The Great Thalidomide Caper Trivia Quiz

Answer: It was a tranquilliser that was impossible to overdose on.

Thalidomide first came about when an anti-allergen was being tested on rats, but instead of preventing the allergies, it caused the rats to become drowsy and placid. No matter how much thalidomide was given to the rats, they remained healthy, and so it was regarded as one of the greatest medical breakthroughs of the 1960's - a tranquilliser that worked, but was essentially harmless to the fully formed adult.

Answer: A normal head and trunk with shortened or no limbs

To this day, doctors have no idea how the mutations form, as they still don't know exactly how thalidomide works. The newest theory is that the blood restricting effects of the drug had prevented a copious supply of blood reaching the developing limbs.

This meant the limbs had failed to develop adequately. The drug was withdrawn in 1962, after 8,000 children in 46 countries were born with the deformities.

Answer: ENL Sores (skin lesions)

ENL sores (erythema nodosum leprosum sores) are large, hideous growths that occur below the skin. These are nothing more than the immune system reacting against the bacteria which cause the disease. The swellings themselves are caused by cytokines and activated macrophages, which eventually destroy tissue and mutilate flesh in a desperate attempt to expel the bacteria from the body. Leprosy, as a disease, is in fact related to tuberculosis, and the paucibaccilary form of leprosy is very similar to the deadly lung disease.

Answer: It suppresses immune receptors, which decreases ulceration

Thalidomide causes blood supply to be decreased, and there is no evidence to show that thalidomide causes antiseptic tissue fluid to be produced. It is this immune system suppression that stops the production of ENL sores on the bodies of leprosy sufferers, and the occurence of ulceration on the bodies of Behçet's victims. Both the ulceration and sores are a result of the human immune system battling desperately against what it believes to be foreign bodies.

Answer: It can cause severe neurological impairment.

The neurological impairment is far rarer than the foetal distortion, and has been found in very few of the children whose mothers took the drug during the last trimester of pregnancy. There is, however, little information on these neurological problems, as very few women who take thalidomide today choose to have children in fear of the potential disfigurement.

Answer: That the drug's recipients would use two forms of contraception during intercourse while using thalidomide.

It was imperative that, in the few places thalidomide was commissioned to use for diseases such as leprosy, children would not be affected by the drug. It is for this reason that women who used the drug had to sign a release form declaring that they would use two forms of contraception during intercourse while taking the drug. Few countries ever licensed thalidomide, but in countries such as Israel, it was felt that the drug was of great use due to the abundance of leprosy. For this reason, the aforementioned legal agreements had to be signed in Israel and all other countries where thalidomide was being prescribed.

Answer: An action whereby the tumour ensures a copious blood supply by creating blood vessels that feed the tumour and nothing else.

Both solid tumours and blood cancers use angiogenesis to ensure that the cancer grows and spreads. Blood cancers create a blood supply to the bone marrow to generate cancerous blood cells (as in leukaemia), and solid tumours generate systems of veins around themselves. They then use the copious blood supply to grow and multiply.

Answer: All of these reasons make thalidomide a better choice

Thalidomide has also proven to be something of a wonder drug for cancers, but scientists are still unsure about how the drug works. It is not a cure, but has given many people suffering from multiple myeloma much more time with their families, as it controls the cancer.

The only drawback is that once the cancer has become accustomed to the thalidomide, the thalidomide will become less and less effective. Thalidomide also has side effects, such as constipation and peripheral neuropathy (numbness in the extremities.)

Answer: They removed an oxygen atom and replaced it with a nitrogen atom.

Although the scientists carrying out this procedure had no idea how the drug worked in the first place, and had even less idea how to alter the drug to make it safe, the new formula has been almost completely successful. "Removid" is now an even more effective drug to use than thalidomide against once-fatal cancers.

It is also being used in the treatment of AIDS and multiple sclerosis. Sadly, it cannot provide a cure - only a drug to make these diseases more bearable.

Answer: No one knows for sure

The drug breaks down into many compounds when dissolved in even the simplest solvents. As mentioned before, no one knows how the drug caused the mutations, and equally, no one is sure what part of the drug retards angiogenesis. As the theory of mutation is based on the restriction of angiogenesis, the research has turned on to why angiogenesis is prevented using thalidomide. Scientists, therefore, are now examining the drug's effects on the immune system. Maybe one day we will know how thalidomide truly works, but for now, this tranquilliser and cancer cure remains shrouded in mystery.