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September 1990, Volume 40, Issue 9

Letter to the Editor


Nighat Murad Khan  ( Department of Pharmacology, Faculty of Health Sciences, The Aga Khan University, Karachi. )


At the time when the number of powerful and toxic drugs is increasing, the rational drug therapy is becoming more important than ever. While medicine has long accepted a systematic approach to diagnosis, the notion that course of the therapy is a routine which follows easily from the diagnosis, has recently been questioned. The relative neglect has been shown in the past. Clinical application of basic pharmacology in medical curricula for undergraduates and postgraduates is now getting heightened attention1. Educators are now realizing that therapeutics can be and must be approached with diligence2. The medical students should receive some formal instruction in clinical pharmacology, so that they can identify certain “core” principles of clinical pharmacol­og9. General principles of clinical pharmacology can be identified as drug-drug interaction, drug therapy in renal and hepatic insufficiency, pregnancy, nursing mother and infant, drug usage in geriatric medicine, management of overdosed and intoxicated patients etc. Alongwith learning core principles, the student must learn skills, such as finding appropriate texts, reading scientific papers, searching the literature for recent primary clinical studies and solving pharmacokinetics problems. These skills are necessary not only to practice therapeutics now, but also enable the students to modify his/her therapeutic approach as new drugs are intro­duced4. Teaching clinical pharmacology, embodies. an attempt to integrate the knowledge of basic pharmacology with an understanding of diseases, in order to develop a maximally effective and minimally toxic therapy. As the drug armamentarium is becoming increasing­ly larger, each year it becomes increasingly difficult to teach the students how to use all individual drugs in a manner that optimises efficacy and minimises toxicity. Rather students must learn an approach for additional thug therapy that is valid for the future drug used in all specialities and subspecialities5 It is clear that no course is long enough to teach all of therapeutics. Even if that could be done the information would soon become outdated as new drugs replace the old ones. Clinical pharmacology has brought two broad themes into mainstreams of medicine today, the reliance on scientific data to make rational therapeutic decisions and the attempts to individualise drug therapy. Both of these are ideally translated into the practice of medicine.

Night Murad Khan
Department of Pharmacology, Faculty of Health Sciences, The Aga Khan University, Karachi.


1. Report of a WHO Group study, Clinical Pharmacology, Scope, organisation, training. W.H.O. Tech. Rep. Ser., 1970; 446: 5.
2. Task Force on Clinical Pharmacology Certification; notes of the American Society for Clinical Pharmacology and Therapeutics. Clin. Pharmacol. Ther., 1980; 27: 708.
3. Breckenridge, A. M. Assessment of new drugs; a clinical pharmacologist’s view. Br. Med. J., 1980; 280: 1303.
4. Melmon, K.L. and Morrelli, H.F. The need to test the efficacy of the instructional aspects of clinical pharmacology. Clin. Pharmacol. Ther., 1969; 10 : 431.
5. Peck, C. C. and Halkin, H. Therapeutic decison-making for second-year medical students. J. Med. Educ., 1981 ; 56: 1024.

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