Drugs and human health

Pharmacy

Patients in life or death situations often can not swallow and also drugs given intravenously often act more rapidly, and some drugs are or can be destroyed by gastric acids.

Nitroglycerin tablets are given sublingually because the blood under the tongue acts to disseminate the medicine almost as effectively as if the drug was given intravenously.

In both open and closed angle glaucoma, the medicine is intended to lower the pressure within the eye and the blood supply to the eye is not as effective in delivering the medicine as a direct application.

Because liver most medicine is metabolized in the kidney and excreted by the liver, kidney and liver disease would not permit the organs to dispose of the medicines and therefore there would or could be excess medicines left in the organs.

The sympathetic nervous system originates in the spinal cord and is responsible for the "Fight or Flight" responses for self preservation by using additional energy - blood pressure increases, increase the heart rate and slows down the digestive process. The cell bodies of the preganglionic neuron are located in the thoracic and lumbar spinal cord and axons from these neurons project to a chain of ganglia located near the spinal cord. Often the neuron makes a synapse with the post-ganglionic neuron in the ganglion. Some preganglionic neurons go to other ganglia outside of the sympathetic chain and synapse there. The post-ganglionic neuron then projects to the "target" - either a muscle or a gland.

The parasympathetic nervous system is responsible for "Rest and Digest" responses so it works to save energy, reduce blood pressure and slow the heart rate and increases the digestive rate. The cell bodies of the parasympathetic nervous system are located in the spinal cord in the sacral region and in the medulla. In the medulla, the cranial nerves III, VII, IX and X form the preganglionic parasympathetic fibers. The preganglionic fiber from the medulla or spinal cord projects to ganglia very close to the target organ and makes a synapse. This synapse uses the neurotransmitter called acetylcholine. From this ganglion, the post-ganglionic neuron projects to the target organ and uses acetylcholine again at its terminal.

6. The first thing I would do is to attempt to confirm the findings in the email and if the information was incorrect I would try to educate anyone needing reassurance. If the information was correct, I would try to follow the prescribed corrective action such as stop filling prescriptions and updating doctors who were prescribing the medicine.

7. I would warn against taking ephedra because it is known agent that raises blood pressure and has been linked to strokes. "Ephedra, also called Ma Huang, is a naturally occurring substance derived from botanicals. Its principal active ingredient is ephedrine, which when chemically synthesized is regulated under the Federal Food, Drug and Cosmetic Act of 1938 as a drug. In contrast to the DSHEA-regulated dietary supplements that contain natural ephedra, the safety and effectiveness of the synthesized ephedrine has to be proven by the manufacturer, not the FDA. In recent years ephedra products have been extensively promoted for aiding weight control and boosting sports performance and energy." (P03-106)

1. The first reason to switch a patient to non-barbiturates as opposed to barbiturates is because of the fear of addiction and a second reason could be the patient is overly lethargic from the barbiturates.

2. JT in this situation is most likely becoming addicted to the drug.

3. Sedatives are given to children for electroencephalograms to slow alpha waves in the brain as well as to help calm the child which in turn also slows brain waves.

4. A The first question I would ask is he taking Dilantin and if so the dosage. b. It would be important to inform the physician so that alternatives can be found so that JT gets his medication in order to avoid future seizures. c. Dilantin causes hypertrophy of the gums.

5. The medicine is a stimulant so that may be keeping the child up at night.

6. The medicine is a stimulant so the MS patient would benefit from the release of adrenalin.

7. SSRI's reestablish the serotonin activity in the brain by either blocking increased serotonergic activity and dopamine stimulation.

8. a. Typical neuroleptics are the traditional mainstay of antipsychotic treatment. They are often referred to as older medications the typical neuroleptics. These drugs block various dopamine receptors in the brain. In addition to limiting psychosis, lower dopamine levels can also affect the motor system. The muscle-related side effects common to these medications are called Extra-Pyramidal Side effects, or EPS. Thus, atypical neuroleptics can be considered the newer drugs and these drugs target specific dopamine receptors and/or may block or inhibit re-uptake of serotonin.

b. "The mechanism of action of Abilify, as with other drugs having efficacy in schizophrenia, is unknown. However, it has been proposed that the efficacy of Abilify is mediated through a combination of partial agonist activity at dopamine D2 receptors and serotonin 5HT1A receptors, and antagonist activity at serotonin 5HT2A receptors. Partial agonism refers to the ability to both block a receptor if it is over stimulated and stimulate a receptor when activity is needed." (Abilify)

9. The entire nervous system is made up of individual units of nerve cells which serve as our body's communication network. To communicate with each other, nerve cells use a variety of chemical messengers or neurotransmitters which carry messages between the nerve cells by crossing the space between cells, called the synapse. One especially important messenger is dopamine, which is manufactured in the substantia nigra. Dopamine is crucial to Parkinson's sufferers because it helps transmit messages to the striatum that both initiate and control movement and balance. These dopamine messages make sure that muscles work smoothly, under precise control, and without unwanted movement.

10. The bacteria could build a resistance to the antibiotics if they are not killed off prior to the completion of the medication or antibiotic.

11. A superinfection can be caused by multiple organisms with one or more resistant to all forms of known medications and antibiotics.

12. a. "The CDC also reported that 1.3% of tuberculosis cases in the U.S. were resistant to both isoniazid and rifampin." (American Lung Association) b & c. "In June 1998, the U.S. Food and Drug Administration approved the first new drug for pulmonary tuberculosis in 25 years. The drug, rifapentine (Priftin), has been approved for use with other drugs to fight TB. One potential advantage of rifapentine is that it can be taken less often in the final four months of treatment --once a week compared with twice a week for the standard regimen." (American Lung Association)