Thursday, June 26, 2008

Big words

So far I hope I've persuaded you that TCM and other medical paradigms can only add to our knowledge base, that new ways of approaching the problem can lead to new solutions. We now come to a point where TCM and other alternative medical paradigms cannot help us: the pharmacologic theory of drug action.

Don't worry, I'm not going to start chucking about complicated equations and talking about kinetics and equilibrium. For starters, this is a blog, not a pharmacology course.

But models have their place in our knowledge base, too. Pharmacological modeling enables us to understand drug-drug interactions better, which allows us to better use the drugs that we have. In the case of plant extracts, it allows doctors to understand which drugs cannot be used with what plants. Multidrug pharmacy is already a major component of treatment regimens for a variety of diseases, most notably pediatric cancer. Unfortunately, most of the regimens in use today come about through trial and error--"experimental", indeed. And let's not forget the plethora of drugs being used "off-label", for other than their intended purpose. Anti-histamines, for instance, are sometimes used by desperate parents to get their kids to sleep.

And if you're using phytotherapy (because "herbal medicine" isn't science-y enough) rest assured that in each leaf of a plant there are easily a hundred compounds, most of them more benign than your average stick of celery. The effects of the few that aren't, however, are no laughing matter. St. John's Wort (you may remember me being surprised that it could be sold in a supermarket) actually has a long list of drug-drug interactions.

The development of mathematical models for drug activity really only began early in the last century. Modifications to the theories over the years has given us a powerful way of predicting the efficacy of drugs, but a model for two drugs, much less many, is still lacking. It is a matter of having the computing power, but also recognizing the need for models, and minimizing the damage on our way to new treatments.

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