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BPS 1101 Topic 1 Intro and History.docx

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Biopharmaceutical sciences
William Ogilvie

BPS1101: Introduction and History -life expectancy in Canada is 81.2 years versus the world average at 66.6 years -at the current time, this life expectancy has pretty much reached its maximum in Canada -life expectancy was 30-35 years for most of history until very recently where it has increased (increases occurred mostly in the last 150 years) -in the last 150 years, scientific principles have been used to determine health outcomes -in the past, most people tended to die from diseases such as pneumonia, tuberculosis, influenza, etc. -life expectancy was ~44 years -this lasted until the 1950s -today, we are much older when we die and our body is more likely to wear out (i.e.: cancer, heart disease, stroke, etc., combine for almost 66% of all deaths) in contrast to getting a life- threatening disease (in contrast to the chronic diseases that are now more prevalent) -in the past, disease was a constant quality and affected the quality of life -i.e.: everyone probably had lice, fleas, or worms (living in the digestive system or muscles) -the diseases that were prevalent in the past can now be cured with treatment -in the past, people carried chronic infections (i.e.: fungal infections, bacterial infections, etc.); now it is cured with treatment -in the past, malnutrition was common -due to things like food spoilage -almost all meals contained something rotten (in times such as the medieval age) Main Reasons for Improved Health -these reasons involve drugs and changes in physical health 1) Sanitation -sanitation has improved drastically -in the past, there were no flushing toilets; it was only developed in the past 100 years -outhouses were common -chamber pts were also used when cesspits / cesspools were available -sewers (especially closed sewers) contributed to better health -in the past, populations were exposed to the dead and the dying -it was common for people to deal with dead bodies -now, it is unlikely to come into contact with corpses 2) Clean Drinking Water -water has historically been unclean / unsafe -it may contain waste materials -nature does not make pure water -it is dangerous to drink from natural sources -organisms may live in that water and enter you -e.g.: dracucculiasis (guinea worm) -it lives inside the body, hatches and grows -the worm gets into the muscles and lays eggs; this causes a burning sensation in the human so the worm can escape into the water and continue its life cycle -this can be prevented by filtering water using cheesecloth, boiling, etc., in order to stop the water fleas -chlorination has helped with water sanitation -this is the final step involved in water treatment -chlorination sterilizes the water -it acts as a preservative so that water remains sterile as it travels through pipes from the processing plant to the user 3) Refrigeration -food spoilage was common, especially before refrigeration -ice houses were used before refrigeration -ice houses were made up of an underground room with ice used to preserve the food -ice houses only work in Northern climates -it is effective only if there was enough ice collected during Spring -in the past, food spoilage was unavoidable -modern food storage is now available year round; this has allowed for year-round food supply due to modern technologies (e.g.: decreasing prevalence seasonal foods since they can now be stored for longer periods of time) 4) Vaccination (Immunization) -pharmaceuticals improve health (e.g.: through vaccination, antibiotics, etc.) -vaccination prevents disease from occurring in the first place -vaccinations are generally the most successful for viruses -we have eradicated smallpox -eliminated in 1977 -only exists in labs and biological weapons -gene sequence is online -there is no longer a need to vaccinate for small pox because it is so rare now -polio has also been eradicated from North America in 1991 -there are less than 1000 cases worldwide, in 10-11 countries -a major barrier to eradication if disease is politics 5) Antibiotics -pharmaceuticals improve health -antibiotics are used for bacterial infections -e.g.: penicillin reduced maternal mortality -mothers giving birth had a low chance of survival before the 1940s (~30%) -penicillin reduced mortality for women giving birth The North American Drug Market (20090 -the prescription drug market is worth $300 billion -we pay more for prescription drugs, which produces a higher profit for pharmaceutical companies -the over-the-counter (OTC) drug market is worth $25 billion -we will use OTC drugs more often in our lifetime -the USA drives the modern drug industry -Canada uses the FDA as a guideline for their standards -half of the drug market can be attributed to the USA -for statistics about North America, we can use these statistics to make estimates regarding world statistics (i.e.: 2N.A. = world); we double the statistics that are related to North America to make an estimate about the world statistics Types of Medical Treatment 1) Surgical -removal of affected body part (traditional) -modification of affected body part (modern) -this is made possible by the use of drugs / anaesthetics 2) Medicinal -use of chemical compounds to treat disease Plants as Sources of Drugs -plants have been a primary source of medications in the past Why Plants? -plants are immobile and cannot run away; they use chemicals to protect themselves (e.g.: poisons) -poisons can be used for medications in humans -effects can be developed so that they are beneficial for humans -drugs produce beneficial / desired biological effects -poisons produce harmful / undesired biological effects -the only difference between a poison and a drug is the dose (both are "pharmakon") -sola dosis facit veneum = only the dose makes the poison -poisons kill; potions cure Dosages -normally we assume: -low doses produce beneficial effects (i.e.: it is a drug) -high doses produce harmful effects (i.e.: it is a poison) -sometimes: -low doses produce harmful effects (i.e.: it is a poison) -high doses produce beneficial effects (i.e.: it is a drug) -we need the dose that is just right -e.g.: water poisoning -drinking too much water changes the electrolyte balance in the body -therefore, it is the dose that makes the difference between something that is dangerous and something that is safe How Were Drugs Discovered? 1) Observation and Experiment -requires a clear effect (i.e.: strong poisons given in low doses) -observation and experimentation is the best form of drug discovery -people observe the effect of a drug 2) Philosophy -cure is arrived at by reasoning -the reasons for the cure are "made up" based on reasoning and philosophy -methods require good information (if we use garbage information, we get garbage results; garbage in, garbage out) -healing is often connected with superstition, magic, and religion Drugs From Observation and Experiment -strong poisons -the effect is easily identified -low doses of poisons make it into a drug -weak poisons -requires a large quantity for effect -e.g.: almonds contain cyanide (at very low doses) -papyrus ebers contain a list of 600 plants their uses Hippocrates (460-370 BC) -known as the father of medicine -promoted experimental methods / observations -rejected superstition and religion from healing -e.g.: ox liver = vitamin A = cure for night blindness; poppy juice for crying babies; animal fat for baldness (this did not work) Dioscorides (40-90 AD) -wrote a book documenting uses of plants -the information describes materials still used today Identification of Opium for Pain -opium is a narcotic pain killer and a sedative -it is medicinal in low doses, but toxic in high doses -we use many drugs derived from opium (i.e.: morphine, oxycodone, etc.) -opium is found in many products -opium makes you feel good, but doesn't really cure the problem that is causing the pain Identification of Cocaine as a Stimulant -cocaine gives a clear indication of its effect -Peruvians consume cocaine (they normally feel drowsy due to the high altitude) -coca leaves + limes act as a stimulant do combat this drowsiness -cocaine was present in coca-cola Quinine as a Malaria Treatment -quinine is naturally present in the bark of a South American tree (Peruvian bark) -it is beneficial at the proper dose -at one point, Peruvian bark was worth more than gold -quinine was consumed with alcohol because of its bitter taste -e.g.: gin and tonic -tonic contained quinine (tonic will fluoresce under UV light if there is quinine in it, since quinine fluoresces under UV light) Problems with Observation -the human brain looks for patterns, even when none are present -statistical analyses are now used for accuracy -anecdotal (subjective) evidence (e.g.: "it worked for me") is unreliable -drugs and its effect may just be coincidence -we require larger sample sizes for accuracy -once evidence is available, it is hard to contradict -e.g.: parent's cold remedies are passed on from generation to generation, even though they may not work -many harmful remedies / useless remedies are retained because of this -once we get misleading information, it is hard to unthink / contradict -anecdotal evidence relies on random chance -the medication and the cure may not be connected -we have to replicate the experiment many times with many people to see if it is actually effective -poison and harm may not be connected either -e.g.: people thought tomatoes were poisonous -someone probably ate a bad tomato and anecdotal evidence spread -insects are actually nutritious and can be good for you -bugs are always in our food supply, but we think it is dangerous to eat -only experimental evidence is reliable -we collect data from large numbers of experiments -we must make measurements -we must measure properly -we must measure accurately -experimental methods are controlled and direct -we must rely on statistical significance -we collect data from large numbers of experiments and not just from one person -we compare results with a number of treatments -we need to measure the general population -we look for averages and trends in the population Problems with Herbal Remedies -we have poor control over dose -plants produce variable amounts of the active ingredient -variation in preparation and administration affects the effectiveness of herbal remedies -cooking (i.e.: heat, time of cooking, etc.) affects the active ingredients -in the past, there was no standardization in terms of dose and herbal remedies -there is no instruction for use of herbal remedies -information about use of herbal remedies was passed on verbally and the information changed over time -information was not precise -there were poor levels of reproducibility of these herbal remedies (i.e.: can't keep the amount of active ingredient constant) -the method that herbal remedies were prepared controls the final chemical composition -philosophy was used to identify cures -cures / treatments were made up -historically, medicine has been dominated with these 'philosophical / made up' cures -Hippocrates develops the Doctrine of Humors -this doctrine states that the universe is made up of 4 elements: 1) earth 2) air 3) fire 4) water -medicine started with information that was completely wrong -likewise, the body was made up of 4 elements: 1) blood 2) phlegm 3) yellow bile 4) black bile -the elements were known to have 4 properties: 1) earth = dry 2) air = cold 3) fire = hot 4) water = wet -likewise, if the body had the same 4 humors, these humors also had the same properties as the elements: 1) blood = cold 2) phlegm = wet 3) yellow bile = hot 4) black bile = dry -according to the doctrine of humor
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