Good Question: How Do Pills Know Where To Target?

MINNEAPOLIS (WCCO) — Americans spend more than $250 billion a year on over-the-counter and prescription medications. When we have an ache or pain, we often take an aspirin or ibuprofen pill. But how do medications know where to target?

“Pills are actually really dumb,” said Allyson Schlichte, PharmD, a pharmacist at Fairview Health Services, adding “they have no idea” where they’re targeting.

So your aspirin doesn’t know if it’s your head or your back or your ankle hurting.

When you take a pill, generally it stays intact in the stomach, through the small intestine, and into the liver, where it dissolves.

“All medicines that we take orally then go to the liver, then go into the bloodstream, where they exert their effect,” said Schlichte.

She compared the body and medication to a lock and key system.

“The medicine is like the key, it searches all over the body until it finds the locks that it fits into,” she said.

So when you take ibuprofen, it’s working everywhere, reducing swelling throughout your body.

“Your body doesn’t notice when there’s a little extra pain killer where you don’t feel pain,” she said.

That is why so many medications have such a giant list of side effects.

“Absolutely, it’s because that drug doesn’t know where to go — so it’s working where it shouldn’t,” said Schlichte.

Sometimes those side effects become intended effects: like with Viagra. It was originally designed to be a blood pressure drug with a goal of opening up blood vessels. The side-effect was improving erectile function in men who had trouble.

The theory also explains why people taking chemotherapy medication find that the drugs attack more than just cancer cells.

“The chemotherapy looks for fast-growing rapidly diving cell, and that’s why a lot of people lose their hair. Their hair is a fast-growing rapidly dividing cell,” Schlichte said.

There is hope that someday medications can become more targeted, said Schlichte. “We’re working really hard in the research to try to find out if we can do targeted gene therapy.”

In the meantime, we’re stuck with medications that work everywhere.

More from Jason DeRusha
  • wrong

    Stays intact until it gets to the liver? I don’t think so. maybe the molecular structure of the chemical stays intact, but the pill sure doesn’t pass through the whole digestive system intact.

    • Another Pharmacist

      She was explaining first pass metabolism. She did a good job explaining it in the limited time she had.

    • Sue

      I was thinking the same thing. The liver cleans the blood, right? It’s not like food and pills go through the digestive track and then hit the liver. It absorbs thorugh your digestive track, into your blood, then flushed through the liver. Or, that’s how I understand it.

  • Not a Dr.but play one Up North

    It hits everything~ dulls everything. Then sits in the liver and destroys it after time. If you have a headache and a sore toe… they both get hit and everything in between!

  • DougT

    Well children – The pills have tiny little brains…….

    Really? It a odd way to headline the “good question”. Unless you are trying to dumb this down to the Kindergarten Society we are becoming…….

    • Real Talk

      Exactly….who the hell ever thought that when you take an aspirin for a headache…the pill magically traveled from your stomach up to your head just where the pain is.

      An elementry understanding of anatomy would have answered this “good” questions.

      Try harder Jason…..FAIL!!!!

  • Paula Swanson

    I am commenting on the drug Viagra. November is pulmonary hypertension awareness month. Our Governor Mark Dayton just signed a proclamation declaring recognition of this in the state of MN. Pulmonary Hypertension is the other high blood pressure that many people are unaware of. Many patients that have pulmonary hypertension take Viagra to prolong their life. It would be nice if WCCO could someday do a story on this disease to increase the public’s awareness of this horrible disease.

    • Ummm...

      WCCO could do an effin news story EVERYDAY about some horrible disease. Point being…it gets old fast, and its only interesting if you or someone you love has the disease.

  • Keith S.

    Paula, yes, this is Pulmonary Hypertension. I don’t use a Viagra, I wear Flolan infusion pump for 10 years. I’m still be going strong. I’m doing so fine. But sometimes, I struggling with it, yet I have to deal with it, I’m fine with that. There is PH symptoms are: blue colors of the lips or skin, chest pain, shortness of the breath, ankle and/or leg swelling, fatigue and or weakness.

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    Good Question: How Do Pills Know Where To Target? « CBS Minnesota

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    Good Question: How Do Pills Know Where To Target? « CBS Minnesota

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