From its earliest beginnings, the practice of medicine has encompassed patient management through intervention to prevent or treat disease. In turn, the principles of clinical therapeutics are rooted in fundamental pharmacology. Reflecting a continuous landscape without borders, pharmacology and therapeutics are at once intimately interrelated, recursively synergistic, and mutually reinforcing. This nexus of basic and clinical sciences has emerged as central to realizing the clinical value of advances in discovery sciences, driving translation at the laboratory bench to patient-directed practice. The biological and mechanistic diversity inherent in individuals and populations offers unprecedented opportunities to tailor further prevention and treatment, while minimizing off-target adverse events. Indeed, the close interdependence of basic and clinical pharmacological principles and their application to human therapeutics is the cornerstone required to realize the full potential of individualized therapy and the future of clinical care.
Beyond the interrelatedness of scientific principles, the diversity of mutually complementary approaches defines the practice of human therapeutics in the healthcare community worldwide. Students, scholars, and educators in human therapeutics approach the field from divergent practice perspectives with information requirements that emphasize different portions of a continuum of knowledge embodying drug discovery, development, regulation, and utilization. Discovery scientists seek insight into principles underlying the pharmacological basis of (patho)physiology to identify novel targets for therapeutic intervention. Drug development professionals translate discoveries in fundamental mechanisms of disease into safe and effective human therapy through clinical trials. Regulatory experts focus on mechanisms underlying drug actions, their adverse reactions, and their interactions in the context of heterogeneous populations to evaluate empirical data from human clinical trials and formulate objective decisions concerning the safety and efficacy of novel therapeutic agents. Clinicians and other health professionals apply the principles of basic pharmacology, the evidence base that supports specific therapeutic interventions, and an understanding of the principles and practice of clinical pharmacology to formulate and implement therapeutic algorithms that maximize efficacy of care, minimize adverse events, and optimize cost-effectiveness.
Collectively, the pharmacology and therapeutics continuum contributes directly to the value proposition of healthcare delivery. It is recognized that pharmacotherapy is the most cost-effective management tool in the clinical armamentarium. Beyond treatment of active disease, prevention is increasingly extended as a therapeutic paradigm to achieve sustained wellness and disease avoidance. As a prototype of success in public health, disease prophylaxis through immunization represents one of the capstone achievements of medicine in the last century, with a cost-effectiveness unmatched in other models of disease management. Looking forward, the revolution in regenerative medicine and therapeutic repair offers the opportunity to advance the management paradigm from palliation to cure, with the potential to transform the efficiency of disease resolution, shortening hospital stays and decreasing healthcare expenditures over the long-term. Thus, pharmacology and therapeutics is instrumental in realizing the clinical value of advances in the new biology, driving translation of discovery to personalized healthcare solutions.
The multidimensional texture of therapeutics draws from across all life sciences and provides a common thread through distinct patient management strategies. The strength and uniqueness of this contemporary model is rooted in its comprehensive systems approach, where the integrated development of pharmacological therapies enhanced by their companion diagnostics reflects the productivity of the discovery and development components, continuously surveyed and gated through feedback from regulatory and utilization processes. The pipeline of new products, along with the safety and efficacy of applied therapeutics, is thus dependent on the optimum linkage of the discovery engine with the high fidelity of fail-safe surveillance. The overarching goal of this continuum, defined by systems integration, is to achieve better clinical outcomes in patients and populations by ensuring the availability of innovative, effective, and safe therapeutic modalities.
Taken together, these considerations suggest the timeliness for a new textbook in human therapeutics that broadly integrates information over diverse disciplines to serve knowledge requirements across the continuum of practice. To fill this informational and conceptual gap, this new textbook integrates across three dimensions. First, concepts and information are presented in ever-increasing layers of complexity and integration. Next, there is integration across disciplines, wherein each therapeutic topic incorporates relevant information concerning biochemistry, physiology and pathophysiology, basic and clinical pharmacology, and clinical medicine. Lastly, there is integration across the continuum of practice, wherein each therapeutic topic incorporates relevant information or cross-references concerning discovery, development, regulatory considerations, and utilization. Importantly, where appropriate, each therapeutic topic presents specific recommendations for therapy according to guidelines for the standard of care and the critical evidence base that supports those recommendations, with appropriate citations to original literature. In the context of these three dimensions, each chapter in human therapeutics examines the fundamental principles of drug actions, the clinical pharmacology of specific agents, the evidence base supporting the efficacy of key therapeutic agents, practice guidelines for pharmacotherapy, and emerging paradigms for therapeutic intervention in the future. Integration in three dimensions optimizes assimilation of critical information by students and practitioners, permitting a “customized” approach to information acquisition, tailored to specific content requirements and learning platforms across the community of practices.
Scott A. Waldman, Andre Terzic
FOREWORD
Personalized therapy has emerged as the new frontier to realize the clinical value of advances in discovery sciences, driving translation of innovation to patient-centered practice. Modern biology provides the enabling platforms to customize patient-specific therapeutic strategies based on individual genetic makeup to predict, prevent, diagnose, and treat disease, advancing treatments beyond the traditional “one-size-fits-all” approach. The enormity of this challenge is apparent by considering that there are >25,000 genes in humans, and the information encoded therein is exponentially compounded by >100,000 splice variants of messenger RNA. Further, there are 15 million loci along the genome where a single base can differ between individuals or populations, contributing to the polygenic origins of disease. This diversity, further amplified by systems-wide epigenetic and posttranslational modifications, underscores the challenge of individualized therapy.
While daunting for such a complex matrix of information to be resolved, numerous therapeutic advantages come to mind. Identified subpopulations of patients with specific disorders within disease syndromes should permit improved therapeutic responses in smaller populations of patients in clinical trials and thereby reduce drug development costs. Specifically, individual designed therapy may also reduce side effects as well as healthcare costs.
The emergence of customized and personalized medicine as the envisioned future of healthcare, driven by the new biology, suggests the timeliness of a contemporary paradigm to maximize translation of pharmacology to human therapeutics. This paradigm bridges the traditional separation of basic and applied pharmacology. Hierarchically merging these core concepts with supporting principles in basic and clinical sciences forms a framework for defining individualized approaches to the patient, capitalizing on advances in medicine.
The Editors of Pharmacology and Therapeutics: Principles to Practice have captured that vision, providing a fully integrated curriculum directing the understanding of human therapeutics. This comprehensive textbook uniquely nucleates contemporary information across traditionally disparate domains providing a tool for knowledge acquisition and management. This dynamic synthesis enables clear conceptualization of therapeutics across the spectrum of fundamental and applied practice. Concepts are vertically organized, presented in increasing strata of complexity. Further, information is integrated across scientific disciplines, and therapeutic topics to incorporate concepts central to cell biology, biochemistry, physiology and pathophysiology, fundamental and applied pharmacology, and molecular and clinical medicine. Moreover, therapeutic topics incorporate concepts across the matrix of discovery, development, regulatory sciences, and utilization algorithms. Full integration across the continuum of practice is reflected by therapeutic recommendations formulated from recent practice guidelines for the standard of care and the evidence base that supports those recommendations.
I applaud the Editors for bringing together, between the covers of this first edition, a superb textbook bridging basic and clinical pharmacology, from classic principles to future concepts. This exciting textbook will be invaluable to students, scholars, and professionals across the practice in human therapeutics. My congratulations to the Editors for undertaking this enormous task of dedication, and for the outstanding result of those efforts.
Ferid Murad, MD, PhD
Key Features
- Includes access to the complete contents of the book online, fully searchable, for rapid, efficient consultation from any computer.
- Features a logical organization (by body system, rather than by drug class) and an exceptionally user-friendly format so you can find the clinically actionable information you need more easily.
- Offers evidence-based therapeutic guidelines to help you make sound clinical decisions.
- Includes cutting-edge coverage of pharmacogenetics and pharmacogenomics, regenerative pharmacology, stem cell therapies, and the emerging field of individualized medicine across medical specialties.
- Examines nutrition, complementary and alternative medicines, neutraceuticals, and dietary supplements, allowing you to effectively counsel patients and avoid dangerous drug interactions.
Contents
Part I - Principles
- SECTION 1 - Pharmacotherapeutic Continuum
- SECTION 2 - Molecular Pharmacology
- SECTION 3 - Systems Pharmacology
- SECTION 4 - Clinical Pharmacology
Part II - Practice
- SECTION 5 - Cardiovascular Therapeutics
- SECTION 6 - Pulmonary Therapeutics
- SECTION 7 - Renal Therapeutics
- SECTION 8 - Gastroenterologic Therapeutics
- SECTION 9 - Endocrinologic Therapeutics
- SECTION 10 - Neuropharmacologic Therapeutics
- SECTION 11 - Psychopharmacologic Therapeutics
- SECTION 12 - Ophthalmologic Therapeutics
- SECTION 13 - Anesthesia
- SECTION 14 - Hematologic Therapeutics
- SECTION 15 - Oncologic Therapeutics
- SECTION 16 - Dermatologic Therapeutics
- SECTION 17 - Rheumatologic Therapeutics
- SECTION 18 - Therapy of Infectious Diseases
- SECTION 19 - Practical Therapeutics
- SECTION 20 - Emerging Therapeutics
Product Details
- Hardcover: 1536 pages
- Publisher: Saunders; Har/Psc edition (December 8, 2008)
- Language: English
- ISBN-10: 1416032916
- ISBN-13: 978-1416032915
- Product Dimensions: 11.2 x 8.8 x 1.8 inches
List Price: $164.00