Thalidomide was a sedative drug that was withdrawn in 1961 after being linked to severe birth defects in thousands of babies. It was never tested in pregnant animals before being used in humans. The thalidomide tragedy led to major reforms in drug safety regulations, including the establishment of the FDA and new preclinical testing requirements. It showed the need for rigorous safety testing and established windows of exposure during pregnancy that can cause defects from drug exposure.
Drug discovery is a
process which aims
at identifying a
compound
therapeutically useful
in curing and treating
disease
Target identification is process of
identifying the direct molecular
target(protein, nucleic acid, or
small molecule).
Identifying the biological of the
disease and the potential targets
for involvement ,is the first step in
the discovery of a medicine
To study new drug registration process in u.sManoj Dagwar
Legislative History of Drug Regulation
Derived from the Dutch word meaning to boast (quacken), “quack” is the word Americans have commonly used to describe charlatans in medicine. Quacks peddled adulterated and mislabeled Medicines throughout the United States without penalty until 1906, when Congress passed the Food and Drugs Act, one section of which outlawed the practice.
Over the next half-century, Congress passed two major pieces of legislation expanding FDA Authority. It passed the Federal Food, Drug, and Cosmetic Act (FFDCA) in 1938, requiring that
Drugs be proven safe before they could be sold in interstate commerce. Then, in 1962, in the wake of deaths and birth defects from the tranquilizer thalidomide marketed in Europe, Congress passed the Kefauver-Harris Drug Amendments to the FFDCA,3 increasing safety provisions and
Requiring that drugs be proven effective as well.
Congress has amended the FFDCA many times, leading to FDA’s current mission of assuring
Americans that the medicines they use do no harm and actually work—that they are, in other words, safe and effective. In recent decades Congress has passed additional laws to boost
Pharmaceutical research and development and to speed the approval of new medicines.
FDA also regulates products other than drugs—for example, biological products, medical devices,
Dietary supplements, foods, cosmetics, animal drugs, and tobacco products. Sometimes the
Agency addresses issues that straddle two or more product types that the law treats differently.
How FDA Approves New Drugs
To market a prescription drug in the United States, a manufacturer needs FDA approval. to get that approval, the manufacturer must demonstrate the drug’s safety and effectiveness according to criteria specified in law and agency regulations, ensure that its manufacturing plant passes FDA inspection and obtain FDA approval for the drug’s labeling—a term that includes all written material about the drug, including, for example, packaging, prescribing information for physicians, and patient brochures.
The approval process begins before the law requires FDA involvement. Figure 1 illustrates a product’s timeline both before and during FDA involvement.
The research and development process for a finished drug usually begins in the laboratory. Basic research is often conducted or funded by the federal government.7 when basic research yields an idea that someone identifies as a possible drug component, government or private research groups focus attention on a prototype design. At some point, private industry (either a large, established company or a newer, smaller, start-up company) continues to develop the idea, eventually testing the drug in animals. When the drug is ready for testing in humans, the FDA must get involved.
The Standard Process of Drug Approval
The four FDA steps leading to the agency’s approval of a new drug for marketing in the United
States are described below.
Drug discovery is a
process which aims
at identifying a
compound
therapeutically useful
in curing and treating
disease
Target identification is process of
identifying the direct molecular
target(protein, nucleic acid, or
small molecule).
Identifying the biological of the
disease and the potential targets
for involvement ,is the first step in
the discovery of a medicine
To study new drug registration process in u.sManoj Dagwar
Legislative History of Drug Regulation
Derived from the Dutch word meaning to boast (quacken), “quack” is the word Americans have commonly used to describe charlatans in medicine. Quacks peddled adulterated and mislabeled Medicines throughout the United States without penalty until 1906, when Congress passed the Food and Drugs Act, one section of which outlawed the practice.
Over the next half-century, Congress passed two major pieces of legislation expanding FDA Authority. It passed the Federal Food, Drug, and Cosmetic Act (FFDCA) in 1938, requiring that
Drugs be proven safe before they could be sold in interstate commerce. Then, in 1962, in the wake of deaths and birth defects from the tranquilizer thalidomide marketed in Europe, Congress passed the Kefauver-Harris Drug Amendments to the FFDCA,3 increasing safety provisions and
Requiring that drugs be proven effective as well.
Congress has amended the FFDCA many times, leading to FDA’s current mission of assuring
Americans that the medicines they use do no harm and actually work—that they are, in other words, safe and effective. In recent decades Congress has passed additional laws to boost
Pharmaceutical research and development and to speed the approval of new medicines.
FDA also regulates products other than drugs—for example, biological products, medical devices,
Dietary supplements, foods, cosmetics, animal drugs, and tobacco products. Sometimes the
Agency addresses issues that straddle two or more product types that the law treats differently.
How FDA Approves New Drugs
To market a prescription drug in the United States, a manufacturer needs FDA approval. to get that approval, the manufacturer must demonstrate the drug’s safety and effectiveness according to criteria specified in law and agency regulations, ensure that its manufacturing plant passes FDA inspection and obtain FDA approval for the drug’s labeling—a term that includes all written material about the drug, including, for example, packaging, prescribing information for physicians, and patient brochures.
The approval process begins before the law requires FDA involvement. Figure 1 illustrates a product’s timeline both before and during FDA involvement.
The research and development process for a finished drug usually begins in the laboratory. Basic research is often conducted or funded by the federal government.7 when basic research yields an idea that someone identifies as a possible drug component, government or private research groups focus attention on a prototype design. At some point, private industry (either a large, established company or a newer, smaller, start-up company) continues to develop the idea, eventually testing the drug in animals. When the drug is ready for testing in humans, the FDA must get involved.
The Standard Process of Drug Approval
The four FDA steps leading to the agency’s approval of a new drug for marketing in the United
States are described below.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
August 2, 2014 presentation to the Orange County Regulatory Affairs (OCRA) Discussion Group Regulatory Affairs Certification (RAC) Review Course, with a focus on:
• History of FDA
• Overview of US Legal System
• General Structure of FDA
• FDA Definitions
The Status of the Regulatory and Economic Landscape for Innovation in Big Pha...Lindsay Meyer
The purpose of engaging this topic is to: examine the current regulatory environment for new drugs, gain an understanding of breakthrough innovation in pharmaceuticals, evaluate the efforts of key players, and make projections about the future of this industry. As therapeutics has evolved away from their theistic origins, natural products, synthetic chemistry, and biopharmaceuticals have emerged. Yet many difficulties remain for this specialized industry. The approval process for a new drug can take upwards of eight years and cost $800 million. The progression from test tube to commercial distribution includes preclinical trials followed by three phases of clinical (human) trials, marked by ongoing dialogue between the Food and Drug Administration (“FDA”). Five of largest American pharmaceutical companies have intensified their efforts in Research and Development (“R&D”) in recent years. But in a space marked with competition from generic manufacturers and maturing biotech companies, understanding the dynamics of this highly scrutinized market requires an awareness of the political and economic climate these key players face. Where this industry is headed is much less clear than where it is coming from. Careful analysis is one lens through which to examine all of these intricate elements and is the focus of this research paper.
This was a lecture in the course "Significant Medical Conditions in Seniors" presented at Peer Learning in Chapel Hill, NC, USA in 2016 by Michael C. Joseph, MD, MPH.
Thalidomide was first developed by CIBA, a Swiss pharmaceutical company in the early 1950s, and subsequently introduced as Contergan by Chemi Grunenthal.
The drug was initially advertised as a sedative which would allow users to undergo a deep sleep in the absence of a hangover and with a reduced risk of developing drug dependency. At the time, basic testing was done on the drug, and it was considered not to have any toxic effects on humans.
However, unlike today’s level of rigorous testing, the drug was not analyzed for any potentially dangerous teratogenic effects.
In the 1950s, scientists did not know that the effects of a drug could be passed through the placental barrier and harm a foetus in the womb, so the use of medications during pregnancy was not strictly controlled. And in the case of thalidomide, no tests were done involving pregnant women.
As the drug was traded under so many different names in 49 countries, it took five years for the connection between thalidomide taken by pregnant women and the impact on their children to be made. A UK Government warning was not issued until May 1962.
One reason why researchers and doctors were slow to make this connection was due to the wide range of changes to foetal development. Limbs, internal organs including the brain, eyesight and hearing could all be affected.The first time the link between thalidomide and its impact on development was made public in a letter published in The Lancet from an Australian doctor William McBride, in 1961.
The drug was formally withdrawn by Chemie Grünenthal on 26 November 1961 and a few days later, on 2 December 1961, the UK distributors followed suit. However, it remained in many medicine cabinets under many different names.
In the few short years that thalidomide was available, it's estimated that over 10,000 babies were affected by the drug worldwide. Around half died within months of being born. The thalidomide babies who survived and their families live with the effects of the drug.
The Thalidomide Society was formed in 1962 by the parents of children affected by the drug thalidomide. The original aim of the Society was to provide mutual support and a social network as well as to seek compensation.
In 1972, a highly publicised campaign led by the Sunday Times newspaper helped to secure a further settlement for children affected by thalidomide in the UK.
Thalidomide forced governments and medical authorities to review their pharmaceutical licencing policies. As a result, changes were made to the way drugs were marketed, tested and approved both in the UK and across the world.
One key change was that drugs intended for human use could no longer be approved purely on the basis of animal testing. And drug trials for substances marketed to pregnant women also had to provide evidence that they were safe for use in pregnancy.
Regulations for drug approval in USA, E.U & India
Pharmaceutical industry is the most regulated of all the industries. Regulations are put in order to develop the most efficient and safe pharmaceutical products. It takes more than 8 to 15 years to develop a new drug product & costs more than $ 800 million.
Thalidomide tragedy and History of MedicineClinosolIndia
The Thalidomide tragedy is one of the most notorious episodes in the history of medicine and pharmaceutical regulation. Thalidomide, initially introduced as a seemingly safe and effective medication, led to a public health crisis with severe and lasting consequences. Here's an overview of the Thalidomide tragedy
Basic aspects of Pharmacovigilance (Clinical Research & Pharmacovigilance).pptxDureshahwar khan
The slides in this presentation mainly focus on History and Progress of Pharmacovigilance, significance of safety monitoring and Pharmacovigilance in India & International aspects.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
August 2, 2014 presentation to the Orange County Regulatory Affairs (OCRA) Discussion Group Regulatory Affairs Certification (RAC) Review Course, with a focus on:
• History of FDA
• Overview of US Legal System
• General Structure of FDA
• FDA Definitions
The Status of the Regulatory and Economic Landscape for Innovation in Big Pha...Lindsay Meyer
The purpose of engaging this topic is to: examine the current regulatory environment for new drugs, gain an understanding of breakthrough innovation in pharmaceuticals, evaluate the efforts of key players, and make projections about the future of this industry. As therapeutics has evolved away from their theistic origins, natural products, synthetic chemistry, and biopharmaceuticals have emerged. Yet many difficulties remain for this specialized industry. The approval process for a new drug can take upwards of eight years and cost $800 million. The progression from test tube to commercial distribution includes preclinical trials followed by three phases of clinical (human) trials, marked by ongoing dialogue between the Food and Drug Administration (“FDA”). Five of largest American pharmaceutical companies have intensified their efforts in Research and Development (“R&D”) in recent years. But in a space marked with competition from generic manufacturers and maturing biotech companies, understanding the dynamics of this highly scrutinized market requires an awareness of the political and economic climate these key players face. Where this industry is headed is much less clear than where it is coming from. Careful analysis is one lens through which to examine all of these intricate elements and is the focus of this research paper.
This was a lecture in the course "Significant Medical Conditions in Seniors" presented at Peer Learning in Chapel Hill, NC, USA in 2016 by Michael C. Joseph, MD, MPH.
Thalidomide was first developed by CIBA, a Swiss pharmaceutical company in the early 1950s, and subsequently introduced as Contergan by Chemi Grunenthal.
The drug was initially advertised as a sedative which would allow users to undergo a deep sleep in the absence of a hangover and with a reduced risk of developing drug dependency. At the time, basic testing was done on the drug, and it was considered not to have any toxic effects on humans.
However, unlike today’s level of rigorous testing, the drug was not analyzed for any potentially dangerous teratogenic effects.
In the 1950s, scientists did not know that the effects of a drug could be passed through the placental barrier and harm a foetus in the womb, so the use of medications during pregnancy was not strictly controlled. And in the case of thalidomide, no tests were done involving pregnant women.
As the drug was traded under so many different names in 49 countries, it took five years for the connection between thalidomide taken by pregnant women and the impact on their children to be made. A UK Government warning was not issued until May 1962.
One reason why researchers and doctors were slow to make this connection was due to the wide range of changes to foetal development. Limbs, internal organs including the brain, eyesight and hearing could all be affected.The first time the link between thalidomide and its impact on development was made public in a letter published in The Lancet from an Australian doctor William McBride, in 1961.
The drug was formally withdrawn by Chemie Grünenthal on 26 November 1961 and a few days later, on 2 December 1961, the UK distributors followed suit. However, it remained in many medicine cabinets under many different names.
In the few short years that thalidomide was available, it's estimated that over 10,000 babies were affected by the drug worldwide. Around half died within months of being born. The thalidomide babies who survived and their families live with the effects of the drug.
The Thalidomide Society was formed in 1962 by the parents of children affected by the drug thalidomide. The original aim of the Society was to provide mutual support and a social network as well as to seek compensation.
In 1972, a highly publicised campaign led by the Sunday Times newspaper helped to secure a further settlement for children affected by thalidomide in the UK.
Thalidomide forced governments and medical authorities to review their pharmaceutical licencing policies. As a result, changes were made to the way drugs were marketed, tested and approved both in the UK and across the world.
One key change was that drugs intended for human use could no longer be approved purely on the basis of animal testing. And drug trials for substances marketed to pregnant women also had to provide evidence that they were safe for use in pregnancy.
Regulations for drug approval in USA, E.U & India
Pharmaceutical industry is the most regulated of all the industries. Regulations are put in order to develop the most efficient and safe pharmaceutical products. It takes more than 8 to 15 years to develop a new drug product & costs more than $ 800 million.
Thalidomide tragedy and History of MedicineClinosolIndia
The Thalidomide tragedy is one of the most notorious episodes in the history of medicine and pharmaceutical regulation. Thalidomide, initially introduced as a seemingly safe and effective medication, led to a public health crisis with severe and lasting consequences. Here's an overview of the Thalidomide tragedy
Basic aspects of Pharmacovigilance (Clinical Research & Pharmacovigilance).pptxDureshahwar khan
The slides in this presentation mainly focus on History and Progress of Pharmacovigilance, significance of safety monitoring and Pharmacovigilance in India & International aspects.
CASE 15 The Diethylstilbestrol Story An Investigation into the Evo.docxwendolynhalbert
CASE 15 The Diethylstilbestrol Story An Investigation into the Evolving Public Health Policy for Pharmaceutical Products
MARGARET ANN MILLER, EMILY BLECKER, AND MEGHAL PATEL
i Regulatory agencies such as the United States Food and Drug Administration (FDA) play an important role in promoting and protecting public health by preventing or limiting exposure to unsafe products. Unfortunately, laws and regulations that protect public health are rarely proactive. Most current laws, regulations, and policies governing the manufacture and sale of pharmaceutical drug products (drugs) were enacted following a public health disaster. Understanding how public health disasters have impacted the development of health laws and regulations is critical for understanding current public health policy in the United States and for developing a proactive, rather than reactive public health framework. This case study describes the tragic story of the prescription drug, diethylstilbestrol (DES). It involves numerous players in the public health arena including research scientists, regulators, pharmaceutical companies, physicians, lawyers, advocates, and of course, patients.
INTRODUCTION
In 1971, several physicians noted an alarming increase in the development of clear cell adenocarcinoma in teenage girls and young women. This rare and potentially deadly form of vaginal and cervical cancer had previously occurred mainly in women over 50 years of age. The only treatment was major invasive surgery to remove the uterus (hysterectomy) or vagina (vaginectomy). This surgery was not only emotionally and physically painful but sometimes not a cure. A few physicians began to search for the cause of this rare form of cancer, and one physician, Arthur Herbst, described a common link: all of the women developing clear cell adenocarcinoma were exposed to DES in utero.1 The implications of this finding were terrifying for the American public—millions of children might develop cancer or some other reproductive problem after an unknown length of time because their mothers took this prescription medication during pregnancy. Today there is still no test for detecting DES exposure and it is impossible to know how many people were, or will be, affected by the medication. DES remains one of the most significant public health disasters of the 20th century.
THE BEGINNING
Starting in the mid-1920s, scientists understood the action of natural estrogens and their potential utility for treating numerous conditions from cancer to wrinkles. The natural estrogens identified at that time were not water soluble and showed no activity when given orally. Several research scientists (many of whom were supported by pharmaceutical companies) began their search for an orally active form of estrogen. In 1938, British physician and chemist Charles Dodds and his team of scientists published a paper describing the synthesis of DES, a compound that showed estrogenic activity when consumed orally in t ...
73What is Special Education 1iStockphotoThinkstock.docxalinainglis
73
What is Special Education? 1
iStockphoto/Thinkstock
Pre-Test
1. You can use the terms disability and handicap interchangeably. T/F
2. The history of special education began in Europe. T/F
3. The first American legislation that protected students with disabilities was passed in the 1950s. T/F
4. All students with disabilities should be educated in special education classrooms. T/F
5. Special education law is constantly reinterpreted. T/F
Answers can be found at the end of the chapter.
4Accreditation, Regulation, and
Agencies of Healthcare Quality
Alex Brandon/AP/Associated Press
Learning Objectives
After reading this chapter, you should be able to do the following:
• Illustrate how healthcare policies, rules and regulations, and guidelines impact quality of care.
• Analyze the role of accreditors, including The Joint Commission, along with major steps in the
accreditation of healthcare organizations.
• Evaluate the role of Leapfrog group on quality of healthcare and the methodology used to compute
the hospital safety score.
• Analyze the structure and process of the National Committee for Quality Assurance (NCQA)
accreditation for health plans.
• Assess the role of several government institutions on the quality of care.
fin81226_04_c04_073-118.indd 73 10/30/14 7:41 PM
Introduction
Introduction
At the turn of the 20th century, there were few federal regulations to protect the public from
dangerous drugs. Many harmful products were freely sold, such as William Radam’s Microbe
Killer and Benjamin Bye’s Soothing Balmy Oils to cure cancer. As is sometimes the case, trag-
edy brought about the first real regulation to protect consumers health and safety. The Bio-
logics Control Act was passed in 1902 after two incidents involving the deaths of children
caused by contaminated vaccines. The law mandated producers in the U.S. to be licensed each
year for the manufacture and sale of biologics such as antitoxins, serum, and vaccines to pre-
vent future tragedies from reoccurring. That was followed by the Pure Food and Drugs Act in
1906, which prohibited interstate commerce in misbranded and adulterated foods, drinks,
and drugs and mandated strict health safety and testing policies. The law was passed mainly
in response to shocking public disclosures of unsanitary conditions in meat packing plants, as
well as fears over poisonous preservatives and dyes in foods.
However, the 1906 law had its shortcomings and the government’s hands were tied when it
came to preventing the sale of medicinal products that carried wild claims of health cures.
In 1910, the government stopped sales of a product called Dr. Johnson’s Mild Combination
Treatment for Cancer, but the Supreme Court ruled in favor of the company because the prod-
uct’s false claims were not within the scope of the Pure Food and Drugs Act (Meadows, 2006).
As a result, in 1912, Congress passed the Sherley Amendment, which prohibited labels on
medicines that fals.
Drug Safety & Pharmacovigilance - Introduction - Katalyst HLSKatalyst HLS
Introduction to Drug Safety & Pharmacovigilance in Pharmaceuticals, Bio-Pharmaceuticals, Medical Devices, Cosmeceuticals and Foods.
Contact:
"Katalyst Healthcares & Life Sciences"
South Plainfield, NJ, USA
info@KatalystHLS.com
IN THIS SUMMARY
The United States Food and Drug Administration (FDA) has significant reach in the American economy, ranging from medicines and medical devices to items on the grocery store shelves. Since its inception in 1906, the agency has faced a variety of technical and political challenges. Looking ahead, the FDA faces many new demands that could enlarge the agency’s already expansive mandate. New responsibilities may include the cost of medicine, consumers’ pursuit of perfection through drugs, consumer lifestyles, tobacco, and counterterrorism. As the nature of public health changes over time, it is inevitable that the FDA’s scope and responsibilities will change as well. In Inside the FDA, Fran Hawthorne explains the history of the FDA, how its processes work, and what the future may hold for this government agency.
SUBSCRIBE TODAY
http://www.bizsum.com/summaries/inside-fda
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
1. 1
Sixty years on: The thalidomide tragedy
Prepared by: Amit Mishra
Submitted to: Dr. Sayantan Mukhopadhyay
Dev Bhoomi Institute of Pharmacy and Research, Dehradun
(Uttarakhand)
• Correspondence to Author Amit Mishra E-mail: amitmishrapci@gmail.com
Introduction
1.Sixty years ago (2 December 1961) the sedative drug thalidomide was withdrawn
from use in the UK. After being on the market for five years as a treatment for
morning sickness in pregnant women, it had finally been established that the
medicine was responsible for babies being born with underdeveloped arms and
legs and other malformations.
2.No drug has had a greater effect than thalidomide on the extent and intensity of
the preclinical investigation of potential medicines required by the regulatory
authorities. Indeed, the establishment of thalidomide as the cause of the apparent
epidemic of children born with horrific deformities in the late 1950s was
responsible for the institution of some regulatory bodies, such as the United
Kingdom’s Committee on the Safety of Drugs, and for the strengthening of others,
such as the Food and Drugs Administration (FDA) of the United States. Despite
this, the history of the development of thalidomide, and of the subsequent studies
of the teratogenic and other effects of the drug, has become confused, because of
misrepresentation by those anxious to discredit the contribution of animal
experimentation to medical advances.
Thalidomide was never administered to pregnant animals before it was used in
humans.
Laboratory Studies
3.The first paper describing the pharmacological actions of thalidomide was
published in 1956 by Kunz, Keller and Mückter from the Research Laboratories of
2. 2
the German pharmaceutical firm Chemie Grünenthal .Thalidomide, designated
then as K17, was alleged to reduce spontaneous movement in mice without the
initial excitement phase observed with other sedative drugs such as phenobarbitone
and glutethimide.
Thalidomide was claimed to be virtually non-toxic, oral doses in excess of
5000mg/kg failing to cause death, whereas 600mg/kg and 300mg/kg doses of
glutethimide and phenobarbitone respectively were sufficient to kill half of the
mice in a test group. Chronic administration of 100-500mg/kg thalidomide to mice,
rats, guinea pigs and rabbits for 30 days appeared to be well-tolerated. Thus it was
proposed by the researchers at Chemie Grünenthal that thalidomide would be a
useful sedative or hypnotic that did not carry the suicide risk of contemporary
medicines.
4.The actions of thalidomide were also investigated by G. B. Somers chief
pharmacologist at the Distillers Company, which was licensed by Grünenthal to
distribute thalidomide in the British and Commonwealth markets. Somers, using
thalidomide as a suspension in 1% carboxymethylcellulose, generally confirmed
the inhibition of spontaneous movement by the drug in mice and also remarked on
its apparent lack of toxicity in animals. Important caveat when discussing the
results of his toxicity studies: “It may well be that the absence of toxicity is due to
a limited absorption, for the compound has a low solubility in body fluids, and
when administered parenterally remains at the site of injection. In the absence of a
suitable assay method absorption studies have not yet been made.”
WINDOWS OF EXPOSURE
5.‘‘All substances are poisons; there is none which is not a poison. The right dose
differentiates a poison from a remedy.’’
A timetable of critical exposure periods for thalidomide embryopathy. For
example, the window of exposure in humans for upper limb malformations is days
24–32 postfertilization; the window for lower limb malformations is days 27–34
postfertilization (Miller and Stro¨mland, 1999). Other endpoints include external
ear malformations (days 20–24), inner ear malformations (days 24–34), thumb
hypoplasia (days 21–28), and triphalangism of the thumbs (days 32–36). The
sensitive period during pregnancy for thalidomide effects in humans is
approximately days 20–34 after fertilization (Miller and Stro¨mland, 1999; Miller
et al., 2009). A summary of these windows of critical exposures and limb defects.
3. 3
Defects of Thalidomide Children
• 6 Defects of the Upper Limbs.
• Defects of the Lower Limbs
• Defects of the Ears and Eyes.
• Defects of Internal Organs
4. 4
7.The malformations induced by thalidomide were rare under normal conditions,
consisting of limb dysmelia in 80% and ear defects in 20%.326 The drug was said
to increase the rate of limb reduction by 80-f0ld;~~’ the most common pattern of
malformation, encountered in 38% of the cases, was upper limb amelia or
phocomelia, with normal legs.328 Other malformations occurring in addition to
limb and ear defects included, in descending order of frequency: loss of hearing,
abducens paralysis, facial paralysis, cryptorchidism, renal malformations,
congenital heart disease, inguinal hernia, and stenosis/atresia of the anus, pylorus,
or duodenum. 329
The evolution of FDA in shadow of Thalidomide
8.Francis Kelsey, Ph.D., was hired to work for the FDA in 1960 and the first drug
she was asked to review for approval was thalidomide. she was vindicated when
children being born with birth defects were linked back to the use of thalidomide.
From 1956 to 1962, approximately 10,000 children were born with severe
malformities, including phocomelia, because their mothers had taken thalidomide
during pregnancy. she played a key role in shaping and enforcing the 1962
Amendments.
5. 5
The Kefauver-Harris Amendment provided the modern scenario for approving new
drugs:
• Initial drug discovery.
• Preclinical (animal) testing.
• An investigational new drug application (IND) outlines what the sponsor of
a new drug proposes for human testing in clinical trials.
• Phase 1 studies (typically involves 20 to 100 healthy people).
• Phase 2 studies (typically involves 100 to 500 people with the ailment that
the new drug is intended to treat).
• Phase 3 studies (typically involves 1,000 to 5,000 people with the ailment
that the new drug is intended to treat).
• The pre-NDA period, just before a new drug application (NDA) is
submitted. A common time for the FDA and drug sponsors to meet.
• Submission of an NDA is the formal step asking the FDA to consider a drug
for marketing approval.
• After an NDA is received, the FDA has 60 days to decide whether to file it
so it can be reviewed.
• If the FDA files the NDA, an FDA review team is assigned to evaluate the
sponsor's research on the drug's safety and effectiveness. This review may
take from 6 months to 2 years.
6. 6
• The FDA reviews information that goes on a drug's professional labeling
(information on how to use the drug).
• The FDA inspects the facilities where the drug will be manufactured as part
of the approval process.
• FDA reviewers will approve the application or find it either "approvable" or
"not approvable."
• Post marketing study commitments, also called Phase 4 commitments.
9.After thalidomide babies tragedy FDA's attitude was changed and pushed
congress to enact so-called "Kefauver Amendment" to Act in 1962. Senator
Kefauver's motives were noble to bring better , safer , medicine and establish a
more effective system of endorsement of drug laws.
Relation between Thalidomide tragedy & Kefauver-Harris Amendment
10.Senator Estes Kefauver, who sat on the Senate Antitrust and Monopoly
Subcommittee, decided that in dealing with medications, the government must do
more than control their labels, contents, and safety and their marketing and
distribution processes. It must also control their prices and enforce “competition.”
In 1960, Kefauver initiated hearings in an attempt to expose unfair marketing
practices. Kefauver’s bill called for a scheme of compulsory patent sharing. Each
pharmaceutical company would, after three years, be required to share its new
patents with competitors, while collecting an annual royalty fee of some 8 percent
of the total.
In the United States, an NDA for thalidomide had been submitted to the FDA in
1960, but approval had been delayed as the FDA investigated adverse neurological
reactions. FDA officials had not even suspected that the drug caused birth defects.
In 1962, President Kennedy bestowed the Distinguished Federal Civil Service
Award on the FDA physician who held up approval, Frances Kelsey, even though
her withholding of approval was more a matter of bureaucratic delay than of
investigation.
7. 7
REFERENCES
1 Schardein, J L and Keller, K A (1989) Potential of human developmental
toxicants and the role of animal testing in their identification and
characterisation. CRC Crit. Rev. Toxicol. pg 251-330
2 Animals and Medicine: The Contribution of Animal Experiments to the
Control of Disease CH18
3 Animals and Medicine: The Contribution of Animal Experiments to the
Control of Disease CH18
4 Somers, G F (1960) Pharmacological properties of thalidomide (α-
phthalimido glutarimide), a new sedative hypnotic drug. Brit.
J. Pharmacol. 15 111-16.
5 James H. Kim*,1 and Anthony R. Scialli†Thalidomide: The Tragedy of
Birth Defects and the Effective Treatment of Disease pg 2
6 R. W. SMITHELLS Defects and Disabilities of Thalidomide Children
British Medical Journal, 1973, pg 269-72
7 James L. Schardein Kit A. Keller POTENTIAL HUMAN
DEVELOPMENTAL TOXICANTS AND THE ROLE OF ANIMAL
TESTING IN THEIR IDENTIFICATION AND CHARACTERIZATION
pg 275
8 http://rx-wiki.org/index.php?title=Kefauver-Harris_Amendment
9 The Real Thalidomide baby 1960-1977 ( 1997 Third Year Paper) (DASH)
10 https://www.fdareview.org/issues/history-of-federal-regulation-1902-
present/#p10.