NHP Flashcards
what helped the growth of NHP?
- increased interest in food that can be used in prevention and treatment of illnesses
- belief that NHPs are better than conventional drugs
- aggressive marketing
what are the two things drugs have to demonstrate?
- safety
- effectiveness
what do NHPs have to demonstrate?
- purity
- safety
Natural Health Products Directorate regulations define NHPs as products for use in:
- diagnosing, treating, mitigating, or preventing a disease, disorder, etc
- restoring or correcting organic functions in humans
- modifying functions in a manner that maintains or prpmotes health
Do NHPs need a prescription?
no
Do NHPs require evidence to support claims of safety and efficacy?
- must include clinical trial data
- references to published studies and pharmacopoeias
NHP as traditional use requirement?
50 yr of consecutive years of use within a cultural belief system (represents 2 generations - reproductive side effects can be determined)
include:
- references that support recommended condition of use and dose info
- method of preparation
St John’s Wort
Hypericum perforatum ("devils scourge")
-supposed prevention of possession by demon
anxiety (limited evidence) & antidepressant
- as effective as standard antidepressant with less side effects
- superior to placebo
SAMe
active form of methionine
acts as a methyl donor
antidepressant
-as effective as tricyclic antidepressants
Ginkgo Biloba
long history in China
improve memory and cognitive function
- not clear on effectiveness
- may help Alzheimers
reduces blood clotting (enhance circulation )
-combining with Aspirin = dangerous
In Canada, as of 2004, all natural products with associated claims of health benefits are subject to regulations from the:
NHPD
A recent survey showed that ____of Canadians regularly use NHPs.
71%
Evidence suggests that Ginko Biloba may act as a:
blood thinner
What is phenyl-propanolamine (PPA)?
an active ingredient in some weight-loss products that has been banned.
Diphenhydramine, which is found in most sleep aids, is really a(n):
antihistamine
Acetylsalicylic acid was originally sold under the brand name:
Aspirin
Aspirin should not be given to children because of increased risk for:
Reye’s syndrome.
Dextromethorphan is the most common active ingredient in what OTC medicines?
cough and cold
Ibuprofen:
is an example of an NSAID.
anesthetics
“without sensibility”
reduce all types of sensation or by blocking consciousness completely
analgesics
"without pain" compounds that reduce pain selectively two groups: -opioids -OTC: aspirin, acetaminophen, ibuprofen
types of pain
visceral pain (opioids)
- intestinal cramps
- nonskelatal portions
somatic pains (salicylates)
- muscle or bone
- sprains, headaches, arthritis
salicylic acid
1838 synthesized and isolated from willow bark
used for arthritis
Bayer Labs
salicylic acid caused great gastric discomfort so Hoffmann synthesized acetylsalicylic acid in 1898
-product patented and released in 1899 under the name Aspirin
heroin was also synthesized here
aspirin
-potency?
more potent than salicylic acid because Aspirin irritates stomach less and thus absorbed more rapidly
aspirin effects
- analgesic
- antipyretic: reduces fever
- antiinflammatory: reduces swelling, inflammation, soreness
aspirin adverse effects-
- reduce blood clotting
- induce gastrointestinal bleeding
- Reyes syndrome (children with chicken pox): vomiting, disoriented, lethargic, mortality rate 25%
aspirin mechanism of action
- central and peripheral analgesic effect
- aspirin blocks synthesis of prostaglandins (mediate pain) by inhibiting two forms of cyclooxygenase enzyme COX-1,2
-antipyretic: anterior hypothalamus -> sweating and dilation of peripheral blood vessels
phenacetin
- analgesic & antipyretic
- kidney lesions and dysfunction :0
- rapidly convert to acetaminophen
acetaminophen
- less gastric bleeding but also less useful as anti-inflammatory
- Tylenol
- overuse => liver disorders
Ibuprofen
- analgesic and potent anti-inflammatory
- gastrointestinal: nausea, stomach pain, and cramping
- fatal liver damage with overdose
- NSAID (nonsteroidal antiinflammatory drug)
who regulates prescribing, distribution, selling, dispensing of drugs?
FDA
Controlled Drugs and Substance Act (CDSA)
who maintains classification of drugs approved for use?
National Drug Scheduling System
-National Association of Pharmacy Regulatory Authorities (NARPA)
how are drugs placed in the NARPA schedules?
based on pharmacological and toxicological profile
what schedule is a drug that can be sold without a prescription but must be kept behind the counter?
2
what schedule is a drug that can be sold openly
1
what schedule is a drug that requires a prescription?
3
what is the active ingredient in OTC sleep aids and cough and cold products?
antihistamine
what are factors in the movement to deregulate many prescription drugs?
growth in modern notions of individual responsibility
pharmaceutical companies seeking increased sales
growing challenges in maintaining public and private prescription drug plans
what are two ingredients WERE in OTC sedatives
scopolamine (acetylcholine blocker)
antihistamine methapyrilene
why was methapyrilene no longer used?
caused cancer in lab animals
what do modern day sedatives contain?
diphenhydramine:
- hydrochloride
- citrate
how do diphenhydramines work?
block effects of histamine at H1 receptor sites in CNS
what do antihistamines do?
induce drowsiness
what are two classes of drugs used to reduce pain/awareness of pain
anaesthetics
analgesics
what does anaesthetics mean?
without sensibility
what does analgesics mean?
without pain
what are some examples of analgesics
Aspirin
acetaminophen
ibuprofen
what are the two types of pain
visceral
somatic
what kind of pain are opioids effective in reducing?
visceral pain (from nonskeletal portions of body)
what kind of products do you need to use in order to reduce somatic pain (muscles, bone, headaches, arthritis)
salicylates (Aspirin)
how many peopl receive pain relief from placebos
35%
St Augustine declared what about diseases?
diseases were the work of demons and thus a punishment from God
what did the Aboriginals do to reduce fevers?
brewed tea from willow bark
what was the active ingredient in the preparation used by Reverend Edward Stone?
salicylic acid
when was salicylic acid synthesized and made readily available?
1838 - synthesized
1859 - mass production
what is the major difficulty with salicylic acid?
drug caused gastric discomfort
who synthesized acetylsalicylic acid and when?
Hofmann of Bayer Labs
1898
What is the brand name for acetylsalicylic acid?
Aspirin
why is apirin more potent analgesic than saliclic acid?
Aspirin irritates the stomach less and is thus more rapidly absorbed
what is an antipyretic?
fever reducing
what is an anti-inflammatory?
reducing swelling and inflammation
what is the therapeutic dose of aspirin
600-1000 milligrams
what are some side effects of ibuprofen
nausea, stomach pain, cramping
fatal liver damage with overdose
ibuprofen is an example of
NSAID
what does NSAID stand for?
Nonsteroidal antiinflammatory drug
what is a co-codaprin
a drug that contains acetylsalicylic acid, codeine, caffeine
why is caffeine sometimes taken with codeine
caffeine offsets the sedative effects of codeine
what are the two groups of viruses that are known to be associated with colds
rhinovirus
coronavirus
what does the rhinovirus do?
zero in on the upper respiratory tract, at first causing irritation, which can lead to reflex coughing and sneezing
increased irritation inflames tissue and is followed by soreness and swelling of mucous membrane
-as a defense against infection, the mucous membranes release considerable fluid, which causes runny nose
how do colds usually start?
fingers pick up viruses and then the individual rubs eyes or picks nose
modern cold remedies contain which three common types of ingredients?
antihistamines (for runny nose)
sympathomimetic nasal decongestants (swollen membrane)
analgesic-antipyretic (aches, fever reduction)
what is the most common antihistamine in cold remedies?
chloropheniramine maleate
what is the most common nasal decongestant
phenylephrine
what is the most common analgesic-antipyretic
acetaminophen
what is the most common active ingredient in OTC cough medicines?
dextromethorphan
which chemical do allergy relief pills rely on?
antihistamines
which chemicals do sinus medications use?
sympathomimetic nasal decongestants (phenylephrine)
analgesic
