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PubMedDate not supplied

[Non-compliance with pharmacological treatment in patients with epilepsy].

INTRODUCTION: The factors that affect adherence to pharmacological treatment with anticonvulsive drugs are manifold and can be classified as psychosocial, educational and related to the medication and the relation between physician and patient. Non-compliance with pharmacological treatment leads to: lack of control over seizures, recurrence, increased absenteeism from work and, possibly, injury to oneself or to others. AIMS: To determine and to analyse the variables associated to compliance with pharmacological treatment in a sector of the population in Peru. PATIENTS AND METHODS: The sample consisted of 114 patients evaluated between June 2001 and December 2002 at the Epilepsy and Clinical Electroencephalography Department of the National Neurological Sciences Institute Oscar Trelles Montes in Lima. RESULTS: In this study the rate of non-compliance with the pharmacological regimen was 67.2% and those who did not adhere to the anticonvulsive therapy had poorer control over their seizures. The variables that were significantly associated to non-compliance with the pharmacological treatment were: lack of money to buy the medicine, patient's failure to acknowledge the disease, poor response to treatment, belief that the treatment is of no use or has no beneficial effects, and factors linked to the relationship between physician and patient. Patients who did not comply claimed that not being able to afford the medication was the most frequent reason why they had stopped following the treatment.

Adult↗
PubMed2006

Estimates of quality and reliability with the physiotherapy evidence-based database scale to assess the methodology of randomized controlled trials of pharmacological and nonpharmacological interventions.

BACKGROUND AND PURPOSE: Systematic reviews and meta-analyses often include an evaluation of the methodological quality of the individual studies that have been included, and are usually conducted by at least 2 individuals. The objective of this study was to assess the methodological quality and reliability of a series of randomized controlled trials (RCTs) of both pharmacological and nonpharmacological interventions by use of the 10-item Physiotherapy Evidence-Based Database (PEDro) Scale. METHODS: Two abstractors independently reviewed 81 RCTs assessing a variety of interventions. The Cohen kappa statistic and the intraclass correlation coefficient (ICC) were used to assess agreement between abstractors. RESULTS: The average total PEDro scores were 5.94 (SD=1.43) for all studies combined, 6.88 (SD=1.2) for pharmacological studies, and 5.29 (SD=1.26) for nonpharmacological studies. The median score for pharmacological studies was significantly higher than that for nonpharmacological studies (7 versus 5). Pair-wise kappa scores ranged from a low of .452 for concealed allocation among drug trials to perfect agreement (1.00) for randomization and reporting of results from between-group comparisons. The ICCs associated with the cumulative PEDro score were .91 (95% confidence interval [CI]=.83-.94) for all studies, .89 (95% CI=.78-.95) for pharmacological studies, and .91 (95% CI=.84-.952) for nonpharmacological studies. DISCUSSION AND CONCLUSION: The methodological quality for pharmacological interventions was significantly higher than that for nonpharmacological interventions. There was good agreement between raters at an individual item level and in total PEDro scores. A lack of reporting clarity, poor organization of the report, or the failure to include salient details contributed to less-than-perfect agreement between raters.

Drug Therapy↗
PubMedDate not supplied

[Probability of control of the patient with diabetes exclusively treated with pharmacological therapy].

OBJECTIVE: to predict the probability of blood glucose control in patients with type-2 diabetes mellitus, exclusively treated with pharmacology therapy. MATERIAL AND METHODS: secondary analysis of a database to evaluate the therapeutic attachment in type-2 diabetics older than 60 years old. We interviewed 123 patients in their home to get information about sociodemographic aspects and diabetes characteristics. The blood glucose control was measured through glycated hemoglobin and the attachment to the pharmacological treatment was measured by the Morisky-Green test. The analysis included simple logistic regression; the calculation of probability of control for different levels of therapeutic attachment was estimated using the result of the regression equation (y) and applying the formula 1/1 + e(-y). RESULTS: Monotherapy was present in 82.1%, glibenclamide was prescribed alone in 77.2%, glycated hemoglobin average was 11.5 +/- 3.5 %, 18% of the population was controlled and 58.1% showed some attachment to the pharmacological treatment. With a total attachment to the pharmacological prescription, the control probability is 27%, and without it, it corresponds to 10%. CONCLUSION: Almost three out of ten patients with a total attachment to the pharmacological treatment have chances of being controlled.

Acarbose↗
PubMed1990

[The use of pharmacological criteria in the toxicological evaluation of veterinary drugs].

The toxicological evaluation of residues of veterinary drugs in foods of animal origin, which is done within the framework of the Netherlands Veterinary Drugs Act, is based on an EEC guide line in which, in addition to the clinical and analytical criteria, the requirements regarding the pharmacological and toxicological evaluation are laid down. In principle, this evaluation is based on classical toxicological criteria. As veterinary drugs have a specific pharmacological action, it is essential that these pharmacological effects should be in included in the toxicological evaluation in view of an adequate protection of public health. The selected starting point is that a pharmacological effect desired in a target animal is regarded as an undesirable effect in consumers. In this presentation, two examples are referred to, viz. the bèta agonist clenbuterol and the bèta-blocking agent carazolol; the approach is compared with a 'classical' toxicological evaluation. This shows that the acceptable daily intake in human individuals (ADI), based on pharmacological criteria is lower by a factor of approximately 50 than is the ADI on the basis of 'classical' toxicological criteria. This clearly illustrates the value of this approach in protecting the health of consumers.

Adrenergic beta-Antagonists↗
PubMed1991

Physical and pharmacologic restraint of nursing home patients with dementia. Impact of specialized units.

This case-control study of 31 specialized dementia units and 32 traditional units in five states investigated use of physical and pharmacologic restraints among 625 patients with the diagnosis of dementia. Physical restraints were observed in use on 18.1% of dementia unit patients and on 51.6% of comparison unit patients who were out of bed during the day (adjusted odds ratio, 0.283;95% confidence interval, 0.129 to 0.619). Pharmacologic restraints were routinely given to 45.3% of dementia unit patients and 43.4% of comparison unit patients (adjusted odds ratio, 0.950; 95% confidence interval, 0.611 to 1.477). We used multivariate logistic regression to identify residence in a nonspecialized nursing home unit, nonambulatory status, transfer dependency, mental status impairment, hip fracture history, and a high nursing staff-to-patient ratio, which we found to be independent predictors of physical restraint use. Physically abusive behavior, severe mental status impairment, and frequent family visitation were found to be significant predictors of pharmacologic restraint use, while advanced patient age, large nursing home size, and patient nonambulatory status were protective against such use. These results support the conclusion that physical and pharmacologic restraint constitute separate treatment modalities with different risk factors for use, and indicate that specialized dementia units are successful in reducing the use of physical but not pharmacologic restraints.

Aged↗
PubMed1990

Parental perceptions of newborn pharmacologic paralysis.

This is a descriptive exploratory study of 9 parent-dyads who experienced pharmacologic paralysis of their newborn within a prior 6-month period. Perceptual responses included feelings, values, and needs related to the pharmacologic paralysis therapy. Newborns receiving pharmacologic paralysis had direct dependence to the caretaker for mechanical ventilation, precise monitoring of physiological parameters, and extensive life support due to altered sensory-motor function and breathing. The appearance of the immobile newborn and the protocols for the administration of paralyzing agents, which eliminate excessive stimulation and handling, were suspected of impacting parental interaction. The convenience sample of parents was representative of three newborn critical care units. Open-ended, retrospective interviews were completed in either the parents' home or in a private room of the critical care complex. Physiologic complications precluded use of a prospective interview technique. Chart reviews and a background questionnaire provided demographic data. Data collection consisted of a parent-directed interview. Data were subjected to content analysis and descriptive statistics. The mother's and father's responses were coded separately. The identified common perceptual themes within the pharmacologic paralysis experience were empathy, normalcy, acceptance, and sedative association. Ancillary experiences include the perinatal period and newborn illness. Analysis of ancillary experiences revealed continued themes of empathy and normalcy as well as guilt, separation, shock and anxiety, and uncertainty. Nurses may provide parents whose ill newborn undergoes pharmacologic paralysis a supportive team approach and guidance within a framework of their feelings, values, and needs.

Adaptation, Psychological↗
PubMed1988

Pharmacologic characterization of tardive dyskinesia.

Tardive dyskinesia (TD) occurs in approximately 20% of patients treated chronically with antipsychotic drugs and constitutes a major public health problem. The cause of this disorder remains unknown, and no effective treatment has yet been found. The major etiologic theory (dopamine [DA] supersensitivity hypothesis) suggests that TD is the pharmacologic opposite of Parkinson's disease and implies that all patients with TD should respond uniformly to specific pharmacologic agents. Clinical research, however, has not borne this out. To evaluate pharmacologic response in TD syndromes, 15 patients underwent single dose acute administration of four different drugs: a DA agonist (bromocriptine 5 mg orally), a DA antagonist (haloperidol 5 mg intravenously), a cholinergic agonist (physostigmine 2 mg intravenously) and a cholinergic antagonist (benztropine 4 mg intravenously), individually in separate procedures at weekly intervals for four consecutive weeks in randomized order and under controlled double-blind conditions. Patients were evaluated for their clinical and endocrine responses. Pre- and post-drug administration TD exams were blindly rated. Results were not consistent with the DA supersensitivity theory; instead they demonstrated marked inter- and intrasubject variability in pharmacologic responses. Greatest uniformity in response was found among the tardive dystonic subjects, although this also was not consistent with a DA supersensitivity hypothesis. TD appears to be a pharmacologically heterogeneous condition, which may reflect the neurochemical complexity of the basal ganglia.

Adult↗
PubMed1987

[Comparison of nyctohemeral somatotropin secretion and response to pharmacological tests in 38 children with growth retardation].

We report a comparative study of the growth hormone nycthemeral secretion and the response of growth hormone secretion to pharmacological stimulation tests in 38 children with growth retardation. Two groups were separated according to the results of the nycthemeral growth hormone secretion study: a group of 26 children with normal secretion (mean maximum peak: 26.6 +/- 9.6 ng/ml and mean integrated concentration: 4.26 +/- 2.13 ng/ml/min) and a 2nd group of 12 children with hyposecretion (mean maximum peak: 6.7 +/- 2.6 ng/ml and mean integrated concentration: 1.08 +/- 0.45 ng/ml/min). There was no correlation between nycthemeral secretion and the responses to pharmacological tests. Thus, in the group with hyposecretion, 5 children had normal responses to a pharmacological test and in the group with normal secretion 13 children had intermediate responses to 2 pharmacological tests and 4 had dissociated responses. Thus, it appears mandatory to perform 2 different pharmacological tests in any investigation and to study the nycthemeral secretion in cases with intermediate or dissociated responses as well as in cases with normal responses when the clinical picture is consistent with growth hormone deficiency.

Adolescent↗
PubMed1986

[Immunologic and pharmacologic activity of atropine-protein conjugates].

The immunological (production of specific antibodies to hapten) and pharmacological activity of bovine serum albumin conjugates with different chemical modifications of atropine was investigated. Mice and rabbits treated with atropine-protein conjugates (1-10 mg/kg) have produced a considerable number of specific serum antibodies to hapten during primary and secondary immune response. Mice treated with atropine-protein conjugates (25 and 50 mg/kg) have produced undetectable amounts of specific serum antibodies. The study of pharmacological activity in mice has revealed peripheral activity of atropine-protein conjugates. There was a correlation between the pharmacological activity of atropine-protein conjugates (25-50 mg/kg) and the activity of atropine (5 mg/kg), however the pharmacological effect of atropine-protein conjugates was somewhat longer. The results suggest that atropine-protein conjugates are both immunologically and pharmacologically active compounds.

Animals↗
PubMed1995

An attempt to standardize the pharmacological diagnostic screening of vasculogenic impotence with prostaglandin E1.

The response to the intracavernosal injection of differing doses of prostaglandin E1 (PGE1)(10, 20 and 30 micrograms) was compared in a randomized prospective manner in 283 men with chronic impotence, in an attempt to identify the optimal drug dose for pharmacological diagnosis. The mean age of patients studied was 63.1 years, and comprised 90 men with arteriogenic impotence, 133 men with either pure venogenic impotence or venous leakage associated with arteriogenic impotence, and 60 men with psychogenic impotence. Erectile responses were quantified using real-time RigiScan monitoring and were compared to a diagnosis based on the patient history, examination findings and all subsequent investigations. In patients with arteriogenic impotence, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1, was made in 71, 89 and 90% of patients respectively. In patients with venous leakage, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1 was made in 95, 95 and 93% of patients respectively. In patients with psychogenic impotence, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1 was made in 72, 95 and 98% of patients respectively. This study indicates that pharmacological diagnosis with PGE1, is a useful screening test to differentiate penile vascular disease from psychogenic impotence and arteriogenic impotence from cavernosal venous leakage, achieves optimal sensitivity and specificity with doses of 20 micrograms or greater, but is associated with a high false diagnosis rate of diagnosis of penile vascular disease if doses of less than 20 micrograms are used.

Adult↗
PubMed1994

Pharmacological characterization of metabotropic glutamate receptors in several types of brain cells in primary cultures.

Several cDNAs coding for metabotropic glutamate receptors (mGluR1-7) have now been isolated. mGluR1 and -5 are positively coupled to phospholipase C, whereas mGluR2, -3, -4, -6, and -7 are negatively coupled to adenylyl cyclase (AC) when they are expressed in Chinese hamster ovary or baby hamster kidney cells. However, the exact transduction mechanisms of these receptors in their natural environment remain to be determined. In a previous work, we demonstrated that striatal neurons in primary culture expressed a mGluR that is negatively coupled to AC and that has a pharmacology different from that of mGluR2. In the present study, the pharmacology of mGluRs negatively coupled to AC in several neuronal types and in glial cells was compared with the pharmacology of mGluR2, -3, and -4. Like striatal neurons, cerebral cortical neurons express a mGluR that is able to inhibit AC both in intact cells and in membrane preparations, via a pertussis toxin-sensitive G protein. This mGluR has a pharmacological profile similar to that of mGluR3, because quisqualate is active at relatively low concentrations (EC50 < 100 microM). Similar experiments revealed that cerebellar granule cells expressed mGluR2-like and mGluR4-like receptors. Striatal glial cells also expressed a mGluR negatively coupled to AC via a pertussis toxin-sensitive G protein. However, only glutamate and aspartate, and not quisqualate, 2-(carboxycyclopropyl)glycine, trans-1-aminocyclopentane-1,3-dicarboxylate, or L-2-amino-4-phosphonobutyrate, were agonists for this glial mGluR. This pharmacology is different from that of any cloned mGluR. Reverse transcription associated with polymerase chain reaction revealed that mGluR2 and mGluR3 mRNAs are present in striatal, cortical, and cerebellar neurons but not in striatal glial cells. Interestingly, mGluR4 mRNA was found at a high level in cerebellar granule cells and at a lower level in cortical neurons and glial cells. However, the mGluR4-specific agonist L-2-amino-4-phosphonobutyrate was found to inhibit AC very slightly in granule cells only. In conclusion, our data show that mGluR2- and mGluR3-like receptors can directly inhibit AC in neurons, and they raise the question of whether mGluR4 is really negatively coupled to AC in its normal environment. We also present evidence for a new mGluR subtype expressed in glial cells.

Adenylate Cyclase Toxin↗
PubMed1997

FP prostaglandin receptors mediating inositol phosphates generation and calcium mobilization in Swiss 3T3 cells: a pharmacological study.

A detailed pharmacological characterization of the prostaglandin (PG) receptor coupled to phosphoinositide (PI) turnover and intracellular calcium mobilization in Swiss 3T3 mouse fibroblast cells was undertaken. The pharmacological profile of this functional receptor was compared with the pharmacological profile of specific [3H]PGF2 alpha binding to bovine corpus luteum membranes, which are known to contain a bona fide FP receptor. PGs that were potent stimulators and full agonists in the PI turnover assay in the 3T3 cells were the following (for all, n = 3-45): 16-phenoxy-PGF2 alpha (EC50 = 0.61 +/- 0.1 nM), cloprostenol (EC50 = 0.73 +/- 0.04 nM), 17-phenyl-PGF2 alpha (EC50 = 2.71 +/- 0.35 nM), fluprostenol (EC50 = 3.67 +/- 0.61 nM), PhXA85 (EC50 = 27.3 +/- 5.63 nM) and PGF2 alpha (EC50 = 28.5 +/- 5.26 nM). However, PGD2 (EC50 = 155 +/- 29.9 nM; Emax = 49% of cloprostenol), PGE2 (EC50 = 2570 +/- 566 nM; Emax = 59%) and U46619 (EC50 = 1060 +/- 310 nM; Emax = 63%) were less potent and were partial agonists, and iloprost and BW245C were inactive. Although the PGs tested exhibited lower affinities in the 3[H]PGF2 alpha binding assay than their functional potencies in the PI turnover assay, the rank orders of potencies and affinities were well correlated (r = 0.94; n = 15 compounds). However, the PI turnover assay was more sensitive than the calcium mobilization assay for rank ordering PG agonists. In conclusion, the Swiss 3T3 cells express an FP receptor coupled to PI turnover and intracellular Ca+2 mobilization signal transduction pathways. The pharmacological profile of this receptor was similar to that of the FP receptor found in the bovine corpus luteum, a tissue previously used to clone the first pharmacologically defined FP receptor.

3T3 Cells↗
PubMedDate not supplied

[Non-pharmacologic prevention of sudden cardiac death].

Non-pharmacologic therapy has revolutionized the management of arrhythmias and prevention of sudden cardiac death (SCD). Of particular importance is the introduction of radiofrequent catheter ablation (RFCA) and implantable cardioverter-defibrillator (ICD). RFCA is effective and useful in the treatment and prevention of SCD, especially in supraventricular tachyarrhythmias related to dual or accessory atrioventricular pathways. There are some limitations in using this method in the prevention of SCD in ventricular tachyarrhythmias. RFCA is very successful, particularly in the treatment of bundle branch reentrant ventricular tachycardia and ventricular tachycardia in patients without structural heart disease. RFCA can be used as a palliative treatment of incessant or frequent VT before and after ICD implantation. Antibradycardia pacing decreases SCD not only by the removal of serious bradyarrhythmias but also by prevention of the occurrence of malignant ventricular tachyarrhythmias induced by bradyarrhythmia. Antitachycardia pacing is used in the prevention of SCD only as a part of ICD device. Implantation of an antitachycardia pacemaker as an isolated permanent treatment of tachycardias is currently almost not used. This method was replaced by RFCA in supraventricular tachyarrhythmias and by ICD in ventricular tachyarrhythmias. ICD is a very perspective non-pharmacologic approach to SCD prevention, particularly as transvenous leads were introduced and device construction was simplified. ICD is indicated especially in patients with spontaneous sustained hemodynamically significant ventricular tachycardia/ventricular fibrillation and when antiarrhythmic drug treatment, RFCA or antitachycardia surgery are ineffective, intolerated, contraindicated or cannot be performed. ICD as the treatment of first choice instead of antiarrhythmic drugs as well as prophylactic ICD implantation in asymptomatic patients at high risk is a subject of discussion. ICD decreases the incidence of SCD significantly. However, the decrease in overall mortality was not verified. Antitachycardia surgery is less frequently used after RFCA, and ICD have been introduced. At present, this therapy is reserved only for the cases of failure of RFCA or the impossibility to use RFCA and ICD. Surgical therapy can be combined also with concommitant surgical correction of associated structural heart disease. Sympathectomy is used in prevention of malignant ventricular tachyarrhythmias and SCD in patients with congenital long Q-T syndrome. Selective left cardiac sympathetic denervation significantly reduces the risk of SCD in these patients but does not remove it completely. Heart transplantation is the last alternative of non-pharmacologic prevention of SCD. It is indicated in cases when all pharmacologic and non-pharmacologic approaches have been exhausted. Heart transplantation is the only effective modality for the improvement of long-term prognosis in patients with malignant ventricular tachyarrhythmias and advanced chronic heart failure.

Arrhythmias, Cardiac↗
PubMed1998

[The role of peptidic toxins in the pharmacological approach of the diversity of calcium channels].

Peptidic toxins extracted from spider, marine snails or snakes venoms, have considerably helped the pharmacological characterization of calcium channels. They have successfully been used for calcium channels mapping. However, the actual situation remains unclear. Genetic investigations demonstrated the existence of a great number of types or sub-types of calcium channels. In recent year a large number of toxins have been purified. Many of these toxins have specific actions on calcium channels and have been used as powerful tools in pharmacological approaches of calcium channels. However the pharmacology of the calcium channels remains very limited, many of them are waiting for the discovery of pharmacological tools allowing their molecular approach in order to determinate their biological implications. In this paper we describe the different families of calcium channels and toxins that interact with these channels. We also recapitulate the "non defined" calcium channels i.e. calcium channel which does not correspond to a N, L, P/Q, R or T type channel and for which no effector are available. We report the discovery and characterization of mapacalcine, a toxin extracted for a marine sponge, as an example of an approach of an undefined calcium channels first characterized by electrophysiological techniques and for which a specific toxin has been purified allowing its pharmacological approach. We also state the possible role of calcium channel toxins in the domain of therapeutic applications.

Calcium Channels↗
PubMed1998

A comparative study of the clinical efficacy of immunotherapy and conventional pharmacological treatment for patients with perennial allergic rhinitis.

This study was designed to compare the clinical outcome of prolonged immunotherapy for perennial allergic rhinitis with that of pharmacological treatment. Patients with perennial allergic rhinitis due to Dermatophagoides farinae (D. farinae) were divided into two groups; a pharmacotherapy group and an immunotherapy group. The pharmacotherapy group was treated with conventional pharmacological treatment using antihistamine tablets and topical steroid sprays and the immunotherapy group was treated with D. farinae extracts for 5 successive years. None of symptom scores at enrollment differed significantly between the groups. At 6 months and 1 year after the start of treatment the rate of decrease in each score was significantly greater in the pharmacotherapy group than in the immunotherapy group. The rate of decrease in sneezing scores, but not in the other scores, at 2 years after the start of treatment was also greater in the pharmacotherapy group than in the immunotherapy group. However, at 3 years the rate of decrease in any of the scores did not differ significantly between groups. The differences between the groups became clear-cut again after 5 years of treatment, when the rate of decrease in all of the scores was significantly greater in the immunotherapy group than in the pharmacotherapy group. Therefore, short-term treatment with pharmacological agents is probably superior to immunotherapy but, in the long-term, immunotherapy is apparently superior to pharmacological treatment with respect to clinical efficacy. In addition, prolonged immunotherapy provided long-term clinical efficacy and might provide a long-standing cure even after discontinuation of the therapy. In a questionnaire interview, approximately half of patients were very satisfied with prolonged immunotherapy and three-quarters were fairly satisfied or more. Additionally, the magnitude of improvement in nasal stuffiness contributed significantly and exclusively to the patient evaluation of immunotherapy. We propose that prolonged immunotherapy is never inferior to anti-allergenic pharmacological treatment and that it is possible to achieve long-term clinical efficacy or long-standing cure even after the discontinuation of immunotherapy, and that patients with perennial allergic rhinitis will be very satisfied with this prolonged therapeutic technique if nasal stuffiness is considerably alleviated.

Adolescent↗
PubMed1998

Pharmacological activation.

Despite the disparate results in clinical studies a few conclusions can be made. Pharmacologic activation during ECoG serves a minor role in determining the limits of a cortical excision during surgical treatment for intractable partial epilepsy. The extensive preoperative evaluation including long-term EEG monitoring to assess the electroclinical correlation and MRI are of primary importance. There is sufficient information at some epilepsy centers demonstrating a putative beneficial effect of ECoG that its continued use can be justified. Pharmacologic activation of epileptiform discharges is never preferred to spontaneous alterations occurring in the pre-excision ECoG. It would seem reasonable to consider pharmacologic activation at the time of the pre-excision ECoG if no discharges are present. Further studies will be needed to decide on the 'drug of choice', but for now methohexital would be most reasonable given the enormous amount of information regarding its induction properties. One must keep in mind the clear limitations associated with the use of these drugs especially the possibility of 'misleading' informations as documented by Fiol et al. (1990). The use of post-excision ECoG in general is sufficiently dubious that the practice of pharmacologic activation during this recording cannot be recommended. Perhaps the most reasonable view of pharmacologic activation is the position articulated by our Dr. Norman So (1995): 'There are many who advocate the injection of a short-acting barbiturate like methohexital to activate spiking during ECoG, but given the difficulty already encountered in interpreting the spontaneous ECoG it seems foolhardy to complicate the picture with potentially non-specific drug effects'.

Alfentanil↗
PubMedDate not supplied

The teaching of pharmacology in Italian medical schools: the point of view of Italian doctors.

OBJECTIVE: A survey was carried out to gather the opinions of doctors about the current method of teaching pharmacology in Italy. METHODS: A questionnaire was mailed to 3860 doctors, who were asked a series of questions regarding the teaching of pharmacology to medical students in Italian universities. RESULTS AND CONCLUSIONS: The great majority of those who replied considered the teaching they received to be mainly theoretical. The doctors thought that much more time and attention should be dedicated to those pharmacology subjects that are more closely connected to physiopathology and clinical practice (clinical pharmacology).

Data Collection↗
PubMedDate not supplied

Origins, practices and future of safety pharmacology.

The origins of safety pharmacology are grounded upon observations that organ functions (like organ structures) can be toxicological targets in humans exposed to novel therapeutic agents, and that drug effects on organ functions (unlike organ structures) are not readily detected by standard toxicological testing. Safety pharmacology is " em leader those studies that investigate the potential undesirable pharmacodynamic effects of a substance on physiological functions in relationship to exposure in the therapeutic range and above em leader " [International Conference on Harmonization (ICH) S7A guidelines; Safety Pharmacology Studies for Human Pharmaceuticals]. This publication provides a comprehensive review of the history of safety pharmacology, international regulatory guidelines that govern the practices of this important field, and the scientific challenges that are being faced by its rapid emergence in pharmaceutical development. The criticality of identifying undesired adverse effects of new drugs in nonclinical models, which reflect the overall human condition, is reflected in the importance of generating an integrated and accurate assessment of possible human risk. The conundrum posed by the challenge of formulating a reliable risk assessment is the importance of improving and enhancing the safe progression of new drugs to the marketplace, while preventing unnecessary delays (or discontinuances), based on nonclinical findings that are not relevant or interpretable in terms of clinical response or human risk.

Animals↗