Pharmacotherapeutics is the study of the therapeutic use and effects of drugs. It deals with drug absorption, distribution, elimination, and action/effects. Pharmacotherapeutics provides information on how drugs act to prevent or eliminate disease based on receptor binding and bioavailability. It is also used as drug therapy after other treatments. Evidence-based medicine and rational drug use are important to pharmacotherapeutics to ensure safety and efficacy. Standard treatment guidelines, essential medicine lists, and drug formularies are tools to promote rational use of medicines.

1. PHARMACOTHERAPUTICS
Prepared by:
Ms. Mokshada.R.Bhirud.

2. Pharmacotherapeutics is the study of the therapeutic use and
effects of drugs.
• Pharmacotherapeutics word derived from the two words, Pharmakon means
‘the drugs’, and therapeutic means ‘diagnosis or treatment of any disease. It is
the branch of pharmacology that deals with drug absorption, drug distribution,
drug elimination, and their action/effects.
• In another word, we can say that it is provided information regarding the drugs
and their action for preventing/eliminating the disease. On the basis of receptor
capability and bioavailability, drugs act on the body and cure the disease.
PHARMACOTHERAPEUTICS

3. • Pharmacotherapy is included as drug therapy to treat the disease after surgical,
radiation, or physical therapy.
• In the modern day, different types of chemicals constituted medicine are available
which show the effect (may be positive or negative), to correct this problem
(according to the demand or patient need) pharmacotherapeutics play a major
role in the Indian system of medicine.
Branches of the Pharmacotherapeutics—
1. Pharmacokinetics—
A. Drug absorption— Initially, when we consume the medicine then it is dissolved
or broken down into smaller or absorbable particles absorbed by the different-
different route according to their solubility and protein/receptor binding capacity.
B. Drug distribution— After the completion of absorption, drugs are distributed to
the effective area through the blood or other connective tissue and finally bind to
the specific receptors and show their action. Distribution is also based on the
solubility and protein/receptor binding capacity.

4. C. Drug elimination— on the basis of the bioavailability of any drug, the drug is
excreted/eliminated from the body.
2. Pharmacodynamics—
A. Systemic effects- In this branch, we study the drug’s action on body organs and
their responses. Different chemicals show different mechanisms of action on the
different body parts.
B. Cellular effects- when the drugs are absorbed they reach the cell and bind to the
specific cell receptors and carry on the metabolism.

5. SCOPE OF PHARMACOTHERAPEUTICS:
• The study of pharmacotherapeutics focuses on the relationship between drugs and their
safe and efficient use by humans.
• It ensures the proper and rational use of drugs determination of therapeutic activities,
selection of the most appropriate drug, dosage, and duration of treatment considering the
stages of the disease.
Objectives of pharmacotherapeutics
1. the main objective of pharmacotherapeutics is to hence the safety of prescription maximize the effect of
the drug and minimize side effects.
2. To prepare individualized therapeutic plans based on the diagnosis.
3. Defined therapeutic goal to improve a patient's quality of life while minimizing harmful effects.
4. To maintain drug therapy costs and provide quality and effective treatment.
5. Ensure patient compliance.
6. To avoid medical errors.

6. What is Rational use of Medicines
Rational use of medicines "means prescribing
the right medicines, in an adequate dose for a
sufficient duration to produce appropriate
therapeutic action for the patient at the lowest
cost” (WHO, 1985).
Rational
use of
medicine
Right
drug
Right
indication
Right drug
efficacy,
safety,
suitability
Right
dispensing
Patient
adherence
to
treatment

7. • Rational drug use implies the correct drug, appropriate indication, and selection with
respect to efficacy, safety, suitability for the patient, and cost.
• Three tools have been identified to implement the Rational Use of Medicines effectively.
These include:
Essential
Medicines
List
Drug
Formulary
Standard
Treatment
Guidelines

8. The following steps will help to remind prescribers/physicians of the rational approach to therapeutics:
1. Define the patient's problem- making the right diagnosis is based on pieces of information
like the complaint as described by the patient; a detailed history; physical examination;
laboratory tests; X-rays, and other investigations.
2. Specify the therapeutic objective- Doctors must clearly state their therapeutic objectives
based on the pathophysiology underlying the clinical situation.
3. Selecting therapeutic strategies- The selected strategy should be discussed with the patient.
a. Non-pharmacological treatment- The patient does not always need medicine for the
treatment of the condition. Very often, health problems can be resolved by a change in lifestyle,
dietary habits, use of physiotherapy or exercise, provision of adequate psychological support,
and other non-pharmacological treatments; they have the same importance as a prescription
drug, and instructions must be written, explained and monitored in the same way.

9. b. Pharmacological treatment- Provide the correct group of drugs to treat the disease. It must be
remembered that each drug has adverse effects.
4. Prescription writing- The prescription is the link between the prescriber, the pharmacist (or
dispenser), and the patient so it is important for the successful management of presenting
medical condition. The instructions and medicines are covered in more detail in the prescription.
5. Giving information, instructions, and warnings- This step is important to ensure patient
adherence and is covered in detail in the following section.
6. Monitoring treatment Evaluation of the follow-up and the outcome of treatment provides
information on whether the patient's problem is solved or to reformulate, if necessary.

10. EVIDENCE-BASED MEDICINE
Evidence-based medicine is a systemic approach to medicine in which doctors
and other healthcare professionals use the current, best scientific evidence from
clinical research to make decisions about the care of individual patients.
• Significance of Evidence-based medicine:
1. It provides cost-effective medical care.
2. It promotes consistency of treatment and optimal outcomes.
3. It helps to establish national standards of patient care.
4. It keeps doctors and other healthcare professionals updated.
5. It identifies and promotes practices that work, and eliminates those
that are ineffective or harmful.

11. • When doctors look at the research before recommending a treatment, they are using
evidence-based medicine. A physician’s clinical experience and the patient’s values and
evidence play an important role in the process of using evidence to make decisions.

12. The practice of evidence-based medicine involves five essential steps:
1. Converting information needs into answerable questions.
2. Finding the best evidence.
3. Appraising the evidence for its validity and usefulness.
4. Applying the results of appraisal into clinical practice.
5. Evaluation performance.

13. a) Disease occurrence
b) Efficacy of medicines
c) Safety of medicines
d) Comparative cost-effectiveness of medicines
e) Easy availability of medicines
• The list of essential medicines needs to be updated/revised
periodically. The updated WHO List of Essential Medicines
and List of Essential Medicine for Children is published every
two years.
ESSENTIAL MEDICINE LIST
WHO defines “Essential Medicines as the medicines that satisfy the priority healthcare
needs of the population. An essential medicine list is prepared by considering.

14. History of the Essential Medicines List.:
• In 1970, Tanzania became the first country to prepare its EML.
• The Ministry of Health and Family Welfare, Government of India prepared and released the first
National List of Essential Medicines (NLEM) of India in 1996 consisting of 279 medicines. This list
was subsequently revised in 2003 containing 354 medicines, 2011 containing 348 medicines, 2015
containing 376 medicines, and now in 2021 containing 399 medicines.

15. Selection of Essential Medicines:
The following factors are considered for the selection of essential medicines:
1. Occurrence of disease.
2. Efficacy, safety, and comparative cost-effectiveness of available medicines.
3. The medicine should be aligned with the current treatment guidelines for the disease.
4. Level of healthcare facility available.
5. Treatment facilities are available.
6. Training and experience of the available personnel.
7. Local availability of individual drugs.
8. Available financial resources.
9. Environmental factor/stability of the product.

16. A standard Treatment Guideline (STG) is a systematically developed statement designed to
assist practitioners and patients in making decisions about appropriate healthcare for
specific clinical circumstances.
STANDARD TREATMENT GUIDELINE
ADVANTAGES
1. Provides standardized guidance to practitioners.
2. It provides the most effective therapy in terms of quality.
3. Encourages practitioners for high-quality care.
4. The healthcare system needs to provide only the medicines as per the formulary or list of
essential medicines.
5. Enables healthcare providers to concentrate on making the correct diagnosis.
6. Provides a basis for evaluating the quality of care provided by health care professionals.
7. Provides a vehicle for integrating special programs (e.g., diarrhoea disease control,
tuberculosis control, malaria, etc.)
8. Helps to manage the drug supply system.

17. Standard Treatment Guidelines in India:
1. Hypertension: Screening, Diagnosis, Assessment, and Management of Primary Hypertension in
Adults in India, AUGUST 2017, Ministry of Health and Family Welfare, Government of India.
2. Treatment Guidelines for Antimicrobial Use in Common Syndromes. 2nd edition. Publications of the
ICMR, New Delhi.
3. Guidelines for Programmatic Management of Drug Resistant TB (PMDT) in India, March 2021,
National TB Elimination Programme, Central TB Division, Ministry of Health and Family Welfare,
Government of India, New Delhi.
4. National Guidelines for Clinical Management of Dengue Fever, National Vector Borne Disease
Control Programme, WHO, 2015.
5. Standard Treatment Protocol, Public Health Department, Government of Maharashtra.
6. Standard Treatment Guidelines, A Manual for Medical Therapeutics, First Edition 2014, Gujarat
Medical Services Corporation Ltd., Health and Family Welfare Department, Government of Gujarat.
7. Standard Treatment Guidelines (2016), Department of Public Health and Family Welfare, Madhya
Pradesh.

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