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Clinical pharmacology has been defined as "that discipline that teaches, does research, frames policy, gives information and advice about the actions and proper uses of medicines in humans and implements that knowledge in clinical practice". Clinical Pharmacology is inherently a translational discipline underpinned by the basic science of
pharmacology Pharmacology is a branch of medicine, biology and pharmaceutical sciences concerned with drug or medication action, where a drug may be defined as any artificial, natural, or endogenous (from within the body) molecule which exerts a biochemica ...
, engaged in the experimental and observational study of the disposition and effects of drugs in humans, and committed to the translation of science into evidence-based therapeutics. It has a broad scope, from the discovery of new target
molecules A molecule is a group of two or more atoms held together by attractive forces known as chemical bonds; depending on context, the term may or may not include ions which satisfy this criterion. In quantum physics, organic chemistry, and bio ...
to the effects of drug usage in whole
population Population typically refers to the number of people in a single area, whether it be a city or town, region, country, continent, or the world. Governments typically quantify the size of the resident population within their jurisdiction usi ...
s. The main aim of clinical pharmacology is to generate data for optimum use of drugs and the practice of 'evidence based medicine'. Clinical pharmacologists have
medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
and scientific training that enables them to evaluate
evidence Evidence for a proposition is what supports this proposition. It is usually understood as an indication that the supported proposition is true. What role evidence plays and how it is conceived varies from field to field. In epistemology, evidenc ...
and produce new data through well-designed
studies Study or studies may refer to: General * Education ** Higher education * Clinical trial * Experiment * Observational study * Research * Study skills, abilities and approaches applied to learning Other * Study (art), a drawing or series of d ...
. Clinical pharmacologists must have access to enough patients for clinical care, teaching and education, and research. Their responsibilities to patients include, but are not limited to, detecting and analysing adverse drug effects and reactions, therapeutics, and toxicology including reproductive toxicology, perioperative drug management, and
psychopharmacology Psychopharmacology (from Greek grc, ψῡχή, psȳkhē, breath, life, soul, label=none; grc, φάρμακον, pharmakon, drug, label=none; and grc, -λογία, -logia, label=none) is the scientific study of the effects drugs have on mo ...
. Modern clinical pharmacologists are also trained in data analysis skills. Their approaches to analyse data can include modelling and simulation techniques (e.g. population analysis, non-linear mixed-effects modelling).


Branches

Clinical Pharmacology consists of multiple branches listed below: *
Pharmacodynamics Pharmacodynamics (PD) is the study of the biochemical and physiologic effects of drugs (especially pharmaceutical drugs). The effects can include those manifested within animals (including humans), microorganisms, or combinations of organisms ...
- what drugs do to the body and how. This includes not just the cellular and
molecular A molecule is a group of two or more atoms held together by attractive forces known as chemical bonds; depending on context, the term may or may not include ions which satisfy this criterion. In quantum physics, organic chemistry, and bio ...
aspects, but also more relevant clinical measurements. For example, not just the pharmacological actions of
salbutamol Salbutamol, also known as albuterol and sold under the brand name Ventolin among others, is a medication that opens up the medium and large airways in the lungs. It is a short-acting β2 adrenergic receptor agonist which works by causing rel ...
, a beta2-adrenergic receptor agonist, but the respiratory peak flow rate of both healthy volunteers and patients. *
Pharmacokinetics Pharmacokinetics (from Ancient Greek ''pharmakon'' "drug" and ''kinetikos'' "moving, putting in motion"; see chemical kinetics), sometimes abbreviated as PK, is a branch of pharmacology dedicated to determining the fate of substances administered ...
- what happens to the drug while in the body. This involves the body systems for handling the drug, usually divided into the following classification: **
Absorption Absorption may refer to: Chemistry and biology *Absorption (biology), digestion **Absorption (small intestine) *Absorption (chemistry), diffusion of particles of gas or liquid into liquid or solid materials *Absorption (skin), a route by which s ...
- the processes by which the drug move into the bloodstream from the site of administration (e.g. the gut) **
Distribution Distribution may refer to: Mathematics * Distribution (mathematics), generalized functions used to formulate solutions of partial differential equations *Probability distribution, the probability of a particular value or value range of a vari ...
- the extent to which the drug enters and leaves different tissues of the body **
Metabolism Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run ...
- the processes by which the drug is metabolized in the liver, i.e. transformed into molecules that are usually less pharmacologically active ** Excretion - the processes by which the drug is eliminated from the body, which mostly happens in the liver and kidneys. * Rational Prescribing - using the right medication, in the right dose, using the right route and frequency of administration, and for the right duration of time. *Adverse drug effects - unwanted effects of a medicine that are typically not noticed by the individual (e.g. a reduction in the white cell count or a change in the serum uric acid concentration) *Adverse drug reactions - unwanted effects of the drug that the individual experiences (e.g. a sore throat because of a reduced white cell count or an attack of gout because of an increased serum uric acid concentration) *
Toxicology Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating e ...
- the discipline that deals with the adverse effects of chemicals *
Drug interaction Drug interactions occur when a drug's mechanism of action is disturbed by the concomitant administration of substances such as foods, beverages, or other drugs. The cause is often the inhibition of the specific receptors available to the drug, ...
s - the study of how drugs interact with each other. A drug may negatively or positively affect the effects of another drug; drugs can also interact with other agents, such as foods, alcohol, and devices. *
Drug development Drug development is the process of bringing a new pharmaceutical drug to the market once a lead compound has been identified through the process of drug discovery. It includes preclinical research on microorganisms and animals, filing for re ...
- the processes of bringing a new medicine from its discovery to clinical use, usually culminating in some form of
clinical trials Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dieta ...
and marketing authorization applications to country-specific drug regulators, such as the
US FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food s ...
and the UK's MHRA. * Molecular Pharmacology - the discipine of studying drug actions at the molecular level; it is a branch of pharmacology in general. *
Pharmacogenomics Pharmacogenomics is the study of the role of the genome in drug response. Its name ('' pharmaco-'' + ''genomics'') reflects its combining of pharmacology and genomics. Pharmacogenomics analyzes how the genetic makeup of an individual affects the ...
- the study of the human genome in order to understand the ways in which genetic factors determine the actions of medicines.


History

Medicinal uses of plant and animal resources have been common since prehistoric times. Many countries, such as China, Egypt, and India, have written documentation of many traditional remedies. A few of these remedies are still regarded as helpful today, but most have them have been discarded, because they were ineffective and potentially harmful. For many years, therapeutic practices were based on Hippocratic
humoral theory Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers. Humorism began to fall out of favor in the 1850s ...
, popularized by the Greek physician
Galen Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be o ...
(129 – c. AD 216) and not on experimentation. In around the 17th century physicians started to apply use methods to study traditional remedies, although they still lacked methods to test the hypotheses they had about how drugs worked. By the late 18th century and early 19th century, methods of experimental physiology and pharmacology began to be developed by scientists such as François Magendie and his student Claude Bernard. From the late 18th century to the early 20th century, advances were made in chemistry and physiology that laid the foundations needed to understand how drugs act at the tissue and organ levels. The advances that were made at this time gave manufacturers the ability to make and sell medicines that they claimed to be effective, but were in many cases worthless. There were no methods for evaluating such claims until rational therapeutic concepts were established in medicine, starting at about the end of the 19th century. The development of receptor theory at the start of the 20th century and later developments led to better understanding of how medicines act and the development of many new medicines that are both safe and effective. Expansion of the scientific principles of pharmacology and clinical pharmacology continues today.


See also

* Dormant therapy


References

{{ Reflist


External links


International Union of Basic and Clinical Pharmacology
(IUPHAR)
European Association for Clinical Pharmacology and Therapeutics
(EACPT)
Dutch Society on Clinical Pharmacology and Biopharmaceutics
(NVKF&B)
American Society for Clinical Pharmacology and Therapeutics
(ASCPT)
American College of Clinical Pharmacology
(ACCP)
British Pharmacological Society
(BPS)
Korean Society for Clinical Pharmacology and Therapeutics
(KSCPT)
Japanese Society for Clinical Pharmacology and Therapeutics
(JSCPT) Pharmacology