10.6 Consider This: 3-D Drugs

See for yourself how drug molecules appear in three dimensions; visit the 3D Drug Structures at the University of Oxford (UK). Note: To view the molecules you will have to download and install a browser "plug-in" called Chime and then use these directions .

1. Select several drugs and examine their three-dimensional structure. How do these computer representations differ from the structural formulas of drugs shown in this chapter?
2. What are the advantages of the computer representations over two-dimensional drawings? What are their limitations compared to "real" molecules? Are there any disadvantages?

10.11 Consider This: "Off-Label" Drugs

Additional information about "off-label" uses of drugs and many other subjects appear at the FDA. Drugs such as methotrexate and misoprostol can be prescribed for "off-label" uses (also called "unapproved," "unlabeled," or "extra-label" uses).

1. In general, does prescribing medications to be used in this way strike you as a reasonable thing for physicians to do? Explain your reasoning. Compare your opinion with what the FDA thinks.
2. Use the search engine provided at the site and enter "off label." From the lengthy list of citations, pick two that interest you and summarize their contents.
3. Explain how what you learned from this exercise strengthened or modified your opinion of "off-label" uses.

10.14 Consider This: Buying "Andro"

As this edition went to press, "andro" could be purchased via the Web. Is this still possible? To find out, search for "androstenedione" and see what turns up.

1. Is "andro" still sold over the counter (via the Web)?
2. What do web sites claim about "andro"?
3. What does this steroid cost individuals both in dollars and in health effects? As always cite both the sponsor and URL of the web sites that you visit.

10.15 Consider This: FDA in Handcuffs?

Writing about "andro," Pamela Zurer, a columnist for Chemical & Engineering News (September 28, 1998, page 37) comments: "I lay the blame squarely on Congress, which handcuffed FDA with the Dietary Supplement Health & Education Act (DSHEA) of 1994. Until some regulatory body is given the authority to require the safety . . . of so-called nutritional supplements. . .we're going to see a lot more of these controversies. I hope not too many people ruin their health in the meantime." It may take a bit of detective work, but you can find the details of the DSHEA on the Web.

1. See for yourself - did this really handcuff the FDA? Give the rationale for your choice.
2. Whose needs was the DSHEA intended to meet?

10.21 Consider This: Safety and Standards on the Fast Track

The credibility of the FDA's fast-track drug testing program is called into doubt when 11 drugs released under the program were withdrawn within a period of 5 years (1997 - 2001). For example, some would argue that the recall of the pain killer Duract or heartburn medicine Propulsid show that adequate testing had not taken place on these drugs. Others could counter that standards of testing have not changed, only the speed with which data are evaluated, and that no tests can produce data that are 100% reliable in humans. Search the FDA and other web sites to gather information about Duract or Propulsid. Use what you learn to reach a decision as to whether you think fast-track drug testing is overall a benefit or a risk to the health of Americans.