Market prospects for drug development

The two goals of drug development are effectiveness and safety. Because all drugs can be both helpful and harmful to patients, safety is relative. The greater the safety, i.e., the wider the range between the effective dose and the dose that produces serious adverse effects, the greater the applicability of the drug. If a drug's commonly used effective dose is also a toxic dose, physicians will generally not use it except when they have no choice but to use it to save their lives.

A good drug should be both effective and safe in most therapeutic situations. Penicillin is such a drug and is practically nontoxic except for those who are allergic to it, even in high doses. In addition, barbiturates, which are commonly used for hypnosis, can interfere with breathing, disrupt heart rhythms, and even cause death in overdose. Newer hypnotics such as triazolam and hydroxyzine have a higher safety profile.

Despite their narrow safety profile, some drugs have to be used clinically. Warfarin, for example, acts as an anticoagulant and can also cause bleeding. Patients using warfarin must be tested frequently to see if the amount of drug used to achieve anticoagulation is too much or not enough.

Clozapine is another example. It is used when other medications have failed to treat schizophrenia. However, it has a serious side effect: the drug can cause a significant drop in infection-fighting white blood cells. Because of this danger, patients using clozapine need to have frequent blood tests while on the drug.

When people know the effects and side effects of a drug, they and their doctors will be better able to evaluate how the drug works and whether potential adverse reactions have occurred. Each patient should not hesitate to ask doctors, nurses and pharmacists to explain the purpose of the medication, possible adverse effects and how the patient should be involved in the treatment to get the most out of the medication. Patients should familiarize their health care practitioner with all of their medical history, treatment status, and a number of other pertinent circumstances.

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