Clinical Pharmacy
General Adverse Events in Clinical Trials
FATIGUE: Persistent tiredness not relieved by rest. FEVER: Elevated body temperature due to infection or inflammation. HEADACHE: Pain or discomfort in the head or upper neck. DIZZINESS: A feeling of lightheadedness or unsteadiness. NAUSEA: Sensation of wanting to vomit. VOMITING: Forceful expulsion of stomach contents. DIARRHEA: Frequent, watery bowel movements. ... Read More
Pharmacokinetics of Naproxen
In linear pharmacokinetics (PK), when we increase the dose (D) of the drug, its level in our body or systemic exposure (AUC) increases proportionally (red curve on left graph). What is our inference? This implies that both oral bioavailability (F) and clearance (CL) are constant such that dose (D) and ... Read More
Classification of Antibiotics
Inhibitors of Cell Wall Synthesis These antibiotics target the bacterial cell wall, leading to lysis and death. Beta-lactams: Interfere with peptidoglycan synthesis by inhibiting penicillin-binding proteins (PBPs).Examples: Glycopeptides: Bind to peptidoglycan precursors, preventing cross-linking.Examples: Vancomycin, Teicoplanin. Others: Bacitracin (used topically). Inhibitors of Protein Synthesis These antibiotics target bacterial ribosomes, disrupting ... Read More
ESC Key Notes on Obesity and Cardiovascular Disease
European Society of Cardiology (ESC) Clinical Consensus Statement on Obesity and Cardiovascular Disease Read also: Read also: Dr. Suzan Gharaibeh
Prevention or Delay of Diabetes | Standards of Care in Diabetes 2024
In people with prediabetes, monitor for the development of type 2 diabetes at least annually; modify based on individual risk assessment. Refer adults with overweight or obesity at high risk of DM2, as seen in the Diabetes Prevention Program (DPP), to an intensive lifestyle behavior change program to achieve and ... Read More
Citrus Food with Substrate of Pgp and CYP3A4
Do we know that jabara is a Japanese citrus that is similar to yuzu and is consumed as an anti-allergic functional food in Japan and worldwide? We have previously discussed how grapefruit juice interacts with medications (drugs). A question arises: does jabara also interact with drugs? Guess what? It has ... Read More
Concepts of Elimination Rate and Clearance of Drugs
Have we come across a presenter who commented that the ‘clearance rate of a drug is high or low’? A question arises: Is clearance an elimination rate of a given drug? Some of us remain unclear regarding the concepts of elimination rate and clearance of drugs. Elimination rate is the ... Read More
Free Drug Hypothesis in Drug Discovery and Clinical Pharmacotherapy
Do we know why understanding the nuances associated with the free drug hypothesis is important for both drug discovery and clinical pharmacotherapy? Free drug hypothesis defines that (1) changes in drug action (pharmacodynamic or PD) is associated with changes in unbound drug concentration at target tissue (CuT), and (2) based ... Read More
Relation Between Renal clearance and Urine pH
Do we know why the renal clearance of some drugs (e.g. memantine) is sensitive to the change in urine pH? Memantine is a medication taken to slow the progression of moderate-to-severe Alzheimer’s disease. It is a basic (alkaline) and lipophilic (fat-liking) drug (pKa 10 and logP 3). Once memantine is ... Read More
Volume of Distribution (V)
Do we know that one of the most misunderstood pharmacokinetic (PK) parameters is volume of distribution (V)? This is especially exacerbated by the many terminologies of V. Let’s start with a simple yet important understanding that V is a proportionality factor that relates the amount of drug in the body ... Read More