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 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
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
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Northwestern
SIU
U Miss – KC
NEOCOM
U Cincinatti
U Penn
MUSC
• Do NOT require Org Ch
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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
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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
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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
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Stoichiometry
Electrochemistry
Gas laws and diffusion
Solubility
Kinetics
Acid-Base
Metals
Nuclear Chemistry
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
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
Gas laws and diffusion
• O2 and CO2 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
• pH balance to maintain homestasis
• Buffers in the body
– HCO3-
Metals
• Iron
– Hemoglobin and O2 transport
• Copper
– Immune system health
• Zinc
– Wound healing, smell and taste
Nuclear chemistry
• Isotopes used for imaging studies
– Technetium Tc99
• Emission of gamma rays
• Isotopes used for therapy
– Radioactive Iodine I131
Hidden Curriculum in Chemistry
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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 ……….