Wednesday, February 10, 2010

Watching the Clox

This is actually Day Three of my cloxacillin odyssey. I am quietly amused every time I try a new drug, attempt to predict its effects on my body, which has an alarming genetic payload of internal problems, and get it right. It helps that I've always been interested in chemistry, and pharmacology in particular, from a very young age.

When I was in primary school, my grandfather used to (well, this is what they'd call it nowadays) 'dispense pharmaceuticals' from a little dispensary called the United Pharmacy along North Bridge Road. I used to walk there after school, little boy with a hefty schoolbag, and deposit myself behind the counter. I'd generally get underfoot, attempt to avoid dangerous collisions, and try to figure out what was in those odd porcelain and glass jars lined up in impressive ornate rows on every wall.

Grandfather always was one for education, so he'd let me explore the dusty, plant-colonised areas of the rooms upstairs, read anything I found, examine the long-dead X-ray machine in the side room, and in general learn stuff I couldn't have learnt anywhere else. His Hainanese factotum, Ah Siew, looked every inch the sage as he interpreted, carried out various odd tasks, and conveyed instructions.

But the drugs were the important part of my life. My grandaunts used to produce them, grinding out odd powders and pressing tablets, mixing up strange-looking potions from arcane ingredients, making up whatever was directed from the airy chamber from whence Grandfather handed down instructions in a language that seemed wholly unnatural.

It was this that led me to explore the interactions between organic materials — this, following Grandfather on his daily rounds, and wandering around the open-air wards at the hospital which was Eldest Uncle's domain. Yet, it was never the practice of medicine, but the art of making medicines, that intrigued me most.

And so now, decades later, I look at my drugs, figure out their molecular structures, predict their effects, and am childishly happy when I am right. Cloxacillin, with its big fat chlorophenyl-oxazole defensive sidechain, is a penicillin designed to defeat naughty bacteria which would normally be able to destroy penicillins. But that very defence is what makes it mild and slow, like a warrior armed with a shield that is too large. Nevertheless, it is helping to deny the enemy its footing in my upper right arm, while not seriously messing with my guts.

Why is it so important for me to know all that? It's because when you feel not quite yourself (as some people do after losing their gustatory virginity to caffeine), it helps to have expectations of future sensation and the ability to explain what's happening to yourself. Knowledge is not only power, but sometimes a tower of strength in times of uncertainty.

That's why teachers should always go through examination rubrics (the administrative basis) and curriculum underpinnings (the academic basis) before getting too far into the intricacies of the course they are teaching. If students don't know where you're going, they might not follow you all the way. Best then to provide a map of some sort, so they can catch up if lost, or find their own way around.

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2 Comments:

Blogger BenSohBS said...

Heh why not Flucloxacillin? It's better tolerated in general and has a better overall drug profile =) (or at least from what I vaguely remember learning last november)

Wednesday, February 10, 2010 9:19:00 pm  
Blogger Trebuchet said...

*grin* It's easier (i.e. cheaper) to make clox than floxapen, and the two are nearly interchangeable. Generally the metabolic rule is that Cl- is bad for liver and F- is bad for kidney. Best stick to one and not both, I suppose.

But I suspect the #1 reason is akin to the reason why we serve up chlorpheniramine in Atlantean hospitals rather than some more potent less sleep-inducing antihistamine.

Thursday, February 11, 2010 1:40:00 am  

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