Pharmacokinetics Includes The Study

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Introduction

Clinical pharmacology is the science of drugs and their clinical use.


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 Pharmacologic Objectives

1. Pharmacokinetics: Pharmacokinetics includes the study


of the mechanisms of absorption and distribution of an
administered drug, the rate at which a drug action begins
and the duration of the effect, the chemical changes of
the substance in the body (e.g. by enzymes) and the
effects and routes of excretion of the metabolites of the
drug. In short it includes –Absorption , Bioavailability,
Distribution, Excretion Metabolism

2. Pharmacodynamics - finding out what drugs do to the


body and how. This includes not just the cellular and
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 rate of both healthy volunteers and real
patients

3. Pharmacogenetics- Pharmacogenetics involves variations


in drug response due to genetic make up
4. Therapeutic drug monitoring: Includes measurement of
plasma drug concentrations (including "free" rather than
total drug concentrations) when indicated.

5. Adverse drug reactions:

6. Drug interactions: In pharmacodynamic interactions, one


drug alters the sensitivity or responsiveness of tissues to
another drug by having the same (agonistic) or a blocking
(antagonistic) effect. These effects usually occur at the
receptor level but may occur intracellularly.In
pharmacokinetic interactions, a drug usually alters
absorption, distribution, protein binding, metabolism, or
excretion of another drug. Thus, the amount and
persistence of available drug at receptor sites change.

7. Special factors in each patient: consideration of


recognize factors (such as age, sex, underlying disease,
pregnancy, nursing, etc.).

8. Obtaining and interpreting drug information: retrieving


and understanding scientific data available from experts,
internet sources, books, and other databases. Evaluate a
new drug's efficacy and toxicity by reviewing primary,
peer reviewed papers.

9. Prevention and management of drug overdoses:


10. Substance abuse: recognizing the presentations of
intoxication, withdrawal, and medical complications of
the common drugs of abuse.

11. Prescribing:

12. Communications skills:

13. Integrating basic and clinical science:

14. Recognition of pressures to prescribe irrationally

Adherence to a Drug Regimen

Adherence (compliance) is the degree to which a patient follows a


treatment regimen. For drugs, adherence requires that the
prescription is obtained promptly and the drug is taken as prescribed
in terms of dose, dosing interval, and duration of treatment. Patients
should be told to alert their physician if they stop or alter the way
they take a drug, but they rarely do so.

Only about half of patients who leave a physician's office with a


prescription take the drug as directed. The most common reasons for
non-adherence are

1. Frequent dosing
2. Denial of illness
3. Poor comprehension of the benefits of taking the drug
4. Cost

Placebos
Placebos are inactive substances or interventions, most often used in
controlled studies for comparison with potentially active drugs

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