20th-Century Advances in Clinical Pharmacology
Abstract
KEEFE AND BAKRISEDITORIAL EDITORIAL 20th-Century Advances in Clinical Pharmacology Clinical pharmacology is a 20th-century develop- ment. Thus, essentially, the entire history of the field can be covered by describing the advances of the past century. In 1900, pharmaceutical products were proprietary, essentially unregulated, and their use sup- ported only by anecdotal evidence. Remedies were usually compounds of various substances with multi- ple ingredients. A century later, therapeutic prepara- tions usually contain one or, at most, a few well- characterized, chemically pure active ingredients. These ingredients have demonstrated safety and effi- cacy for particular diseases and symptoms. Efforts are made to demonstrate safety and efficacy in special pop- ulations, including children, the elderly, and patients with impaired renal and hepatic function. Much knowledge about the specific mechanism of action is available for each drug. The growth of knowl- edge has been explosive in parallel with the growth of molecular biology and genetics. Small molecules are now designed to interact with specific protein or nu- cleic acid-binding sites, and specific molecular mecha- nisms of action are known for most of the older agents. New techniques for large throughput screening en- hance the possibility of finding useful agents. The growth in