Clinical pharmacology studies the effects and uses of drugs in humans, including their therapeutic effects, safety, and how the body processes them. It aims to ensure rational and optimal drug use by evaluating drugs' efficacy, safety, appropriate dosage, and monitoring treatment outcomes. Choosing drugs based on clinical needs, costs, and minimizing use is important to avoid issues like delayed treatment, unnecessary side effects, and developing antimicrobial resistance. Selecting a limited set of well-understood "P-drugs" can help providers give more effective care while reducing complications.

2. Clinical pharmacology - the science that
studies the characteristics, effects, properties,
reactions and uses of drugs—especially their
therapeutic effect in humans—including
toxicology, safety, pharmacodynamics and
pharmacokinetics.
2/9/2015 By Dr. Mirbek Nyshanbaev

3. Pharmacotherapy (drug therapy,
medication treatment ) is the application
of drugs in the prevention treatment or
diagnosis of diseases and their use in the
purposeful alteration of normal function.
2/9/2015 By Dr. Mirbek Nyshanbaev

4. The studying of all aspects of drug influence
on human body
2/9/2015 By Dr. Mirbek Nyshanbaev

5. Tasks of clinical pharmacology
• The study of clinical pharmacokinetics
• The study of clinical pharmacodynamics
• The study of drug interactions
• The study of adverse and toxic effects of
drugs
• Monitoring of efficacy and safety of drug
treatment
• Formulating of good recommendations to
drug therapy for rational drug use
2/9/2015 By Dr. Mirbek Nyshanbaev

6. General principles of drug therapy
• Safety – providing the benefit exceeding than risk
• Rationality – optimal ratio of benefit/risk
• Minimizing – use of minimal numbers of drugs
and minimally effective duration of drug therapy,
excluding of polypharmacy
• Monitoring of efficacy and safety of drug
therapy
• Individualizing – accounting of pharmacologic
properties of drugs depending on patients
individual peculiarities and clinical characteristics
of disease2/9/2015 By Dr. Mirbek Nyshanbaev

7. Rational use of drugs
The rational use of drugs requires that:
–patients receive medications
appropriate to their clinical needs,
–in doses that meet their own
individual requirements
–for an adequate period of time, and
–at the lowest cost to them and their
community.
WHO conference of experts, Nairobi 1985
2/9/2015 By Dr. Mirbek Nyshanbaev

8. • Rational use of drugs should ensure:
• correct drug
• appropriate indication
• appropriate drug considering efficacy, safety, suitability
for the patient, and cost
• appropriate dosage, administration, duration
• no contraindications
• correct dispensing, including appropriate information
for patients
• patient adherence to treatment
2/9/2015 By Dr. Mirbek Nyshanbaev

9. IMPACT OF IRRATIONAL PRESCRIBING
• Delay in cure
• More adverse effects
• Prolonged hospitalization
• Emergence of antimicrobial resistance
• Loss of patient’s confidence in the doctor
• Loss to the patient/community
• Lowering of health standards
2/9/2015 By Dr. Mirbek Nyshanbaev

10. Prescription: Types of Irrational Drug
Use
• Under-prescribing
• Incorrect prescribing
• Extravagant prescribing
• Over-prescribing
• Multiple prescribing
2/9/2015 By Dr. Mirbek Nyshanbaev

11. HOW TO CHOOSE A DRUG ?
• Ask the following sequence of questions before
writing the prescription
• Is the drug therapy Indicated ?!!
• Which drug?
• Which class---which group----which particular
drug
• Which route?
• Which formulation?
• What dosage regimen?
2/9/2015 By Dr. Mirbek Nyshanbaev

12. Good prescribing (rational drug use) is to give:
• Right drug in the right dose
• In the right formulation
• At the right frequency
• For the right duration
2/9/2015 By Dr. Mirbek Nyshanbaev

13. P-Drug Concept
2/9/2015 By Dr. Mirbek Nyshanbaev

14. • WHO has produced a Guide
for Good Prescribing - a
problem-based method
• Developed by Groningen
University in collaboration
with 15 WHO offices and
professionals from 30
countries
• Widely translated and
available on the WHO
medicines website
2/9/2015 By Dr. Mirbek Nyshanbaev

15. P-Drug Concept (Personal drugs)
• P-drugs are the drugs you have chosen to
prescribe regularly,
• With whom you have become familiar.
• They are your drugs of choice for given
indications
• Choosing and using only 50-60 drugs only
among 1000s
2/9/2015 By Dr. Mirbek Nyshanbaev

16. ADVANTAGES OF USING P DRUGS
• More convenient
• More confidence
• Can be able to master easily
• Drug effects predictable
• Less chances of unexpected adverse effects
and drug interactions
• Less complications
2/9/2015 By Dr. Mirbek Nyshanbaev

17. ADVANTAGES OF USING P DRUGS
• Possibility of adopting to rational drug use
• Less burden on the physicians
• Health care delivery is easy
• Health care management is simple
• Less health care costs
2/9/2015 By Dr. Mirbek Nyshanbaev

18. A P-drug is a drug that
is ready for action!
2/9/2015 By Dr. Mirbek Nyshanbaev

19. • Step i : Define the diagnosis
• Step ii : Specify the therapeutic objective
• Step iii : Make an inventory of effective groups of
drugs
• Step iv : Choose an effective group according to
criteria: efficacy, safety, suitability and cost
• Step v : Choose a P-drug
• Step vi : Give information, instruction and warning
about drug (effects of the drug, side effects,
instruction and warning)
• Step vii: Monitor and stop the treatment
2/9/2015 By Dr. Mirbek Nyshanbaev

20. • Efficacy is based on pharmacodynamics and
pharmacokinetics
• Safety – the risk of side effects and
overdosage of drugs
• Suitability: The comorbidities, drug
interactions, easy to handle, physiologic
conditions
• Cost of drug
2/9/2015 By Dr. Mirbek Nyshanbaev

21. Most of the illness respond to simple, inexpensive
drugs
Physician should avoid :
 Use of expensive drugs.
Use of drugs in nonspecific conditions (e.g., use
of vitamins).
 Use of not required forms (e.g. injection in place
of capsules, syrup in place of tablets)
2/9/2015 By Dr. Mirbek Nyshanbaev

22. 2/9/2015 By Dr. Mirbek Nyshanbaev