⦁ Clinical pharmacology- introduction, subject, aim and tasks. Evidence-based medicine and drug therapy, based on evidence.

Question 1

objective of clinical pharmacology

Answer 1

optimize drug therapy

Question 2

Aims of clinical pharmacology

Answer 2

⦁ Optimal use of existing medications.

⦁ Scientific study of drugs in humans

Question 3

Scientific study of drugs in humans includes what?

Answer 3

⦁ Safety and efficacy of currently available drugs, and

⦁ Development of new and improved drug therapy

Question 4

Tasks of clinical pharmacology

Answer 4

⦁ Making an accurate diagnosis
⦁ Understanding the pathophysiology of the disease
⦁ Review the drug therapy options
⦁ Select patient’s specific drug and dose
⦁ Select endpoints to follow of efficacy and toxicity
⦁ Maintain therapeutic team with the patient

Question 5

what is Evidence-based medicine

Answer 5

intergration of external data and physician’s clinical expertise with pt values

Question 6

how is external data organiseed (7)

Answer 6

⦁ High quality meta-analyses (very low risk of bias)
⦁ Well- conducted meta-analysis (low risk bias)
⦁ Meta-analysis of low-risk bias
⦁ High quality systemic review of case control or cohort studies with low risk bias
⦁ Case control or cohort studies with high risk of bias
⦁ Non-analytical studies (case reports)
⦁ Expert opinion

Question 7

what are foreground and background questions used for

Answer 7

developing accurate clinical questions for evidence based medicine

Question 8

what is a Background question

Answer 8

ask for general information about a condition or thing. answered by textbooks

Question 9

what is a ⦁ Foreground question

Answer 9

ask for specific knowledge about a specific patient with a specific condition

answered by data bases

Question 10

4 components of foreground questions

Answer 10

⦁ P = Patient population
⦁ I = Intervention/Investigation
⦁ C=Comparison Intervention/Investigation
⦁ O = Outcome (Patient-Oriented)

Question 11

what is a p drug

Answer 11

best drugs for a specific patient with a specific condition.

Question 12

Criteria for choosing a p-drug

Answer 12

⦁ Efficacy: Which treatment is the most effective

⦁ Safety: Are there harmful effects of a particular treatment

⦁ Suitability:takes into account the convenience of dosage form, dosage schedule, and route of administration. It also considers the safety features like contraindications and drug interactions.

⦁ Cost: Looks at cost effectiveness, cost/benefit analysis.

Question 13

Sources of external evidence

Answer 13

⦁ Cross-sectional survey- simultaneous assessments of outcomes, descriptive features, and predictors are made.

⦁ Case control studies: patients who already have a specific condition are compared with people who do not

⦁ Randomized controlled trials- include methodologies that reduce the potential for bias

⦁ Systematic review- studies are collected, reviewed, assessed and the results summarized according to predetermined criteria of the review question.

Question 14

what is a level of evidence

Answer 14

the degree to which data regarding a disease is rigoursly carried out

Question 15

⦁ Level I: gold standard of evidence.

Answer 15

at least one properly controlled randomized trial,

Question 16

⦁ Level II

3 levels

Answer 16

⦁1:controlled trials without randomization
⦁2: cohort or case-control studies.
⦁3:studies with external control groups or ecological studies.

Question 17

optimizing drug and dose selection

Answer 17

⦁ Choosing drug with the best clinical outcomes,

⦁ Low cost of therapy

⦁ awareness thay No drug treatment may be the best choice, e.g in cases of viral diseases

⦁ knowledge about the drug’s adverse reactions

⦁ Select appropriate end-points e.g. pt satisfaction