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“The Pharmacy of the Future”
(1 March 2005)
There are a few basics in the world of pharmacology that even the average adult in
today’s world would be able to recognize and explain. I don’t mean Prozac, Lipitor, Viagra, or
even penicillin. Science has demonstrated that as antibiotics are over-prescribed, original strains
of diseases are able to mutate. Some ear infections no longer respond to penicillin-type drugs.
Instead, often times cephalosporin-class drugs are used. When these drugs like Kelfex or
Omnicef don’t work, some physicians are even resorting to Ciprodex, a product similar in
chemical design and structure to it’s parent drug Cipro, or ciprofloxacin, listed in 2001 as one of
the drugs to combat anthrax infection, if ever a dose were to be lethally administered by
terrorists. Beyond Cipro, our line of defense gets more experimental. Luckily, drug research
ensures the progression of pharmacological science with disease mutations. But how much are
we willing to invest? In 2003, America spent about $33 billion on drug research1. At what cost
must we labor to keep protecting ourselves? Biologically speaking, just as organisms and
species tend to follow the “survival of the fittest” rule, so too do many common human diseases.
This poses an enormous threat to human kind in general, should some new strain of a disease
emerge and strike in epidemic proportions.
Another big newsmaker these days is Merck’s blockbuster arthritis drug, Vioxx, which
was recalled last fall because people were unexpectedly dying due to heart complications from
the Cox-2 inhibitor. This has led to a flurry of activity within the FDA and the subsequent
creation of a new government outlet- the Drug Safety Oversight Board, a division of the Dept. of
Health and Human Services. On Monday, February 28, 2005, an article appeared in US Today
“Drug Stocks that Put Money to the Work.” Yahoo Finance. 7 January 2005.
http://biz.yahoo.com/ms/050107/124756_1.html
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about the decision of the FDA, under the new leadership of acting commissioner Lester
Crawford, to begin evaluating drugs such as Vioxx through a new program called “Critical
Path.” This initiative will focus drug development on genetic information about diseases and
drug responses. Individuals or populations within the same disease group would be studied and
then treatments would target a smaller group of patients.2
So where is the pharmacy of the future headed? It seems, as has been repeatedly
discussed in this class and hinted at in the USA Today article, that it will only be sensible to
begin tailoring drug therapy to individual patients, based on genetics, a new field known as
pharmacogenomics. This is where biocomplexity, DNA sequencing, and protein structure also
assume a large role.
Nanotechnology will undoubtedly play a part in shaping this new field. Say
nanotechnology and we automatically think small. But how small? …Approximately 2-5 atoms
across. When nanotechnology is functional, a time frame that is much closer than most of us
could probably fathom, so called nano-bots will do most of the work. Nano-bots, simply
defined, are robots on the nano-scale. “Nanotechnology will allow us to economically create an
extensive range of complex molecular machines (as well as, molecular computers). It will let us
build an amount of computer controlled molecular tools much that are smaller than a human cell
but built with the accuracy and precision of drug molecules. For the first time, these tools will
permit medicine to intervene in an advanced and controlled way at the cellular and molecular
level. They could remove obstructions in the circulatory system, kill cancer cells, or take over the
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“The FDA and Drugmakers Should Think Small.” USA Today. 28 February 2005. 15A.
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function of sub cellular organelles. Just as today we have the artificial heart, so in the future we
could have the artificial mitochondrion.”3
And where exactly are we headed, nanometrically-speaking, in terms of drug delivery
systems? While nano-bots themselves may be several years down the road, a company known as
“Nanoceutical Labs” has developed Health Plus - Nanoceutical Spray For Life - B-12 Energy
Booster ™ oral delivery system utilizing Nanotechnology. The system is comprised of
nanoparticle size droplets derived from HPI's proprietary dispersion process. This may sound a
little sketchy, but according to their website, a Nanoparticle acetaminophen, or Tylenol, as well
as a natural remedy for Type 2 diabetes, could be on its way.4 You can even buy Nanomist,
marketed as “Spray for Life” for $12.95 online.
In 2002, PharmaGenomics published an article that challenged drug design and the
economics of it. They presented the idea of “rational drug design” which began with the
availability of crystallographic structures of target proteins. As the shapes of these proteins were
unveiled, the idea was that chemists might be able to produce more efficient drugs. Problems
began to emerge with the great amounts of requisite data which was expensive to collect in vitro,
often times risky to collect in vivo, but slightly ameliorated with in silico experimentation. Still,
researchers have made leaps and bounds in terms of discovering things, but it’s the development
that becomes trickier. Another critical factor is that most experiments are completed at a certain
point in time, with a certain set of conditions. Biological species age and it would be impossible
to collect data at an infinite number of points, so Time-Series methods for modeling data will
hopefully lead to a better understanding of biological processes. This moves us forward into
network biology in which cellular communication is quantified. Next issue? …How to validate
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Theory: Nanotechnology. The Thinkquest Group. 28 February 2005.
http://library.thinkquest.org/TQ0313009/Theory.htm
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Nanoceutical Laboratories, Inc. 28 February 2005. http://www.nanolabs-inc.com/products.html
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these networks. As professor Barabasi explained, mathematical methods are needed to
investigate the robustness of network structures. What a mess pharm. Researchers have on their
hands. We pump billions of dollars into rational drug design, and then something like the Vioxx
recall happens, sending the industry into a perpetual tailspin. As investigations of these complex
systems probes deeper into the mysteries of biochemistry and genetics, the amount of
information generated seems to grow at least proportionally. The 2002 PharmaGenomics article
suggests that the industry itself might be taking a new shape. With pharmacogenomics comes
many enigmas that only science holds the answers to. In the meanwhile, we have our
conventional means of the traditional pharmacy, with a chain drug store on every corner in town.
Until nano-bots are fully efficient or the field pharmacogenomics has sorted itself out, or the
FDA has reached a consensus on Vioxx (which will set the standard for future improvements),
we will continue to pump money into the system. And we’ll still have the same old antibiotics.
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