Using Chemistry in MedicineNorman Ferrari, MDWest Virginia University School of Medicine

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

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– 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

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 …….. 12– SIU …………………. 10– U Miss – KC ……… NR– NEOCOM …………. 9– U Cincinnati ………. 11– U Penn ……………. 12– MUSC ……………… 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 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• 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 ……….