Drogas emergentes (I): las «smart drugs» / Emergent drugs (I): smart drugs

En los últimos años han ganado popularidad unaserie de nuevas drogas, conocidas como smart drugs olegal highs, fácilmente accesibles a través de tiendas online.Ello ocurre sobre todo en los segmentos jóvenesde la población, asociado a su consumo lúdico fundamentalmentedurante los fines de semana.En general son derivados sintéticos de productosnaturales, de los que apenas existe investigación clínicay que no son detectables en los laboratorios de loshospitales.Tres de estos productos, el BZP (1-benzilpiperacina),la mefedrona (4-metilcatinona) y el Spice sonprobablemente los más utilizados en Europa. Los dosprimeros se consumen como alternativas al éxtasis y lacocaína, y se caracterizan por producir un cuadro clínicode tipo simpaticomimético, en ocasiones de consecuenciasgraves, con convulsiones e incluso muerte. ElSpice (mezcla de hierbas con cannabinoides sintéticoscomo el JWH-018, el JWH-073 y el CP 47,497-C8) estáocasionando cuadros de dependencia y esquizofrenia.Aunque las drogas emergentes poseen un aurade seguridad, cada vez hay más experiencia sobre susefectos secundarios(AU)

In recent years, a series of new drugs, known assmart drugs or legal highs, have gaining in popularity.They are easily obtainable through online shops. Thisis happening amongst younger segments of the populationand is associated with recreational consumption,at weekends.In general, they are synthetic derivatives of naturalproducts. There has been hardly any clinical researchinto them and they are not detectable in hospital laboratories.Three of these products, BZP (1-benzylpiperazine),mefedrone (4-methylmethcathinone) and Spice are probablythe most widely used in Europe. The first two areconsumed as an alternative to ecstasy and cocaine andare characterized by their producing a clinical profile ofa sympathetic mimetic type; on occasion, they have seriousconsequences, with convulsions and even death.Spice (a mixture of herbs with synthetic cannabinoidssuch as JWH-018, JWH-073 and CP 47497-C8) is givingrise to profiles of dependence and schizophrenia.Although the emergent drugs have an aura of safety,there is an increasing amount of experience on theirsecondary effects(AU)

Translation of the Philadelphia chromosome into therapy for CML.

Throughout its history, chronic myeloid leukemia (CML) has set precedents for cancer research and therapy. These range from the identification of the first specific chromosomal abnormality associated with cancer to the development of imatinib as a specific, targeted therapy for the disease. The successful development of imatinib as a therapeutic agent for CML can be attributed directly to decades of scientific discoveries. These discoveries determined that the BCR-ABL tyrosine kinase is the critical pathogenetic event in CML and an ideal target for therapy. This was confirmed in clinical trials of imatinib, with imatinib significantly improving the long-term survival of patients with CML. Continuing in this tradition of scientific discoveries leading to improved therapies, the understanding of resistance to imatinib has rapidly led to strategies to circumvent resistance. Continued studies of hematologic malignancies will allow this paradigm of targeting molecular pathogenetic events to be applied to many additional hematologic cancers.

Treatment for chronic myelogenous leukemia: the long road to imatinib.

The scientists of today have become accustomed to the extremely rapid pace of progress in the biomedical sciences spurred on by the discovery of recombinant DNA and the advent of automated DNA sequencing and PCR, with progress usually being measured in months or years at most. What is often forgotten, however, are the many prior advances that were needed to reach our present state of knowledge. Here I illustrate this by discussing the scientific discoveries made over the course of the past century and a half that ultimately led to the recent successful development of drugs, particularly imatinib mesylate, to treat chronic myelogenous leukemia.

The role of serendipity in drug discovery.

Serendipity is one of the many factors that may contribute to drug discovery. It has played a role in the discovery of prototype psychotropic drugs that led to modern pharmacological treatment in psychiatry. It has also played a role in the discovery of several drugs that have had an impact on the development of psychiatry. "Serendipity" in drug discovery implies the finding of one thing while looking for something else. This was the case in six of the twelve serendipitous discoveries reviewed in this paper, i.e., aniline purple, penicillin, lysergic acid diethylamide, meprobamate, chlorpromazine, and imipramine. In the case of three drugs, i.e., potassium bromide, chloral hydrate, and lithium, the discovery was serendipitous because an utterly false rationale led to correct empirical results; and in case of two others, i.e., iproniazid and sildenafil, because valuable indications were found for these drugs which were not initially those sought The discovery of one of the twelve drugs, chlordiazepoxide, was sheer luck.

Role of allogeneic stem cell transplantation for adult chronic myeloid leukemia in the imatinib era.

Due to superior survival in the short to medium term, the first-generation ABL kinase inhibitor imatinib mesylate has generally supplanted all other therapies as the initial treatment of choice in chronic phase chronic myeloid leukemia. The role of allogeneic stem cell transplantation (alloSCT) has shifted from a preferred first-line therapy to a possible second- or third-line therapy. However, despite generally excellent responses to imatinib, some patients respond poorly or lose response, and the risk-benefit equation in these cases may rapidly shift in favor of the alloSCT option. These patients need to be identified as soon as possible so that the alloSCT option can be applied while they are still in controlled chronic phase. Monitoring of imatinib response in patients who have suitable donors and are potentially eligible for alloSCT needs to be frequent, sensitive, and accurate. Clear criteria for switching from imatinib therapy to the alloSCT option should be established for each patient according to the specific risk profile of the transplant. The potential efficacy and safety of clinical trials combining reduced intensity alloSCT with ABL kinase inhibitor therapy warrants further consideration.

A history of sexual medicine in the United kingdom.

The history of sexual medicine in the United Kingdom since the 19th century is reviewed, with particular reference to masturbation, homosexuality, contraception, and in the past four decades, the treatment of sexual dysfunction. The medical profession's tendency to deal with sexual issues according to the sociopolitical and moral issues of the time is emphasized, and whereas "sex negativism" has prevailed within the medical profession for most of this historical period, there has been a succession of individuals within the profession who have presented a more positive approach to defining and promoting sexual health. Four tracks within sexual medicine over the past 30 years are described: the psychoanalytic approach of the Institute of Psychosexual Medicine, modern "sex therapy," psychophysiological sex research, and the involvement of andrology in the assessment and treatment of erectile dysfunction. The impact of Viagra is seen as the most recent chapter in this history.

Two pills, two paths: a tale of gender bias.

In Japan, it took over 30 years to register the contraceptive Pill, but it took only six months to approve Viagra. The Pill was developed in an academic institution and no large pharmaceutical manufacturer wished to market it. Viagra was developed inside a big company and actively promoted. In the USA, the Pill was almost removed from the market because of widely publicized reports of deaths, but mortalities associated with Viagra do not make the headlines. Viagra has been promoted by the famous, whilst those who use the Pill do not appear in advertisements. Even theologians have treated these two drugs according to different standards. It is suggested that this asymmetry is not accidental, but is an expression of a deep-seated dual standard that is ultimately driven by biosocial differences in male and female power, and reproductive agendas rooted in human evolution.