Term Paper: Prescription, Nonprescription and Herbal Medicines

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[. . .] The effect of certain drugs on the enzymes in the liver must also be taken into consideration. Different sorts of drugs have a range of affects of the Cytochrome enzymes that exist in the liver. The drugs either induct or inhibit their performance these enzymes in the process of catalyzing other drugs. The effects of such activities are of particular importance in those patients that have been prescribed an assortment of drugs. The effect of a drug on the performance of an enzyme must be calculated in order to prescribe the proper dosage of the drug, so that it can be sufficiently be administered to the individual, who can receive it without having most of its quantity being reduced by reactions with enzymes in the liver.

The size of the kidneys, as with the liver, decreases with the age of the individual. As a consequence, there are smaller numbers of functioning nephrons present in the renal cavity that will result in a lower globular filtration rate. The function of the kidneys is also subdued because of the lesser blood circulation in the renal cavity. It has been established that after the age of 40, the kidney function in human beings reduces at a rate of 1% per annum (Sarnak, et al., 2009). Thus, in the elderly, the kidneys are less effective in the elimination of the residual medicine and drugs that are present in the blood stream. Kidney infections and diseases that are common in the elderly may also hinder the process of proper excretion of drugs from the kidneys. Again, there is a recommendation for a drop of dosage of the drugs and medicines.

One of the categories of drugs often used by the elderly population is the analgesics class of medication. These drugs, more commonly, are known as pain killers that function to relieve the body from pain rather than acting as anesthetics to leave the patient sensation less. With increasing age, the human body tends to function less efficiently, which results in painful problems for the older people. To counter such problems, various types of analgesic drugs, both prescriptive and over the counter, are now easily available in the market with many in use to treat numerous different kinds of pains. One of these prescription drugs is the Ultram. Its chemical name is the Tramadol Hydrochloride. The primary purpose of this drug is to provide treatment from mild to severe chronic pain pertaining to back aches and joint pains. Ultram has been known to work effectively in the treatment of fibromyalgia, rheumatoid arthritis and restless legs syndrome. Although the form of action of Ultram is not completely understood, it is believed to have two complimentary mechanisms, which are the weak inhibition of reuptake of norepinephrine and serotonin (which help in increasing the blood flow to the skeletal muscle and triggering the release of glucose from energy stores) and acting as a µ-opioid receptor agonist (which helps the nervous system to achieve decreased perception of pain as well as increased tolerance of pain).

Another prescribed analgesic drug used by the elderly population is the Celebrex, having the generic name of Celecoxib. This drug is manufactured by the pharmaceutical giant Pfizer and is available in the form of a capsule. This drug also acts as a pain reliever for treatments of rheumatoid arthritis, osteoarthritis, painful menstruation and acute pain. Celebrex is a non-steroidal anti-inflammatory drug (NSAID) that acts as an inhibitor to the COX-2 (cyclooxygenase-2), which is an enzyme that is responsible for pain and inflammation and the production of prostaglandins which leads to pain in arthritis patients.

One more prescription drug in use by the geriatrics patients is the Mobic. The generic name of this drug is Meloxicam. This medication is used as an analgesic for arthritis and has fever reducing effects. Alike Celebrex, Mobic is also a non-steroidal anti-inflammatory drug (NSAID). Such class of drugs is known to act as analgesics and antipyretics (fever reducers) and is usually used for treatment of chronic or acute conditions of pain. Mobic tends to acts as an inhibitor to the COX (cyclooxygenase) enzyme. This enzyme is responsible in converting the Arachidonic acid present in the membranes of cells into prostaglandin. After administration, it only takes Mobic around 30 to 60 minutes to relieve the host from pain.

Apart from prescription drugs, there are a number of over the counter medications that the geriatrics population uses as pain killers. These drugs are very easily available and therefore are used in huge numbers. According to a survey, around 80% of the adults in America use at least one over the counter drug once a week. Out of this number, 17 to 23% of the drugs are of the analgesics category (Kaufman DW, 2002 Jan 16). One of these drugs is the Aspirin. This drug is very commonly used and is used as a pain killer to provide relief from minor aches and pains such as headaches and backaches. The chemical name of Aspirin is Acetylsalicylic acid. This drug is also used in the treatment of joint pain symptoms of the acute rheumatic fever. The mechanism of action of the aspirin is to suppress the production of prostaglandins and thromboxane (an enzyme responsible for the clotting of blood). This suppression is done by deactivating the cyclooxygenase enzyme irreversibly.

Another of such over the counter drugs commonly used is the Ibuprofen. This drug is also a non-steroidal anti-inflammatory drug (NSAID). It is primarily used as a pain reliever, a fever reducer and helps reducing swelling. A much as this drug is common, it is considered a core medicine by the World Health Organization (WHO) and is included in the WHO's Model List of Essential Medicines (Stuart MC, 2009). Like other NSAIDs, Ibuprofen works by inhibiting the COX (cyclooxygenase) enzyme to suppress the production of prostaglandins. One more such analgesic drug that is available over the counter is the Naproxen. Although in most parts of the world, this drug is a prescription drug, in the United States of America, the Food and Drug Administration (FDA) approved its use as an over the counter drug in 1994. The medicinal function of this drug is to relieve from pain and stiffness caused by several conditions that include migraines, osteoarthritis, kidney stones, tendinitis, rheumatoid arthritis and menstrual cramps. This is also used in the treatment of primary dysmenorrhoea, a gynecological condition of pain during menstruation. Naproxen is also a NSAID, but its mechanism of action is clearly understood, although, it is believed to also function as a prostaglandin synthetase inhibitor.

While medicines and drugs are available to cure and act as painkillers, there exist various alternative or complimentary therapies for the older patients to reduce medicinal intake and reduce pain using simple physical exertions and therapies. One of these therapies is the acupuncture. This is a very famous technique for pain relief for various conditions, originating in China over 3000 years ago and is in practice around the globe. Researchers have found that through acupuncture treatments, patients have achieved relief from chronic back and neck pain, headaches and osteoarthritis without the use of any medications. Acupuncture is performed using the insertion of needles at various pressure points (commonly referred as acupoints) of the human body to treat various types of pains. There are various mechanisms of actions of acupuncture, one being the producer of natural opioid substances in the human body, as needling increases the production of naturally occurring opiate substances in the body that act as blockers of pain arising from the musculoskeletal system. Acupuncture is also known to induce relaxation in myofibrils within tissue planes, resulting in reduction of myo-brillary entanglement.

Chiropractic care is another form of such alternative therapy that is in use to gain pain relief. This treatment is primarily used in the manual therapy of some musculoskeletal conditions such as lower back pains which are more common in the geriatric population. This is possible using the spinal manipulation effects of this therapy. Using chiropractic care, the mechanisms of actions measured are the immediate decrease of stiffness in the lower spine and the improved recruitment of the lumbar multifidus muscle in the lower spine to reduce pain. One more very common therapy for pain relief is the massage therapy. This has been in existence for a very long time, and has been practiced all over the globe. This therapy is used to relax the body, relieve from pain and increase blood circulation by simply rubbing and applying pressure on the body. Massage therapies can easily relieve and loosen the sore muscles of the body which eventually results in reduction of pain.

Another class of drugs also commonly used by the geriatric population is the antihypertensive drugs. Such drugs help to reduce the high rate of blood pressure which can ultimately result in complications such as heart diseases and strokes (J.… [END OF PREVIEW]

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