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Summary: Clinical Pharmacology Insights into Patient Care
Panel Discussion Overview: Moderated by Dr. Shambo Samrat Samajdar with insights from Prof. Jyotirmoy Pal, Prof. Santanu K Tripathi, Prof. Nandini Chatterjee, and Prof. Sandhiya Selvarajan, this session explored practical applications of clinical pharmacology principles in patient care.
Key Topics:
1. Polypharmacy:
High prevalence globally and in India among the elderly, often associated with increased risk of adverse outcomes.
Challenges include inappropriate medication use, undertreatment, and anticholinergic burden.
Strategies like clinical pharmacological reconciliation and review ensure safe prescribing.
2. Prescribing Cascade:
Avoid initiating medications to treat side effects of others unnecessarily.
Deprescribing emphasized as a systematic and patient-centered approach.
3. Dose Modifications:
Critical for patients with chronic kidney disease (CKD) or chronic liver disease (CLD).
Factors like hepatic extraction ratio, intrinsic clearance, and altered pharmacokinetics guide adjustments.
4. Drug-Induced Disorders:
Examples included interactions between linezolid and digoxin, highlighting the importance of therapeutic drug monitoring (TDM).
Managing adverse effects and ensuring optimal drug levels were stressed.
5. Case Studies:
Detailed cases illustrated challenges of polypharmacy, prescribing cascades, and dose adjustments in vulnerable patients.
Take-Home Messages:
Rationalize polypharmacy.
Prevent prescribing cascades.
Tailor dose modifications for CKD/CLD patients.
View deprescribing as a positive, collaborative intervention.
Focus on a patient-centric approach for safe and effective clinical pharmacological care.
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