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171 Cards in this Set
- Front
- Back
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How much do we spend annually on OTC stomach remedies in North America?
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$1.4-1.6
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Which actor from the Alka Seltzer ads was black, Jewish, and blind in one eye?
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Sammy Davis Jr
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How much do North Americas spend annually on prescription drugs which target stomach problems?
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$20 billion
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Why is more money spent on prescription drugs than OTC drugs?
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Although people buy more OTC drugs, they are much less expensive than prescription drugs. Hence, more money is spent on the prescription drugs
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What is the role of the gastrointestinal tract?
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The role of the gastrointestinal tract is to process and digest o=ingested substances
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Which chemical is responsible for breaking down food in the stomach?
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Hydrochloric Acid
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Where is the stomach located in the body ( relatively)
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Higher than most people think - above the belly button, around the chest
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Why are upset stomachs sometimes mistaken for heart attacks?
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Because the two organs are so close together, problems with one of them can sometimes be assumed to be associated with the other.
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What is the role of the stomach?
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To breakdown and digest larger substances and molecules before they are fed to the small intestine.
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What does the stomach use to break down these molecules ( ie what kind of chemical)?
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The stomach uses acidic mediums to break down molecules. ie Gastric juices which are particularly acidic
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The small intestine is referred to as small not because of his length but because of what measurement?
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The "small" intestine refers to the 2 inch diameter of the tubing.
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What is the major role of the small intestine?
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The major role of the small intestine is the metabolism of fats
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tTo shift from the different digestive roles of the stomach to the small intestine, what is required of the acid?
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The acid must be neutralized
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What is secreted into the small intestine to neutralize acid and increase basicity?
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Alkaline juice
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Where does alkaline juice come from?
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The pancreas
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What factors control the amount of HCl in the body ( 5)
note : excess HCl can cause problems? |
exces HCl triggers:
- eating too fast -eating too much - spicy foods - smoking -side effect of pan relieving medication ( stomach distress, gastric irritation) |
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What is the only type of pain relieving drug which can trigger excess HCl in the stomach ( which leads to stomach irritation?
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Non-Steroidal Anti-Inflammatory Drugs (NSAID)
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Which molecules do Non-Steroidal Anti-Inflammityoory Drugs (NSAID) target?
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NSAIDS target prostaglandins, which are involved in the regulation o digestive activities.
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What are Cox2 inhibitor drugs used for and what makes them better than other pain reducers?
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Cox-2 inhibitor drugs are aimed at reducing pain but DO NOT cause side effects which involve stomach pain.
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What are two examples of Cox-2 inhibitor drugs?
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- Celebrex
- Vioxx |
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What can increased stress mean for the stomach?
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Increased stress is an important factor in stomach chemistry and can lead to increased production of stomach acid
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How do antacids sooth the stomach?
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They sooth the stomach by neutralizing the acid with a base to produce salt and water
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What should one take if they are experiencing stomach pain due to acid?
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Antacids
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Why are strong bases like sodium hydroxide not used to neutralize acids?
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BECAUSE THEY ARE VERY HARMFUL AND WOULD KILL YOU!
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Sodium bicarbonate, one used as an antacid, combines with HCl and yields what?
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water (h20), sodium chloride/table salt (NaCl), and carbon dioxide (C02)
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What does the carbon dioxide yielded from the combination of sodium bicarbonate (NaHC03) and HCl?
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burping and gas
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What are the benefits(2) and disadvantages (4) of sodium bicarbonate?
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benefits:
- fast -cheap disadvantages: - doesn't last long - high in sodium ( not good for those who suffer from hypertension or high blood pressure) - can cause systemic alkalosis in body and blood ( if used in large doses) |
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Which stomach ache remedy uses sodium bicarbonate as its active medicinal ingredient?
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Alka Seltzer
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Why does Alka Seltzer fizz and produce C02 when combined with water?
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- A small amount of acid, not enough to neutralize the base, is added to the solid tablet
- Hence when it dissolves, both the acid and base components react to form C02 |
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What is Alka Seltzer more commonly known as?
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Baking soda
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What can be taken instead of Alka Seltzer to sooth stomach pain?
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Baking soda, though it is less soluble in water
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What is the difference between Alka Seltzer regular and Alka Seltzer Gold?
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Alka Seltzer regular, aside from containing sodium biocarbonate, contains a small amount of ASA.
As ASA can upset the stomach, this combination of ingredients will not necessarily tackle stomach pain in everyone. Alka Seltzer GOLD does not contain ASA, and is therefore more effective |
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What is the difference between baking soda and baking powder ?
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The two contain the same ingredients but in different ratios/quantities
Baking powder is predominantly used in baking in order for the dough to rise, and thus also contains acid to increase C02 release during baking so dough will rise more. |
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What does the combination of calcium carbonate and HCl yield?
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Calcium chloride (CaCl2), water, and carbon dioxide
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Which antacid brand contains calcium carbonate as its active medical ingredient?
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Tums
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What common classroom item also is made of calcium carbonate?
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Chalk
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What is the difference between the calcium carbonate found in Tums and that in chalk?
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The calcium carbonate in Tums is finer than that in chalk and therefore much easier digest
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What vitamin is often prescribed in parallel with calcium as it is required for its metabolism?
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Vitamin D
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What are the advantages(3) and disadvantages(3) of calcium carbonate?
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advantages:
- fast -cheap -long lasting disadvantages: -can cause acid rebound - can lead to the formation o kidney stones ( though this is rare) - affects the absorption of tetracycline |
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Why is it bad to consume calcium products when taking antibiotics?
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Calcium binds to the same receptors as that of the antibiotics, rendering them useless as they can no longer bind to kill the specific micro organisms which make one sick.
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What active ingredient does Phillip's Milk of Magnesia contain, and what is its main side effect?
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Phillips milk of magnesium contains Magnesium hydroxide.
Its side effect is diarrhea |
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What active ingredient does Amphogel contain and what is its side effect?
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Amphogel contains Aluminum Hydroxide .
Its side effect is constipation |
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What does Maalox contain?
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Maalox is a combination of both magnesium hydroxide and aluminum hydroxide., which isthough to neutralize the diarrhea and constipation!
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Fenster thinks its notable that Maalox was voted what in a study conducted a few years ago?
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Maalox was voted the best tasting antacid
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What is simethicone?
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Simethicone is a compound which is used to help expel gasses produced during the reaction of the antacid and stomach acid.
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Simethicone acts as an agregator of gas molecules, meaning that gasses produced by the reaction of antacids and stomach acids do what?
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The gasses produced will coalesce onto the simethicone particles
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What can excess acidity potentially cause in the stomach?
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Excess acidity in the stomach can potentially eat away at stomach tissue
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When do ulcers occur?
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Ulcers occur when the stomach lining has been superficially attacked and is in a damaged state
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How many people in the United States get ulcers on an annual basis?
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5 million
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How many deaths due to stomach ulcers occur annually?
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4,000
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What can untreated ulcers lead to?
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bleeding ulcers, which affect the blood vessel
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When do perforated ulcers occur?
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Perforated ulcers happen when the acid eats right through the stomach lining!
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What are the two different types of stomach ulcers?
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Gastric ( Peptic ) Ulcers, and Duodenal Ulcers
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Why do gastric ulcers occur?
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Gastric ulcers occur due to a weakened stomach wall
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What organ of the body do gastric ulcers affect?
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Gastric ulcers affect the stomach
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Who are at highest risk for gastric ulcers?
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the elderly and older people
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Who was a famous victim of gastric ulcer?
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Napoleon. He was often featured placing his arm under his shirt to ease his stomach pain. He later died of stomach cancer.
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Which part of the body do Duodenal ulcers affect?
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Duodenal ulcers affect the duodenum ( part of the small intestine)
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Who are most affected by duodenal ulcers?
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younger people
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What is the significance of the name duodenum?
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Duode : twelve in latin, approximately the size of the duodenum in finger measurements
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As the small intestine is active under basic conditions, when the neutralization of acid is not sufficient, what happens?
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When the neutralization of acid is not sufficient, parts of the upper small intestine (duodenum) can be affected by acid coming down.
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What part of the body does GERD ( Gastro Esophageal Reflux) affect?
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The esophagus
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What causes GERD ( Gastro Esophageal Reflux) and what is the affect?
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There is a ring of tissues that lies along the border btw the esophagus and the stomach which prevents the flow of gastric juices from the stomach into the esophagus. GERD occurs when the ring or valve is not working, and there is a reflux in the esophagus.
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What sensation occurs in the body during GERD?
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Heart burn sensation
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How many people in the US are affected GERD ?
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20 million
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What can happen to an individual if they do not deal with their GERD properly?
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Untreated GERD can lead to deterioration of tissue as well as cancer.
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What is a histamine?
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Histamine is a compound release by the stomach which binds to specific receptors called H2 receptors and also bind to androgen receptors which affect the action of male sex hormones.
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What chemical is released when histamine binds to an H2 receptor?
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HCl is released when a histamine binds to an H2 receptor.
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What are H2 receptors designed to do?
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H2 receptors are designed to block the binding of histamine released by the stomach to the H2 receptors
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What were the undesirable side affects of Tagament ( Cimetidine), the first marketed H2 receptor antagonist?
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Mental changes, sexual dysfunction, and gynecomastia ( breast growth in men )
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Why did tagament, the first H2 receptor antagonist, cause changes in male sex hormones?
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Cimetidine, the active component in Tagamet, not only targeted the H2 receptors, but also bound androgen receptors which affected the action of male sex hormones
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What are two "engineered' forms of cimetidine ( active compound in Tagamet ) , which did not bind to androgen receptors ?
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Zantac ( Ranitidine )
Pepcid AC ( Famotidine ) |
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Losec ( omperazole ) is the #1 prescription drug in the world, and brings how much money annually?
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$6 billion
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What pumps in the body are targeted for reducing acid secretion?
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Proton ( Acid ) pumps
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Acids are chemicals which produce which ions?
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H+ ions ( hydrogen ions ) or protons
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What is the protein pump, in terms of composition and location?
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The protein pump is an enzyme at the cell membrane ( border between the inside and outside of the cell)
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What ions does the proton (acid) pump recruit from outside the cell, and what does it recruit from inside the cell?
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The proton acid pump recruits H+ hydrogen ions from inside the cell, and recruits ATP energy and K+ ions from outside the cell
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What source fuels and provides energy for the proton ( acid ) pump process?
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ATP
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During the proton pump process, which ions are drawn into the cell and which ions are pumped out of the cell?
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The enzyme takesH+ from inside the cell and pumps it outside the cell, while drawing a K+ into the cell
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What does omeprazole do to the proton pump and which ion does it prevent the release of?
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Omperazole blocks the action of the pump and prevents the release of H+ into the stomach
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Omeprazole is a racemic mixture of which two optical isomers ?
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S-Omperazole and R-Omeprazole
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What are optical isomers? Are they made of the same materials?
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Specific molecules which exist as mirror images of each other ( like a right hand and a left hand) .
Although the two molecules are made of the same things, they are readily distinguishable in terms of the molecules they interact with - they are similar, but not exactly the same. |
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When optical isomers occur in organic chemistry, what kind of carbon is there and what is its structure like ( simply )?
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There is a chiral carbon, a carbon atom with 4 different things bound to it, or substituents
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When a chiral substance is produced by a drug, how many optical isomers will be able to perform its function by binding to a specific enzyme?
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Only one.
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What are racemic mixtures?
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An equal mixture of both isomers
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Are specific active isomers often isolated in drugs? Why or why not.
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No, because it is very expensive to do so .
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Why are optical isomers called "optical" isomers?
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Optical isomers are called "optical" isomers because they are able to rotate the plane of polarized light
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Which optical isomer of omeprazole is now marketed as Esomeprazole (Nexium )?
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S- omeprazole
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Are the detoxification methods for optical isomers the same?
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No! they are different, and different enzymes will act on each respective isomer!
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Why is Nexium said to reduce stomach acidity somewhat more than Losec ?
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Because the S-omeprazole, or esomeprazole, is less metabolized or detoxified by the liver than r-omeprazole
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Are there proven clincial differences btw Nexium and other protein pump inhibitors?
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NO
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What was the result of the executive monkey experiment of 1950, and is it reliable?
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After two monkeys were given shocks on a regular basis, the " executive monkey" had the choice to stop the shocks from occurring as a light would flash before the shock and he woild have the option of pulling a preventative lever. After several days the executive monkey had an ulcer from the stress while the other did not.
However results are not reliable as this was not properly controlled. |
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Which two Australian scientists believed that it was not stress but bacteria which caused ulcers, and in what year?
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Barry Marshall and Robin Warren in 1983.
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What did scientist Marshall do in attempt to prove ulcers were caused by bacterial infections? Did he prove his theory?
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Marshall ingested the suspected bacteria to see if he would develop an ulcer... AND HE DID!
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Where in the body is Helicobacter Pylori able to survive, and how does it manage this?
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H.pylori can survive in the stomach despite the environment's digestive enzymes and HCl acid!
It does this by sing urea ( body waste) to convert it to carbon dioxide and ammonia. The ammonia protects against the harsh acidic conditions of the stomach |
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How do you test for the presence of H.pylori?
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When the bacteria uses urea to produce ammonia, carbon dixoide is a byproduct.
Urea is labelled with a radioactive carbon marker. The carbon atom on the urea molecule is swapped with a radioactive form of carbon, carbon-13. When the bacteria reacts with urea, the final destination of the carbon atom is usually carbon dioxide. Thus if one is infected, they will expel radioactive carbon dioxide with C-13 instead of regular carbon. |
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How many duodenal ulcers and how many stomach ulcers are believed to be caused by H.pylori? (percents)
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- 90% of duodenal ulcers
- 70% of stomach ulcers |
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What percentage of the population is infected with H. pylori ? Does this mean that they have stomach ulcers?
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10-20% of the population is effected by the h.pylori bacteria but it does not necessarily mean they have stomach ulcers
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What Alfred Nobel discover?
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nitroglycerine ( dynamite )
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What are the 5 different types of Nobel Prize?
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Medicine, Peace, Literature, Physics and Chemistry
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Why is there no Mathematical nobel prize?
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Because Nobel's wife left him for a mathematcian
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What is the leading cause of death in Canada and world wide?
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Heart Disease
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What were the two leading causes of death in the 1900's and what are the two leading causes of death today? why has this changed?
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In the 1900's: the leading causes of death were pneumonia and tuberculosis
Now, the two leading causes of death are heart disease and cancer. This is because of the invention of antibiotics! |
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When were antibiotics introduced?
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1940's, after WWII
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Which infectious disease killed much of the European population in the middle ages?
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Black Plague
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How many people did the black plague kill?
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25 million, a quarter of the population
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In the 1800's, what was the death rate percentage due to post natal infection?
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30% death rate
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In 1935 pneumonia was the cause of approximately how many deaths?
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250,000 deaths
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Presently, obesity causes how many deaths?
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300.000
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Which scientist introduced the first synthetic dye in 1865 and which colour was it?
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William Henry Perkins produced the first synthetic dye in 1865, and it was mauve
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What was the first produced type of dye called?
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Gentian violet?
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H.C Gram founded the terminology of gram positive bacteria and gram negative bacteria. What was the difference btw them?
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Gram positive bacteria can take up dye and therefore appear purple under the microscope.
Gram negative bacteria can NOT take up dye. |
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In 1907, Paul Ehrlich developed the first systematic approach to treat bacterial infections by trying to do what?
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He tried to find a chemical treatment which would target specific bacteria, known as the "Magic Bullet"
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What is trypan red and what is it effective in curing?
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Trypan red is both a compound and a dye.
It was found to be affective in ridding an individual of the bacteria which causes sleeping sickness |
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How was the bacteria which causes sleeping sickness transmitted?
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Through the Tse-Tse fly
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Trypan contains two central atoms - which kind of atoms?
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nitrogen atoms
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How did Paul Ehrlich re engineer trypan to treat the bacterial disease syphilis and what was this new molecule called?
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By replacing the nitrogen atoms with arsenic atoms. Because they were in the same column on the periodic table they had similar properties but arsenic is much more poisonous to bacteria.
This new molecule was called Salversan 606 |
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In the past, how many people did
- tuberculosis - syphilis -cancer kill? |
- tuberculosis: 150,000
- syphillis: 140,000 - cancer: 40,000 |
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What is pharmacology's aim?
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To develop drugs which target specific elements in bacteria
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In 1932, Gerhard Domagk discovered Prontosil which was effective in eliminating which bacteria?
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Streptococcus bacteria
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Why does Prontosil only fight bacteria in "in vivo" situation as opposed to "in vitro" ?
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Prontosil is not effective in "in vitro" situations because the compound itself does not actually fight the bacteria.
Rather, when metabolized by an organism it yields Sulfanilimide, a strong antibacterial agent |
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What common infections are frequently treated with Sulfa drugs?
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UTIs( unitary tract infections)
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What was commonly used during WWII to treat bacterial infections in wounded soldiers?
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Sulfa Drugs
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In 1928, Alexander Flemming discovered contamination on one of his bacterial plates with a fungal species. What did he notice about this mold?
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He noticed that where the mold had been growing the bacteria had disappeared. He realized that the fungal species was secreting something which was killing off teh bacteria
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In 1941, Howard Florey and Ernest Chain were the discovers of compound penicillin. What is penicillin?
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Penicillin is the chemical secreted by the mold Penicilium notatum which kills bacteria.
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How/Where was the penicillin notatum fungus first produced?
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In milk jugs, where the fungus would grow at the top and produce the chemical in very low quantities.
1 gram of penicillin needed 1000Kg of mold! |
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Who was a first patient injected with penicillin?
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A british police officer who had cut himself while shaving
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What was the second growth medium for penicillin after milk jugs?
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Corn starch
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Mary Hunt brought in a moldy cantaloupe to the office which was tested to isolate new fungal species capable of producing penicillin. What could this "better mold", which could produce more penicillin, cure?
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syphilis and gonorrhea
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Penicillin was initially more expensive than?
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GOLD
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What are the three main types of penicillin and how are they taken?
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Penicillin G: has to be injected because it is metabolized by stomach acid
Penicillin V: acid stable, so can be ingested Ampicillin: first broad spectrum antibiotic |
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What is the difference in the cell walls of gram positive bacteria and gram negative bacteria?
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Gram positive bacteria have thick polysaccharide walls. ( the sugar in these polysaccharide walls could attract/stick to dye. thick walls could also trap dye)
Gram negative bacteria have thin polysaccharide walls |
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What is the name of the 4-membered ring does the molecular structure of penicillin contain?
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BETA-LACTAM RING
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What three antibiotics are structured together due to their incorporation of the Beta Lactam Ring?
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Penicillins, Cephalosporins, and Monobactams.
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What is the old definition of an antibiotic and what is the new one?
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" an antibacterial agent produced by a living microorganism"
now, " an antibacterial agent" |
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Where were streptomycin, cephalosporin, and seminal plasmin found?
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- mold of throat in chickens
- sewage off the coast of italy - semen ( protects women from infection during intercourse) |
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Why are many antibiotics known as "semi-synthetic"?
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Because antibiotic substances have been isolated in nature and further engineered improve the antibiotic nature of the substance
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What is cyclosporin used for now, and why?
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It is used as an immunosupressant during organ transplants instead of an antibiotic as it was found to reduce the activity of the immune system but is effective in ensuring organ transplants are not rejected.
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What is the mode of action of sulfa drugs?
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They affect the metabolic activity of bacteria.
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How do bacteria use PABA to produce B vitamins?
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Para-amino-benzoic-acid( PABA) is used by bacteria to make B vitamins, which bacteria require to survive.
- To produce these B vitamins, the bacteria have a receptor in which PABA can fit in, and they fix PABA into this site. After the PABA is inserted to its receptor site, the bacteria builds Folic Acid ( a vitamin B derivative) from PABA |
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What do sulfa drugs do to kill bacteria?
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Sulfa drugs mimic PABA in structure. If the bacteria incorporate the drug instead of PABA, no be vitamins will be produced and the bacteria will die.
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How does penicillin kill bacteria?
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Penicillin affects the cell wall synthesis. The bacteria can not withstand the pressure inside the cell, and they eventually burst
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What bacterial process do tetracyclins affect?
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Bacterial protein synthesis
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What types of disease do antibiotics not work against?
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Viral diseases such as colds, influenza, or poliomyelitis
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What is the main reason why antibiotics do not work against viral diseases?
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Because viral diseases because they are relatively simple compared to bacteria and there are less things which can go wrong in their replication process.
It is easier to interfere with the growth or replication of more complicated systems |
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What are the most common type of allergies?
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Allergies caused by penicillin
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What sensitivities can tetracyclin cause in certain individuals?
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photosensitivity
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Why should tetracyclins not be taken with dairy and antacids?
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Cheese and antacid both contain calcium, which can interfere with its function by binding and blocking the receptor sites of the antibiotic
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What common female prescription drug can tetracyclins interfere with?
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The birth control pill
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What can tetracyclin do to the teeth and how was this prove?
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Tetracyclin can stain teeth brown. This was proven when meat balls containing tetracyclin were air dropped and the foxes which consumed them got brown teeth.
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Name an example of antibiotic resistance ie the drug and the symptom it can no longer treat.
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Penicillin used to be used to treat gonorrhea but is not anymore due to resistance
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When bacteria develop an enzyme it is because of their ability to produce which enzyme?
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Antibiotics become ineffective when the bacteria can produce Pellicinase ( Beta-Lactamase) - the enzyme which cleaves the Beta-Lactam Ring ( at a carbon molecule )
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What substance is added to amoxycillin, a penicillin antibiotic?
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Clavulanic acid, which has no antibiotical properties but has a Beta-Lactam_ring is added to the amoxicillin antibiotic because pecicillinase enzymes have a higher affinity for the Beta-Lactam-Ring and will therefore go for that enzyme, leaving the amoxcillin free to do its duty
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How many infections does super infection cause annually?
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100,000
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Why is flesh eating bacteria a typical super infection?
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Flesh eating bacteria is a typical super infection because the bacteria develops and grows so rapidly that by the time the doctor finds the appropriate antibiotic it is too late.
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What do non flesh eating bacteria produce and what do they do?
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Non flesh eating bacteria produce toxins which destroy muscle tissue
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Why is flesh eating disease so bad even though the bacteria that causes it is not particularly bad?
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- could be a particularly virulent strain of bacteria
- some people could be more prone to a serious reaction |
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How many cases of Clostrifium difficile occur annually in Quebec?
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1,000,000
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What does the c. difficile bacteria infect?
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colon lining
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Why must individuals take antibiotics for an extended period of time?
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- when one initially takes an antibiotic, only the weak bacteria are rapidly killed off, and the genetically superior live longer
- if antibiotics are stopped at a point, the stronger will multiply and produce a large quality of resistant bacteria. |
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What does Methicillin- resistant staphlyococcus aureus have (MRSA) have?
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Contains a certain strand that is resistant to the methicillin antibiotics
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Why are antibacterial products such as soaps harmful? what antibacterial agent do they contain?
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Antibacterial products often contain Trisclosan.
Antibacterial soaps kill 99% of bacteria, the weakest 99%. Hence when we repetitively use them we ware effectively selecting for the bacteria that are resistant to these methods. |
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What is the only antibiotic s. aureus is NOT immune to?
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Vancomycin
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How could bacteria resistant to all antibiotics be created?
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A certain strand of s. aureus is immune to all antibiotics with the exception of vancomycin. There is another specices of bacteria called Enterococcus which is immune to many bacteria including vancomycin. Hence, if the two interacted and the e. species transfered its vancomycin resistance to the s. species, DOOMSDAY WOULD OCCURRR
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What are plasmids physically like and what do they do?
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they are small, circular pieces of genetic material which transfer resistance
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What is SYNERCID composed of and how is it taken?
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SYNERCID antibiotic is composed of Quinupristin and Dalforpristin and must be taken intravenously
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What is Zyvox?
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a new antibiotic which is synthetic and can be taken orally
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Why have so many bacteria become resistant(3)?
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- mis and over use through overprescription
- non compliance or patients not taking them for the full course -animal feed |
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What percentage of antibiotics are used for animals in north america?
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70%
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What do the antibiotics in animal feed do?
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Promote more growth on less feed
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What is the worry when antibiotics are ingested into animal feed?
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After animals are killed resistant bacteria can continue to grow and affect people * ie salmonella
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