Editorial

Role of Clinical Pharmacologist in Healthcare-

Present Scenario

Dr. Farhan Ahmad Khan

involved in the health sector, Clinical Pharmacologist play a Discovery of drugs as a therapeutic agent is one of the pivotal role in improving patient care, directly or indirectly, biggest achievement in the history of medical science. We can by promoting the safer and more effective use of drugs. This see that the mortality and morbidity due to different type of goal is achieved by conducting clinical trials, drug diseases has declined if we compare from the past. This is evaluations, and studies on Pharmacoepidemiology, possible because of the discovery of new drugs. This shows pharmacoeconomics, pharmacogenetics, pharmacovigilance the significance of the knowledge of application of drugs, its and clinical drug toxicology. These type of studies can also be mechanism, its contraindication. Misuse of drugs can lead to traced from the ancient times such as the discovery of drugs drug resistance, e.g in case of antibiotics its irrational use has such as quinine, reserpine and artemisinin, which were first lead to worldwide problem of Antibiotic Resistance. used as herbal medicines.

Therefore, to combat the above drug related problems, a Several Nobel Prize laureates in medicine in the past can be branch of medical science was developed. Clinical considered as representatives of clinical pharmacological pharmacology is the scientific discipline that involves all research such as Sir John Vane, Sir James Black, George aspects of the relationship between drugs and humans. Harry Hitchings, Gertrude Elion and Arvid Carlsson. They all Gold in the early 1940s at Cornell was the person who first ‘practised’ clinical pharmacology during their efforts to introduced the name clinical pharmacology.[1,2] In addition, introduce new pharmacotherapeutics principles into clinical Paul Martini, professor of medicine in Bonn, published his medicine. monograph in 1932 entitled ‘Methodology of Therapeutic

Investigation’ and he is considered by some as the first clinical Improvements in the health care were made possible because pharmacologist.[3] of the role of clinical Pharmacologists responsible for the

development of new and innovative medicines. Clinical Pharmacology can help variety of professionals including physicians, pharmacists, nurses and scientists in Roles of Clinical Pharmacologists many different disciplines. As different professionals are The endeavour of a Clinical Pharmacologist is to develop Access this article online methods and strategies that improve the quality of drug use in Quick Response Code Website: www.iabcr.org individual patients and patient populations. In the first WHO report on clinical pharmacology in 1970,[4] the section on research emphasized the need for studies that explored the Int Arch BioMed Clin Res. mechanisms of action of drugs and identified their 2016 Mar;2(1):1-2 pharmacokinetics in humans.

Clinical drug evaluation and clinical trial Creative Commons CC-BY-NC: This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 License Phases I–III (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial Clinical Pharmacologist are also involved in Phase I-IV use, reproduction and distribution of the work in any medium, provided the original work is properly cited. studies. Clinical pharmacologists have been the pioneers in introducing the RCT and in particular in introducing the For reprints contact: [email protected] placebo as control. RCTs is considered to be the gold standard for documenting the efficacy of drugs.[5]

International Archives of BioMedical and Clinical Research | Jan-Mar 2016 | Vol 2 | Issue 1 1 | P a g e

Editorial

Therapeutic drug monitoring. Therapeutic drug Measures to be taken monitoring is a scientific medical technology where clinical 1. Mandatory set up of Drug and Therapeutic Committee in pharmacology has made major contributions. The the hospitals under the guidance of Clinical Pharmacologists. measurement of drug concentrations in blood or plasma that 2. There should be proper and reliable data for diseases burden will help in recommending targets ranges in plasma at which in a community. The disease burden is a major determinant of there is an optimal therapeutic effect or an increased risk of the amount and type of medicines required by a given ADRs. community, and this, in turn, determines the scale of clinical pharmacology services required to ensure rational use of these Pharmacovigilance or Post-Marketing Surveillance. medicines. Reporting of Adverse drug reactions actions is necessary to 3. Formulation and implementation of the policy for ‘rational know the safety profile of the drug. Clinical Pharmacologists use of medicines’. This is also emphasized in the WHO confirm the ADRs. recommendations that countries must encourage or ensure Drug utilization studies. Clinical pharmacologists play a more appropriate (rational) use of medicines by;[9,10] key role in drug utilization research, which can be defined as establishing a national drug regulatory authority, formulating an eclectic collection of descriptive and analytical methods standard treatment guidelines, selecting an essential and theories for the quantification, understanding and medicines’ list, enforcing continuing medical education, evaluation of the processes of prescribing, dispensing and promoting prescribing audit or accredited standard of health consumption of medicines. care, providing unbiased medical information through medicines information centres and national drug formularies Clinical care. Critical drug evaluation is the cornerstone for Rational Use of Medicine. Critical drug evaluation assists the Prof. (Dr.) Farhan Ahmad Khan MBBS, MD practicing physician in rating the strength of documentation Professor and HOD about efficacy, safety and cost-effectiveness for a specific Department of Pharmacology drug therapy as compared with alternative therapies. Teerthanker Mahaveer Medical College and Research Centre Corresponding Author: Present Scenario Prof. (Dr.) Farhan Ahmad Khan Pharmacologists in our set up are mainly involved in either Professor and HOD teaching or industry. They have not played an active role in Department of Pharmacology Teerthanker Mahaveer Medical College and Research the delivery of patient care. In addition, they have not been Moradabad, India. involved in deciding the national drug policy or in the Email: [email protected] planning of various health programmes. More active and REFERENCES purposeful interaction with clinicians in the daily deliver y of 1. Dollery CT. Clinical pharmacology the first 75 years and a view patient care is required. Therefore, there is not proper of the future. Br J Clin Pharmacol 2006;6:650–5. utilization of Clinical Pharmacologists in our set up. 2. Reidenberg MM. The discipline of clinical pharmacology. Clin Pharmacol Ther 1985;38:2–5.

3. Shelley JH, Baur MP. Paul Martini: the first clinical In 1986, Dr. Satoskar stated in his paper ‘The expanding role pharmacologist? Lancet 1999;353:870–3. of Pharmacologists in the Indian scene, “a pharmacologist can 4. Clinical Pharmacology. Scope, Organisation, Training. Report of contribute a lot, not only by doing research, but also by a WHO Study group. World Health Organ Tech Rep helping the government in formulating the drug policy, in Ser1970;446:5–21. 5. Rawlins MD. De orienting the teaching programmes so as to make the students Testimonio. http://www/rcplondon.ac.uk/pubs/contents/304df931 aware of the social responsibility, and in educating the -2ddc-4a54-894e-e0cdb03e84a5.pdf (last accessed on 10 March community regarding the use and the abuse of drugs so as to 2016). [6] 6. Satoskar RS. The expanding role of pharmacologists in the achieve better health care” Today, the pharmacologist, the changing Indian scene. J Postgrad Med 1986;32:111-4. physician, and the drug industry function independently 7. World Health Organization: World directory of medical schools. without necessary coordination and collaboration. A sound 2010, University of Copenhagen. The AVICENNA directory of knowledge of pharmacology is mandatory for doctors to medicine,http://www.who.int/hrh/wdms/en/, 8. Smith AJ: Unfinished business: clinical pharmacology and world rightly prescribe drugs for any disease. health. Int J Risk Safety Med. 2005, 17: 65-71. 9. World Health Organization: Promoting rational use of medicines: Clinical pharmacology with its emphasis on critical drug Core components. 2002, Geneva: WHO Policy Perspectives on evaluation, scientific methodology, drug development and Medicines,No.5,http://apps.who.int/medicinedocs/pdf/h3011e/ involvement in the work of drug and therapeutics committees h3011e.pdf. 10. World Health Organization: The World Medicines Situation is strategically positioned to bridge the knowledge gap 2011: Rational Use of Medicines. Edited by: Holloway K, van between stakeholders including patients, clinicians, Dijk L. 2011, Geneva: WHO,http://apps.who.int/medicinedocs/ pharmacists, administrators, politicians and pharmaceutical documents/s16874e/s16874e.pdf companies within and outside healthcare institutions.[7,8] How to cite this article: Khan FA. Role of Clinical Pharmacologist in Healthcare-Present Scenario. Int Arch BioMed Clin Res. 2016 Mar;2(1):1-2

Source of Support: Nil, Conflict of Interest: None declared

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