46 - Why do Side Effects Vary? (w/ Connor Wander!)
46. Why do Side Effects Vary?
Drug discovery has helped ease pain, prevent disease, and save lives. However, humans are new to the game at designing molecules to aid human health. What are pharmaceuticals? What are side-effects? Let’s learn to be scientifically conversational.
LEARN MORE ABOUT STRAIGHT FROM A SCIENTIST!
General Learning Concepts
1) Relevant Background
a. What is a pharmaceutical? A compound manufactured for use as a medicinal drug. WHO: Pharmaceutical products – more commonly known as medicines or drugs – are a fundamental component of both modern and traditional medicine. It is essential that such products are safe, effective, and of good quality, and are prescribed and used rationally. [2]
i. Safe: which means that the benefits of the drug appear to be greater than the known risks
b. What is a side-effect? Food and Drug Administration (FDA): Side effects, also known as adverse events, are unwanted or unexpected events or reactions to a drug.
c. Metabolism: Merck: Some drugs are chemically altered by the body (metabolized). The substances that result from metabolism (metabolites) may be inactive, or they may be similar to or different from the original drug in therapeutic activity or toxicity. Some drugs, called pro-drugs, are administered in an inactive form, which is metabolized into an active form. The resulting active metabolites produce the desired therapeutic effects. Metabolites may be metabolized further instead of being excreted from the body.
2) Factors that can impact adverse reactions
a. Age: Age impacts the functions of internal organs that can be important for metabolism of certain pharmaceuticals: the liver, the kidney, the GI tract, etc. This leads to increased risk of side effects that can be mild to significant.
b. Sex: Females have naturally higher body fat percentages, lower total body weights, different hormone cycles, and metabolism. Different drugs have better response with different sexes, and this can be perpetuated with testing model organisms that are only male. [2]
c. Allergies: A drug allergy is the abnormal reaction of your immune system to a medication. Any medication — over-the-counter, prescription or herbal — is capable of inducing a drug allergy. [2]
i. For instance, if you have an allergy to a particular medication, your immune system identifies that drug as an invader or allergen. Your immune system may react to medications in several ways.
d. Additional medications: Drug drug interactions are when two or more drugs react with each other to cause an unexpected side effect. This could be altering the sensitivity or responsiveness of one drug to another, one drug absorbing or changing the excretion of a second drug, and so on. [2]
i. Merck: Rarely, clinicians can use predictable drug-drug interactions to produce a desired therapeutic effect. For example, coadministration of lopinavir and ritonavir to patients with HIV infection results in altered metabolism of lopinavir and increases serum lopinavir concentrations and effectiveness
4) Fun Tidbits
a. Side-effects are not exclusive to pharmaceuticals: Radiation therapy, for example, not only kills or slows the growth of cancer cells but can also affect nearby healthy cells. Damage to healthy cells can cause side effects.
b. Advertising: Only America and New Zealand allow pharmaceutical companies to market prescription drugs directly to potential patients. In the United States, companies need to warn people of all the potential risks of their drug, and advertise only the indication for which the drug has been approved by the Food and Drug Administration.
5) Solicited Questions
a. How to better handle side-effects? I will not answer this question, as I have no accreditation from any medical institution or degree to qualify me. I recommend speaking to your physician.