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ABCs of Pharmacology

Know why some people’s stomachs burn after they swallow an aspirin tablet? Or why a swig of grapefruit juice with breakfast can raise blood levels of some medicines in certain people?

Understanding some of the basics of the science of pharmacology will help answer these questions, and many more, about your body and the medicines you take.

So, then, what’s pharmacology?

Despite the field’s long, rich history and importance to human health, few people know much about this biomedical science. One pharmacologist joked that when she was asked what she did for a living, her reply prompted an unexpected question: “Isn’t ‘farm ecology’ the study of how livestock impact the environment?”

Of course, this booklet isn’t about livestock or agriculture. Rather, it’s about a field of science that studies how the body reacts to medicines and how medicines affect the body. Pharmacology is often confused with pharmacy, a separate discipline in the health sciences that deals with preparing and dispensing medicines.

For thousands of years, people have looked in nature to find chemicals to treat their symptoms. Ancient healers had little understanding of how various elixirs worked their magic, but we know much more today. Some pharmacologists study how our bodies work, while others study the chemical properties of medicines, Others investigate the physical and behavioral effects medicines have on the body. Pharmacology researchers study drugs used to treat diseases, as well as drugs of abuse. Since medicines work in so many different ways in so many different organs of the body, pharmacology research touches just about every area of biomedicine.

A Juicy Story

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Did you know that, in some people, a single glass of grapefruit juice can alter levels of drugs used to treat allergies, heart disease, and infections? Fifteen years ago, pharmacologists discovered this “grapefruit juice effect” by luck, after giving volunteers grapefruit juice to mask the taste of a medicine. Nearly a decade later, researchers figured out that grapefruit juice affects medicines by lowering levels of a drug-metabolizing enzyme, called CYP3A4, in the intestines.

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More recently, Paul B. Watkins of the University of North Carolina at Chapel Hill discovered that other juices like Seville (sour) orange juice—but not regular orange juice—have the same effect on the body’s handling of medicines. Each of 10 people who volunteered for Watkins’ juice-medicine study took a standard dose of Plendil® (a drug used to treat high blood pressure) diluted in grapefruit juice, sour orange juice, or plain orange juice. The researchers measured blood levels of Plendil at various time afterward. The team observed that both grapefruit juice and sour orange juice increased blood levels of Plendil, as if the people had received a higher dose. Regular orange juice had no effect. Watkins and his coworkers have found that a chemical common to grapefruit and sour oranges, dihydroxybergamottin, is likely the molecular culprit. Another similar molecule in these fruits, bergamottin, also contributes to the effect.

Many scientists are drawn to pharmacology because of its direct application to the practice of medicine. Pharmacologists study the actions of drugs in the intestinal tract, the brain, the muscles, and the liver—just a few of the most common areas where drugs travel during their stay in the body. Of course, all of our organs are constructed form cells and inside all of our cells are genes. Many pharmacologists study how medicines interact with cell parts and genes, which in turn influences how cells behave. Because pharmacology touches on such diverse areas, pharmacologists must be broadly trained in biology, chemistry, and more applied areas of medicine, such as anatomy and physiology.

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