❑A drug is any absorbed substance that changes or enhances a physical or psychological function in the body. A drug can be a gas, a liquid, or a solid and can have a simple structure or a complicated one.
❑Drugs have been used by humans for thousands of years to alleviate pain and illness. By trial and error, people learned which herbs, berries, roots, and bark could be used for medicinal purposes.
❑The knowledge about natural medicines was passed down from generation to generation without any understanding of how the drugs worked. Those who dispensed the drugs, medicine men, shamans, and witch doctors were important members of every civilization. However, the drugs available to them were just a small fraction of the drugs available to us today.
❑Even at the beginning of the twentieth century, there were no drugs for the dozens of functional, degenerative, neurological, and psychiatric disorders; no hormone therapies; no vitamins; and most significantly no effective drug for the cure of any infectious disease.
❑Local anesthetics had just been discovered, and there were only two analgesics to relieve major pain. One reason that families had many children was that some of the children were bound to succumb to childhood diseases. Life spans were generally short. In 1900, for example, the average life expectancy in the United States was 46 years for a man and 48 years for a woman.
❑In 1920, about 80 of every 100,000 children died before their fifteenth birthday, most as a result of infections in their first year of life. Now there is a drug for treating almost every disease, and this is reflected by current life expectancies: 74 years for a man and 79 years for a woman.
❑Now only about four of every 100,000 children die before the age of 15 mainly from cancer, accidents, and inherited diseases.
❑The shelves of a typical modern pharmacy are stocked with almost 2000 preparations, most of which contain a single active ingredient, usually an organic compound.
❑These medicines can be swallowed, injected, inhaled, or absorbed through the skin. In 2001, more than 3.1 billion prescriptions were dispensed in the United States.
❑Antibiotics are the most widely prescribed class of drugs in the world. In the developed world, heart drugs are the most widely prescribed class, partly because they are generally taken for the remainder of the patient’s life.
❑In recent years, prescriptions for psychotropic drugs have decreased as doctors have become more aware of problems associated with addiction, and prescriptions for asthma have increased, reflecting a greater incidence (or awareness) of the disease. The U.S. market accounts for 50% of pharmaceutical sales. The aging U.S. population (by 2005, nearly 30% will be over 50 years old) will lead to increased demand for treating conditions such as high cholesterol levels, hypertension, diabetes, osteoarthritis, and menopause symptoms.
❑A drug must get to the right place in the body, at the right concentration, and at the right time. Therefore, a drug must have the appropriate solubility to allow it to be transported to the target cell. If it is taken orally, the drug must be insensitive to the acid conditions of the stomach, and it also must resist enzymatic degradation by the liver before it reaches its target. Finally, it must eventually be either excreted as is or degraded to harmless compounds that can be excreted.
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