Using Chemistry in Medicine Norman Ferrari, MD West Virginia University School of Medicine.
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Transcript of Using Chemistry in Medicine Norman Ferrari, MD West Virginia University School of Medicine.
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Using Chemistry in MedicineNorman Ferrari, MDWest Virginia University School of Medicine
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West Virginia University Eberly College of Arts and SciencesBennett Department of Chemistry Lecture 2008
Professor and Senior Associate Dean
Board Certified in two specialties
Pediatrics
Internal Medicine
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How did I get there …….• Completed the 24th grade
– 8 primary, 4 high school, 4 college, 4 med school, 4 residency
• Years 13 to 16 were studying chemistry• Years 17 to 24 refining my use of chemistry• Beyond the 24th grade
– Using chemistry to improve health of patients– Using chemistry to prepare future physicians
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Medical Education
• Long process• College experience
– At least 90 credit hours– 44 hours are for specific content– 16 hours are chemistry
• 8 each of inorganic and organic
• Doctoral Degree– 4 years
• Post graduate Residency Training– Specialty specific– 3 years to 8 years
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Question• What is the most important academic
preparation for a career in medicine ?
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Requirements for admission to MD Programs ……..
• Chemistry is the most required undergraduate subject area– Inorganic and Organic
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Requirements for admission to MD programs …….
• Do NOT require Chem– Northwestern– SIU– U Miss – KC– NEOCOM– U Cincinatti– U Penn– MUSC
• Do NOT require Org Ch– Northwestern– SIU– U Miss – KC– U Cincinnati– U Penn– MUSC
Have NO course requirementsNEOCOM does require Org Ch and Physics
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Requirements for admission to MD programs ….
• MCAT ……… PS section– 4 schools do not require MCAT
• U Miss – KC• Dartmouth• Brown• Meharry
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MCAT results ……….• MCAT ……… PS section
• U Miss – KC [no data]• Dartmouth 8 to 15, mean 11• Brown 8 to 15, mean 12• Meharry 5 to 12, mean 7
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MCAT results• Scores for schools that do not require Chem
– Northwestern …….. 12– SIU …………………. 10– U Miss – KC ……… NR– NEOCOM …………. 9– U Cincinnati ………. 11– U Penn ……………. 12– MUSC ……………… 9
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Uses of Chemistry in Practice of Medicine• Stoichiometry• Electrochemistry• Gas laws and diffusion• Solubility• Kinetics• Acid-Base• Metals• Nuclear Chemistry
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Stoichiometry
• Management of fluids and electrolytes• Solutions
– Normal Saline: 154 mEq Na+ / L– D10W: 10% glucose solution
• Volume of fluids– 100 cc/Kg/day for first 10 Kg ……
• Electrolytes– Current concentrations to needed
concentrations
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Electrochemistry
• Na+ ions have higher concentrations outside cell membrane via Na+/K+ pump
• Electrical gradient across the cell membrane of -70 mV
• Nerve conduction and action potentials
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Gas laws and diffusion
• O2 and CO2 diffuse in alveoli in lungs and the capillary beds in tissues until they reach equilibrium
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Solubility• Will certain chemicals be able to diffuse
through the cell membrane lipid bilayer• How will the concentration of chemicals
(drugs) be distributed through body tissues that are aqueous verses lipid
• What tissues do you want the drug to be highly concentrated …..
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Kinetics• How rapidly are chemicals we give patients
degraded in the body• Half life of drugs
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Acid-Base• pH balance to maintain homestasis• Buffers in the body
– HCO3-
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Metals
• Iron– Hemoglobin and O2 transport
• Copper– Immune system health
• Zinc– Wound healing, smell and taste
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Nuclear chemistry• Isotopes used for imaging studies
– Technetium Tc99
• Emission of gamma rays
• Isotopes used for therapy– Radioactive Iodine I131
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Hidden Curriculum in Chemistry• Problem solving skills• Data gathering skills• Critical thinking skills• Time management skills• Good work ethic
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In my humble opinion ……Chemistry is the most important science in the
preparation for a career in medicine ……….