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HL CHEM D: Medicine and Drugs BY HEIMAN KWOK 12N03S 13.7.14

Jan 02, 2016

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HL CHEM 2: Atomic Structure

HL CHEM D: Medicine and DrugsBY HEIMAN KWOK 12N03S13.7.14D.1 pharmaceutical productsBackground InformationThe best way to fight disease is by maximizing the effectiveness of the bodys natural defence system, by supplementing our natural healing process

Prevent Entry > Attack Invaders > Immune SystemEffect of Medicine and Drugs on the functioning of the body Alter incoming sensory sensations Alters mood or emotions Alters physiological states, including consciousness, activity level or coordination

The Placebo Effect - used as a control substance; shows the power of suggestion, or the bodys natural healing

NOTE THAT Medicine and DrugsMay or may not be from doctors or pharmacies May or may not have beneficial medical properties From Plants or Fungi in labs or from GMOHelpful/ Harmful Legal/ illegal

RECOGNISE Categories of MedicineInfection Fighters: Antiseptics, Antibiotics, Antivirals Affecting metabolism: hormones and vitamins Affecting CNS: stimulants, depressants, analgesics (painkiller), anaesthetics (remove sense of felling)Methods of AdministrationOral: taken by mouth tablets, capsules, pills, liquids, enteric = coating, so its of slow release Inhalation: vapour breathed in; rapid, anaesthesia smoking asthma, nicotine and cocaineParenteral/ Injection 1. intramuscular (to the muscle) vaccines; 2. intravenous (bloodstream) local anaesthetics; 3. subcutaneous (underneath the skin) dental injectionsMethods of AdministrationTopical: skin patches and ointments absorbed directly from the skin into the bloodstream hormone treatments such as nicotine patches and oestrogen Rectal: inserted into the rectum can be destroyed by acids treatment of digestive illnesses, haemorrhoids Eye or Ear Drops: liquids delivered directly to the opening treatment of infections in the eye or earLethal Dose = dose of a substance in mg per kg of body mass that kills 50% of the sample

The smaller the LD 50, the more toxic the substance Effective Dose = dose of a substance in mg per Kg of body mass that work 50% of the sample

The smaller the ED 50, the more effective the substance Therapeutic WindowStages in Research, Development and testing of new Pharmaceutical Products CASE STUDY: Thalidomide Sleeping aid to combat morning sickness One isomer of the racemic mixture was harmful Caused deformations in the babies of pregnant women Caused by not testing on pregnant mice or having clinical trials on humans Drug Effect Main Effect: desired Side Effect: unintended physiological effects

Eg. Morphine for pain relief, however constipation is side effect; or for diarrhea but pain relief as a side effect Depends on the purpose sought after

ToleranceD.2 antacids Excess secretion = Gastric JuiceGastric glands in the lining of the stomach produce HCl which keep the pH of the stomach at 1-2 Acid environment kills bacteria and provides optimum environment for digestive enzymes^ can cause acid indigestion, heart burn/ acid reflux to the esophagus and stomach ulcersPepsinogen and PepsinPepsinogen forms pepsin in an acidic environmentPepsin breaks down proteins into amino acids AntacidsAntacid EquationsCaCO3 + 2 HCl CaCl2 + H2O + CO2NaHCO3 + HCl NaCl + H2O + CO2Al(OH)3 + 3 HCl AlCl3 + 3 H2OMg(OH)2 + 2 HCl MgCl2 + 2 H2OMgO + 2 HCl MgCl2 + H2O

Alginates and anti-foaming agentsSome contain alginates which produce a neutralising layer 1) produces a neutralising layer on top of acid 2) prevents acid from rising reflux into the esophagusOthers contain anti-foaming agents (dimethicone/ simethicone) which prevents formation of gases and reduces bloating and flatulence as a result of Carbon Dioxide productionAntacids Side EffectsMg compounds cause constipationAl: laxative or causes diarrhoea Carbonates: produce Carbon Dioxide causing bloating and flatulence Because antacids change the pH of the stomach, they can alter other chemical reactions including the absorption of other drugs. They should never be taken for an extended period without medical supervision.

d.3 analgesics - painkillersHow is pain perceived?Where you are injured; prostaglandins are produced Ways Analgesics Prevent Pain Mild Analgesics eg. Ibuprofen, Paracetamol are considered non-addictive: intercept the transmission of pain at the source; indirectly blocks the enzyme-controlled synthesis of prostaglandins Strong Analgesics (opioids/ narcotics) eg. morphine may have dependence: temporarily binds to opioid receptors sites in the brain and CNS hence you dont sense the pain but its still there Relative value of these two approaches to pain management Derivatives of Salicylic Acid (eg. Aspirin) in Use Mild analgesic for minor aches and pains to relieve headaches, sunburn pain and pain of arthritis Anti-pyretic to reduce feverAnti-inflammatory agent to prevent swelling from injuries Anti-platelet to prevent clotting by inhibiting the production of prostaglandins, prevents heart disease Aspirin and Paracetamol (non-steroidal analgesics and anti-inflammatory)Aspirin Benzene Ring Ester Carboxylic Acid

Paracetamol Benzene Ring Hydroxol Amide Carbonyl

Aspirin vs ParacetamolAspirin Paracetamol Analgesic painkiller? Yes Yes Antipyretic reduces fever Yes Yes Anti-inflammatory Yes No Anti-Platelet Yes (No)Side Effects Stomach wall irritant, blood anti-coagulant, internal bleeding, ulcerationNo upset stomach or internal bleeding Severe Side Effects (over dosage)Gastrointestinal Bleeding following use of alcohol Serious kidney, liver and brain damage Allergies 0.5% get skin rashes, respiratory difficulty, shock RareChild-Use Friendly No; causes Reyes Syndrome fatal liver and brain disorderYes Codeine, Morphine and Diamorphine (Heroin) P.631 of Brown and Ford

Potent-ness: Codeine > Morphine > Heroin Use of Morphine and its derivatives (Opiates) Advantages Disadvantages Relief of Severe Pain eg. From injury, chronic disease (cancer), surgery Treatment of diarrhoea by its constipating effect Relieve coughing by supressing the brain stem Relief from emotional and psychological pain Analgesia, drowsiness, mood changes, mental clouding, anxiety, fear, sedation, nausea, vomiting Tolerance due to adaption of neurons and Cross Tolerance (tolerance to similar opiates)P.141 Figure 1509 Green and Damji Physical Dependence withdrawal symptoms d.4 depressants Effect of Depressants Figure 15.9 P.633

Supresses the brain and CNS Changes the communication between brain cells by altering the concentration or activity of the chemicals called neurotransmitters Cause a DECREASE in brain activity which in turn influences the functioning of the other parts of the body such as the heart and breathing rate (NOTE: analgesics are also depressants)Effect of Use of alcoholSocial Physiological Sense of occasion Antiseptic Creates mild excitement Hardens the skin Allows users to become more talkative, confident and relaxed Craving or compulsion to drinkLost in productivity Physical addition withdrawal symptoms such as nausea, sweating, anxiety, increased blood pressure Increased crime, accidents rates Tolerance needing increasing amounts for the same effect Effect of Abuse of alcoholShort TermLong TermLoss of self-restraint, memory, concentration and insight are impaired Dependence Alcoholism w/ withdrawal symptoms Loss of balance and judgement Liver disease eg. Cirrhosis, liver cancer Violent behaviour associated with domestic abuse and family breakdown Coronary heart disease Dangerous risk-taking behaviour leading to accidents High blood pressure Dehydration caused by increased urine output leading to hangover and lost of productivity Fetal alcohol syndrome At high doses - vomiting, loss of consciousness, coma and deathPermanent brain damage Detection of ethanol in BreathBreathalyser The alcohol in the blood is realised into the air with the exhaled breath The alcohol vapour is oxidised by Potassium Dichromate +6 to +3 which then changes from orange to green The extent of colour change is then measured using a photocell and converted into a percentage BAC mass in grams of ethanol per 100 ml of blood Detection of ethanol in Breath 2Infrared Spectroscopy with an intoximeter (more accurate)Causes vibrational motions depending on the mass of the atoms and the length/ strength of the bonds within the molecule Compares the intensity of IR radiation through the sample with the intensity through air Does not distinguish between ethanol an propanone which is often present in the breadth o a diabetic patient

Detection of ethanol in Blood and Urine Gas-liquid Chromatography Blood or Urine is vapourised and injected into a stream of an inert gas (mobile phase) over the surface of a non-volatile liquid (stationary phase) Components of the vapour including ethanol gas move at different rates depending on their boiling pints and relative solubility in the two phases Leaving the column holding the liquid phase after a specific interval of time known as retention time Area under the peak is compared the a known standard in the mixture such as propan-1-ol Synergistic effects of ethanol with other drugs With Aspirin causes increased bleeding of the stomach lining and increased risk of ulcers With other depressants such as barbiturates such as sleeping pills can induce heavy sedation, possibly leading to comaWith Tobacco increases the incidence of cancers esp. liver and intestines With other drugs interfere with the metabolism by the liver which may cause greater and prolonged effects of the drugCommonly used depressants and structures

d.5 stimulants What are Stimulants? Acts on the brain and CNS Changes the communication between brain cells by altering the concentration or activity of the chemicals called neurotransmitters Cause an INCREASE in brain activity which in turn makes the body more alertPrevent excessive drowsiness thro

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