Transcript English Lecture - Medicinea 1

III. TECHNOLOGY MILESTONES IN
HEALTH AND MEDICINE
Chronology
III.1. Pain and Inflammation Management
Morphine
Aspirin
Cortisone
III.2. Psychotherapeutic Agents
Chlorpromazine
Tricyclic antidepressants
Benzodiazepines
III.3. Hormones and Hormone Regulators
Insulin
Testosterone
Progestins, estrogens, and oral contraceptives
III.4. Gastro-intestinal Agents
Evolution of ulcer therapy
Chemistry has contributed many of the life-saving
breakthroughs in health and medicine that allow us to live
longer, happier, and healthier.
Throughout much of human history, medicine and health
care was primitive. If people became sick or injured, doctors
could do little more than comfort them and keep them clean.
The last 100 years have revolutionized the way in which
doctors heal patients by curing disease, repairing injuries, and
even preventing health problems before they occur. Hardworking chemists and chemical engineers have helped to
found modern medicine by developing novel pharmaceuticals,
creating new medical equipment, and refining diagnostic
procedures.
Millions of human lives have been saved and improved by
the health and medical advances developed through
chemistry.
III.5. Medical Testing and Disease Diagnostics
Medical imaging technologies
Medical isotopes
Development of chemical assays
Evolution of personal monitoring
III.6. Anti-infective Drugs
Salvarsan and Prontosil
Penicillin
Zidovudine (AZT)
III.7. Cardiovascular Management
Regulating heart beat
Treating heart failure
Affecting blood clots
Controlling blood cholesterol levels
III.8. Cancer Chemotherapy
Evolution of cancer chemotherapy
Cytotoxic drugs
Tamoxifen
III.9. Novel Healthcare Materials
Artificial limbs and medical devices
Medical equipment
Disinfectants and bleach
Technology Milestones in Health and Medicine
Chronology
1899 Aspirin is manufactured to fight pain, joint inflammation and swelling.
1909 Salvarsan is the first major chemotherapeutic agent to be made.
1922 Insulin is used to alleviate high blood sugar associated with diabetes
1923 The chemical structure of morphine is determined.
1927 Pregnancy test developed to detect estrogens in urine.
1935 Prontosil cures the deadly streptococcal infection.
1942 Nitrogen mustards begin the age of cancer chemotherapy.
1943 Penicillin fights infection and inaugurates antibiotic therapy.
1954 Digoxin is approved to treat thrombotic diseases (blod clot formation).
1954 Chlorpromazine begins modern antipsychotic therapy.
1960 Enovid is manufactured and enters to market as an oral contraceptive.
1963 Herbal cytotoxic drugs are used to fight cancer.
1976 Tagamet inhibits acid secretion in stomach during treatment of gastric ulcers.
1977 Tamoxifen introduces hormone blockers in cancer chemotherapy.
1987 Zidovudine (AZT) is approved by FDAfor treatment of HIV infection.
III.1. Pain and Inflammation Management
Morphine
Used from the early 1800s to decrease
the sensation of pain, morphine was
extracted from raw opium. The
Hungarian pharmacist Janos Kabay
revolutionized morphine production in
the 1920s : by extracting it not only from
the immature poppy-head but from the
dry poppy-straw. It was studied in 1923
to determine its chemical structure in an
effort to synthetize a potent analgesic
free from undesirable properties such as
addiction and respiratory depression.
Understanding
exactly
how
the
naturally-occurring extract worked in the
human body allowed a synthetic version
of morphine to be developed and
subsequent, safer drugs to be created,
such as nalorphine and naloxone in
1961.
The thomb of Janos
Kabay in Budapest,
Hungary
III.1. Pain and Inflammation Management
Aspirin
In 1890, salicylic acid was being manufactured as a cheap
and effective inflammation reliever for rheumatoid arthritis
despite unpleasant side effects (nausea, gastric catarrh).
Acetylsalicylic acid (or aspirin) was synthesized in 1897 by
the German chemist Felix Hoffmann at Bayer and tested
pharmacologically by Heinrich Dreser. Production started
in 1899 and first pills were sold in 1900.. Aspirin soon
became popular because it had fewer side-effects than
salicylic acid. Aspirin, the first medicine to be produced at
industrial level, is still manufactured in large quantities
today. Aspirin was consumed mainly as an anti-headache
drug until the mid-eighties when its beneficial effects in
preventing heart attacks were discovered
Acetylsalicylic acid
Aspirin, the first pills
manufactured ever
(1900)
III.1. Pain and Inflammation Management
Cortisone
Lewis Hastings Sarett
In the 1940s, studies of the adrenal
gland cortex in the 1940s identified that
certain naturally-occurring hormones
(also called steroids) have antiinflammatory properties. First isolated
from its natural source in 1936,
cortisone was synthesized by the
American Lewis Hastings Sarett in
1948.
It
was
already
being
commercially manufactured in the next
year du to its miraculous activity in
rheumatoid
arthritis.
Subsequent
clinical studies showed that it did not
cure arthritis, triggered serious side
effects, but enjoyed additional uses in
asthma and allergy treatments. Further
studies of steroid synthesis led to the
creation of prednisone, prednisolone,
and dexamethasone as better antiinflammatory agents with reduced side
effects.
Deformity induced by joint
inflammation
III.2. Psychotherapeutic Agents
Chlorpromazine
Chlorpromazine (Thorazine, Hibernal) was
first used to treat schizophrenia in 1954
after its original creation as an
antihistamine anti-allergic. This new
therapy proved itself dramatically and
heralded the modern era of antipsychotic
therapy, and became a reference of the
central nervous system drugs. Controlling
mental illness through medication soon
supplanted earlier treatment methods,
such as electroshock, insulin shock,
prefrontal lobotomy (a surgical treatment
disconnecting prefrontal hemispheres),
and helped to decrease the rate of
institutionalization
worldwide.
Later
research
shed
light
on
the
pharmacological
mechanism
of
chlorpromazine and served as a basis for
the development of many other antipsychotic drugs such as haloperidol and
olanzapine.
Pictures from the film: One Flew Over the
Cucoo’s Nest (1975), which portrays the
disastrous effect of mental illness.
III.2. Psychotherapeutic Agents
Tricyclic antidepressants
The more the
sunshine the
less the
depression
In 1958, a clinical study of imipramine, a drug which
was originally developed as an antipsychotic, revealed
its
antidepressant
properties.
It
functions
therapeutically
by
affecting
the
activity
of
neurotransmitters (stimulus transmitting agents) in the
brain. The many subsequent drugs that were
developed in this class became collectively known as
`tricyclic’ antidepressants. Tricyclic antidepressants
become the standard of therapy for this disease.
The onset of depression
following labour
III.2. Psychotherapeutic Agents
Benzodiazepines
In 1959, chlordiazepoxide (Librium) launched a potent new class of anti-anxiety agents,
the benzodiazepines. This drug and its subsequent derivatives rapidly replaced
barbiturates and Meprobamate, an earlier moderately successful anxiolytic agent
discovered in 1950, and are considered to be some of the most successful drugs of this
era. The highly tolerable and safe benzodiazepines also prove successful as hypnotic
agents, muscle relaxants, and treatment of for epilepsy.
III.3. Hormones and Hormone Regulators
Insulin
Insulin, a protein hormone produced by
special cells of the pancreas, controls the
level of blood sugar (glucose) in the blood.
Lack of insulin leads to the development a
fatal disease, diabetes type I. Two young
Canadian doctors, Frederick Banting and
Charles H. Best isolated and purified a new
injectable extract from bovine pancreas in
1921. Their first patient was a dying 14year-old boy, who was released from the
hospital after a few weeks. Insulin was
manufactured from bovine pancreas by Eli
Lilly and Company in 1922. The first insulin
engineered from human sources using
recombinant
DNA
technology
was
produced in 1982.
Frederick Banting and
Charles H. Best, the
inventors of insulin
III.3. Hormones and Hormone Regulators
Testosterone
Testosterone
is
responsible
for
the
development of the male sex organs and
secondary sexual characteristics. It is a steroid
hormone, structurally similar to cholesterol.
Testosterone was first synthesized from
cholesterol in 1935 to treat hormone deficiency
diseases. Testosterone can be manufactured
by chemical and microbiological modification of
readily available naturally-occurring materials.