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A Futuristic View
Published in Gary M. Matoren, The Clinical Research Process in the Pharmaceutical Industry, 2020
Clinical pharmacology in recent decades has had great difficulty in establishing its role in an acceptable and uncontroversial way in many medical institutions. Essentially this difficulty has stemmed from the confusion of clinical pharmacology and experimental therapeutics. Clinical pharmacology is the domain of the clinically orientated researcher whose role is to define the actions and side effects of drugs in physiologically normal humans and in appropriate models of disordered physiology which can be reversibly developed in normal humans. Experimental therapeutics must be seen to be the appropriate domain of the clinician, with research training dedicated to study the therapeutic efficacy of drugs in patients.
Sharing Our Thinking about Clinical Cases: Clinical Case Reporting—“Getting the Best Information from Just One Case or from a Fistful of Cases or Events?” 1
Published in Milos Jenicek, How to Think in Medicine, 2018
Establishing a cause-effect relationship based on evidence from only a few cases is appropriate in clinical pharmacology in specific cases where required conditions are met and related to adverse drug reactions. These four conditions are related to adverse drug reactions and which stem from anecdotal reports (i.e., few cases):
The basics of clinical pharmacology
Published in Conrad Harris, Jane Richards, Prescribing in General Practice, 2018
Many doctors have only vague ideas of what clinical pharmacology is and only distant memories of what they were taught about it. Clinical pharmacology is best defined as the study of drugs and their effects in people and on society. It clearly has an educational role for health care professionals and roles in drug development and drug safety. It also is very practical, addressing the optimal use of drug therapy for patient benefit while minimizing adverse effects. Some doctors argue that one does not need to know any clinical pharmacology to use drugs perfectly adequately. While this may work where prescribing is purely a reflex action, doctors today need to understand the basics of clinical pharmacology to make best use of existing drugs, especially in patients with complex problems, and to evaluate the many new drugs which emerge every year.
Safety and efficacy considerations amongst the elderly population in the updated treatment of heart failure: a review
Published in Expert Review of Cardiovascular Therapy, 2022
To manage comorbidities, an increased number of medications are utilized in the daily treatment regimen of elderly patients. The abundance of medications used for these comorbidities increases the concern of possible drug-drug interactions. Table 3 summarizes a list of common drug-drug interactions with both classes of medications following drug databases [3,39–56]. Interactions are described if they were listed as category D or X in the Lexicomp database [39]. Moreover, those flagged as contraindicated or major in the Micromedex database were included [40]. A major interaction in the Clinical Pharmacology database was also included [41]. Drug interactions were also cross-checked with the package insert of each medication. Furthermore, medications were listed if they were available and commonly used in the United States. In addition to these interactions, closely monitoring the elderly patients’ blood pressure becomes critical due to a multitude of antihypertensive agents as these patients may succumb to these effects more drastically.
The safety of available treatment options for short bowel syndrome and unmet needs
Published in Expert Opinion on Drug Safety, 2021
Loris Pironi, Emanuel Raschi, Anna Simona Sasdelli
The pharmacological options for SBS can be categorized as ‘symptomatic’ and ‘curative,’ although the effective identification of a curative therapy is still suboptimal. The pharmacological therapy aims to improve the symptoms, to correct nutrient deficiencies by routes other than IVS, and to improve the absorptive capacity of the remnant bowel. Successful treatment reduces or eliminates the need of IVS, thus decreasing the risk of IF/PN complications and ameliorating the patient’s QoL. The high variability of the anatomy and function, as well as the integrity, of the remnant bowel makes it difficult to predict the effectiveness and the safety of the pharmacotherapy in the individual patient. From a clinical pharmacology viewpoint, the actual absorption cannot be precisely assessed, thus making pharmacodynamic/pharmacokinetic monitoring a key strategy to tailor therapy at the individual patient.
The management of anti-infective agents in intensive care units: the potential role of a ‘fast’ pharmacology
Published in Expert Review of Clinical Pharmacology, 2020
Dario Cattaneo, Alberto Corona, Francesco Giuseppe De Rosa, Cristina Gervasoni, Danijela Kocic, Deborah Je Marriott
It is clear that the implementation of appropriate programs and interventions aimed to reduce the frequency of DDIs in ICU is critical. An additional important role of a ‘fast’ clinical pharmacology would be the correct and prompt identification of clinically relevant DDIs, taking advantage from both the availability of dedicated drug interaction software [46] and the therapeutic drug monitoring (TDM) of anti-infective and non-anti-infective medications when available [47]. Indeed, preliminary but consistent evidence is now available showing that a combination of the evaluation of potential DDIs by clinical pharmacy/pharmacology services and the monitoring of critically ill patients is an effective strategy that can be used as a complementary tool for safety assessments and the prevention of drug-related adverse events in ICU patients [39,46].