Lecture 14 Flashcards

1
Q

where was thalidomide founded

A
  • Chemie Grünenthal GmbH,
    personal products company
  • Founded in Germany in 1946
  • Many former Nazis in company
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2
Q

who discovered thalidomide

A
  • Wilhelm Kunz, Grunenthal chemist
  • Discovered thalidomide (by-product while making antibiotic peptides)
  • commenced testing on rats, mice, guinea pigs
  • inactive in classic sedative tests (righting reflex)
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3
Q

What was the infamous Grunenthal ‘jiggle cage’?

A
  • 8 mice treated with sedatives (e.g. barbiturates) or thalidomide (hypnotic)
    are less active (less H2 gas released) than drug-free controls
  • measure H2 release with hydrogen detector
  • Reduction of H+ at electrode releases hydrogen gas
  • platinum electrode dips into acid when mice move or jiggle the cage
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4
Q

what were the symptoms reported after the 1st year of distrabution

A
  • Dizziness
  • Memory loss
  • Blood pressure loss
  • Cold hands and feet
  • Numb hands & feet
  • GI-tract pain & constipation
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5
Q

what epidemic unfolded due to thalidomide

A
  • Phocomelia: seal limbs, absent or ill formed upper or lower limbs
  • amelia: both upper and lower limbs are affected
  • rare condition
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6
Q

Who made the link between thalidomide and the epidemic

A
  • William McBride
  • drug removed from hospital pharmacy
  • dec 1961 famous letter in BMJ
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7
Q

how many babies did thalidomide effect

A
  • 10,000 malformed babies worldwide
  • excludes miscarriages and still births
  • high mortality rate in newborns
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8
Q

what was the window of susceptibility for a thalidomide toxicity

A
  • Day-20 to Day-36 post-fertilization
  • Day 34 to Day 50 after last menstrual cycle
  • 1 pill sufficient within this period
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9
Q

Disability Issues in Ageing Thalidomiders

A
  • Musculoskeletal Problems
  • pain
  • dental complications
  • sensory deficits
  • general health
  • mental health
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10
Q

how did thalidomide make a comback ?

A
  • Used to slow down body wasting in leprosy victims
  • Also to prevent weight loss &
    mucocutaneous ulcers in HIVinfected patients
  • cancer
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