Pharmacology 2060A/B Lecture Notes - Lecture 11: Pepperoni, Blood Proteins, Probenecid

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3 Mar 2016

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Module 11 - drug interactions. Drugs interact with eachother or components in our diet to = complicated responses. Drug- drug interacts (taking 2 drugs) Most common of drug- drug interaction are those affecting pharmocinetics (adme) 3 possible outcomes when 2 drugs or more interact: drug + drug = increased effects: Drug interactions can increase drug effects by either an increase in the therapeutic effect or an increased adverse effect. Ampicillin is an antibiotic that is rapidly inactivated by bacterial enzymes. Warfarin is an anticoagulant used to thin the blood. Aspirin is an analgesic that also thins blood: warfarin effective blood thinner, warfarin + aspirin bleeding (pot. Drug + drug = decreased effects. Dtug interactions can reduce drug effects by either reducing therapeutic effects or reduced adverse effects. It is a pro- drug that rquires metabolic activation by cyp2c19. Omeprazole (a drug used to treat stomach ulcers) inhibits cyp2c19.

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The people of Malaysia belong to three communities: the local people called Malays, immigrants from South India called Tamils, and immigrants from China. During the early 20th century, the Malays lived mainly in coastal villages, the Tamils worked on rubber estates, and the Chinese worked in tin mines. In general, the people were very poor and they consumed a limited variety of foods.[1] Rice was the staple diet of all three communities and therefore the key source of caloric and nutrient content. Malays typically grew their own rice and dehulled it before consuming it; dehulling partially removes the aleurone layer of the rice seed. Following their South Indian food habits, the Tamils ate parboiled rice, and the Chinese ate polished white rice imported from Thailand. It was found that among the three Malaysian communities, the Chinese community was much more prone to suffer from some degree of sub-optimal thiamin intake. Out of every 1,000 Chinese inhabitants, about 120 had mild thiamin deficiency, about 80 had severe thiamin deficiency, and about 16 people had died of it. Suboptimal intake of thiamin was rare in Malays and was not reported at all in Tamils.[1] Thiamin, also called Vitamin B1, is required for all tissues, and its deficiency causes the disease Beriberi. Less severe deficiency results in non-specific symptoms such as weight loss, malaise, irritability, and confusion. Although the origin of the word Beri-beri is disputed, it is believed to be a Philippine word meaning âI canât, I canâtâ and was probably coined to refer to the lack of neuromotor coordination in people afflicted with this disease.[2] Thiamin is water-soluble and is stable in the acidic medium. It is unstable to heat, oxygen, and UV light in neutral and alkaline medium. The active form of thiamin is thiamin pyrophosphate (TPP). This active form is a cofactor for pyruvate dehydrogenase and transketolase enzymes that are involved in the metabolism of carbohydrates. These enzymes play an important role in the biosynthesis of a number of cell constituents such as neurotransmitters, pentoses, and reduced equivalents, used in oxidant stress. The human body cannot store thiamin and therefore requires a continuous supply of the vitamin. The thiamin in an individual on a thiamin-free diet typically depletes in fewer than two weeks. Thiamin absorption is affected by compounds, called thiamin antagonists or anti-thiamin factors, that alter the structure of thiamin. These compounds include alcohols, polyphenols, flavonoids, and thiaminase, a heat labile enzyme found in certain foods.[2] In affluent countries, where the diet is rich in thiamin, the most common cause of thiamin deficiency is excessive alcohol consumption. Alcohol intake affects thiamin status in two ways. First, alcoholics get a significant percentage of their daily energy intake from alcoholic beverages, which are nutrient deficient. In other words, alcoholics replace their consumption of nutrient dense foods that are part of their normal diet with the consumption of nutrient deficient alcohol. Second, alcohol inhibits the intestinal ATPase involved in the absorption of thiamin.[4] Sub-clinical thiamin insufficiency associated with excessive alcohol consumption produces an encephalopathy called Wernicke-Korsafoff syndrome. Patients with this syndrome have a higher than normal incidence of abnormal transketolase, which has a very low binding affinity to TPP. This problem can be overcome by putting patients on high-dose thiamin therapy. Some patients, however, might have a form of abnormal transketolase that does not bind at all with TPP. Such people do not respond to high-dose thiamin therapy.[4] Thiamin deficiency is observed in individuals who have low thiamin intake and a diet rich in polished rice, especially if their diet also consists of anti-thiamin factors such as tea, coffee, raw fermented fish, and betel nuts. The minimum amount of thiamin needed by the body can increase because of increased physiological or metabolic demands arising from pregnancy and lactation, heavy physical exertion, illnesses like cancer, liver diseases, hyperthyroidism, and surgery. Since TPP is required for carbohydrate metabolism, the recommended dietary allowances for thiamin are based on the assumption that its intake is related to total energy intake. The recommended dietary allowance in the United States is 0.5 mg/1000 Kcal.

Questions
1. Thiamin deficiency was observed only in the Chinese community even though all three
communities had the same staple (rice) diet. Explain.
2. On packages of enriched rice sold in supermarkets, the rice preparation directions state that the
rice should not be washed before cooking. Explain.
3. Severe metabolic acidosis caused by high levels of lactate is often associated with thiamin
deficiency. Explain.
4. Provide two plausible explanations for what might cause above normal levels of pyruvate in blood
and urine. How can one determine which of the two explanations is correct?
5. Why does thiamin utilization increase among cancer patients?
6. A negative correlation exists between the need for thiamin and the amount of fat in the diet.
Explain.

taupehound665


(Please Summerize the work down below, thank you)

Political	Economic
Growing political influences on healthcare advances	Cost of living increases
Global government influence on healthcare cost	Cost of insurance prices
Government control of Medicaid, Medicare funding	Rise of forecasted interest rates
Social/Cultural	Technical or Technology
Increase average age of population	Demand on new medical treatments
Patient expectations increase	Customize treatments
Demographics are in constant change	More advance service facilities
Environmental	Legal
Growing need for green business	Constant change of government drug Regulations
Environmental agenda and community awareness	Consumer laws
	Health and safety regulations



Porters 5 forces of business model

Competitive Rivalry
Growth opportunity for healthcare companies are expected to growing the next few years
Increase in new revolutionary drugs both in and outside of the US

Threat if New Entrants
Strict government regulations
Difficult to keep up due to constant change
Huge startup cost

Substitute Products
Threat of other substituting product and service at lower cost



Bargaining Power of Customers
Generic drugs offered at large discount to consumer
Larger less customized healthcare facility with lower housing costs
Several facilities offering similar services.

Bargaining power of supplier
Medical suppliers have a large pricing power
Bargaining power of physicians and nurses is huge because of large hospital benefits

Swot Analysis

Strengths

Highly trained and capable employees

Market experience

Strong leadership

High level of organizational efficiency

Excellent facilities

Strong commitment to bettering the community

Weaknesses

Increased cost of healthcare could lower our clientele

Limited staff resources

Limited cash flow to hire and train new employees

Lack of resources

Opportunities

Fast growing technology opens new doors for using state of the art equipment to better serve the patients.

Nursing and residential care is one of the fastest growing industries

Aging population

Threats

Uncertainty in political and economic climate causes hesitation for receiving new patients.

Funding constraints

Highly competitive market

Product or Service Analysis

Our services will be used by patients who cannot afford experimental treatments and patients who have been abandoned by the system because hospitals can no longer provide medical assistance. At our facility, we will be able to work with the families and provide them with different payments options, such as low monthly payment plans. Our main goal is to be able to treat the patient at a very affordable cost; however, if any patient does not possess the means to pay for treatment, he or she would not be turned away; our facility will tap into government and private funding to cover treatment cost.

The beauty of this service is that there isnât a charge of any kind to take part in our program because it is completely funded by government grants. Individuals that would take part would more than likely not have the means to pay a monthly deductible. Due to the nature of the business listed as a non-profit agency, there is no way to make a profit of any kind, as it would jeopardize the business in its entirety.

Some of the market factors that create a demand for our services include the need of medical care after having maximized all resources, the number of low income families, and the number of patients facing health issues needed extended medical care.

Opportunities that may derive from this business is the opportunity to expand and open multiple facilities, while extending a helping hand to many more in need. The risk, however, is the unstable funds deriving from grants. This can pose a huge treat to the business, as grants often times come and go and cannot be counted on as a constant income.

After studying the healthcare system and current policies in place, data shows many individuals facing severe health issues usually go untreated and uncared for due to the outrageous cost of medical care. It is devastating to see how often people, especially the elderly, are sent home and forgotten for the mere reason that hospitals and doctors are not willing to care for patients without financial means. In fact, in 2009 Harvard news reported 45,000 annual deaths due to lack of health coverage in the U.S. alone, which is significantly higher than the 18,000 reported by USA Today in 2002.

Financial Analysis

Clermont will be a nonprofit organization, dedicated to help the most needed. To open the facility fully operational we must take in consideration some fixed expenses like the land acquisition, permits, interest, brokers, administration fees, professionals (facility setup), staff, reports (environmental, occupational, fire, FDA), electricity, water, phone, water & sewer , connections, taxes, insurance, management, security, advertising, accountants, food, lawn mowers, bank fees, etc.

The facility will need have a total value of approximately three million dollars, but if we break the price of the land acquisition in to a thirty (30) year mortgage we can star up the business with an investment of approximately $ 233,944.61 USD to cover the first month of operation including all the startup permits and connections. After the first month the fixed expenses will be $184,444.00 USD with the exception of the months were taxes are due; taxes are around $ 43,000.00 USD paid quarterly will increase the tax month (depending on the facility fiscal year) for $ 10,750.00 USD approximately. We will fund all the costs with private and public funding, fundraiser, events, raffles, and most important with the help of the community.

As we mentioned before, Clermont is a nonprofit organization and we will do everything in our power to give the relief to the families in need. No one will be rejected because they do not have the money or the insurance cannot help. No money will be required from patient and every single dollar received will be spent in the patients, and in improving our facility and our service every day.

We believe our financial even breaking point will be a year after we begin operations, and be profitable soon after. There are many patients in need, and with the government and public grants each person will receive the treatment they need, and we will become the hope of many.

Physiology Psychology

1. The mind-body problem is a fundamental philosophical issue at the base of all cognitive/behavioral neuroscience research. Why? Discuss the mind-body problem and give an example of how it relates to an issue in cognitive/behavioral neuroscience. Explain.

2. Explain how an action potential occurs. Start with Glutamate release from the presynaptic neuron and end with neurotransmitter release from the postsynaptic neuron.

3. How does a neuron inhibit another neuron? Explain. {~1 paragraph}

4. Design a drug that would increase Dopamine (DA) and/or Norepinephrine (NE) levels and explain its mechanism of action (explain how it works to increase DA and/or NE). What kind of disorder could this drug be used to treat? What would be some side-effects you might expect from taking such a drug? Would there be any risks expected from long-term treatment? Explain.

5. Alzheimerâs dementia is a neurodegenerative disorder that results in severe cognitive impairment. Researchers hypothesize that Alzheimerâs is due to low Acetylcholine activity in the cerebral cortex. How could a researcher test this hypothesis? Justify your answer.

6. What is neural plasticity? Give an example and explain. [3-4 sentences]

7. Dr. Butthurt, a prominent pain researcher, has recently discovered that a Chinese form of meditation called Tai Chi can be a very effective pain-relief method. In Dr. Butthurtâs studies, he found that people in pain experience profound pain relief after participating in just 30 minutes of Tai Chi meditation. Now, Dr. Butthurt wants to determine the neural mechanism by which Tai Chi works to relieve pain. The first hypothesis he wants to test is that Tai Chi works because it stimulates endorphin activity in the brain. How can Dr. Butt-hurt test this hypothesis? Explain. [~1 paragraph]

8. A dominant view in neuroscience is that the human brain is âmodularâ. For example, many have claimed that the Fusiform Face Area (FFA) is a specialized, domain-specific module for recognizing faces. Discuss the issue, giving evidence for and against the claim that the FFA is domain-specific for face-processing. (1-2 paragraphs)

9. The Wernicke-Geschwind model of language was the dogma in neuroscience and psychology for many years. According to the W-G model, Brocaâs Area and Wernickeâs area are the two main language modules in the brain. What does the model argue is the function of Brocaâs area? Explain one piece of evidence to support it. What does the model argue is the function of Wernickeâs area? Explain one piece of evidence to support it. Why has the current theory of language moved away from the W-G Model? Explain.

10. If a person has the genes associated with a particular psychopathological disorder (e.g., depression, schizophrenia, bipolar, etc), will that person definitely develop the disorder? Why or why not? Explain. Use an example to help you explain. (few sentences to a short paragraph)

11. Why is it the case that there are some very high-pitched ringtones that are typically only audible to people under 18 years old? Why canât (most) adults hear these high-pitched tones? Explain. (few sentences)

12. How does Miraculin act on the nervous system to change our perception of taste? Explain.

13. Discuss the Triune Brain model. Explain what happens to the functioning of the Triune Brain model when an individual is intoxicated by alcohol, and link that to drunk behavior.

14. Some patients develop disorders in which they believe that one of their limbs is not, in fact, their own limb. What could be happening in the nervous system that would lead to this peculiar phenomenon? Justify your answer and explain. (I am looking for you to come up with a reasonable hypothesis as to what could be causing it that you can sensibly justify and explain)

15a. What is schizophrenia? Describe 2 positive and 2 negative symptoms. Explain one way that the brains of schizophrenic patients are different from healthy controls, and link the brain abnormality to one of the symptoms of schizophrenia that you just described. 15b. What is the Dopamine (DA) Hypothesis for schizophrenia? Explain two pieces of evidence to support the DA Hypothesis. Explain one piece of evidence against the DA hypothesis. [~1 short paragraph] 15c. What is the Glutamate Hypothesis for schizophrenia? Explain two pieces of evidence to support the Glutamate hypothesis. Explain one piece of evidence against the Glutamate hypothesis. [~ 1 short paragraph] 15d. Schizophrenia is estimated to be about 80% heritable, but there are other factors that researchers have found to influence the development (or flare) of schizophrenia. Give an example of one of these other factors, and briefly explain the evidence for it. [2-3 sentences]

16. Major depression (unipolar) is a psychiatric disorder affecting over 15% of the U.S. population. Explain two of the dominant hypotheses about the biological factors in depression, discussing the evidence for and against those hypotheses. What is the most effective treatment for long-term relief from depression? Why? Explain. (~2 paragraphs)

17. Explain how the amygdala and brain stem are involved in the development of anxiety disorders such as PTSD, phobias or panic disorder.

18. Explain the basic function of the mesolimbic DA reward pathway. Discuss how drug use alters the pathway and contributes to the development of compulsive disorders like drug addictions/alcoholism.

19. If a stroke patient has damage to their right posterior parietal lobe, along the dorsal stream of visual processing, what syndrome would the patient have? Describe the major symptoms and explain what the personâs behavior would be like. What did we learn about the function of the parietal lobe from studying these patients? Explain.

20. If a stroke patient has damage to their temporal lobe, along the ventral stream of visual processing, what type of disorder would the patient have? Describe the major symptoms and explain what the personâs behavior would be like. What did we learn about the function of the temporal lobe from studying these patients? Explain.

21. What is blindsight? Explain how studying patients with blindsight informed our understanding of the visual system.

22. What are implicit and explicit memories? Do implicit and explicit memories represent independent neural systems for memory? Why or why not? Justify your answer with evidence.

23. What is retrograde amnesia? What did we learn about long-term memory from studying patients with retrograde amnesia (e.g., patient KC)? Explain.

24. What is our current understanding of how the Medial Temporal Lobe (MTL) stores and retrieves explicit memories? Discuss how the function of the MTL can explain cases of anterograde amnesia like HMâs.

25. Imagine that a doctor developed a drug called Memoryhole that is a Glutamate-NMDA receptor antagonist in the hippocampus. What effect would Memoryhole have on the process of Long-Term Potentiation (LTP), and, in turn, memory? Explain.

26. Do we have evidence for a biological basis for sexual preference? Discuss with respect to the Sexually Dimorphic Nucleus of the hypothalamus.

27. Helen Fisherâs research delineated 3 stages of love in the brain. Explain, with an emphasis on the brain-behavior relationships.

28. Parkinsonâs disease is a neurodegenerative disorder that results in severe motor impairments. What causes Parkinsonâs? Explain the major treatment for the disorder and the extent to which the treatment is successful. Are there any negative side-effects of that treatment? Explain.

29. What are mirror neurons? Explain two pieces of evidence for the hypothesis that mirror neurons are the neural substrate for empathy and theory of mind in humans. Do we have evidence linking mirror neurons to autism? Explain.

30. What was the most interesting thing you learned in class this semester? Why did you find it interesting? Explain.

31. What is a circadian rhythm? Explain how light acts as a zeitgeber to control our sleep/wake circadian rhythms. If someone had trouble falling asleep (insomnia), what advice would you give them? Justify your answer.

32. Seasonal Affective Disorder is a type of depression that occurs when depression symptoms consistently flare in the winter season and abate in the summer season. One successful treatment for this type of depression is âlight therapyâ in which the patient sits in front of a sunlight-emitting device for a certain number of hours a week. How could this type of depression and its treatment be explained by what we know about the neural basis of arousal and circadian rhythms?

Pharmacology 2060A/B Lecture Notes - Lecture 11: Pepperoni, Blood Proteins, Probenecid

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