0:13 okay so hopefully we understood all of
0:16 that and we're getting now into
0:19 understanding anti- coleric effects in
0:22 the brain and in the peripheral tissue
0:26 because the anti-histamines that were
0:29 the first generation anti-histamines had
0:33 a another problem they bound fairly
0:37 strongly to the acetal choline receptor
0:40 the muscarinic receptor not the
0:43 nicotinic receptor if they bound to the
0:46 acetylcholine nicotinic re receptor we'd
0:48 be in big trouble because we'd be
0:50 winding up with muscle weakness and
0:52 things like that but no they only bind
0:56 to The muscarinic receptors we've got
0:58 muscarinic acetylcholine receptors up in
1:01 the brain and we've up muscarinic acetal
1:04 choline receptors in the parasympathetic
1:07 nervous system and this portion actually
1:12 deals with that now what I'll do is I'll
1:15 actually before I even start talking
1:17 about that too much what I'll do is copy
1:19 and paste this into the chat board and
1:23 give you an idea of what sub question so
1:25 go ahead and copy and paste that one and
1:27 we're just going to talk about uh
1:30 crossover effects of anti histamines
1:32 also the crossover effects of
1:36 medications in general now one of the
1:38 important things to realize is that our
1:41 medications one of the big reasons that
1:43 our medications have any side effects at
1:47 all is because they might cross over and
1:50 and bind to some receptor or some enzyme
1:52 or something that they're not supposed
1:55 to bind to you know the perfect
1:58 medication is going to bind to only the
2:01 thing that we want it to bind to but
2:03 unfortunately a lot of our medications
2:07 inadvertently bind to something else in
2:10 addition especially if they're in a
2:13 higher dose so basically the higher the
2:15 dose gets with a medication if it for
2:18 instance has anti-cholinergic effects
2:21 it'll have much greater anticholinergic
2:24 effects as you increase the dose so as
2:28 that dose increases those bindings will
2:31 increase as well and and that is going
2:33 to result in a lot of the side effects
2:37 of medications our medications and if
2:40 you take a look at this simplistic uh
2:44 representation of the anti-histamine
2:47 trying to bind to exactly what it wants
2:50 needs to bind to so this anti-histamine
2:54 wants to bind to the histamine one
2:56 receptor that's the only thing that it
2:58 wants to bind to that's the only thing
3:00 that it should bind to if it's going to
3:04 be the perfect medication
3:06 unfortunately with the antihistamines
3:09 and especially the ones that were the
3:12 first generation antihistamines
3:14 Unfortunately they also bound to the
3:19 acetal Coline receptor fairly strongly
3:21 now all of our antihistamines have
3:24 varying degrees of binding to the
3:27 acetylcholine receptor don't get me
3:30 wrong none of them just don't bind to
3:34 them at all but in general our first
3:37 generation antihistamines the old ones
3:40 bound much stronger to the acetyl
3:42 choline receptor and therefore had what
3:46 we call anti-cholinergic or
3:51 antimuscarinic effects so that is what
3:54 was happening with the first generation
3:57 antihistamines and this is this portion
4:00 of the tutorial is really important and
4:02 the reason that it's a three-point
4:05 question instead of a two-point question
4:08 or whatever is because of the fact that
4:11 a lot of our medications like to bind to
4:14 that acetal choline receptor and
4:17 decrease the the actual actions of
4:20 acetal choline in the parasympathetic
4:23 nervous system and also a lot of our
4:25 medications will actually get uh have
4:28 anti-colic effects and go into the
4:30 bloodb brain barrier and act on those
4:33 receptors over there so this is a very
4:35 common thing and by the end of this
4:38 portion of the tutorial you'll actually
4:40 understand why a lot of our medications
4:43 wind up with dry mouth you know why is
4:45 it that your grandmother is going to
4:48 always complain about her medications
4:50 causing dry mouth because something in
4:53 that group of medications is causing a
4:56 dry mouth it's it's it has that
4:59 anti-colic effect most likely there's
5:01 other reason there there there's other
5:03 potential reasons but that's the most likely
5:04 likely
5:10 one so uh the very first thing that we
5:13 need to do is is actually look at this
5:15 one right here which doesn't really have
5:19 to do with the adverse effects of the
5:23 acetyl choline uh binding in the brain
5:24 uh the antihistamines the first
5:26 generation antihistamines that broke
5:29 into the bloodb brain barrier and went
5:33 into to the uh the brain they actually
5:36 affected the other neurotransmitter that
5:39 goes from the vestibular area through
5:41 the vestibular portion of the vestibular
5:44 cular nerve to the vomiting Center so
5:47 there's two neurotransmitters there
5:49 there's primarily the histamine one but
5:52 there's also acetal choline uh this is a
5:54 question from the above information from
5:56 that information that we just had you
5:59 just answer on the chat board what is do
6:01 you what do you think our very best
6:11 sickness the the D Dien hydramine and
6:14 other first generation antihistamines
6:17 okay so Dien hydramine and other first
6:19 generation antihistamines just in in
6:23 just as a a summary they are going to
6:25 actually block the histamine one
6:27 receptor which goes from the vestibular
6:30 area to the vomiting Center and they're
6:32 going to block the other
6:34 neurotransmitter which is going to carry
6:36 that message that you're sick from the
6:40 motion so with respect to our very best
6:42 medications for
6:45 decreasing uh motion sickness it will be
6:47 the antihistamines so I just wanted to
6:51 point that out that there is a a good
6:54 reason for it being the most commonly
6:56 prescribed or most commonly
7:00 recommended uh medication for F
7:03 sickness the other thing about this
7:05 though and the more important thing
7:07 especially with respect to the actual
7:10 question is the fact that the acetal
7:14 choline is really important in memory in
7:17 the in the brain and to give you an
7:18 example of why it's that
7:21 important uh the medications that we
7:23 have that are currently the most
7:27 effective for reducing the symptoms of
7:30 or of um of Alzheimer's disease and
7:33 other forms of demena of dementia are
7:36 going to increase the amount of acetal
7:39 choline in the brain so therefore the
7:43 very thing that we want is an increased
7:45 level of acetylcholine in the brain and
7:47 obviously as you're taking an
7:50 anti-histamine like dyen hydramine we're
7:53 decreasing the acetylcholine levels in
7:56 the brain and the other really really
7:57 important thing that I want you to
8:00 address in this question is that any of
8:02 those medications including the first generation
8:03 generation
8:06 antihistamines any of those medications
8:09 that actually bind to the acetylcholine
8:12 receptor and block it and they're in the
8:14 brain blocking the acetylcholine
8:17 receptor they're going to increase the
8:20 risk of developing Alzheimer's disease
8:23 and other forms of dementia so really
8:24 you shouldn't really be taking it for
8:27 long periods of time like Mrs Myers is
8:30 taking it at all especially at her age
8:33 because she already has and and as a
8:36 matter of fact you would say it is
8:40 contraindicated for Mrs Mars or you know
8:43 in a person of advancing age so a person
8:46 of advancing age has that risk of
8:48 developing Alzheimer's disease if you
8:51 have another risk factor like you know
8:54 taking antihistamines every single day
8:55 that's going to be another if you have
8:57 another risk factor like familial
8:59 predisposition that's going to to be
9:03 another uh kind of risk factor so uh it
9:06 it it's really important for this client
9:08 especially it's really important that
9:12 she gets off of the antihistamines now
9:15 and uh just allows as much acetal
9:19 choline there as possible so that's
9:22 what's happening in the brain and that's
9:24 relevant by the way just it's relevant
9:27 to any of our medications that
9:30 inadvertently uh kind of bind to the
9:31 acetylcholine the muscarinic
9:34 acetylcholine receptor that break into
9:36 the bloodb brain barrier actually kind
9:38 of seriously increasing the risk of
9:40 developing Alzheimer's at the same
9:43 time so uh the peripheral
9:46 anti-cholinergic effects of medications
9:49 you know like we will see this really
9:51 quite frequently we know that it's going
9:55 to be seen and the best way to really
9:58 kind of um kind of picture it is with a
9:59 picture like this where you got the
10:01 parasympathetic nervous system over here
10:03 and the sympathetic nervous system over
10:05 here and remember that that's one of our
10:08 ways of having homeostasis how do we
10:11 actually control the internal
10:13 environment and regulate it and make
10:15 sure that it's balanced well we've got
10:17 the Sy one of the ways is the
10:18 sympathetic and the parasympathetic
10:21 nervous system and virtually they do the
10:24 opposite kind of effect so anytime
10:28 you're blocking one of these if it has a
10:29 general an
10:31 antimuscarinic effect all the way
10:34 through the body what you're doing is
10:36 blocking this side over here the
10:38 parasympathetic nervous system and
10:41 allowing the sympathetic nervous system
10:44 to dominate so really easy on this one
10:47 you can actually think about you know
10:49 what happens in the pupils of the eyes
10:51 when you're just resting and relaxing
10:53 and there's no lights on and you're just
10:56 kind of really relaxing and just about
10:58 ready to go to sleep uh you know you've
11:00 you've got the lights dimmed it's going
11:03 to be a constriction of the pupils but
11:06 then if you're going to be eliminating
11:09 or decreasing the actions of the
11:11 parasympathetic nervous system then
11:14 what's going to happen is the the pupils
11:16 will dilate that's going to possibly
11:18 give a person a little bit of blurred
11:20 vision and it's also going to possibly
11:22 give the person a little bit of eye pain
11:24 because they might be a little bit too
11:28 bright a light so those are some of the
11:31 that's one couple of the uh primary
11:34 things that you find with an
11:37 anti-colic uh drug another thing that
11:39 happens with the parasympathetic nervous
11:43 system it's the rest and digest system
11:46 so we're resting and digesting but the
11:48 entire digestive system is going to be
11:51 going over time and just stimulated and
11:52 that kind of thing so therefore you know
11:54 you're going to have lots of saliva for
11:57 instance in the parasympathetic nervous
12:01 system kind of actions but then if you
12:03 cross that out if you actually uh bind
12:06 to those receptors those muscarinic
12:09 receptors and allow the sympathetic
12:12 nervous system to dominate then what
12:14 happens you've got an in inhibition of
12:16 salivation one of the things that
12:20 happens with a really severe like if
12:22 people in battle for instance we'll
12:24 actually talk about this uh the mouth
12:27 becomes so dry a very very dry mouth as
12:30 you have that severe sympathetic nervous
12:33 system stimulation and almost impossible
12:36 to uh to swallow but what you're ending
12:39 up to do on with with this you're
12:41 allowing that sympathetic nervous system
12:44 to dominate inhib inhibiting the
12:47 salivation and having a dry mouth now
12:49 it's got a lot of other effects as well
12:53 but the main effects the other main
12:56 effect that the person will be having is
12:58 going to be the the fact that the
13:01 sympathetic nervous system is the we
13:05 need to flee not we we've got to get out
13:09 of there and not take the time to uh you
13:10 know to urinate you know we've got to
13:12 get out of there so that's the other
13:17 thing that a person who is on a
13:20 anti-colic drug they're going to wind up
13:23 with not being able to urinate as well
13:26 so you can mention in in the answer to
13:28 this question you can mention some of
13:30 the other ones certainly mentioned some
13:33 of the other anti- coleric effects that
13:36 you find I'm going to allow you to
13:37 research this one a little bit more I'm
13:39 not going to give you every single
13:42 portion of the answer to this one you do
13:44 a little bit of work it's the most
13:45 important one and that's why I want you
13:47 to do a little bit of research you know
13:51 what are the anti-colic effects of a
13:53 first generation anti-histamine for
13:56 instance that might be a good search and
13:58 you'll find urinary retention because we
14:00 need def Fleet not we were're allowing
14:02 the sympathetic nervous system to
14:05 dominate uh dry mouth and other git
14:07 complaints because of the fact that
14:11 you're shutting down the rest and digest
14:14 system um and basically what you'll be
14:17 uh explaining is Dien hydramine is going
14:21 to cause is going to do a couple things
14:25 um with its binding to the acetylcholine
14:27 receptor as it binds to the
14:29 acetylcholine receptor in the brain
14:31 it's going to result in this as it binds
14:34 to the acetylcholine receptor on our
14:37 organs on our internal organs it's going
14:39 to do these things as well so just talk
14:43 about it in that way and it is a very
14:44 important thing so just make sure you
14:46 spend a little bit extra time on that
14:50 what I'm going to do right now is look
14:54 at and then how do you treat dry mouth
14:57 um you can stop taking the the drug
14:59 that's causing the dry mouth which often
15:02 times has to happen because some some
15:05 people don't get relief there are lenes
15:06 and that kind of thing that try to
15:10 stimulate the the saliva and uh try to
15:13 have the person tolerate the medication
15:16 a lot of people just simply from the dry
15:18 mouth they actually have to get off of
15:22 the medication that has the anti-colic
15:24 effects so were there any other
15:27 questions on this before we sign out one
15:30 thing that we don't ever do in this unit
15:35 is just grab 100 different side effects
15:37 of a medication and just stick it into
15:40 our workbook or whatever we whatever it
15:42 happens to be we we just don't do that
15:44 we don't kind of stick all of those side
15:47 effects we have to find out what the
15:49 most important side effects are what the
15:53 ones that actually are most frequently
15:57 uh found and also the ones that are most
16:00 most profound you know so for instance
16:02 the fact that this medication actually
16:05 causes an increased risk of developing
16:07 Alzheimer's disease that's really
16:10 important so uh so you really do put
16:12 down that kind of thing and you
16:14 definitely put down the things that I
16:15 talked about with respect to the
16:17 peripheral anti-cholinergic effects
16:19 because those are all really important
16:21 as well but like I said you might add to
16:24 those okay guys thanks for all the
16:28 things for coming in and I I do um kind
16:30 of uh look forward to seeing you next
16:33 week if you decide to come here next
16:36 week and if not then you can hit the uh
16:38 video tutorial series you can test out
16:41 that video tutorial series when it goes online
