Pharmacy Notes and Drug Information

The New Frontier of Life

2012-02-02T19:49:00.000-08:00

by John Anthony M. Pingol

A world full of life emerges from the bosom of the earth. The flora and fauna of our planet gives life. They are the progenitors of the ever changing mechanism of adaptation. and to adapt is to survive our planet. And in order to survive, the least of the factors are of the greatest impact to life.

since we are composed of matter, we are molecular and atomically alike to each and every thing that lives and gives life. We eat, breathe, drink and excrete just as plants and animals do. These molecules will give rise to those who will adapt and continue in the conquest for life. These molecules can be seen anywhere and related to different processes of life. We eat because we need energy from carbohydrates and lipids. We grow in the presence of proteins. We change through the action of nucleic acids and create what we are thru enzymes.

These macromolecules will aid the world for a better view of internal and external processes of man. They can be treated as markets of illness or even as a remedy to one. The chemistry of life will show the compatibility of the molecules with each other and it is the duty of a pharmacist to study the compatibilities and rationalize them for the use in fighting for human survival.

The pharmacist will be the one to mediate the treatment of certain diseases with the aid of these molecules. They will be the first line of defense, along with other health care professionals, against the battalion of diseases. They will counter protein invaders with enzymes and antibodies. Repel immunosuppressing agents with vitamins and minerals. They will give power with the aid of carbohydrates and lipids and aid us in growth with the aid of proteins.

With our own legion of Medically allied professionals all will come to an end, a better one. But without the guide and help of the One who created everything, all will be lost and no one will be spared. With the help of unity and prayer, we will give effort to the works of our defenders and stop the siege of these diseases.

But for now, let us continue our never ending search for the ammunition than can and will out best the horrifying agents of diseases. May these researches be directed to the light. and should we find this ammunition, let us not forget all the efforts in it. The pharmacist, for one, because he will guide the human race to the eradication of this unwanted captors of life. They will let loose of the binds of death that slowly pulls us towards it. and when this moment comes, we are prepared to stop the almost never ending fight for survival? Are we ready for change? Are we ready for change? Are we ready for the better? All this will be answered by the future.

Extraordinary Measures - In the Eyes of Mary Charity Guiya-an

2011-03-12T08:57:00.000-08:00

Extraordinary measures is an ordinary film with ordinary characters in a story too big for it. This story is based on facts. This story is about a family with two sick children have no more than a year to live when their father determines to seek out a maverick scientist who may have a cure in Pompe disease.

I found out that the movie extraordinary measures is exciting, enlightening, interesting and useful. It is an interesting and exciting movie because I am interested on how Mr. Crowley discover on the Internet professor at the university of Nebraska named Dr. Robert Stonstill he's working on a controversial cure for pompe disease that the medical establishment rejects and Dr. Stonstill is not interested in Pompe patient, only on the chemistry of the disease. I am interested on how these two men come together? How they come up with the treatment of the disease.

Extraordinary measures is also enlightening and useful on the viewers especially on the parents who have children,in this movie I've learned a lot and we should apply this lessons on the reality because it is used to believed that the parent had unlimited claim on their children and rights over him. In a truer view of a matter,we are coming to see that the rights are on the side of the child and the duties on the side of the parents and one duty of a parent is to make a child to be happy,like Mr. Crowley done to his two children who has Pompe disease,He make his best or he make a way just to make Dr. Stonestill agree with his proposal to help him with the disease of his children and he also do his best just to earn such money for the cost of the medication of his children even though he knows that it is impossible to earn such money.

I've learned that people should not just easily quit if they failed or insulted by others,They should take that as a challenge like again Mr. Crowley done to this movie that even though Dr. Stonestill do not agree with him he didn't quit easily,he did not loose hope he patiently wait for the answer of Dr. Stonestill if he agree with him.

I also learned that we must have to accept failures, we must have to be humble because if a person is not humble there is no right path for their works and life. We people are not perfect so we make mistakes and we have to learn our mistakes and so that we can improve ourself. We should consider other peoples opinion on the idea, as they say “No man is an Island” like Dr. Stonstill hardly accept others opinion.

If one family has a strong bonding, love,openness and faithful to God , even they are poor people if they have this three character if they have any kind of problems they can find way to solve it and overcome it without hurting anyone.

Extraordinary Measures - In the Eyes of Andrea Marie Enriquez

2011-03-12T08:55:00.000-08:00

The movie Extraordinary Measures based from a nonfiction book The Cure, by the Pulitzer prize journalist Greeta Anand present on how a father do all his best to bucked the medical establishment in a quest to save his children is quiet impressive. It is about a parents who form a biotechnology company to develop a drug to save the lives of their children, who have a life-threatening disease called Pompe disease. In the movie, they are able to present all the needed information regarding Pompe disease including its possible signs and symptoms to an individual, even the early onset and the late onset of the disease are being well presented on the story. The film also included an examination of how medical research is conducted and financed means they made all the research to make this movie realistic and purely based on the scientific principle.

When it talks about the different character of the movie, all of them were able to do or performed well on their designated role especially to Brendan Fraser when he play as John Crowley, a biotechnology executive whose two youngest children were affected with Pompe Disease or acid maltase deficiency. Along with his wife Aileen (Kerri Rusell) and Harrison Ford as Dr. Robert Stonehill's. all of them were able to portray all the necessary emotions on a particular scene that is being felt by the viewers.

When it comes to the main plot of the said movie, it is quiet inspirational and motivating, since it is based on a true story. Especially on how John Crowley together with his wife and Dr. Robert Stonehill passed all the obstacles to be able to push through the new drug for the treatment of Pompe disease on a very short period of time. To save the life of Megan, before she turned 9 Because at this age it is a common life span of a children suffering from Pompe disease or before it totally disables the heart and muscles of Megan. But the main point there is whatever happens as long as the person is determined to reach a particular goal even if it is impossible he/she will risk anything like what John Crowley did on the movie. He did all his best to convinced Dr. Robert Stonehill to pursue his theory in the clinical trial for the benefit of the entire Pompe disease victim. This is maybe the main reason why the main motto of the movie is don’t hope for a miracle. Make one…especially when it talks about for treating a fatal condition.

Drug Interactions: ANALGESICS AND ANTI-INFLAMMATORY DRUGS

2011-02-26T22:04:00.000-08:00

Drug Interactions

These are various reactions of a certain drug to other drugs, food, laboratory tests, and herbal products which can either be beneficial or detrimental to the patient depending on the result of the interaction.

In general, drug interactions can occur due to chemical, physiologic, or pharmacological actions. The object drug (one with desired effect) can be altered by a precipitant drug (one causing the interaction) by several mechanism. Pharmacokinetic alterations can be brought up by any alteration in gastric pH, complexation and adsorption of object drug, delayed or rapid rate of gastric emptying, malabsorption, displacement from protein binding sites, induction or inhibition of biotransformation, and alteration of excretion. Pharmacodynamic interactions can occur from antagonism, potentiation/addition/synergistic effects, alteration of electrolytes, interactions at receptor sites, alteration of gastrointestinal flora, and different drug combinations.

Overview of Analgesics and NSAIDs' Mechanism of Action

Analgesia, or loss of sensitization to pain, can be achieved using drug groups such as opioids, acetaminophen, steroids, and non-steroidal anfi-inflammatory agents. Other drugs such as local and general anesthetics can also give the same effect although their use is more on the loss of sensitization to stimuli rather than pain alone.

Steroids, acetaminophen and NSAIDs are more directed to the inhibition of prostaglandin production. Prostaglandins are endogenous substances which are considered to be a chemical mediator for pain and inflammation. These substances are derived as end products from the metabolic pathway of arachidonic acid (ARA). Free ARA, the one undergoes biotransformation, is cleaved out from the phosphobilipid layer of the cell membrane by the enzyme phospholipase A2. The free ARA will be enacted by cyclooxygenase (COX) enzyme and/or lipooxygenase enzyme, however the latter is not directly relevant to pain and inflammation. The cycooxygenase enzyme will act on the arachidonic acid to form prostaglandins which as discussed earlier will contribute to the pain sensation. Steroids, such as prednisone, will act on the phospholipase A2 enzyme which will limit the amount of free ARA to be converted to prostaglandins. NSAIDs can inhibit either COX1 or COX 2 or both to prevent the formation of prostaglandins. Acetamiinophen is a weak inhibitor of COX1 and COX in the periphery due to the presence of peroxidases in inflammatory sites but pose its inhibition on COX3 found in the central nervous system in which the analgesic effect is directed to the brain pain centers.

A more powerful group of analgesics are called collectively as opioids. With morphine as the prototype, they will act not on the ARA-COX-prostaglandin pathway but mimics the action of endorphins and they bind to opioid receptors. Such receptors are called mu, kappa, delta, and iota receptors. When opioid drugs will bind to these receptors especially to mu receptors, this will result to depression of certain brain functions that will lead to analgesia.

Morphine is a drug that is used for patients who are terminally ill and requires analgesia for hospice treatment. NSAIDs like aspirin, ibuprofen, and mefenamic acids are over the counter drugs that may be used by anyone even without medical advice. Acetaminophen is the most commonly used drug for fever due to safety profile.

List of Drug-Drug Interactions for Analgesics and NSAIDs
List of Drug-Food Interactions for Analgesics and NSAIDs
List of Drug-Laboratory Interactions for Analgesics and NSAIDs

References:

Brunton, L. et.al. (2006). Goodman and gilman's the pharmacologic basis of therapeutics. New York: McGraw Hill. 11th Ed.
Hacker, M. et.al. (2009). Pharmacology principles and practice. San Diego, CA: Elsevier
Katzung, B. (2007). Basic and clinical pharmacology. New York: McGraw Hill. 10th Ed.
Rybacki, J. (2004). Essential guide to prescription drugs. New York: Harper Collins

Glutathione As a Skin Whitener

2010-10-19T04:06:00.000-07:00

Over the past few years, the Philippine market has been saturated by the drug product Glutathione. This drug is used as a skin whitener in the form of soaps and capsules. There are so many brands in the market and it has been one of the most popular whitening agent for women and men alike. There has been controversies regarding the quality standards of some brands before and I believe it has been resolved now.

Glutathione is an endogenous substance, i.e. it normally exist in the body, that is used as an antioxidant primarily in the liver. It is used as a substance to counter act free radicals that might damage normal cells in the body. Free radicals are unstable chemical compounds that are looking for electrons for its stability. When it enters the body, it can react with the chemical components of our cells since it contains electrons that the free radical need. When the cell is affected by the free radical, it can cause the death of that cell or it can cause mutation that might lead to cancer. Glutathione's chemical structure is composed of electrons that can be readily accessible for the free radicals. It will provide them the electrons that they need for them to become stable and will not cause harm to the living cells. So, instead of the cells, glutathione will be the one which will be enacted upon by the free radicals. Glutathione is a drug that is used in medicine before as a liver protectant. Since this drug is a known antioxidant, it will prevent the damage inflicted on healthy liver cells. It was found out that one of its side effect is the whitening of the skin.

Glutathione can act on the normal synthesis or the creation of a protein called melanin. Melanin in its simples definition is a protein that causes the formation of skin pigments or skin color. This is a natural protectant of the body agains the harmful rays of the sun. Depending on different factors such as race, location, and genetics, the amount of melanin produced in the skin will vary among people. People living in the upper and lower hemispheres may have a fairer skin due to the fact that the region do not receive that much sunlight and melanin production can be minimal. People who are inhabitants of those regions may adapt to their environment and will carry the trait of having a fair skin that can be passed on to their off springs and new generations. Unlike those people who lives near the equator which receives ample amount of sunlight, the body will counteract that by producing melanin to protect the underlying tissues from too much sun damage. People who have traits of having a fair skin may produce more melanin if they are exposed in an environment near the equator but still maintains their natural color. This is called the "tan" skin. When those people living in a region near the equator will live in an environment that is not receiving too much sunlight, their bodies will produce less of melanin but still maintains their dark skin color. Depending on those situation, the body will produce a melanin that is suited for each individual. If the body perceives that it needs a darker melanin color, then it will produce the protein and if not, it will produce less. Now, glutatione will act on these melanin production. The drug will not stop the generation of melanin since it is required to maintain body color. It will just act chemically with the production of melanin and combine itself to melanin to produce a variety of melanin that have less pigmentation or color. Aside from the giving you a healthy liver, it also promotes a fairer white skin. Now that’s sweet. The question left is whether it is effective?

In the practice of pharmacy and medicine, a certain drug should meet a required amount or concentration before an effect would be seen. In the case of glutathione, there is an intravenous injection preparation that will guarantee that this concentration is reached. However, this is very expensive. When it comes to soaps and other skin products, glutathione may somewhat be absorbed but it varies and the application should be done on the time that the body is producing melanin. The exact time is unknown in each individual and therefore it may lead to frustrations. Oral preparations such as capsules are readily available in the market in doses required to have a whitening effect. But, based on the chemical properties of glutathione, it is not well absorbed in the gut and therefore will not deliver the required amounts. Even if you will overdose yourself with it, that will not guarantee of a whiter skin. It will also need some time before a fairer skin will be seen. Glutathione is also combined with other antioxidants such as vitamin C and vitamin E in order to have a better effect. But still, the vitamins can be easily absorbed by the body but glutathione will not. In this case, the most effective way would be the administration with the use of an injection. But like as stated before, it is very expensive.

Other drugs are available and in the market and people may have heard of it. This is called as N-acetylcysteine. This drug is a metabolic precursor of glutathione. It means that when this drug is taken in the body, it will be metabolized and be formed as glutathione. N-acetylcysteine is well absorbed in the stomach and is used to replenish glutathione stores in the body in case of poisoning. Once, transformed into glutathione, it will act as glutathione which can have an effect of skin whitening. However, the drawbacks of using N-acetylcysteine are primarily, it is a prescription drug (it requires a valid prescription before purchasing) that is used in the management of severe cough. If this drug is used for more than three (3) days, it can cause a side effect in which a person will suffer a more severe cough. Whitening agents are used for long periods of time before effects can be seen and this drug should not.

Even if glutathione is created in our body, its primary function is to protect the liver and therefore it is not produced in amounts that will affect the skin production of melanin.

Fairer skin is one of the impacts of modern day advertisement in the Philippines which for someone to be beautiful or handsome requires a light skin color. This is the primary reason why the market for glutathione had increased in the past few years and may still increase.

This article does not intend to discredit the whitening effects of glutathione and does not point out that the use will not give effects.

Having a fair skin for a Filipino is something but do not forget that our skin color especially the one called as “Kayumangging Kaligatan” is envied by foreigners in our land. Many of the “whites” spends hundreds of dollars just to have a tan skin and we are spending thousands of pesos just to have a whiter skin. This skin color, kayumanggi, is what is given to us and should be proud of.

How To Properly Answer Question in Quizzes and Exams

2010-08-26T10:29:00.000-07:00

As a student, we have all wanted to prevent quizzes and exams since it would be a dreaded day or hour for us. Some people take it lightly and even get a high score even they do not review. If you are in the side that needs an extra effort to pass then apply that extra..hehe.. Quizzes and exams from various faculty staff are always unique in their methods. We cannot compare them when it comes to their teaching methodology and we should simply comply. Generation of questions for evaluating students is not as easy as one may think. Faculty members thinks carefully before they create a question that they believe students can answer. Most quizzes and exams have an approximate 10% easy questions and 10% difficult questions. The remaining 80% would be moderate.

You might have been wondering why sometimes you do not obtain the score you expect even if you review that much. We sometimes think that we will already pass if we have easily answered the questions, but in reality we haven't. Sometimes, students fail to answer the question even if they have already written so much.

Here are tips that may help you in your quiz and exam.

On Instructions

Read the instructions carefully or listen for the instructions carefully. A proctor, or the one giving the examination may not repeat it or may not explain the instruction. Follow each of them and take note of the important parts like "No erasures", "Give (number) examples", "capital letters only", and the likes. Many students have failed in the board exams just because of failure to follow instructions. Faculty staff might be strict when it comes to placing your answers on the paper or answer sheet so take note of that.

Examination Types

There are various exam types that is used by a faculty or a teacher. The type they use are dependent on their preference and usually it will be repetitive.

Objective Type of Questions

This will involve a single answer that can be equivalent to a certain number of points.

1. Identification type - one of the easiest type of questions because it only involves simple recall of data from the discussion. This is easy for those who are good in memorizing stuff and quite moderate for those who prefer to analyze. There is a wide range of answer using this type of questions so it is necessary to give the most appropriate. It usually start with what, when, and who. Be careful of the spelling though because you are required to write whole words or phrases.

2. Enumeration - almost the same with identification but it will involve the writing down of members of a certain group or parts of a certain series that can be in order or not. People may fail to remember all of those asked like for example the steps in neurotransmission.

3. Matching Type - this involves finding a certain characteristic from the item being asked for example is the generic name and find its brand name or pharmacologic category. If the number of items is equivalent to the choices, there is a very high chance that the choices are not repeated to you can rule out the items that you already know. The difficulty lies if there is more choices than that of the items or the choices are less than that of the items. In the former, some of the choices may just be an additional for you to be able to think but just answer the items that you are really sure before ruling out the other choices. The latter is somewhat difficult because choices are repeated but identifying a certain group of items that is under the one of the items will lead to ease in answering the others.

4. Multiple Choice - the chances of getting the correct answer is higher as compared to the first three. But choosing the answer would be difficult because right answers may be present on all of the choices and choosing the best answer is a problem if there is "all of the above". Use a lifeline! 50-50!Rule out answers that you think is possibly incorrect and then you'll have 50% of having the correct answer. Only use the "all of the above" or "none of the above" if you are confident that all of the other answers are correct or incorrect. If you do not know the right answer right away, skip to the next one and go back to the item if you still have time.

5. True or false question - it can give you a 50% chance of getting the right answer if there is no need to prove your answer or write or underline the word that makes the sentence incorrect. Watch out for words such as "not, always, usually, including, all, most, some," and other qualifiers. Analyze the sentence taking note of this words that can alter the meaning of the sentence. Numbers found in statements can be tricky but most of the time if numbers are placed on them, it is true although it is not always the case. This type of question can be combined to multiple choice that resulted to the painful morse type. This type is just like the normal T or F question but it has more than one statements and answered using letters indicating which items are true. Take note of the choices and the statements. If you find a statement that you really know that is true or false, then make that statement as a basis for the other statements. for example, A. 1 and 3 are correct, B. 2 is the only correct, C. 1 and 2 is correct, D. 2 and 3 is correct, E. 1,2,3 are all correct. If you are sure that 2 is incorrect then the answer will have a high chance to be A even if you do not know whether 1 or 3 is correct.

Essay Type

This type of examination is the hated by most students since they will have to write so many things and yet obtain a few points. Still, proper analysis of the question is needed. Tips that can be given will include proper grammar since most sentences have different meanings just by changing a certain word or just by the verbe tenses. E.g. I will receive, receiving, received have different meanings already. Placement of words in the sentence is also crucial to the meaning of the sentence. Completeness may also be a factor. Keywords should be placed in the sentences or better yet underline them. Answer the question direct to the point. You can have a single sentence intro or conclusion but do not write everything that is in your notebooks or books. Simplify thoughts with the use of your own words or using words that have similar meanings. Several cues in the question can be useful to answer them properly and if you will not be able to answer or notice this cues, you might have a large red question mark since you did not answer the question.

1. Define - it is a process of giving a meaning to a certain word. Definitions can come from your notes or books but they are written in a certain pattern.

Word to be defined + qualifier + short description

Like in the first sentence, define is the object word, a process would be the qualifier, and the rest would be the description. Do not define words using the same word e.g. define is a process of defining words. You will never understand the meaning of the word because the description contains the same word. It is like a math equation that there is two variables in which it will take time to find the value of each. Do not also use "is when" in defining e.g. hypertension is when person have .... because it is not a qualifier. Better if you would use e.g. hypertension is a condition... which will state its type.

2. Rationalize/Explain/Why/Give the rationale behind - these statements are usually of the same method of answering. You must provide the reasons that underlies in the question which will cause or brought about the events or principles being asked. Do not define!Do not explain ONLY USING EXAMPLES! There are not the information that you are asked to state so do not do them. Examples can be given only to strengthen your reason and they should not be the primary reason that you have. Base answers from principles or events and in pharmacy use the drug mechanism of action.

3. Describe - this statement asks you to provide an information about the overview of a certain principle or event. It is like talking to someone and telling them the looks of the hottest girl or guy in campus, or the combination of clothes of a certain person. Again, do not define!

4. Compare or differentiate - students usually define the two words to be compared or diffentiated and place while in between definitions. This is not the answer that can be generated and this is not the information that is asked to be stated. You can define somehow but establish points of comparison or differentiation. E.g. compare drug A to drug B - Drug A is similar to drug B since both of them are under this chemical class. Drug B may be more effective as compared to drug A because of this factor. If you are asked to differentiate then establish points that will prove that the two factors are different. E.g Drug A does not have the same effect with Drug B due to their binding sites are different. Drug A binds to this receptor in which drug B does not. This receptor is known to contribute to the effectivity of drug A, although drug B does not have a significant affinity to this...

5. Questions beggining with What , Who, or When - since this is an essay type of quiz you must provide some details regarding your answer.

6. How Questions - provide information that will generally tell a process, mechanism, or methods in which a certain event or principle is attributed to. Do not define! This type of questions are detailed and usually should be choronologically ordered since it will explain a process. If the proces is composed of several steps, provide a brief description (1 to 3 sentences or 1 line only)

These are just few of those question types that usually goes out of the quizzes. I am already sleepy so I can't type any more..hehe. but if you would like to ask for tips post a comment and I'll try to answer them soon enough..

Thanks pipz..