Clinical pharmacology

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Clinical pharmacology Clinical pharmacology is the science of drugs and their clinical use. It is underpinned by the basic science of pharmacology, with added focus on the application of pharmacological principles and methods in the real world. It has a broad scope, from the discovery of new target molecules, to the effects of drug usage in whole populations.

Clinical pharmacology connects the gap between medical practice and laboratory science. The main objective is to promote the safety of prescription, maximise the drug effects and minimise the side effects. It is important that there be association with pharmacists skilled in areas of drug information, medication safety and other aspects of pharmacy practice related to clinical pharmacology.

Clinical pharmacologists usually have a rigorous medical and scientific training which enables them to evaluate evidence and produce new data through well designed studies. Clinical pharmacologists must have access to enough outpatients for clinical care, teaching and education, and research as well be supervised by medical specialists. Their responsibilities to patients include, but are not limited to analyzing adverse drug effects, therapeutics, and toxicology including reproductive toxicology, cardiovascular risks, perioperative drug management and psychopharmacology. In addition, the application of genetic, biochemical, or virotherapuetical techniques has led to a clear appreciation of the mechanisms involved in drug action.

[edit] Branches

• Adverse Drug Reactions --

Adverse Drug Reactions Adverse drug reaction (ADR, or adverse drug effect) is a broad term referring to unwanted, uncomfortable, or dangerous effects that a drug may have. ADRs can be considered a form of toxicity; however, toxicity is most commonly applied to effects of overingestion (accidental or intentional—see Poisoning) or to elevated blood levels or enhanced drug effects that occur during appropriate use (eg, when drug metabolism is temporarily inhibited by a disorder or another drug). Side effect is an imprecise term often used to refer to a drug's unintended effects that occur within the therapeutic range. Because all drugs have the potential for ADRs, risk-benefit analysis (analyzing the likelihood of benefit vs risk of ADRs) is necessary whenever a drug is prescribed.

Etiology Most ADRs are dose-related; others are allergic or idiosyncratic. Dose-related ADRs are usually predictable; ADRs unrelated to dose are usually unpredictable.

Dose-related ADRs are particularly a concern when drugs have a narrow therapeutic index (eg, hemorrhage with oral anticoagulants). ADRs may result from decreased drug clearance in patients with impaired renal or hepatic function or from drug-drug interactions. Diagnosis Symptoms that occur soon after a drug is taken are often easily connected with use of a drug. However, diagnosing symptoms due to chronic drug use requires a significant level of suspicion and is often complicated. Stopping a drug is sometimes necessary but is difficult if the drug is essential and does not have an acceptable substitute. When proof of the relationship between drug and symptoms is important, rechallenge should be considered, except in the case of serious allergic reactions.

• Concepts in Pharmacotherapy --

Introduction Adherence to a Drug Regimen Drug Development Drug Errors Drug Interactions Minimizing drug interactions Pharmacogenetics Malignant hyperthermia Placebos

• Drug Therapy in the Elderly

Introduction Adverse Drug Effects in the Elderly Considerations for Effective Drug Therapy in the Elderly Drug Categories of Concern in the Elderly -Analgesics -Anticoagulants -Antihypertensives -Antiparkinsonian drugs -Digoxin -Diuretics -Antihyperglycemics -Psychoactive drugs Pharmacodynamics in the Elderly Pharmacokinetics in the Elderly

• Pharmacodynamics - finding out what drugs do to the body and how. This includes not just the Cell (biology)cellular and molecule|molecular aspects, but also more relevant clinical measurements. For example, not just the biology of salbutamol, a beta2-adrenergic receptor agonist, but the peak flow meter|peak flow rate of both healthy volunteers and real patients.

• Pharmacokinetics - what happens to the drug while in the body. This involves the body systems for handling the drug, usually divided into the following classifcation:
  • Absorption
  • Distribution
  • Metabolism
  • Elimination

• Medical prescription|Rational Prescribing --

A prescription (℞) is a health-care program implemented by a medical practitioner in the form of instructions that govern the plan of care for an individual patient. [1] Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist. Prescriptions are often written, though they may be typed into a computerized physician order entry, termed computerized prescriber order entry system, or issued verbally to the patient, a nurse, a pharmacist or other therapist. Prescriptions have legal implications, as they may indicate that the prescriber takes responsibility for the clinical care of the patient and in particular for monitoring efficacy and safety. using the right medication, at the right dose, using the right route and frequency of administration for the patient, and stopping the drug appropropriately.

• Toxicology