Introduction to clinical pharmacology

Introduction to clinical pharmacology

Clinical pharmacology encompasses all aspects of the relationship between drugs and humans. For healthcare professionals, clinical pharmacology is important because it is the scientific discipline that underpins the rational prescribing of medicines to alleviate symptoms, treat illness and prevent future disease. Medicines contain drugs (the specific chemical substances with pharmacological effects), either alone or in combination, in a formulation mixed with other ingredients. The beneficial effects of medicines must be weighed against potential adverse drug reactions and interactions, often caused by injudicious prescribing decisions and by prescribing errors, and their cost.

CPT-01-01-01 What is clinical pharmacology? from Simon Maxwell on Vimeo.

CPT-01-01-02 What topics are embraced by CPT? from Simon Maxwell on Vimeo.

CPT-01-01-03 Why is CPT important to medical students? from Simon Maxwell on Vimeo.

CPT-01-01-04 What is extent of medicines use? from Simon Maxwell on Vimeo.

CPT-01-01-05 What are challenges for prescribers? from Simon Maxwell on Vimeo.

CPT-01-01-00 How should you organise your CPT learning? from Simon Maxwell on Vimeo.

Geriatric clinical pharmacology

The world’s population is ageing and this means that growing numbers of patients are living with multiple morbidities. Thus, prescribers face the challanges of dealing with multi-morbidity and the polypharmacy of the drugs used to manage complex patient needs, and at the same time be aware of the impact of ageing on pharmacokinetics and pharmacodynamics.

We have included this topic in the 'Introduction to clinical pharmacology' module as it impinges on a number of the subsequent modules.

The Clinical Division of IUPHAR (International Union of Basic and Clinical Pharmacology) has produced a comprehensive model geriatric pharmacology curriculum for medical education that is applicable internationally.

The suggested curriculum identifies eight key areas where the effects of ageing have impact clinical pharmacology, and which should be considered independently of (and/or in addtion to) general clinical pharmacology:

(1) biology, physiology and pathophysiology i.e. how altered physiology and pathophysiology in ageing affect pharmacokinetics and pharmacodynamics

(2) principles of geriatric clinical pharmacology i.e. application of the understanding of altered pharmacokinetics and pharmacodynamics to prescribing for older patients

(3) communication i.e. considerations for effective communication when prescribing for older people

(4) quality use of medicines i.e. providing appropriate prescribing for older patients

(5) individualization of therapy and pharmacogenomics

(6) polypharmacy i.e. understanding the risk factors for polypharmacy in older patients, managing the risks, and minimising polypharmacy (e.g. by deprescribing where appropriate)

(7) adverse drug events, adverse drug reactions, medication errors and drug interactions i.e. understanding the prevalence, aetiology, diagnosis, management and implications of adverse drug events and drug interactions in older patients

(8) drug development, evaluation and regulation i.e. being cognisant of the impact of ageing on clinical pharmacology at all stages during the drug development process.

Link to an article published in the journal Pharmacological Research in 2019. In this paper, Kashyap et al. provide a comprehensive teaching curriculum that covers the field of geriatric clinical pharmacology, a topic that is often taught fleetingly in medical school programmes.

This article is intended for use by medical students, medical graduates and other health care professionals that are involved in prescribing to geriatric patients.

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