Drugs 10, 11, 12

Tobacco use became popular in European culture because

it was associated with wealth and status.

The major commercial species of Nicotiana that is grown for tobacco products is

Nicotiana tobacum.

During the 18th century, which method of use of tobacco increased in England?

Snuff

Chewing was the most popular form of tobacco use until about 1900, but by 1920 the most popular form was

cigars

Over 90 percent of all U.S. cigarettes sold are now

Filter cigars

Per capita sales of cigarettes in the U.S. began to decline

after the 1964 Surgeon General’s report.

In 2000, the U.S. Supreme Court ruled that the FDA

Had no authority to regulare tobacco products

People who switch to low tar and nicotine brand cigarettes

typically take more and deeper puffs and probably get no safety benefit.

Reynolds was unable to market Premier, a plastic cigarette containing catalytic crystals coated with tobacco extract, because

the FDA considered them a "nicotine delivery device" rather than an agricultural product.

One big factor associated with lower rates of cigarette smoking among adults is

Higher level of education

The biggest health concern for users of smokeless tobacco has been

cancer of the mouth, pharynx, and esophagus.

One recent fad in tobacco use has been

hookahs (water pipes).

Although lung cancer is not common, about _______ percent of all lung cancers occur in smokers.

85

Annual "smoking attributable mortality" in the U.S. is estimated at

440,000.

In 1993, the Environmental Protection Agency declared that

secondhand smoke is a known carcinogen that increases lung cancer risk.

One of the most consistent and best-documented effects of cigarette smoking during pregnancy is

low birth weight

Nicotine acts in the brain by

first stimulating and then blocking cholinergic receptors

As a potent poison, nicotine causes death by

increasing blood pressure until a stroke occurs.

The psychological effect of cigarette smoking is

arousal and activation–a mild stimulant effect calm and relaxation–a mild antianxiety effect.

Recent research on the dependence produced by nicotine has focused on genetic differences related to

acetylcholine receptors

About 90 percent of the more than 40 million former smokers in the U.S. report that

they quit smoking without a treatment program.

Gum, patches, lozenges, and inhalers are all various forms of

nicotine replacement therapy

In 2006, the FDA approved a nicotine partial agonist drug as a smoking treatment. The drug is

varenicline (Chantix).

In 2009, the Family Smoking Prevention and Tobacco Control Act

authorized the FDA to regulate tobacco products in specific ways.

In July 2011, the nicotine vaccine NicVax was

found to be no better than placebo.

T or F: The major commercial species of tobacco in Nicotiana tobacum.

True

T or F: The most popular form of tobacco use in America before 1900 was cigar smoking.

False

T or F: Per capita sales of cigarettes in the U.S. started to decrease in 1990.

False

T or F: The FDA has regulated nicotine content of cigarettes since 1964.

False

T or F: Although there are concerns about smoking during pregnancy, the research studies have not consistently demonstrated any specific risks.

False

T or F: Nicotine acts in the brain to first stimulate and then block several nicotinic sub-types of cholinergic receptor.

True

T or F: A cigar contains enough nicotine for two lethal doses, if the nicotine were injected.

True

T or F: Ambien (zolpidem) has recently been approved by the FDA for use in smoking cessation.

False

T or F: According to a 2010 report, 70% of R-rated movies (and 30% of G, PG, and PG-13 movies) in the U.S. contained some tobacco use. Compared to 2005, this represents a decrease in depictions of tobacco use.

True

T or F: New battery-powered electronic cigarettes (i.e. tobacco-less nicotine delivery systems) are quickly becoming one of the largest U.S. exports.

False

T or F: There is no evidence indicating that cigarette smoking has skin-aging effects.

False

Caffeine

Most popular drug- taking in the world. Psychoactive stimulant. Dose- dependent (Xanthines family) Theophylline ( tea) theobromine ( chocolate)

Coffee drinking

Drinking before bed you more than likely will have a harder time falling asleep " wine of Islam"

Coffee

Goat herder- prepared beverages from berries Middle of 17th century – England coffee houses/ penny universities Us is main importater After American Revolution this became the national drink

Major sources of coffee

Coffee beans ( arabica) and coffee robusta (Java) harder tasting

Caffeine content in coffee

Standard 5 ounce cup- 57 to 145 mg Dosage depends on method of brewing (Xanthines interfere ) kills flies because it over stimulates.

Tea

Worlds oldest caffeine contacting beverage. Discovered by Chinese emperor

How it’s tea brewed

Brew of leaves from the Canellia sines is evergreen tree

National pastime between trade with Chinese and Dutch

Tea drinking

Most tea in Us

Ice tea ; introduced in Losiana purchase

Content in tea

Caffeine is 60 mg Theophylline – bronchi dilating effect- treat asthma Corolated with dementia anti- cancer treatment

Green tea

Blood thinner

Chocolate

Made from cocoa beans. Was a gift from the Aztec gods to give humans a taste of paradise Italian lover- Casanova

How is chocolate made

Roast beans- cocoa butter Edible chocolate began with Swiss chocolate Small amounts of butterfat my palm oil and coconut oil.

Chocolate Xanthine content

Caffeine 6-8 mg. and theobromine 40 mg.

Dark chocolate

Reducer artery clogging. Eat 2-3 bars a week!

Higher consumers of chocolate

Made in Hershey company and Mars. Switzerland consumes the most chocolate

Soft drinks

95 % of caffeine is added by manufacture. Us leads the world ( 45 gallons annually)

Leaders of soft drinks

Coke and Pepsi ( 3-5 mg per fluid ounce)

2012 FDA reported

13 deaths over a 4 period that cited possible involvement of 5 hour energy and 30 incidents of serious life threatening injuries. ( heart attacks and seziures)

Caffeine from OTC drugs

Sold as pure stimulant-NoDoz and Vivarian tablets.. Pain relievers ( Excedrian and Amacin) Dietary substances. Caffeinated lip balm, beer, sunflower seeds.

Caffeine as a drug

When ingested orally caffeine is absorbed 30-60 min. Peak blood level 60 min CNS reaction 2 hours 1/2 life- 3/7 hours

Effect s of caffeine on the body

Double blind negative effect- blocks adenosine Brinds to receptors on the surface of cells and produces sleepiness, dilation of blood vessels and construction of bronchial tubes. Protects against seziures, slows body’s reaction to stress, and lowers heart rate, blood pressure, and body temperature.

Effects on caffeine behavior

Feeling of mental altertness Increased performance Increase vigilance and attentiveness Decrease time to response time to simple visual or auditory signals

Caffeine & alcohol

Caffeine will NOT sober you up

Potential health benefits and risks

Lower risk of Parkinson’s disease Women- high or low consumption was protective hormonal factors in women caffeine and estrogen interactiontional effect Mild risk of heart attack Don’t drink if having panic attacks. High levels of caffeine related to risk of miscarriage in first trimester.

Dependence, acute toxicity, and medical application

85 % us population is 2-3 cups a day Tolerance effect seen with 1-2 cups Withdrawal- headaches Lethal dose 50000- 100000 mg a day

Food drug and cosmetic act

A product intended for use in diagonsis, cure, mitigation, treatment, or percent of disease. (1938) – food pure , and safe – drugs safe, effective

Dietary supplement health and education act

Passed in part due to pressure on congress from the supplement industry. Industry wanted to limit FDA regulation

DSHEA CHANGES

Redefinition of which substances could be dietary supplements. Redifinition of presumed safety Vague health claims without proof were allowed

Dietary supplements

products that supply one or more nutrients as a supplement to, not a substitute for, healthful foods

DSHEA : defying safety

– FDA can declare a dietary supplement to be unsafe or adulterated.

Supplement labeling

– supplements cannot claim to be a treatment for a disorder – can be beneficial effects. – must carry a disclamimer

Boon

Many more supplements on the market. Thus, consumers have more options

Cons about suplements

Much less research available about safety and effectiveness. Remain on the market until FDA present clear evidence of risk

Case study: Ephedra

A stimulant or weight loss First evidence of safety concerns published by FDA. Took 10 years to compile evidence to get it taken off shelves.

Dietary supplement act

2010 introduce by senator John McCain. All manufactures would have to register with FDA. Have to provide a complete list of ingredients. FDA can recall it if it’s unsafe ( McCain withdrew the bill)

Saint John’s wort

Hypericum perforatum Currently used as a potential treatment for both anxiety and depression.

SAMe

S- adenosyl- L- methionine A naturally occurring substance found in the body. Active form of amino acid methionine. It is as effective as approved antidepressants.

Ginko biloba

Long history of medical use in China Reduced blood clotting. May improve circulation. Potentially risky if used with aspirin or other drugs that reduce clotting

Weight Control Products

People hoping to lose weight. No evidence of effectiveness. ( placebo effect) Herabalife reported $3.5 billion in worldwide sales

Over the counter drugs

Self perscribed for treatment self diagnosed illness. Americans spend over $18 billion per year on otc.

FDA regulation of OTC

1962 Kefauver- Harris ammendement required all drugs be evaluated for safety and efficacy. – charged with reviewing all OTC drugs currently on the market. – only active ingredients were reviews Currently one is Orlistat ( alli) FDA approved

Gras- generally recognized as safe

Given currently available information, the ingredient is considered safe

GRAE- generally recognized as effective

As reasonable expectation that the pharmacological effect of the drug will provide clinically significant relief

GRAHL- generally recognized as honestly labeled

Labeled honestly.

OTC drug labeling

active ingredients and amount, purpose of medication, use for drug, specific warnings, dosage instructions, inactive ingredients

Dosage

An OTC version of a drug may come in smaller doses

Chemicals

A perscription drug may contain a chemical not allowed for OTC sale due to potential toxicity

Examples of OTC

Ibuprofen, lansoprazole( heart burn), fexofendaine

Stimulants

Only legal ingredient is caffeine. Ex. Vivarian

Sedatives and sleep aids

Combination of scopolamine( acetylcholine receptor blocker) and methapryline Current OTC is diphenhydramine

People and pain

Anesthetics- reduce all types of sensations or consciousness Analgesics- reduce pain selectively without causing a loss of other sensations ( aspirin, ibprohen, acetaminophen)

ASPRIN

Chemical name : acetylsalicylice acid Examples: analgesic, antipyretic, anti inflammatory

Analgesic

Effectively blocks mid to moderate somatic pain. Especially effective for headache and musculoskeletal pain

Antipyretic

Reduces fever Causes vasodilation of peripheral blood vessels and increased perscription

Anti inflammatory

Reduce swelling inflame ions and soreness

Aspirin effects

Inhibits blood platelet aggregation. Induce gastrointestinal bleeding, Reye’s syndrome.

Aspirin working

Inhibits the synthesis of prostaglandins are local acting hormones. Released when cell membranes are injured. ( heat regulation)

Ibupofen

Don’t take for hang over. Can over dose.

Cold and allergy products

Treat the symptoms. Such as coughing, sneezing, productions of fluid by the mucous memebranes. ( can last up to 3 days on hard surfaces)

Modern cold remedies

Antihistamines – dry up the nose Nasal decongestants- swollen nasal membranes