MEDICAMENTS

 

1927, Belgium (Manceau laxative syrup for children) advertised booklet

 

 

            

 

Many infectious diseases have been conquered in the 20^th century by improved sanitation, antibiotics and vaccines. Specific drug therapy for infections began with the discovery by the German doctor              Paul Ehrlich 1854 – 1915 of arsphenamine, an arsenic-containing compound, as a treatment for syphilis. This was followed in 1932 by the announcement by the German scientist Gerhard Johannes Paul Domagk 1895 – 1964  that the dye prontosil rubrum was active against streptococcal infections. Discovery of the active agent in prontosil, sulphanilamide, led to proliferation of the first group of “wonder drugs”, the sulphonamide antibiotics. The purification of penicillin in 1938 by the British biochemists Howard Florey and Ernst Chain followed by ten years the discovery by Alexander Fleming of the germ-destroying activity of the Penicillium mould. The outbreak of World War II prompted immediate commercial production of penicillin, which was credited with greatly reducing fatalities. Ernest Duchense 1874 – 1912 Before Fleming he worked with antibiotic treatment. Because of his sickness he did not work enough about it and died. 

 

 

 

Aspirin is a synthetic chemical compound, acetylsalicylic acid, one of the analgesic class of painkilling drugs. It is made from salicylic acid, found in the bark of the willow tree, which was used by the ancient Greeks and Native Americans, among others, to counter fever and pain. Salicylic acid is bitter, however, and can irritate the stomach. The German chemist Felix Hoffman synthesized the acetyl derivative of salicylic acid in the 1890’s in response to the urging of his father, who took salicylic acid for rheumatism.

 

Aspirin is currently the first-choice drug for fever, mild-to-moderate pain, and inflammation due to arthritis or injury. It acts at the site of tissue damage rather than in the pain centers of the brain, as do opiates such as codeine. It is a more effective analgesic than codeine. Aspirin causes insignificant gastrointestinal bleeding that can over time, however, cause iron deficiency; gastric ulcers may also occur with long-term use. Complications can be avoided by using enteric-coated aspirin, which does not dissolve until reaching the intestine. Aspirin should not be given to children because it increases the risk of contracting the rare and frequently fatal Reye's syndrome, a disease of the brain and some abdominal organs. An alternative anti-inflammatory analgesic, ibuprofen, does not carry this risk.

 

It has been found that aspirin acts by interfering with synthesis of prostaglandins, which are implicated in inflammation and fever. It does this by blocking the enzyme cyclo-oxygenase, which stimulates prostaglandin release. Studies of aspirin's effects on blood platelet aggregation, making the blood less liable to clotting, suggest that half an aspirin tablet per day may reduce the risk of heart attack and stroke in some individuals. A large study conducted in Britain and published at the end of 1993 indicated that long-term aspirin therapy can help prevent potentially fatal clots forming in blood vessels following bypass surgery and other operations. Evidence from research establishments in the United States and Britain suggests that a regular use of aspirin may also reduce the risk both of colon and rectal cancer and slow the formation of cataracts and additionally that it may prevent migraine.

 

Sir Alexander fleming 1881 – 1955

British bacteriologist and Nobel laureate, best known for his discovery of penicillin. Born near Darvel, Ayr (now part of Strathclyde), Scotland, and educated at St Mary's Hospital Medical School of the University of London, he served as Professor of Bacteriology at St Mary's Hospital Medical School from 1928 to 1948, when he became Professor Emeritus.

Fleming conducted outstanding research in bacteriology, chemotherapy, and immunology. In 1922 he discovered lysozyme, an antiseptic found in tears, body secretions, albumen, and certain plants. His discovery of penicillin came about accidentally in 1928 in the course of research on influenza. His observation that the mould contaminating one of his culture plates had destroyed the bacteria laid the basis for the development of penicillin therapy.

 

Fleming was knighted in 1944. In 1945 he shared the Nobel Prize for Physiology or Medicine with the British scientists Howard Walter Florey and Ernst Boris Chain for their contributions to the development of penicillin.

 

A specific treatment was also found for tuberculosis: the drug streptomycin. When the bacteria became resistant, a combination of Rifampicin plus isoniazid was developed; this remains the first-line treatment for the disease. Hansen's disease (leprosy) is effectively treated by drugs called sulphones and malaria by derivatives of the chemical quinine, which is extracted from the bark of the cinchona tree. Quinine is an alkaloid derived principally from the bark of the cinchona tree. It is an efficient antipyretic (fever-reducing agent) and is used to reduce fever in many diseases. It was the only known remedy for malaria until the development in recent years of synthetic drugs.

 

Antibiotics were not found for diseases caused by viruses, however, so vaccines became the mainstay of treatment. Among the earliest were those: for smallpox, discovered by Edward Jenner in 1796; for typhoid fever, developed by the English bacteriologist Almroth Wright in 1897; for diphtheria in 1923; and for tetanus in the 1930’s.

 

Insulin, hormone, produced in the islets of Langerhans of the pancreas, that regulates the metabolism of carbohydrates, fats, and starches in the body. Like other proteins, insulin is partially digested if administered orally and hence must be injected into a muscle when used clinically. In the treatment of diabetes mellitus, which is caused by a deficiency of insulin production or by inhibition of its action on cells, insulin is often combined with protamine, which prolongs the period of absorption of the hormone. Insulin crystallized from the pancreas contains zinc, which also lengthens absorption. A preparation called protamine zinc insulin extends the hormone's action still further.

 

Insulin was first extracted from the pancreatic tissue of dogs in 1921 by the Canadian physiologists Frederick Grant Banting and Charles Herbert Best and the British physiologist John James Rickard Macleod. The Canadian biochemist James Bertram Collip then produced it in sufficiently pure form to be injected into humans. The molecular structure of insulin was determined in 1955 by the British biochemist Frederick Sanger; it was the first protein to be deciphered. Human insulin, the first human protein to be synthesized, was made in 1965. In 1981 insulin made in bacteria by genetic engineering became the first human hormone obtained in this way to be used to treat human disease.

 

A major advance in preparing virus vaccines came in the 1930’s with the development by the American microbiologists John Franklin Enders and Frederick Chapman Robbins of ways of growing viruses in tissue culture. This soon led to vaccines for yellow fever, poliomyelitis, measles, mumps, and rubella (German measles). In the early 1980’s, genetic engineering led to the development of vaccines against hepatitis B, influenza, herpes simplex, and chicken pox and a malaria vaccine was being tested.

 

The fight against infectious diseases became more complicated in the latter part of the 20^th century with the rise in resistance of micro-organisms to antibiotics and the discovery of new diseases, such as Legionnaires' disease and AIDS.

 

“Medicaments, which you don’t use, save life ” French slogan