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Show Sunday. October 22. 1978. THK HERALD, Antiepileptic r I m Center Evaluates Drugs - XIT iLTTlTV 3u- - un.t, t'uienuai new anticonvulsant drugs from researchers across the nation are arriving at the rate of 50 a month at the University of Utah Center for the Early Pharmacological Evaluation of Antiepileptic Drugs. Moi4 than 2,400 compounds have been tested in the past three years since the center was established by the National Institute of Neurological and Communicative Disorders and Stroke. Of all these compounds, 26 have looked sufficiently promising to pass the third level of antiepileptic and lexicological evaluation and are being considered by anincds for further testing. "In 70 percent of all epilepsies, the cause is unknown," says Dr Ewart A. Swinyard, professor emeritus and director of the center in the College of Pharmacy. "Cure or prevention are off in the future. Even classification and treatment based on known causes are not possible for most epileptics today. Treating the symptoms that is, controll is the ing seizuares with effective drugs best most epileptics can hope for now." But drugs currently available are effective in only about 50 percent of epileptics. Because of this, the federal NINCDS has set up a support network to try to increase the number of effective antiepilepsy drugs available. "Before the 19th century, epilepsy was considered in the realm of witchcraft, possession or affliction by the gods," Dr. Swinyard noted. "In the 1850s, bromides began to be used to control seizures. It wasn't until 1937 that the first antiepileptic drug was found through a deliberate laboratory search. It took that drug one year to come into clnical use. "From that time until about 1960, anticonvulsant drugs were coming on the market at the rate of about one a year. Then the progress halted. "Part of the problem was that it takes eight to 10 years and an investment of $150 million to get a drug from synthesis to market today. An even greater problem was that it was generally believed in the 1960s that drugs already on the market controlled 75 percent of all epilepsies. This r . naI n I i encourged researchers to concentrate on other problems and diseases "In 1970. NINCDS launched a survev of the literature The survey found that, despite widespread beliefs among clinicians, currently available drugs controlled seizures in only about 50 percent of epileptics "Unfortunately, there are certain tvpes seizures for which there are no specific drugs and others for which controlled therapy carries significant toxicity." Dr. Swinyard says. "Yet persons suffering from epilepsy can live normal lives when their seizure? are controlled by drugs with minimal side effects. "There can be no doubt that new agents with greater specificity and less toxicity would mean significant therapeutic advances in the treatment of this disorder." he says. In response to the survey, the Epilepsy-Brancof NINCDS began setting up a support network to encourage development of new drugs. The first step was the development of clinical study centers to improve clinical testing of potential anticonvulsant compounds and compare their effectiveness with that of drugs already on the market. In January 1975. the agency established the center in Utah under the direction of Swinyard, an internationally known figure in epilepsy research for many decades. "This center, currently supported at an annual level of approximately $350,000, illustrates how an academic institution and a federal agency can work together to solve a health problem," Swinyard says. "The NINCDS solicits substances from the pharmaceutical industry, academic institutions and research foundation all over the United States and Canada. "They record the available data on the substances and also study each compound to assure that it is new to the project. The new compounds are then sent to us for tests in laboratory animals to determine potential antiepileptic efficacy and neurotoxic activity." The first stage of testing is identification of any activity. This testing takes a full day, and Dr. Swinyard of - and s.x other e researchers in the center can evaluate about 16 compounds a week at this level. Of the compounds received so far. more than 500 have looked sufficiently promising to be put through the second level of testing, anticonvulsant quantification The staff can process about five compounds a week at this level Twenty-sicompounds have sunned the third level of evaluation. At this stage, each compound is put through a week of testing to determine whether its anticonvulsant activity is the same in varous rodent species and to test different routes of administration, tolerance potential and toxicity profiles The 26 compounds which have survived this testing are now undergoing more advanced toxicological testing at Utah. The Epilepsy Branch of NINCDS will decide which compounds will go on into clinical testing. data from the Utah center age 47 Mr - vi uJ r ANTIEPILEPTIC DRUGS are tested at the University of Utah. Here research assistant Jose Woodhead watches mice balance on a rotating rod in a test to determine neurotoxicity of potential new antieDileosv drum. New com pounds for evaluation are arriving at the rate of about SO a month at the center for early phar- macological evaluation. is returned to Washington, where it by NINCDS. The agency can then notify the chemist who submitted each compound of possible modifications in structure that might make it more ef- d fective. Beginning Utah-P- full-tim- x All Provo. this fall, the NINCDS will start providing grant support for medicinal chemists to synthesize new anticonvulsant compounds to be channled into the center. Dr. Swinyard himself spends a great deal of his time writing and presenting talks and paper at national and international meetings in an effort to disseminate the massive amounts of information generated by the center. Half a dozen scientific papers are on his desk in varous stages of preparation. The work of the center will take on a new direction this fall with the addition to the staff of Dr. Ananth K. Shenoy, a research instructor in pharmacology. "Shenoy is intereted in developing new animal models and tests as researchers learn more about the possible biological roots of epilepsy," says Swinyard. Contact Lenses Not for Evervone Some 10 million Americans have been fitted with contact lenses, and each year more than 1.5 million people put them on for the first time, said the Better Visiion Institute in New York City, in a pamphlet about contact lenses. Some visual problems can be better corrected or improved by waring contacts than with eyeglasses. Still they are not for everyone, and a real need for vision correction and strong motivation are important to successful wearing, the Institute explained. Contact lenses play an important role in today's eye care, and their contributions to man's visual abilities seem destined to increase. Among their advantages: they do not steam or fog; they increase peripheral vision ; and some wear them for cosmetic reasons. In general, they do require more care than eyeglasses, are more expensive, and they easier to lose, continued the pamphlet. It is estimated that three out of four wearers of contact lenses are women. Contact lenses are most popular with young people who are nearsighted and with older people who have had cataract surgery. There are three major types of contact lenses: the hard corneal lens, the flexible or soft lens, and the scleral lens If you select contact lenses, you must remember that they must be kept clean and aseptic; they should not be worn while sleeping, swimming or in the presence of irritating vapors. They should not be exposed to substances such as cosmetics, lotions, soaps, creams, or hair sprays, the Institute rooLxoi Emergency Room Nurse Enjoys Work SALT LAKE sound CITY "This might strange, but I enjoy my work," says University Hospital Emergency Room Supervisor Madeline Anderson, RN. room work is exciting. It's never the same, you can't "Emergency foresee who's going to come through the door next," according to Ms. Anderson. Ms. Anderson has been ER supervisor since 1965 and finds her job a challenging combination of administrative work and patient care. Because of her daily relationship with hospital and com- munity volunteers, paramedics and police, she feels she works as closely with the com- as with the munity University Hospital. "I've wanted to be a nurse since I was knee-hig- h to a grasshopper," says Ms. Anderson. She was born and reared in Salt Lake where her grandmother was a pioneer midwife. After three years training at the old Salt Lake County Hospital, she received her BS degree from the University of Utah College of Nursing. ER each year. "We have staff sleeping quarters She returned to the not been as busy the last and areas for examinacounty hospital to start five years as we used to tion, recovery, waiting, her nursing career "and be." Still, there is never a cast work and comjust moved up here on day without many munications systems. In the communications day one" when the patients. University Medical The diagnosis column room, the ER staff can Center opened in July of the log book has a little radio orders to 1965. of everything. Chest pain, paramedics bringing Since then, Ms. sunburn, lacera;tions, patients into the hospital Anderson has taken only drug overdose, carone year out from the ER diovascular arrest, to organize a patient care backache, burns and dog unit for the rehabilitation bite are just a few of the center. entries. As supervisor, nurse "Unplanned deliveries Anderson hires and trains of babies are also typical staff, serves on various of the ER," says Ms. community and hospital Anderson. "We also see committees and meets psychiatric patients since daily crises involving ac- we're the 24 hour crisis tual patient care. She intervention center for works with every hospital the area. department and with the "People have the misRed Cross, which su- conception that there are pplies many of the a lot of violent injuries in volunteers who assist in the ER. But it's only like ER. that in the case of bad ac"We have RNs, LPNs, cidents. Most of the time attendants, interns and it's similar to a doctor's residents working here," office," she says. To Ms. Anderson, the says Ms. Anderson. "There also are student sight of blood and the nurses, medical students, pressure found in the ER and is "just part of nursing." paramedics emergency medical "You get used to it technicians who we help gradually, starting from train. We're constantly in the beginning of your the teaching business." training." She says an average of The ER really consists 20,000 cases arrive at the of 10 rooms including n and read EKG strips and patient heart monitors. "My work is always Anderson. says Ms. "I'm constant- ly meeting the public. 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