[Chiral switch: pure enantiomers of drugs instead of racemic mixtures]. [Czech]

Chirality of drugs, particularly the comparison of efficacy of enantiomers and their racemic mixtures, has become an object of serious interest of pharmaceutical researchers in recent ten or fifteen years. Advances in chemical technologies connected with the synthesis, separation, and analysis of pure enantiomers from racemates, together with administrative regulatory measures, have resulted in an increase in the number of newly registered chiral drugs containing only one of the enantiomers. Besides new chemical entities, many "old" racemates are being re-evaluated as potentially new sources of pure enantiomers which should improve the therapeutic profile of the drug. Due to this replacement of a racemic mixture with a pure enantiomer, the literature lists both drugs containing a racemate and drugs containing only one of the enantiomers. Nevertheless, the required therapeutic effect is not always achieved, and unexpected undesirable effects have also occurred. The paper summarizes therapeutic and economic problems concerning chiral switch drugs.