TRI-5, Wk14, Day 327

kinda dazed - I got two hours of sleep last night and took a two hour nap when I got home. I think I'm going to sleep in until 3:30, maybe 4 o'clock this morning. I have to have my Diversified polished for our practical at 8:15 a.m.

Cardio Dx Exam 4 will be taking a back seat to Diversified but, after the diversified practical I'll study what I can before that exam.

We've got Radiology Positioning Practical on Wednesday as well as homework and a quiz in Basic III ...here Basic will take a bit of a back seat to the Rad Pos.

Thursday is a free day then two finals a day after that until next Thursday morning.

We studied pain some more in our pharmacology (aka toxicology) class today. I think most people have probably heard of COX inhibitors, maybe on TV or something. There are a few different types of COX - COX1, COX2 and COX3 ....maybe more

COX2 is kind of "bad" and contributes to pain. COX1 is kind of good and contributes to helping to maintain our gastric lining as well as smooth renal function.

First generation COX inhibitors are things like aspirin, acetaminophen and ibuprofen. Those medications can not discriminate between the good and bad COX so they block both of them which can provide relief from blocking the bad COX (COX2) but it also blocks the good (COX1) which helps to protect our stomach and keeps the kidneys running smoothly.

That's the reason we see the side effects about upseting the stomach.

2nd Generation COX inhibitors are a bit more selective and can block only COX2 but still don't seem to work quite as intended. Celebrex is the only one on the market now and the FDA issued a warning about it in 2005. The two other COX2 inhibitors were pulled from the market and include Vioxx (pulled in 2004) and Bextra which was pulled in 2005.

one other thing about COX1 (the "good" COX) is the it promotes platelet aggregation however inhibiting this action may be considered a benefit as it can provide protection against myocardial infarction (as with low dose aspirin)

We also talked about benzodiazepines. Take a look at the last part of that word, benzodiazepines. and you might recognize the generic name for valium, ie diazapam.

Valium (a type of bensodiazepine) is another drug that was in widespread use before we knew how it worked. The first benzodiazepine was discovered in 1955 and made available in 1960 but it wasn't until 1977 when researchers discovered a receptor in the brain specific for bensodiazepine compounds. Tylenol was the same way - wide spread use before we knew exactly how it worked.

Benzodiazepines like valium enhance the effects of GABA which is one of those chemicals our body makes to help calm the nervous system, which is to say it has an inhibitory effect.

GABA is one of those key players in chiropractic since it can be elicited by mechanoreceptors.