Associate Editor's Note

Clinical Pharmacodynamics And Pharmacokinetics -
Issues Of Increasing Importance With Contemporary Pharmaceutical Agents

Charles J. Scheupner, M.S., M.D.
Professor of Medicine
University of North Carolina School of Medicine
Department of Medicine — Coastal AHEC
New Hanover Regional Medical Center
Associate Editor, Jacksonville Medicine

In preparation for this issue of Jacksonville Medicine, the Editorial Board believed that a series of articles reviewing contemporary phamacologic concepts with regard to newer pharmaceutical agents would be important for practicing physicians. These often neglected issues are of increasing significance as newer agents are developed in the marketplace. With this in mind, a lead-in editorial by Paula Fuqua deals specifically with the current "hoops" through which pharmaceutical companies must "jump" as part of the licensure process with the Food and Drug Administration. Dr. Fuqua provides insight into a process which has served the American public well and which has been recently streamlined to enhance its capability for serving all patients in a timely manner.

Dr. Tibisay Villalobos, with Dr. Bill Renfro and Dr. Mobeen Rathore, and Dr. Sherry King have provided us with important insights with regard to differences in the pharmacology of contemporary pharmaceuticals between infants, children, adults and the geriatric population. Their "alpha omega alpha" perspective raises important issues with which all practicing physicians should be familiar in order to assure the safe administration of agents to their patients.

The newer anti-depressant agents, including the selective serotonin re-uptake inhibitors, are important agents in contemporary medicine because of the frequency with which depression affects our population at large, especially aging adults. Dr. Herbert Ward has provided a clear perspective toward the use of these agents and their potential ill effects based upon their pharmacodynamics.

Drs. J. Davis Cury and Karen Malcolm have provided new insights into the management of an increasingly common problem, asthma; especially in view of the most recent National Heart, Lung and Blood Institute guidelines for the contemporary management of asthma, Dr. Cury's article is timely and he has provided a thorough review of these agents with a pharmacologic perspective, including the leukotriene inhibitors.

Finally, in an era when HIV-1 infection is now being far better controlled with the advent of non-nucleoside reverse transcripase inhibitors and protease inhibitors, Drs. Alexander Vandevelde and Biren Amin have provided a broad perspective toward the multiple medication interactions which can occur with these new agents for the management of HIV-1 infection. The multiple possible interactions have been tabulated and serve as a reminder about the potential for such diversity of possible interactions with all medications, not just those used to manage HIV-1 infection.

The editorial staff hope that this issue will provide the practicing physician with valuable additional insights into the utilization of newer pharmaceutical agents in the management of a variety of contemporary and common disease processes.

Feature Articles: Clinical Pharmacology

Jacksonville Medicine / August, 1998