IN THIS ISSUE:
REGULAR FEATURES:
A Message From the President
By the Numbers
Human Resources FYI
Medical News
News Briefs
Professional Notes
SLU Stars
Top Ten
Trivia Corner
By Maurice C. Lunik
With apologies to Ray and Ksir, authors of Drugs, Society and Human Behavior, a reference that examines drugs from all perspectives - behavioral, pharmacological, historical, social, legal and clinical - we attempt to formulate our Top 10 list recognizing the complexity of health care.
The question to be answered is: How can individuals obtain the best possible health care results - length of life, quality of life and productivity - at the lowest possible cost for themselves and their societies?
Pharmaceutical discoveries are the most cost-effective tool of health care delivery. They help reduce the need for surgery, eliminate the need for hospitalizations and keep individuals healthy and on the job.
The average cost of developing a new prescription drug is $500 million. The whole process, from laboratory to the pharmacy, takes an average of 12 years.
Current drugs target about 400 human genes, and genomic research reveals about 3,000 to 10,000 genes that potentially will serve as targets for drug intervention.
In no particular order, here are my Top 10 applied pharmaceutical research examples:
- Insulin, prepared using recombinant DNA technology, is used in humans as replacement therapy to treat diabetes mellitus, a disease that affects a large number of individuals.
- Vaccines have changed the epidemiology of many disease states, making many fatal diseases of the past just that ... of the past.
- Penicillin and Sulfa drugs, the pioneers of all antibiotics, have helped treat and eradicate organisms previously known to be life-threatening.
- Aspirin and acetaminophen, widely and extensively used analgesics, allow people to carry out activities of daily living without problem.
- Cyclosporine prevents graft rejection and prolongs organ and patient survival.
- Chlorpromazine, the grandfather of antipsychotic medications, allowed psychiatric illnesses to be treated and patients to be reintegrated into society.
- Nitrogen mustard, the forerunner of chemo agents, provided great utility in cancer treatment by relieving symptoms, increasing quality of life and prolonging life.
- Fluoride and the fluoridation of water greatly contributed to overall improvement of dental health.
- Warfarin/heparin/tPA, anticoagulants, benefited in prophylaxis and treatment of thromboembolic disorders from heart attacks, stroke and blood clots that improved morbidity and mortality.
- Human genome project. This future mission involves the identification of human genes to uncover mechanisms for diseases. It will pave the way for more effective therapies and preventive measures.
The well-placed high expectations for medical research can be presented by the following model proposed by Lewis Thomas, physician and award-winning essayist. Thomas described three distinct levels of medical technology, the first of which is "supportive technology," which is largely palliative in nature. Level two is termed "halfway technology," which is "make-do" and an expensive proposition. He depicted these efforts as those heroic measures to deal with disease that can't be cured or managed. Thomas' examples include organ transplants, dialysis and in-patient psychiatric care. The third level is the "decisive technology" of modern medicine; this reflects those definitive therapies that attack the fundamental underlying causes of illnesses at the molecular level. In his opinion, this is where the historic opportunity to eradicate disease resides.
As a quaternary care university teaching hospital, we must continue to work toward developing, testing and refining the "decisive technologies" of the future. These efforts build the foundation for disease prevention and treatment.
Maurice Lunik is the investigational drug studies coordinator for pharmacy services.