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
- 64
- what percent of the population will be above 65 years old in 2020
- 16%
- 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
- Polio
- 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?
- 16
- 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?
- oppose
- what percent of individuals taking a placebo during a drug trial will improve in health
- 30-35%
- 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
- Pharmakon
- 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
- nails
- this is an emetic, meaning it iduced vommitting istantaneously
- Ipecac
- poison used by romeo
- aconite
- 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
- DDT
- 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_____
- drugs
- plague spread by
- flea pulexirritans
- the great pox 1945
- syphillis
- 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
- 1800s
- 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
- 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
- cantharidine
- periwinkle flower yields____ a widely used chemotherapeutic agent
- vincristine
- shaman
- witch doctor with good understanding of specific herbs and remedies
- FBLD
- 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
- 10
- 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
- minoxidil
- 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
- OTC
- 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
- salicylates
- 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
- rogaine
- medication applied to scalp to increase hair growth
- proscar
- 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
- 1829
- 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
- powder
- ____ was introduced as a a cough remedy as a subsitute to morphine
- heroin
- the name morphine comes from
- morpheus, god of sleep
- opium once treated gives
- morphine
- morphine plus acetic acid makes
- heroin
- 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
- extroverts
- these are produced by the prostate and were discovered by Ulf Von Euler who won the Nobel prize in 1970
- prostaglandins
- 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?
- 30mg
- 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?
- true
- 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?
- antacids
- 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