The Pharmaceuticals business is the epitome of a modern, mature industry that has found a comfortable way to make profits by the billion; it’s global, hi-tech and has the ultimate customer, the healthcare budgets of the world’s richest countries. Some of today’s most promising drugs for the treatment of cancer, cardiovascular and neurological disorders use only one chiral form of a molecule whose isomers are mirror images of one another as a result catalyst developers and marketers report a brisk demand for chiral catalysts, which are able to produce the desired form of a drug or it’s chemical building block. The managing director of the pharmaceutical company Mr Peter Prophitt said that “More than three quarters of all new products being developed by the pharmaceutical industry are chiral substances”. Agricultural chemicals is another important outlet for chiral chemicals, although interest in chirals from this sector “is more subdued” than from drug makers because of the high development costs for new chiral products says Prophitt.Chiral compounds are also increasingly in demand for flavours and fragrances.
He also cites and emerging market for chiral food addictives, including amino acids, fatty acids, vitamins and other natural products and their synthetic analogs which are generally more potent than the mixture of both chiral forms. Compound in medicine initially used as a sedative and an antiemetic until the discovery that it caused severe fetal malformations. Thalidomide was developed in the mid- 1950’s and was found to induce drowsiness and sleep. The drug appeared to be unusually safe, with few side effects and little or no toxicity even at high doses. Further testing revealed that thalidomide was particularly well-sited to alleviating nausea and other symptoms associated with morning sickness in pregnant women.The drug’s potentially harmful effects on the foetuses of certain mammals were not recognised during testing. ‘Twenty million patients -almost 10 % of the US population- were exposed to five drugs withdrawn from the market between September 1997 and September 1998’ said a member of the committee on safety of medicine Dr Norman Noharm. ‘Yet the drug companies push the public and doctors to use new drugs that are more profitable but also more dangerous’.
He also said that the findings made a strong case for the adoption of a precautionary principle when choosing whether to adopt new drugs. ‘For many years’ Noharm said, ‘we have recommended doctors and patients not to use new drugs until they have been on the market for five years. This study provides more evidence for this approach’.He pointed that, thalidomide went on the market as a treatment for morning sickness in more than 40 countries beginning in 1958. It was soon found to produce more severe malformations in infants born of mothers who had taken the drug during early pregnancy. These included phocomelia, in which the long bones in the arms and legs fail to develop and other deformities such as absence or malformation of the external ear, fusion defects of the eye, and absence of the normal openings of the gastrointestinal tract.
Prophitt said that, ‘ even though it achieved worldwide notoriety as a cause of birth defects and was withdrawn from use a sedative, thalidomide eventually proved to have therapeutic uses.In the mid-1960’s clinicians discovered that it can effectively treat the painful skin nodules and nerve impairment caused by ENL, a complication of leprosy. Pharmaceutical innovation not only allows people with diseases to live longer (and indeed those suffering from AIDS, certain forms of cancer, or rare childhood disorders to live at all), it also reduces the cost of treating disease.
As spending on prescription drugs has increased and the rate of consumption has quickened, the pace of spending on hospitals and physicians has actually slowed, even as research has given the sick longer life. Chemists at the University of North Carolina at Chapel Hill have succeeded in determining the structure of a key molecule in the liver responsible for metabolizing more than 60 percent of drugs taken by humans.The molecule, known as PXR, is the master regulator of a protein called cytochrome P450-3A, or CYP3A, which breaks down medications, scientists say. Like an electric switch, PXR turns on and off the machinery that metabolizes more than half of all drugs used and, for that reason, is critically important to human health. Interactions involving the regulator molecule, scientifically known as a nuclear receptor, have led to so called “St.
John’s wort babies” after the unregulated herbal antidepressant caused the molecule to render oral contraceptives ineffective, university chemists say. Similar interactions have caused certain powerful drugs used for acquired immunodeficiency syndrome (AIDS) and for organ transplantation to become less effective.The drug-drug interaction caused by PXR in humans may also be dangerous, Noharm said. He also said that, ‘Many designer drugs are manufactured in clandestine laboratories, often by amateurs; for this reason they are sometimes more dangerous than the drugs they are intended to replace. One of the best-known is MDMA (3, 4- methylenedioxymethamphetamine), a variation of methamphetamine, popularly called Ecstasy.
Noharm believe that well-informed consumers can help reduce their risk of injury. The same medical errors report made this point: “A major unused resource in most hospitals, clinics and practices is the patient. Not only do patients have a right to know the medications they are receiving, the reasons for them, their expected effects and possible complications, they should also know what the pills or injections look like and how often they are to receive them.”