L20 Cures for Sale Flashcards
What are warts caused by
viruses
What are some traditional remedies for warts? Did they work
rub w miracle flowers, radish, raw potato (bury the potato in clay), dandelion flower milk, etc.
nah, 80% of the time warts disappeared on their own in less than 2 years
What are the 3 questions we ask ourselves in evidence-based medicine?
does this drug work?
what are the side effects?
how does it compare with what is available?
What are 2 kinds of “complementary and alternative medicines CAM”
herbal remedies and homeopathy
What is alternative medicine based on
hearsay, folklore, imagination
TF: alternative medicine can become conventional medicine
True, if there is evidence
Why can CAM be dangerous?
<40% of products used are reported to physicians and many of them have risks associated with them (drug interactions)
What are the 4 traits of conventional medicine
- evidence based
- better than placebo
- benefits outweigh side effects
- documented
Why is developing a novel drug so long an expensive?
many stages of research, must be approved, pre-clinical and clinical trials,
pharmacokinetics and pharmacodynamics must be known, bioavailability, storage,
acute and chronic toxicity, mutagenicity, teratogen
Clinical trials are designed to answer which questions
does it work, is it safe, how does it compare?
What animal testing is done for mutagenicity
AMES
Which tests are followed for drug evaluation?
double blind: person giving the drug and person receiving the drug do not know which is placebo and which is active (no psychological influence)
randomization: random distribution of placebo and drug in group/cohort
Why do placebos work? what fraction of people experience placebo response?
they work thanks to a belief system due to psychosocial context, varies with disorder, relationship to caregivers, ritual of taking medicine, strength of belief
1/3
What conditions must a drug comply to to be deemed effective
better and longer lasting effect than placebo
Cold sores and fevers blisters are caused by _
HSV-1
TF: most plants are non-toxic
False
What is homeopathy? How is it made?
belief system (late 1700s) based on fighting fire with fire; we can fight a disease by giving something else that creates the same symptoms
Made by diluting compound (termed ‘potentization’) 1:100 and banging and mixing the vial in between each dilution
Final concentration of 1/60^60
How are CAMs and homeopathic remedies marketed?
Try to legitimize themselves by using scientific terms
Claim to have superior effectiveness without any side-effects
Capitalize on placebo response
Claim that you need to take them for 6 months for results
Use of testimonials
What alternative medicine is sold as an antibiotic
snake/oregano oil
makes it worse if you have an infection, does not replace vaccines as some claim it to
What are homeopathic nosodes
sugar pills that claim to immunize against diseases such as influenza, whooping cough, measles, diphtheria, polio
- basically “vaccine pills”
TF: dietary supplements can cure hepatitis C
False
What is the estimated worth of herbal medicine globally
60 billion USD
5 trillion by 2050 (estimate)
What are the prime targets for herbal remedies (5)
conditions that eventually go away (colds, aches, pains)
conditions w high psychological component (anxiety, insomnia)
chronic conditions that naturally cycles (GI conditions, allergies, arthritis)
cosmetics (aging)
terminal illnesses (heart failure, cancer)
Gingko biloba was marketed for…
cataracts, erectile dysfunction
Shen min marketed for…
alopecia, hair loss, baldness
HGH (human growth hormone) supplements were marketed for…
weight loss, hair colour, immune system
What compound used to sold as a cure all? What is it nowadays? What did it claim to cure
snake oil
oregano oil
antibiotic for bacterial and fungal infections, parasites, viruses, inflammation
What were Actra-Rx and Yilishen marketed for?
dietary supplements for erectile dysfunction and enhancing sexual performance
illegally contained prescription strength viagra (sildenafil) - serious risk of drug interactions
Yohimbine was sold for
bodybuilding, male sexual performance, impotence
contains an active that is an alpha-2 blocker in the periphery and CNS, can cause seizures and paralysis
Leritone
increase memory and make you smarter
main ingredient: cow brain (cerebral phospholipids)
*CAM
TF: although herbal remedies do not work for osteoarthritis, acupuncture is a proven therapy
False!
glucosamine and chondroitin also aren’t useful for osteoarthritis
What are hazards associated with herbal remedies?
herbal roulette
no quality control
ineffective
+drug interactions
Echinacea is sold as …
antibiotic
for acne, boils, difficult skin conditions, immune system stimulant/booster
equivalent to placebo
What is Ephedra (Ma Huang)
powerful stimulant in the amphetamine family
weight loss, asthma, athletic ability
add ephedra to coffin and aspirin can cure the problem (claimed to be problem in nervous system causing weight gain)
CONS: can cause myocardial infarct (heart attack) and stroke
Kava
sold for stress, anxiety, insomnia
CONS: CNS effects, hallucinations, hepatotoxicity
Green tea extract
causes liver failure when concentrated
sold as weight loss drug
White rhino horn
sold as aphrodisiac, sexual stimulant
now extinct
Chinese remedies were usually made of…
mixtures of compounds from plants and animals
based on trial and error
Describe St John’s wort, what it was used for, its drug interactions
advertised for depression
Many drug interactions (potential fatal)
- Remission of HIV
- Decreased levels of drugs such as Midazolam (benzodiazepine) due to increased CYP3A4 activity
- Decreased levels of statins (thus increase risk of heart attack)
- interactions with anti-epileptics, oral contraceptives, HIV protease inhibitors, chemotherapy drugs like imatinib, immunosuppressants like cyclosporine, causes photosensitivty
Why is concentrated garlic/ginseng dangerous
garlic: concentrated garlic acts as an anti-coagulant (interact with aspirin)
ginseng: Induction of P450s thus lowering your drug activity and bleeding to death
What are major categories of OTCs
analgesics, NSAIDS
TF: OTC are originally prescription drugs that have been ruled to be safe
True
Why is it dangerous to combine medicines that contain acetaminophen
risk of overdose
TF: Most OTCs are symptom relievers
True
How do nasal decongestants work
they constrict the blood vessels in the nasal mucosa thus decreasing leaky-ness and swollen-ness which impedes breathing
Stimulation of which receptors on smooth muscles constricts the blood vessels of the nose
alpha1
Once activated, what do alpha1 receptors do?
stimulate the release of calcium within smooth muscle cells, resulting in contraction and vasoconstriction - mucous production and swelling are reduced
What are some alpha1 receptor agonists
phenylephrine, oxymetazoline
why are nasal sprays better than oral decongestants
local effect, decreased chances of side effects
Drugs for allergies contain _
antihistamines
What happens during an allergic reaction at a molecular level?
allergen reacts with mast cell, causing it to release histamine
histamine an acts on H1/2 receptors on smooth muscle in airways
Blocking which receptor allows for allergy relief? why?
H2 receptors in airways
decreased bronchoconstriction, mucous secretion
Antibiotics can act on which properties of bacteria (5)
cell wall synthesis
DNA gyrase
protein synthesis
cell membrane
folic acid metabolism
Athlete’s foot is treated with
Antifungal preparation (topical): puncture hole in the fungal wall
Tolnaftate 1% solution, cream, or powder
What can be used to cure lice
Nix shampoo
What is heartburn and how can it be treated (2)
gastric acid reflux back into esophagus
decrease gastric acid produced by parietal cells which make HCl
parietal cells have proton pumps that pump out HCl
These cells are stimulated by histamine, ACh, and gastrin
- 2nd gen H2 blocker (histamine receptor) does not inhibit P450 thus less chances of drug interaction
or
- proton pump inhibitors e.g. Omeprazole, lansoprazole, rabeprazole, pantoprazole, esomeprazole (-ole); originally prescription, but now OTC; activated by acid in stomach
Name a drug that can be used for heartburn
omeprazole
-ole = proton pump inhibitor (target for heartburn) along wth H2 rcptrs
Constipation can be treated by _
fiber found in oat bran, cereals, laxatives, metamucil
Lorepramide is used for
diarrhea
What is Lorepramide
an opioid that doesn’t cross the blood brain barrier (thus non-addictive, no CNS effects)
stops diarrhea
stimulates mu (u) receptors (opioid receptors) on intestinal wall in the myenteric plexus
calms the propulsive waves (peristalsis)
Osteoporosis occurs in _% of males and _% of females
20 males
25 females
What are some consequences of osteoporosis
collapse of vertebra and deformity of the spine
When does maximum bone strength occur
late 20s, early 30s
What can be done to increase bone strength
exercise, calcium intake
TF: lower bone strength increases the likelihood of osteoporosis later in life
True
what can be used to increase bone density
calcium carbonate (e.g. TUMS)
helps osteoblast function
OTCs must have (4)
quality control, evidence of efficacy, list of potential side effects, continual monitoring for rare reaction/interactions
What can be used to treat warts
salicylic acid
