How Medicines are Born – the Imperfect Science of Drugs
Medicines dominate modern life. The process of how medicines are discovered, how they are tested, certified as safe for use in humans and monitored for adverse effects are often not known by the lay public. This book by two Italian scientists has been translated into English and is written in an easy to read and understand style. We enjoyed the frank foreword by the authors. The book delves deep into the history of modern medicines. There are detailed descriptions of the discovery and use of penicillin, insulin, ACE inhibitors, aspirin, low-dose aspirin, streptokinase, and cisplatin. Drug discovery previously was often by chance and the book describes the first drug discovered according to a plan, imatinib. The second chapter deals with ‘Hunting for drugs’. Receptors are among the most important targets of drug action and advances in genetics and molecular biology are providing us with an ever deepening understanding of diseases which is being used to develop appropriate tratements. The authors describe ‘biologicals’ in some detail. Biologicals are becoming increasingly dominant in modern day therapy. Erythropoietin is the best known biological. The authors revisit the statement by Paracelsus about all drugs being poisons and only the dose determining whether a substance is a drug or a poison. They describe is a simple manner different routes of drug administration.
Laboratory studies are the focus of chapter 3. The authors argue why even in the modern era of cell lines and molecular targets, animals still remain essential to evaluate a drug. Animal models are being created for most diseases. The authors end this chapter by describing how the results of animal studies are used to decide on whether to go ahead with clinical trials in humans. Many regard the experiments of James Lind on sailors with scurvy to be the first clinical trial. Recruitment of study participants, informed consent and randomization, having a control group and doing a blinded study as the three pillars of a clinical trial are explained. The four phases of a clinical study are described in a simple and engaging manner.