Drugs: From Molecules To Man

Question 1

What was pharmacology like before the scientific era?

Answer 1

Folk remedies i.e. Morphine, cocaine, aspirin, alcohol.
From natural sources.
Side effects not widely recognised.
Mechanisms unknown.
Structure and target of drugs unknown.

Question 2

How was cocaine used initially?

Answer 2

In the Andes as an endurance enhancer and local anaesthetic.

Question 3

How was cocaine used and understood in the 19th century?

Answer 3

Uncontrolled, in patent medicines and commercial products.
Eye surgery (Koller, 1884) (still used today for eye and nasal surgery).
Freud thought cocaine: mental stimulant, for digestive problems, morphine addiction, aphrodisiac, local anaesthetic.

Question 4

Bier and Hildebrandt.

Answer 4

Thought injecting cocaine into spinal chord–> surgery w/o general anaesthetic.
6x successful on patients + self testing.
Lost sensation in legs, touch preserved (for a while), motor function completely preserved, known as Bier block.

Question 5

Modern anaesthetics.

Answer 5

Procaine synthesised in 1905 (has no CNS effects).

Lidocaine (1943), still most widely used today.

Question 6

Who pioneered modern drug discovery?

Answer 6

Paul Ehrlich (1854-1915); research on African sleeping sickness (using dyes), >900 arsenical compounds, 1909 #606 tested on syphilis, completely effective , released as Salvarsan (1909).