Clinical pharmacology
Article Abstract:
Clinical pharmacology concerns itself with the scientific assessment of the properties of drugs and the clinical effect of drugs in the human body. One of the primary goals of this field is to determine why different people respond differently to the same drug. This knowledge has direct clinical applications, since it may provide a means by which drug therapy can be tailored to the needs of the individual patient. One recent example is the discovered of an abnormality in the metabolism associated with the drug debrisoquin. This drug is used to test the pathways that metabolize several antidepressant drugs, including desipramine, imipramine, nortriptyline, and amitriptyline. About 7 percent of the population have a defect in an enzyme that metabolizes these drugs. If such a patient is given one of these antidepressants, a normal dose may result toxic drug levels in the blood because the drug is not being broken down fast enough. However, enzymes do not always act to breakdown or neutralize a drug. In some cases, enzymes are required to activate a drug. Codeine is a good example of this. Codeine is converted into morphine within the liver, and it is this morphine, not the codeine, which is responsible for the painkilling effects. Therefore, patients deficient in the same enzyme that prevents the breakdown of the antidepressant drugs receive no painkilling effect from codeine because their bodies cannot metabolically convert it to morphine. Eosinophilia-myalgia syndrome, associated with tryptophan ingestion, was recently linked with a contaminant that entered the product during manufacturing. In addition, there were 74 product recalls last year of drugs that did not meet manufacturing standards, indicating that vigilance can never be relaxed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Clinical pharmacology
Article Abstract:
Recent pharmacological research and directions for future research are discussed. Pharmacology is the study of the development, use and action of drugs. The interaction between drugs and a patient's metabolism determines which patients are at risk for developing potentially serious side effects. An enzyme known as cytochrome P450IID6 seems to play an important role in the metabolism of a number of commonly prescribed drugs. Studies that evaluate the efficacy of drugs tend to be hindered by their small sample size. The technique of meta-analysis, in which the results of several studies are taken together and statistically analyzed, provides additional information but has its own methodological biases. Epidemiological techniques have recently been used to evaluate drugs to aid in weight loss and the control of aplastic anemia and agranulocytosis.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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Clinical pharmacology
Article Abstract:
The Cardiac Arrhythmia Suppression Trial found that suppression of asymptomatic ventricular premature heart beats using antiarrhythmic drugs can be harmful and has no clinical benefit, which contradicts the belief that this action would extend life. For patients with asymptomatic HIV infection, early treatment using zidovudine therapy does not slow the progression to AIDS, although the CD4 cell count declines more slowly. Patients may react to drugs differently, depending on their genes. Because of genetic defects that affect metabolism, some people do not metabolize certain drugs and therefore do not derive the benefit. For example, people lacking the CYP2D6 enzyme could not benefit from codeine.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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