Introduction - Uppsala Monitoring Centre

digoxin. It was not until the explosion in synthetic drugs in the late 19th century that
were powerful active principles to interact. The first mention of the interaction
between salicylates and sodium bicarbonate was in 1944 and with Aspirin in 1949.
There is no mention of drug interactions in Medline before 1964. An adverse event
caused by an interaction will occur after the second drug or substance has been
started and may reverse on stopping the second drug leading to the opinion that the
second drug is the sole cause of the ADR. However, if the second drug increased
the blood level of the first drug the adverse event will have the characteristics of an
ADR to the first drug not the second drug. Any factor in the causality of an ADR may
be considered as interacting with the drug.
Summary
There are still many papers/books/letters on the mercurial treatment of syphilis. The
symptoms of the ADRs of most our marker drugs are now well established. The
laws and regulations start dealing with dangerous drugs, but still continue to check
the quality of drugs. The first publications that devote themselves to the adverse
effects of more than one drug concentrate on the skin, which is easy to describe
although the vocabulary has always been arbitrary. About mid-century there is the
beginning of new synthetic drug industry which will fuel a new powerful
pharmaceutical industry. Clinical trials use placebos, double-blinding and
randomisation, but little attempt is made to collect ADRs systematically.
Chapter 8. 20 th Century
ynthetic drugs start to displace herbals medicines. Allergic reactions
S
become recognised and pharmacology becomes a powerful force in
medicine.
1901 On October 26th 1901, a five-year-old girl in St. Louis, USA, was
admitted into hospital with diphtheria and was given antitoxin, two
days later she died in the city hospital from tetanus. The admitting
physician stated that she had most likely presented at the hospital
nine days earlier with spinal meningitis, but was given the diphtheria
anti-toxin prophylactically. The municipal health officials investigated
the case and found that the horse from which the anti-toxin had been
taken had produced over 30 quarts of diphtheria antitoxin in his
career, but had been destroyed after contracting tetanus.
Investigators concluded that instead of destroying all of the horse’s
contaminated serum, two officials had allowed some of it to be
distributed resulting in the deaths of twelve more children throughout