Lapeyre-Mestre Maryse, Montastruc François
Service of medical and clinical pharmacology, faculty of medicine, university hospital center, 31000 Toulouse, France; UMR 1027 pharmacoepidemiology, assessment of drug utilization and drug safety, Inserm, university Paul-Sabatier Toulouse III, 31000 Toulouse, France.
Service of medical and clinical pharmacology, faculty of medicine, university hospital center, 31000 Toulouse, France; UMR 1027 pharmacoepidemiology, assessment of drug utilization and drug safety, Inserm, university Paul-Sabatier Toulouse III, 31000 Toulouse, France.
Therapie. 2019 Apr;74(2):209-214. doi: 10.1016/j.therap.2018.12.010. Epub 2019 Feb 6.
Pharmacology is often divided in separate branches, such as molecular and cellular pharmacology, pharmacokinetics, pharmacodynamics, experimental and/or preclinical pharmacology, clinical pharmacology (and therapeutics), pharmacogenetics, pharmacogenomics, pharmacovigilance, pharmacoepidemiology, pharmacoeconomics… This enumeration gives a global picture of different scientific areas, which are however dealing with the same question. Another mindset should be a global interactive and continuous approach, which could be designed as "human pharmacology". An original and attractive way to illustrate this continuous approach is to combine pharmacodynamics and pharmacovigilance and/or pharmacoepidemiologic data. Coupling disproportionality analyses in pharmacovigilance databases or computerized health databases, with pharmacological characteristics of drugs (receptor affinity, for example) allows investigating in humans, the mechanism of adverse drug reactions. Examples of such analyses investigating the risk of movement disorders, diabetes related to psychoactive drugs, or the risk of adverse cardiac outcomes with different drugs (classical drugs or protein kinase inhibitors) are given. The increasing number of research works investigating this topic underlines the importance of this relatively new approach, which gives significant inputs for the better knowledge of drug safety.
药理学通常分为不同的分支,如分子与细胞药理学、药代动力学、药效学、实验和/或临床前药理学、临床药理学(及治疗学)、药物遗传学、药物基因组学、药物警戒、药物流行病学、药物经济学…… 这一列举展示了不同科学领域的整体情况,然而它们都在处理同一个问题。另一种思维方式应该是一种全面的、互动的和持续的方法,可将其设计为 “人类药理学”。一种阐述这种持续方法的新颖且有吸引力的方式是将药效学与药物警戒和/或药物流行病学数据相结合。将药物警戒数据库或计算机化健康数据库中的不成比例分析与药物的药理学特性(例如受体亲和力)相结合,能够在人体中研究药物不良反应的机制。文中给出了此类分析的示例,包括研究运动障碍风险、与精神活性药物相关的糖尿病风险,或不同药物(传统药物或蛋白激酶抑制剂)导致不良心脏后果的风险。越来越多针对这一主题的研究工作凸显了这种相对较新的方法的重要性,它为更好地了解药物安全性提供了重要信息。