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Chapter 12

Drugs and Behaviour - Chapter 12

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Department
Psychology
Course
PS268
Professor
Bruce Mc Kay
Semester
Winter

Description
Drugs and Behaviour – Chapter 12  Natural health products o Health Canada responsible for establishing standards for safety and quality of all foods and drugs sold o Executes this mandate through the Food and Drugs Act (FDA) o Any substance “manufactured, sold or represented for use in diagnosis, treatment, mitigation or prevention of disease, disorder or abnormal physical state or its symptoms in human beings or animals” is a drug o Natural health products – variety of substances formulated, packaged or promoted in similar manner to drugs but classified and regulated as foods o Health Canada’s concern is that natural products, while being promoted as therapeutic were classified as foods  Concerned with purity not efficacy  When NHPs classified as food, manufacturers had to provide evidence that food was safe and pure, no medical claims o NHP  Must be as safe as OTC products and do not need prescriptions  Health claims must now be supported by evidence  May include clinical trial data, references to published studies and pharmacopoeias an traditional resources  To constitute traditional resources – must have at least 50 consecutive years of use as medicinal ingredient o Represents 2 generations  Must have product licence  Some psychoactive natural health products o St. John’s wort  Used for centuries, known as devil’s scourge (prevent demonic possession)  Treat anxiety and depression  “to relieve restlessness or nervousness and help treat symptoms of sleep disorders”  Hypericum extract  Superior to placebo in patients with major depression  Similarly effective as standard antidepressants  Fewer side effects  People using it should notify physicians and pharmacists o SAMe  S-adenosly-L-methionine naturally occurring substance found in body  Active form of amino acid methionine (methyl donor)  SAMe tested as an antidepressant and recent summary analysis found more effective than placebo and no less effective than tricyclic antidepressants  “to help support healthy mood balance”  Ginkgo Biloba  Ginkgo regulated as NHP and sold with recommended uses o To improve memory and cognitive function, enhance circulation  Not completely clear which are the active agents and how effective it is for variety of uses for which it has been proposed  Reduces blood clotting, combining with blood thinner could be dangerous  May improve memory in Alzheimer’s because of its ability to improve circulation to brain  Safe as a stand-alone drug  Protects neurons against oxidative stress o Caffeine  Temporarily restore mental alertness or wakefulness when experiencing fatigue or drowsiness Brian Kwok 1 Drugs and Behaviour – Chapter 12  2004 – Caffeine-based stimulants transitioned from OTCs to NHPs  Number of OTC products contain caffeine in doses similar to cerebral stimulant NHPs  Not intended to be used as stimulant  Adjunct to analgesic ingredient o Weight-control products  None are licensed for sale in Canada  Phenylpropanolamine (PPA)  Psychoactive drug affective and considered safe and effective anorexic agent  PPA shown to increase blood pressure  Could lead to increased risk of hemorrhage stroke in women  Ephedra – misused in quest of weight loss  Used combination of ephedra and caffeine to lose weight o Linked with risk of cardiac death  Orlistat shown to help people lose some weight  Negative effects o Loose, oily stools o Frequent, urgent bowel movements o Flatulence o Sleep aids  Melatonin – hormone that helps increase total sleep time  Produced by pineal gland in humans  Circadian rhythm of endogenous melatonin release shown to be synchronized with habitual hours of sleep  O-T-C drugs o Medicines that may be sold directly to consumer without prescription o Drugs that are self-prescribed and self-administered for relief of symptoms of self-diagnosed illnesses  Extremely common in Canada o Regulated by Health Canada, ensuring ingredients are safe and effective  Determined by evaluation of active pharmaceutical ingredients o Spend more than $3 billion a year o Two biggest markets are aspirin-like analgesics and cough/cold/flu products o Exact number of OTC products on market is unknown o Regulations of OTC products  Before it can be sold in Canada, must seek Notice of Compliance from Health Canada  Drugs can be evaluated for both safety and effectiveness  Effectiveness – reasonable expectation that in significant proportion of target population, pharmacological effect of drug, when used under adequate directions will provide clinically significant relief of type claimed o Improved labeling of OTC drugs  Both safety and effectiveness of OTC drugs depends greatly on consumers using them according to directions and warnings on the label  Uniform standards for labels  Min. print size  Required topics  Bold bulleted headings indicating warnings  Clear concise language  Listing nonmedical ingredients on labels is important  OTC versus prescription drugs o Regulations pertaining to prescribing, distribution, selling and dispensing of drugs derive rom FDA and controlled drugs and substances act Brian Kwok 2 Drugs and Behaviour – Chapter 12 o National Association of Pharmacy regulatory authorities  3 categories of schedules  Schedule 1 – drugs that can be sold only with a prescription  Schedule 2 – drugs can be sold without prescription and kept behind counter  Schedule 3 – can be sold without prescription and displayed in pharmacy o Only difference between OTC and prescription is the greater amount of active ingredient in each dose o Prescriptions are chemicals unavailable OTC o Push to deregulate prescriptions drugs to OTC status  Growth in modern notions of individual responsibility and self-care  Pharmaceutical companies seeking increased sales  Growing challenges in maintaining public and private prescription drug plans o Behind the counter non-prescription drugs  Schedule 2 drugs can be sold without prescription but must be behind counter  Kept behind the counter because of adverse events that may occur  Gives opportunity for pharmacist to counsel patients about patients about proper use and precautions  Sleep Aids o Antihistamine – active ingredient in OTC sleep aids and cough/cold products o Scopolamine – acetylcholine receptor blocker o Methapyrilene accepted as sleep aid and scopolamine rejected  Caused cancer in lab animals, no longer safe o Pyrilamine maleate, then doxylamine succinate, then diphenhydramine o Sleep aids come in a variety of forms, recommended for relief of occasional sleeplessness o Diphenhydramine’s sedating effects derive from ability to block effects of histamine receptor sites in the CNS  Analgesics o Pain such a little word for such a big experience  Pain of varying intensities o Two major classes of drugs used to reduce pain or awareness of pain  Anaesthetics  Analgesics o People and pain  Anaesthetics – without sensibility  Reducing all types of sensation or by blocking consciousness completely  Analgesics – without pain  Reduce pain selectively without causing loss of other sensations  Pain is a complex psychological phenomenon  Two types of pain
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