NAME THAT DRUG BY REBECCA HEIDKER, QUEST DIAGNOSTICS


Just Goofing Around T


his edition of Name that Drug features 1 of only 12 medications that have been clinically


recognized for more than one hundred years. Our mystery medication was brought to market in 1912 by Bayer AG. It was accepted by the United States Pharmacopoeia and the British Pharmacopoeia in 1914 and 1932, respectively, and is currently recognized by the World Health Organization’s Pharmacopoeia Internationalis. The base molecule of this drug was discovered in 1864 by Adolf von Baeyer and is the parent compound of more than 2,500 different chemicals. This family of drugs is well known for their hypnotic, anxiolytic, sedative, anesthetic, and anti-epileptic properties. While originally used as a sedative,


the anti-epileptic properties of this drug were quickly discovered by Alfred Hauptmann, a clinical assistant in Freiburg, Germany. Although unverified,


the popular story is that Hauptmann first administered the drug as a sleeping agent to the noisy epileptic patients above whom he slept. This resulted in the fortuitous discovery that it decreased the number and severity of their seizures. While our mystery medication is now a common treatment for epileptic seizures, this usage did not catch on until after World War I, due to disruptions in international medical communication. Its success as an anti-epileptic medication has spread beyond humans and it is now a commonly utilized seizure treatment for dogs, cats, and horses. Our featured drug has a truly checkered


past. In spite of its benefits for epileptic patients, it has also been used to induce death. In 1939, Adolph Hitler’s atending physician and the director of Hitler’s private chancellery, Karl Brandt and Philipp Bouhler, organized a “Children’s Euthanasia Group” directed at intellectually disabled children. Tis killing ward utilized


the drug to end the lives of these children. In 1997, this medication was used by the religious cult Heaven’s Gate when 39 cult members consumed applesauce laced with our drug and chased it with vodka to end their lives in an effort to “take their souls to the next level of existence”. In 2013, the proposed usage of this drug in lethal injections resulted in Hikma Pharmaceuticals, a current manufacturer of the drug, releasing a statement and refusing to sell it as a means of execution. Its atractiveness as a drug of abuse


comes from its ability to lower inhibitions and anxiety, similar to alcohol, but with much longer lasting effects. Its popularity as a “downer” peaked during the 1950s. However, due to its narrow window of safe dosages, our drug’s popularity was usurped by benzodiazepines, e.g. Valium and Librium, during the 1970s. Currently, this month’s drug is experiencing a resurgence in popularity among teens as a counter to stimulants such as cocaine and methamphetamines. For oral administration, the drug


is available in tablet and liquid forms. Tere is also a sodium salt version that is administered orally and intravenously. Tis drug’s anxiolytic effects, as well as its anti-epileptic properties, occur because it increases the activity of inhibitory neurotransmission. Our drug has up to 90% bioavailability and concentrates in the brain, liver, and kidneys aſter rapid absorption. Compared to other drugs in its class, it has the lowest lipid solubility, plasma binding, and brain protein binding effects. It also has the longest delay in effect onset and the longest duration of activity. Te sodium salt form of this medication is commonly used in both tablet and injectable forms, with effects beginning in approximately one hour and lasting for 10 to 12 hours. Metabolism occurs in the


50 datia focus summer 2017


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