Both from a stroke, and from migraine: why similar drugs work differently

The history of creation of medicine are years of researches and opening. The more fixedly physicians study the mechanism of effect of medicine, the possible circle of its application becomes wider. The medicine knows many examples when the effect of the same substance changes depending on a dosage of medicine or duration of its acceptance. And changes so cardinally that communication between indications becomes unevident for inhabitants.

So there are myths about "magic" or, on the contrary, "harmful" drugs which cause unexpected ghost effects only because were appointed for treatment of other diseases earlier. There is a lot of such legends: Ingavirin® and Dikarbamin are enough to remember. Or Tserebrolizin who, by hearsay, had specific capability to improve penetration of opiates into a brain.

But the fact that it seems to normal patients paradoxical is not any surprising to doctors and scientists. Moreover: experience of development of medicines with identical active ingredient for different appointments showed the special value of such approach.

Studying possibilities of application of a well-known molecule according to new indications, scientists and doctors can rely on a well-known profile of security of such molecule, excluding thus risks for health of patients. It is especially fair concerning modern medicines.

To drugs which enter the market today impose high requirements: existence of successful clinical and preclinical trials as on animals, and in public is just necessary. Having convinced of security of medicine, pharmaceutical companies register it — but molecule researches on it do not come to an end. "New" edges of already known drugs with scientifically proved action mechanism are so shown.

We tell how medications find "the second life" why doctors can appoint the same remedy for heat and a heart attack and what examples of "double drugs" pharmaceutics history knows.

Acetilsalicylic acid or Aspirin

In 2020 legendary "to a tablet from everything" 123 years were performed. Official date of birth of Aspirin — on October 10, 1987 when Felix Hoffman, one of chemists of the German pharmaceutical concern Bayer, recorded successful experiment on synthesizing of pure acetilsalicylic acid in the laboratory magazine.

Actually history of medicine began long before Hoffman and Bayer. In ancient times people for the first time noticed that broth of the willow bark rich with salts of salicylic acid helps at fever. Willow bark and derivatives from it doctors removed heat and treated rheumatism throughout centuries. However, medicine was far from an ideal: it caused severe pains in a stomach and nausea because of unpleasant taste.

Felix Hoffman together with the colleague from Bayer Artur Aykhengryun created "salicylic acid of new generation". It was safer, did not irritate walls of a stomach and did not make sick. The pharmaceutical company registered the "magic tablet" helping from heat and pain — and Aspirin began a triumphal procession along the world. It became this rescue during a flu epidemic in Europe. The main effect of acetilsalicylic acid is used in pharmaceutics and today: it is accepted within several days to reduce temperature at catarrhal diseases.

Aspirin experienced a rebirth in the 1950th when the doctor from California Lawrence Craven for the first time noticed that acetilsalicylic acid prevents formation of blood clots. The doctor himself also not up to the end understood the mechanism of effect of medicine, but its researches confirmed: "Aspirin" reduces risk of a heart attack at patients cores.

Drugs managed to decrypt surprising "off-label-effect" only more than 20 years later. The British pharmacologist John Vane proved that aspirin inhibits formation of prostaglandins and a tromboksan of A2 which participate in fibrillation process. For the opening the scientist got the Nobel Prize, and Aspirin officially began to be applied to treatment and prevention of cardiovascular diseases.

Sildenafil or Viagra

Sildenafil — means for increase in a men's potentiality. The most popular trademark under which it is made sildenafit — Viagra.

Sildenafit substance it was synthesized in 1992 as means for treatment of cardiovascular diseases. It was supposed that medicine will influence coronary vessels and will provide inflow of oxygen to heart. But the theory was defeated utterly on the period of clinical trials. It turned out that sildenafit renders extremely weak effect on heart moreover and has a ghost effect in the form of muscular pain.

However, there were other data: examinees began to announce improvement of an erection. The pharmaceutical company Pfizer conducting researches decided to be engaged in an interesting ghost effect. On tests of a sildenafil as bases for means from impotence four more years left — and in 1997 Viagra was born. By the way, the name of medicine is a combination of two words: Vigor (from Latin — the power, energy, force) and Niagara (the river in North America, known for powerful falls).

But on it history of a sildenafil did not end. Nevertheless returned to active ingredient its "historical mission" to reduce blood pressure in a small circle of blood circulation. In 2012 Pfizer patented the medicine "Revatsio" — the medicine with the low maintenance of a sildenafil applied to treatment of pulmonary arterial hypertension. The same substance became a basis for different medicines: Revatsio is accepted constantly, a lifelong rate, its main appointment — to prolong life to patients with heavy heart failure.

Tricyclic aminoadamantan or Amantadin

Amantadin is the antiviral medicine created in 1967 as means against A2 viruses. As it often happens, the unexpected therapeutic effect was shown accidentally. The patient with Parkinson's disease told the doctor that she treated Amantadin flu and at the same time unexpectedly "cured" drozhatelny paralysis. Outputs of the woman were confirmed by clinical trial with participation of 163 patients with Parkinson: at 66% of the examinees taking medicine improvement of a status was observed.

It turned out that Amantadin acts as dofaminomimetik — i.e. as a stimulator of dopamine receptors. Parkinson's disease arises when at the patient work of dopamine neurons of black substance of a midbrain is broken. There are main motive violations: muscular rigidity, tremor. Amantadin makes complex therapeutic impact, including increases synthesis of dopamine in nigralny neurons.

It is important that Amantadin as antiviral means is accepted by short courses. And here for treatment of Parkinson's disease the long rate is necessary. According to clinical trials, the good therapeutic effect was reached at acceptance of medicine within a semi-annual rate or for the whole year. "Tablets from everything" exist? Ask the doctor!

Plurality of indications — the widespread phenomenon in pharmaceutics. The medicines mentioned in article — only some of examples: history of medicine knows much more successful "regenerations" and surprising opening.

How to understand the main myths of pharmaceutics and to distinguish next "horror story" from objective data? The recipe is simple: pay attention not to purposes of medicine, and to its evidential base and a profile of security.

If medicine underwent all necessary clinical and preclinical trials, and scientists have data on experience of post-registration monitoring of security, the reasons for alarm do not. Such medicine can "open" again and again, to be used for therapy even of such cardinally different diseases as flu and Parkinson — and at the same time to remain absolutely safe and effective.