Class #11 - Drug Development Flashcards
King Charles (1500) experiment?
Thief given bezoar stone (found in goat stomach) with poison to see if would protect him, he died. Spanish noble claimed he wouldn’t.
Jacques Cartier and Scurvy?
Natives gave him cure by making a tea out of tree containing vit. C.
First clinical trial on Scurvy?
James Lund, hypo since its rare on land caused by diet. 6 groups of two + control. Orange and lemon survived. Lime jus mixed with Rum since then.
Dropsy trial?
William Withering with fox glove.
Hierarchy of evidence?
Meta - RCT (double-blind) - Cohort studies - Case control - Cross sectional - animal/in vitro - Case report/opinion
Observational studies with definitions (3)? general particularity?
No control over environment.
- Cross-sectional: Obs of one single point in time of data, no cause-effect relationship (RS).
- Case-Control: Compare risk factors between individuals in population. Retrospectively compare. Try to determine RS, cannot prove cause-effect.
- Cohort: Follow people over time. detect change in heatlh in RS with risk factors.
Drug to market steps?
- Idea/discovery
- In Vitro: Any benefits? /Animal: Determine safety and LD50.
- Investigational New Drug Application: Tell Health Canada
- Phase 1: Evaluate safety on healthy participants, 10s of subjects.
- Phase 2: 100s subject with disease, RCTs
- Phase 3: 1000s subject with disease, up to 5 years, RCTs
- New drug application
- Decision by gov.
- Review of data
- Approved vs Rejection
- Phase 4: Studying people now that drug is on the market.
Arteminisin treat of? Came from?
Malaria, Chinese folklore
Eg of plant origin of drugs: Yew tree
Taxol anti-cancer
Eg of plant origin of drugs: Autumn crocus
Colchicine: gout
Eg of plant origin of drugs: Periwinkle
Vincristine - anti-cancer
Eg of plant origin of drugs: Rauvolfia
Reserpine: anti HTA
Banting and Best found insulin by studying?
Dogs
Most drugs don’t make it past?
Animal studies
Eg drug pull out of market?
Thalidomide; Hismanal (anti-His.) - giving arrythmias; Baycol (statin) - musc. weakness and kidney injury; Redux - heart abnormalities; Vioxx (anti-arthritis) - Augmented risk heart disease