Immortal Drugs: Short Stories from the Early Days of Modern Drug Therapy
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 14, Issue 1
Abstract
Current clinical medical practice traverses through the era of targeted and individualized therapies. The constant development and expansion of novel drug classes is typically a result of series of years of strenuous and focus research and testing. This fact comes into contrast with the early days of pharmacology, when pharmaceutical agents often evolved from folklore-based remedies, at times discovered as a result of an individual physician or researcher’s keen eye, or even emerged through sheer chance. This has endowed contemporary medicine, apart from a series of valuable drugs that have withstood the test of time, with a collection of colorful stories from the dawn of modern therapeutics. Modern evidence-based cardiology still utilizes historical gem drugs in routine everyday practice. The analgesic and antiinflammatory attributes of the salicylate-rich willow bark extracts are mentioned in the 16th century Ebers papyrus [1]. It had been in remedial use already for millennia, from as early as the time of Assyrians, ancient Egyptians and Greeks, when aspirin emerged. In 1897, chemist Felix Hoffman added an acetyl group to salicylic acid which was first synthesized from salicin by Rafaelle Piria earlier in the 19th century [2]. Its use today remains as widespread as ever in the secondary prevention of cardiovascular disease. Τhe antianginal properties of nitroglycerin, which was earlier popularized by Alfred Nobel as a compound of dynamite, were brought to light by British physician William Murrel in 1879 [3]. Exposure to the substance, which was marketed for pharmaceutical purposes as Trinitrin to prevent crowd intimidation, has been speculated to be the aggravating cause of Nobel’s late life health problems which included migraine headaches and angina pectoris. To treat the latter, Nobel was ironically prescribed nitroglycerin by his physicians [4]. Digoxin, the oldest surviving inotrope, is extracted from the leaves of Digitalis purpurea and has been in use since medieval times for a variety of indications, including dropsy [5]. Its artistic depiction in Vincent van Gogh’s painting “Portrait of Dr. Gatchet” has ignited the hypothesis that the dominance of yellow in his late work as well as the halo surrounding luminous objects in certain of his paintings, are a result of chronic digitalis intoxication which he presumably received for the treatment of “temporal epilepsy” [6]. In the 1920s, the investigation of veterinarians Frank Shofield and Lee Roderick into the causes of a mysterious epidemic outbreak of uncontrollable bleeding among cattle throughout northern USA and Canada, led to the later isolation of dicoumarol which is produced in moldy hay. A stronger related compound was named warfarin and was solely used as a rodenticide until 1951, when a navy recruit survived a warfarin suicide attempt after being administered vitamin K [7,8]. Since then, and despite the arrival of novel oral anticoagulants, coumadin agent have retained an everlastingly prominent position in anticoagulation therapy [9].
Authors and Affiliations
Dimitrios Tsilingiris, Stavros Liatis, Nikolaos Katsilambros
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