Midterm 1

Pharmaceutical Industry, Pain Relievers, Cold Meds, Cancer

Finding Information

check minimum 2 sites

most reliable information

pharm, government, scientific journals

Life Expectancy in Canada in 2009

82 years

Average Life Expectancy Worldwide in 2009

66 years

Cause of Death in 1900s

pneumonia, tuberculosis, influenza

Cause of Death in 2000s

heart disease, cancer, stroke, traffic accidents, diabetes

Reason for Improved Health

improved sanitation, clean drinking water, refridgeration, vaccination, antibiotics

Improved Sanitation

waste in separated, open vs closed sewers, population exposed to dead - spreads disease

clean drinking water

safe water supply, simple water treatments, chlorination - water kills microbes

Refridgeration

food spoilage, choose between eating vs starving, seasonal availability, food storage

Vaccination

immunization from disease, infection hosts

antibiotics

reduced death, maternal mortality rate goes downs

prescription drugs market

300 billion

over the counter drugs market

25 billion

pharma industry

start in 1856, regulated by government

ancient medication

made-up cures, placebo effect, treatments actually harmful

plants

used itself defence mechanism or poison

drugs

produce desired biological effect

poison

produce undesired biological effect

drugs are poison

only the does makes the poison

low dosages

most time: produce beneficial effect (drug) sometimes: produce harmful effect (poison)

high dosages

most time: produce harmful effect (poison) sometimes: produce benefit effect (drug)

drugs before 1900

philosophy of belief of a cure was more common than observing a effect from a drug

modern painkillers

from opium (poppy seeds)

cocaine as stimulant

extracted from coca leaves, topical painkiller, stimulant

modern anesthetics from cocane

anesthetics, novocaine, procaine, lidocaine, benzocaine

placebo effect

if you believe something will make you better then it might, even if the thing provided has no effect

problem with observation

human brain searches for patterns, ancients did not use experiments or statistics

apophenia

seeing patterns or connections in random or meaningless data

pareidolia

perceiving sounds or images as something else

traditional remedies

poor control over dose, chemical composition, no standardization, difficult to correct information

doctrine of humors - universe

4 elements: earth, air, fire, water

doctrine of humors - body

blood, phlegm, yellow bile, black bile

issue with doctrine of humors

based on incorrect idea, treatment developed using it were harmful

doctrine of signature

jakob bohme - god left clues to tell use how to use things

doctrine of signature is incorrect

most remedies developed this way were harmfyl, lack of rationality or evidence

surgery

structurally modify a person to alleviate an issue that drugs are unable to affect

problem requires surgery

use drugs to treat, then surgery

amputatuon

most common, unpleasant, done quickly

Sir Humphry Davy

discovered nitrous oxide, first anesthetic now known as laughing gas

William T.G Morton

discovered the ether was much more effective anesthetic than nitrous oxide, no pain during modern surgery

rules

regulation of drugs, medical devices, procedures

before 1907

no rules, anybody can make/sell drugs

alcohol

common active ingredient, “feel good drugs”

board of food + drug inspection

1907, first govern regulations for meds, labeling only

Massengill Company + Drug Safety

creates drug using dangerous chemicals (crystalline sulfanilamide, sulfanimide elixir, refused to take drug off market - caused multiple dead and disabled

crystalline sulfanilamide

first topical antibiotic

Food + Drug Administration (FDA)

food,drug,cosmetic act -1938, ensure safety of drugs, animal testing and human clinical trials

Thalidomide

sedative for pregnancy (1957), recognized as teratogen (1962)

Teratogen

caused birth defects - miscarriage, stillbirth, birth defects

modern safety standards

testing at least 2 species, relevant doses

industry regulation important

safety products, manufacturing quality, regulation increase cost

modern drugs work

scientific idea, tested scientifically, provide scientific proof

prescription drugs

470 billion per year

over to counter

35 billion per year

top over the counter drugs

cough + cold, pain reliever, antacid, toothpaste, laxative

important when buying

safety, indications, counter indications

side effects

all drugs, easy to find, label

incidence

difficult to fine, FDA provide info, ask doctor

most popular drug

aspirin

willow trees

contain salicylates,posion produced by plants

Reverend Edward Stone

rector in church, describe treatment for ague in 1763

doctrine of signatures

association between disease and cure

Willow Bark

bitter, expensive, limited supply, active ingredient (salici)

Salicylic Acid

1838, better than salicin, expensive, manufracture from coal tar, stomach irritation

Synthetic

oil, cheap, mass produces

Natural

natural source, expensive,

Drug Optimization

modified salicylic acid’s chemical structure

Aspirin

Acetylsalicylic acid (ASA)

A.S.A

sold as power, ASA (generic name), Aspirin (trade name), increase acid prodcution, decrease mucus production

Aspirin - Benefit

pain, fever, inflammation relief, reduce heart attack

Aspirin - Side Effect

tinnitus, stomach irritaion, interferes with blood clotting

prostaglandins

local hormones, short times, decrease acid production, increase mucus production

aspirin + explosives

using aspirin to make home made explosives - blew up parliament

bufferin

contains an antacid, protects stomach from acid damage and irritation

Reye Syndrome

children with brain injury while holding high fever, falsely associated with ASA \--- caused children aspirin to be removed in canada

Cause vs Association

between 2 things does not mean that one thing caused the other (winner LSU vs BAMA football game and presidential election

Cause

requires body of evidence - control experiments eliminate other possibilities, biochemical explanation

Aspirin + Stomach Irritation

ulcers common, prostaglandin production in stomach

Name Brand vs Generic

Name Brand (fancier packaging, at eye-level) Generic (less fancy, hard to find)

Quality and Costs

people assume higher costs \= higher the quality, generic drugs are the same quality as name brands

Aspirin: Benefits and Side Effects

Benefits (pain, fever, inflammation, prevent heart attack) Side Effects (decrease blood clotting, stomach irritation, some reye syndrome)

Antikamnia

made from coal tar, cheap mass-produced pain medication

Carl Duisberg

chemist, dispose of 50 tons of aminophenol

Phenacetin

APC tablet, effective with headaches

Acetaminophen

raises pain threshold, lowers sensitivity, muscle/organ pain

Osteoarthritis

tylenol very effective

Rheumatoid Arthritis

involves prostaglandins, tylenol - not effective

Tylenol and Cyanide

cyanide poisonide from tylenol - caused tylenol to be recalled, safety seal were added

Acetaminophen - Benefits and Side Effects

Benefits ( pain, fever, no inflammation, no prevent heart attack) Side Effect (no decrease blood clotting, no stomach irritation, no reye syndrome, liver toxicity)

Ibuprofen

1961, inhibits cyclooxygenase, pain relief longer than tylenol

Ibuprofen - Benefits and Side Effect

Benefits (pain, fever, inflammation, no prevent heart attack) Side Effect (decrease blood clotting, stomach irritation, no reye syndrome, no liver toxicity)

Naproxen

aleve, good for inflammation

Top Pain Relievers

Acetaminophen, Acetylsalicylic Acid (Aspirin), Ibuprofen, Naproxen

Effect of Cox-1 inhibitation

Stomach (increase HCl production, decrease mucus production) Platelets (clotting is inhibited) long term - ulcers - stomach bleeding

Effect of Cox-2 inhibition

reduces pain, inflammation, fever

VIOXX clinical trials

selective cox-2 inhibitor for arthritis, durg approved in 1999

Clinical Trials

done for marketing, used naproxen as placebo, high risk of heart attack

Cephalagia

scientific term heaache

Headache and Demons

no one knew to cause of headache so they blammed it on the demons