Pharmacology and Public Health - New Jersey Medical School
Transcript of Pharmacology and Public Health - New Jersey Medical School
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Pharmacology and Public HealthMini-Med Spring 2021
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Pharmacology
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Name some common medicines found at home!
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Here are a few, but there are many more!
● Advil● Tylenol● Motrin● Aleve● Excedrin● Benadryl● Mucinex● NyQuil/DayQuil
● Visine● Pepto-Bismol● TUMS● Allegra● Flonase● Claritin● Sudafed● Robitussin
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How Does it Work?
Ibuprofen
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Ibuprofen facts
▪ Common brand names include Motrin and Advil
▪ Is classified as an NSAID (Nonsteroidal anti-inflammatory drug)
▪ Used mostly for pain, fever, and inflammation
▪ Ibuprofen purchased over-the-counter (OTC) in low dosages, while prescription doses are available for higher dosages.
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▪ Prostaglandins are molecules that cause inflammation
▪ Cyclooxygenase (COX) enzymes are a necessary part of the body’s pathway to produce prostaglandins
▪ There are 2 COX enzymes: “COX-1” and “COX-2”
▪ Ibuprofen belongs to a class of drugs called NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) that reduce inflammation by inhibiting (blocking) cyclooxygenase (COX) enzymes▪ Ibuprofen is a non-selective NSAID, meaning it blocks both
COX-1 and COX-2 (rather than blocking one or the other)
▪ Therefore, ibuprofen inhibits the production of prostaglandins, which reduces inflammation
Ibuprofen – Mechanism of Action
Phospholipids
Arachidonic Acid
Prostaglandins
NSAIDs(ibuprofen)
Inflammation
COX-1 or COX-2
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Prostaglandins are a class of molecules that promote ___?
A) A healthy heartB) InflammationC) Bone healthD) Allergic ReactionsE) Digestion
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Prostaglandins are a class of molecules that promote ___?
A) A healthy heartB) InflammationC) Bone healthD) Allergic ReactionsE) Digestion
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How Does it Work?
Acetaminophen
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Acetaminophen facts
● A common brand name is Tylenol● Is considered an analgesic (pain reducer) and an antipyretic (fever reducer)● It is used to relieve aches, pains, and reduce fever
○ It is commonly used in the treatment of pain associated with arthritis● Proper dosing depends on type of tablet
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Acetaminophen DOES NOT reduce inflammation
▪ It is believed this drug works mostly on the central nervous system in the brain centers responsible for pain and fever
▪ Like the NSAIDs, studies show acetaminophen inhibits the COX enzymes. So what makes the 2 drugs different?
▪ Where they act. Acetaminophen works mostly in the central nervous system, so it can’t reach inflammation in the body as NSAIDs can
▪ The effect of acetaminophen on the heat centers of the brain are believed to cause the body to sweat and lose body heat which reduces fever
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Where does acetaminophen (Tylenol) produce its effect?
A) The Central Nervous SystemB) The Cardiovascular SystemC) The armsD) The Muscular SystemE) The legs
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Where does acetaminophen (Tylenol) produce its effect?
A) The Central Nervous SystemB) The Cardiovascular SystemC) The armsD) The Muscular SystemE) The legs
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How Does it Work?
Penicillin
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Penicillin is an Antibiotic
● Humans can suffer from bacterial infections (like strep throat)● Antibiotics are a class of drugs that selectively kill/harm bacterial cells, but not human cells
○ To do this, antibiotics must “target” a structure that is in bacterial cells, but not in human cells● Bacterial cells oftentimes have a structure called a cell wall, while human cells never have a cell wall● Penicillin works by inhibiting cell wall synthesis, which selectively hinders bacterial cell survival, but not
human cell survival (since human cells don’t contain a cell wall)● Other types of antibiotics target different bacterial cell structures, but the concept is the same:
○ Antibiotics must target something in bacteria cells but not human cells
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How Does it Work?
Antihistamines
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Allergies, Histamines, and Antihistamines
▪ The immune system works to prevent infection of the body by dangerous foreign substances (like bacteria)
▪ An allergy is an immune system response to a foreign substance that doesn’t really pose a threat to your body (like dog dander or pollen)
▪ When certain immune system cells recognize a foreign substance, they release histamines
▪ Histamines bind to histamine receptors in the body, which ultimately produces inflammation and itching
▪ Antihistamines work by preventing/blocking histamines from binding to the histamine receptors in the body, thereby reducing the inflammation and itching, and combating allergies
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Public Health
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Public Health
• The science of protecting and improving the health of people and their communities by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases.
• In short, public health focuses on interventions to help prevent disease, rather than treating diseases once they have already developed
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Smoking – A public health crisis with a
public health solution
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Smoking – What we
know now
• Smoking is the leading cause of preventable death worldwide
• Smoking can cause:• Cancer• Heart disease• Stroke• Lung diseases• Diabetes• Chronic obstructive pulmonary disease
• On average, smokers die 10 years earlier than non-smokers
• Cigarette smoking accounts for 480,000 deaths in the United States per year
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But in the early 1900s, the dangers of smoking were not known…
● Advertisements glamorizing smoking and falsely claiming cigarettes had health benefits caused tobacco use in the USA to increase
● Lung cancer went from a very rare disease in 1900 to the leading cancer diagnosed in American men in the 1950s
- Note how the increase in lung cancer lags the increase in cigarette consumption in the graph● In the 1950s, several studies were published that
showed a causal link between smoking and lung cancer
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1964 Surgeon General’s Report
▪ Mounting evidence that cigarettes caused lung cancer led to a public health intervention – a report from the US Surgeon General in 1964
▪ “Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.”
● This report and the policy measures that followed it (including an advertisement ban and a tax increase on cigarettes) caused cigarette smoking to decrease in the USA
● Lung cancer rates eventually decreased
Number of Cigarettes per Capita
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What is the focus of public health?
A) Disease TreatmentB) SurgeryC) Lowering drug pricesD) Educating more doctorsE) Disease Prevention
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What is the focus of public health?
A) Disease TreatmentB) SurgeryC) Lowering drug pricesD) Educating more doctorsE) Disease Prevention
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Vaping – A New Public Health
Crisis
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Vaping facts▪ E-cigarettes are generally believed to be safer than
cigarettes because they do not contain tobacco
▪ HOWEVER, THEY ARE STILL DANGEROUS…
▪ 99% of e-cigarettes sold in the USA contain nicotine, a chemical that is highly addictive
▪ Nicotine can harm brain development in people under 20 years old
▪ E-cigarettes may contain chemicals that damage the lungs when inhaled.
▪ Researchers believe vitamin E acetate is a particularly dangerous chemical for the lungs in e-cigarette aerosols.
▪ Vitamin E is in a lot of food and is safe to eat, but when inhaled into the lungs it can cause damage
▪ As of February 2020, 2,807 people have been hospitalized and 68 people have died from a vaping related lung problem
▪ Big picture: research on health effects of vaping still ongoing, but it does seem to increase risk of lung damage
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X-ray Findings
Normal lung x-ray. Note the lungs are dark with very little white infiltrate
X-ray from a patient with vaping related lung injury. Note the white lines spreading throughout both lobes,
indicating damage to the small airways of the lungs
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The Predatory Practices of Vaping
companies▪ E-cigarettes are supposed to be an alternative
to cigarettes for those who already use cigarettes
▪ However, much of the advertising for e-cigarettes was intended to reach young non-smokers
▪ E-cigarette companies heavily advertised on social media platforms with young users
▪ E-cigarette ads (like the one to the left) frequently feature sleek designs, bright colors, and young models
● In addition, flavored e-cigarettes are particularly appealing to teenagers
○ 82% of youth who used e-cigarettes in 2020 used flavored varieties
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Vaping - Public Health Interventions
● On January 2, 2020 the US Food and Drug Administration (FDA) prohibited the sale of prefilled pod or cartridge based e-cigarettes in any flavor other than menthol flavor or tobacco flavor ○ The goal was to get rid of flavors, which appeal to young users
● Some states have enacted broader laws to ban all flavored e-cigarette sales
● Additionally, there have been numerous advertising campaigns targeted to young Americans educating them on the dangers of vaping.
● Note that vaping ads are still legal, but there are ongoing discussions about outlawing them
● Results?
○ In 2020 1.6 million fewer young Americans used e-cigarette products than in 2019
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What addictive chemical can be found in both cigarettes and e-cigarettes?
A) TobaccoB) Carbon DioxideC) VibraniumD) KryptoniteE) Nicotine
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What addictive chemical can be found in both cigarettes and e-cigarettes?
A) TobaccoB) Carbon DioxideC) VibraniumD) KryptoniteE) Nicotine
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QUESTIONS?
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Sources
https://www.cdcfoundation.org/what-public-health
https://salud-america.org/the-upstream-downstream-parable-for-health-equity/
https://www.businessinsider.com/vintage-tobacco-adverts-that-would-be-illegal-today-2016-6
www.cancer.org
https://www.researchgate.net/publication/11080330_Tobacco_use_and_cancer_An_epidemiologic_perspective_for_geneticists
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm#diseases
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
https://truthinitiative.org/sites/default/files/media/files/2020/12/Truth_E-cigarette%20Fact%20Sheet_Dec_2020.pdf
https://www.forbes.com/sites/kathleenchaykowski/2018/11/16/the-disturbing-focus-of-juuls-early-marketing-campaigns/?sh=2905d9b114f9
https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-06-01-003_508.pdf
https://www.fda.gov/news-events/press-announcements/national-survey-shows-encouraging-decline-overall-youth-e-cigarette-use-concerning-uptick-use
https://www.lawsonresearch.ca/news/case-report-describes-suspected-new-type-vaping-related-lung-injury