PHAR 300 Lecture Notes - Lecture 5: Osteoporosis, Omeprazole, Ephedrine
7 Jun 2018
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«!Cures!» for sale : reality vs. distortion
Wart
-have been around during whole human history
-many examples of traditional remedies that were used to get rid of warts
-due to a virus, most of them (80%) will disappear spontaneously in less than 2 years because
our immune system will get rid of the virus
-a lot of different strategies are available to make us well or treat diseases, some are considered to
be drugs
Wellness economy
-huge amount of money involved in health and wellness…to make us healthier, feel better, look
better…
-anything that makes money will attract a lot of people
-$199b in complementary and alternative medicine
Principles in drug evaluation
-2 fundamental concepts in evaluating anything supposed to be beneficial for our health
-double blind study : 2 groups getting something supposed to be beneficial, one gets a real
compound and the other gets a sugar pill (placebo) => see if real drug is better than the
placebo
-we are all humans -> humans respond to the concept of someone taking care of
them so they feel emotionally better => we have to show that the drug is actually better
than that
-even for very serious situations, people will feel better initially with the placebo, but
we will eventually see the difference with the real drug which will be better chronically
-sometimes the drug is better than the placebo at first, but then become equally good
-if the drug is actually better -> a larger fraction of people will feel better for a longer
period of time
-randomisation : healthy people in both groups
-placebo = «!I will please!» -> makes people feel better
-time course of the placebo response will vary with the disorder ; the relationship
caregivers (the more faith we have about the nurses around us, the more we will respond) ;
the ritual of taking medicine (even size and color of the pill has an impact on how much
people feel better) ; strength of belief
-~35% will feel better, will respond positively to a placebo ; ~15% will find negative side
effects from placebo
-often very effective for anxiety, for things that are difficult to quantify
-fever blisters -> herbal remedies (mild core sores will go away within few days by themselves ;
repeated cold sores -> very effective anti viral drug)
-herpes simplex virus : we know how it reproduces itself -> able to develop a drug that will
interfere with viral infections (but took a lot of work to show that it was really better than a
placebo)
-pharmaceuticals companies are faced with investing huge amounts of money in developing new
products, the majority of which never reach the market (if they are not better than placebo)
-advertising comes from the internet, or even via emails
-most of them marketed on the basis that it is natural, from plants
-but in reality plants consist of chemicals
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-same chemical if made in laboratory
Alternative medicines
-no reliable evidence that it works, in contrast to conventional medicine which is drugs
prescribed by doctors, sold in pharmacies or over the counter, approved by national health care
system… => conventional medicine is evidence-based, has displayed the evidence that it works
-if any alternative product can be tested and evidence shows that it works => transferred to
conventional medicine
-some alternative medicines have shown to be useless -> still sold
-marketing techniques use testimonials (one person says that it worked -> can be very
effective BUT one person testimony is no evidence at all), folklore and tradition, belief
system (many people substitute health systems for religion)
-several thousand products in stores as alternative remedies (>1500), and less that 40% products
used are reported to physician
Homeopathy
-has been around for many years
-started in late 1700s by a german physician -> he came up with his own belief system for how to
cure people : find something that would create same symptoms as the disease -> like will cancel
like -> will solve the disease (e.g. vomiting -> find something that causes vomiting and it will
cure it) BUT didn’t work => if we dilute product that causes vomiting enough times, we can get
rid of the actual inducement of vomiting and keep the magic properties of cancelling vomiting
-method : potentisation -> starts with compounds that cause the disease (mother tincture),
dilutes it and bangs the vial 30 times (= succussion) and dilutes again… => banging is
supposed to transfer the natural properties from the molecules to the water -> make
spiritualised water
-dilute 1:100 repeated 30 times -> final concentration : 1/10^60
-pure water is now spiritualised BUT it violates laws of physics, biology and chemistry…
-belief : properties of drug remain even after drug is gone ; vigorous shaking between
dilutions will «!potentize!» the water ; the water retains a «!memory and can act spiritually!»
-now : produced exactly the same way
-very successful -> now advertise it even for horses, dogs, cats…
-homeopathic nosodes -> claim that they are equivalent of immunising against infectious
diseases, influenza, whooping, cough, measles, diphteria, polio
-harmless placebo ? not necessarily
Herbal remedies
-huge profit making business
-very popular and advertised
-prime targets : conditions that resolve anyway, conditions with high psychological
component, chronic conditions that naturally cycle (like seasonal allergies), attempts to improve
appearance and reverse ageing, «!cure!» terminal illness (incredibly vulnerable people -> will
try anything that would help themselves => will spend thousand dollars on fake drugs)
-idea that they don’t have side effects -> false, if they are biologically active they DO HAVE side
effects
-Actra-Rx and Yilishen : sold on websites as «!dietary supplements!» for treating erectile
dysfunction and enhancing sexual performance for men -> illegally contain prescription-strength
quantities of sildenafil (Viagra) ; serious drug interactions
-there are hazards, no quality control, generally ineffective, dangerous
-Comfrey : sold as a tonic, leaf extract, BUT hepatotoxic (causes cirrhosis)
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Document Summary
Have been around during whole human history. Many examples of traditional remedies that were used to get rid of warts. Due to a virus, most of them (80%) will disappear spontaneously in less than 2 years because our immune system will get rid of the virus. A lot of different strategies are available to make us well or treat diseases, some are considered to be drugs. Huge amount of money involved in health and wellness to make us healthier, feel better, look better . Anything that makes money will attract a lot of people. 2 fundamental concepts in evaluating anything supposed to be bene cial for our health. Double blind study : 2 groups getting something supposed to be bene cial, one gets a real compound and the other gets a sugar pill (placebo) => see if real drug is better than the placebo.
