Non-drug Factors Affecting Pharmacologic Effects Of Drugs

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Non-drug Factors Affecting Pharmacologic Effects
Of Drugs

• Group I Members

Andaya, Erwin B Brar, Rita Caangay, Ephraim Chen,Chun-Huang(Alex) Chen,Chun-Yu(Kim) Chen,I-Chung(Afra) Chen.I-Ling(Claire) Chitcaj,Pumchandh Chou,Hsin-Yi (Chou) De Los Reyes, Ellen Marie De Los Santos, Marinelle De Mesa, Andrea Duh, Yidow Huang, Lin-Yi (Tracy)
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Purpose

• Basically, there are three types of drug. And
  each of them will let human produce different
  effects

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The Stimulant Effect

• Substance that causes an increase in activity in
  various parts of the nervous system or directly
  increases muscle activity

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The Depressant Effect

• One of various substances that diminish
  functional activity, usually by depressing the
  nervous system. And it have various modes of
  action and effects. Some are primarily used
  medically to relieve emotion stress, anxiety, and
  tension others induce sleep, and still others
  are used to relieve pain

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The Placebo Effect

• Inert substance given instead of a potent drug.
  Placebo medications are sometimes prescribed when
  a drug is not really needed or when one would not
  be appropriate because they make patients feel
  well taken care of. But A traditional placebo's
  lack of side effects. placebo effect is an
  apparent improvement in health due not to any
  treatment but only to the patient's belief that
  he or she will improve

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Methodology

• Each subject will be given one or two capsules of
  the same color from marked containers. The
  identity of the drug is coded and will be
  revealed to the members of the class only at the
  end of the conference, unless adverse reactions
  by any participants require immediate
  intervention. Students who are not subjects will
  be divided as observers, recorders and
  reporters.Control observations before taking the
  drug should be done. Observations should be
  repeated every 15 minutes or as necessary.

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Methodology

• Changes in observation are noted. All
  observations should be appropriately
  recorded.Subjects should stay apart from each
  other, do not communicate nor compare reactions.
  Observers should refrain from asking leading
  questions e.g. Do you feel sleepy? Avoid
  giving preconceived ideas. Do not inject fear or
  apprehension to the subject.

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Methodology

• The subject will be observed for the following
• Psychological ( self-rating assessment )
• Physiological observations ( objective assessment
  )
• Other reactions

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Methodology

• Rate the degree of reactions of the subject
  before and after intake of the drug according to
  the following scale
• 0 - absent
• - present
• If the reaction is present, take note of the
  intensity according to the followingPresence
  of
• lt3 effects- mild to moderately
  intense
• gt4 effects significantly intense
• For the physiological parameters, compute for the
  increase or reduction
  
• lt10 reduction/increase mild to
  moderate
• gt10 reduction/increase
  significant

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Parameters used
EFFECT CONTROL 15 MINS AFTER 30 MIN 45 MIN gt1HOUR REMARKS
A. Physiological Cheerful Talkative Alert Tense Jittery Irritable Easy-going Drowsy Sulggish Tired Relaxed Calm Sleep Weakness
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Parameters used
EFFECT CONTROL 15 MINS AFTER 30 MIN 45 MIN gt1HOUR REMARKS
B..Physiological Pulse Resp.rate Bld Pressure Pupil Size
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Parameters used
EFFECT CONTROL 15 MINS AFTER 30 MIN 45 MIN gt1HOUR REMARKS
C. Other Effect Tremors Sweating Flushing Headache Dizziness Difficulty in concentration Abdominal Discomfort
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What is a Placebo

• It is an inert material with exactly the same
  physical appearance , odor, consistency as the
  active form

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Types of Placebo

• Pure/Insert Placebo are those that are devoid
  from any action, be it pharmacologic al, surgical
  etc.
• contain starch, flour, sugar
• Impure/Active placebo are those that actually
  have actions that may not be specific to the
  disease
• contain starch and vitamin C

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Placebo Effect

• It is the psychological effect of any medication
  or procedure given with the therapeutic intent,
  which is independent of, or minimally related to
  the specific effects of the procedure and which
  operates through a psychological mechanism

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Placebo theories

1. Psychological theory
2. Nature taking its course
3. Process of Treatment

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Psychological Theory

• The belief that the placebo effect is caused by
  just believing that the given substance or
  procedure will work.
• The power of suggestion, beliefs, and hopes about
  the treatment may have a significant biochemical
  effect

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Nature Taking Its Course Theory

• The placebo effect is due to an illness or injury
  just taking its course.

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Process of Treatment Theory

• By giving the placebo it displays the process of
  treatment that involves showing attention, care,
  affection etc to the patient or subject.
• This process is encouraging and hopeful and this
  may trigger the physical reaction in the body to
  promote healing.

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Advantages of Placebo

• The Placebo effect can supplement pharmacological
  effects
• In trials, can represent the difference between
  success and failure

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Disadvantage of the Placebo

• Because the physician is deceiving the patient,
  there may be an adverse effect on the
  physician-patient relationship
• If the deception is discovered, then the patient
  will feel betrayed by the physician and the
  confidence will be impaired.

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DEPRESSANTS

• Any substance that diminishes functional
  activity.
• Usually depressing the Central Nervous System
• 2 major categories of depressant drugs used as
  medicines are Barbiturates and Benzodiazepines
  - referred to as sleeping pills, tranquilizers,
  sedatives or anxiolytic or hypnotic drugs.

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Barbiturates

• Actions include
• CNS depression
• Respiratory depression
• Enzyme induction
• Anesthetic
• Anticonvulsant.

• Consequences include
• Induction of drug tolerance
• Physical dependence (addiction)
• Severe Withdrawal symptoms
• Can cause coma in toxic dose

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Doses and Effect

• Small amount produce calmness and relax muscles
• Moderate cause drowsiness, confusion, inability
  to concentrate, loss of coordination, tremors and
  slurred speech.
• Large doses produce depressed pulse rate,
  dilated pupils, and shallow breathing. Such doses
  may easily cause unconsciousness and death.

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Barbiturates Pharmacodynamics

• Work by enhancing the action of a brain
  neurotransmitter that is in charge of inhibiting
  parts of the brain.
• Facilitate the activity of one of the main
  inhibiting neurotransmitters (GABA).
• Leads to inhibition of polysynaptic transmissions
  in the CNS
• Commonly abused include amobarbital (Amytal),
  pentobarbital (Nembutal), and secobarbital
  (Seconal).

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Benzodiazepines

• Actions include
• Reduction of anxiety
• Sedative and hypnotic agent
• Anticonvulsant
• Muscle relaxant

• Consequence include
• Drowsiness, confusion
• Dizziness
• Weight gain
• Memory loss

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Benzodiazepines Pharmacodynamics

• Activates all 3 specific gamma amino butyric
  acid-benzodiazepine (GABA-BZ) binding sites of
  GABA receptors
• Opens chloride channels and reduces the rate of
  neuronal and muscle firing.

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STIMULANTS

• Any agent temporarily increasing functional
  activity.
• Stimulants may be classified according to the
  organ upon which they act, as follows cardiac,
  bronchial, gastric, cerebral, intestinal,
  nervous, motor, vasomotor, respiratory, and
  secretory.
• Commonly used stimulants include caffeine, low
  doses of ethanol, methamphetamines, and cocaine.

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Cocaine

• Used as a local anesthesia
• Self administered by chewing, intranasal
  snorting, smoking, and IV.

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Cocaine

• Actions include
• Produce intense euphoria
• Powerful stimulation of cortex and brainstem
• Increased sympathetic fight/flight response

• Consequences include
• Hypertension
• Tachycardia
• Paranoia
• Depression
• Seizures
• Overdosage is fatal
• Addictive

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Caffeine

• stimulates the central nervous system and of
  gastric acid and pepsin secretion, elevation of
  free fatty acids in plasma, diuresis, basal
  metabolic rate increase, total sleep time
  decrease, and possible blood glucose level
  increase.
• Caffeine is considered an ergogenic aid in
  athletics because it tends to enhance endurance
  and improves reaction time.
• Adverse effects include drug dependence and
  withdrawal in some habitual users.

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Physiologic Effects

• CNS usual doses of 50-200 mg. causes a decrease
  in fatigue and mental alertness.
• CVS positive inotropic and chronotropic effects
  on the heart.
• Renal system mild diuretic action that
  increases urinary output of sodium, chloride and
  potassium
• GI system stimulates secretion of gastric acid
  and digestive enzymes

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Clinical uses

• Relaxation of the smooth muscle of the
  bronchioles
• Theophylline, widely used in asthma therapy
  previously.
• For vasomotor headache
• Facilitates falling asleep in elderly people and
  hypertensive patients

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Adverse Effects

• Sensitive to low dose sleeplessness,
  tachycardia, diarrhea
• Moderate dose Insomnia, anxiety, agitation
• High dose emesis, convulsions, restlessness,
  decreased attention span, tremors
• Lethal dose cardiac arrhythmias

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Pharmacodynamics

• Inhibition of phosphodiesterase, thereby
  increasing intracellular cyclic adenosine
  monophosphate (cAMP)
• Directs effects on intracellular calcium
  concentration
• Indirect effects on intracellular calcium
  concentration via cell membrane hyperpolarization
• Uncoupling of intracellular calcium increasing
  with muscle contractile elements
• Antagonism of adenosine receptors

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The Results
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Psychological Stats of DRUG A
Time Depressant Effects Stimulant Effects
0 III III
15 IIII II II
30 IIII I
45 II I
60 IIII II 0
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Vital Stats of Subject A
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Psychological Stats of DRUG B
Time Depressant Effects Stimulant Effects Other Effects
0 III I
15 III III Dizziness Diuresis
30 II IIII Tremors
45 IIII IIII
60 IIII IIII Flushing Cold Extremities
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Vital Stats of Subject B
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Psychological Stats of DRUG C
Time Depressant Effects Stimulant Effects
0 IIII III
15 IIII IIII
30 IIII IIII
45 IIII IIII
60 IIII I IIII
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Vital Stats of Subject C
Blood Pressure reading was not taken at time 15
min
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Psychological Stats of DRUG D
Time Depressant Effects Stimulant Effects
0 IIII III
15 IIII III
30 IIII III
45 IIII III
60 IIII III
Control data (physical), may have be skewed due
to the possibility that the patient was excited
to be the volunteer and that we did not have
lecture )
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Vital Stats of Subject D
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Conclusions
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Stats of Subject A
Depressant Effects Stimulant Effects
21 7
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DRUG A

• Experimental Conclusion
• The drug is probably a
• Depressant

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Stats of Subject B
Depressant Effects Stimulant Effects
16 18
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DRUG B

• Experimental Conclusion
• The drug is probably a
• Stimulant

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Stats of Subject C
Blood Pressure reading was not taken at time 15
min
Depressant Effects Stimulant Effects
24 23
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DRUG C

• Experimental Conclusion
• The drug is probably a
• Depressant

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Stats of Subject D
Depressant Effects Stimulant Effects
24 15
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DRUG D

• Experimental Conclusion
• The drug is probably a
• Depressant

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Summary of Results and Conclusion

• Drug A Depressant
• Drug B Stimulant
• Drug C Depressant
• Drug D Depressant

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Suggestions and Recommendations

• (How we can improvethe experiment.)

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S R Consistency in the subject, data
collection, statistical tools, environment
setting

• Have the control time equal the experimental time
  (includes readings for the hour)
• Have same person collect measurements
• Guidelines need to be established prior to taking
  initial measurements
• Clearer guidelines for psychological factors
• Strict application adherence to the scientific
  method