Clinical pharmacology and therapeutics

The aim of this study was to investigate the potential impact of obesity on patients’ clinical outcome and response to the usual post orthopaedic surgery thromboprophylaxis enoxaparin or aspirin. Additionally, the participants perceived barrier(s) to adherence to the prescribed prophylaxis were explored.

224p runthenight04 02-02-2023 2 1   Download

Harrison's Internal Medicine Chapter 5. Principles of Clinical Pharmacology Principles of Clinical Pharmacology: Introduction Drugs are the cornerstone of modern therapeutics. Nevertheless, it is well recognized among physicians and among the lay community that the outcome of drug therapy varies widely among individuals. While this variability has been perceived as an unpredictable, and therefore inevitable, accompaniment of drug therapy, this is not the case.

5p tubreakdance 26-11-2010 106 8   Download

Anyone who administers drugs acting on cardiovascular adrenergic mechanisms requires an understanding of how they act in order to use them to the best advantage and with safety. Adrenergic mechanisms Classification of sympathomimetics: by mode of action and selectivity for adrenoceptors Individual sympathomimetics Mucosal decongestants Shock Chronic orthostatic hypotension Adrenaline, noradrenaline and dopamine are formed in the body and are used in therapeutics. The natural synthetic path is: tyrosine — dopa — dopamine — noradrenaline — adrenaline.

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Background Definitions Causation: degrees of certainty Pharmacovigilance and pharmacoepidemiology Classification Causes Allergy in response to drugs Effects of prolonged administration: chronic organ toxicity Adverse effects on reproduction Background Cur'd yesterday of my disease I died last night of my physician.1 Nature is neutral, i.e. it has no 'intentions' towards humans, though it is often unfavourable to them.

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We must be daring and search after Truth; even if we do not succeed in finding her, we shall at least come closer than we are at present (Galen AD 130-200) SYNOPSIS (CONTINUED) Surveillance studies and the reporting of spontaneous adverse reactions respectively determine the clinical profile of the drug and detect rare adverse events. Further trials to compare new medicines with existing medicines are also required.These form the basis of cost-effectiveness comparisons.

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Preclinical drug development. Discovery of new drugs in the laboratory is an exercise in prediction • Techniques of discovery. Sophisticated molecular modelling allows precise design of potential new therapeutic substances and new technologies have increased the rate of development of potential medicines. Studies in animals and in humans Prediction. Failures of prediction occur and a drug may be abandoned at any stage, including after marketing. New drug development is a colossally expensive and commercially driven activity. ...

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Clinical pharmacology comprises all aspects of the scientific study of drugs in man. Its objective is to optimise drug therapy and it is justified in so far as it is of practical use. Over recent years pharmacology has undergone great expansion resulting from technology that allows the understanding of molecular action and the capacity to exploit this. The potential consequences for therapeutics are enormous. All cellular mechanisms (normal and pathological), in their immense complexity are, in principle, identifiable.

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PRESCRIBING, CONSUMPTION AND ECONOMICS Prescribing, consumption and economics The reasons for taking a drug history from patients are: • Drugs are a cause of disease. Withdrawal of drugs, if abrupt, can cause disease, e.g. benzodiazepines, antiepilepsy drugs. • Drugs can conceal disease, e.g. adrenal steroid. • Drugs can interact causing positive adverse effect, or negative adverse effect, i.e. therapeutic failure. • Drugs can give diagnostic clues, e.g. ampicillin and amoxicillin causing rash in infectious mononucleosis — a diagnostic adverse effect, not a diagnostic test.

13p bigbaby87 03-09-2010 140 26   Download