November 21, 2005
Where's My Aspirin?
Should aspirin, acetominophen or penicillin be used? Derek Lowe argues that today not only would they not be approved by the FDA they likely would not even be submitted for approval:
The best example is aspirin itself. It's one of the foundation stones of the drug industry, and it's hard to even guess how many billions of doses of it have been taken over the last hundred years. But if you were somehow able to change history so that aspirin had never been discovered until this year, I can guarantee you that it would have died in the lab. No modern drug development organization would touch it.I don't know about you but I would be very unhappy not to have aspirin, etc., in my home arsenal and I had more than one childhood infection cleared by penicillin. On the other hand I have seen first hand the frightening experience of an allergic reaction to one of penicillin's offspring.
I do, though, lean in the same direction as Lowe:
We can be relieved that we've learned so much more about pharmacology, ensuring that the drugs that manage to gain approval today are the safer than ever. Or we can think about how people seem to use aspirin and the other legacy drugs anyway, safety problems and all, and wonder how many more useful medicines we're losing by insisting on a higher bar.The final informed choice on drug use should be made by a well informed patient. If the patient is being treated by a medical professional responsibility for providing the full set of information on a course of treatment belongs to the medical professional. If the patient is self-treating then the patient is responsible for acquiring the information. In both cases it is the patient who must make the final evaluation of a course of treatment.I definitely see the point of the former, but I lean a bit toward the latter.
That many people are not competent to make these evaluations and decisions is one of the great failings of our culture, our education system and our health care system.
Via Marginal Revolution.
