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Sorry, I can't just walk away. When you find patents or pate...

Posted at 4:16 PM on May 07, 2008 by concernedcitizen, #30287
Sorry, I can't just walk away. When you find patents or patent applications for certain purposes, then you know that your ideas are well founded. There are several patents for using an anti-malaria drug for asthma. I would bet that somebody had that idea all the way back to the 1960's. So it is very possibly no coincidence at all that a chloroquinoline or other quinoline ring would be part of montelukast's chemical structure. Here is one of the patents. ****** It is well known that quinoline rings can be toxic to some people even very rapidly. As in this very extreme example. -------------------------------------------------------------------------- PEDIATRICS Vol. 27 No. 1 January 1961, pp. 95-102 This Article FATAL ACUTE CHLOROQUINE POISONING IN CHILDREN Howard M. Cann M.D.1 and Henry L. Verhulst M.S.1 1 National Clearinghouse for Poison Control Centers, Accident Prevention Program, Public Health Service, U. S. Department of Health, Education, and Welfare Four cases of acute chloroquine poisoning in children are presented. In three instances death occurred within 2 hours of ingestion of larger than therapeutic amounts of the drug. The rapid occurrence of death in acute chloroquine poisoning is probably explained by complete and rapid absorption of the drug from the gastrointestinal tract resulting in high blood concentrations which depress vasomotor function and respiration. Cardiac arrest follows and may be caused by the direct myocardial action of chloroquine, to anoxia, or to both. The similarity of the manifestations of acute chloroquine poisoning and those of acute quinine and quinidine poisoning suggests that acute toxicity may be attributed to the quinoline ring portion of these drugs. ---------------------------------------------------------------------------------- I don't think that we are seeing extreme examples. But we may be seeing less extreme immediate reactions or reactions where the toxicity builds up over time. Quinoline rings are know to cause neurotoxicity. There are theories about how that happens. One of the theories is about blocking connexins which are gap junction proteins in the brains. I don't know how montelukast could be breaking up so that it causes toxicity. Or if the problem is the how rapidly the liver enzymes can metabolize it. But there is plenty, plenty, plenty of clinical evidence that there is a quinoline ring culprit somewhere in the picture. Or some by-product of that causing problems. Somehow it was decided that montelukast did not have the safety issues that the other drugs in the same category have. See this. "The starting point in the development of montelukast appears to be a quinoline-containing structure, likely identified as a weak random screening lead (Figure 3). The Merck group hypothesized that this molecule was mimicking the olefin backbone of cysLTs, and that the addition of mimics for the acid and peptide regions of LTD4, might improve its potency. As a first step, the dithioacetal linkage first seen in some SmithKline compounds was incorporated; this led to a compound with greatly increased in vitro potency but poor oral bioavailability. When one of the carboxylic acids was replaced by an amide, forming MK-571, the new antagonist had even greater potency and good efficacy following oral administration. The enantiomers were resolved to yield MK-679 (verlukast), a compound with better clinical effects than MK-571, but whose clinical development was stopped for safety reasons. Further structure-activity relationship studies led to the development of montelukast (16), an antagonist that appears free of the safety concerns plaguing earlier members of this series." If we can find out why the earlier versions were not safe and how they thought fixed it, then maybe we can find out what is going on with the quinoline ring in some people. I would be very surprised if the FDA will address our concerns. Why does it always seem like they wait for enough people to die like in Vioxx? Wasn't Vioxx responsible for thousands of deaths?
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Reply about 1 year ago on May 07, 2008 by sp2008, #8055

We don't want you to walk away!!!!! Please don't!

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Reply about 1 year ago on May 07, 2008 by hrtprice, #8057

A million thank-you's! I look forward to reading what you have to say every day. Some people have no respect. Wish there were more like you.

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Reply about 1 year ago on May 07, 2008 by sing, #8058

I never showed a lack of respect. And I never meant for concernedcitizen to threaten to disappear. I was merely asking about background since the posts were so highly technical.

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Reply about 1 year ago on May 07, 2008 by freakedoutmom, #8063

We are glad you are back. Thanks for all of the great information.

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Reply about 1 year ago on May 07, 2008 by catherineevans, #8070

My husband and I read your posts every day and thank God that you are working on this. Did you see the story on MSNBC on Cody Miller and the "Mystery of Medications That Lead to Suicide." I think Merck's trying to overplay the suicide as the extreme consequence that can't ever possibly be known and not looking at these other side effects. Also, another story came out on the same news network at the same time today on the lack of oversight by the FDA in clinical trials and Congress ignoring this.

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Reply about 1 year ago on May 07, 2008 by dawniesue80, #8075

Thank you!!! Don't leave us again. At least some one is doing the research, it definitely is not Merck! I look forward to reading your posts, everyday!! Thank you again.

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Reply about 1 year ago on May 08, 2008 by kate2, #8078

I was having such a bad day and now I feel so much better knowing your still researching.In time we will have answers,faith and knowledge is the key.Let's keep an open mind and dialogue.Thank You ,Thank You,Thank You!Kate Miller

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Reply about 1 year ago on May 08, 2008 by concernedcitizen, #8082

It is appalling that there can be such an attitude that if the majority takes a med without incident that nobody else counts.

There are many reasons that can cause a med to be unsafe: genetic variation including ethnic groups; diseases that are inherited; predispositions toward genetic diseases and the list can go on and on. If doctors refuse to report adverse drug reactions, then there is insufficient data for the FDA to use in order to try to determine who might be at risk.

I don't have the answers. And, if there are experts who do, then they are not speaking out. The earlier versions of montelukast caused liver problems for even normal people. They made modifications so that montelukast didn't cause elevated liver enzymes. Maybe? There are people here who claim elevated liver enzymes.

Montelukast is a quinoline. The entire category quinoline/quinolone has risk factors for adverse drug reactions. I find it very difficult to believe that there are not some circumstances caused by genetic or other metabolic factors that enter into how the body breaks down montelukast. In some cases, one of the by-products might become toxic. Nobody appears to want to find out about that.

Montelukast might also interupt normal digestive processes. It is an oral medication. It passes into the digestive track. There are cysLT1 receptors in the intestinal mucosa. Research has proven that these receptors are also affected by montelukast. They become unable to function because they are bound just like the receptors in the lung. Merck published in all the papers when montelukast was released that the cysLT1 receptor was only affected in respiratory tissues. When did they ever correct that in the literature? Doctors still tell patients that. If a patient's problems are only seasonal allergies, why subject that patient to a drug that changes intestinal mucosa? I don't think that if doctors knew that, they would prescribe Singulair to so many people.

It seems to me that Merck doesn't want too much information about montelukast to be distributed because it detracts from their marketing message "Singulair is effective and well tolerated by the majority. Take your pill once a day. End of information."

How many patients actually need Singulair in order to function and live normal lives? There are many, many choices of medications.

Why would the medical profession be interested in defending a drug company? So what if the drug company has problems with a drug that need to be addressed? The medical profession should be on the side of the patients not the drug companies.

It seems like Merck- marketer of the year at the ad awards-- is too busy being a marketing company to concern itself with being a medical company.

pharmexec.findpharma.com/.../ArticleStandard/Article/detail/515006?ref=25 - 98k

Kate, You and David are very brave. Neither you nor the Kendalls can change what happened to your sons. I just hope that there will be a big change in the pharmaceutical industry as a result of your campaign of awareness.

If we don't do something better about health care, we might as well have a company called "Be Your Own Doctor. Sign a waiver of liability. Pay for lab tests and our computer analysis of your choice of medications. A complete listing of all the risks of these medications will be provided."

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Reply about 1 year ago on May 08, 2008 by sp2008, #8087

I hope you come back to the Yahoo board also! Thanks again!

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Reply about 1 year ago on May 08, 2008 by concernedcitizen, #8095

I forgot to attach this to my post. It does seem like the AMA wants to do something about drug marketing.

www.nytimes.com/2005/06/22/business/media/22adco.html -

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Reply about 1 year ago on May 09, 2008 by concernedcitizen, #8133

I am sorry that I got upset. As I had said many times, I am not an expert in this field. I am not trying to portray that I am. So far, I am just posting as I uncover other scientist's information on the subject.

In my opinion, there never will be anything but citizens trying to find these answers. Take a good look at the FDA response to Lariam. They try to push it right under the rug. There were 14 suicides in the army in 1964 due to anti-malaria drugs of the quinine-quinoline category.

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