New drugs and drug-delivery systems in the year 2000

Innovative new drugs and drug-delivery systems are discussed as they pertain to health-care delivery for the next 20 years. In general, experts predict that new drugs will differ in three respects from today's agents: (1) they will be more specific, (2) they will act closer to the site of the lesion, and (3) they will more often be natural products such as peptides and proteins. Immunomodulators are expected to be greatly different as substances such as interferon and the interleukins are used clinically. Major innovations are likely to occur for neurotransmitters, neurotrophic hormones, and mood-altering drugs. Genetic engineering will also have a marked effect on the availability of certain kinds of drugs in large quantities, on the treatment of some inherited diseases, and on the prevention of cancer. Monoclonal antibodies and prostaglandins are already being considered for therapeutic roles. Finally, genetic engineering will permit the development of vaccines with increased safety profiles. Regarding drug-delivery systems, controlled-release technology is an area of intense research. Magnetic systems are in the development stage for the treatment of localized internal conditions such as tumors or transplanted organs. Implanted pumps, liposomes, and improved delivery of neurotransmitters are also being developed further. The implications of new drugs and delivery systems are far-reaching for pharmacists. The role of pharmacists as information providers will likely increase, and pharmacists will find that they increasingly will handle high-technology drug-delivery systems rather than simple tablets and syrups.