Category Archives: Medicines & Drugs

Thalidomide

In class, we recently discussed the thalidomide incident and how it represented a pivotal shift in the way drugs were developed—particularly in providing an insight into the way drugs taken by a pregnant mother affect her baby. I was reminded of this while reading the news yesterday, as I came across this article discussing a case that could lead to the criminalization of alcohol consumption during pregnancy. (Gander, 2014)

Case: A six-year old girl suffered brain damage because of her mother’s alcohol consumption while carrying her—and it is now being argued that she is the victim of a crime / criminal offense committed by her mother.

This article deeply intrigued me, as I thought about all the implications that a law like this, if passed, could have. As we have (in our Medicines & Drugs unit) studied the effects that alcohol has on the body, I decided to investigate the chemistry of alcohol as it affects her mother and baby to answer the following question: to what extent does alcohol consumption by a mother negatively impact her baby?

I found that, once consumed, most substances are broken down in an intermediate step by enzymes (biological catalysts) to “metabolites”: other compounds that can be easily processed by the body. However, the alcohol we consume (ethanol– CH3CH2OH), is broken down by the body to the toxic and carcinogenic Ethanal (also called ‘Acetaldehyde’: CH3CHO). (Alcohol Metabolism: An Update, 2007)

The breakdown of Ethanol

Figure 1. The breakdown of Ethanol by the body.
(Alcohol Metabolism: An Update, 2007)

Note: ADH (Alcohol Degenerase) and ALDH (Aldehyde Degenerase) are the enzymes that catalyze the reactions.

As we can see from the above equation, in normal (non-pregnant) individuals the Ethanal is usually short-lived as it serves as an intermediate to when it is further broken down to Ethanoic Acid (also called ‘EthylAcetate’: CH3COOH), and then to carbon dioxide and water, after which it is eliminated from the body. (Alcohol Metabolism: An Update, 2007)

Ethanal itself is an aldehyde, and contains 2 carbons, a methyl group and its characteristic aldehyde functional group (C=O double bond).

Structure of Ethanal

Figure 2. Structure of Ethanal
(Environmental Chemistry: Lecture 21, n.d)

In pregnant women, this compound does pose a risk for their babies. A meta-analysis of 14 studies found that while 43% of pregnant alcoholics had high levels of acetaldehyde in their blood, 34% of them gave birth to a baby with ABRD (Alcohol Related Birth Defect). The researchers concluded that acetaldehyde “may play a major role in the cause of ARBD”. (Hard, Einarson, & Koren, 2001)

The precise mechanism as to how acetaldehyde impacts a fetus is not yet known, but alcohol in general has also been found to increase risk of foetal damage, and the risk of miscarriage. (Abuse and Mental Health Services Administration, n.d;  Bailey & Sokol, 2011) Other investigations have linked alcohol to damaging the DNA of a growing/ developing baby in the womb (however, these investigations have so far only been conducted on lab mice). (Medical Research Council, 2011) Already, a 50% increase has been seen in FAS cases (Fetal Alcohol Syndrome) in the past three years, and the Department of Health estimates that 1/100 babies are born with alcohol-related disorders. (Gander, 2014)

The adoptive mother of the six-year old has seen first-hand the consequences that alcohol consumption can have on children, and strongly believes that the legal system should step in and enforce some laws to prevent against further cases of FAS. “You can’t make it a criminal offense if you are still legally saying this a safe amount to drink, or you can drink. It needs to be clear from the start that you can’t [drink]”. (Gander, 2014)

Her argument is also supported by Dr. Raja Mukherjee, a consultant psychiatrist, who asserts that even minimal consumption by a woman during pregnancy puts her baby at risk for FAS, “If you want to guarantee safety and you want to guarantee no risk then no alcohol is the best way forward”. (Gander, 2014)

The implications of a law criminalizing the consumption of alcohol while pregnant will certainly serve to reduce the high numbers of babies suffering from ABRDs such as FAS. Babies suffering from FAS are usually hyperactive and delayed in their development– if exposed to high levels of alcohol while in the womb, they can display withdrawal symptoms such as extreme irritability, shaking, and diarrhea. Additionally, school aged children with FAS often experience learning and behavioral disabilities, and for this reason find themselves falling behind in school. They also are high at risk for having trouble with the law, developing mental health problems and themselves abusing alcohol and/ or drugs. (Canadian Paediatric Society, 2002) Considering this, as well as the previously conducted research demonstrating other harmful effects of alcohol consumption during pregnancy, it is apparent that alcohol is to a large extent extremely damaging to developing babies. A law criminalizing this act may not be the worst idea.

References

(2007). Alcohol Metabolism: An Update. Alcohol Alert, 72. Retrieved February 23, 2014, from http://pubs.niaaa.nih.gov/publications/AA72/AA72.htm

Bailey, B. A., & Sokol, R. J. (2011). Prenatal Alcohol Exposure and Miscarriage, Stillbirth, Preterm Delivery, and Sudden Infant Death Syndrome . Alcohol Research & Health, 34(1), 86-91. Retrieved February 23, 2014, from the NIAAA Publications database.

Paediatric Society. (2002). Fetal alcohol syndrome: What you should know about drinking during pregnancy. Paediatrics & Child Health , 7(3), 177-178. Retrieved February 24, 2014, from the PMC database.

Environmental Chemistry: Lecture 21. (n.d.). NAU Courses. Retrieved February 23, 2014, from http://jan.ucc.nau.edu/~doetqp-p/courses/env440/env440_2/lectures/lec21/lec21.html

Gander, K. (2014, April 23). Drinking alcohol while pregnant could become a crime after landmark test case . The Independent. Retrieved February 23, 2014, from http://www.independent.co.uk/life-style/health-and-families/health-news/drinking-alcohol-while-pregnant-could-become-a-crime-after-landmark-test-case-9147417.html

Hard, M. L., Einarson, T. R., & Koren, G. (2001). The Role of Acetaldehyde in Pregnancy Outcome After Prenatal Alcohol Exposure. Therapeutic drug monitoring, 23(4), 427-434. Retrieved February 23, 2014, from the PubMed database.

Research Council. (2011, July 6). Excess alcohol could damage our DNA. Medical Research Council News. Retrieved February 23, 2014, from http://www.mrc.ac.uk/Newspublications/News/MRC008040

Abuse and Mental Health Services Administration. (n.d.). Effects of Alcohol on the Developing Embryo and Fetus. FASD Center for Excellence. Retrieved February 23, 2014, from http://fasdcenter.samhsa.gov/educationTraining/courses/CapCurriculum/competency1/effects1.aspx

Decongestants – Visine for Your Nose?

A few weeks ago I traveled to Beijing for a golf tournament.  Unfortunately, I have terrible allergies to pollen and other air pollutants, so as soon as the plane landed in Peking and I stepped into the airport I immediately began my sneezing fit.  Ordinarily, after sneezing, your nose will feel congested for a few moments and then will return to “normal.”  However, because the air was so thick with pollutants, my nose remained congested and I continued to sneeze on approximately five-minute intervals.  Frustrated that I couldn’t breath well through my nose and because my mouth was becoming dry, I hesitantly decided to take a decongestant pill.  This has been a regular occurrence since I was a child: allergies act up, nose becomes congested, pop a pill, few minutes later I can breath again.  For the longest of time, I never questioned this process.   Then, a few months ago, I found that I was always congested, even on the days when pollution levels were low and there were little to no blooming flowers.  I couldn’t breath normally without taking a decongestant and ended up it everyday for approximately two and a half weeks.  As I look back, it was quite foolish of me to do so.  I didn’t know anything about the drug other than it helped me breath, and I didn’t think much of the fact that I couldn’t breath normally.  So as I arrived in Beijing two weeks ago, I wondered, what does this pill really do to me, how does it work, and did I harm myself beyond repair?

Typically, when people think of nasal congestion, they think it is a result of copious amounts of mucus or fluid forming in their nose.  However, this is not the case.  Nasal congestion occurs when the arterioles (small blood vessels) in the membranes of the nose dilate and become inflamed.  This results in a kind of swelling in the nose and makes it difficult to breath because the passage has narrowed or closed off.  (Kaneshiro, N. n.d.)

When individuals take nasal decongestants, such as pseudoephedrine hydrochloride (C10H16ClNO) (Pseudoephedrine Hydrochloride. n.d.)

Chemical Structure of Pseudoephedrine
Chemical Structure of Pseudoephedrine HCl

the chemical will bind to alpha receptors (receptors on the membranes of nerve cells) to send a signal to the membranes in the nasal passages to force the blood vessels to constrict.  (Guzman, F. n.d.)

This inhibits the dilation of the arterioles and reduces the inflammation, therefore relieving congestion and allowing the nasal passages to relax.  Based on principle, nasal decongestants are similar to red eye reducing eye drops in that the topical eye drops constrict the blood vessels in the eye to reduce redness.

While an addiction in the traditional sense cannot be developed from long-term use of decongestants, a kind of dependency and tolerance can build up over time from using them daily.  With daily use, the body will become tolerant to the decongestant and will begin to produce chemicals and antibodies to combat the effects of the drug.  In this case, it will begin to produce vasodilators in order to reverse the effects of the decongestant (which are now perceived by the body as unnecessary).  As a result, higher doses of the drug are needed to achieve the same decongestant effects as originally produced.  (Discovery Health “Can nasal sprays be addictive?”. n.d.)  With continued use for many months, or years, continuously using a decongestant can increase blood pressure as it constricts the blood vessels, or can create other, more severe side effects such as tachycardia and seizures.  (Pray, S., & Pray, J., n.d.)

Vasodilation in Arteries
Vasodilation in Arteries

Fortunately, the tolerance that may develop from continued use of decongestants can be reversed.  If use is discontinued for a few weeks, it gives the body the time it needs to return to “normal” and the changes it made to produce the antagonistic chemicals (to the effects of the drug) will disappear.  This implies that even if a tolerance and “dependency” is developed, they can easily be annulled and the body will lose its tolerance.  After the body has returned to a normal state, should the need arise, individuals may choose to take the decongestant and can expect to experience the full effects of the decongestant – open nasal passages and the ability to breath easy.  (Discovery Health “Can nasal sprays be addictive?”., n.d.)

After researching, I realized the severity of taking decongestants for extended periods of time.  Prior to researching, I had assumed that decongestants were not, “serious” drugs in that they couldn’t possibly have many negative long-term effects.  However, I now realize that drugs, regardless of their purpose and accessibility, are strong chemicals used to create chemical changes in our bodies.  While I will never take a decongestant for more than seven consecutive days, the occasional use of it is acceptable and in the long run, it will not harm my body and has not done any lasting damage to my body.

References

Discovery Health “Can nasal sprays be addictive?”. (n.d.). Discovery Health “Discovery Fit & Health”. Retrieved October 12, 2013, from http://health.howstuffworks.com/mental-health/question546.htm

Guzman, F. (n.d.). Alpha receptors | CME at Pharmacology Corner. Medical Pharmacology | Pharmacology Corner. Retrieved October 21, 2013, from http://pharmacologycorner.com/alpha-receptors-1-2/

Kaneshiro, N. (n.d.). Nasal congestion: MedlinePlus Medical Encyclopedia. National Library of Medicine – National Institutes of Health. Retrieved October 10, 2013, from http://www.nlm.nih.gov/medlineplus/ency/article/003049.htm

MedicineNet.com. (n.d.). Pseudoephedrine – Oral, Afrinol, Novafed, Sudafed . Retrieved October 10, 2012, from www.medicinenet.com/pseudoephedrine-oral/page5.htm

Pray, S., & Pray, J. (n.d.). Safe Use of Nasal Decongestants. Medscape Multispecialty . Retrieved October 13, 2012, from www.medscape.com/viewarticle/484014

Pseudoephedrine (Oral Route) – MayoClinic.com. (n.d.). Mayo Clinic. Retrieved October 13, 2013, from http://www.mayoclinic.com/health/drug-information/DR601759

Pseudoephedrine Hydrochloride. (n.d.). ChemicalBook—Chemical Search Engine. Retrieved October 11, 2013, from http://www.chemicalbook.com/ProductChemicalPropertiesCB1399716_EN.htm

Pseudoephedrine Information from Drugs.com. (n.d.). Drugs.com | Prescription Drug Information, Interactions & Side Effects. Retrieved October 12, 2013, from http://www.drugs.com/pseudoephedrine.html

Sudafed decongestant tablets and liquid (pseudoephedrine). (n.d.). NetDoctor.co.uk – The UK’s leading independent health website. Retrieved October 13, 2013, from http://www.netdoctor.co.uk/ear-nose-and-throat/medicines/sudafed-decongestant-tablets-and-liquid.html

Images:

http://www.chemicalbook.com/ProductChemicalPropertiesCB1399716_EN.htm

http://www.daftblogger.com/wp-content/uploads/2011/07/Vasodilation.jpg

Analgesic Properties of …. Snail Venom?

I know what you’re probably thinking; snails have venom? This was exactly what I had thought when I came across a post on the popular social media website, Reddit. I was intrigued because I didn’t even know that snails have venoms and that they could even be used as painkillers. Turns out, the post wasn’t referring to the typical snails you find in a garden, but instead, the cone snails that are typically found in warm and tropical seas and oceans. Interested by the topic, I decided to investigate more on how exactly the snail venom can act as an analgesic, and its possible significance in the medical field.
Analgesics are commonly known as painkillers, and are divided into two types, mild and strong. Mild analgesics, such as aspirin and paracetamol, are used to treat the typical headaches, toothaches, or sore throats by, “preventing the stimulation of nerve endings at the site of pain and by inhibiting the release of prostaglandins, the chemical responsible for the widening of blood vessels near the site of the injury, from the site of injury to provide relief to inflammation, fever and pain” (Brown, Ford, 2008). For more severe pains, strong analgesics bind to opioid receptors in the brain to alter the perception of pain by blocking the transmission of pain signals between brain cells (Brown, Ford, 2008). Today, many cancer patients, diabetic patients, and other victims of chronic pain are treated with strong analgesics like morphine and heroine. The problem is that these opioids are highly addictive and repeated usage can lead to tolerance, which a reduced response to the drug. Scientists have discovered that the venom found in cone snails have analgesic properties that are 10000 times more powerful than morphine, and the best part about the venom is that it is not addictive. (National Geographic, n.d.) Since cone snail venom is clearly a better analgesic than opioids, I questioned why isn’t it replacing morphine and heroine as the common analgesics to treat victims with chronic pain?
deadly cone

Figure 1: Image of a Marble Cone Snail (National Geographic, (n.d.))

Although they are only about four to six inches long, these carnivorous mollusks they have venoms poisonous enough to kill 15 adult human beings (Compassionate Healthcare Network, 2004). To do this, the cone snails have teeth that are similar to hypodermic needles that inject venom into their preys. The venom instantly paralyzes the victims by interfering with the communications of the nervous systems. In a typical nervous system, the neurons transmit chemical signals to another neuron through ion channels. The chemical signals are repeatedly transmitted from neuron to neuron until it reaches a muscle cell and tells it to contract. The venom of cone snails contain hundreds of thousands of short polypeptide proteins that blocks specific ion channels to prevent neurons from transmitting chemical signals, inhibiting muscle movement, leading to paralysis (Chadwick, 2013)(Discovery News, 2013).
So how can something so deadly be beneficial to humans? For many years, scientists have studied several hundreds of the short polypeptide proteins, called conotoxins, before the isolating analgesic conotoxin agent and creating the synthetic version named Ziconotide, or often known by the name Prialt. Unlike other analgesics, Ziconotide inhibits pain in a different way. People feel pain because electrical signals are carried across a synapse from the pain fibers to the nerve cells in the spinal cord that signals the brain. In order for the electrical signals to cross the synapses, electrical signals has to be converted into a chemical signal with the help of calcium. Ziconotide blocks the calcium gateways in the nerve fibers so that the chemical signals cannot cross the synapse to reach the nerve cells in the spinal cord. As a result, the brain does not receive the signal and therefore, one does not perceive pain (Compassionate Healthcare Network, 2004).
Although Ziconotide is 10000 times more powerful than morphine and is non-addictive, it is not commonly use to treat patients with chronic pain. This is because like any other drug, Ziconotide comes with many side effects such as abnormal vision, amnesia, vertigo, anxiety and possibly more undiscovered side effects. Furthermore, ziconotide cannot be administered orally because the body will break down the swallowed ziconotide before it can reach the receptors they need to reach. Therefore, zinconotide is currently administered with a direct injection into the spinal cord, a costly and invasive method of drug delivery.
107452-89-1

Figure 2: Structure of Ziconotide (ChemBlink, (n.d.))

The discovery of Ziconotide has many implications in the medical field. Firstly, future research can be synthesized or modified Ziconotide to withstand the digestive processes of the body so that zinconotide can be taken more conveniently and without economic strain. In fact, scientists have already engineered a circular shaped synthetic Ziconotide conotoxin that is more stable to be administered orally (Discovery News, 2013). Ziconotide that can be administered orally will be more accessible to patients with chronic pain that have developed tolerance to morphine and heroine and need stronger analgesics to suppress the pain. Secondly, the discovery of Ziconotide suggest a bigger picture that many medical issues that people face today could possibly be cured by something in nature. There are so many microorganisms, animals and plants on Earth that have not yet been discovered. Perhaps, the secret to the cures of cancer and other illnesses lie in the Amazon jungle or at the bottom of the Mirana Trench.

References:
Brown, C., Ford, M. (2008). Higher Level Chemistry Developed Specifically for
the IB Diploma. England: Pearson Education Limited.

Chadwick, A. (2013). Venom. The Cone Snail. Retrieved September 5, 2013, from
http://www.theconesnail.com/explore-cone-snails/venom

Compassionate Healthcare Network. (2004). Cone Snail Venom Attacking Pain.
Compassionate Healthcare Network. Retrieved September 5, 2013 from http://www.chninternational.com/cone_snail_venom_attacking_pain.htm

Discovery News. (2013, February 11). Snail Venom Inspires Powerful Pain
Reliever. Discovery News. Retrieved September 5, 2013, from http://news.discovery.com/human/snail-venom-painkiller.htm

National Geographic. (n.d.). Geographic Cone Snail. National Geographic.
Retrieved September 5, 2013, from http://animals.nationalgeographic.com/animals/invertebrates/geographers-cone-snail/

Marble Cone Snail [Web Graphic]. (n.d.) Retrieved September 5, 2013 from http://lhs204.stellpflug.com/Period%202/Canutito%20Payan/Marble%20cone%20snail.html

Wikipedia. (n.d.). Conus. Wikipedia. Retrieved September 5, 2013 from
http://en.wikipedia.org/wiki/Conus

Wikipedia. (n.d.). Zinconotide. Wikipedia. Retrieved September 5, 2013 from
http://en.wikipedia.org/wiki/Ziconotide

Ziconotide Acetate [Web Graphic]. (n.d.). Retrieved September 5, 2013 from http://www.chemblink.com/products/107452-89-1.htm

A Silver Bullet?

When my sister went to get her ears pierced over the summer, my mother recounted how, instead of using devices like the sterilized piercing guns used today, Indian people used to use thin wires of silver to pierce their ears because of its supposed antimicrobial properties. This intrigued me. Of course I had heard of molecules like penicillin that could kill off bacteria, but never before had I considered that a single, naturally occurring element would be able to accomplish the same. How does this seemingly benign molecule cause so much damage?

The transition metal itself is biologically inert; the real structural damage stems from its Ag+ ion. This is released when Ag comes into contact with moisture (Kenyon University & Garduque), and does its work inside the microbe itself. I stopped as soon as I read that last part. Something didn’t seem right. I had learned from my AP Biology class that the majority of cell membranes are hydrophobic. They consist mainly of a phospholipid bilayer with the polar hydrophilic heads facing outwards into the environment and inwards towards the cell’s cytoplasm, and the long, non-polar hydrophobic tails made of hydrocarbons chains in-between. These tails don’t like to let polar atoms and molecules in and out by themselves, and I thought it highly unlikely that microbes would have special protein channels built to let in damaging substances. So how did these Ag+ molecules get in in the first place?

figure_04_14_labeled

Figure 1: The Phospholipid Bilayer

(Midlands Technical College, n.d.)

A while of digging later, I had no definitive answer. Some research hypothesized that the ions got through via protein channels made for other ions (Kenyon University & Garduque), but since there wasn’t any conclusive evidence I still remained somewhat skeptical. I continued to research the effects of the Ag+ ions, tough, and the evidence I found in favor of its microbial properties was strong enough for me to overlook this tiny blip.

What I found was that Ag+ works in three major ways: by reacting with the disulfide (R-S-S-R) and sulfhydryl (R-S-H) groups of microbial protein structures, by interacting with the microbial DNA, and by damaging the membrane structures of the cells. In the first method, the interactions of the ion change the quaternary (outer) structure of some of the microbes key proteins and enzyme, leaving it unable to function properly. The ion reacts to form, “a stable S-Ag” bond with the sulfhydryl-containing compounds, which are involved in, “trans-membrane energy generation and ion transport,” located in the microbial cell membrane, and are also believed to, “take part in catalytic oxidation reactions that result in the formation of disulfide bonds,” which are key components of a protein’s outer structure. The latter doesn’t involve Ag+ acting as reactant, but rather as a catalyst between existing the oxygen and hydrogen portions of the sulfhydryl groups. This reaction also ends up releasing H2O as a product (Jung, Koo, Kim, Shin, Kim & Park)

500px-Quaternary_structure

Figure 2:“Structure of the protein 1EFN, with focus on the quaternary structure.”

(Wikipedia, 2012)

Next, while it is clear that the Ag+ ions do have effects on microbial DNA, it is unclear exactly how it interacts with the DNA. Some scientists suggest that, “…they interact preferentially with bases in the DNA (Jung, Koo, Kim, Shin, Kim & Park),” while others think that the ions’ various other reactions in the cell, “…lead to an increased production of reactive oxygen species,” that in turn damages the microbe’s DNA, eventually leading to its death (Morones-Ramirez, Winkler, Spina & Collins, 2013). Finally, the microbe’s increased cell membrane permeability, which is also said to occur as a byproduct of these reactions and subsequent metabolic disruption and homeostatic iron levels, which, “…[restores] antibiotic susceptibility to a resistant bacterial strain (Morones-Ramirez, Winkler, Spina & Collins, 2013).”It is important to note, however, that this does not reverse the bacterial resistance, only temporarily weakens it.

400px-FIGURE_3_Feng_et_al

Figure 3: “Figure 3. Treatment of cells with Ag+ results in DNA condensation, cell wall damage, and silver granule formation. (A) E. coli and (B) S. aureus cells with and without Ag+ treatment were observed with transmission electron microscopy (Feng et al., 2000).”

(Kenyon University, n.d.)

As much as it would be great to regard the Ag+ ion as an end to all our troubles, it’s not without its side effects. Some people are allergic to silver (Elsner & Hipler, 2006), and those that aren’t are in danger of having the element accumulate in their bodies (Fung & Bowen, 1996). Long-term intake can lead to increased levels of skin silver and/or silver sulfide particle levels. Sunlight causes these particles to darken, leading to a skin discoloration known as argyria (Elsner & Hipler, 2006). Furthermore, silver is no different from traditional antibiotics in that it is simply ‘another chemical’ in action. As such, it is plausible that overuse of it may eventually lead to increased silver resistance in bacteria, and then we would simply end up in the same place we are now with the antibiotic resistance problem; at best we’ll just delay our troubles. Still, since there’s little doubt in the actual antimicrobial properties of silver, all of this doesn’t completely take it off the table. If it were possible to distribute the dosages in a way to avoid some of the adverse side effects, we could take advantage of the aforementioned delay. Time is arguably the most valuable resource for humans, and with all of the major medical advances taking place in the modern age, that extra time might be just what we need to come up with a true solution.

Works Cited

Elsner, P., & Hipler, U. -. (2006). Silver in health care: Antimicrobial effects and

safety in use. Biofunctional Textiles and the Skin, 33, 17-34. doi: 10.1159/000093928

Retrieved from

http://www.karger.com/Article/Abstract/93928

Fung, M. C., & Bowen, D. L. (1996). Silver products for medical indications: Risk-

benefit assessment. Clinical Toxicology, 34(1), 119-126. doi: 10.3109/15563659609020246

Retrieved from

http://informahealthcare.com/doi/abs/10.3109/15563659609020246

Jung, W., Koo, H., Kim, K., Shin, S., Kim, S., & Park, Y.

(2008). Antibacterial Activity and Mechanism of Action of the Silver Ion in Staphylococcus aureus and Escherichia coli. Applied Environmental Microbiology, 74(7), 2171-2178 doi:10.11.28/AEM.02001-07.

Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292600/

Kenyon University. , & Garduque, G. (n.d.). Silver as an antimicrobial agent.

Retrieved from http://microbewiki.kenyon.edu/index.php/Silver_as_an_Antimicrobial_Agent

Midlands Technical College. (Producer). The Phospholipid

Bilayer [Web Graphic]. Retrieved from http://classes.midlandstech.edu/carterp/courses/bio225/chap04/lecture5.htm

Morones-Ramirez, J. R., Winkler, J. A., Spina, C. S., & Collins,

J. J. (2013). Silver enhances antibiotic activity against gram-negative bacteria. Science Translational Medicine, 5(190), 198ra81. doi: 10.1126/scitranslmed.3006276

Retrieved from:

http://stm.sciencemag.org/content/5/190/190ra81

Wikipedia. (Producer). (2012, August 27). Protein structure with focus on the

quaternary structure [Web Graphic]. Retrieved from http://en.wikipedia.org/wiki/File:Quaternary_structure.png

Red Bull- Energy, or Not

Sometimes exhausted from volleyball practice, I would go to the cafeteria to buy a gatorade as it claims to replenish energy. However, I never understand how the chemistry behind energy drinks work so I decided to focus on one of the most popular energy drink, Red Bull, “with sales in the region of 1 billion.” (Thomas, 2007) Through further investigation, Red Bull claims that “the unique combination of ingredients caffeine and taurine” (McKellar, 2013) improves one’s cognitive ability and muscular performance. This leads to my main question: How can the customer trust what Red Bull says? I am curious because there are many times where manufactures states things that are not always true.

In order to understand if Red Bull is making accurate claims, I investigated the chemistry and effect of the two main ingredients, caffeine and taurine.  Caffeine is one of the most widely used stimulants in the world. The structure of caffeine consists of heterocyclic rings, a tertiary amine group and two amide groups as shown in diagram 1. “Caffeine works by blocking the effects of adenosine, a brain chemical involved in sleep. It causes neurons in the brain to fire and the pituitary gland initiates the body’s response by releasing adrenaline.” (Watson) In AP Biology, I learned that adrenaline causes the liver to release more sugar than the body needs into the blood stream. The extra sugar in the blood stream then is converted to energy through cellular respiration.

cafmol

Diagram 1: Caffein Structure (itech,2008)

Understanding the effects of caffeine, I went on to research the chemistry and effect of taurine. Taurine is an amino acid, with an amino group(digram2), naturally found throughout the body. It is produced in the liver and the brain and taurine plays an important role in muscle contraction. “Taurine increase force generation by enhancing Sarcoplasmic Reticulum’s Ca2+ accumulation and release.” (Kim, 2003) I learned that in AP Biology, Ca2+ are intracellular signaling molecule for muscled contraction. This shows that an increase concentration in Ca2+ causes the muscles to contract more, therefore causing more movement of the body. Force generation is how much energy is generated in the body for the muscles to properly contract. Looking at the effect of taurine, it can be inferred that increasing the concentration of taurine in one’s body through Red Bull could possibly improve the bodies force generation. “However, no definite study exists on the absorption rate of taurine following dietary ingestion into muscle cells.” (Kim, 2003) “ The evidence for [taurine’s] implicated role is weak still; much more research needs to be done to fully understand taurine’s role.” (Batts, 2006)  According to Kim (2003), “an increase plasma level of taurine [concentration] from dietary concentration is unlikely to cause a sudden influx of taurine.”

Taurine

Diagram 2: Taurine Structure (chemistry, 2012)

Looking at these two main compounds in Red Bull, they seem to suggest that caffeine could perhaps be the sole ingredient responsible for the energetic effect of Red Bull. In a study, “Alford et al. compared the effects of Red Bull with carbonated mineral water as placebo-control and reported that the experimental group showed increase subjective alertness, concentration, and physical endurance. However, they also noted that the improvements in cognitive functions were similar to those observed in caffeine study.” (Kim, 2003) This experiments implies that while taurine has effects in the body, the main contributor to the responses from energy drinks is caffeine. In addition, there hasn’t been enough evidence to claim that taurine obtained from supplements can provided extra movement of the body.

In conclusion, base on the research of the two compounds, it shows that probably only caffeine is responsible for the effects of Red Bull stated by the manufacture. This means that the manufacture’s claim that there is a combination of ingredients to provide the effect is most likely false. Perhaps the manufacture’s purpose was to create placebo effect on the consumer. With the consumers knowing that there are “several” things contributing to the effect, they are prone to develop the chemical’s actual effect. This suggests that many products in the market are not as what the manufactures claim. While in this case the false information seems to do no harm, there could be potential danger to the consumers.

Bibliography

Batts, S. (2006, June 17). Pop Science: The Chemistry Behind Red Bull’s “Wings”. Retrospectacle: A Neuroscience Blog. Retrieved August 28, 2013, from scienceblogs.com/retrospectacle/2006/06/17/pop-science-the-chemisty-behin/

Caffeine Structure [Image]. (2008). Retrieved from http://itech.dickinson.edu/chemistry/?cat=92

Kim, W. (2003). Debunking the Effects of Taurine in Red Bull Energy Drink [eScholarship]. eScholarship | University of California. Retrieved August 28, 2013, from http://www.escholarship.org/uc/item/65k8r

McKellar, C. (2013, August 28). Red Bull Gives You Wings – RedBull.com. Red Bull Gives You Wings – RedBull.com. Retrieved August 28, 2013, from http://www.redbull.com/en

Taurine Structure [Image]. (2012) Retrieved from http://chemistry.about.com/od/factsstructures/ig/Chemical-Structures—T/Taurine.htm

Thomas, P. (2007, March 1). Behind the label: Red Bull – The Ecologist. Environment, Climate Change, News, Eco, Green, Energy – The Ecologist. Retrieved August 28, 2013, from http://www.theecologist.org/green_green_

Watson, S. (n.d.). HowStuffWorks “How do energy drinks work?”. HowStuffWorks “Science”. Retrieved August 28, 2013, from http://science.howstuffworks.com/innovation/edible-innovations/energy-drink.htm

Medicine for the Incurable Disease

Recently one of my closest friends was diagnosed with epilepsy. Prior to this, epilepsy treatment had always been an unknown topic and I was fairly sure that the treatments were very limited if not ineffective. I’d heard about treatment medicines to slow down your brain, making you sluggish, dull, and personally thought that the side effects outweighed the benefits. As I was told his news, I decided that as I spend a deal of time around him that I should really be aware of what to do in the event of a seizure. While doing this, I came across treatments for epilepsy and was surprised to see abundance treating its symptoms. I became interested as to how effective the current treatments for epilepsy are, as my friend began his drugs this summer.

Epilepsy can be defined as “a common serious neurological condition where there is a tendency to have seizures that start in the brain.” (Epilepsy Society, 2013) There are 40 types of epilepsy (Epilepsy Society, 2013), all without known cures but with a large amount of preventative medicine to stop seizures and treat symptoms. For the sake of my search, I focused upon the most common drugs used to treat epilepsy; Depakene ® (valproate, valproic acid) and Zonegran ® (zonisamide), which my friend is currently taking. Depakene works to target epilepsy by increasing the “level of gamma-aminobutyric acid in brain” (Farlex) thus reducing seizure activity. “ Gamma-Amino Butyric acid (GABA) is an amino acid which acts as a neurotransmitter in the central nervous system. It inhibits nerve transmission in the brain, calming nervous activity. “ (Denver Naturopathic Clinic) Zonegran is also known to affect the levels of this acid, however its precise method of preventing seizures is unknown. It is thought that zonisamide prevents the movement of sodium and calcium, as they must move into nerve cells to build up an electrical signal to throughout the brain. By stopping nerve cells from firing rapid electrical signals this stabilizes brain activity and prevents seizure-causing signals from spreading. (Netdoctor) Although Netdoctor at first seemed to be an unreliable source, I noted that “Over 250 of the UK’s and Europe’s leading doctors and health professionals write, edit and update the contents of NetDoctor.co.uk.”(Netdoctor) and the information, particularly the one I took note form, is not written by the general public. 

I dove deeper into the adverse reactions stemming from the use of Depakene, which were copious. Notable common side effects included but were not limited to “vomiting, hair loss, and a decrease in thinking speed.” (WebMD) Long term usage of the drug led to possible hearing loss, liver damage, decreased platelets (clotting cells), bone thinning and pancreatic issues. (WebMD). WebMD, like Netdoctor, turned out to be a reliable source when i was researching as many of their articles were written by experts in the field. Depakene turned out to not be the only epilepsy treatment with severe side effects, as the use of Zonegran can induce metabolic acidosis, fatal skin rashes, kidney stones, reduced white and red blood cell counts, and problems with concentration, attention, memory, thinking, speech, or language. (FDA, 2012)

Treatment for epilepsy, though abundant, is still limited. Many medicines counter the symptoms of epilepsy, but do not actively cure the disease itself.

For 70% of patients with epilepsy, drugs can control seizures. (WebMD) Medicine to prevent epilepsy, though beneficial, is still very limited as it does not cure the disease and has severe side effects.  As these medications are dangerous and do not cure epilepsy, are they worth taking at all? These medications do actively prevent the biggest symptom of epilepsy, seizures. I can conclude personally, that they are worth taking, as the risk of having a spontaneous seizure is reduced if not eradicated. Nevertheless, takers should be fully aware of the side-effects and take these medicines with caution and be fully aware of the risk of severe side effects. Seizures interfere with daily life, preventing the epileptic from daily activities such as driving or swimming for the fear of having a seizure and crashing or drowning. Though the medications have severe side effects, the implications of these medicines mean that people with epilepsy can continue to have a regular lifestyle without worry of personal injury. Currently treatments for epilepsy are effective to an extent, and I do hope that research into the disease yields brighter results for cures in the future.

Work Count: 628

References:

References

Denver Naturopathic Clinic. (n.d.). GABA.  Welcome to the Denver Naturopathic Clinic . Retrieved September 6, 2013, from http://www.denvernaturopathic.com/news/GABA.html

Epilepsy society. (2013, May 5). What is epilepsy | Epilepsy Society. epilepsy society | Epilepsy Society. Retrieved September 6, 2013, from http://www.epilepsysociety.org.uk/what-epilepsy#.UhGGNKA2W0s

FDA. (2012, January 24). Medication Guide ZONEGRAN®. fda.gov. Retrieved September 3, 2013, from www.fda.gov/downloads/Drugs/DrugSafety/UCM152828.pdf

Farlex. (n.d.). Depakene – definition of Depakene by the Free Online Dictionary, Thesaurus and Encyclopedia.. Dictionary, Encyclopedia and Thesaurus – The Free Dictionary. Retrieved September 6, 2013, from http://medicaldictionary.thefreedictionary.com/Depakene

NetDoctor. (n.d.). Zonegran (zonisamide). NetDoctor.co.uk – The UK’s leading independent health website. Retrieved September 6, 2013, from http://www.netdoctor.co.uk/brain-and-nervous-system/medicines/zonegran.html#ixzz2cOMj5wr

WebMD. (n.d.). Common Epilepsy Seizure Medications: Types, Uses, Effects, and More. WebMD – Better information. Better health.. Retrieved September 6, 2013, from http://www.webmd.com/epilepsy/medications-treat-seizures

Brain Chemistry

Being from the United States, a country that is facing the harsh issue of obesity, I decided that it would be very interesting to research about exercise. Caroline wrote a blog post about brain chemistry and she put much emphasis on dopamine.  I found it very interesting that altered levels of dopamine can have such a large affect on the body.  I wondered what kinds of chemicals and neurotransmitters were released when someone exercised.  When you think about it, many people get incredibly positive effects from exercise, meaning that it must force a release of something in the brain to induce this.  But which neurotransmitters and hormones are responsible for this? Since we just recently did the medicines and drugs unit, I thought it would be beneficial and quite helpful to be able to research about exercise and be able to truly understand what it all means.  When I was doing my primary research, all kinds of things came up about how exercise makes you smarter, fixes health problems, reduces stress, helps you become more fit, and much more.  Wouldn’t everyone be exercising a very large amount if they knew this?


To begin, regular exercise can alleviate anxiety and boost energy. When you exercise, you work your heart, thus making it stronger, but also increased heart pumping increases the release of certain types of neurotransmitters, such as serotonin, norepinephrine and GABA. Even small amounts of activity can help the body be more resistant to stressful situations even hours later. To expand on the effects of these neurotransmitters, serotonin (C10H12N2O) leaves you happier and more relaxed after working out. (Branch, S.) This is because the physical activity stimulates the release of these chemicals. When reading about this, I automatically thought of all of the drugs we learned about.  I went back to the mouse party simulation and reviewed how these drugs work. I noticed something in common with all of these drugs; they all have relate in the way they work with chemicals in the brain. All of the drugs either work with serotonin, dopamine or GABA receptors. For example, LSD deals with the serotonin receptors.  It binds to serotonin receptors and it binds to various ones, sometimes inhibiting them and sometimes exciting them. LSD excites a particular part of the brain, the locus coeruleus. This area of the brain forms feelings of wakefulness, etc.  LSD also has effects such as changed body temperature and heart rate which also occurs when you exercise.(Mouse Party)  To connect this to exercising, when you exercise, serotonin is released, making the person who was working out feel more relaxed and happy. Even though exercise is not a drug that chemically alters the brain, it certainly acts in similar ways as many drugs are meant to act.


Although exercise is certainly not a drug and usually it can be closely connected because it has many of the same effects and usually creates better moods, more relaxation, and a more stimulated brain. With this being said, it is not to get mixed up because drugs also have many negative effects which are not associated with exercising.  Additionally, norepinephrine is a very important neuromodulator in the brain.  Many scientists believe that the norepinephrine concentrations are much higher in the brain during physical activity, thus leading to the body being able to deal with stress more effectively. 50% of norepinephrine is created in the LC (locus coeruleus) and this area of the brain is “involved in emotional and stress responses.”(Dishman, R.)

Serotonin

Serotonin Structure

Serotonin Neuron

Serotonin Neuron

Endorphins also play a key role in helping to decrease stress levels.  Endorphins are created in the “pituitary gland in response to stress or pain. They bind to opioid receptors in neurons, blocking the release of neurotransmitters and thus interfering with the transmission of pain impulses to the brain”.(McGovern, M.) When you exercise, the activity stimulates the release of endorphins and these help you to deal with the stress and pain dealt with during exercise. For example, “runners high” is considered to be because the increased release of endorphins is responsible for the euphoria feeling after running and thus the runner feels a very happy, relaxed feeling. (McGovern, M.) Endorphins are much like drugs in the way that their effects have a very addictive effect and the person exercising builds a tolerance to these, and must exercise more to get the same euphoria feeling over time. “In fact, endorphins attach to the same neuron receptors as opiates such as morphine and heroin.” (McGovern, M.) Many scientists believe that only a small amount of people exercise regularly because the endorphins take about 30 minutes to kick in.  This means that the person doesn’t feel these positive effects until a while after their exercise and only associates exercising with stress and pain.


To continue, exercise and physical activity can also make your brain stronger, thus leading to a more efficient brain. “Exercise slows the loss of gray matter in the brain.” This is because the chemicals that are produced and released while exercising help to fight brain-killing chemicals that are produced during stressful periods. According to Forbes, “ In the long term, it [exercise] can even help starve off brain aging and Alzheimer’s. This works on the cellular level through neuroplasticity, the ability of the brain to improve itself with blood flow and levels of brain-derived protein. He calls it “miracle-gro” for the brain, and it all comes from regular exercise!” Neuroplasticity changes the neural pathways when changes in behavior, environment, or even injuries.  Neuroplasticity is very recognized “in healthy development, learning, memory, and recovery from brain damage.”(Branch, S.) I think that this is very important because when you exercise and work your body and strengthen your brain, very complicated processes take place to alter and help the brain to possibly recover, and or build cells, etc.


To continue, when exercise takes place, the stress you put on your own body forces the brain to create new neurons (called neurogenesis) “especially in the hippocampus- the area in charge of learning and memory”.  This happens because when exercise occurs, you are stressing your body and it’s systems and in order for it to recover, it needs to repair this damage.  This is significant because it leads to an “increase in brainpower” and thus makes the brain more efficient and stronger. (Andersen, C.) This gets mixed up very frequently with the thought that if you exercise enough, you will be a genius. This is not true.  If you overexercise, it is possible that your brain will actually become weaker and it will be more difficult to learn.

hippocampus

Hippocampus in the Brain


While it may not be possible to exercise enough to become a genius, it is definitely possible “to exercise to happiness.”(McGovern, M.) To understand how this works, when a person becomes depressed, they show a lack of vital neurotransmitters such as norepinephrine and serotonin.  As said before, exercise increases the concentration of these neurotransmitters in the brain, thus leading to an increased mental health and stimulating the brain.  As seen below, the depressed brain has much less activity in it, while the “not-depressed” brain has much more activity.  When exercise occurs and the concentration of positive neurotransmitters increases, depression can be alleviated.


c7_pet_depression

Effects of Depression on the Brain


When I did my research, I couldn’t help but connect this to economics.  Even though this is a health aspect, it has many economic effects. Every year, the United States spends millions, even billions on health care and running can have so many positive effects on the body that could potentially lower these costs. If physical education and exercise was incorporated into schools more, depression rates could drop, obesity could start to plateau and stop growing, and the government in turn could save large amounts of money on healthcare and put it to other causes, such as research and development to help healthcare in the future.  But first, the mentality needs to change.  People have become lazy and thus don’t have any motivation to exercise.  More education needs to take place to educate children and adults on the dangers of obesity, and also the positive effects of exercise on your body.

References

Websites:

Andersen, C. (n.d.). Exercise and the Brain: 4 Ways Working Out Changes the Human Brain – Shape Magazine. Shape Magazine – Diet, Fitness, Recipes, Healthy Eating Expertise. Retrieved May 30, 2013, from http://www.shape.com/lifestyle/mind-and-body/your-brain-exercise


Branch, S. (2011, February 24). How Exercise Alters Brain Chemistry | LIVESTRONG.COM. LIVESTRONG.COM – Lose Weight & Get Fit with Diet, Nutrition & Fitness Tools | LIVESTRONG.COM. Retrieved May 30, 2013, from http://www.livestrong.com/article/390773-how-exercise-alters-brain-chemistry/


Cohen, J. (2012, May 8). 6 Ways Exercise Makes You Smarter – Forbes. Information for the World’s Business Leaders – Forbes.com. Retrieved May 30, 2013, from http://www.forbes.com/sites/jennifercohen/2012/05/08/6-ways-exercise-makes-you-smarter/


Dishman, R. (n.d.). Exercise Fuels the Brain’s Stress Buffers. American Psychological Association (APA). Retrieved May 30, 2013, from http://www.apa.org/helpcenter/exercise-stress.aspx


Exercise: 7 benefits of regular physical activity – MayoClinic.com. (n.d.). Mayo Clinic. Retrieved May 30, 2013, from http://www.mayoclinic.com/health/exercise/HQ01676


Girdwain, J. (2013, May 28). How to fix health problems with exercise – CNN.com. CNN.com – Breaking News, U.S., World, Weather, Entertainment & Video News. Retrieved May 30, 2013, from http://www.cnn.com/2013/05/28/health/fix-problems-exercise/index.html?hpt=he_t2


McGovern, M. (n.d.). The Effects of Exercise on the Brain. Serendip Studio. Retrieved May 30, 2013, from http://serendip.brynmawr.edu/bb/neuro/neuro05/web2/mmcgovern.html


Mouse Party. (n.d.). Learn. Genetics. Retrieved May 30, 2013, from learn.genetics.utah.edu/content/addiction/drugs/mouse.html

Images:

N/A. PET scan of the brain for depression. N.d. Mayo Clinic, N/A. Mayo Clinic. Web. 30 May 2013.

N/A. Hippocampus. N.d. Memory Loss & The Brain, Rutgers University. Memory Loss Online. Web. 30 May 2013.

N/A. Serotonin. N.d. Serotonin, N/A. Chemistry-Reference. Web. 30 May 2013.

N/A. What is Serotonin?. N.d. N/A, N/A. News-Medical. Web. 30 May 2013.

Anesthesia, Safe or Not?

Throughout my life I’ve had a couple of surgeries. Every time I have received surgery, my mother always asked the doctor, “Do you have to use general anesthesia?”. In times like that I have always told myself, why does my mom even ask, of course the doctors are going to use general anesthesia, why not?  One day I asked my mother “Why do you ask the doctors the same question every time?”, and she told me that general anesthesia was very dangerous, and if it is unnecessary it would be better not to use it. This is why I chose to research general anesthesia. I would like to formulate my own conclusions about the dangers of general anesthesia. The way I will do this is through a careful analysis of the facts, side effects and the way general anesthesia works. I will also use my knowledge of chemistry to aid me in making my conclusion.

The functions of anesthesia include: analgesia (no pain), amnesia (loss of consciousness), impairment of skeletal muscle, and weakened autonomic responses. The most important part of anesthesia is that after the surgery all of these effects can be reversed.  Not all anesthetics will provide all of these effects. For example, barbiturates are not analgesics, but will bring loss of consciousness. This is often why most anesthesias are a combination of many anesthetics.

Anesthetics have many side effects. The first one is a decrease in respiration. Anesthesiologists deal with this by attaching all patients to ventilators during surgery. The second most common side effect is nausea, when a patient is under general anesthesia, their lower esophageal sphincter is relaxed. To avoid death by aspiration, doctors use endotracheal tubes to provide ventilation.

Endotracheal tube

Picture 1: Endotracheal Tube

The third side effect is hypothermia. To prevent this side effect is one of the major goals for anesthesiologists. Anesthesiologists prevent hypothermia by warming the fluids (anesthesia), which are injected into the human body.

How does anesthesia work? Anesthetics block certain protein receptors, inhibiting the protein from performing its task. For example, the NMDA (N-methyl-D-aspartate) receptor is one of the main mediators of excitatory neurotransmission. The receptor is an ion channel, which permits the movement of calcium, sodium and potassium across the post-synaptic membrane. Anesthesiologists inhibit this protein receptor by depolarizing the cell with the anesthesia, which then results in the protein receptor not completing its task. Anesthesia depolarizes the cell inducing the cell with a net positive charge.  (Gambulos)

NMDA receptor

Picture 2: NMDA Receptor

The Ca2+ and Na+ enter the cell and induce a net increase of 3+. The anesthesias, which are involved, are Xenon, Ketamine (C13H16ClNO), and nitrous oxide (N2O). (Gambulos)

Anesthesias are really useful in putting you to “sleep”, but once surgery is over and you wake up you don’t want these chemicals to linger around in your body.This diagram shows how propofol (C12H18O) interacts with your metabolism in order to exit the human body.

Propofol and your metabolism

Picture 3: Propofol exiting the body

The propofol interacts with the liver glucuronate and sulfate conjugation. Then is excreted into the urine to exit the body. Usually 70% of the propofol is gone in 24 hours, and about 90% is gone in 5 days.

Before I started this blog assignment I thought anesthesia was the “simple” part of surgery. After doing all this research I have realized that the anesthesiologists must consider many things before using an anesthesia.  For example, if the anesthesia will interact correctly with the patients protein receptors. The anesthesiologist’s job doesn’t stop there, while the patient is “under” they must ensure that they are ready to deal with any side affects that might occur from the anesthesia, and after surgery is complete the anesthesiologist must then ensure that the anesthesia administered must exit the human body safely.

In conclusion, general anesthesia is safe. The side effects are all dealt with appropriately. For example, the hypothermia is dealt with warm anesthesia pumped through your veins. After examining the way anesthesia works, obstructing the function of protein receptors, I have realized that drugs work the same way. The reason why drugs are so dangerous is because often it is difficult to stay within the therapeutic window. Anesthesiologist deals with this by constantly staying by your side, ensuring that the drugs in your system do not exceed the toxic level or go under the therapeutic level. Finally the last part of anesthesia is the way it exits your body. Your body does this through a reaction of the anesthetics with your liver glucuronate and sulfate conjugation. Then the anesthetic proceeds to your urine. At first I thought this was dangerous, but then I remembered that almost every adult drinks alcohol, and 90% of the ethanol, from alcohol, is broken down by your liver. Therefore I concluded that the way anesthesia leaves your body is not so dangerous after all.

References

Garcia, Paul, Scott Kolesky, and Andrew Jenkins. “General Anesthetic Actions on GABAA Receptors .” PMC. Bentham Science Publishers, n.d. Web. 25 Mar 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866459/>.

Gambulos, Rachel. N.p., 20 04 2008. Web. 25 Mar 2013.

Gordon, G. (2010, August 31). Propofol-3. Retrieved from http://www.anesthesiawiki.net/metrohealthanesthesia/MHAnes/edu/ivanes/propofol3.htm

Lundbeck Institute. (n.d.). Nmda receptor, showing different subtypes. Retrieved from http://www.cnsforum.com/imagebank/item/hrl_rcpt_sys_NMDA/default.aspx

Oda, Yutaka. Hamoka, N. Hiroi, T., Imaoka, S., Hase, I., Tanaka K., Funae Y., Involvement of Human Liver Cytochrome P4502B6 in the metabolism of Propofol. The British Journal of Pharmacology. 51. 281-285. 2001.

Thomas, Shawn. Drug Reference for FDA Approved General Anesthetics @ Neurotransmitter.net. 2007.

The Alkaline Diet

After reading Nicholas’ post on the claim made by the company that produced water ionizers, I was reminded of a similar claim made by advocates of the ‘Alkaline Diet’. I decided to investigate whether these claims were accurate, or like the ones made by the water-ionizer company, scientifically wrong.

The Alkaline Diet is based on the theory that eating specific foods can affect maintenance of the body’s ideal pH balance, and improve health. (Collins & Chang, n.d) A website promoting holistic treatments gave the following reasoning for the diet:

The pH of the blood must always fall between 7.35 and 7.45  (slightly alkaline) to ensure an appropriate concentration of oxygen in the blood. A pH lower than 7.35 (Acidosis) may portray the beginnings of a disease / aging, while a pH higher than 7.45 (Alkalosis) would result in seizure, and a possible coma.

In order to keep the blood within this pH range, the website then explains, 75% of alkaline forming foods must be consumed; however, the American diet consists of 80% of acid forming foods.

The body creates a buffering system in order to counteract this abundance of acidic food in the diet; this buffering system runs on electrolytes, which are important for the metabolic functioning of body systems. Adequate electrolyte supply will pose no problem on the buffer system, however a shortage of these electrolytes will make it difficult for the body to maintain homeostasis (a state of equilibrium). A shortage of electrolytes usually occurs as a cause of excessive consumption of acid forming foods. (Frequency Rising, n.d)

At first, this claim made sense to me. After all, medical websites confirm that the blood’s pH must fall within a certain range. (Collins & Chang, n.d) Furthermore, there is evidence that shows that the concentration of Oxygen in the blood is affected by the blood’s pH, and as I have previously learnt in Biology class, it is true that the pH of blood must remain within a certain range to ensure health.  (RSC, n.d) Another medical website mentioned diseases such as Acidosis and Alkalosis, the former caused by a blood pH lower than what it should be, and another caused by a blood pH higher than it should be. (Dugdale & Zieve, n.d) Was the claim made by the holistic website accurate? Upon further examination and reflection, it was clear to me what the problem was: the holistic website was trying to convince people on the basis of a logical fallacy!* Our body deals with acidic food with a buffer system that does not work properly when you consume excessive acidic foods?

What?

That makes no sense.

I soon realized that it was very easy to see the reason they would make this claim, as directly under the article, I saw this.

Water Ionizer Advertisement

This reminded me of Nicholas’ post, and confirmed my doubts: it was all just a marketing technique.

I decided to look at the biochemistry myself to determine the validity of the diet.

I found the concentration of Oxygen in the blood is controlled by a separate mechanism: oxygen flows around the body in blood by hemoglobin, a complex molecule with a central ion. (AUS-e-TUTE, n.d) The oxygenation of blood is an equilibrium reaction:

Hb4(aq) + 4O2(aq) <–> Hb4O8(aq)

A number of equilibrium reactions involving hemoglobin are responsible for the buffering of the blood: the net reaction being –

HbH+(aq) + O2(aq) <–> HbO2(aq) + H+(aq)

Metabolic reactions in the body release many acidic compounds, which lowers the blood’s pH by increasing the concentration of H+ ions present in the blood. This in turn, forces the equilibrium position to the left, resulting in acidosis. This decrease in oxygen supply causes fatigue and headaches. Acidosis is also the same condition you experience temporarily when you exercise without warming up, or when you engage in strenuous exercise when the available supply of oxygen cannot meet the demand for energy to complete the oxidation of glucose to carbon dioxide. (AUS-e-TUTE, n.d)

Thus, Acidosis really has nothing to do with what you eat.

Additionally, although electrolytes are important for the body, the only ion that affects the pH of the blood is the Phosphate Ion (PO42-), which is part of the Phosphate Buffer System. (Electrolytes, n.d) However, the primary buffer system for balance of the blood pH’s remains the Hydrogen Carbonate Buffer System.

Hydrogen Carbonate is produced in the body with water and CO2 (the end product of cellular metabolism) with the following reaction:

H2O + CO2 <–> H2CO3(aq)

The Hydrogen Carbonate is then involved in another (can be classified as a Bronsted-Lewry) reaction, which produces bicarbonate and the Hydronium ion:

H2CO3 + H2O <–> H3O+ + HCO3

If there is excess acid in the body (H3O+), the equilibrium shifts left.

H2CO3 + H2O <–  H3O+ + HCO3

Thus, the excess acid is neutralized by the base (HCO3)

The reverse takes place if there is excess base (OH) in the body: this reacts with the carbonic acid (H2CO3) and the equilibrium shifts right.

H2CO3 + OH <–  H2O + HCO3

This system thus operates under Le Chaletier’s principle, which states that “if a chemical system at equilibrium experiences a change in concentration, temperature, or total pressure, the equilibrium will shift in order to minimize that change ”. This reaction is the main mechanism used by our body to maintain homeostasis.

The Phosphate Buffer System plays a role in plasma and erythrocytes (components of blood)- (Tamarkin, n.d)

H2PO4- + H2O <–> H3O+ + HPO42-

Any excess acid reacts with monohydrogen phosphate to form dihydrogen phosphate –

H2PO4- + H2O <– H3O+ + HPO42-

Similarly, excess base is neutralized by dihydrogen phosphate –

H2PO4- + H2O –> H3O+ + HPO42-

So if this is all true, and the claim that eating alkaline foods can affect blood’s pH is not correct, then why do people continue to follow the Alkaline diet: and how can we explain their success stories?

The Alkaline Diet is “a diet of fresh fruits and vegetables, plenty of water, avoiding processed foods, coffee, and alcohol, which are all recommendations for a generally healthy diet anyway,” says Marjorie Nolan, who is an American Dietetic Association spokeswoman. (Collins & Chang, n.d) This is evident by an Alkaline Diet cheat sheet, which recommends eating cold-pressed olive oil instead of butter, frozen fruit instead of canned fruit, sparkling water instead of soda, honey instead of sugar, and so on. (Wilkinson, n.d) According to Nolan, any diet consisting of this meal plan is bound to prove successful, because it is “basically healthy”. She confirms however, that the body “regulates our pH between 7.35 and 7.45 no matter how we eat.” (Collins & Chang, n.d)

Alkaline Diet for Dummies: Cheat Sheet

Alkaline Diet for Dummies: Cheat Sheet

Alkaline Diet for Dummies: Cheat Sheet

So, what are the implications of this finding?


First, the negative implications: because the Alkaline diets promotes less consumption of dairy products and animal fats, followers of the diet if not careful, may develop calcium and protein deficiencies, according to John Asplin, an MD and kidney specialist. (Collins & Chang, n.d) A vegetarian myself, I was quick to disagree with this statement in my mind, however, he acknowledged that “vegetarians can be completely healthy in their diets, as long as they make sure to get adequate supplies of essential components to a diet.” Asplin also asserted that this could be seen as benefit also, because “many Americans over-consume protein”. (Collins & Chang, n.d) Another implication of this finding is that followers of the Alkaline Diet may not have a scientifically correct view of the functioning of their body, and this could lead to potential problems in the future. Followers of the diet may also waste money on expensive products (such as the water ionizer advertised on the holistic website) that do not affect our body in the way that the manufacturers claim.

What are the benefits? Because excess animal protein results in a higher risk of developing kidney stones, “eating a diet rich in vegetables, as with the alkaline diet” can lower this risk, according to Asplin. (Collins & Chang, n.d) It has also been suggested by research that an alkaline diet may slow bone loss and muscle waste, increase the growth hormone, and reduce the risk of certain chronic diseases (these are correlations however, and cannot be stated as a cause-effect relationship). (Schwalfenberg, 2011)

A negative correlation between the alkaline diet and incidence of cancer has also been shown, however the same results were obtained when the vegetarian diet was measured against cancer rates: additionally, as the study was correlational, there were many confounding variables that may have affected the results such exercise, alcohol consumption, smoking, genetics, etc. (Collins & Chang, n.d)

Nolan speaks of this finding, stating that “clinical studies have proved without a doubt that people who eat more fresh fruits and vegetables and hydrate properly do have lower rates of cancer and other diseases”, but that “it probably has nothing to do with blood pH”. (Collins & Chang, n.d)

The journey I took while examining this diet taught me to properly examine the agenda of the source making a claim before choosing to accept it: because the holistic website was advertising the water ionizer, they made claims that were scientifically inaccurate to make the product seem more appealing to customers. Web MD on the other hand, a medical website dedicated to providing people with factual information on clinical practices, provides evidence and information that supports the knowledge we have of the biochemistry of our body.

Thus, William Mundel, the vice chair of the department of General Internal Medicine at the Mayo Clinic in Rochester, advises against diets that “want you to buy only their product” (i.e.: the water ionizer), “focus on a narrow spectrum of foods” (i.e.: eliminate all animal fats), and “claim that science has kept something secret, or that someone has discovered something that nobody else knows about”. These are the types of diets that tend to be scientifically wrong. (Collins & Chang, n.d)

* The logical fallacy used is Circular Reasoning / Begging the Question.

References

Chemical Buffer Systems- Acid-Base Balance. (n.d.). Boundless. Retrieved May 22, 2013, from https://www.boundless.com/physiology/fluids-and-acid-base-balance/acid-base-balance/chemical-buffer-systems/

Chemistry Tutorial : Oxygen Transport in Blood. (n.d.). AUS-e-TUTE For Astute Science Students. Retrieved May 22, 2013, from http://www.ausetute.com.au/blood.html

Chemistry for Biologists: Transport of Oxygen in the Blood. (n.d.). Royal Society of Chemistry | Advancing the Chemical Sciences. Retrieved May 22, 2013, from http://www.rsc.org/Education/Teachers/Resources/cfb/transport.htm

Collins, S., & Chang, L. (n.d.). Alkaline Diet: Pros, Cons, and Do They Really Affect Acid Levels in the Body?. WebMD. Retrieved May 22, 2013, from http://www.webmd.com/diet/features/alkaline-diets-what-to-know

Dugdale, D., & Zieve, D. (n.d.). Alkalosis – Symptoms, Diagnosis, Treatment of Alkalosis – NY Times Health Information . Health News – The New York Times. Retrieved May 22, 2013, from http://health.nytimes.com/health/guides/disease/alkalosis/overview.html

Life Balances: Electrolytes. (n.d.). John Kitkoski’s Life Balances Program: Home Page. Retrieved May 22, 2013, from http://www.lifebalancesprogram.com/Library/Electrolytes.html

Schwalfenberg, G. (2011, October 12). The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health?. National Center for Biotechnology Information. Retrieved May 22, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/

Tamarkin, D. (n.d.). Buffers. STCC Faculty Webpages. Retrieved May 22, 2013, from http://faculty.stcc.edu/AandP/AP/AP2pages/Units21to23/ph/buffers.htm

Wilkinson, J. (n.d.). Acid Alkaline Diet For Dummies – Cheat Sheet. For Dummies . Retrieved May 20, 2013, from http://www.dummies.com/how-to/content/acid-alkaline-diet-for-dummies-cheat-sheet.html

pH balance. (n.d.). Frequency Rising – Alternative Medicine and Holistic Health Products. Retrieved May 22, 2013, from http://www.frequencyrising.com/pH.htm

Ionised water = The new snake oil

During Chinese New Year, my family and I went back to Malaysia to visit my relatives. We visited one of my aunts had undergone surgery to remove a small cancerous growth. Besides ensuring us that she would make a complete recovery soon, my aunt also told her plan of improving her health. Part of that plan involved the purchase of a water-ionizer machine. When we asked her what was the function of the water-ionizer, my aunt told us that she purchased the machine after seeing it on a television advertisement. The advertisement claimed that when the body becomes “too acidic”, it encourages the growth of cancer cells and other diseases such as obesity. The solution to this problem would be the water-ionizer. The advertisement claimed that the water-ionizer would ionize drinking water using electrolysis, producing “alkaline water” and “acidic water”. By drinking the alkaline water, the advertisement claims that the alkalinity would reduce the acidity of the body. The advertisement also claimed that the water acts as an anti-oxidant. (Snyder et al., 2008)

Convinced by my aunt, my parents bought a water-ionizer to ring back to Shanghai. At first, I myself had no doubts about the “benefits” of the water-ionizer. When we started our unit on acids and bases, I decided to see if the water-ionizer was really beneficial. To my dismay, the many claims that the water-ionizer company made were scientifically wrong.

Many water-ionization companies claim that by drinking alkaline water, it will neutralize the acidity of the body. Firstly, the intake of alkaline water does not affect the ph of the body. If alkaline water is drunk, the acids in the stomach will neutralize the basic nature of the alkaline water. The body has its own system of regulating the ph levels of the various parts of the body, such as blood and urine. For example, in the blood, the bicarbonate buffering system keep’s the blood’s ph at a constant level.

CO2 (g) + H20 (l) <=> H2CO3 (aq) <=> H+ (aq) + HCO3- (aq) (Frey et al., 2008)

The CO2 in the blood , when mixed with water, produces carbonic acid. The carbonic acid in turn can disintegrate into hydrogen ions and the basic bicarbonate. Hence, drinking alkaline water has no effect in changing the body’s ph level.

“Ionized water” is a misleading term. In chemistry, pure water has a neutral ph of 7, meaning that there are no ions in pure water. Water that is not pure water, such as rainwater, is already ionic, since they contain ions present in it, such as Sodium. Therefore, the term “ionized water” does not describe anything.

Secondly, the water-ionizer is supposed to turn water into alkaline water by “ionizing” the water through electrolysis. However, significant electrolysis cannot occur in pure water due to the lack of ions. The water-ionizer is a machine with 2 metal plates that are normally made out of inert metals such as stainless steel, separated by a membrane. They serve as electrodes, which are electrical conductors that conduct electricity to a non-metallic part of a circuit, in this case, the water. When connected to the power source, one of the plates becomes negatively charged while the other becomes positively charged. (Lower et al., 2008)

The negatively charged plate releases electrons. Hydrogen ions than bond to these electrons to produce hydrogen gas and OH-

2 H2O(l) + 2e → H2(g) + 2 OH(aq)

Based on Bronsted-lowry theory, the excess OH- ions make that side of the machine alkaline.

and the positively charged plate, oxidation takes place, producing oxygen gas.

2 H2O(l) → O2(g) + 4 H+(aq) + 4e-

Based on Bronsted-lowry theory, the excess H+ ions make that side of the machine acidic.

However, the H+ and OH- ions eventually recombine to form water, and the final equation reveals that the final product is hydrogen and oxygen gas, which does not affect ph.

2 H2O(l) → 2 H2(g) + O2(g)

Therefore, significant electrolysis can only occur when the water is ionic. However, most tap water is alkaline in order to prevent the disintegration of water pipes. Slightly acidic water, such as water from mountain glaciers and streams, is safe to drink. (Dunning et al., 2009)

Lastly, I also found out that the claim that cancer cells grow better in acidic environment is actually a misinterpretation of the fact that cancer cells release acids.  (Mathani et al., 2010)

So, what were the implications of this research? I believed that this research was very important. By understanding the complete process of the electrolysis of water, I was able to see that the water-ionizer’s claim of being able to raise the ph of pure water was false. I was also able to realise that the misuse of Bronstend-Lewis law could be used as convincing ways to trick people. Most importantly, this research shows that many health products will not only misinterpret and misuse scientific data to give their claims false credibility. This research also highlights the practicality of studying chemistry, since a basic understanding of chemistry can helps us deduce whether these claims are false. In conclusion, I feel that this research warned me to guard myself against false scientific claims and to apply my previous knowledge in chemistry to real world settings.

References:

Dunning, B. (2009). Kangen Water: Change Your Water, Change Your Life. Skeptoid: Critical Analysis Podcast. Retrieved March 14, 2013, from http://skeptoid.com/episodes/4139

Lower, S. (2012, November 20). “Ionized” and alkaline water: snake oil on tap. “Ionized” and alkaline water. Retrieved March 14, 2013, from http://www.chem1.com/CQ/ionbunk.html

Mahtani, R. L. (2010, August 15). Acid Balance in the Body and Cancer – Caring4Cancer. caring4cancer. Retrieved March 14, 2013, from https://www.caring4cancer.com/go/cancer/nutrition/questions/acid-balance-in-the-body-and-cancer.htm

Snyderhealth (n.d.). cannotParse. snyderhealth. Retrieved March 14, 2013, from http://www.snyderhealth.com/water_ionizers/how_does_a_water_ionizer_work.html

University of Washington (n.d.). pH Buffers in the Blood. Department of Chemistry | Washington University in St. Louis. Retrieved March 14, 2013, from http://www.chemistry.wustl.edu/~edudev/LabTutorials/Buf