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Perspectives in Pharmacy

Scope and Fields of Pharmaceutical the nature and quality of pharmaceutical


Services education
- “Shapes the course of profession”
PHARMACY - art and science of preparing, ● Wholesaling - products of hundred
dispensing and proper utilization of medications manufacturers can be obtained from a single
and provision of drug related information to the agency.
public. ● Pharmaceutical Journalism - offers rewarding
- Preparing from natural and synthetic experience for a limited number of pharmacists
sources. with writing and editing skills.
- “The profession responsible for the ● Government Services - Law Enforcers, Board
appropriate use of medications, devices Examiners, Food and Drug Analyst.
and services to achieve optimal - Organization Management - offers an
therapeutic outcomes” opportunity for pharmacists who want to
-American be officers of national and provincial
Pharmaceutical Association associations.
PHARMACEUTICAL CARE - responsible - Philippine Pharmacists
provision of drug therapy for the purpose of Association (PPhA)
achieving definite outcomes that improve a ● Medical Communication - embraces many
patient’s quality of life. activities including computer handling of
PHARMACIST - “educated and licensed to medical data, creation of reference materials,
dispense drugs and provide drug information.” and research, evaluate, assemble and package
- Drug experts information specifically for the end user.
- Most accessible member of today’s ● Nuclear Pharmacy - applies principles and
healthcare team. practices of pharmacy and nuclear chemistry to
DRUGS - articles intended for use in diagnosis, produce radioactive drugs used for diagnosis
cure, mitigation, treatment or prevention of and therapy.
diseases. PPhA and its Affiliate Organizations:
Pharmaceutical Services PAPPI - Philippine Association of Pharmacist in
the Pharmaceutical Industry
● Community Pharmacy - “Retail Pharmacy” PACOP - Philippine Association of Colleges of
- This is the area of service mostly Pharmacy
strongly identified with the word PSHP - Philippine Society of Hospital
pharmacy Pharmacy
● Industrial Pharmacy - Research, Production, CPAP - Community Pharmacist Association of
Quality Control, Distribution/Marketing the Philippines.
- Research: formulation of the PAPVI - Philippine Association of Pharmacists
most suitable dosage forms. in Veterinary Industry
- Production: raw materials to DOH-LP - Department of Health-League of
finished product. Pharmacists
● Hospital Pharmacy - Pharmacists dispense IPAP - Industrial Pharmacists Association of
medications, prepare sterile solutions, advice other Philippines
professionals and patients on the use of drugs, DSAP - Drugstore Association of the
monitor drug regimens and evaluate drug use. Philippines
● Clinical Pharmacy - said to be the saving FJCPPhA - Federation of Junior Chapter-
grace to the commercialism pervading the Philippine Pharmacist’s Association
profession. YPG - Young Pharmacist Group Philippine.
● Pharmacists in Education - responsible for -
Perspectives in Pharmacy

Pharmaceutical Product Development

Definitions of a Drug:
- Article intended for and having as their
main use the diagnosis, cure, mitigation,
treatment or prevention of disease in
man and other animals
- Article recognized by monograph in the
compendia
- Article (other than food) used to affect
the structure or any function of the body
of man and other animals
- Article used as a component of any of
the previously mentioned articles.
Active Ingredient
- any component that is intended to
furnish pharmacological activity or other
direct effect in the diagnosis, cure,
Pharmaceutical Product Development
mitigation, treatment or prevention of
● Drug Discovery
disease or to affect the structure or
- Determine target disease.
function of the body of man or other
- Develop hypothesis for a
animals
mechanism of treatment.
The Pharmaceutical Product Development
- Evaluate hypothesis.
Process
- Determine feasibility of producing
- Research activities directed to the
and evaluating the selected
creation of new drugs for new products
compound.
- New drugs may be intentionally or
● Screening
accidentally produced from natural
- Combination Chemistry
sources or by chemical synthesis
- Make many possible compounds
at one time.
- Focus on quantity of possible
compounds, not purity of each.
- High Throughput Screening
- Test hundreds at a time for
activity.
- Process requires serious technology.
- 1 in 10,000 makes it to the
market.
Two Main Stages of Drug Development
● Preclinical Research
- involves synthesis and purification
testing in the lab and animal testing
- thousands of compounds are tested
Sequence of Events in Pharmaceutical
in preclinical research before a
Product Development
handful are chosen to enter the
second stage, which requires filing
Perspectives in Pharmacy

of an IND - Safe starting dose for clinical


- Pre-Clinical Testing trials
- Evaluate acute and short term - Objective 4: Physicochemical
toxicity in animals (one rodent, properties
one non-rodent). - Structural characterization
- Dose at increasingly high - Impurity identification
levels to induce toxicity. - Solubility assessment
- Determine lethal dose. - Stability
- Dose at normal levels for - Output – Raw Material
short and long term. Specifications
- Assess how drug is absorbed, ● Pharmaceutical Manufacturing Research
distributed, metabolized, and - The aim of pharmaceutical
excreted in animals. manufacturing development is to
- Primary goals of early preclinical design a quality product and its
development manufacturing process to
- to determine if the product is consistently deliver the intended
reasonably safe for initial use in performance of the product.
humans - The information and knowledge
- to determine if the compound gained from pharmaceutical
exhibits pharmacological activity manufacturing development studies
that justifies commercial and manufacturing experience
development. provide scientific understanding to
- to determine recommended dose support the establishment of the
for initial use in humans design space*, specifications, and
- to establish the physicochemical manufacturing controls.
properties of the drug: its ● Investigational New Drug (IND)
chemical makeup, stability, - Application filed by a sponsor to get
solubility FDA approval to conduct clinical
- Objective 1: Safety studies of an IND on human subjects
- Toxicity Studies - done on - Investigational new drug means a
experimental animals: murine new drug or biological drug that is
(rats or mice), canines (dogs), used in a clinical investigation. The
primates (monkeys), porcine terms ‘‘investigational drug’’ and
(pigs) ‘‘investigational new drug’’ are
- Dose at increasingly high levels deemed to be synonymous for this
to induce toxicity purpose.
- Determine lethal dose - Clinical investigation (or trial) means
- Dose at normal levels for short any experiment in which a drug is
and long term administered or dispensed to, or
- Objective 2: Pharmacologic activity used involving, one or more human
- Pharmacodynamics – what the subjects.
drug does to the body - Sponsor means a person who takes
- Pharmacokinetics – what the responsibility for and initiates a
body does to the drug ADME – clinical investigation.
absorption, distribution, - Contract research organization
metabolism excretion means a person that assumes, as
- Objective 3: Recommended Dose an independent contractor with the
Perspectives in Pharmacy

sponsor, one or more of the - Participating in a clinical trial can


obligations of a sponsor, e.g., design provide researchers with valuable
of a protocol, selection or monitoring information on new treatments; in
of investigations, evaluation of some cases, it may also offer the
reports, and preparation of materials chance for a cure or improvement in
to be submitted to the Food and a patient's quality of life that's not
Drug Administration. provided by standard therapy.
- Investigator means an individual - Participation in clinical trials is
who actually conducts a clinical voluntary, and individuals are
investigation (i.e., under whose allowed to discontinue the treatment
immediate direction the drug is at any time .
administered or dispensed to a - The purpose of clinical trials is to
subject). decide if a new medication or
- Sponsor-Investigator means an treatment is safe and effective.
individual who both initiates and - Clinical trials are research studies
conducts an investigation, and under that are conducted on human
whose immediate direction the subjects to find more effective ways
investigational drug is administered to treat, prevent, or diagnose
or dispensed. disease.
- Subject means a human who - They may also be done to find
participates in an investigation, treatments with fewer side effects, or
either as a recipient of the treatments that are easier for
investigational new drug or as a patients to tolerate.
control. Phase 0
● Institutional Review Board (IRB) - A recent designation for exploratory,
- Reviews, approves, and monitors first-inhuman trials conducted in
research involving human subjects accordance with the US FDA’s 2006
in order to evaluate the ethical Guidance on Exploratory IND Studies.
acceptability and the scientific - They are exploratory studies that often
validity of any such studies. use only a few small doses of a new
- An IRB is formally designated by an drug in a few patients
institution in which research takes - Also known as human microdosing
place, such as a hospital or studies
university. - Designed to speed up the development
- Research cannot begin until the of promising drugs by establishing very
IRB approves. early on whether the drug behaves in
human subjects as was expected from
preclinical studies.
● Clinical Studies - Involves the administration of single
- Clinical trials are research studies subtherapeutic doses of the study drug
done to evaluate whether a drug or to a small number of subjects (10 to 15)
treatment is both safe and effective to gather preliminary data on the agent's
for people. pharmacokinetics (what the body does
- Prior to being used in clinical trials, to the drug).
drugs or procedures are first - Help researchers find out whether the
evaluated extensively in the lab drugs do what they are expected to do.
and/or in animal studies. - May help avoid the delay and expense
Perspectives in Pharmacy

of finding out years later in phase II or Phase 1 trial is not used to see if the
even phase III clinical trials that the drug drug is effective, only that it is mainly
doesn’t act as expected to based on lab safe for humans to use.
studies - Some of the questions researchers may
- If there are problems with the way the be looking to answer about a drug with a
drug is absorbed or acts in the body, this Phase 1 trial include:
should become clear very quickly in a • Does it cause any serious side
phase 0 clinical trial. effects?
- Not yet being used widely, and there are • Are patients able to tolerate the drug?
some drugs for which they wouldn’t be • What's the safest route of
helpful. administration (such as pill, injection,
- Studies are very small, often with fewer infusion)?
than 15 people, and the drug is given • How is it metabolized by the body?
only for a short time. • What's the highest dose that is
- They’re not a required part of testing a tolerable to patients?
new drug. ● Phase II
Phase I - Conducted on a larger group of people
- This phase consists of short-term to further evaluate the safety of the
clinical tests of the drug on 20 to 80 treatment and to determine how well it
healthy volunteers to determine basic works.
pharmacological and toxicological - Typically the drug is tested in 100 to 300
information in humans especially as patients.
regards safety. The FDA can stop - Dosage levels are experimented with to
clinical testing if they deem the drug find optimal dosage levels, and further
unsafe. information on safety is collected
- Studies that are usually conducted with - The main purpose of a Phase II clinical
healthy volunteers and that emphasize trial is to begin to assess whether a drug
safety. is effective while exposing as few people
- The goal is to find out what the drug's as possible to any unwanted side
most frequent and serious adverse effects.
events are and, often, how the drug is - All study participants will have been
metabolized and excreted. diagnosed with the condition that the
- The aims of this initial trial include: new medication has been designed to
- Determining that the drug is safe for treat.
humans ● Phase III
- Gaining information about proper - Designed to provide proof of the drug's
dosage amounts effectiveness in treating the target health
- Assessing side effects at different problem and to assess the risk vs.
dosage amounts benefits of using the drug
- Determining how the drug is - Drug is given to large groups of people
metabolized by the human body often numbering in the thousands (1,000
- Assessing the effect of the drug on to 3,000)
target symptoms - Data is gathered regarding side effects
- Phase I typically takes about one year, and optimal dosage amounts in order to
which is much shorter than other phases provide labeling and physician
of the trial period. prescription information
- The short time period is because a - Trials are tightly controlled and can take
Perspectives in Pharmacy

several months to several years to the "placebo effect."


complete ● New Drug Application (NDA)
- Done to determine if the new treatment - The NDA application is the vehicle
is more effective, or has less side through which drug sponsors formally
effects, than the standard (currently propose that the FDA approve a new
approved) method. pharmaceutical product for sale and
- This phase answers the question "does marketing.
it work better than the standard - The data gathered during the animal
treatment?" studies (preclinical) and human clinical
- Controlled clinical trial is a type of trials of an Investigational New Drug
treatment research study in which a become part of the NDA.
treatment is compared to a control - The goals of the NDA are to provide
group. This control group may be either enough information to permit the FDA
another active treatment (e.g., another reviewer to reach the following key
medication), a non-active treatment decisions:
(e.g., a placebo), or some other type of • Whether the drug is safe and effective
control group. in its proposed use(s), and whether the
- In some forms of research, a control benefits of the drug outweigh the risks.
group is used to provide a basis of • Whether the drug's proposed labeling
comparison to the group of individuals (package insert) is appropriate, and
who are being studied in support of the what it should contain.
research theory • Whether the methods used in
- A placebo is a substance given to a manufacturing the drug and the controls
study participant that has no known used to maintain the drug's quality are
treatment value. adequate to preserve the drug's identity,
- Placebos are made as similar to the strength, quality, and purity.
actual treatment as possible. If the new - The documentation required in an NDA
medication being studied is in the form is supposed to tell the drug's whole
of an injection, the placebo will be an story, including
injection. The idea is that the study • what happened during the clinical
participants and the researchers do not tests,
know who is getting the real treatment • what the ingredients of the drug are,
and who is getting a placebo. • the results of the animal studies,
- Trials are typically conducted in a • how the drug behaves in the body,
"double-blind" manner, where neither • how it is manufactured, processed and
the researchers nor the participants packaged
know who received the placebo and ● Abbreviated New Drug Application
who received the medication. (ANDA)
- In this study, half of the participants - Contains data which when submitted
usually receive a placebo and the other to the provides for the review and
half get the actual medication of interest. ultimate approval of a generic drug
- Double-blind studies are conducted to product.
prevent bias on the part of the - Once approved, an applicant may
researchers and the participants. manufacture and market the generic
- Any effects seen as a result of taking the drug product to provide a safe,
placebo are usually attributed to the effective, low cost alternative to the
expectations of the patient is known as public.
Perspectives in Pharmacy

● Phase IV
- Generic Drug Product - Done in the post-marketing stages -
• Product that is comparable to after the Food and Drug
an innovator drug product in Administration (FDA) has approved
dosage form, strength, route of the product for general use
administration, quality, - Studies are conducted on hundreds
performance characteristics and to thousands of people
intended use. - Study answers the question "does it
• Generic drug applications are work over time and for purposes
termed "abbreviated" because other than what it was initially meant
they are generally not required to for?"
include preclinical (animal) and - done to continue monitoring the risks
clinical (human) data to establish and benefits of the drug
safety and effectiveness. - may look at the drug's effect on
• Instead, generic applicants are different subgroups of individuals
required to scientifically (such as different genders or ages)
demonstrate that their product is or to gather information about the
bioequivalent (i.e., performs in long-term effects of drug usage
the same manner as the - may be conducted in order to get
innovator drug). FDA approval for the drug to be
• Generic applicants are required used for a different purpose than the
to scientifically demonstrate that target symptoms it was originally
their product is bioequivalent approved for
(i.e., performs in the same
manner as the innovator drug).
• One way scientists
demonstrate bioequivalence is to
measure the time it takes the
generic drug to reach the
bloodstream in 24 to 36 healthy
volunteers.
• This gives them the rate of
absorption, or bioavailability, of
the generic drug, which they can
then compare to that of the
innovator drug.
• The generic version must
deliver the same amount of
active ingredients into a patient's
bloodstream in the same amount
of time as the innovator drug. -
bioequivalence
● Marketing Authorization (MA)
● Certificate of Product Registration
(CPR)
● Routine Commercial Production New
Product Launching Marketing

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