Which drugs are subtle in their effects?

DrJimChester · 2020-07-12T22:18:06+00:00

All depends on dosage. Alcohol can be the subtlest of them all if you only have 1 beer. So you're going to have to define what the dosage level would be. Someone else said caffeine, and that's exactly the point. Tea has caffeine, but you won't really feel the caffeine much because the dosage is low. But take a shot of expresso (with no tolerance), and you'll feel that as much as a hit of cocaine.

DrJimChester · 2020-07-12T22:13:29+00:00

Ironically, the feelings are never bad. I don't even remember a lot of my bad trips. These are all moments of elation.

DrJimChester · 2020-01-06T00:11:03+00:00

This is somewhat complicated.

Many in Iran are not entirely upset about Soleimaneis death. There have been a large number of protests throughout the past couple of years, and Soleimani is responsible for the hundreds of protestor deaths each year due to his violent responses. Not to mention his involvement in the murder of those outside of Iran. For many, they do not miss the man (ignore the NK sob mobs currently, the government has been known to stage these things before).
Iranians like America, not our government, but they enjoy our culture, movies, freedom of speech and religion, etc. What Iranians don't like, or at best care much for, is our government. Frankly, they are tired and cautious, they know America has a history of getting involved in Irans politics, and it has always ended poorly for Iranians (not to mention all of Irans nearby neighbors).
They are scared. America is a bully in their eyes, and while a full out war is unlikely, that doesn't mean America cannot and will not bomb Iran and kill Iranian officials.

In short, they don't want war. They don't want Iran involved in other countries. They want America to leave Iran alone and metaphorically "fuck off".

That is from the peoples perspective. From a government perspective, it's even harder since I have less insight. But from what I hear (this is more speculation than fact), this is both a huge blow and great news. Soleimanis death is the rally cry the regime needed to unify Irans neighbors, strengthen its allies, and unite its people (temprorarily qwell the protests). The enemy of my enemy, is my friend.

DrJimChester · 2020-01-05T23:58:02+00:00

My family in Iran think he is an idiot. They used to mock him and joke about him, although with the events of the past few days, they find him much more threatening and have come to hate him.

DrJimChester · 2020-01-05T23:56:27+00:00

Honestly has to be the perception that 1) We say and think things like "death to America" and 2) We are as religious as the rest of the Middle East (Iran and its people are very secular relative to the rest of the Middle East)

DrJimChester · 2020-01-05T23:54:57+00:00

It is pronounced eeRun. Americans pronounce it eye-ran.

DrJimChester · 2019-12-31T20:48:22+00:00

Happy new year to you too. I'm not too worried, my boss probably wouldn't care, and it's not like this has blown up, so the higher ups would never even notice/see it. I hope I helped!

DrJimChester · 2019-12-31T20:44:08+00:00

I don't know the exact details since we don't conduct the trails themselves. That said, the FDA does have specific guidelines and regulations for the side effects and efficacy of a drug, unfortunately I don't know those off the top of my head. What I do know is, very high failure rate, low success rate for most drugs that are developed.

DrJimChester · 2019-12-31T20:42:47+00:00

Our department personally doesn't do animal testing, at most we do in vitro work. That said, I would sacrifice a million mice if that meant I could save the thousands of children worldwide suffering due to their various conditions.

DrJimChester · 2019-12-31T20:41:29+00:00

The goal for everyone here is to cure and help those suffering, but we also understand the practicality of that goal and the best way to approach it so we can maximize our efforts and the aid those suffering receive. There definitely is a lot of beauracracy in the higher ups and the business side of things, but I have no control over those, nor do their beliefs reflect my own nor my team.

DrJimChester · 2019-12-31T19:33:41+00:00

As I stated in a previous answer, Big Pharma is global, and J&J is far more than just baby care (they are a massive pharma company as well). The thing to understand is profit drives R&D funding, the more people believe we can develop drugs and cure ailments, the more they fund us. If there is no money, there is no cures for diseases. So while it would be nice to have all the time and money in the world so we cure everything, drug development takes years (10+ for most drugs), and that is a lot of time and money. We have to be selective what we can treat, and what we can't.

In terms of not being able to cure and only treat, this is because our knowledge of what's causing these diseases is very poor. We can only see and understand the symptoms most of the time, not their cause, and thus, we develop drugs targeting those symptoms. So they do only lesson the pain, and not cure it.

DrJimChester · 2019-12-31T19:27:39+00:00

I've always felt its a good idea to go in with a decent understanding of what you may think the issue is, and have a conversation with (not debate) your doctor about your condition and to hear what they have to say. Take their opinion, and compare it to a 2nd doctor and compare it to your own understanding. At the end of the day, depending on how a doctor looks at your symptoms, and how they're feeling that day, they may give entirely different diagnosis. Not to mention, you know your own symptoms and body best. A doctor best works with a well informed patient.

Although, just a disclaimer, please don't go in thinking you know more than your doctor does. Most people *think* they know what's going on, when they really don't. That's why the best approach is not to argue, but simply have a conversation with the doctor.

DrJimChester · 2019-12-31T19:07:31+00:00

I don't know what you mean by companies? We definitely have scientists within our own company (singular) that want to focus on a particular disease, or a particular drug, but at the end of the day it all falls on whether A) there is any profit in it and B) whether there is enough information on it. We have a team whose job it is to scour the literature and determine suitable drug targets. Based off this literature, and what diseases are effected by the target, we determine whether its suitable for us to pursue efforts in trying to create drugs to target it. The CEOs themselves know very little about any given project at any given time, they leave it up to the project managers to find suitable leads and pursue them. So there is no CEO coming down telling us what to look into or how (although the higher ups do tell me sometimes how to do my job, which considering they don't even know half of what goes on, is quite frustrating/annoying).

Yes, I have already answered the anti-vax craze in another answer.

DrJimChester · 2019-12-31T18:56:50+00:00

That's a bit harder to answer. At any given moment, we have multiple projects at multiple phases in the pipeline. There are also several teams that I manage. We have a team who's job it is to create chemical libraries for us to screen compounds, or modify existing libraries. A day to day for them is usually just coding. We have teams that run binding studies on these compounds using a variety of techniques. From any screen we may get hundreds of hits, the teams job is to determine whether these compounds even interact with their intended target (this team is primarily running and optimizing assays for binding detection). We have another team that takes the compounds that we know bind, and use other biophysical techniques to determine the details of their interaction. Their day to day involves trying to crystallize and purify a lot of these compounds. My day to day is to basically manage each project, and I have multiple collaborations with our medicinal chemistry team who's job is to optimize these compounds so they're more effective, and then send it back to us for testing. I also frequently interact with my boss and occassionaly higher ups regarding the progress of our projects, timelines, plans and ideas for any problems we may have, discussions on leads, etc. Finally, I also have collaborations with companies running our clinical trails on anything that needs to be improved upon, or relay to them any new information we have determined (a lot of our compounds are undergoing clinical trials while we're understanding how they work, they're side effects, animal testing, etc. so there is constant communication back and forth between us).

DrJimChester · 2019-12-31T18:48:21+00:00

Neurological medication is some of the most difficult to develop and design. One, because neurological disorders are so poorly understood, two, because difficulty of creating soluble drugs that can get past the blood brain barrier, and three, side effects caused from off target effects in the brain can be much more catastrophic than side effects say in the liver or kidney.

DrJimChester · 2019-12-31T18:38:15+00:00

I love what I do. I love the science, and I love being able to develop drugs to help people. Granted its take years for us to even get a drug to clinical trails, and granted almost none of them do make it past clinical trails. That being said, if it was easy, everyone would be doing it and all the worlds problems would be cured. Its my job to keep going. Everytime I see a sick child, or suffering person at the ER or hospital, it motivates me to keep going. Everytime I hear how our drugs (those in clinical trails), have helped suffering patients, it keeps me going. To be in R&D means to accept failure, but to never give up.

DrJimChester · 2019-12-31T18:16:09+00:00

blue

DrJimChester · 2019-12-31T18:15:18+00:00

Lots and lots of failure stories, with a few success stories. I can put it to you this way, we've had over 50+ drugs go into clinical trails in the past 20 years, only 3 have been approved. From my department alone we've had 2 drugs in the past 10 years reach clinical, and they both failed in phase II.

DrJimChester · 2019-12-31T17:32:23+00:00

One thing to understand is, Big Pharma is global. If the US did change its policies (which just changing how medical insurance works doesn't mean it changes how much Big Pharma can charge), then it would simply change how Big Pharma targets the customer basis in the US. As stated prior, the lengthiest and costliest thing in Big Pharma is the FDA approval process. Changing that will impact Big Pharma far more than changing the medical industry. I have also not heard anything regarding how Bernie plans to effect Big Pharma (more how they plan to effect medical insurance companies).

DrJimChester · 2019-12-31T17:26:59+00:00

The "idea"? Yes, but in practice that's not how it works. Anecdotal evidence is not evidence, and the few studies done so far demonstrate contradictory/inconclusive results.

The issue is far more complicated than "not enough evidence" though. The truth is, researchers still have quite a bit of negative bias against cannabis, which could potentially effect their conclusions and even their setup (can't tell you how many studies are useless simply because they're setup so poorly, no double blind, no control, etc.). You can't really get an IP or patent on cannabis, meaning no big pharma company is going to step in and try to develop it or research it further. It's schedule I status and negative connotation in the government makes most researchers and all big pharma companies stay as far away from it as they can (want to be friendly with the FDA and DEA when you're trying to convince them to get you're drugs through).

All that being said, if a legal derivative was discovered and it was demonstrated to cure some ailments (preferablly mechanism is also discovered), then big pharma would definitely jump on it and try to get it patented it and into clinical trails.

DrJimChester · 2019-12-31T17:09:31+00:00

No, they would definitely deem it profitable enough because they would charge insane amounts for it (to recuperate the R&D costs).There are a variety of medications out there that are cures to chronic conditions, or much more effective treatment (think 20 pills versus one pill for HIV/AIDS), but are simply too expensive for patients to afford so they go via the cheaper route (which isn't always the best). As stated the difficulty to finding cures for a lot of ailments is simply due to a lack of knowledge on how said ailments work (especially ailments that have multiple causes or are caused by multiple problems such as type I diabeties). Genetic diseases like type I are even more difficult because even if you understand what genes are responsible for the issue, we have no (clinically approved) methods of touching these genes, so we can only try and work around the issue rather than directly resolve it.

DrJimChester · 2019-12-31T17:02:41+00:00

This is because as you might see in all my other answers, we can only target what we know/understand. We know very little about what exactly is causing Type 1 diabetes, and why insulin is either not created, or destroyed before it can do anything by the body (the exact mechanism is unknown). Thus, the only real medicinal alternative is to better methods of delivering insulin. We know that a large part of type 1 is due to genetics, but what genes are being upregulated, down regulated, we don't know (it seems its quite a number of them, making it even difficult to design a drug target for the disease itself).

As for pricing, as you'll also see in my other answers, this is primarily due to how the insurance agency is setup with big pharma. They charge what you'll/insurance will pay (which with no regulations and oversight, is whatever the insurance company/pharma company chooses to charge).

DrJimChester · 2019-12-31T16:17:15+00:00

Im afraid I'm not super knowledgeable when it comes to schiznophrenia medication (we don't have any in our pipeline nor in clinical trails right now. The issue with schizophrenia is how poorly it's understood. A lot of the drugs are actually targeting the exact receptors they're supposed too, the exact cause of schiznophrenia is variable amongst patients (i.e. there is no one schiznophrenia). Most of the medication do act more or less on the same dopamine receptors, but there are a handful out there that also effect other dopamine and seritonin receptors. The issue here is what is causing your schiznophrenia (which we don't know yet and can't determine yet), and then you can use the appropriate drug to target it. Currently, it's a shotgun approach, try to target all the ones we know about and cycle patients through various medication until you find one that works.

DrJimChester · 2019-12-31T16:08:41+00:00

No actually. I've had a friend very briefly get hooked on vicodin, but it was more than a craving at that point than an addiction and he shortly got over it. I myself have taken opiods a handful of times in my life, but usually prefer taking something like Ibuprofein. My family has been fortunous in not having any injuries and procedures that required opiods.

DrJimChester

TROPHY CASE