Nigel S. Baber

Opportunities for a career in clinical pharmacology

Nigel Baber, Morris J Brown, and David Webb set out the pros and cons ![][1] Clinical pharmacology or, more precisely, clinical pharmacology and therapeutics is a relatively young specialty concerned with the understanding of drug action in man, and with the practice of rational prescribing. Clinical pharmacology was born out of pharmacology - drug action in animals and in in vitro systems and out of the explosion in the number of new drugs which were emerging about 20 years ago. Three developments in particular have enabled the specialty to flourish and a fourth is responsible for current excitement. Firstly, the recognition that clinical studies must be properly designed, executed, and analysed in order to be certain that observed drug effects are real and not due to chance, bias, or a placebo effect. In particular, the randomised, placebo controlled, or positive controlled double blind trial of sufficient size and power has been a mainstay of clinical pharmacology. Secondly, the development of sensitive and specific assays of biological fluids by chromatography, and more recently by mass spectrometry, has enabled the detection of small quantities of parent drug and metabolises to be determined. This has enabled the subspecialty of pharmacokinetics - the study of the absorption, distribution, metabolism, and excretion of drugs to emerge. Thirdly, the development of techniques to measure dynamic responses to drugs has allowed clinical pharmacologists to better define the dose effect or response relationship and to understand the mechanism of action of many important drugs. Some drugs can be used as tools or probes to understand physiological and pathophysiological processes, even if the drug itself never becomes a prescription medicine. The fourth and most recent development is the interaction of molecular genetics and studies on the human genome with drug response and drug development. As we move into the era … [1]: /embed/graphic-1.gif