Difference Between Abuse and Dependence

 

Abuse vs Dependence 

Abuse and dependence is more related to drugs. Sometimes abuse and dependence are used interchangeably. Though these two terms refer to drug usage, they are different. Abuse can be defined as the inappropriate usage of a drug. Dependence can be defined as an addiction to drugs.

While abuse is a severe desire to get a particular drug, dependence can be termed as the body’s physiological need to have the drug.

Taking of drugs without a doctor’s prescription can be termed as drug abuse. There are many abused drugs that are obtained from over the counter. A person can become drug dependent when he or she continues to use the drug. This means that going beyond the prescribed dosage of drug can lead to drug dependence. It can also be seen that drug dependence can lead to behavior problems, and also cause physical harm.

When talking about drug abuse, there is no strong desire or compulsion to continue with the drug. On the other hand, a person has a strong desire to continue with the drug usage when he is dependent. This person is emotionally addicted to the drug.

In the case of drug abuse, it is easier for people to get out of it, but it is harder for people who have become dependent to get out of the clutches of drugs.

While drug abuse is more related to the physical aspect, drug dependence is related more to physiological aspects. In drug abuse, people will only have a physical craving for the drug, and think that it is needed for their bodily functions. On the contrary, persons who are dependent on drugs have an emotional or psychological need for the drug.

Summary:

1. Abuse can be defined as the inappropriate usage of a drug. Dependence can be defined as an addiction to drugs.

2. When talking about drug abuse, there is no strong desire or compulsion to continue with the drug. On the other hand, a person has a strong desire to continue with the drug usage when he is dependent.

3. While abuse is a severe desire to get a particular drug, dependence can be termed as the body’s physiological need to have the drug.

4. In drug abuse, people will only have a physical craving for the drug, and think that it is needed for their bodily functions. On the contrary, persons who are dependent on drugs have an emotional or psychological need for the drug.

Difference Between Pneumonia and Bronchitis

Pneumonia vs Bronchitis

Both bronchitis and pneumonia are serious diseases affecting the lower respiratory tract. They can lead to a lot of discomforts and, if left untreated, may cause other serious conditions. There are a number of differences between the two. Understanding these differences will help you identify the two.

Symptoms
Pneumonia manifests itself in the form of high fever, cough and chills. It is accompanied by rapid breathing and a certain amount of wheezing. The patient often complains of chest pain. Some patients also feel extremely exhausted and nauseous. The symptoms of viral pneumonia often resemble those of ordinary flu. There are chills and high fever. It is often accompanied by chattering teeth. It may also produce sputum that is green, yellow or rust colored. Pneumonia becomes apparent when the patient experiences a shortness of breath.

Bronchitis manifests itself as a cough with headache, chills and a slight fever. A patient may also experience a shortness of breath.

Different reasons
Pneumonia and bronchitis are caused by different factors. Bronchitis occurs when there is an inflammation of the bronchial tubes. It may be caused by a number of factors, including a bacterial or viral infection. It is also caused by irritation originating from pollution and smoke. Bronchitis may be chronic or acute in nature. Chronic bronchitis occurs over a period of time. Acute bronchitis may last for a few days. However, it is usually cured with the help of antibiotics. Pneumonia is caused by an infection of the lungs. It may be caused by bacteria, fungi or by a virus. It usually affects people over the age of 65, or people who have had their immune systems compromised.

Differences in treatment
The treatment for bronchitis is relatively simple. Once the doctor has identified the reasons for the infection, he will put you on a course of antibiotics. You will be advised rest and you will need to avoid pollution and smoke. Pneumonia is more of a serious affliction. If you have been diagnosed with this disease, you will be prescribed a strong antiviral or antibiotics. If the condition worsens, the doctor may advise that the patient be removed to the hospital and additional breathing apparatus installed. You may be hospitalized anywhere between one and three days, depending on the seriousness of your condition.

Pneumonia is a serious medical condition and requires urgent medical attention. If the patient suffers from difficulties in breathing and begins throwing up sputum, you should seek immediate medical attention.

Summary:

1. Patients suffering from pneumonia will have a high fever, difficulties in breathing and wheezing. Bronchitis has similar symptoms, but the patients have a lower temperature.
2. Bronchitis is caused by an inflammation of the bronchial lining. It may occur due to a bacterial or viral infection. However, pneumonia is caused by an infection of the lungs.
3. The treatments for the two also vary. Bronchitis may be treated by antibiotics. However, a patient suffering from pneumonia may have to be hospitalized. He is generally advised very strong antibiotics or an antiviral.

Pharm.D organic chemistry Notes & PPT's

Aromatic Compounds-1.doc[103.5 KB]
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Electrophilic  [164.5 KB]
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Organic reactions and mechanisms[35.0 KB]
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Organic-I [1.1 MB]
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Lecture sheet of directive effect [3.9 MB]
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“PHARMACY THE CHALLENGE “-Roger Walker

The use of medicines is the most common intervention

in healthcare. As a consequence this puts the pharmacist at the heart of patient care and presents both opportunities and responsibilities.

Opportunities include direct patient contact and the chance to understand the patient in the context of their own background, guide the choice of therapeutic selection or formulation and provide appropriate, personalized support to facilitate patient medication adherence.

But medicine use also has a down side. It has the potential to be fraught with problems that include complexities of selecting the most appropriate medicine,dose selection and administration, medicine formulation and stability, the

potential to interact with other medicines, poor patient adherence and a changing harm-benefit risk profile.

As a consequence the mantra of promoting safe, appropriate and cost-effective prescribing that respects patient choice and promotes adherence is a continuous challenge. This is true whether we are students or qualified pharmacists and requires a sustained enthusiasm to question and learn, and a commitment to

continually update our knowledge and practice.

The emerging dimension that we also consider alongside the patient focused approach is the public health perspective. No longer is it acceptable to ignore the\ population based impact of any health care intervention whether this is linked to the inappropriate and wasteful use of healthcare resources or involves overuse of

a given medicine. This is well illustrated by the restrictions we must now place on the use of antibiotics to prevent the emergence of antibiotic-resistance to preserve their effectiveness for use in those most in need.

Whether we practice in a patient facing setting, work in public health or combine the two dimensions, the opportunity for pharmacy to make a significant and valued contribution to healthcare and society has never been greater. This is our challenge.

Roger Walker

Chief Pharmaceutical Officer, Welsh Assembly

Government, U.K.

Goals for PharmD Students — Joseph DiPiro, PharmD,USA.

Training of pharmacists at the doctor of pharmacy (PharmD) level is expanding around the world and has greatly increased clinical practice of pharmacists. Pharmacy students now spend much more time in patient-centered activities,experiential training,and in courses that teach therapeutics.While a good, clinically based curriculum is necessary for success as a pharmacy practitioner the curriculum alone is not sufficient. In these modern times, health care needs are quite extensive and the complexity of health care systems is often daunting.

“To be a truly successful pharmacy practitioner it is important that students accept 

personal goals to clearly recognize the health needs and concerns of their society.”

Recognition of these needs will keep one connected to and focused on the most important issues. In most countries the biggest societal concerns related to medications are cost (can they afford their medicines), access to medications (are they available),effectiveness (will they work), and safety (will they cause an adverse effect). Pharmacists will always have an important role in health care if they focus on these major issues. Pharmacy students who are committed to addressing these major issues will need more than factual knowledge that is gained in lecture classes.

To be effective in addressing these issues pharmacy students should also have personal goals to gain the skills necessary to solve these problems, namely, communication skills, knowledge of health care systems, information technology skills, business skills, or leadership skills. Most people will not possess a high level for all of these skills but it is possible to advance the profession and health care by acquiring proficiency in some of these areas.

“PharmD students have a lot to learn and acquiring the right skills assures the best use of your knowledge.”

Joseph T. Dipiro 

Professor and Executive Dean 

South Carolina College of Pharmacy

USA.

Pharm.D Patient care Mnemonics: WWHAM, ASMETHOD, ENCORE and SIT DOWN SIR

A mnemonic is sometimes used by pharmacists to gather information to help them in diagnosing a patient's presenting complaint. Caution should be exercised when using a mnemonic due to the fact that a mnemonic may fail to obtain all necessary information that is needed before diagnosing the patient's presenting complaint accurately and further questioning may be necessary depending on the patient's response to questions. Listed below are some of the mnemonics used when responding to symptoms.

WWHAM

W	Who is the patient
W	What are the symptoms
H	How long have the symptoms been present
A	Action taken
M	Medication being taken

ASMETHOD

A	Age/appearance
S	Self or someone else
M	Medication
E	Extra medicines
T	Time persisting
H	History
O	Other symptoms
D	Danger symptoms

ENCORE

E	Explore
N	No medication
C	Care
O	Observe
R	Refer
E	Explain

SIT DOWN SIR

S	Site or location of a sign/symptom
I	Intensity or severity
T	Type or nature
D	Duration
O	Onset
W	With (other symptoms)
N	Annoyed or aggravated by
S	Spread or radiation
I	Incidence or frequency
R	Relieved by

BIOCHEMISTRY MNEMONICS

Essential Amino Acids

• PriVaTe TIM HALL
• Phe, Val, Thr, Trp, Ile, Met, His, Arg, Leu, Lys

 

Urea Cycle

• Ordinarily, Careless Crappers, Are Also Frivolous About Urination.
• Ornithine, Carbamoyl, Citrulline, Arginosuccinate, Aspartate, Fumarate, Arginine, Urea.

 

Cell division

• Prophase, metaphase, anaphase, telophase.
• "People Meet And Talk."

 

In the Phasted State

• Phosphorylate Phosphorylation cascade active when blood glucose low.
• DNA expression into mature mRNA
• Exons expressed, Introns in the trash.
• Pyrimidines are CUT from purines.
• Pyrimidines are Cytosine, Uracil, Thiamine and are one ring structures.
• Purines are double ring structures.

Porphyrias: acute intermittent porphyria symptoms 5 P's:

Pain in abdomen

Polyneuropathy

Psychologial abnormalities

Pink urine

Precipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs) 

BUN:creatinine elevation: causes ABCD:

Azotremia (pre-renal)

Bleeding (GI)

Catabolic status

Diet (high protein parenteral nutrition) 

G6PD: oxidant drugs inducing hemolytic anemia AAA: Antibiotic (eg: sufamethoxazole)

Antimalarial (eg: primaquine)

Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

Vitamin B3 (niacin, nicotinic acid) deficiency: pellagra

The 3 D's of pellagra: Dermatitis Diarrhea Dementia

· Note vitamin B3 is the 3 D's. 

Tangier's disease: hallmark

"Tangierene tonsils":

Hallmark is large orange tonsils.

· Important clinical note: there is no increased risk of atherosclerosis, just like eating tangerenes.

Na+/K+ pump: movement of ions and quantity

K+ and in each consist of 2 characters, so so 2 K+ are pumped in. Na+ and out each consist of 3 characters, so 3 Na+ are pumped out

Glycogen storage: Anderson's (IV) vs. Cori's (III) enzyme defect

ABCD:

Anderson's=Branching enzyme.

Cori's=Debranching enzyme.

· Otherwise, can't really distinguish clinically. 

Nitric oxide: amino acid precursor

When the dentist works on your teeth, you say, "AAArg! (Arginine)" before he administers Nitric Oxide (NO) to take the pain away.

· Other players necessary for NO synthesis: NO synthase, Ca++, NADPH. 

Pompe's disease: type "Police = Po + lys":

Pompe's disease is a lysosomal storage disease (alpha 1,4 glucosidase). 

 

Metabolic acidosis (normal anion-gap): causes

· With hyperkalemia: RAISE K+:

RTA type 4

Aldosterone or mineralocorticord deficiency

Iatrogenic: NH4Cl, HCl

"Stenosis": obstructive uropathy

Early uremia

· With hypokalemia: ReDUCE K+:

Renal TA type 1 and 2

Diarrhoea

Urine diversion into gut

Carbonate anhydrase inhibitor

Ex-hyperventilation

Galactosaemia: enzyme deficiency

GALIPUT: Galactose 1 Phosphate Uridyl Transferase.

· There is an assay called the Galiput test for this.

Citric acid cycle compounds

"Our City Is Kept Safe And Sound From Malice":

Oxaloacetate Citrate Isocitrate alpha-Ketoglutarate Succinyl-CoA Succinate Fumarate Malate 

Folate deficiency: causes A FOLIC DROP:

Alcoholism

Folic acid antagonists

Oral contraceptives

Low dietary intake

Infection with Giardia

Celiac sprue

Dilatin

Relative folate deficiency

Old

Pregnant 

Mitochondrial DNA (mt DNA) properties

"mt DNA".

mt stands for: Maternal Transfer Mutates Tremendously (high mutation rate) 

Vitamins: which are fat soluble

"The FAT cat is in the ADEK (attic)":

Fat soluble vitamins are A,D,E,K.

Enzyme kinetics: competitive vs. non-competitive inhibition

With Kompetitive inhibition: Km increases; no change in Vmax. With Non-kompetitive inhibition: No change in Km; Vmax decreases. 

Glycogen storage: names of types I through VI

"Viagra Pills Cause A Major Hardon":

Von Gierke's

Pompe's

Cori's

Anderson's

McArdle's

Her's

Sickle cell disease pathophysiology

SICKle cell disease is due to a Substitution of the SICKsth amino acid of the B chain.

Glucagon function

"Mr. Gluca has Gone to the cAMP to bring out some Glucose":

· Glucagon elevates glucose by cAMP mechanism.

Van den Bergh reaction (Jaundice test)

"Indirect reacting bilirubin = Unconjugated bilirubin":

Both start with vowels, so they go together:

Indirect & Unconjugated.

Hemoglobin binding curve: causes of shift to right

"CADET, face right!":

 CO2

Acid

2,3-DPG (aka 2,3 BPG)

Exercise

Temperature 

G proteins for respective receptors

"QISS & QIQ" (Kiss and Kick):

· G-proteins and their respective receptors (alphabetical order):

Q: alpha 1 I: alpha 2 S: beta 1 S: beta 2 &

Q: M1 I: M2 Q: M3 

Adrenaline mechanism

"ABC of Adrenaline":

Adrenaline--> activates

Beta receptors--> increases

Cyclic AMP

Citric acid cycle compounds

"Can I Keep Selling Sex For Money, Officer?":

Citrate Isocitrate alpha Ketogluterate Succinyl CoA Succinate Fumerate Malate Oxaloacetate 

Carbon monoxide: electron transport chain target

"CO blocks CO":

Carbon monoxide (CO) blocks Cytochrome Oxidase (CO) 

Metabolism sites

"Use both arms to HUG":

Heme synthesis Urea cycle Gluconeogenesis · These reactions occur in both cytoplasm and mitochondria. 

Na/K pump: concentrations of Na vs. K on inside/outside of cell, pump action, number of molecules moved

HIKIN': There is a HIgh K concentration INside the cell. From this can deduce that the Na/K pump pumps K into cell and Na out of cell. Alternatively: When I was learning this pump (circa 1992), a band that was "in" was Kris Kross, and a band that was "out" was "Sha Na Na Na": So pump moves K K (2 K) in and Na Na Na (3 Na) out. · Sadly, as infectious as their debut album was, Kris Kross can really no longer be classed as "in".

DNA bond strength (nucleotides)

"Crazy Glue":

Strongest bonds are between Cytosine and Guanine, strong like Crazy Glue (3 H-bonds), whereas the A=T only have 2 H-bonds. · This is relevant to DNA replication, as the weaker A=T will be the site where RNA primer makes the initial break. 

Dicarboxylic acids (alpha, omega) C2 through C10: common names

"Oh My, Such Good Apple Pie, Sweet As Sugar!":

Oxalic Malonic Succinic Glutaric Adipic Pimelic Suberic Azelaic Sebacic 

Infantile Beriberi symptoms

Restlessness Sleeplessness Breathlessness Soundlessness (aphonia) Eatlessness (anorexia) Great heartedness (dilated heart)

· Alternatively: Get 5 of 'em with BERI: Breathless/ Big hearted, Eatless, Restless, Insomnia. 

AcetylCoA and acetacetylCoA: amino acids forming them

"A Lighter Lease" (A LyTr LeIs):

A=AcetylCoA or Acetoacetyl CoA

Ly=Lysine

Tr=Tryptophan

Le=Leucine

Is=Isoleucine 

Fasting state: branched-chain amino acids used by skeletal muscles

"Muscles LIVe fast":

Leucine

Isoleucine

Valine 

Glycolysis steps

"Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies":

Glucose

Glucose-6-P

Fructose-6-P

Fructose-1,6-diP

Dihydroxyacetone-P

Glyceraldehyde-P

1,3-Biphosphoglycerate

3-Phosphoglycerate

2-Phosphoglycerate (to)

Phosphoenolpyruvate [PEP] Pyruvate · 'Did', 'By' and 'Pies' tell you the first part of those three: di-, bi-, and py-.

· 'PrEPare' tells location of PEP in the process. 

Fabry's disease

FABRY'S:

Foam cells found in glomeruli and tubules/ Febrile episodes

Alpha galactosidase A deficiency/ Angiokeratomas

Burning pain in extremities/ BUN increased in serum/ Boys

Renal failure

YX genotype (male, X linked recessive)

Sphingolipidoses 

B vitamin names

"The Rhythm Nearly Proved Contagious":

· In increasing order: Thiamine (B1) Riboflavin (B2) Niacin (B3) Pyridoxine (B6) Cobalamin (B12) 

Electron transport chain: Rotenone's site of action

Rotenone is a site specific inhibitor of complex one. 

Citric acid cycle compounds

"Oh! Can I Keep Some Succinate For Myself?":

Oxaloacetate Citrate Isocitrate Ketoglutarate Succinyl coA Succinate Fumarate Malate 

Citric acid cycle compounds

"Oh Citric Acid Is Of (course) A SiLly STupid Funny Molecule":

Oxaloacetate Citrate Aconitate Isocitrate Oxalosuccinate Alpha-ketoglutarate SuccinyL-CoA SuccinaTe Fumarate Malate

· SilLy and sTupid used to differentiate succinyL and succinaTe 

Type 1 glycogen storage disease

Type 1 = one (Von), ie Von Giereke's disease 

Essential amino acids

PVT. TIM HALL: Phe Val Thr Trp Ile Met His Arg Leu Lys

· Pvt. is short for Private in the military.

· Arg and His are considered semiessential.

· Alternatively: "MATT VIL PHLy". 

Citric acid cycle compounds

"Can I Ask Sharon Stone For My Orgasm?":

Citrate Isocitrate Alpha-Ketoglutarate Succinyl CoA Succinate Fumerate Maleate Oxaloacetate 

Golgi complex: functions

"Golgi Distributes A SPAM": 

Distributes proteins and lipids from ER

Add mannose onto specific lysosome proteins

Sulfation of sugars and slected tyrosine

Proteoglycan assembly

Add O-oligosugars to serine and threnonine

Modify N-ologosugars on asparagine 

Pyruvate: products of complete oxidation

"4 Naked Fun 3 Coeds + 1 Guy":

· Complete oxidation of pyruvate yields:

4 NADH FADH2 3 CO2 1 GTP 

Catabolism steps of branched chain amino acids

"Truck hit the Ox to Death":

Transamination

Oxidative decarboxylation

Dehydrogenation 

Niacin deficiency: signs and symptoms

The famous 4 D's:

Diarrhoea Dermatitis Dementia Death (if untreated) 

Creatine phosphate: amino acid precursors

"Nice GAMs!": Glycine Arginine Methionine

· Gam is slang for a person's leg, especiallay an attractive female's leg: "Nice gams = nice legs!"

· Creatine phosphate is a muscle energy store, and spontaneously converts to creatinine which is excreted in the urine in direct proportion to muscle mass: clinically useful, such as in MS Dx.

Enzymes: classification

"Over The HILL":

Oxidoreductases

Transferases

Hydrolases

Isomerases

Ligases

Lyases

· Enzymes get reaction over the hill. 

Insulin: function

INsulIN stimulates 2 things to go  IN 2 cells: Potassium and Glucose. 

Collagen concisely covered

COLLAGEN:

C-terminal propeptide (procollagen)/ Covalent Cross links/ C vitamin/ Connective tissue/ Cartilage/ Chondroblasts/ Copper Cofactor (Covalent Cross linking)

Outside the cell is where collagen normally functions/ Osteoblasts/ Osteogenesis imperfecta

Lysyl hydroxylase/ Lysyl oxidase (oxidatively deaminates lysyl and hydroxylysyl residues to form collagen cross links, last biosynthesis step)

Long triple helical fibers/ Ligaments

Alpha chains/ Attached by H bonds form triple helix/ Ascorbate for hydroxylation of lysyl and prolyl residues of pro-Alpha chains (postranslational modification)

Gly in every third position/ Glycosylation of hydroxyl group of hydroxylysine with Glucose and Galactose; GOlgi allows procollagen to GO outside of cell

Extracellular matrix/ Eye (cornea, sclera)/ Ehlers-Danlos Syndrome

N-terminal propeptide (procollagen)/ Nonhelical terminal extensions

· Note: Procollagen LEAVEs the cell to be cLEAVEd by procollagen peptidases 

Essential amino acids

"PVT. TIM HALL always argues, never tires":

Phe Val Thr Trp Ile Met His Arg Lue Lys

· Always argues: the A is for Arg, not Asp.

· 'Never tires': T is not Tyr, but is both Thr and Trp. 

Hypervitaminosis A: signs and symptoms

"Increased Vitamin A makes you HARD":

Headache/ Hepatomegaly

Anorexia/ Alopecia

Really painful bones

Dry skin/ Drowsiness 

Heme synthesis: amino acid precursors to basic unit of porphyrins, heme (pyrrole ring)

"Dracula wants to Suck a Co-ed's blood [think heme] with his Glystening teeth!":

Succinyl CoA and Glycine are precursor amino acids to pyrrole rings, which is the basic unit of porphyrins and heme.

Enzymes: competitive inhibitors

"Competition is hard because we have to travel more kilometers (Km) with the same velocity":

With competitive inhibitors, velocity remains same but Km increases

 

Phosphorylation cascade: action during low glucose

"In the Phasted State, Phosphorylate":

The phosphorylation cascade becomes active when blood glucose is low.