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THE RÔLE OF PHARMACOLOGY IN THE DEVELOPMENT OF IDEAL ANESTHESIA

THE RÔLE OF PHARMACOLOGY IN THE DEVELOPMENT OF IDEAL ANESTHESIA Abstract Since no drug is quite ideal for its purpose, stimulus exists for commercial as well as scientific efforts to develop better drugs than any now in use for a particular clinical effect. Scientifically, such an effort is usually based on some phase of what may be called biochemorphology,1 i. e., the relation between chemical constitution and biologic action. A chemist, after considering, for instance, the biochemorphic aspects of hypnotics, synthesizes a new substance, which is found to have hypnotic action. Commercially there now comes a strong temptation to introduce the new agent clinically without furnishing physicians sufficient comparative scientific data to enable them to judge whether or not it has advantages recommending it over hypnotics already in common use. One would be naive indeed to believe that the pharmaceutic concern developing the new hypnotic could give unbiased judgment on this point. But it is thus that the hopeful good References 1. Dyson, G. M.: The Chemistry of Chemotherapy , London, 1928 2. Leake, C. D.: The Pharmacologic Evaluation of New Drugs , J. A. M. A. 93: 1632 ( (Nov. 23) ) 1929.Crossref 3. Dale, H. H.: Academic and Industrial Research in the Field of Therapeutics , Science 77: 521 ( (June 2) ) 1933.Crossref 4. Leake, C. D.: Some Pharmacologic Aspects of Preanesthetic Medication , Northwest Med. 29:561 ( (Dec.) ) 1930. 5. Grabfield, G. P.: Observations on the Efficiency of Commonly Used Hypnotics , J. A. M. A. 96:1865 ( (May 30) ) 1931.Crossref 6. Stewart, J. D.: Rectal Paraldehyde Before Operation , Brit. M. J. 2: 1139 ( (Dec. 24) ) 1932.Crossref 7. Burn, J. H.: Errors of Biological Assay , Physiol. Rev. 10:146 ( (Jan.) ) 1930. 8. Luckhardt, A. B., and Carter, J. B.: Physiologic Effects of Ethylene: A New Gas Anesthetic , J. A. M. A. 80:765 ( (March 17) ) 1923.Crossref 9. Brown, W. E., and Henderson, V. E.: On Ethylene as an Anesthetic , Arch. internat. de pharmacodyn. et de thérap 28:257, 1923. 10. Richardson, B. W.: A Synopsis of Anesthetics , Scient. Am. ( (supplement) ) 20:8227, 8240, 1885. 11. Luckhardt, A. B., and Lewis, Dean: Clinical Experiences with Ethylene-Oxygen Anesthesia , J. A. M. A. 81: 1851 ( (Dec. 1) ) 1923.Crossref 12. Leake, C. D.: The Effect of Ethylene-Oxygen Anesthesia on the Acid-Base Balance of Blood: A Comparison with Other Anesthetics , J. A. M. A. 83:2062 ( (Dec. 27) ) 1924.Crossref 13. Henderson, V. E., and Lucas, G. H. W.: Cyclopropane, a New Anesthetic , Anesth & Analg. 9: 1 ( (Jan.) -Feb.) 1930 14. The Effect of Cyclopropane on Metabolism , Arch. internat. de pharmacodyn. et de thérap 37: 155, 1930 15. Henderson, V. E., and Johnston, J. F. A.: Anesthetic Potency in the Cyclohydrocarbon Series , J. Pharmacol. & Exper. Therap. 43:89 ( (Sept.) ) 1931. 16. Leake, C. D., and Chen, M. Y.: Anesthetic Properties of Certain Unsaturated Ethers , Proc. Soc. Exper. Biol. & Med. 28: 151 ( (Nov.) ) 1930. 17. Ruigh, W. L., and Major, R. T.: Preparation and Properties of Pure Divinyl Ether , J. Am. Chem. Soc. 53:2662 ( (July) ) 1931. 18. Leake, C. D.; Knoefel, P. K., and Guedel, A. E.: Anesthetic Action of Divinyl Oxide in Animals , J. Pharmacol & Exper. Therap. 47: 5 ( (Jan.) ) 1933. 19. Gelfan, S., and Bell, I. R.: Anesthetic Action of Divinyl Oxide on Humans , J. Pharmacol. & Exper. Therap. 47: 1 ( (Jan.) ) 1933. 20. Goldschmidt, Samuel; Ravdin, I. S.; Lucke, Baldwin; Muller, G. P., and Johnston, C. G.: Divinyl Ether: Experimental and Clinical Studies , J. A. M. A. , this issue, p. 21. 21. Waters, R. M., and Guedel, A. E.: Independent personal communication to theauthor. 22. Lucas, G. H. W.: Fate and Toxicity of Bromine and Chlorine Containing Anesthetics , J. Pharmacol. & Exper. Therap. 34:223 ( (Oct.) ) 1928. 23. Patty, F. A.; Yant, W. P., and Waite, C. P.: Acute Response of Guinea-Pigs to Vapors of Some New Commercial Organic Compounds: V. Vinyl Chloride , Pub. Health Rep. 45:1963 ( (Aug. 22) ) 1930. 24. Peoples, S. A., and Leake, C. D.: Anesthetic Action of Vinyl Chloride , J. Pharmacol. & Exper. Therap. , to be published. 25. Waters, R. M.: Carbon Dioxide Absorption from Anesthetic Mixtures , California & West. Med. 35:342 ( (Nov.) ) 1931. 26. Herb, Isabella C.: Administration of General Anesthetics with Special Reference to Ether and Chloroform , J. A. M. A. 56: 1312 ( (May 6) ) 1911. 27. Gatch, W. D.: The Use of Rebreathing in the Administration of Anesthetics , J. A. M. A. 57: 1599 ( (Nov. 11) ) 1911. 28. Bevan, A. D.: The Choice of the Anesthetic , J. A. M. A. 57: 1821 ( (Dec. 2) ) 1911. 29. Leake, C. D.: Chemical Adjuncts to General Anesthesia , California & West. Med. 33: 714 ( (Oct.) ) 1930. 30. Eddy, N. B.: Studies of Morphine, Codeine and Their Derivatives , J. Pharmacol. & Exper. Therap. 45:339, 361 ( (July) ) 1932. 31. Barbour, H. G.: Heat Regulation and Water Exchange , J. Pharmacol. & Exper. Therap. 29:427 ( (Oct.) ) 1926 32. Physiol. Rev. 1: 295 ( (April) ) 1921. 33. Barlow, O. W., and Stormont, M. F.: Premedication Values of Morphine, Codeine, Papaverine, Narcotine and Pantopon in Relation to Nitrous Oxide Anesthesia , J. Pharmacol. & Exper. Therap. 46: 141 ( (Oct.) ) 1932. 34. Barlow, O. W.: Preanesthetic Value of Scopolamine and Mixtures of Scopolamine and Morphine in Relation to Nitrous Oxide Anesthesia in the Rat , J. Pharmacol. & Exper. Therap. 46: 131 ( (Oct.) ) 1932. 35. Anderson, H. H.; Chen, M. Y., and Leake, C. D.: Possible Substitutes for Morphine in Preanesthetic Medication: Observations on Common Barbituric Acid Derivatives , J. Pharmacol. & Exper. Therap. 39: 271 ( (July) ) 1930 36. Effects of Barbituric Acid Hypnotics on Basal Metabolism in Humans , Anderson J. Pharmacol. & Exper. Therap. 40:215 ( (Oct.) ) 1930. 37. Shonle, H. A.: Chemical Basis of Hypnotic Action as an Index of Clinical Efficiency , Anesth. & Analg. 11:210 ( (Sept.) -Oct.) 1932. 38. Koppanyi, T., and Lieberson, A.: J. Pharmacol. & Exper. Therap. 39: 177 ( (June) ) 1930. 39. Knoefel, P. K.; Lonergan, Lester, and Leake, C. D.: Biochemorphic Aspects of Paraldehyde and Certain Acetals , Proc. Soc. Exper. Biol. & Med. 29:730 ( (March) ) 1932. 40. Knoefel. P. K.: Nature of Anesthetic Shock and the Value of Premedication , California & West. Med. 29: 344 ( (Nov.) ) 1933. 41. Chen, K. K., and Schmidt, C. F.: Ephedrine and Related Substances , Medicine 9:1 ( (Feb.) ) 1930. 42. Hartung, W. H.: Epinephrine and Related Compounds, Influence of Structure on Physiological Activity , Chem. Rev. 9:389 ( (Dec.) ) 1931. 43. Sollmann, Torald: Comparative Activity of Local Anesthetics , J. Pharmacol. & Exper. Therap. 10:379 ( (Nov.) ) 1917 44. 11:1, 9, 17, 69 (Feb.) 1918 45. 13:429 (Aug.) 1919. 46. Schmitz, H. L., and Loevenhart, A. S.: Comparative Study of Local Anesthetics , J. Pharmacol. & Exper. Therap. 24: 159, 167 ( (Sept.) ) 1924. 47. Hirschfelder, A. D., and Bieter, R. N.: Local Anesthetics , Physiol. Rev. 12: 190 ( (April) ) 1932. 48. Uhlmann, F.: Percaine , Arch. internat. de pharmacodyn. et de thérap. 36:2531929. 49. Wahl, C. C., and Knoefel, P. K.: Toxicity of Nupercaine , Proc. Soc. Exper. Biol. & Med. 29:368 ( (Jan.) ) 1932. 50. Knoefel, P. K.: Use of Pitressin in Local Anesthesia , Proc. Soc. Exper. Biol. & Med. 30:243 ( (Nov.) ) 1932. 51. Alles, G. A., and Knoefel, P. K.: Local Anesthetics with Vasopressor Activity , Arch. internat. pharmaco. thérap. , to be published. 52. Tatum, A. L.; Atkinson, A. J., and Collins, K. H.: Acute Cocaine Poisoning , J. A. M. A. 84: 1177 ( (April 18) ) 1925 53. J. Pharmacol. & Exper. Therap. 26:325 ( (Dec.) ) 1925. 54. Cunningham, T. D.: A Method for the Permanent Staining of Reticulated Red Cells , Arch. Int. Med. 38:405 ( (Sept.) ) 1926. 55. Knoefel, P. K., Herwick, R. P., and Loevenhart, A. S.: Prevention of Acute Intoxication from Local Anesthetics , J. Pharmacol. & Exper. Therap. 39:397 ( (Aug.) ) 1930. 56. Knoefel, P. K.: Carbazol Derivatives: Local Anesthetics of Urethane Type , J. Pharmacol. & Exper. Therap. 47: 69 ( (Jan.) ) 1933. 57. Rider, T. H.: Piperidinopropanediol Di-Phenylurethane Hydrochloride, a New Anesthetic , J. Pharmacol. & Exper. Therap. 47:255 ( (Feb.) ) 1933. 58. Loevenhart, A. S.: A Proposed Therapeutic Institute , Proc. Third Race Betterment Conference , (Jan. 26) , 1928, p. 489. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

THE RÔLE OF PHARMACOLOGY IN THE DEVELOPMENT OF IDEAL ANESTHESIA

LEAKE, C. D.
JAMA , Volume 102 (1) – Jan 6, 1934
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References (44)

Publisher
American Medical Association
Copyright
Copyright © 1934 American Medical Association. All Rights Reserved.
ISSN
0098-7484
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1538-3598
DOI
10.1001/jama.1934.02750010001001
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Abstract

Abstract Since no drug is quite ideal for its purpose, stimulus exists for commercial as well as scientific efforts to develop better drugs than any now in use for a particular clinical effect. Scientifically, such an effort is usually based on some phase of what may be called biochemorphology,1 i. e., the relation between chemical constitution and biologic action. A chemist, after considering, for instance, the biochemorphic aspects of hypnotics, synthesizes a new substance, which is found to have hypnotic action. Commercially there now comes a strong temptation to introduce the new agent clinically without furnishing physicians sufficient comparative scientific data to enable them to judge whether or not it has advantages recommending it over hypnotics already in common use. One would be naive indeed to believe that the pharmaceutic concern developing the new hypnotic could give unbiased judgment on this point. But it is thus that the hopeful good References 1. Dyson, G. M.: The Chemistry of Chemotherapy , London, 1928 2. Leake, C. D.: The Pharmacologic Evaluation of New Drugs , J. A. M. A. 93: 1632 ( (Nov. 23) ) 1929.Crossref 3. Dale, H. H.: Academic and Industrial Research in the Field of Therapeutics , Science 77: 521 ( (June 2) ) 1933.Crossref 4. Leake, C. D.: Some Pharmacologic Aspects of Preanesthetic Medication , Northwest Med. 29:561 ( (Dec.) ) 1930. 5. Grabfield, G. P.: Observations on the Efficiency of Commonly Used Hypnotics , J. A. M. A. 96:1865 ( (May 30) ) 1931.Crossref 6. Stewart, J. D.: Rectal Paraldehyde Before Operation , Brit. M. J. 2: 1139 ( (Dec. 24) ) 1932.Crossref 7. Burn, J. H.: Errors of Biological Assay , Physiol. Rev. 10:146 ( (Jan.) ) 1930. 8. Luckhardt, A. B., and Carter, J. B.: Physiologic Effects of Ethylene: A New Gas Anesthetic , J. A. M. A. 80:765 ( (March 17) ) 1923.Crossref 9. Brown, W. E., and Henderson, V. E.: On Ethylene as an Anesthetic , Arch. internat. de pharmacodyn. et de thérap 28:257, 1923. 10. Richardson, B. W.: A Synopsis of Anesthetics , Scient. Am. ( (supplement) ) 20:8227, 8240, 1885. 11. Luckhardt, A. B., and Lewis, Dean: Clinical Experiences with Ethylene-Oxygen Anesthesia , J. A. M. A. 81: 1851 ( (Dec. 1) ) 1923.Crossref 12. Leake, C. D.: The Effect of Ethylene-Oxygen Anesthesia on the Acid-Base Balance of Blood: A Comparison with Other Anesthetics , J. A. M. A. 83:2062 ( (Dec. 27) ) 1924.Crossref 13. Henderson, V. E., and Lucas, G. H. W.: Cyclopropane, a New Anesthetic , Anesth & Analg. 9: 1 ( (Jan.) -Feb.) 1930 14. The Effect of Cyclopropane on Metabolism , Arch. internat. de pharmacodyn. et de thérap 37: 155, 1930 15. Henderson, V. E., and Johnston, J. F. A.: Anesthetic Potency in the Cyclohydrocarbon Series , J. Pharmacol. & Exper. Therap. 43:89 ( (Sept.) ) 1931. 16. Leake, C. D., and Chen, M. Y.: Anesthetic Properties of Certain Unsaturated Ethers , Proc. Soc. Exper. Biol. & Med. 28: 151 ( (Nov.) ) 1930. 17. Ruigh, W. L., and Major, R. T.: Preparation and Properties of Pure Divinyl Ether , J. Am. Chem. Soc. 53:2662 ( (July) ) 1931. 18. Leake, C. D.; Knoefel, P. K., and Guedel, A. E.: Anesthetic Action of Divinyl Oxide in Animals , J. Pharmacol & Exper. Therap. 47: 5 ( (Jan.) ) 1933. 19. Gelfan, S., and Bell, I. R.: Anesthetic Action of Divinyl Oxide on Humans , J. Pharmacol. & Exper. Therap. 47: 1 ( (Jan.) ) 1933. 20. Goldschmidt, Samuel; Ravdin, I. S.; Lucke, Baldwin; Muller, G. P., and Johnston, C. G.: Divinyl Ether: Experimental and Clinical Studies , J. A. M. A. , this issue, p. 21. 21. Waters, R. M., and Guedel, A. E.: Independent personal communication to theauthor. 22. Lucas, G. H. W.: Fate and Toxicity of Bromine and Chlorine Containing Anesthetics , J. Pharmacol. & Exper. Therap. 34:223 ( (Oct.) ) 1928. 23. Patty, F. A.; Yant, W. P., and Waite, C. P.: Acute Response of Guinea-Pigs to Vapors of Some New Commercial Organic Compounds: V. Vinyl Chloride , Pub. Health Rep. 45:1963 ( (Aug. 22) ) 1930. 24. Peoples, S. A., and Leake, C. D.: Anesthetic Action of Vinyl Chloride , J. Pharmacol. & Exper. Therap. , to be published. 25. Waters, R. M.: Carbon Dioxide Absorption from Anesthetic Mixtures , California & West. Med. 35:342 ( (Nov.) ) 1931. 26. Herb, Isabella C.: Administration of General Anesthetics with Special Reference to Ether and Chloroform , J. A. M. A. 56: 1312 ( (May 6) ) 1911. 27. Gatch, W. D.: The Use of Rebreathing in the Administration of Anesthetics , J. A. M. A. 57: 1599 ( (Nov. 11) ) 1911. 28. Bevan, A. D.: The Choice of the Anesthetic , J. A. M. A. 57: 1821 ( (Dec. 2) ) 1911. 29. Leake, C. D.: Chemical Adjuncts to General Anesthesia , California & West. Med. 33: 714 ( (Oct.) ) 1930. 30. Eddy, N. B.: Studies of Morphine, Codeine and Their Derivatives , J. Pharmacol. & Exper. Therap. 45:339, 361 ( (July) ) 1932. 31. Barbour, H. G.: Heat Regulation and Water Exchange , J. Pharmacol. & Exper. Therap. 29:427 ( (Oct.) ) 1926 32. Physiol. Rev. 1: 295 ( (April) ) 1921. 33. Barlow, O. W., and Stormont, M. F.: Premedication Values of Morphine, Codeine, Papaverine, Narcotine and Pantopon in Relation to Nitrous Oxide Anesthesia , J. Pharmacol. & Exper. Therap. 46: 141 ( (Oct.) ) 1932. 34. Barlow, O. W.: Preanesthetic Value of Scopolamine and Mixtures of Scopolamine and Morphine in Relation to Nitrous Oxide Anesthesia in the Rat , J. Pharmacol. & Exper. Therap. 46: 131 ( (Oct.) ) 1932. 35. Anderson, H. H.; Chen, M. Y., and Leake, C. D.: Possible Substitutes for Morphine in Preanesthetic Medication: Observations on Common Barbituric Acid Derivatives , J. Pharmacol. & Exper. Therap. 39: 271 ( (July) ) 1930 36. Effects of Barbituric Acid Hypnotics on Basal Metabolism in Humans , Anderson J. Pharmacol. & Exper. Therap. 40:215 ( (Oct.) ) 1930. 37. Shonle, H. A.: Chemical Basis of Hypnotic Action as an Index of Clinical Efficiency , Anesth. & Analg. 11:210 ( (Sept.) -Oct.) 1932. 38. Koppanyi, T., and Lieberson, A.: J. Pharmacol. & Exper. Therap. 39: 177 ( (June) ) 1930. 39. Knoefel, P. K.; Lonergan, Lester, and Leake, C. D.: Biochemorphic Aspects of Paraldehyde and Certain Acetals , Proc. Soc. Exper. Biol. & Med. 29:730 ( (March) ) 1932. 40. Knoefel. P. K.: Nature of Anesthetic Shock and the Value of Premedication , California & West. Med. 29: 344 ( (Nov.) ) 1933. 41. Chen, K. K., and Schmidt, C. F.: Ephedrine and Related Substances , Medicine 9:1 ( (Feb.) ) 1930. 42. Hartung, W. H.: Epinephrine and Related Compounds, Influence of Structure on Physiological Activity , Chem. Rev. 9:389 ( (Dec.) ) 1931. 43. Sollmann, Torald: Comparative Activity of Local Anesthetics , J. Pharmacol. & Exper. Therap. 10:379 ( (Nov.) ) 1917 44. 11:1, 9, 17, 69 (Feb.) 1918 45. 13:429 (Aug.) 1919. 46. Schmitz, H. L., and Loevenhart, A. S.: Comparative Study of Local Anesthetics , J. Pharmacol. & Exper. Therap. 24: 159, 167 ( (Sept.) ) 1924. 47. Hirschfelder, A. D., and Bieter, R. N.: Local Anesthetics , Physiol. Rev. 12: 190 ( (April) ) 1932. 48. Uhlmann, F.: Percaine , Arch. internat. de pharmacodyn. et de thérap. 36:2531929. 49. Wahl, C. C., and Knoefel, P. K.: Toxicity of Nupercaine , Proc. Soc. Exper. Biol. & Med. 29:368 ( (Jan.) ) 1932. 50. Knoefel, P. K.: Use of Pitressin in Local Anesthesia , Proc. Soc. Exper. Biol. & Med. 30:243 ( (Nov.) ) 1932. 51. Alles, G. A., and Knoefel, P. K.: Local Anesthetics with Vasopressor Activity , Arch. internat. pharmaco. thérap. , to be published. 52. Tatum, A. L.; Atkinson, A. J., and Collins, K. H.: Acute Cocaine Poisoning , J. A. M. A. 84: 1177 ( (April 18) ) 1925 53. J. Pharmacol. & Exper. Therap. 26:325 ( (Dec.) ) 1925. 54. Cunningham, T. D.: A Method for the Permanent Staining of Reticulated Red Cells , Arch. Int. Med. 38:405 ( (Sept.) ) 1926. 55. Knoefel, P. K., Herwick, R. P., and Loevenhart, A. S.: Prevention of Acute Intoxication from Local Anesthetics , J. Pharmacol. & Exper. Therap. 39:397 ( (Aug.) ) 1930. 56. Knoefel, P. K.: Carbazol Derivatives: Local Anesthetics of Urethane Type , J. Pharmacol. & Exper. Therap. 47: 69 ( (Jan.) ) 1933. 57. Rider, T. H.: Piperidinopropanediol Di-Phenylurethane Hydrochloride, a New Anesthetic , J. Pharmacol. & Exper. Therap. 47:255 ( (Feb.) ) 1933. 58. Loevenhart, A. S.: A Proposed Therapeutic Institute , Proc. Third Race Betterment Conference , (Jan. 26) , 1928, p. 489.

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JAMA – American Medical Association

Published: Jan 6, 1934

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