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March 1990, Volume 40, Issue 3

Letter to the Editor



With the number of powerful and toxic drugs in­creasing, rational drug therapy is assuming more impor­tance. Medicine as long accepted a systematic approach to diagnosis yet the notion, that course of therapy is a routine consequence of the diagnosis, has recently been ques­tioned. Clinical application of basic pharmacology in medical curricula for undergraduates and postgraduates is now getting more attention with educators now realising that therapeutics should be approached with diligence2. The medical students should receive some formal instruction in clinical pharmacology, to enable identifica­tion of its certain ‘core” principles . General principles of clinical pharmacology can be identified as drug-drug interaction, drug therapy in renal and hepatic insufficien­cy, pregnancy, nursing mother and infant, drug usage in geriatric medicine, management of overdose and intoxi­cated patients, etc. Besides learning core principles, the student must learn skills, such as finding appropriate texts, reading scientific papers, searching the literature for recent primary clinical studies and solving pharmacokinetics problems. These skills are necessary not only to practice therapeutics now, but also enable the students to modify his/her therapeutic approach as new drugs are intro­duced4. Teaching clinical pharmacology embodies an attempt to integrate the knowledge of basic pharmacology with an understanding of diseases, in order to develop a maximally effective and minimally toxic therapy. As the drug armamentarium is expanding, it be­comes and minimises toxicity, Students must learn to approach traditional drug therapy in a manner valid for the future drugs in all specialities and subspecialities5,6. No teaching course can compass all therapeutics and current information would become outdated as new drugs replace the old ones. Clinical pharmacology has brought two broad themes into mainstreams of medicine today, the reliance on scientific data to make rational therapeutic decisions and the attempts to individualise drug therapy. Both of these are ideally translated into the practice of medicine.

Nighat Murad Khan
Department of Pharmacology, Faculty of Health Sciences, The Aga Khan University, Karachi.


1. World Health Organization, Clinical Pharmacology, Scope, or­ganization, training. WHO Tech. Rep. Ser., 1970, p.446.
2. Task Force on clinical Pharmacology Certification Report. Notes of the American Society for Clinical Pharmacology and Therapeutics. Clin. Pharmacol. Ther., 1980; 27: 708-710.
3. Breckenridge, A.M. Assessment of new drugs: a clinical pharmacologist’s view. Br. Med. 1., 1980; 280: 1303.
4. Melmon, K.L., Morrelli, H.F. The need to test the efficacy of the international report of clinical pharmacology. Clin. Pharmacol. Ther., 1989; 10:451.
5. Wardell, W.M. Clinical Pharmacology at University Medical Centers. 1. Functions and Organization. J. Clin. Pharmacol., 1974; 14: 309.
6. Peck, C.C., Halkin, H. Therapeutic decision making for second-year medical students. J. Med. Educ., 1981; 56:1024.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: