Introduction to clinical pharmacology (RUD)

Clinical pharmacology - the science that

studies the characteristics, effects, properties,

reactions and uses of drugs—especially their

therapeutic effect in humans—including

toxicology, safety, pharmacodynamics and

pharmacokinetics.

2/9/2015 By Dr. Mirbek Nyshanbaev

Pharmacotherapy (drug therapy, medication treatment ) is the application

of drugs in the prevention treatment or

diagnosis of diseases and their use in the

purposeful alteration of normal function.


The studying of all aspects of drug influence on human body


Tasks of clinical pharmacology

• The study of clinical pharmacokinetics

• The study of clinical pharmacodynamics

• The study of drug interactions

• The study of adverse and toxic effects of

drugs

• Monitoring of efficacy and safety of drug

treatment

• Formulating of good recommendations to

drug therapy for rational drug use2/9/2015 By Dr. Mirbek Nyshanbaev

General principles of drug therapy

• Safety – providing the benefit exceeding than risk

• Rationality – optimal ratio of benefit/risk

• Minimizing – use of minimal numbers of drugs and minimally effective duration of drug therapy, excluding of polypharmacy

• Monitoring of efficacy and safety of drug therapy

• Individualizing – accounting of pharmacologic properties of drugs depending on patients individual peculiarities and clinical characteristics of disease


Rational use of drugs

The rational use of drugs requires that:

–patients receive medications appropriate to their clinical needs,

– in doses that meet their own individual requirements

–for an adequate period of time, and

–at the lowest cost to them and their community.

WHO conference of experts, Nairobi 1985


• Rational use of drugs should ensure:• correct drug

• appropriate indication

• appropriate drug considering efficacy, safety, suitability for the patient, and cost

• appropriate dosage, administration, duration

• no contraindications

• correct dispensing, including appropriate information for patients

• patient adherence to treatment


IMPACT OF IRRATIONAL PRESCRIBING

• Delay in cure

• More adverse effects

• Prolonged hospitalization

• Emergence of antimicrobial resistance

• Loss of patient’s confidence in the doctor

• Loss to the patient/community

• Lowering of health standards


Prescription: Types of Irrational Drug Use

• Under-prescribing

• Incorrect prescribing

• Extravagant prescribing

• Over-prescribing

• Multiple prescribing


HOW TO CHOOSE A DRUG ?

• Ask the following sequence of questions before writing the prescription

• Is the drug therapy Indicated ?!!

• Which drug?

• Which class---which group----which particular drug

• Which route?

• Which formulation?

• What dosage regimen?


Good prescribing (rational drug use) is to give:

• Right drug in the right dose

• In the right formulation

• At the right frequency

• For the right duration


P-Drug Concept


• WHO has produced a Guide for Good Prescribing - a problem-based method

• Developed by Groningen University in collaboration with 15 WHO offices and professionals from 30 countries

• Widely translated and available on the WHO medicines website


P-Drug Concept (Personal drugs)

• P-drugs are the drugs you have chosen to prescribe regularly,

• With whom you have become familiar.

• They are your drugs of choice for given indications

• Choosing and using only 50-60 drugs only among 1000s


ADVANTAGES OF USING P DRUGS

• More convenient

• More confidence

• Can be able to master easily

• Drug effects predictable

• Less chances of unexpected adverse effects and drug interactions

• Less complications


ADVANTAGES OF USING P DRUGS

• Possibility of adopting to rational drug use

• Less burden on the physicians

• Health care delivery is easy

• Health care management is simple

• Less health care costs


A P-drug is a drug that is ready for action!


• Step i : Define the diagnosis

• Step ii : Specify the therapeutic objective

• Step iii : Make an inventory of effective groups of drugs

• Step iv : Choose an effective group according to criteria: efficacy, safety, suitability and cost

• Step v : Choose a P-drug

• Step vi : Give information, instruction and warning about drug (effects of the drug, side effects, instruction and warning)

• Step vii: Monitor and stop the treatment2/9/2015 By Dr. Mirbek Nyshanbaev

• Efficacy is based on pharmacodynamics and pharmacokinetics

• Safety – the risk of side effects and overdosage of drugs

• Suitability: The comorbidities, drug interactions, easy to handle, physiologic conditions

• Cost of drug


Most of the illness respond to simple, inexpensive drugs

Physician should avoid :

Use of expensive drugs.

Use of drugs in nonspecific conditions (e.g., use of vitamins).

Use of not required forms (e.g. injection in place of capsules, syrup in place of tablets)


Introduction to clinical pharmacology (RUD)

Health & Medicine

Transcript of Introduction to clinical pharmacology (RUD)