A presentation with guidelines on how to effectively manage medication and health.

1. Managing Medication
Managing Health
DR MICHELLE RUSSELL
PharmD

2. History of Medicines
• God, demons, witches or the stars
• No record of first herbs used
• Shamans and apothocaries (herbalists) these made
simple drugs from crushing etc powders, teas, pastes
• Folk medicine i.e. word of mouth
• 1800s advances in chemistry and extraction
• 1900s synthetic compounds

3. Basic Medication Design
Taken by mouth
• Tablets
coated and uncoated
• Capsules
• Softgels
• Liquigels
• Sub Lingual
• Slow and extended
release

4. Liquids
• Syrups
• Elixirs
• Suspensions
• Drops

5. Injections
Intra muscular Injection Subcutaneous injection

6. Intravenous Injections

7. Topical Applications
Tran dermal patch Creams, Ointments, Gels,
Paints, Sprays & eyedrops

8. Inhalers – Metered
Dose/nasal

9. Suppositories

10. How Medications Work
• Absorption
• Distribution
• Metabolism
• Excretion

11. Absorption
It can be absorbed :
• Through And Under Your Skin
• In Your Heart
• Into Your Stomach
• In Your Intestines
• In Your Kidneys Or Liver
• In Your Nose
• Under Your Tongue

12. Absorption

13. Distribution
• Point of absorption to site of action
• Blood flow - rate and amount
• Size of molecule
• Attraction to other components in the
blood
• Crossing natural barriers e.g. blood brain
barrier

14. Metabolism
How the body changes what goes in to
what comes out
• Enzymes
• Changing charges
• Breaking down
• Alcohol and insulin
• Toxification and Detoxification

15. Elimination
• The removal of drugs from the body
• Water soluble through the kidneys
• Gall bladder
• Skin

16. Generics and Equivalents
• Identical or within an acceptable
bioequivalent range to the brand name
counterpart
– In dose
– Strength
– Route of administration
– Safety
– Efficacy
– and intended use

17. Generics and Brands
• Branded products usually do not have
the drugs chemical name .
• Some generics have chemical name as
product name
• Newer generics often have a ―brand
name‖ that does not include the
chemical name.
• A drug may have several brand names

18. Therapeutic Equivalents
• A drug that has essentially
the same effect in the
treatment of a disease or
condition as one or more
other drugs.
• A drug that is a
therapeutic equivalent
may or may not be
chemically
equivalent, bioequivalent,
or generically equivalent.

19. Over The Counter – OTC
List One List Two
• Free sale • Patient must
• Patient makes
request item
choice
• Package sizes • Some intervention
limited
• Package size
• No intervention
limited
may occur

20. Meds & Athletic Performance
Ergolytic Actions
Ergogenic Actions
improves performance decreases performance
• Alcohol and Marijuana
• Performance • cocaine
enhancing • Some blood pressure
• Stimulants meds
• Pain killers • eye drops, and diuretics.
• Anti-inflammatory • Some antidepressants
• some antihistamines
• even caffeine--

21. Ergogenic Drugs
Caffeine
• Improves athletic performance
• Increases energy and delays fatigue – (T)
• Improves fat burning by increasing fat metabolism (F)
• Spares muscle glycogen ( slightly)
• Enhances body fat loss (F)
• Acts as a central nervous system (CNS) stimulant (T)
• Raises epinephrine levels (T)
• Increases alertness (T)

22. Ergogenic Drugs
• Ephedrine Claims
– Increases body fat loss
– Improves athletic performance
– Improves concentration
• Research Shows
– Research has found no effect of ephedrine on
strength, endurance, reaction time, anaerobic
capacity, or recovery time after prolonged exercise
– Caffeine potentiates the effect of Ephedrine and the
combination can be dangerous

23. Ergolytic Drugs in Sports
Alcohol
Impairs motor skills including :
• reaction
time, balance, accuracy, hand-eye
coordination and complex
coordination
• may impair strength, power, speed
and both muscular and cardiovascular
endurance as it reduces the force of
hearts contraction

24. Ergolytics Con’t
Cocaine and Marijuana.
• Both increases the work of
the heart
• Decreases performance.
• Cocaine can also lead to
more serious
complications, including
– Heart attack
– Cardiac arrhythmia (heart
rate changes)
– Seizure (fits)
– Stroke and death.

25. Ergolytics Con’t
Nicotine
• While nicotine will give athletes
a "high" and they may feel more
alert, their performance
decreases.
• Negative changes in the hearts
performance that impair heart
function.

26. Ergolytics Cont’t
Diuretics (water tablets)
• Throw off the body's electrolyte balance
• Causes muscle cramps
• Reductions in strength and power
• They also affect hydration
• Cardiovascular performance decreases
Diuretic use has played a role in the
collapse of runners during hot-weather
races .

27. Ergolytics Cont’t
Blood pressure pills and eye drops
• Beta-blocker reduces the heart's ability to respond to exercise
stress.
• It can reduce maximal oxygen uptake by up to 15 percent
among elite athletes.
• The same thing happens to performance capacity during
exercise.
• Competitive athletes should avoid beta-blockers; calcium
channel blockers, seem to have very little negative effect on
exercise capacity.

28. Ergolythics Cont’t
Ergolytics Con’t
Other drugs
• Sleeping tablets-
hangover effect
• Tranquilizers
• Most anti allergy –cause
drowsiness and
listlessness
• Caffeine high then
low, sleep disruption

29. Storing Medications
Factors affecting medication
stability
• Heat
• Cold
• Dampness
• Drying out because left open
• Keep out of the reach of children

30. How to take Medications
• Route, frequency, and
duration
• Before , during or after meals
• Breaking and crushing and
dissolving tablets
ANY QUESTIONS?

31. Exercise because…
• Sufficient Flexibility
• Adequate Muscular
Endurance
• Adequate Strength
• Cardiovascular Endurance
• Healthy Body Composition

32. What & How Much To Eat?
• Learn the body’s nutrient needs
• Categorize the body’s nutrient
needs
• Learn the foods that meet these
needs
• Learn how to think critically about
food choices, read labels, and
evaluate foods

33. Causes of Athlete’s Fatigue
• Glycogen depletion (stored
carbohydrate )
• Hypoglycemia
• Dehydration
• Lactic acid accumulation
• Electrolyte imbalances
• Amino acid imbalances
• Muscle overuse
• Lack of muscle recovery

34. How much do you need
• Active people and athletes should consume a
majority (65-75%) of their Calories from
Carbohydrates. Average person 55% may be enough
• The government recommends less that 30% of
Calories come from Lipids, but many nutritionists
recommend less than 20%.
• Proteins should be approximately 10-15% of one’s
Calories

35. Functions of Carbohydrates
• Blood glucose maintenance (80 Calories)
• Glycogen storage in the liver (400 Calories)
• Glycogen storage in the muscle (1400-1800 Calories)
• Primary brain fuel
• Protein-sparing; prevents ketosis
• Essential for athletes, especially endurance athletes

36. Wholesome Unrefined Complex
Carbohydrates
• Whole-grain
cereals, waffles, and breads
• Beans and legumes
• Pastas
• Brown rice
• Barley, quinoa, oats
• Fresh veggies
• Fresh fruits
• Polenta (coarse cornmeal)

37. Functions of Fat
• Stores energy
• Cushions vital organs
• Insulates the body and maintain body temperature
• Transports essential fatty acids and fat soluble vitamins
• Part of cell membrane structure
• Offers satiety in meals
• Enhances food flavor and aroma

38. Water
• Vital to life
• Is a
solvent, lubricant, m
edium for
transport, and
temperature
regulator
• Makes up majority
(2/3) of our body
• Yields no energy

39. Dehydration Causes Fatigue

40. Hydration
• Thirst is not a reliable indicator of fluid
needs
• General guideline: 2-3 Cups of fluids per
each pound of weight loss during activity
• Drink fluid freely 24 hours before the event
• Drink 1.5-2.5 Cups two-three hours before
the event
• Consume 3-8 ounces every 15 minutes for
events lasting longer than 30 min.
• At 3% water loss, performance shown to
decrease 10%

41. Rehydration
• Water good for first 90 minutes
• >90 mins blood sugar falls
• Sodium and potassium lost through
sweat
• Sports drink can raise blood sugar
levels
• Not all sports drinks are created
equal
• Juice and sodas too sugary need to
be diluted

42. Supplements
• Something added to the diet, to make
up for a nutritional deficiency.
• Supplements include the following:
– Vitamins
– Amino Acids
– Minerals
– Herbs
– Other Botanicals

43. Supplements are not
• Required to meet the same safety requirements as over-the-
counter or prescription drugs or food ingredients
• Held to specific manufacturing standards
• Guaranteed to meet product potency or purity ratings
• Required to prove the effectiveness of any health claim they
make
• Required to meet safety or efficacy testing prior to going to
the market

44. Supplement Facts Sheet
Supplement Facts
Serving Size 1 Tablet
Amount Per Serving % Daily Value
Thiamin (Vitamin B-1)(as Thiamin
Yeast) 7 mg 467%
Hydrochloride and Brewer’s
Riboflavin (Vitamin B-2)(as Riboflavin and
Yeast) 14 mg 824%
Brewer’s
Niacin (as Niacin and Brewer’s Yeast) 4.5 mg 23%
Vitamin B-12 (as Cyanocobalamin and
Yeast) 25 mcg 417%
Brewer’s
Protease (as Papain Powder) 10 mg *
*

45. Supplements
Vitamin Bs
• May be a link between the B-
vitamins
(thiamin, riboflavin, vitamin B-
6, B-12 and folate) and
performance in high-level athletes
• Even a small B-vitamin deficiency
can result in reduced performance
and recovery.

46. Essential Fatty Acids
Omega 3, 6 and 9
• Body can’t make it
• Needed for immune
function
• Vision
• Cell membrane
• Production of hormone-like
compounds

47. Nutrient needs
Adequate nutrients can
mean
• Quicker recovery time
• Lower infection rates
• Less fatigue
• Ultimately, can help
athletes reach their desired
performance levels.

48. The Female Athlete Triad (or
Triple Threat to Female Athletes
1. Eating Disorders
2. Cessation of
Menstruation
(Amennorhea)
3. Bone Fractures (and
ultimately osteoporosis

49. Supplements –The Good
Antioxidants Anti -Inflammatory
• Omega 3
• Turmeric
• A • Bromelian
• C • Capsaicin
• E • Pycnogenol
• Co-enzyme Q 10 • Glucosamine and
chondrotin
& MSM

50. Supplements –the good
Supplements –The Good
Minerals
• Calcium 1000 - 1500/d
• Iron > 6 hours/week
10- 15mg/d
• Magnesium 500-800mg/d
• Potassium
• Selenium 100-200mcg
• Sodium
• Zinc
May 1999 Issue of Nutrition Science News

51. Health ,Harm or Rip Off?
• Energy drinks — which are often loaded
with caffeine, sugar and herbal stimulants
may pose various health risks, including:
– Restlessness and irritability head aches n&v
– Increased blood pressure
– Possible dehydration
– Weight gain
– Excessive amounts of energy drinks have been
associated with manic episodes, seizures, chest
pain, heart attacks and sudden cardiac death
Mayo clinic

52. Supplements – The Dangerous
• All athletes need to be proactive in
asking questions so they don’t
jeopardize their sporting careers.
• If you have a question - ASK!
• If you cannot be 100% sure of the
ingredients or don’t know the status of a
substance – DON’T TAKE IT!
WADA

53. www .easy access. com
We sell only the highest quality pharmaceutical grade
anabolics.
** Warning: Deca-
Durabolan, Dianabol, Winstrol, Clenbuteral, Anavar, and
Trenbolone are toxic Anabolic Steroids

54. Too good to be True
• Performance enhancing
• Bulk and cut
• Extreme muscle
development
• Quicker recovery time
• Less injury
• More power
• Muscular development

55. ANABOLIC ANDROGENIC
STEROIDS
• They increase protein synthesis
within cells
• They reduce the rate of muscle
breakdown
• Muscle cells formed preferentially
over fat cells
• Increase of Basal Metabolic Rate (
BMR) burning fat stores

56. MEDICINAL USES
• Replace testosterone after surgery or cancer
• Adolescent males with pituitary malfunction
• After certain kinds of surgery and cancer.
Anabolic steroids are used , with exercise and
diet, to build up lost muscle tissue.
• AAS are given by mouth, via injections or by
adhesive patches.

57. SPECIFIC USES OF AAS
• Danazol –Endometriosis
• Mesterolone (Proviron) – low sperm
count
• Stanozolol - anemia and hereditary
angioedema
• Oxymetholone (Anadrol) –anemia
osteoporosis

58. Beta Blockers
• Asthma
• High blood pressure
• Glaucoma in the eye
• Racing heart
Beta blocker widen blood
vessels and reduce muscle
spasms.

59. Aromatase Inhibitors
EstroBlock
Anti-Estrogen/Aromatase Inhibitor
� Conquers Estrogen
Bodybuilders and strength athletes are
well aware that the female hormone
estrogen can seriously harm their
attempts to build muscle and strength.
Estrogen MUST be kept under control
or some pretty undesirable conditions
may arise in the body.

60. Hormone Antagonists and
Modulators
• Many used to treat various forms of
breast cancer
• Low sperm count
• Infertility in both men and women

61. Stimulants
• Appetite suppression
• Attention deficit disorder with
hyperactivity
• Narcolepsy

62. • May 1999 Issue of Nutrition Science News