Second-Generation Thalidomide Victims!! 
Author Message
 Second-Generation Thalidomide Victims!!

Quote:
Henry Walker writes:
>One thalidomide victim is enough justification to have such a drug
>banned forever.

So would you also ban penicillin, since some people have allergic reactions to
it which can (and have) lead to death?

Quote:
>Personally, I believe there are many things that we can do and many
>more resources (such as natural healing modalities) that we can
>utilize without resorting to such dangerous chemicals.

Thalidomide is only dangerous to women who intend to bear children, just as
penicillin is only dangerous to those who are allergic to it.  How can you tell
a gay male AIDS victim that he cannot have a drug that may save his life?

The answer is not to make decisions based on emotional hysteria.  The answer
is to make sure that people are educated as to the risks of the drug before
it is made available.  After that, it should be their decision whether or not
to take it.  If someone is terminally ill and there is no hope or cure for the
disease they have, then they should have the right to try whatever drug they
want so long as they are provided with all the information about that drug.

I'm curious as to what you would say to the woman who had cancer and said that
thalidomide saved her life.  Would you have denied her the drug and let her
die?   How would you explain that to her family?

--Dena Bruedigam



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!

Quote:
>Path: magnus.acs.ohio-state.edu!dbruedig

>Newsgroups: sci.med,sci.med.pharmacy
>Subject: Re: Second-Generation Thalidomide Victims!!
>Date: 5 Jun 1995 12:53:25 GMT
>Organization: The Ohio State University
>Lines: 29


>NNTP-Posting-Host: beauty.magnus.acs.ohio-state.edu
>Xref: magnus.acs.ohio-state.edu sci.med:122256 sci.med.pharmacy:10823
>Thalidomide is only dangerous to women who intend to bear children, just as
>penicillin is only dangerous to those who are allergic to it.  How can you tell
>a gay male AIDS victim that he cannot have a drug that may save his life?
>The answer is not to make decisions based on emotional hysteria.  The answer
>is to make sure that people are educated as to the risks of the drug before
>it is made available.  After that, it should be their decision whether or not
>to take it.  If someone is terminally ill and there is no hope or cure for the
>disease they have, then they should have the right to try whatever drug they
>want so long as they are provided with all the information about that drug.
>I'm curious as to what you would say to the woman who had cancer and said that
>thalidomide saved her life.  Would you have denied her the drug and let her
>die?   How would you explain that to her family?
>--Dena Bruedigam


More needs to go into approval of an agent than the feeling that it "might
help" with a disease.  Efficacy must be proven and a reasonable side-effect
profile must be seen.  Approval of an agent for a single indication does not
exclude its use for other indications at the doctor's discretion and as the
60 minutes expose showed, not all women who took the medication had it
prescribed for them.  This same thing can and does happen here in the USA.  
That is the basis of any apprehension many individual have toward
thalidomide's possible FDA approval.  Personally, until thalidomide is proven
to be more effective at improving the quality of lifeof  individual with AIDS
than the available alternatives, I don't see a need to risk approval.

my $ 0.02 worth,
H.



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!
Did anyone else see the Thalidomide segment on "60 Minutes" aired last
night? God, it was incredible. Who would have thought such a drug
would be administered again after the tragedy in Britain.  My heart
just went out for those children in Brazil.

Thalidomide is making a "comeback" because it is now being touted as a
wonder drug for illnesses such as AIDS, Leukemia, and Diabetes. The
reasoning is as follows: there are many {*filter*} that are teratogenic,
yet that doesn't mean that thousands of people should be deprived of
something that would potentially cure or alleviate their suffering. In
the U.S, we have more restrictions and ample warnings would be given.

Personally, I believe there are many things that we can do and many
more resources (such as natural healing modalities) that we can
utilize without resorting to such dangerous chemicals.

One thalidomide victim is enough justification to have such a drug
banned forever.

Any other thoughts, opinions, criticisms?

--Henry



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!
Your comments are ill thought-out. The plain fact is that thalidomide has
a number of important applications in medicaine. One that you did not
mention is leprosy - which is still a major public health problem in the
world. Of course, thalidomide should not be taken by young women of
childbearing age - and every RESPONSIBLE physician knows that. Thalidomide
should be available BY PRESCRIPTION ONLY for the conditions for which it
is likely to be of benefit.

I did not see the "60 Minutes" article, but it sounds to have been yet
another irresponsibel piece of journalistic sensationalism. (It is, of
course, close to "Sweeps month".........).



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!

Quote:

> Did anyone else see the Thalidomide segment on "60 Minutes" aired last
> night? God, it was incredible. Who would have thought such a drug
> would be administered again after the tragedy in Britain.  My heart

There ARE a number of {*filter*} that would be harmful to a fetus while
administered but that are harmless to {*filter*}s...so the answer is not to
take them when pregnant or to put off pregnancy until AFTER treatment.  
There is no logical reason to eliminaate {*filter*} wholesale simply because
they might affect fetuses.  Most people aren't pregnant and the {*filter*} are
often quite necessary or useful.

 > > Personally, I believe there are many things that we can do and many

Quote:
> more resources (such as natural healing modalities) that we can
> utilize without resorting to such dangerous chemicals.

There are many "natural" medicines that can be harmful if taken at the
wrong time or in too high a dose too.

Quote:

> One thalidomide victim is enough justification to have such a drug
> banned forever.

And accutane, for instance?  Should IT be banned because it induces gross
abnormailities in developing fetuses?  Again, it is quite simple:  DON'T
GET PREGNANT WHILE ON THE DRUG.  As far as being pregnant...a doctor wont
prescribe teratogens or other fetal-dangerous {*filter*} if you are pregnant.  
In any case, men cannot get pregnant so no matter your reasoning, you
cannot deny THEM a drug that could be beneficial just because it strictly
damages fetuses in PREGNANT women only.

Patrick



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!
: Did anyone else see the Thalidomide segment on "60 Minutes" aired last
: night? God, it was incredible. Who would have thought such a drug
: would be administered again after the tragedy in Britain.  My heart
: just went out for those children in Brazil.

: Thalidomide is making a "comeback" because it is now being touted as a
: wonder drug for illnesses such as AIDS, Leukemia, and Diabetes. The
: reasoning is as follows: there are many {*filter*} that are teratogenic,
: yet that doesn't mean that thousands of people should be deprived of
: something that would potentially cure or alleviate their suffering. In
: the U.S, we have more restrictions and ample warnings would be given.

: Personally, I believe there are many things that we can do and many
: more resources (such as natural healing modalities) that we can
: utilize without resorting to such dangerous chemicals.

: One thalidomide victim is enough justification to have such a drug
: banned forever.

: Any other thoughts, opinions, criticisms?

: --Henry

        I heard it said that the toxicity of thalidomide was limited to one
of the stereoisomers only, whereas the therapeutic activity was largely in
the other. Is this true? If so, is it possible to selectively synthesise one
and keep it from racemising under storage?

        I would be concerned if thalidomide re-entered general use as there
would be a great chance that the wrong person could come in contact with the
dosage form. However, that said, we currently have {*filter*} available with
known or assumed teratogenic capabilities (for example, finasteride and
whatever retinoid is currently in favour). The manufacturers of such products
provide the prep in blister packs and the packs come with big warnings all
over them. This policy could be applied to thalidomide with effect and the
previous poster does allude to this. However, the thalidomide issue is
not only one of science but also one of emotion and it would be insensitive
now to widely reintroduce the drug.

        This is not to say that those who could benefit from thalidomide
should be deprived it. But this must be done on a named patient basis under
specialist care, after suitable alternative avenues have been explored and
ceased upon the production of an appropriate therapy. We cannot protect
everyone all of the time and it would be naive to suggest that we could. An
accident will eventually occur. But there again, that accident could just as
easily happen with another drug with the level of use envisaged. What would
be tragic is if the lessons of the past were not heeded and patient selection
was not performed with diligence. Informed consent from the patient is
another thing I should throw into the above.

        It should be noted that one is also at risk from some of the various
"natural healing modalities". Some are far from safe. I have heard that some
of the herbal remedies tried in ezcema are fairly harsh on the liver, for
example. One must be extra vigilant when such treatments are administered
as often the same weight of data is not available for the clinician.

        No human invention, be it drug or otherwise, is without its drawbacks.
Thalidomide and benoxyprofen are cases in point. Thalidomide is
especially tragic as it appears to have conferred an hereditary abnormality.
That alone must preclude a return to general use. Even if it were safe to
use in people other than women of childbearing age or potential then the risk
of accidental exposure is probably too high for most of us to accept.
However, there must be a case for those groups in society who are terminally
ill or suffering great agonies that cannot be adequately relieved by other
means. That level of use would be acceptable to me. And even this must be
ceased in the event of a safer alternative.

        These opinions are of course my own. It is a very interesting issue
and I'm sure I will not be the only contributor to this discussion. Sorry
to waffle on for so long but I'm trying to clarify myself and not rubbish
another's point of view even if it differs from my own.

Ian Baxter,
Aston Uni, Birmingham, UK.

PS- I would love some clarification on the stereochemistry. Am I mistaken?
Also, what is the collective feeling out there regarding the victims of such
tragedies and the compensation / support they receive. From what I remember
of the benoxyprofen (Opren) tragedy and still hear on the news from time to
time about thalidomide, the system of support is in this country at least
far from satisfactory.  



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!

Quote:

>Thalidomide is making a "comeback" because it is now being touted as a
>wonder drug for illnesses such as AIDS, Leukemia, and Diabetes. The
>reasoning is as follows: there are many {*filter*} that are teratogenic,
>yet that doesn't mean that thousands of people should be deprived of
>something that would potentially cure or alleviate their suffering. In
>the U.S, we have more restrictions and ample warnings would be given.

  Who is "touting thalidomide as a wonder drug"?  I think we are coming to
a realization that the drug may have some therapeutic properties that may
be helpful in medicine.  And the argument you stated above gives the
reason that it should be used... it is teratogenic, and that adverse effect
can be controlled by not giving the drug to women of child bearing age.

Quote:
>Personally, I believe there are many things that we can do and many
>more resources (such as natural healing modalities) that we can
>utilize without resorting to such dangerous chemicals.

  Thats why I'm glad people like you dont make public policy.  Natural
Healing Methods ( especially herbal methods) may be just as teratogenic
as thalidomide, but untested.

Quote:
>One thalidomide victim is enough justification to have such a drug
>banned forever.

 Therefore, we should punish the drug (or manufacturer) by banning it
forever rather than turn the product into something potentially useful
for many patients?  I dont follow the logic...

-Paul



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!

Quote:
 (Henry Walker) writes:
>Well, all the information is not in yet. Do we know for sure that
>thalidomide is ONLY dangerous to fetuses? I just don't trust it.

I think we can be almost certain, given thalidomide's powerful effects
on angiogenesis and TNF, that it will be dangerous to certain non-fetus
humans in certain situations.  It also appears likely that it will be helpful
to many non-fetus humans in many situations, but clinical trials are
needed to figure out both the risks and the benefits.  The fact that
a drug is dangerous is not a reason for never using it, only a reason
to be certain why you are using it.

--
David Rind



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!


Fri, 19 Jun 1992 00:00:00 GMT
 Second-Generation Thalidomide Victims!!

If a woman stops taking Thalidomide before getting pregnant, can her child be
affected even though she is no longer taking the drug?



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!


Fri, 19 Jun 1992 00:00:00 GMT
 Second-Generation Thalidomide Victims!!

Quote:

>Your comments are ill thought-out. The plain fact is that thalidomide has
>a number of important applications in medicaine. One that you did not
>mention is leprosy - which is still a major public health problem in the
>world. Of course, thalidomide should not be taken by young women of
>childbearing age - and every RESPONSIBLE physician knows that

Why should those women be denied treatment just because of their
gender. There are plenty of {*filter*} to which pregnancy is a counter
indication. Would you ban for example Cytotec (a prostaglandin that is
used for gastric ulcers, but it can be used to induce {*filter*}s, and
is used for that purpose in Brazil [Studies in Family Planning
1993;24,4,236-240])

Quote:
>Thalidomide
>should be available BY PRESCRIPTION ONLY for the conditions for which it
>is likely to be of benefit.

>I did not see the "60 Minutes" article, but it sounds to have been yet
>another irresponsibel piece of journalistic sensationalism. (It is, of
>course, close to "Sweeps month".........).

Osmo


Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!
: Did anyone else see the Thalidomide segment on "60 Minutes" aired last
: night? God, it was incredible. Who would have thought such a drug
: would be administered again after the tragedy in Britain.  My heart
: just went out for those children in Brazil.

I saw it too, it's really mind boggling, and disturbing.

: Thalidomide is making a "comeback" because it is now being touted as a
: wonder drug for illnesses such as AIDS, Leukemia, and Diabetes. The
: reasoning is as follows: there are many {*filter*} that are teratogenic,
: yet that doesn't mean that thousands of people should be deprived of
: something that would potentially cure or alleviate their suffering. In
: the U.S, we have more restrictions and ample warnings would be given.

According the the film, and several articles I read, it's here already,
with or without the FDA approval.  If there is a ban, there is the black
market. And the most of disease that Thalidomide  can be used are terminal
or hard to cure disease, there will be surely lots of people try to get it
no matter what the cost is.

: Personally, I believe there are many things that we can do and many
: more resources (such as natural healing modalities) that we can
: utilize without resorting to such dangerous chemicals.

Well, may be or may not be, there are probably more than hundreds of
chemicals in pharmacutical industry were approved for human consumption
also have severe side effect. and they were approved none the less for
particular treatment.

: One thalidomide victim is enough justification to have such a drug
: banned forever.

Again, it depends on the point of view of individual, whoever suffer from
AIDS , cancer, MS, RA.. may think differently.

A total ban may not be the perfect solution, unless it can be banned totally
from the earth surface, otherwise people can get it oversea, smuggle it in
at black market, without prescription and caution from physician, and it will
become more dangeous situation.

Or we can be the ostrich to bury one's head in the sand, ban it in USA, and
let whoever need it to get it and take it on their own risk. If being caught,
put them in jail, right ?

John



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!
: Did anyone else see the Thalidomide segment on "60 Minutes" aired last
: night? God, it was incredible. Who would have thought such a drug
: would be administered again after the tragedy in Britain.  My heart
: just went out for those children in Brazil.

: Thalidomide is making a "comeback" because it is now being touted as a
: wonder drug for illnesses such as AIDS, Leukemia, and Diabetes. The
: reasoning is as follows: there are many {*filter*} that are teratogenic,
: yet that doesn't mean that thousands of people should be deprived of
: something that would potentially cure or alleviate their suffering. In
: the U.S, we have more restrictions and ample warnings would be given.

: Personally, I believe there are many things that we can do and many
: more resources (such as natural healing modalities) that we can
: utilize without resorting to such dangerous chemicals.

: One thalidomide victim is enough justification to have such a drug
: banned forever.

: Any other thoughts, opinions, criticisms?
Clearly you have not taken care of a child with chronic graft versus host
disease who is gasping her life away because the "safe" {*filter*} you want to
leave us with don't do anything.  Thalidomide can cause birth defects,
but used properly, it may be a god-send to many people that you would
doom in the name of "safety".

 : --Henry



Fri, 21 Nov 1997 03:00:00 GMT
 Second-Generation Thalidomide Victims!!

[stuff deleted]

Quote:
>One thalidomide victim is enough justification to have such a drug
>banned forever.

>Any other thoughts, opinions, criticisms?

Its only dangerous when used during pregnancy, there are many substances
that are, should they all be banned?

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Fri, 21 Nov 1997 03:00:00 GMT
 
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