reality vs distortion Flashcards
Warts are caused by ______
A virus
What were some traditional remedies for warts?
Traditional “remedies”: rub with miracle flowers; rub with a radish, rub with raw potato, and bury the potato in clay; use dandelion flower milk; put an equal number of stones in a bag and bury it
Did traditional remedies work?
No, but people thought they did since a lot of things heal on their own
What questions are asked in evidence-bases medicine?
- Does this drug work?
- What are the side effects?
- How does it compare to what is available? Is there anything safer and better out there already?
Alternative medicine is based on what?
hearsay, folklore, or somebody’s imagination
Marketing techniques for alternative medicine used are what?
testimonials (‘I tried it and it was great!’), folklore, tradition, belief system.
What classifies something as being conventional medicine?
- Evidence-based
- Better than placebo
- Benefits outweigh the side effects.
- Documented.
What differentiates marketing for alternative and conventional medicine?
- conventional must list side effects, and show evidence that the drug works
what is double blind?
Neither the person giving the drug, nor the person receiving the drug knows if they are given the placebo or active drug, such that there is no psychological influence.
what questions do clinical trials try to answer?
- Is the drug safe?
- Does it work?
- How does it compare to what is available?
what is a randomized test?
Random distribution of placebo and active drug in a group of similarly aged, built, health individuals, so that one group isn’t in greater health than the other.
what is a placebo and how does it work?
- is a pill with no active ingredients
- Works thanks to a belief system, due to the psychosocial context. So, people can start taking
things that they believe will help, and they start feeling better
how do we know that a drug is good?
superior to placebo
what is the nocebo effect?
If you tell the test subjects to watch out for side effects, about 15% will respond negatively to the placebo
what is homeopathy?
A belief system formed in the late 1700s by a physician in Europe, where he believed “like counteracts like”: We can fight a disease by giving something else that creates the same symptoms.
what happened with initial homeopathic products and what was done to “solve” this?
- Resulted in making the situation worse.
- Then came up with the idea of diluting the original properties, so he could ‘maintain the magical properties’ from the initial sample
approximately __% will respond positively to placebo
35
what is the process of potentization?
Making something potent by diluting it.
- Start with the initial compound (mother tincture) and sequentially dilute it 1:100.
- Succussion: bang/mix the vial in between each dilution.
- Repeat 30 times.
- In doing so you transfer the “magical compound” from the original compound into the water molecules & thus “spiritualize/potentize” the water
- Final concentration 1/1060 => just water; there is nothing left
what is the most probable reason why a homeopathic product might work?
- placebo effect: Person will spend a lot of time talking to you – placebo response can be very strong, especially if you feel that somebody cares about you
Can you argue that homeopathy is a harmless placebo?
It’s rather unethical to say that something can cure something else when there is no evidence. If people do need treatment, taking homeopathic remedies delays the time they go to an actual physician, situation may get worse
what is snake and oregano oil sold as? how is this dangerous?
- both as antibiotics, which can be dangerous if you have an actual infection
- snake oil: claim it can replace vaccines
against whooping cough, can cure headaches, tuberculosis - oregano oil: an antibiotic curing bacterial and fungal infections, parasites, viruses, inflammation, etc.
what are homeopathic nosodes and what do they claim?
- sugar pills
- Claim: immunize against influenza, whooping cough, measles, diphtheria, and polio. Claims that it is better than vaccination
what is the advertised vs reality of herbal extracts?
- Advertised in a very appealing way; often plants are presented in a very beautiful and “healing” way.
- Reality is: we are taking chemicals from plant extracts – they may have side effects. Plants also have thousands of chemicals in them, some of which are toxic and can make us sick
what are the prime target conditions for herbal remedies?
- Conditions that would go away eventually anyway (ex. colds, aches, and pains)
- Conditions with high psychological component (ex. mild anxiety, insomnia) → respond well to
placebo - Chronic conditions that naturally cycle (ex. gastrointestinal conditions, allergies, chronic types
of arthritis) - Attempts to improve appearance, reverse aging, etc. (cosmetics)
- “Cure” terminal illness (ex. heart failure, cancer) => very unethical
what was Ginkgo biloba marketed for? what is the best way to treat this?
- cataracts: surgery best way
- also for erectile dysfunction
Shen min was marketed for what?
alopecia, hair loss, baldness
what does HGH supplements claim to do? what is the reality?
- Claims to help you lose weight without exercise, to recover hair color, to strengthen the immune system
- reality is that these supplements use marketing techniques to rope buyers into continuing to purchase them
what do Actra-Rx and Yilishen claim to do? did they work?
- “dietary supplements” for treating erectile dysfunction and enhancing sexual performance for men
- yes only because they illegally contain prescription-strength quantities of sildenafil
what so herbal cosmetics do?
Do not do anything
what is Yohimbine sold for? what does it contain/what is its effect?
- Sold for bodybuilding, male sexual performance, impotence
- Contains an active drug that is an α-2 blocker in the periphery and CNS.
- can cause seizures and paralysis
what is peelu and what does it contain/what is its effect?
- all-natural toothpaste
- contains none of the active ingredients (fluoride)
- you will get cavities
what is leritone and what does it contain/what does it do?
- Junior formula: to increase memory and to make you smarter.
- Main ingredient: cerebral phospholipids (ground up cow brains)
when taking a herbal remedy, why do we say you are taking a “herbal roulette”?
No quality control – no relationship between content claimed on the bottle and how much is
actually in there (& manufacturing conditions are not monitored, unlike with prescription medicine)
what is Echinacea sold as/used to treat?
- sold as an antibiotic
- used to treat acne, boils and difficult skin conditions, mean to be an immune system stimulant/booster to ward off many winter ailments
what is ephedra and what was it sold as/what did it do?
- A very powerful stimulant in the amphetamine family.
- Sold for weight loss (to correct obesity), asthma, increase athletic ability.
- Claim that weight gain is caused by a problem in your nervous system (causing metabolic
defect), and that concoctions of ephedra with caffeine and aspirin (ECA) can cure the problem
with your nervous system - Claim that you only need to take the pill, and no need to exercise, or watch what you eat.
- Cons: myocardial infarct and stroke
what is Kava sold for? what is its potetial effect?
- Sold for stress, anxiety, and insomnia
- Cons: CNS effects, hallucinations, and hepatotoxicity
what is green tea extract sold for? what is its potential effect?
- sold as weight loss drug
- can cause liver failure
plant chemical composition is different depending on ______________. Why?
- which field it is from
- plants take in chemicals from the soil
White rhino horn sold as _______________
an aphrodisiac and sexual stimulant
what was st john’s wort sold for?
depression
what other drugs does st john’s worts affect?
- antiepileptics (risk of seizures),
- oral contraceptives (risk of pregnancy),
- HIV protease inhibitors (go out of HIV remission),
- chemotherapy drugs like imatinib (now can die from acute myelogenous leukemia),
- immunosuppressants like cyclosporine (can reject a transplant),
- Also causes photosensitivity.
what is the effect of Garlic/Ginseng supplements? (how do they affect other drugs?)
- anti-coagulant (interact with aspirin)
- Induction of P450s, so your drug can end up not being effective and you can bleed to death
what are the major categories for OTC drugs?
- Analgesics, NSAIDs
- Cough and cold related.
what is the goal of most OTC drugs?
the relieve symptoms
how do nasal decongestants work?
constrict blood vessels in the nasal mucosa by stimulation of α1 receptors on smooth muscles which stimulate the release of calcium, such that blood vessels are less leaky and less swollen
what do phenylephrine and oxymetazoline do?
α1 agonists, so can be sprayed as nasal sprays for almost immediate relief
how do antihistamines work?
- histamine is released and acts on cells in the
H1/2 receptors on smooth muscle in the airway. - these drugs block H2 receptors in the airways to give allergy relief
what are different places where antibiotics can act?
cell wall synthesis, DNA gyrase, protein synthesis, cell membrane, folic acid metabolism
what is Tolnaftate?
an OTC drug to treat athlete’s foot (fungus infection)
what is heartburn?
gastrointestinal difficulties ; Gastric acid refluxing back into esophagus
what is the main strategy to relieve heartburn?
decrease the amount of gastric acid produced in the stomach by the Parietal cells
What is the difference between 1st and 2nd generation H2 blockers?
- Second generation doesn’t have P450 inhibition → less chances of drug interaction.
- Greatly decrease acid output
All proton pump inhibitors are ______ so must be ___________
- prodrugs
- activated by acid in the stomach
What are OTC solutions for constipation and diarrhea?
- constipation: fibre
- diarrhea: loperamide
What is loperamide and how does it work?
- An opioid that doesn’t cross blood-brain-barrier that stops diarrhea
- Stimulant for the μ receptors on the intestinal wall
- This then alters the type of peristalsis, calms down the propulsive waves.
Osteoporosis occurs in __% males and __% females
- 20
- 25
What is osteoporosis?
Collapse of the vertebra and deformity of the spine.
What is a way to avoid osteoporosis?
exercising enough to build up bones and that you are eating enough calcium in your youth.
What OTC drugs can be used to prevent osteoporosis?
Calcium carbonate supplements
OTC drugs must have: ?
whatmust they have to be aproved and to stay on the market
- Quality control
- Evidence of efficacy
- List of potential side effects
- Continual monitoring for rare reactions and interactions
