13 Drugs Summary of Specification content Testing of new drugs and clinical trials Thalidomide Learning Outcomes Define the term drug Give examples of medical drugs Explain why drugs need to be tested before they can be prescribed ID: 510495
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Slide1
The use and abuse of drugs
1.3 DrugsSlide2
Summary of Specification content
Testing of new drugs and clinical trials.
ThalidomideSlide3
Learning Outcomes
Define the term ‘drug’.
Give examples of medical drugs.
Explain
why drugs need to be tested before they can be prescribed.
Describe the uses and problems associated with thalidomide.
Explain how the drug testing procedure for thalidomide was inappropriate.
Describe the main steps in testing a new drug.
Explain the terms placebo and double-blind trial. Slide4
Discuss:
what
is a drug?
Names
of medicines
.Slide5
Medicines from plants
Drugs are chemicals
that affect the way cells work
That have an effect on the processes of the body
Medicinal drugs
Have a beneficial effect
Used
for treating disease, injury and
pain
Example: - Paracetemol
Effective painkiller
High doses can cause liver damage
In extreme cases it can be lethalSlide6
Recreational drugs
Some drugs are taken for pleasure
These include
Caffeine
Alcohol
Cannabis
Nicotine
HeroinSlide7
Natural medicines
Many of the chemicals used to make medicines occur naturally in plants
aspirin
white willow bark
quinine
to treat malaria
from Cinchona tree
morphine and codeine
analgesics
from opium poppiesSlide8
Natural medicines
75 – 80% of the world’s population use medicines originally derived from plants
Many of these plants are found in rainforests
The rosy periwinkle is the source of two chemicals that are used to treat cancer.Slide9
Obtaining drugs from plants
Many of the plants contain these chemicals to protect them from herbivores
Problem
they are harmful to other living organisms
could be potentially harmful to humans if used in drug preparations
So any potential drug has to be tested for:
efficacy
toxicitySlide10
Modern Drug Testing
Modern clinical trials are double blind trials, where some patients are given a placebo.
Placebo
compound
presented in the same
way
Double blind
neither
doctors nor patients know who gets drug or
placebo
avoids
bias in ‘looking for
results’Slide11
Modern Drug testing
Stage 1:
Laboratory
Animals
or tissues
used in a lab to find out
Level of toxicity
Efficacy – does the drug work?
Phase 1 Clinical
trial
Low doses tested on a group of healthy people
Evaluate safety
Identify side effectsSlide12
Modern Drug testing
Phase
2
Clinical
trial
Larger group of people
See if it is effective
Further evaluate safety
Determine optimum dose
Phase 3 clinical trial
Large groups of people
Confirm effectiveness
Monitor side effectsSlide13
History of drug testing
Digitalis
is a natural toxin found in foxgloves
can be fatal in even quite small doses.
used for centuries in herbal remedies to treat some heart conditions.
William Withering rigorously tested digitalis and brought it into conventional medicine in 1775.Slide14
Testing a new drugSlide15
Testing a new drug
Compare the two flow charts by answering the following questions
What similarities are there
?
What differences are there?
In
what way is the current system of drug testing safer and more reliable
?
What
do we gain nowadays from testing the drug on healthy volunteers first
?
Why is it important to randomly assign patients to the treatments and have a double blind trial?Slide16
What similarities are there?
In both cases a potentially useful medicinal substance was identified
First small and then larger groups of patients were treated with the drugSlide17
What differences are there?
The current method seeks single active ingredients
Animal trials are used before testing on humans to assess
efficacy
toxicity
Drug tried out on a group of healthy people
first
confirms
whether drug behaves in the body in the way predicted by the lab tests
effects
of different doses
monitored
Independent
review of data carried out in current systemSlide18
Further differences
Statistical analysis of data
to see if any difference is due to
chance
the drug
Once regarded as effective and safe drug has to be strictly licensed before it can be marketedSlide19
In what way is the current system of drug testing safer and more reliable?
Safer
Use of specific active ingredient should allow a more precise dose to be given
Any serious ill effects may be detected in the animal trials first
More reliable
Uses larger samples reduces effects of
chance
Double
blind testing avoids patient/researcher bias in observing, recording and interpreting effects
Statistical analysis of data improves accuracy of conclusions as to whether or not drug
has an effectSlide20
What do we gain nowadays from testing the drug on healthy volunteers first?
Check no unexpected side effects
Observe
behaviour
of drug in a human e.g. is the compound absorbed, how is it distributed, is it
metabolised
and broken down too quickly, is it excreted before it has an effect etc.Slide21
Why is it important to randomly assign patients to the treatments and have a double blind trial?
Prevents
subconscious prediction or influence of the outcome by both patient and researcher
psychosomatic influencesSlide22
In the news
Sometimes things do go wrong!
http://news.bbc.co.uk/1/hi/england/london/4811626.stm
Ethical issues here!
http://www.bbc.co.uk/science/hottopics/animalexperiments/
http://www.beep.ac.uk/content/396.0.html
Even licensing can lead to controversy!
http://www.bbc.co.uk/stoke/content/articles/2005/09/26/herceptin_intro_2005_feature.shtm
lSlide23
Even licensing can lead to controversy!
http://www.bbc.co.uk/stoke/content/articles/2005/09/26/herceptin_intro_2005_feature.shtm
lSlide24
Use of animals in research
http://www.mrc.ac.uk/NewsViewsAndEvents/News/MRC003445
http://news.bbc.co.uk/1/hi/sci/tech/5365206.stmSlide25
Thalidomide
Thalidomide
drug used in the 1960’s as a sleeping pill
Effective at relieving morning sickness in pregnant women, but had not been tested for this use
Reduced the development of blood capillaries in the foetus and babies were born with underdeveloped arms and legs
Banned as soon as these side effects were noticed
Currently used for
Treating leprosy
Treating cancerSlide26
Thalidomide Activities
Use
pictures to relate uses and problems associated with thalidomide.
Research
and produce a report on thalidomide – original use, use in pregnant women, current uses. Slide27
How Science Works - ICT
You have developed a drug that can make people more intelligent. Create a multimedia advertising campaign explaining what your drug can do and showing that it has been properly tested and is safe to use.Slide28
PPQ Jan 10 (H) Question 4
(a)
testing
for toxicity / see if it is safe
/ see
if it is dangerous / to see if
it works
ignore side effects unqualified 1
(
b)(
i
)
testing
for side effects / testing
for reactions
(to drug)
ignore to see if it works
do
not
accept
dosageSlide29
(
b)(ii) any
one
from
dose
too low to help
patient
higher
risk for
patient
might
conflict with
patient’s treatment
/ patient on other
drug
effect
might be masked
by patient’s
symptoms / side
effects clearer
ignore immune
systemSlide30
(c
)
to
find optimum dose
allow
testing on larger sample
or
it makes
results more
reliable
allow
to find out if drug is effective
/ find
out if drug works on ill people
(not just if drug works)Slide31
(d
)(
i
)
(
tablet
/
drug
/
injection) that
does not
contain drug
allow control / fake / false
allow tablet / injection that does
not affect
body
do
not
accept drug that does
not affect
body
(d
)(ii)
neither patients nor doctors Slide32
Drug trialling – Suggested Activities
Discuss:
Discuss
drug safety and how drugs are tested today.
Activity
:
Cards/cut-outs
to sequence stages in drug testing and trialling and purpose of each stage.Slide33
Summary of Specification content
Statins lower the amount of cholesterol in the blood.
Recreational drugsSlide34
Learning Outcomes
Describe and evaluate the effect of statins in cardiovascular disease
.Slide35
Cholesterol Revision
Cholesterol
is produced naturally in the liver
Some people have high cholesterol levels
Too much cholesterol
increases the build up of fatty deposits in artery walls
Increases risk of heart disease
Evidence that reducing cholesterol in the blood reduces the risk of heart disease and heart attacksSlide36
Statins
Statins
Reduce the production of cholesterol by the liver
Reduces blood cholesterol levels
Used to treat patients who are at risk because they have a high cholesterol and a history of heart disease in their family.Slide37
Task: Interpret data
on
statinsSlide38
any
two
from:
balance
between two important
for good
heart
health
i
gnore
blood pressure
high
LDL causes heart disease /
high Cholesterol
do
not
accept converse argument
high
HDL reduces heart disease
/ cholesterol
do
not
accept converse argumentSlide39
heart attacks greater amongst
patients with
low HDL
levels
ignore
statins cause heart disease
statins
reduce heart attacks of patients
or
placebo
is less effective
ignore
comparative effects of the
two statins
allow pravastatin is more
effective supported
by appropriate calculationsSlide40
Revision – drug testing
T
toxicity
H
Healthy people for side effects
P
Patients for effectiveness
D
Patients for dose
Make your own mnemonic to remember the sequence of events in drugs testing.Slide41
Learning Outcomes
Name some recreational drugs.
Describe some effects of caffeine on the body.Slide42
Recreational drugs
A drug is any chemical that alters how our body works
Drugs that affect the central nervous system control the movement of chemicals across the synapses.
Drugs have similar shapes to these chemicals and can mimic what they do.
Recreational drugs are taken for pleasureSlide43
Recreational drugs
Legal
Alcohol
Caffeine
Nicotine
Illegal
Cannabis
Cocaine
Heroin
Ecstasy
All of these may have adverse effects on the heart and circulatory system.Slide44
Drug Dependence
Chemical
Dependence
the body adapts
to the presence of the drug.
When
the chemical is removed the body is no longer able to function normally.
The body then goes into withdrawal symptoms such as hallucinations, fevers, nausea (feeling sick) and shakes.
These
are real, physical signs
.
Psychological
dependence
the
person feels a need for the drug.
They feel
unable to cope without the drug.
For example:
some
smokers need to chew sweets after they give up because they miss having a cigarette in their mouths.Slide45
Caffeine
A
stimulant
is a drug that increases the activity of the nervous system.
It
can raise the alertness, emotions or mood.
Caffeine
is a mild stimulant found in tea and coffee.
Prolonged
overuse may lead to problems with the heart, stomach and pancreas.Slide46
Discuss:
Brainstorm on recreational drugs, sort into legal and illegal and discuss why people use them.
How
Science Works:
Investigate the effect of caffeine on heart rate or reaction timeSlide47
Summary of Specification content
Recreational drugs
Impact
of legal drugs on health is greater than illegal drugs as more people use them
.Slide48
Learning Outcomes
Evaluate the impact of smoking on
health.
Evaluate
why some people use illegal drugs for recreation.
Evaluate claims made about the effect of prescribed and non-prescribed drugs on health.Slide49
Smoking
Benson And Hedges Gold 20
Pack
£
7.25
Lambert
And Butler King Size 20 Pack
£
6.89
Decide how many cigarettes you are going to smoke in one day
Calculate how much you will spend on cigarettes in a week
Calculate how much you will spend on cigarettes in
a year
If you started smoking at 16 and continued to smoke until you were 65, how much money will you have spent on cigarettes?Slide50
Smoking and Health
To
understand the effects of smoking you need to look at the
three components
of cigarette
smoke
Nicotine
Carbon monoxide
Tar Slide51
Nicotine
Nicotine is
Addictive
a
stimulant
make
the heart beat faster
Increasing
the normal heart beat rate can cause stress for the heart which can lead to heart disease. Slide52
Carbon Monoxide
This
gas binds irreversibly to the haemoglobin in red blood cells preventing them from carrying oxygen.
This
will make the smoker more out of
breath.
Smoking during pregnancy
Reduces the
amount of oxygen which is being passed on to the developing
foetus
This
slows down the growth of the foetus as it develops. Slide53
Tar
Tar
is a mixture of many different
chemicals.
It
prevents the cilia in the lungs from working and so the dirt and tar cannot be removed from the lungs.
The
tar damages the delicate alveoli, often making them burst.
This
reduces the surface area of the lungs and leads to breathing problems like
Emphysema
and COPD (chronic obstructive pulmonary disease) Slide54
Carcinogens
Tar contains carcinogens which are chemicals which
can cause cancer.
A cancer is an abnormal growth of cells caused by a change in the genes which control growth.
The
tumour damages healthy cells and tissues as it grows and can spread to other areas of the body.
Smoking increases the risk of lung cancer, mouth cancer and throat cancer.Slide55
Pupil Activities
Poster
to show effects of chemicals in smoke on the body.
Show
health warning on packets of cigarettes; video clips of smoking adverts. Why do people smoke?Slide56
Further information
Useful
information on drugs can be found at
www.talktofrank.com
A useful tool about smoking can be found on the NHS website at
www.nhs.uk
by searching ‘smoking calculator’.
Further information on smoking can be found at
www.ash.org.uk
Slide57
Jun 09 Qu
3 BLY1H
(
a)(
i
)
tobacco / nicotine / alcohol accept solvent / glue / caffeine
ignore cigarettes /
coffee
(a
)(ii)
cannabis / heroin / cocaine allow
eg
crack / weed / ecstasy /
LSD /
amphetamine / speed / steroids
/ GHB
(b)(
i
)
heroin / cocaine / tobacco / nicotine ignore alcohol / cigarettes /
cannabis /
caffeine / coffee
(b
)(ii)
alters body chemistry
ignore
withdrawal symptoms
/ craving
ignore non-chemical effects
on nervous
systemSlide58
Jun 09 Qu 3 BLY1H
(
c)
any
two
from:
increase
in cannabis
smoking increases
(%) depression
greater
effect in
women
allow women become more depressed
depression
linked with /
not directly
caused by cannabis
not
all cannabis smokers
get depression
ignore
cannabis causes
depressionSlide59
Jan 09 Qu
3 BLY1H
(
a)(
i
)
does not contain drug / chemical
allow eg fake / sugar pill /
dummy
drug
(a
)(ii)
as control
or
to see if the effects
are psychological
or
allows blind
testing
allow ‘to compare (with NRT)’
(b
)(
i
)
gum
allow gum placebo
allow placeboSlide60
(
b)(ii)
high / highest number of participants
/ people
or
correct number given
ie
gum
16706
, gum placebo 9319,
placebo
16458
(c)(
i
)
nasal spray
(c
)(ii)
highest percentage of people stopped
/ 24
% stopped
biggest difference between
treatment and
placebo
allow ‘highest by 4%’ for
2
marksSlide61
Summary of Specification content
Recreational drugs
Impact
of legal drugs on health is greater than illegal drugs as more people use them.Slide62
Learning Outcomes
Evaluate the impact of alcohol on health.
Evaluate why some people use illegal drugs for recreation.
Evaluate claims made about the effect of prescribed and non-prescribed drugs on health.Slide63
Alcohol and Health
The
alcohol in alcoholic drinks such as wines, beer and spirits is
ethanol
.
It
is a
depressant
It slows
down
impulses
in the nerves and brain.
Health
Small
amounts of alcohol help people to
relax
greater
amounts lead to a
lack of self-control
.
Long-term
effects of alcohol include
damage to the liver and brain
.
Alcohol
may also cause weight
gain
it
is addictive.Slide64
In an exam you may be asked to:-
Discuss
effects of alcohol on the body,
R
ecommended
units for men and women.
Calculate number of units of alcohol consumed.
Relate
smoking and alcohol to NHS costs
.Slide65
Summary of Specification content
Recreational drugs
Cannabis
Drug
addiction and withdrawal symptoms – heroin and cocaine
.Slide66
Learning Outcomes
Describe the effects of cannabis on the body.
Consider the possible progression from recreational to hard drugs.
Describe the effects of heroin/cocaine addiction and withdrawal symptoms
.Slide67
Cannabis
Cannabis is an illegal drug that can be smoked, producing feelings of well-being.
like
tobacco it can cause lung cancer and bronchitis.
it
can cause permanent damage to the mental health of its users.
Research
has shown that cannabis has some useful painkilling properties, but it is illegal to prescribe it for this use.Slide68
Card sort
Cut and sort into arguments for pro and anti-legislation for cannabisSlide69
It can be used for nervous conditions to relieve anxiety due to its relaxing properties
Cannabis is addictive due to the tobacco it is mixed with
Cannabis can be an effective pain killer for diseases such as cancer and multiple sclerosis
Cannabis can be a starter for harder more dangerous drugs
It would reduce crime as there would be no need for a “black” market for the drug
It will make the drug more readily available to younger citizens
No-one has ever died from an overdose of cannabis
It can be the cause of many mental conditions later in life
It is a stress reliever, which could save money for the NHS, and reduce the amount of people on sick pay.
It slows down your reactions making it almost impossible to make informed decisions
As well as its own effects, it holds all the bad effects of tobacco, when smoked with tobacco.
It contains carcinogens 6 times stronger than those in tobacco, which can cause lung cancer. Slide70
Interpret
data on cannabis use and progression to hard drugs
.Slide71
Does cannabis lead to hard drugs?
Cannabis can cause mental illness in some people
Cannabis is an illegal drug which is bought from dealers
This brings cannabis users into contact with hard drugs such as heroin
Not all cannabis users go on to hard drugs
Nearly all heroin users previously smoked cannabis.Slide72
Withdrawal
Once addicted people will suffer withdrawal symptoms if they don’t take the drug.
Withdrawal symptoms can be
Psychological e.g. paranoia
Physical e.g. sweating and
vomittingSlide73
Websites
Information on cannabis can be found on the NHS website at
www.nhs.uk
by searching ‘the dangers of cannabis’.
Further information on drugs can be found on the following websites
www.dare.uk.com
www.nida.nih.gov
and on the NHS website at
www.nhs.uk
by searching for ‘drugs’Slide74
Summary of Specification content
Steroids and performance enhancing drugs
.Slide75
Learning Outcomes
Evaluate the use of drugs to enhance performance in sport.
Consider the ethical issues of performance enhancing drugs.
Describe some effects and risks of these drugs
.Slide76
Drugs in sport
Some
atheletes
use drugs to enhance their performance
Steroids are used to build up muscle mass, other drugs can improve stamina
Strong painkillers are banned
Athlete might ignore an injury, suffering further damage
Performance enhancing drugs can damage the body permanentlySlide77
Drugs in Sport
Some
athletes take illegal substances to enhance their performance, an activity known as ‘doping’.
There
are 5 'doping
classes which
are categories of banned drugs
:
Stimulants
Anabolic agents - steroids
Diuretics
Narcotic analgesics
Peptides and hormonesSlide78
Drugs in sport
Doping class
Effect on performance
Dangerous side-effects
Stimulants
Make athletes more alert and mask fatigue
Can cause heart failure, addictive
Anabolic agents - steroids
Help athletes to train harder and build muscle
Increased aggression andkidney damage
Diuretics
Remove fluid from the body. Used :to make the weight, eg in boxing
to hide other drug use
Causes severe dehydration
Narcotic analgesics
Mask pain caused by injury or fatigue which can make the injury worse
Addictive
Peptides and hormones
EPO (Erythropoietin) red blood cells - gives more
energy
HGH (Human Growth Hormone) - build muscle
EPO - risk of stroke or heart problems
.
HGH - abnormal growth, heart disease, diabetes, arthritis
etcSlide79
Questions to think about
Is it unethical to take drugs to enhance
performance?
Are
there
any current news items regarding the use of drugs in sport?
Lance Armstrong - cycling
Alan Baxter - SkiingSlide80
Research:
Research
types of drugs used in sport and their effects on the body and produce a table
.Slide81
Activity:
Role
play, write a story or debate about using drugs in sport; random drug testing; getting caught cheating
.