In the Last Thirty Years of Prescription Medications...

by Aimee Amodio | More from this Blogger

13 Sep 2008 01:14 PM

I have to admit -- I'm spoiled by modern technology and comforts. It's hard to imagine what life was like without prescription medications... but just three decades ago, they were far less advanced than they are now.

According to the National Institutes of Health, just thirty years ago very little was known about predicting drug interactions and/or serious side effects. Doctors, researchers, and pharmacists had no way to anticipate these problems until drugs started clinical studies -- or were widely used by consumers in some cases. Potential toxicity was determined by the effects of a medication on animals -- if a drug caused organ damage in lab animals, it was probably toxic to humans, too.

Drug makers were still working on ways to customize the delivery of a drug so that the body could absorb and use it well. Drug-metabolizing enzymes (agents that help the body absorb and use a medication) were tested on lab rats or mice -- meaning researchers didn't have very much information about the enzymes in humans.

It's kind of frightening to think that some of the things people put into their bodies were largely based on assumptions! "If it's safe for rats, it'll be safe for humans, too."

The NIH reports that even as recently as fifteen years ago, up to forty percent of drugs failed to work because they were poorly absorbed, excreted too quickly, or just didn't make it to the right place. Nowadays, less than ten percent of medications fail for these reasons.

What made the difference? Work with drug-metabolizing enzymes. Researchers have studied dozens of these enzymes in humans, figuring out how they regulate the activity and levels of drugs in the body. There are more than a hundred different versions of these enzymes -- some rare variations can alter the activity and side effects of some drugs.

Another big improvement in the last thirty years has been work with drug interactions. Researchers have identified medications, vitamins, supplements, and herbal remedies that can interfere with drug-metabolizing enzymes and protein transporters -- causing adverse reactions. Thanks to this research, it has become easier to predict potential problems when a drug is still in development -- it doesn't have to go all the way to human trials before a problem is discovered.

One more big improvement is in delivery method. A drug's delivery method -- a pill, a pump, an injection, an implant, or a patch -- can ensure proper absorption. Antibiotics and antihistamines, for example, are acid-sensitive and used to have trouble making it through the stomach and into the intestines. Now they are packaged so that they can survive stomach acids and be absorbed properly in the small intestine. Medications also come with instructions that suggest the best time of day and other conditions for taking the drug.

In another thirty years? Today's medication might seem primitive and scary.

Learn more about Aimee Amodio

Aimee is a fiction writer... dog lover... music lover...

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