See for yourself how drug molecules appear in three dimensions by visiting the Center for Molecular Modeling at the National Institute of Health (NIH). Note: To view the molecules, you will need to install a "plug in" called CHIME.

a. Select several drugs and examine their three-dimensional structure. How do these computer representations different from the structural formulas shown in this chapter? You might want to select the drugs that interest you from this alphabetical list of chemicals.
b. What are the advantages of the computer representations over over two-dimensional drawings? What are their limitations, when compared to "real" molecules?

Off-label uses are on the web at the Food and Drug Administration. This site contains a wealth of information that is organized in a user-friendly fashion; check out some of its features. Drugs such as methotrexate and misoprostol can be prescribed for "off-label" uses (also called "unapproved," "unlabeled," or "extra-label" uses).

a. In general, does prescribing medications to be used in this way strike you as a reasonable thing for physicians to do? Explain your reason. Compare your opinion with what the FDA thinks.
b. Use the search engine provided at the site and enter "off label". From the lengthy list of "hits", pick two that interest you, and summarize their contents.
c. Explain how what you learned from this exercise strengthened or modified your opinion of "off label" uses.

As this edition went to press, you could purchase "andro" via the web. Is this still possible? To find out, search for androstenedione and see what turns up.

a. Is "andro" still sold over-the-counter (over the web)?
b. What do web sites claim about "andro"?
c. What does this steroid cost you, both in dollars and in effects on your health? As always, cite both the sponsor and the URL of the web sites you visit.

Writing about "andro", Pamela Zurer, a columnist for Chemical & Engineering News (September 28, 1998, page 37) comments: "I lay the blame squarely on Congress, which handcuffed FDA with the Dietary Supplement Health & Education Act (DSHEA) of 1994. Until some regulatory body is given the authority to require that the safety . . .of so-called nutritional supplements . . . we're going to see a lot more of these controversies. I hope not too many people ruin their health in the meantime". It may take a bit of detective work, but you can find the details of the DSHEA on the web.

a. See for yourself - did this really handcuff the FDA?
b. Whose needs was the DSHEA intended to meet?

The credibility of the FDA's fast-track drug testing program is called into doubt when five drugs released under the program have had to be withdrawn within a period of a year from mid-1997 to mid-1998. For example, some would argue that the recent recall of the pain killer Duract shows that adequate testing had not taken place on this drug. Others could counter that standards of testing have not changed, only the speed with which data are evaluated and that no set of tests can produce data that are 100% reliable in humans. Search the FDA and other web sites to gather information about this particular drug. Use what you learn to reach a decision as to whether you think fast-track drug testing is a benefit or a risk to the health of Americans.