Rethinking Drugs Exam #1

Private/Liberal Medicine:

Choice is complicated in an algorithmic world; the health of a collectivity is supported by the structure of power. Individual choice/agency - Enlightenment value; life, liberty, choice “my body my choice” - looking for a healthy YOU

Medical/health Politics

collective, institutional governmental, corporate regulation of health through policy, goal is to create a healthy labor force/military

Romantic

interested in personal logic, not rational logic, personal truth above all else. feeling over thought. mystical, exceptional, spiritual, heightened sense, valorization of the primitive  

The Age of Kale 

valorizing the natural, clean/safe over the synthetic (dirty/unsafe) 

The Moral

drugs framed through morality and vice. good vs. bad substances, good vs. bad users. often tied to stigma, ex) “war on drugs rhetoric, heroin demonization 

Biopower

makes use of/trades on the supposed power/legitimacy of a doctor - Micheal Foucault

The Seige Cycle

the cyclical nature of the careers of psychotropic drugs. drug career cycle encompassed into three phases: high expectations, rising criticism, and disappointment

Capitalism

profit incentive/driving towards profit. drugs as commodities. their production, marketing, and profit-making drive how they are used 

Bioavailability

the ability of a drug or other substance to be absorbed and used by the body

MEC

minimum effective concentration - the lower level of a drug in the body that will still be effect - or minimal concentration of drugs thats doing something - higher dose/adverse affection 

Pollan Reading takeaways

Pharmocokinetics

study of kinetics of absorption, distribution, metabolism, and excertion of drugs. studying how drugs move in and out of the body, not what they do. this information is legally required by the FDA 

ET half life 

how long it takes for half of the drugs concentration to leave your body/systemic circulation

plasma concentration

the concentration of an agent in the plasma which is derived from the blood

1st pass metabolism

metabollic destruction/transformation of the drug by the mouth, stomach, and small intestine - elimination/metabolism outside of the liver- particular to oral administration

oral 

slow and high variable absorption, subject to first-pass effect, ex) alcohol, caffeine, LSD, cannabis, PCP

rectal

slightly variable absorption, quicker absorption than oral administration ex) diazepam, acetaminophen, laxatives

vaginal

steady drug levels, can go directly to affected tissue, quicker than oral administration ex) estrogen cream

sublingual and buccal 

under the tongue administration - rapid absorption, higher bioavailability than oral administration 

intranasal

rapidly absorbed, both local and systemic effects ex) cocaine, heroine, powdered tobacco

eye drops, ear drops

goes directly to affected tissue

trandsdermal 

on the skin, slow and continuous drug delivery

inhalation

very rapid onset of action ex) cannabis, nicotine

intravenous

IV - rapid, most accurate blood concentration ex) heroin

intramuscular 

slow and even absorbtion, sustained release possible ex) vaccines

subcutaneous

injection in fatty tissue under the skin, slow and prolonged absorption

CYP enzymes

cytochrome p450 - drug processing enzyme: family of proteins in the liver (and other tissues) that help the body break down (metabolize) drugs, toxins, and even some natural body chemicals like hormones.

what determines the rate of elimination

CYPs

blockers of CYPs

the metabloite is/is not inert

the fat soluability of the drug