Q: Why do diuretics trigger sulfa allergies?
A: The observation that patients treated with sulfonamides developed a hyperchloremic metabolic acidosis led to the development of acetazolamide and subsequently the thiazide diuretics. (Note: loop diuretics also trigger sulfa allergies, but I am not sure why)
Q: Which drug used to treat hypertension was noted to have a side effect that some middle aged men might find beneficial?
A: Minoxidil was found to cause hypertrichosis (increased hair growth), so a less potent form was marketed as the anti-balding agent Rogaine.
Q: A patient presents with hypotension, weakness, disorientation, psychosis, and a breath that smells like bitter almonds. Which antihypertensive drug might the patient have been on?
A: The bitter almond breath is due to cyanide toxicity, a side effect of nitroprusside. The metabolism of nitroprusside releases cyanide.
Q: Why should people on Viagra not take nitrates?
A: Sildenafil (Viagra) and nitrates act synergistically. Nitrates activate guanylate cyclase to increase cyclic GMP; sildenafil inhibits phosphodiesterase V to inhibit break down of cGMP. Together, the drugs markedly increase cGMP which leads to massive vasodilation and hypotension. Not exactly the best way to rekindle one's marriage, huh?
Quick note: One of the side effects of Viagra is difficulty with blue-green color discrimination, just like the color of the pills.
Q: What are "poppers"?
A: Per PharmCards, poppers are "street forms of amyl nitrates used to produce giddiness and enhance sexual perfomance via release of NO in the corpora cavernosa." The drug is related to nitroglycerin.
Q: What drug was initially discovered by William Wuthering as a treatment for dropsy, an old term for edema?
A: Digoxin is a purified extract of the foxglove plant, also known as digitalis.
Another quick note: One of digoxin's side effects is blurry yellow vision (think Van Gogh).
Q: Why are tricyclic antidepressants sedating?
A: They were first developed as antihistamines.
Q: How was penicillin discovered?
A: Penicillin was included in this list of 10 notable accidental inventions. As the story goes:
Everybody knows the story – or at least, should – the brilliant yet notoriously absent-minded biologist Sir Alexander Fleming was researching a strain of bacteria called staphylococci. Upon returning from holiday one time in 1928, he noticed that one of the glass culture dishes he had accidentally left out had become contaminated with a fungus, and so threw it away. It wasn’t until later that he noticed that the staphylococcus bacteria seemed unable to grow in the area surrounding the fungal mould.
Fleming didn’t even hold out much hope for his discovery: it wasn’t given much attention when he published his findings the following year, it was difficult to cultivate, and it was slow-acting – it wasn’t until 1945 after further research by several other scientists that penicillin was able to be produced on an industrial scale, changing the way doctors treated bacterial infections forever.
Can't get enough? Check out why Italian women love atropine, or the top 5 medical urban legends.