Clinical Pharmacology I [antikvár]

INTRODUCTION THE MANY FACES OF CLINICAL PHARMACOLOGY Louis Lasagna, M.D. Departments of Medicine {Division of Clinical Pharmacology) and of Pharmacology and Experimental Therapeutics, The Johns Hopkins University School of Medicine, Baltimore, Maryland Why is it necessary to Imve a volume on " clinical" pharmacology in an international encyclopedia of pharmacology? To begin with, clinical pharmacology is not " merely pharmacology in other species " although there is, to be sure, an important problem in species variation, as anyone knows who has ever been involved in attempts to predict response in man on the basis of data from animal experiments. Although the basic principles of good pharmacological research apply to man as well as to other species, there are, nevertheless, aspects of drug investigation in man which impart almost a qualitative difference to the field of clinical pharmacology. The ethical aspects of experimentation in man come immediately to mind when one is trying to make distinctions between sub-human and human experimentation. The time has not yet come (thank God!) when one can order one hundred humans to be delivered bright and early on Monday morning for an experiment. The principled investigator often has ethical conflicts to resolve before initiating an experiment with a drug on even a single human being, and additional ones often crop up before the experiment is completed. But the ethical aspects of human experimentation do not constitute the only area of important difference between animals and man. Clinical pharmacology is usually involved with the study of sick patients. This means studying the drug under conditions which may affect in strange ways the drug's handling and its pharmacological impact. Although such interactions are not always predictable, it is clearly to the advantage of the clinical pharmacologist to know as much as possible about not only his drug but the disease he is studying, and its natural history.