[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:07.05,0:00:10.21,Default,,0000,0000,0000,,Have you ever wondered what\Nhappens to a painkiller, like ibuprofen,
Dialogue: 0,0:00:10.21,0:00:11.96,Default,,0000,0000,0000,,after you swallow it?
Dialogue: 0,0:00:11.96,0:00:14.97,Default,,0000,0000,0000,,Medicine that slides down\Nyour throat can help treat a headache,
Dialogue: 0,0:00:14.97,0:00:16.05,Default,,0000,0000,0000,,a sore back,
Dialogue: 0,0:00:16.05,0:00:17.93,Default,,0000,0000,0000,,or a throbbing sprained ankle.
Dialogue: 0,0:00:17.93,0:00:20.83,Default,,0000,0000,0000,,But how does it get where it needs\Nto go in the first place?
Dialogue: 0,0:00:20.83,0:00:24.72,Default,,0000,0000,0000,,The answer is that it hitches\Na ride in your circulatory blood stream,
Dialogue: 0,0:00:24.72,0:00:27.44,Default,,0000,0000,0000,,cycling through your body in a race\Nto do its job
Dialogue: 0,0:00:27.44,0:00:31.14,Default,,0000,0000,0000,,before it's snared by organs\Nand molecules designed to neutralize
Dialogue: 0,0:00:31.14,0:00:33.93,Default,,0000,0000,0000,,and expel foreign substances.
Dialogue: 0,0:00:33.93,0:00:36.60,Default,,0000,0000,0000,,This process starts \Nin your digestive system.
Dialogue: 0,0:00:36.60,0:00:40.84,Default,,0000,0000,0000,,Say you swallow an ibuprofen tablet\Nfor a sore ankle.
Dialogue: 0,0:00:40.84,0:00:44.12,Default,,0000,0000,0000,,Within minutes, the tablet starts\Ndisintegrating in the acidic fluids
Dialogue: 0,0:00:44.12,0:00:45.74,Default,,0000,0000,0000,,of your stomach.
Dialogue: 0,0:00:45.74,0:00:48.55,Default,,0000,0000,0000,,The dissolved ibuprofen travels\Ninto the small intestine
Dialogue: 0,0:00:48.55,0:00:53.28,Default,,0000,0000,0000,,and then across the intestinal wall\Ninto a network of blood vessels.
Dialogue: 0,0:00:53.28,0:00:56.00,Default,,0000,0000,0000,,These blood vessels feed into a vein,
Dialogue: 0,0:00:56.00,0:00:59.84,Default,,0000,0000,0000,,which carries the blood,\Nand anything in it, to the liver.
Dialogue: 0,0:00:59.84,0:01:02.53,Default,,0000,0000,0000,,The next step is to make \Nit through the liver.
Dialogue: 0,0:01:02.53,0:01:07.78,Default,,0000,0000,0000,,As the blood and the drug molecules\Nin it travel through liver blood vessels,
Dialogue: 0,0:01:07.78,0:01:11.20,Default,,0000,0000,0000,,enzymes attempt to react with \Nthe ibuprofen molecules
Dialogue: 0,0:01:11.20,0:01:13.30,Default,,0000,0000,0000,,to neutralize them.
Dialogue: 0,0:01:13.30,0:01:16.77,Default,,0000,0000,0000,,The damaged ibuprofen molecules,\Ncalled metabolites,
Dialogue: 0,0:01:16.77,0:01:19.84,Default,,0000,0000,0000,,may no longer be effective as painkillers.
Dialogue: 0,0:01:19.84,0:01:24.40,Default,,0000,0000,0000,,At this stage, most of the ibuprofen\Nmakes it through the liver unscathed.
Dialogue: 0,0:01:24.40,0:01:26.53,Default,,0000,0000,0000,,It continues its journey out of the liver,
Dialogue: 0,0:01:26.53,0:01:27.77,Default,,0000,0000,0000,,through veins,
Dialogue: 0,0:01:27.77,0:01:30.21,Default,,0000,0000,0000,,into the body's circulatory system.
Dialogue: 0,0:01:30.21,0:01:32.18,Default,,0000,0000,0000,,Half an hour after you swallow the pill,
Dialogue: 0,0:01:32.18,0:01:36.99,Default,,0000,0000,0000,,some of the dose has already made it\Ninto the circulatory blood stream.
Dialogue: 0,0:01:36.99,0:01:39.70,Default,,0000,0000,0000,,This blood loop travels through every\Nlimb and organ,
Dialogue: 0,0:01:39.70,0:01:44.67,Default,,0000,0000,0000,,including the heart, brain, kidneys,\Nand back through the liver.
Dialogue: 0,0:01:44.67,0:01:47.22,Default,,0000,0000,0000,,When ibuprofen molecules \Nencounter a location
Dialogue: 0,0:01:47.22,0:01:50.08,Default,,0000,0000,0000,,where the body's pain \Nresponse is in full swing,
Dialogue: 0,0:01:50.08,0:01:54.61,Default,,0000,0000,0000,,they bind to specific target molecules\Nthat are a part of that reaction.
Dialogue: 0,0:01:54.61,0:01:57.68,Default,,0000,0000,0000,,Painkillers, like ibuprofen, block the\Nproduction of compounds
Dialogue: 0,0:01:57.68,0:02:00.86,Default,,0000,0000,0000,,that help the body transmit pain signals.
Dialogue: 0,0:02:00.86,0:02:02.76,Default,,0000,0000,0000,,As more drug molecules accumulate,
Dialogue: 0,0:02:02.76,0:02:05.39,Default,,0000,0000,0000,,the pain-cancelling affect increases,
Dialogue: 0,0:02:05.39,0:02:09.08,Default,,0000,0000,0000,,reaching a maximum within about\None or two hours.
Dialogue: 0,0:02:09.08,0:02:11.95,Default,,0000,0000,0000,,Then the body starts efficiently \Neliminating ibuprofen,
Dialogue: 0,0:02:11.95,0:02:16.30,Default,,0000,0000,0000,,with the blood dose decreasing by half\Nevery two hours on average.
Dialogue: 0,0:02:16.30,0:02:19.24,Default,,0000,0000,0000,,When the ibuprofen molecules detach\Nfrom their targets,
Dialogue: 0,0:02:19.24,0:02:22.83,Default,,0000,0000,0000,,the systemic blood stream carries\Nthem away again.
Dialogue: 0,0:02:22.83,0:02:26.41,Default,,0000,0000,0000,,Back in the liver, another small fraction\Nof the total amount of the drug
Dialogue: 0,0:02:26.41,0:02:29.17,Default,,0000,0000,0000,,gets transformed into metabolites,
Dialogue: 0,0:02:29.17,0:02:32.73,Default,,0000,0000,0000,,which are eventually filtered out\Nby the kidneys in the urine.
Dialogue: 0,0:02:32.73,0:02:35.53,Default,,0000,0000,0000,,The loop from liver to body to kidneys\Ncontinues at a rate
Dialogue: 0,0:02:35.53,0:02:38.22,Default,,0000,0000,0000,,of about one blood cycle per minute,
Dialogue: 0,0:02:38.22,0:02:42.40,Default,,0000,0000,0000,,with a little more of the drug neutralized\Nand filtered out in each cycle.
Dialogue: 0,0:02:42.40,0:02:45.57,Default,,0000,0000,0000,,These basic steps are the same for\Nany drug that you take orally,
Dialogue: 0,0:02:45.57,0:02:47.12,Default,,0000,0000,0000,,but the speed of the process
Dialogue: 0,0:02:47.12,0:02:50.09,Default,,0000,0000,0000,,and the amount of medicine that makes\Nit into your blood stream
Dialogue: 0,0:02:50.09,0:02:51.54,Default,,0000,0000,0000,,varies based on drug,
Dialogue: 0,0:02:51.54,0:02:52.46,Default,,0000,0000,0000,,person,
Dialogue: 0,0:02:52.46,0:02:54.71,Default,,0000,0000,0000,,and how it gets into the body.
Dialogue: 0,0:02:54.71,0:02:57.32,Default,,0000,0000,0000,,The dosing instructions \Non medicine labels can help,
Dialogue: 0,0:02:57.32,0:03:00.11,Default,,0000,0000,0000,,but they're averages based on \Na sample population
Dialogue: 0,0:03:00.11,0:03:02.93,Default,,0000,0000,0000,,that doesn't represent every consumer.
Dialogue: 0,0:03:02.93,0:03:05.20,Default,,0000,0000,0000,,And getting the dose right is important.
Dialogue: 0,0:03:05.20,0:03:07.99,Default,,0000,0000,0000,,If it's too low, \Nthe medicine won't do its job.
Dialogue: 0,0:03:07.99,0:03:12.21,Default,,0000,0000,0000,,If it's too high, the drug \Nand its metabolites can be toxic.
Dialogue: 0,0:03:12.21,0:03:14.15,Default,,0000,0000,0000,,That's true of any drug.
Dialogue: 0,0:03:14.15,0:03:18.35,Default,,0000,0000,0000,,One of the hardest groups of patients\Nto get the right dosage for are children.
Dialogue: 0,0:03:18.35,0:03:22.93,Default,,0000,0000,0000,,That's because how they process medicine\Nchanges quickly, as do their bodies.
Dialogue: 0,0:03:22.93,0:03:26.63,Default,,0000,0000,0000,,For instance, the level of liver enzymes\Nthat neutralize medication
Dialogue: 0,0:03:26.63,0:03:29.78,Default,,0000,0000,0000,,highly fluctuates \Nduring infancy and childhood.
Dialogue: 0,0:03:29.78,0:03:32.59,Default,,0000,0000,0000,,And that's just one \Nof many complicating factors.
Dialogue: 0,0:03:32.59,0:03:33.46,Default,,0000,0000,0000,,Genetics,
Dialogue: 0,0:03:33.46,0:03:34.20,Default,,0000,0000,0000,,age,
Dialogue: 0,0:03:34.20,0:03:34.94,Default,,0000,0000,0000,,diet,
Dialogue: 0,0:03:34.94,0:03:35.68,Default,,0000,0000,0000,,disease,
Dialogue: 0,0:03:35.68,0:03:40.70,Default,,0000,0000,0000,,and even pregnancy influence the body's\Nefficiency of processing medicine.
Dialogue: 0,0:03:40.70,0:03:45.84,Default,,0000,0000,0000,,Some day, routine DNA tests may be able\Nto dial in the precise dose of medicine
Dialogue: 0,0:03:45.84,0:03:49.57,Default,,0000,0000,0000,,personalized to your liver efficiency\Nand other factors,
Dialogue: 0,0:03:49.57,0:03:50.70,Default,,0000,0000,0000,,but in the meantime,
Dialogue: 0,0:03:50.70,0:03:52.34,Default,,0000,0000,0000,,your best bet is reading the label
Dialogue: 0,0:03:52.34,0:03:54.26,Default,,0000,0000,0000,,or consulting your doctor\Nor pharmacist,
Dialogue: 0,0:03:54.26,0:03:57.92,Default,,0000,0000,0000,,and taking the recommended amounts\Nwith the recommended timing.