Accidental Blockbusters: Viagra

“What is luck', he said, 'but the ability to exploit accidents?” Jeanette Winterson

Viagra is a well-known name. It is used to treat over 90 % of patients with erectile dysfunction but in fact was developed for an entirely different condition.

Viagra was originally developed in Kent as a treatment for hypertension. Phase 1 trials in patients in Swansea showed that whilst it had little effect on angina, it did induce marked penile erections. And so Pfizer decided to market it for erectile dysfunction rather than hypertension.

The drug inhibits an enzyme leading to dilation of the veins increasing blood flow in certain areas. In the penis, this causes an erection. However Viagra is also used in an area linked more towards its original research field; pulmonary arterial hypertension. In this condition patients suffer from constricted blood vessels causing shortness of breath, as oxygenated blood cannot reach the heart. Viagra is used as one of the treatments for this condition to help relax the blood vessels allowing efficient blood flow to the heart.

 

Viagra, interestingly, has been documented as a drug of abuse in sports, as athletes believe that opening up blood vessels will enrich their muscles with oxygen, an especially useful feature in endurance events. In fact it has already been a point of controversy when the Italian cyclist, Andrea Moleta, was found with 82 Viagra pills on the Tour of Italy, hidden in toothpaste bottles. This bizarre incidence, seeing as doping on Viagra would be very unsubtle in such tight lycra, led to confusion at the time. Although no doping allegations could be made, seeing as Viagra is yet a banned drug, he was nonetheless excluded from the tour on suspicions of attempting to bypass blood doping tests.

The World Anti-Doping Agency (WADA) is currently investigating whether to ban Viagra in sport, by testing in possibly the least likely bunch of people to need the drug; collegiate athletes. Lacrosse players at Marywood University are taking part in a study to look at whether an increased blood-flow, and hence oxygen capacity, can really benefit athletes. If this is found to be the case, it will be added to WADA’s extensive list of banned substances.

 

Accidental Blockbusters: Disulfiram

 

“Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened.” Winston Churchill

Disulfiram is a drug used to support the treatment of chronic alcoholism. It came about after a strange occurrence in the 1920’s; men working in a rubber factory suddenly found that when hitting the pub after work, they had lost their tolerance to alcohol. This was largely ignored at the time until 20 years later Dr Erik Jacobsen investigated the use of disulfiram to treat intestinal worms. He ingested some of the drug before attending a dinner party, where he proceeded to become violently sick. This led to the connection between disulfiram and alcohol intolerance which further explained why the workers in rubber factories faced similar effects, as disulfiram is a product of chemicals used in their factory.

When you drink alcohol, it is normally degraded by the body into a substance called acetaldehyde. When you drink too much, acetaldehyde builds up in the body and this is what causes you to have a stonking hangover. An enzyme called alcohol dehydrogenase clears acetaldehyde out of the body but not necessarily as rapidly as you drink.

Disulfiram blocks this enzyme meaning that if you even have a sip of alcohol, you will immediately feel the same effects as if you had had a 3 day bender.

Disulfiram is sold in tablets where the effects last less than a week. However in Russia, where there is a long, destructive history with alcohol, you can have a procedure where a Disulfiram capsule is implanted into your buttocks and remains there for three years. In Moscow alone there are dozens of clinics where you can get this procedure done. In fact up to 80 % of alcohol addiction treatments in Russia are from this capsule procedure. Drinking alcohol with this tablet implanted in you is thought by Russians ‘to kill you’. Of course this would in fact be entirely unethical, but the symptoms may suggest as such to the patient. An antidote for these effects can be bought for $300 which renders the drinker back to full health.