Using Chemistry in Medicine Norman Ferrari MD West

Using Chemistry in Medicine Norman Ferrari, MD West Virginia University School of Medicine

West Virginia University Eberly College of Arts and Sciences Bennett Department of Chemistry Lecture 2008 Professor and Senior Associate Dean Board Certified in two specialties Pediatrics Internal Medicine

How did I get there ……. • Completed the 24 th 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 24 th grade – Using chemistry to improve health of patients – Using chemistry to prepare future physicians

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

Question • What is the most important academic preparation for a career in medicine ?

Requirements for admission to MD Programs ……. . • Chemistry is the most required undergraduate subject area – Inorganic and Organic

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 requirements NEOCOM does require Org Ch and Physics

Requirements for admission to MD programs …. • MCAT ……… PS section – 4 schools do not require MCAT • U Miss – KC • Dartmouth • Brown • Meharry

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

MCAT results • Scores for schools that do not require Chem – – – – Northwestern ……. . SIU …………………. U Miss – KC ……… NEOCOM …………. U Cincinnati ………. U Penn ……………. MUSC ……………… 12 10 NR 9 11 12 9

Uses of Chemistry in Practice of Medicine • • Stoichiometry Electrochemistry Gas laws and diffusion Solubility Kinetics Acid-Base Metals Nuclear Chemistry

Stoichiometry • Management of fluids and electrolytes • Solutions – Normal Saline: 154 m. Eq Na+ / L – D 10 W: 10% glucose solution • Volume of fluids – 100 cc/Kg/day for first 10 Kg …… • Electrolytes – Current concentrations to needed concentrations

Electrochemistry • Na+ ions have higher concentrations outside cell membrane via Na+/K+ pump • Electrical gradient across the cell membrane of -70 m. V • Nerve conduction and action potentials

Gas laws and diffusion • O 2 and CO 2 diffuse in alveoli in lungs and the capillary beds in tissues until they reach equilibrium

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 …. .

Kinetics • How rapidly are chemicals we give patients degraded in the body • Half life of drugs

Acid-Base • p. H balance to maintain homestasis • Buffers in the body – HCO 3 -

Metals • Iron – Hemoglobin and O 2 transport • Copper – Immune system health • Zinc – Wound healing, smell and taste

Nuclear chemistry • Isotopes used for imaging studies – Technetium Tc 99 • Emission of gamma rays • Isotopes used for therapy – Radioactive Iodine I 131

Hidden Curriculum in Chemistry • • • Problem solving skills Data gathering skills Critical thinking skills Time management skills Good work ethic

In my humble opinion …… Chemistry is the most important science in the preparation for a career in medicine ……….