chapter 22+23 notes
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HLTB03H3Y: Foundations in Health
Department of Health Studies
University of Toronto at Scarborough
Instructor: Anna Walsh.
Term: Winter 2011: Wednesdays 9 a.m.-11 a.m.
Lecture Room: Room HW216.
March 30, 2011 Pharmaceutical Industry and Research Ethics. Chs. 22 and 23.
Current events: most patients are receiving priority procedures within medically
recommended wait times (health and aging lecture for this week also)
-In 2010 about 98% of all Canadians who needed cancer radiation treatment
received it within clinically recommended timeframe. It ranged from 85% in nova
scotia to 100% in Manitoba.
-Bypass surgery is about 98% for waiting time
-Problems with diagnostic scans and CT scans, waiting times are longer.
-Ontario will be increasing patient access to certain cancer drugs.
-Percepton: well known breast cancer drug. 35 year old women had a tumour that
was half a centimetre large. She wanted the treatment early so that she has a better
chance of living if the tumour is treated early.
-Federal government has created the Canadian MS system, this is also in response
to the controversial procedure that dr. Zamboni in Italy had recommended for MS.
-News article: link identified here in Toronto by DR. Roger mackentire who is a
psychiatrist and he detailed in a conference the fact that insulin has a role in
triggering mood disorders and medical imbalances in the brain. Insulin levels play
a part in depression, bipolar disorder, effective disorders, and the result is that we
are learning more that illnesses such as depression and other types of effective
disorders are really being caused by imbalances.
-At toronto’s mt. Sinai hospital: people were given insulin inhaler who had bipolar
disorder and they were seen to improve. There is also a connection with people
who are suffering from obesity and depression with insulin - 50%-75% of people
suffering from bipolar disorder or depression are obese or overweight.
-Prozac: used to weightless which is an example of off label drug use.
-Singular: prescribed for allergies, and it was wildly shown as providing a benefit
for people who were suffering with allergies. Unfortunately, it is sometimes
dangerous, especially for kids.
-Singular associated with suicide: allergy drug. Caused depression and anxiety.
-Reflex dystrophy syndrome: A woman broke her leg, could be because the cast
was put on too tight, which is usually the cause. She was given morphine.
According to her mother, she said she died because a lot of people made a lot of
-Testimony of Alicia shore: her toes turned purple after her casts was put on, her
mother took her to emergency again but damage has already been done. She
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suffered from a lot of pain so they gave her morphine. Two nurses gave her too
much morphine, the morphine did not help her at all, and instead it killed her.
After the coroner’s inquest the findings were so strong, there was a criminal
investigation and two nurses were charged with Alicia’s death.
•Example of adverse reactions: Montelukast sodium (Singulair), a leukotriene-
receptor antagonist prescribed for treatment of asthma in patients 2 years of age
and older. Monograph warns people about the side effects of depression and
•Just in Canada there were 13 adverse reports about people thinking about
committing suicide, under the Canada health act all necessary drug therapy within
a Canadian hospital setting is insured and publically funded. Once one is
discharged from the hospital, they will have to pay for their own medications.
•In Canada, the federal provincial and territorial government for managing
prescription drugs. At the federal level, health Canada regulates clinical trials.
They look at the quality and effects of medications and the safety of the products,
they control the prices and review patented drugs. Federal government also
provides drug coverage for veterans, first nations and inmates. Health Canada is
also a supporter of research.
•Province and territories provide benefits for seniors, social assistance and certain
people with certain diseases and conditions. The trend has been to foster more
treatment at home. Such as home infusion technology. The goal has been to
prevent lengthy hospital stays to encourage people to be discharged earlier.
• It is also indicated for the relief of symptoms of seasonal allergies in patients 15
years of age and older when other treatments are not effective or not tolerated.
Montelukast has been marketed in Canada since 1997.
•Many times people are not aware of the risk is because people are not reporting
risks to certain drugs and prescriptions.
•Prof is allergic to penicillin; she was prescribed a penicillin derivative that caused
a lot of problems. She was covered in hives from head to two.
Canada's Pharmaceutical Industry
•Pharmaceuticals are a vital component of the Canadian health care system. When
used appropriately, they save lives, treat diseases, and enhance the quality of life
for millions of Canadians. Despite these benefits, pharmaceuticals give rise to a
number of challenges related to safety and effectiveness, access, optimal drug
therapy, and health care system sustainability. Prescription drugs also constitute
the fastest growing and second largest category of health care expenditure in
Canada. Like governments around the world, Canada is faced with the challenge
of optimizing the benefits of prescription drugs for Canadians while managing the
risks and complexities associated with this rapidly evolving sector.
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