The document discusses the process of clinical drug design and development. It begins by defining drugs and their targets in the body. It then outlines the various phases of clinical trials that drugs must undergo to test their safety and efficacy before regulatory approval. These phases progress from small healthy volunteer groups to large patient populations. The document also discusses strategies for drug design such as targeting specific sites in the body and computer-aided approaches. Quality by design principles are highlighted as important to developing products that meet clinical performance standards.
This In-house presentation was given as part of MSc. Clinical Research and consist only the Design and Conduct of BA/BE Studies of CDSCO Guideline. (INDIA)
This In-house presentation was given as part of MSc. Clinical Research and consist only the Design and Conduct of BA/BE Studies of CDSCO Guideline. (INDIA)
Significance of BA/BE studies in drug research and evaluation of different as...inemet
PharmaCon2007 Congress, Dubrovnik, Croatia "New Technologies and Trends in Pharmacy, Pharmaceutical Industry and Education" http://www.pharmacon2007.com
Abstract is available at http://www.pharmaconnectme.com
Young pharmaceutical scientists are and can get involved in all aspects of new drug discovery and development. They have to be appropriately qualified, trained and experienced though,
Bioavailability and Bioequivalence StudiesPranav Sopory
BA and BE studies.
Seminar presented in All India Institute of Medical Sciences (AIIMS - New Delhi).
Focus in Pharmacokinetic parameters (Cmax, AUC)
Single dose PK study, Steady state PK study, Modified drug release PK study, In vivo mechanisms, invitro mechanisms, Pharmacodynamic Study, Comparatice Clinical Trials. Biowavers and Biosimilimars.
Reference: CDSCO guideline, USFDA guideline, ICH guidelines
Significance of BA/BE studies in drug research and evaluation of different as...inemet
PharmaCon2007 Congress, Dubrovnik, Croatia "New Technologies and Trends in Pharmacy, Pharmaceutical Industry and Education" http://www.pharmacon2007.com
Abstract is available at http://www.pharmaconnectme.com
Young pharmaceutical scientists are and can get involved in all aspects of new drug discovery and development. They have to be appropriately qualified, trained and experienced though,
Bioavailability and Bioequivalence StudiesPranav Sopory
BA and BE studies.
Seminar presented in All India Institute of Medical Sciences (AIIMS - New Delhi).
Focus in Pharmacokinetic parameters (Cmax, AUC)
Single dose PK study, Steady state PK study, Modified drug release PK study, In vivo mechanisms, invitro mechanisms, Pharmacodynamic Study, Comparatice Clinical Trials. Biowavers and Biosimilimars.
Reference: CDSCO guideline, USFDA guideline, ICH guidelines
a beautiful ppt, illustrating the principles for prescribing, current concepts for clinical decision making, for practicing medicine and health care planning worldwide...
Historia cosmética- maquillaje ahora y luegoPandora Garcia
Con la introducción de tantos nuevos productos sorprendentes en el mundo de los cosméticos, usted pensará que estos maquillaje y otros productos de belleza fueron descubiertos en este momento.
Definition and scope of Pharmacoepidemiology ABUBAKRANSARI2
In these slides I shared the information of definition and scope of pharmacoepidemiology. Types of studies - cohort studies, cross-sectional studies etc.
MAYBE WE ALL DON'T EVEN KNOW WHAT "CLINICAL TRIAL" ACTUALLY MEANS...
I THINK THIS SLIDES WILL HELP YOU TO KNOW...
PLEASE LIKE AND FOLLOW IF OUR WORK HAVE ANSWERED YOUR QUESTIONS...
THANK YOU;)
Reasons for conducting clinical trialsJohn Douglas
To explain in simple terms, a clinical trail is a research in human volunteers to answer certain health questions. Carefully conducted clinical trails are the quickest and safest way to discover new treatment
methods that work in people and enhance their health.
Biomarkers in Clinical Trials: Enhancing Drug DevelopmentClinosolIndia
Biomarkers play a crucial role in enhancing drug development by providing objective, measurable indicators of biological processes, disease progression, and treatment effects. These indicators can help researchers and pharmaceutical companies make informed decisions at various stages of clinical trials, leading to more efficient and successful drug development. Here's how biomarkers contribute to enhancing drug development in clinical trials:
Adapting Clinical Trials During a Global Pandemic: Lessons LearnedClinosolIndia
The COVID-19 pandemic has had a significant impact on clinical trials worldwide, requiring rapid adaptations to ensure patient safety, data integrity, and the continuity of research efforts. Several key lessons have been learned during this challenging time:
Flexibility and Adaptability: The pandemic highlighted the importance of flexibility in clinical trial design and operations. Researchers and regulatory bodies had to quickly adapt protocols to accommodate remote visits, decentralized approaches, and virtual assessments. Being able to modify protocols and implement alternative strategies allowed trials to continue while minimizing disruptions.
Remote Monitoring and Data Collection: Remote monitoring and data collection became crucial during the pandemic to ensure patient safety and collect data without in-person visits. Technologies such as wearable devices, telemedicine platforms, and electronic patient-reported outcomes (ePROs) played a significant role in enabling remote data collection and reducing the need for site visits.
Patient-Centric Approaches: The pandemic emphasized the importance of considering patients' needs and preferences. Remote visits, home healthcare services, and decentralized trial models were implemented to reduce the burden on patients and ensure their safety. Patient engagement and education became even more critical to maintain participation and retention in trials.
Regulatory Flexibility: Regulatory agencies recognized the need for flexibility during the pandemic and implemented measures to expedite trial approvals and amendments. They provided guidance on remote monitoring, virtual visits, and other alternative approaches, allowing researchers to adapt quickly while ensuring patient safety and data integrity.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
1. Clinical Drug Design
Prof. Dr. Basavaraj K. Nanjwade M. Pharm., PhD
Department of Pharmacy Practice,
The Oxford College of Pharmacy,
Bengaluru-560068, Karnataka, India.
E-mail: nanjwadebk@gmail.com
15/08/2016 1ICIP-2016, IIUM Kuantan, Pahang, Malaysia.
2. What is Drug
• Drugs are chemical or biological substances that have some kind
of physiological or biochemical effect on our bodies.
• They may be single compounds or a mixture of different
compounds.
• Their effects are intended to be beneficial but can cause harmful side
effects in some people.
• All drugs interact with specific ‘targets’ in the body, with the aim of
modifying their activity and often resulting in a therapeutic effect.
• Drug targets are usually proteins but are in some cases small regions
of DNAor RNA.
• Drugs work either by stimulating or blocking the activity of their
targets.
15/08/2016 ICIP-2016, IIUM Kuantan, Pahang, Malaysia. 2
4. Drug Design
• Drug design is the approach of finding drugs by
design, based on their biological targets.
• Typically a drug target is a key molecule involved in
a particular metabolic or signaling pathway
• Other approaches may be to enhance the normal
pathway by promoting specific molecules in the
normal pathways that may have been affected in the
diseases state.
15/08/2016 ICIP-2016, IIUM Kuantan, Pahang, Malaysia. 4
6. Drug Design
• Enzymatic physicochemical-based (e.g., brain-
targeting) CDSs: exploit site-specific traffic
properties by sequential metabolic conversions that
result in considerably altered properties
• Site-specific enzyme-activated (e.g., eye-targeting)
CDSs: exploit specific enzymes found primarily,
exclusively, or at higher activity at the site of action
• Receptor-based transient anchor-type (e.g., lung-
targeting) CDSs: provide enhanced selectivity and
activity through transient, reversible binding at the
receptor
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8. Advances in Drug Design
• Computer aided based drug design
• Chemistry based drug design (Property-based drug
design)
• Ligand based drug design
• Bioinformatics based drug design
• In Silica based drug design
• Structured based drug design
• Pharmaceutics/Biopharmaceutics based drug design
• Clinical Based Drug Design
15/08/2016 8ICIP-2016, IIUM Kuantan, Pahang, Malaysia.
9. Pharmacokinetics
• Drug design strategies used to optimise binding site
interactions of modified lead compounds were described
earlier.
• A compound with good binding site interactions may not be
able to overcome the obstacles interfering with the
compound’s ability to reach the target.
• A compound with optimised binding site interactions may be
susceptible to enzymatic degradation.
• Most drugs in clinical use are orally administered.
• Methods used to improve drug absorption, distribution, site-
specificity, and metabolic stability must be used alongside
strategies used to improve binding site interactions.
15/08/2016 ICIP-2016, IIUM Kuantan, Pahang, Malaysia. 9
11. Drug Design for Oral Route
• Log P is less than +5
• Molecular mass is less than 500 Da
• Hydrogen bond acceptors must not be greater than
10
• Hydrogen bond donors must not be greater than 5
15/08/2016 ICIP-2016, IIUM Kuantan, Pahang, Malaysia. 11
13. Phase I Clinical Trial
(INITIAL SAFETY TESTING IN A SMALL GROUP OF HEALTHY VOLUNTEERS )
• In Phase I trials the candidate drug is tested in people for the first
time.
• These studies are usually conducted with a small number of healthy
volunteers, generally 100 or less.
• The main goal of a Phase I trial is to assess the safety of the
medicine when used in humans.
• Researchers look at the pharmacokinetics of a drug: How is it
absorbed?
• How is it metabolized and eliminated from the body?
• They also study the drug’s pharmacodynamics: Does it cause side
effects?
• These closely monitored trials are designed to help researchers
determine what the safe dosing range is and if the candidate
medicine should move on to the next stage of development.
02/06/2016 13CDD-2016, Phuket, Thailand.
14. Phase I
• Patients: 20 to 100 healthy volunteers or people with
the disease/condition.
• Length of Study: Several months
• Purpose: Safety and dosage
• Percentage of Drugs that Move to the next Phase
70%
02/06/2016 14CDD-2016, Phuket, Thailand.
15. Study Types Included
• Safety & Tolerability studies (Single/ multiple dose in
patients or healthy volunteers)
• Oncology studies in patients with tolerability / MTD
as primary endpoint (efficacy might be a secondary
endpoint)
• Drug-Drug interaction & Food Effect
• PK in renal or hepatic impaired patients
02/06/2016 CDD-2016, Phuket, Thailand. 15
16. Phase II Clinical Trial
(ASSESS SAFETY AND EFFICACY IN A SMALL GROUP OF PATIENTS)
• In Phase II trials researchers evaluate the candidate
drug’s effectiveness in 100 to 500 patient volunteers
with the disease or condition under study.
• Researchers also analyze optimal dose strength and
schedules for using the drug and examine the possible
short-term side effects (adverse events) and risks
associated with the drug.
• If the drug continues to show promise, they prepare
for the much larger Phase III trials.
02/06/2016 16CDD-2016, Phuket, Thailand.
17. Phase II
• Phase IIA: Exploratory (non-pivotal) study that has
clinical efficacy, Pharmacodynamics or biological
activity as primary endpoint, conducted in patients or
healthy volunteers.
• Phase IIB: Definite dose range finding study in
patients with efficacy as primary endpoint.
02/06/2016 CDD-2016, Phuket, Thailand. 17
18. Phase II
• Patients: Up to several hundred people with the
disease/condition.
• Length of Study: Several months to 2 years
• Purpose: Efficacy and side effects
• Percentage of Drugs that Move to the Next Phase
33%
02/06/2016 18CDD-2016, Phuket, Thailand.
19. Study Type Included
• Proof of concept, efficacy, or mechanism
• Mechanistic studies
• Dose range exploration
• Pilot studies
• Definite dose finding studies
• Extension studies of Phase IIB studies
02/06/2016 CDD-2016, Phuket, Thailand. 19
20. Phase III Clinical Trial
(DEMONSTRATE SAFETY AND EFFICACY IN A LARGE GROUP OF PATIENTS)
• Phase III trials generate statistically significant data about
the safety, efficacy and the overall benefit-risk
relationship of the investigational medicine.
• Phase III trials may enroll 1,000 to 5,000 patients or more
across numerous clinical trials sites around the world.
• This phase of research is essential in determining whether
the drug is safe and effective.
• It also provides the basis for labeling instructions to help
ensure proper use of the drug (e.g., information on
potential interactions with other medicines, specific
dosing instructions, etc.)
02/06/2016 20CDD-2016, Phuket, Thailand.
21. Phase III
• Patients: 100 to 5000 volunteers who have the
disease or condition
• Length of Study: 1 to 4 years
• Purpose: Efficacy and monitoring of adverse
reactions
• Percentage of Drugs that Move to the Next Phase
25-30%
02/06/2016 21CDD-2016, Phuket, Thailand.
22. Phase III
• Phase IIIA: A Pivotal study that is a trial designed &
executed to get statistically significant evidence of
efficacy and safety as required NDA/ sNDA approval. It
also provides the basis for labeling instructions to help
ensure proper use of the drug (e.g., information on
potential interactions with other medicines, specific
dosing instructions, etc.)
• Phase IIIB: A study started prior to approval and whose
primary intention is support of publications rather than
registration or label changes. The results are not intended
to be included in the submission dossier.
02/06/2016 CDD-2016, Phuket, Thailand. 22
23. Study Time Included
• Pivotal studies (vs placebo/comparator)
• Long term safety studies for registration
• Local registration studies
• Post marketing study commitments
• Phase IIIA extension studies
• Studies intended to support publication, claims or
to prepare launch, which start before approval but
are not intended for Regulatory submissions
02/06/2016 CDD-2016, Phuket, Thailand. 23
24. Phase IV
• Phase IV: A study started after approval with primary
intention to support publications rather than
registration or label changes.
• The results are not intended to be included in a
submission dossier.
02/06/2016 CDD-2016, Phuket, Thailand. 24
25. Phase IV Clinical Trial
• Patients: Several thousand volunteers who have the
disease/condition
• Purpose: Safety and efficacy
02/06/2016 25CDD-2016, Phuket, Thailand.
27. Quality by Design (QbD)
• QbD became the answer to assisting both the industry
and FDA to move toward a more scientific, risk-
based, holistic and proactive approach to
pharmaceutical development.
• In the QbD paradigm, a product is designed so that it
will meet its desired clinical performance.
15/08/2016 ICIP-2016, IIUM Kuantan, Pahang, Malaysia. 27
29. Clinical Design Space
• The concept of clinical design space can be used to
quantify the clinical experience with a product.
• The size of the clinical design space for a given
product will depend on the number of manufactured
lots put in the clinic.
• The clinical design space should be given
consideration, patient safety should not be
jeopardized.
15/08/2016 ICIP-2016, IIUM Kuantan, Pahang, Malaysia. 29