart removing substance
late 19th century (1897)he discovered acetyl sallicylic acid
felix hoffman
karl friedrich gerhardt
previously prepared same compounds but never managed to completely purify it
the combination of salicylic acid with acetic acid is what type of reaction
condensation reaction
Who was arthur eichengrun?
belief he was true discoverer of Aspirin however he was Jewish and the Nazis may have suppressed his discovery, he also discovered cellulose acetate which had a huge impact on the film industry
he promoted use of Aspirin
Carl Duisberg
aspirin was initially sold as a
____ was introduced as a a cough remedy as a subsitute to morphine
the name morphine comes from
morpheus, god of sleep
opium once treated gives
morphine plus acetic acid makes
1918 and 1994
bayer name sold for 5.3 million german bayer company purchased bayer company for 1 billion
what is a grain
unit of measure, 60 mg
ASA is effective for ____pain but not for _____ pain
muscular, visceral (deep pain such as severe stomach pain)
introverts or extroverts are more susceptible to pain
these are produced by the prostate and were discovered by Ulf Von Euler who won the Nobel prize in 1970
he discovered the mode of action of prostaglandins in 1971 and received nobel prize in 1981 for this discovery
John Vane
what happens when you feel pain
damaged cells produce arachidonic acid which is a precursor to prostaglandins which go to the brain and transmit signals to the nerves which cause you to feel pain
what does aspirin do in terms of how you feel pain?
blocks to conversion of arachidonic acid to prostaglandins, this conversion is done by enzyme CycloOxygenase (COX) therefore it is said that Aspirin in a COX inhibitor
by blocking prostaglandins, aspirin helps to
reduce fever and inflammation
what are the uses of Aspirin
heart disease 38%, arthritis 23%, headache 14%, body ache 3%, other 14%
Physicians health study, what was it?
done in 1989, studied over 22 000 make physicians , men were taking one aspirin every second day or a placebo every second day, rates were much lower for both fatal and non fatal heart attacks
how much aspirin is needed a day to see beneficial results?
how does aspirin help lower heart attack rates?
prevents formation of certain Prostaglandins such as Thromboxine A2 that aids in clotting, by blocking it the blood becomes thinner
why do chronic aspirin users have fewer colon cancer deaths?
aspirin increases bleeding in your stool if you have the cancer and so causes ppl to go see the doctor and catch the cancer at an early stage
what is a way that aspirin might aid in colon cancer patients?
these patients may have higher levels of COX enzymes and reducing their activity may help
What are diseases caused by ASA
salicylism 12-25 tablets a day, tinnitus (ringing in the ears) death 20-30 tablets a day
what is the difference between child's aspirin and adult aspirin?
childrens only have 80mg instead of 325mg, have less tablets so that if a kid gets into the bottle they won't overdose as much
what are the 3 main side effects and 2 minor ones of aspirin?
gastric irritations, gastrointestinal bleeding, ulcers, allergic reactions (minor), reye syndrome (minor)
aspirin effects the Gastrointesitnal system because:
prostoglandins help regulate acid secretion and so when they are reduced by aspirin acid secretion may be increased and the stomach lining compromised.
what is buffered ASA
asa buffered with Antacids which will counteract surplus of acid in the stomach. There is also coated aspirin (delayed release) which are coated with a special polymer to prevent them from dissolving in the stomach. Instead they dissolve in the intestines
why is aspirin not reccomended for teenagers or young children
reye syndrome
what is reye syndrome?
affects young children or teens after they have the flu or chicken pox, when aspirin is given to treat symptoms it causes an inflammation of the brain which has no place to expand to--fatal, 300 deaths a year
why should aspirin not be given to women in the last three months of pregnancy?
because prostaglandins promote uterine contractions so aspirin could delay delivery
extra strength aspirin
500mh rather than 325mg
aspirin caplets
caplets rather than tablets, easier to swallow, more "pill shaped"
what is Anacin?
contains 325mg of ASA and 32 mg of caffeine . it may increase absorption of medications and caffeine is a vasoconstrictor so if you have a headache caused by dilated blood vessels it can be helped
what is Midol?
contains 500mg of ASA and 32 mg of caffeine (overpriced)
what is the structure of acetaminophen?
benzene ring, same as ASA
benefits of acetominophen
pain relief, lowers fever, no association with reye syndrome
downsides of acetominophen
useless for inflammation, less effective than ASA in terms of heart disease prevention because does not have an acetyl group
is tylenol better for osteoarthritis or rheumatoid arthritis
it is better for osteoarthritis because it is caused by aging, your joints wear out and start rubbing NOT associated with inflammation where as rheumatoid arthristis is an autoimmune disease that is associated with inflamation
acetominophen is easier for children to take in drop form because
it dissolves better in liquids
danger of acetominophen?
affects the liver, never be taken on an empty stomach or after you have had alcohol
what is added to acetominophen in the UK to prevent poisoning?
methionine--> leads to the proudction of more of the enzyme glutathione which breaks down the acetominophen
what medications used to contain ASA but are being switched over to acetaminophen?
Anacin, excedrin (both gentler on the stomach)
Why do all medications now have safety seals?
1982 major recall of tylenol, someone slipped Potassium cyanide into the gel capsules of tylenol, 7 people died.
pros of ibuprofin
better pain relief than either ASA or acetaminophen, better for pre-menstrual pain, lowers fever and inflammation, no association with reye's syndrome
does ibuprofin help with heart disease
no bitch!
why shouldn't ppl who take ASA regularly take ibuprofin
it will negate these benefits
whats the deal with Naproxen Sodium?
pain reliever but lasts longer, US brand name is Alieve, in Canada a prescription is required
what are the highest ranked pain releievers in terms of market share?
Acetominophen 43%, ASA 28%, ibuprofin 26%, naproxen sodium 3%
2 types of pain relievers
Non-Steroidal Anti-Inflammatory Drugs NSAID, other (acetominophen)
what are the 2 types of COX enzymes?
COX 1 - stomach protection COX 2- causes pain and inflammation (ASA blocks both of these so reduces pain and inflammation but compromises the stomach)
what are two drugs that only block the cox 2 enzyme and thus prevent pain and inflammation without affectign the stomach
celebrex and vioxx
whats wrong with Vioxx
it can cause heart failure
who was ordered to pay a woman millions of dollars for the death of her husband due to vioxx?
merck frosst
what makes celebrex able to only bind to Cox-2
it has a tail on its molecular structure that does not allow it to bind to cox 1
vioxx has no more risk than other pain relievers true or false?
what NSAID has the least amount of risks in terms of heart disease
naproxen sodium
how much is spent annually on OTC stomach drugs
$1.4-1.6 billion
how much money is spent annually on prescription stomach drugs?
$20 billion
who is sammy davis Jr?
seen in alka-seltzer add, he was black, jewish, and blind in one eye
what is the role of the gastrointestinal tract?
processing and digesting subtances that are ingested
this acid is responsible for the breakdown of foods in the stomach
hydrochloric acid
what is the first organ of the GI tract
the stomach
role of the stomach
breakdown of larger susbtances/molecules before they are fed into the small intestine, cleavage occurs of carbohydrates and proteins, uses an acidic medium to better perform its task (gastric juice)
diameter of small intestine
2 inches (25 feet long)
role of small intestine
metabolism of fats, basic medium for neutralization of acid
how is the acid in the small intestine neutralized?
pancreas secretes alkaline juice
why does the pancreas deliver specific enzymes in the small intestine?
to digest fats
what causes overproduction of HCl in the stomach?
eating too much, eating too fast, spicy food, smoking, pain relieving medication (NSAIDs), stress
what is the common reliever of stomach pain?
acid is neutralized with a base to produce
salt and water
why aren't strong bases (such as sodium hydroxide) to treat upset stomachs?
they are hazzardous to the individual, instead weak bases are used
_____ was once and no longer is used as an antacid
sodium bicarbonate
sodium bicarbonate reacts with HCl to produced
salt, water, and carbon dioxide (carbon dioxide causes burping and gas)
what are the pros and cons of sodium bicarbonate as an antacid?
pros: fast and cheap cons: can lead to acid rebound, body overproduces acid in response to weak base, doesn't last long, high in sodium, can cause systemic alkalosis in the body and blood

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