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136-863: Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics , pharmacodynamics , therapeutic use, and toxicology . More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function. If substances have medicinal properties, they are considered pharmaceuticals . The field encompasses drug composition and properties, functions, sources, synthesis and drug design , molecular and cellular mechanisms , organ/systems mechanisms, signal transduction/cellular communication, molecular diagnostics , interactions , chemical biology , therapy, and medical applications and antipathogenic capabilities. The two main areas of pharmacology are pharmacodynamics and pharmacokinetics . Pharmacodynamics studies

272-507: A {\displaystyle Va} is the drug's rate of administration and τ {\displaystyle \tau } is the rate at which the absorbed drug reaches the circulatory system. Finally, using the Henderson-Hasselbalch equation , and knowing the drug's p K a {\displaystyle pKa\,} ( pH at which there is an equilibrium between its ionized and non-ionized molecules), it

408-679: A myograph , and physiological responses are recorded after drug application, allowed analysis of drugs' effects on tissues. The development of the ligand binding assay in 1945 allowed quantification of the binding affinity of drugs at chemical targets. Modern pharmacologists use techniques from genetics , molecular biology , biochemistry , and other advanced tools to transform information about molecular mechanisms and targets into therapies directed against disease, defects or pathogens, and create methods for preventive care, diagnostics, and ultimately personalized medicine . The discipline of pharmacology can be divided into many sub disciplines each with

544-535: A "gem". As of May 2011, in order to promote TCM worldwide, China had signed TCM partnership agreements with over 70 countries. His government pushed to increase its use and the number of TCM-trained doctors and announced that students of TCM would no longer be required to pass examinations in Western medicine. Chinese scientists and researchers, however, expressed concern that TCM training and therapies would receive equal support with Western medicine. They also criticized

680-409: A blood plasma concentration of 80 mg that has the capacity to have a pharmaceutical effect. This concept depends on a series of factors inherent to each drug, such as: These concepts, which are discussed in detail in their respective titled articles, can be mathematically quantified and integrated to obtain an overall mathematical equation: where Q is the drug's purity. where V

816-540: A classificatory and mnemonic device to observe health problems and to reflect upon, store, and recover empirical knowledge," but they were also "subject to stultifying theoretical elaboration, self-deception, and dogmatism ." The doctrines of Chinese medicine are rooted in books such as the Yellow Emperor's Inner Canon and the Treatise on Cold Damage , as well as in cosmological notions such as yin–yang and

952-426: A concentration-time profile. Chemical techniques are employed to measure the concentration of drugs in biological matrix , most often plasma. Proper bioanalytical methods should be selective and sensitive. For example, microscale thermophoresis can be used to quantify how the biological matrix/liquid affects the affinity of a drug to its target. Pharmacokinetics is often studied using mass spectrometry because of

1088-555: A corresponding graphical representation . The use of these models allows an understanding of the characteristics of a molecule , as well as how a particular drug will behave given information regarding some of its basic characteristics such as its acid dissociation constant (pKa), bioavailability and solubility , absorption capacity and distribution in the organism. A variety of analysis techniques may be used to develop models, such as nonlinear regression or curve stripping. Noncompartmental methods estimate PK parameters directly from

1224-446: A dispensing or clinical care role. In either field, the primary contrast between the two is their distinctions between direct-patient care, pharmacy practice, and the science-oriented research field, driven by pharmacology. The word pharmacology is derived from Greek word φάρμακον , pharmakon , meaning "drug" or " poison ", together with another Greek word -λογία , logia with the meaning of "study of" or "knowledge of" (cf.

1360-401: A drug can be used in industry (for example, in calculating bioequivalence when designing generic drugs) or in the clinical application of pharmacokinetic concepts. Clinical pharmacokinetics provides many performance guidelines for effective and efficient use of drugs for human-health professionals and in veterinary medicine . Models generally take the form of mathematical formulas that have

1496-440: A drug will affect the rate and extent of absorption, extent of distribution, metabolism and elimination. The drug needs to have the appropriate molecular weight, polarity etc. in order to be absorbed, the fraction of a drug the reaches the systemic circulation is termed bioavailability, this is simply a ratio of the peak plasma drug levels after oral administration and the drug concentration after an IV administration(first pass effect

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1632-503: A full agonist, antagonists have affinity for a receptor but do not produce a biological response. The ability of a ligand to produce a biological response is termed efficacy , in a dose-response profile it is indicated as percentage on the y-axis, where 100% is the maximal efficacy (all receptors are occupied). Binding affinity is the ability of a ligand to form a ligand-receptor complex either through weak attractive forces (reversible) or covalent bond (irreversible), therefore efficacy

1768-538: A largely 20th century invention. In the early twentieth century, Chinese cultural and political modernizers worked to eliminate traditional practices as backward and unscientific. Traditional practitioners then selected elements of philosophy and practice and organized them into what they called "Chinese medicine" (Chinese: 中医 Zhongyi ). In the 1950s, the Chinese government sought to revive traditional medicine (including legalizing previously banned practices) and sponsored

1904-442: A more rapid distribution, comprising organs and systems with a well-developed blood supply; and a peripheral compartment made up of organs with a lower blood flow. Other tissues, such as the brain, can occupy a variable position depending on a drug's ability to cross the barrier that separates the organ from the blood supply. Two-compartment models vary depending on which compartment elimination occurs in. The most common situation

2040-493: A narrow therapeutic margin: toxic side-effects are almost always encountered at doses used to kill tumors . The effect of drugs can be described with Loewe additivity which is one of several common reference models. Other models include the Hill equation , Cheng-Prusoff equation and Schild regression . Pharmacokinetics is the study of the bodily absorption, distribution, metabolism, and excretion of drugs. When describing

2176-435: A number of factors such as: the properties of the substances that act as excipients , the characteristics of the appropriate biological membranes and the way that substances can cross them, or the characteristics of the enzyme reactions that inactivate the drug. The following are the most commonly measured pharmacokinetic metrics: The units of the dose in the table are expressed in moles (mol) and molar (M). To express

2312-483: A number of things: The inverse benefit law describes the relationship between a drugs therapeutic benefits and its marketing. When designing drugs, the placebo effect must be considered to assess the drug's true therapeutic value. Drug development uses techniques from medicinal chemistry to chemically design drugs. This overlaps with the biological approach of finding targets and physiological effects. Pharmacology can be studied in relation to wider contexts than

2448-435: A practical level, a drug's bioavailability can be defined as the proportion of the drug that reaches the systemic circulation. From this perspective the intravenous administration of a drug provides the greatest possible bioavailability, and this method is considered to yield a bioavailability of 1 (or 100%). Bioavailability of other delivery methods is compared with that of intravenous injection (absolute bioavailability) or to

2584-418: A reduction in government testing and regulation of the production of TCMs, some of which were toxic. Government censors have removed Internet posts that question TCM. In 2020 Beijing drafted a local regulation outlawing criticism of TCM. According to Caixin , the regulation was later passed with the provision outlawing criticism of TCM removed. At the beginning of Hong Kong 's opening up, Western medicine

2720-473: A single pharmaceutical in the samples. The samples represent different time points as a pharmaceutical is administered and then metabolized or cleared from the body. Blank samples taken before administration are important in determining background and ensuring data integrity with such complex sample matrices. Much attention is paid to the linearity of the standard curve; however it is common to use curve fitting with more complex functions such as quadratics since

2856-416: A specific focus. Pharmacology can also focus on specific systems comprising the body. Divisions related to bodily systems study the effects of drugs in different systems of the body. These include neuropharmacology , in the central and peripheral nervous systems ; immunopharmacology in the immune system. Other divisions include cardiovascular , renal and endocrine pharmacology. Psychopharmacology

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2992-400: A standard value related to other delivery methods in a particular study (relative bioavailability). Once a drug's bioavailability has been established it is possible to calculate the changes that need to be made to its dosage in order to reach the required blood plasma levels. Bioavailability is, therefore, a mathematical factor for each individual drug that influences the administered dose. It

3128-504: A symbol of the Cultural Revolution, for the introduction of modern medicine into villages where traditional Chinese medicine services were used. The State Intellectual Property Office (now known as CNIPA ) established a database of patents granted for traditional Chinese medicine. In the second decade of the twenty-first century, Chinese Communist Party general secretary Xi Jinping strongly supported TCM, calling it

3264-413: A table of concentration-time measurements. Noncompartmental methods are versatile in that they do not assume any specific model and generally produce accurate results acceptable for bioequivalence studies. Total drug exposure is most often estimated by area under the curve (AUC) methods, with the trapezoidal rule ( numerical integration ) the most common method. Due to the dependence on the length of x in

3400-518: A tradition of more than 2,000 years, including various forms of herbal medicine , acupuncture, massage ( tui na ), exercise ( qigong ), and dietary therapy. It is primarily used as a complementary alternative medicine approach. TCM is widely used in China and it is also used in the West. Its philosophy is based on Yinyangism (i.e., the combination of Five Phases theory with Yin–Yang theory), which

3536-635: Is a subfield of pharmacology that combines principles from pharmacology, systems biology, and network analysis to study the complex interactions between drugs and targets (e.g., receptors or enzymes etc.) in biological systems. The topology of a biochemical reaction network determines the shape of drug dose-response curve as well as the type of drug-drug interactions, thus can help designing efficient and safe therapeutic strategies. The topology Network pharmacology utilizes computational tools and network analysis algorithms to identify drug targets, predict drug-drug interactions, elucidate signaling pathways, and explore

3672-468: Is also called "Eighty-One Nan". The book is based on basic theory and has also analyzed some disease certificates. Questions one to twenty-two is about pulse study, questions twenty-three to twenty-nine is about meridian study, questions thirty to forty-seven is related to urgent illnesses, questions forty-eight to sixty-one is related to serious diseases, questions sixty-two to sixty-eight is related to acupuncture points, and questions sixty-nine to eighty-one

3808-541: Is also true the other way around, a point easily overlooked." TJ Hinrichs observes that people in modern Western societies divide healing practices into biomedicine for the body, psychology for the mind, and religion for the spirit, but these distinctions are inadequate to describe medical concepts among Chinese historically and to a considerable degree today. The medical anthropologist Charles Leslie writes that Chinese, Greco-Arabic, and Indian traditional medicines were all grounded in systems of correspondence that aligned

3944-550: Is an alternative medical practice drawn from traditional medicine in China. A large share of its claims are pseudoscientific , with the majority of treatments having no robust evidence of effectiveness or logical mechanism of action . Medicine in traditional China encompassed a range of sometimes competing health and healing practices, folk beliefs , literati theory and Confucian philosophy , herbal remedies , food , diet, exercise, medical specializations, and schools of thought. TCM as it exists today has been described as

4080-461: Is an act related to drug policy. Prescription drugs are drugs regulated by legislation. The International Union of Basic and Clinical Pharmacology , Federation of European Pharmacological Societies and European Association for Clinical Pharmacology and Therapeutics are organisations representing standardisation and regulation of clinical and scientific pharmacology. Pharmacokinetics Pharmacokinetics : A number of phases occur once

4216-461: Is avoided and therefore no amount drug is lost). A drug must be lipophilic (lipid soluble) in order to pass through biological membranes this is true because biological membranes are made up of a lipid bilayer (phospholipids etc.) Once the drug reaches the blood circulation it is then distributed throughout the body and being more concentrated in highly perfused organs. In the United States ,

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4352-689: Is called "Traditional Chinese Medicine" and practiced today in China and the West is not thousands of years old, but recently constructed using selected traditional terms, some of which have been taken out of context, some badly misunderstood. He has criticized Chinese and Western popular books for selective use of evidence , choosing only those works or parts of historical works that seem to lead to modern medicine, ignoring those elements that do not now seem to be effective. Critics say that TCM theory and practice have no basis in modern science , and TCM practitioners do not agree on what diagnosis and treatments should be used for any given person. A 2007 editorial in

4488-572: Is currently no evidence that the Shang nobility used herbal remedies. Stone and bone needles found in ancient tombs led Joseph Needham to speculate that acupuncture might have been carried out in the Shang dynasty. This being said, most historians now make a distinction between medical lancing (or bloodletting ) and acupuncture in the narrower sense of using metal needles to attempt to treat illnesses by stimulating points along circulation channels ("meridians") in accordance with beliefs related to

4624-434: Is dependent on binding affinity. Potency of drug is the measure of its effectiveness, EC 50 is the drug concentration of a drug that produces an efficacy of 50% and the lower the concentration the higher the potency of the drug therefore EC 50 can be used to compare potencies of drugs. Medication is said to have a narrow or wide therapeutic index , certain safety factor or therapeutic window . This describes

4760-492: Is intended to fall within a range in which the drug produces a therapeutic effect or desired outcome. The safety and effectiveness of prescription drugs in the U.S. are regulated by the federal Prescription Drug Marketing Act of 1987 . The Medicines and Healthcare products Regulatory Agency (MHRA) has a similar role in the UK. Medicare Part D is a prescription drug plan in the U.S. The Prescription Drug Marketing Act (PDMA)

4896-537: Is one of the earliest written medical books in China. Written during the Eastern Han dynasty between 200 and 250 CE, it was the combined effort of practitioners in the Qin and Han dynasties who summarized, collected and compiled the results of pharmacological experience during their time periods. It was the first systematic summary of Chinese herbal medicine. Most of the pharmacological theories and compatibility rules and

5032-431: Is possible to calculate the amount of a drug in the blood plasma that has a real potential to bring about its effect using the formula: where De is the effective dose , B bioavailability and Da the administered dose. Therefore, if a drug has a bioavailability of 0.8 (or 80%) and it is administered in a dose of 100 mg, the equation will demonstrate the following: That is the 100 mg administered represents

5168-446: Is possible to calculate the non-ionized concentration of the drug and therefore the concentration that will be subject to absorption: When two drugs have the same bioavailability, they are said to be biological equivalents or bioequivalents. This concept of bioequivalence is important because it is currently used as a yardstick in the authorization of generic drugs in many countries. Bioanalytical methods are necessary to construct

5304-454: Is related to the needlepoint methods. The book is credited as developing its own path, while also inheriting the theories from Huangdi Neijing. The content includes physiology, pathology, diagnosis, treatment contents, and a more essential and specific discussion of pulse diagnosis. It has become one of the four classics for Chinese medicine practitioners to learn from and has impacted the medical development in China. Shennong Ben Cao Jing

5440-493: Is represented by a curve ; the relationships between the factors can then be found by calculating the dimensions of different areas under the curve. The models used in non-linear pharmacokinetics are largely based on Michaelis–Menten kinetics . A reaction's factors of non-linearity include the following: It can therefore be seen that non-linearity can occur because of reasons that affect the entire pharmacokinetic sequence: absorption, distribution, metabolism and elimination. At

5576-447: Is studied in pharmacokinetics due to the substances responsible for harming the environment such as pesticides can get into the bodies of living organisms. The health effects of these chemicals is thus subject to research and safety trials by government or international agencies such as the EPA or WHO . How long these chemicals stay in the body , the lethal dose and other factors are

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5712-556: Is that elimination occurs in the central compartment as the liver and kidneys are organs with a good blood supply. However, in some situations it may be that elimination occurs in the peripheral compartment or even in both. This can mean that there are three possible variations in the two compartment model, which still do not cover all possibilities. In the real world, each tissue will have its own distribution characteristics and none of them will be strictly linear. The two-compartment model may not be applicable in situations where some of

5848-452: Is the ability to modify parameters and to extrapolate to novel situations. The disadvantage is the difficulty in developing and validating the proper model. Although compartment models have the potential to realistically model the situation within an organism, models inevitably make simplifying assumptions and will not be applicable in all situations. However complicated and precise a model may be, it still does not truly represent reality despite

5984-505: Is the application of genomic technologies to drug discovery and further characterization of drugs related to an organism's entire genome. For pharmacology regarding individual genes, pharmacogenetics studies how genetic variation gives rise to differing responses to drugs. Pharmacoepigenetics studies the underlying epigenetic marking patterns that lead to variation in an individual's response to medical treatment. Pharmacology can be applied within clinical sciences. Clinical pharmacology

6120-490: Is the application of pharmacological methods and principles in the study of drugs in humans. An example of this is posology, which is the study of dosage of medicines. Pharmacology is closely related to toxicology . Both pharmacology and toxicology are scientific disciplines that focus on understanding the properties and actions of chemicals. However, pharmacology emphasizes the therapeutic effects of chemicals, usually drugs or compounds that could become drugs, whereas toxicology

6256-432: Is the study of chemical's adverse effects and risk assessment. Pharmacological knowledge is used to advise pharmacotherapy in medicine and pharmacy . Drug discovery is the field of study concerned with creating new drugs. It encompasses the subfields of drug design and development . Drug discovery starts with drug design, which is the inventive process of finding new drugs. In the most basic sense, this involves

6392-416: Is the study of the use of drugs that affect the psyche , mind and behavior (e.g. antidepressants) in treating mental disorders (e.g. depression). It incorporates approaches and techniques from neuropharmacology, animal behavior and behavioral neuroscience, and is interested in the behavioral and neurobiological mechanisms of action of psychoactive drugs. The related field of neuropsychopharmacology focuses on

6528-519: Is to consume, its stability in the human body and the best form for delivery to the desired organ system, such as tablet or aerosol. After extensive testing, which can take up to six years, the new medicine is ready for marketing and selling. Because of these long timescales, and because out of every 5000 potential new medicines typically only one will ever reach the open market, this is an expensive way of doing things, often costing over 1 billion dollars. To recoup this outlay pharmaceutical companies may do

6664-434: Is used to change for shape and chemical properties of the drug, resulting in different biological activity. This is done to ultimately achieve control when and where drugs are active in a reversible manner, to prevent side effects and pollution of drugs into the environment. The study of chemicals requires intimate knowledge of the biological system affected. With the knowledge of cell biology and biochemistry increasing,

6800-435: Is usually carried out by determination of plasma concentrations as this data is usually the easiest to obtain and the most reliable. The main reasons for determining a drug's plasma concentration include: Ecotoxicology is the branch of science that deals with the nature, effects, and interactions of substances that are harmful to the environment such as microplastics and other biosphere harmful substances. Ecotoxicology

6936-511: Is widely used in the Sinosphere . One of the basic tenets is that the body's qi is circulating through channels called meridians having branches connected to bodily organs and functions. There is no evidence that meridians or vital energy exist. Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to

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7072-657: The Treatise on Cold Damage Disorders and the Essential Prescriptions of the Golden Casket , which were edited separately in the eleventh century, under the Song dynasty . Nanjing or "Classic of Difficult Issues", originally called "The Yellow Emperor Eighty-one Nan Jing", ascribed to Bian Que in the eastern Han dynasty . This book was compiled in the form of question-and-answer explanations. A total of 81 questions have been discussed. Therefore, it

7208-476: The Food and Drug Administration (FDA) is responsible for creating guidelines for the approval and use of drugs. The FDA requires that all approved drugs fulfill two requirements: Gaining FDA approval usually takes several years. Testing done on animals must be extensive and must include several species to help in the evaluation of both the effectiveness and toxicity of the drug. The dosage of any drug approved for use

7344-622: The Inner Canon and developed a complete medical system centered on needling therapy. The AB Canon of Acupuncture and Moxibustion ( Zhenjiu jiayi jing 針灸甲乙經 , compiled by Huangfu Mi sometime between 256 and 282 CE) assembled a consistent body of doctrines concerning acupuncture; whereas the Canon of the Pulse ( Maijing 脈經 ; c. 280) presented itself as a "comprehensive handbook of diagnostics and therapy." Around 900–1000 AD, Chinese were

7480-567: The Middle Ages , with pharmacognosy and Avicenna 's The Canon of Medicine , Peter of Spain 's Commentary on Isaac , and John of St Amand 's Commentary on the Antedotary of Nicholas . Early pharmacology focused on herbalism and natural substances, mainly plant extracts. Medicines were compiled in books called pharmacopoeias . Crude drugs have been used since prehistory as a preparation of substances from natural sources. However,

7616-630: The Tung Wah Hospital was established in Hong Kong in 1869 based on the widespread rejection of Western medicine for pre-existing medical practices, although Western medicine would still be practiced in the hospital alongside Chinese medicinal practices. The Tung Wah Hospital was likely connected to another Chinese medical institution, the Kwong Wai Shiu Hospital of Singapore, which had previous community links to Tung Wah,

7752-465: The active ingredient of crude drugs are not purified and the substance is adulterated with other substances. Traditional medicine varies between cultures and may be specific to a particular culture, such as in traditional Chinese , Mongolian , Tibetan and Korean medicine . However much of this has since been regarded as pseudoscience . Pharmacological substances known as entheogens may have spiritual and religious use and historical context. In

7888-401: The brain tissue) that present a real barrier to the distribution of drugs, that can be breached with greater or lesser ease depending on the drug's characteristics. If these relative conditions for the different tissue types are considered along with the rate of elimination, the organism can be considered to be acting like two compartments: one that we can call the central compartment that has

8024-458: The discovery , formulation , manufacturing and quality control of drugs discovery is studied by pharmaceutical engineering , a branch of engineering . Safety pharmacology specialises in detecting and investigating potential undesirable effects of drugs. Development of medication is a vital concern to medicine , but also has strong economical and political implications. To protect the consumer and prevent abuse, many governments regulate

8160-602: The etymology of pharmacy ). Pharmakon is related to pharmakos , the ritualistic sacrifice or exile of a human scapegoat or victim in Ancient Greek religion . The modern term pharmacon is used more broadly than the term drug because it includes endogenous substances, and biologically active substances which are not used as drugs. Typically it includes pharmacological agonists and antagonists , but also enzyme inhibitors (such as monoamine oxidase inhibitors). The origins of clinical pharmacology date back to

8296-559: The five phases . The "Documentation of Chinese materia medica" (CMM) dates back to around 1,100 BCE when only a few dozen drugs were described. By the end of the 16th century, the number of drugs documented had reached close to 1,900. And by the end of the last century, published records of CMM had reached 12,800 drugs." Starting in the 1950s, these precepts were standardized in the People's Republic of China, including attempts to integrate them with modern notions of anatomy and pathology . In

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8432-405: The humoral theory of ancient Greece and ancient Rome . The demand for traditional medicines in China was a major generator of illegal wildlife smuggling , linked to the killing and smuggling of endangered animals . However, Chinese authorities have in recent years cracked down on illegal wildlife smuggling, and the industry has increasingly turned to cultivated alternatives. Scholars in

8568-406: The multi-compartment model with a number of curves that express complicated equations in order to obtain an overall curve. A number of computer programs have been developed to plot these equations. The most complex PK models (called PBPK models) rely on the use of physiological information to ease development and validation. The graph for the non-linear relationship between the various factors

8704-473: The 17th century, the English physician Nicholas Culpeper translated and used pharmacological texts. Culpeper detailed plants and the conditions they could treat. In the 18th century, much of clinical pharmacology was established by the work of William Withering . Pharmacology as a scientific discipline did not further advance until the mid-19th century amid the great biomedical resurgence of that period. Before

8840-570: The 1950s, the Chinese government promoted a systematized form of TCM. Traces of therapeutic activities in China date from the Shang dynasty (14th–11th centuries BCE). Though the Shang did not have a concept of "medicine" as distinct from other health practices, their oracular inscriptions on bones and tortoise shells refer to illnesses that affected the Shang royal family: eye disorders, toothaches, bloated abdomen, and such. Shang elites usually attributed them to curses sent by their ancestors. There

8976-554: The 1970s from the Mawangdui tomb that had been sealed in 168 BCE, the Inner Canon rejected the influence of spirits and the use of magic. It was also one of the first books in which the cosmological doctrines of Yinyang and the Five Phases were brought to a mature synthesis. The Treatise on Cold Damage Disorders and Miscellaneous Illnesses (Shang Han Lun) was collated by Zhang Zhongjing sometime between 196 and 220 CE; at

9112-460: The Chinese philosopher Zhang Gongyao triggered a national debate with an article entitled "Farewell to Traditional Chinese Medicine", arguing that TCM was a pseudoscience that should be abolished in public healthcare and academia. The Chinese government took the stance that TCM is a science and continued to encourage its development. There are concerns over a number of potentially toxic plants, animal parts, and mineral Chinese compounds, as well as

9248-576: The Five Phase theory, were used to explain health and disease in texts such as Huangdi neijing . Yin and yang are the changing factors in cosmology, with qi as the vital force or energy of life. The Five Phase theory ( Wuxing ) of the Han dynasty contains the elements wood, fire, earth, metal, and water. By understanding medicine from a cosmology perspective, historians better understand Chinese medical and social classifications such as gender, which

9384-716: The History of Medicine . Ian Johnson says, on the other hand, that the English-language term "traditional Chinese medicine" was coined by "party propagandists" in 1955. Nathan Sivin criticizes attempts to treat medicine and medical practices in traditional China as if they were a single system. Instead, he says, there were 2,000 years of "medical system in turmoil" and speaks of a "myth of an unchanging medical tradition". He urges that "Traditional medicine translated purely into terms of modern medicine becomes partly nonsensical, partly irrelevant, and partly mistaken; that

9520-412: The advantage of avoiding animal sacrifice. Population pharmacokinetics is the study of the sources and correlates of variability in drug concentrations among individuals who are the target patient population receiving clinically relevant doses of a drug of interest. Certain patient demographic, pathophysiological, and therapeutical features, such as body weight, excretory and metabolic functions, and

9656-487: The basic tenets of TCM is that the body's qi (sometimes translated as vital energy ) is circulating through channels called meridians having branches connected to bodily organs and functions. The concept of vital energy is pseudoscientific. Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to Classical humoral theory . TCM has also been controversial within China. In 2006,

9792-466: The body. Human health and ecology are intimately related so environmental pharmacology studies the environmental effect of drugs and pharmaceuticals and personal care products in the environment . Drugs may also have ethnocultural importance, so ethnopharmacology studies the ethnic and cultural aspects of pharmacology. Photopharmacology is an emerging approach in medicine in which drugs are activated and deactivated with light . The energy of light

9928-457: The circulation of "Qi". The earliest evidence for acupuncture in this sense dates to the second or first century BCE. The Yellow Emperor's Inner Canon ( Huangdi Neijing ) , the oldest received work of Chinese medical theory, was compiled during the Han dynasty around the first century BCE on the basis of shorter texts from different medical lineages. Written in the form of dialogues between

10064-425: The clinical use of population pharmacokinetics) is the direct application to a therapeutic situation of knowledge regarding a drug's pharmacokinetics and the characteristics of a population that a patient belongs to (or can be ascribed to). An example is the relaunch of the use of ciclosporin as an immunosuppressor to facilitate organ transplant. The drug's therapeutic properties were initially demonstrated, but it

10200-730: The colonial and feudal past. The government established a grassroots health care system as a step in the search for a new national identity and tried to revitalize traditional medicine and made large investments in traditional medicine to try to develop affordable medical care and public health facilities. The Ministry of Health directed health care throughout China and established primary care units. Chinese physicians trained in Western medicine were required to learn traditional medicine, while traditional healers received training in modern methods. This strategy aimed to integrate modern medical concepts and methods and revitalize appropriate aspects of traditional medicine. Therefore, traditional Chinese medicine

10336-417: The complex nature of the matrix (often plasma or urine) and the need for high sensitivity to observe concentrations after a low dose and a long time period. The most common instrumentation used in this application is LC-MS with a triple quadrupole mass spectrometer . Tandem mass spectrometry is usually employed for added specificity. Standard curves and internal standards are used for quantitation of usually

10472-504: The design of molecules that are complementary in shape and charge to a given biomolecular target. After a lead compound has been identified through drug discovery, drug development involves bringing the drug to the market. Drug discovery is related to pharmacoeconomics , which is the sub-discipline of health economics that considers the value of drugs Pharmacoeconomics evaluates the cost and benefits of drugs in order to guide optimal healthcare resource allocation. The techniques used for

10608-549: The dose-concentration relationship and the extent of these changes so that, if such changes are associated with clinically relevant and significant shifts in exposures that impact the therapeutic index, dosage can be appropriately modified. An advantage of population pharmacokinetic modelling is its ability to analyse sparse data sets (sometimes only one concentration measurement per patient is available). medication medication medication medication medication medication (HIV) medication Clinical pharmacokinetics (arising from

10744-403: The drug are the only information needed to determine the drug's concentration in other fluids and tissues. For example, the concentration in other areas may be approximately related by known, constant factors to the blood plasma concentration. In this one-compartment model, the most common model of elimination is first order kinetics , where the elimination of the drug is directly proportional to

10880-433: The drug enters into contact with the organism, these are described using the acronym ADME (or LADME if liberation is included as a separate step from absorption): Some textbooks combine the first two phases as the drug is often administered in an active form, which means that there is no liberation phase. Others include a phase that combines distribution, metabolism and excretion into a disposition phase. Other authors include

11016-542: The drug's concentration in the organism. This is often called linear pharmacokinetics , as the change in concentration over time can be expressed as a linear differential equation d C d t = − k el C {\textstyle {\frac {dC}{dt}}=-k_{\text{el}}C} . Assuming a single IV bolus dose resulting in a concentration C initial {\displaystyle C_{\text{initial}}} at time t = 0 {\displaystyle t=0} ,

11152-423: The drug's toxicological aspect in what is known as ADME-Tox or ADMET . The two phases of metabolism and excretion can be grouped together under the title elimination . The study of these distinct phases involves the use and manipulation of basic concepts in order to understand the process dynamics. For this reason, in order to fully comprehend the kinetics of a drug it is necessary to have detailed knowledge of

11288-669: The drug. Beyond AUC exposure measures, parameters such as Cmax (maximum concentration), Tmax (time to maximum concentration), CL and Vd can also be reported using NCA methods. Compartment models methods estimate the concentration-time graph by modeling it as a system of differential equations. These models are based on a consideration of an organism as a number of related compartments . Both single compartment and multi-compartment models are in use. PK compartmental models are often similar to kinetic models used in other scientific disciplines such as chemical kinetics and thermodynamics . The advantage of compartmental over noncompartmental analysis

11424-898: The effect of the body on the chemical (e.g. half-life and volume of distribution ), and pharmacodynamics describes the chemical's effect on the body (desired or toxic ). Pharmacology is typically studied with respect to particular systems, for example endogenous neurotransmitter systems . The major systems studied in pharmacology can be categorised by their ligands and include acetylcholine , adrenaline , glutamate , GABA , dopamine , histamine , serotonin , cannabinoid and opioid . Molecular targets in pharmacology include receptors , enzymes and membrane transport proteins . Enzymes can be targeted with enzyme inhibitors . Receptors are typically categorised based on structure and function. Major receptor types studied in pharmacology include G protein coupled receptors , ligand gated ion channels and receptor tyrosine kinases . Network pharmacology

11560-399: The effects of a drug on biological systems, and pharmacokinetics studies the effects of biological systems on a drug. In broad terms, pharmacodynamics discusses the chemicals with biological receptors , and pharmacokinetics discusses the absorption , distribution, metabolism , and excretion (ADME) of chemicals from the biological systems. Pharmacology is not synonymous with pharmacy and

11696-447: The effects of drugs at the overlap between the nervous system and the psyche. Pharmacometabolomics , also known as pharmacometabonomics, is a field which stems from metabolomics , the quantification and analysis of metabolites produced by the body. It refers to the direct measurement of metabolites in an individual's bodily fluids, in order to predict or evaluate the metabolism of pharmaceutical compounds, and to better understand

11832-505: The efficacy of any Traditional Medicine intervention." A 2012 review of cost-effectiveness research for TCM found that studies had low levels of evidence , with no beneficial outcomes. Pharmaceutical research on the potential for creating new drugs from traditional remedies has few successful results. Proponents suggest that research has so far missed key features of the art of TCM, such as unknown interactions between various ingredients and complex interactive biological systems. One of

11968-516: The effort involved in obtaining various distribution values for a drug. This is because the concept of distribution volume is a relative concept that is not a true reflection of reality. The choice of model therefore comes down to deciding which one offers the lowest margin of error for the drug involved. The simplest PK compartmental model is the one-compartmental PK model. This models an organism as one homogenous compartment. This monocompartmental model presupposes that blood plasma concentrations of

12104-450: The end of the Han dynasty. Focusing on drug prescriptions rather than acupuncture, it was the first medical work to combine Yinyang and the Five Phases with drug therapy. This formulary was also the earliest public Chinese medical text to group symptoms into clinically useful "patterns" ( zheng 證 ) that could serve as targets for therapy. Having gone through numerous changes over time, the formulary now circulates as two distinct books:

12240-445: The enzymes responsible for metabolizing the drug become saturated, or where an active elimination mechanism is present that is independent of the drug's plasma concentration. If we label the drug's volume of distribution within the organism Vd F and its volume of distribution in a tissue Vd T the former will be described by an equation that takes into account all the tissues that act in different ways, that is: This represents

12376-444: The equation can be solved to give C = C initial × e − k el × t {\displaystyle C=C_{\text{initial}}\times e^{-k_{\text{el}}\times t}} . Not all body tissues have the same blood supply , so the distribution of the drug will be slower in these tissues than in others with a better blood supply. In addition, there are some tissues (such as

12512-466: The facilitation of disease. Trafficked and farm-raised animals used in TCM are a source of several fatal zoonotic diseases . There are additional concerns over the illegal trade and transport of endangered species including rhinoceroses and tigers, and the welfare of specially farmed animals, including bears. Traditional Chinese medicine (TCM) is a broad range of medicine practices sharing common concepts which have been developed in China and are based on

12648-451: The field of pharmacology has also changed substantially. It has become possible, through molecular analysis of receptors , to design chemicals that act on specific cellular signaling or metabolic pathways by affecting sites directly on cell-surface receptors (which modulate and mediate cellular signaling pathways controlling cellular function). Chemicals can have pharmacologically relevant properties and effects. Pharmacokinetics describes

12784-512: The first pharmacology department in England was set up in 1905 at University College London . Pharmacology developed in the 19th century as a biomedical science that applied the principles of scientific experimentation to therapeutic contexts. The advancement of research techniques propelled pharmacological research and understanding. The development of the organ bath preparation, where tissue samples are connected to recording devices, such as

12920-433: The first to develop a form of vaccination, known as variolation or inoculation , to prevent smallpox . Chinese physicians had realised that when healthy people were exposed to smallpox scab tissue, they had a smaller chance of being infected by the disease later on. The common methods of inoculation at the time was through crushing smallpox scabs into powder and breathing it through the nose. Prominent medical scholars of

13056-479: The healing strategies of the practitioner was unique every time to the specific diagnosis of the patient. Medical case studies existed throughout Chinese history, but "individually authored and published case history" was a prominent creation of the Ming dynasty. An example such case studies would be the literati physician, Cheng Congzhou, collection of 93 cases published in 1644. Historians of science have developed

13192-474: The history of medicine in China distinguish its doctrines and practice from those of present-day TCM. J. A. Jewell and S. M. Hillier state that the term "Traditional Chinese Medicine" became an established term due to the work of Dr. Kan-Wen Ma, a Western-trained medical doctor who was persecuted during the Cultural Revolution and immigrated to Britain, joining the University of London's Wellcome Institute for

13328-470: The human body is opposed to the European duality of a separate mind and body. It is critical for scholars to understand the fundamental differences in concepts of the body in order to connect the medical theory of the classics to the "human organism" it is explaining. Chinese scholars established a correlation between the cosmos and the "human organism". The basic components of cosmology, qi, yin yang and

13464-538: The integration of TCM and Western medicine, and in the Cultural Revolution of the 1960s, promoted TCM as inexpensive and popular. The creation of modern TCM was largely spearheaded by Mao Zedong , despite the fact that, according to The Private Life of Chairman Mao , he did not believe in its effectiveness. After the opening of relations between the United States and China after 1972, there

13600-444: The interaction between an organism and a chemical substance. Pharmacokinetic modelling may be performed either by noncompartmental or compartmental methods. Multi-compartment models provide the best approximations to reality; however, the complexity involved in adding parameters with that modelling approach means that monocompartmental models and above all two compartmental models are the most-frequently used. The model outputs for

13736-454: The journal Nature wrote that TCM "remains poorly researched and supported, and most of its treatments have no logical mechanism of action ." It also described TCM as "fraught with pseudoscience ". A review of the literature in 2008 found that scientists are "still unable to find a shred of evidence" according to standards of science-based medicine for traditional Chinese concepts such as qi , meridians, and acupuncture points, and that

13872-404: The legendary Yellow Emperor and his ministers, it offers explanations on the relation between humans, their environment, and the cosmos , on the contents of the body, on human vitality and pathology, on the symptoms of illness, and on how to make diagnostic and therapeutic decisions in light of all these factors. Unlike earlier texts like Recipes for Fifty-Two Ailments , which was excavated in

14008-673: The main focus of Ecotoxicology. All model based software above. Global centres with the highest profiles for providing in-depth training include the Universities of Buffalo , Florida , Gothenburg , Leiden , Otago , San Francisco , Beijing , Tokyo, Uppsala , Washington , Manchester , Monash University, and University of Sheffield . Traditional Chinese Medicine Model humanity: Main philosophical traditions: Ritual traditions: Devotional traditions: Salvation churches and sects : Confucian churches and sects: Traditional Chinese medicine ( TCM )

14144-674: The manufacture, sale, and administration of medication. In the United States , the main body that regulates pharmaceuticals is the Food and Drug Administration ; they enforce standards set by the United States Pharmacopoeia . In the European Union , the main body that regulates pharmaceuticals is the EMA , and they enforce standards set by the European Pharmacopoeia . The metabolic stability and

14280-513: The metrics of the table in units of mass, instead of Amount of substance , simply replace 'mol' with 'g' and 'M' with 'g/L'. Similarly, other units in the table may be expressed in units of an equivalent dimension by scaling. where C av , ss = A U C τ , ss τ {\displaystyle C_{{\text{av}},{\text{ss}}}={\frac {AUC_{\tau ,{\text{ss}}}}{\tau }}} In pharmacokinetics, steady state refers to

14416-483: The organization of society, the universe, and the human body and other forms of life into an "all-embracing order of things". Each of these traditional systems was organized with such qualities as heat and cold, wet and dry, light and darkness, qualities that also align the seasons, compass directions, and the human cycle of birth, growth, and death. They provided, Leslie continued, a "comprehensive way of conceiving patterns that ran through all of nature," and they "served as

14552-435: The pharmacokinetic profile of a drug. Pharmacometabolomics can be applied to measure metabolite levels following the administration of a drug, in order to monitor the effects of the drug on metabolic pathways. Pharmacomicrobiomics studies the effect of microbiome variations on drug disposition, action, and toxicity. Pharmacomicrobiomics is concerned with the interaction between drugs and the gut microbiome . Pharmacogenomics

14688-481: The pharmacokinetic properties of the chemical that is the active ingredient or active pharmaceutical ingredient (API), pharmacologists are often interested in L-ADME : Drug metabolism is assessed in pharmacokinetics and is important in drug research and prescribing. Pharmacokinetics is the movement of the drug in the body, it is usually described as 'what the body does to the drug' the physico-chemical properties of

14824-402: The physiology of individuals. For example, pharmacoepidemiology concerns the variations of the effects of drugs in or between populations, it is the bridge between clinical pharmacology and epidemiology . Pharmacoenvironmentology or environmental pharmacology is the study of the effects of used pharmaceuticals and personal care products (PPCPs) on the environment after their elimination from

14960-422: The polypharmacology of drugs. Pharmacodynamics is defined as how the body reacts to the drugs. Pharmacodynamics theory often investigates the binding affinity of ligands to their receptors. Ligands can be agonists , partial agonists or antagonists at specific receptors in the body. Agonists bind to receptors and produce a biological response, a partial agonist produces a biological response lower than that of

15096-486: The post-Han period included Tao Hongjing (456–536), Sun Simiao of the Sui and Tang dynasties, Zhang Jiegu ( c.  1151 –1234), and Li Shizhen (1518–1593). Chinese communities living in colonial port cities were influenced by the diverse cultures they encountered, which also led to evolving understandings of medical practices where Chinese forms of medicine were combined with Western medical knowledge. For example,

15232-492: The presence of other therapies, can regularly alter dose-concentration relationships and can explain variability in exposures. For example, steady-state concentrations of drugs eliminated mostly by the kidney are usually greater in patients with kidney failure than they are in patients with normal kidney function receiving the same drug dosage. Population pharmacokinetics seeks to identify the measurable pathophysiologic factors and explain sources of variability that cause changes in

15368-579: The president of the Chinese Medical Association said that, "This One Medicine, will possess a basis in modern natural sciences, will have absorbed the ancient and the new, the Chinese and the foreign, all medical achievements – and will be China's New Medicine!" During the Cultural Revolution (1966–1976) the CCP and the government emphasized modernity, cultural identity and China's social and economic reconstruction and contrasted them to

15504-571: The proposed "seven emotions and harmony" principle have played a role in the practice of medicine for thousands of years. Therefore, it has been a textbook for medical workers in modern China. The full text of Shennong Ben Cao Jing in English can be found online. In the centuries that followed, several shorter books tried to summarize or systematize the contents of the Yellow Emperor's Inner Canon . The Canon of Problems (probably second century CE) tried to reconcile divergent doctrines from

15640-524: The ratio of desired effect to toxic effect. A compound with a narrow therapeutic index (close to one) exerts its desired effect at a dose close to its toxic dose. A compound with a wide therapeutic index (greater than five) exerts its desired effect at a dose substantially below its toxic dose. Those with a narrow margin are more difficult to dose and administer, and may require therapeutic drug monitoring (examples are warfarin , some antiepileptics , aminoglycoside antibiotics ). Most anti- cancer drugs have

15776-412: The reactivity of a library of candidate drug compounds have to be assessed for drug metabolism and toxicological studies. Many methods have been proposed for quantitative predictions in drug metabolism; one example of a recent computational method is SPORCalc. A slight alteration to the chemical structure of a medicinal compound could alter its medicinal properties, depending on how the alteration relates to

15912-490: The relationships between the Five Phases in terms of sequence, of acting on each other, of counteraction, etc. All these aspects of Five Phases theory constitute the basis of the zàng-fǔ concept, and thus have great influence regarding the TCM model of the body. Five Phase theory is also applied in diagnosis and therapy. Correspondences between the body and the universe have historically not only been seen in terms of

16048-401: The response of most mass spectrometers is not linear across large concentration ranges. There is currently considerable interest in the use of very high sensitivity mass spectrometry for microdosing studies, which are seen as a promising alternative to animal experimentation . Recent studies show that Secondary electrospray ionization (SESI-MS) can be used in drug monitoring, presenting

16184-483: The second half of the nineteenth century, the remarkable potency and specificity of the actions of drugs such as morphine , quinine and digitalis were explained vaguely and with reference to extraordinary chemical powers and affinities to certain organs or tissues. The first pharmacology department was set up by Rudolf Buchheim in 1847, at University of Tartu, in recognition of the need to understand how therapeutic drugs and poisons produced their effects. Subsequently,

16320-418: The situation where the overall intake of a drug is fairly in dynamic equilibrium with its elimination. In practice, it is generally considered that once regular dosing of a drug is started, steady state is reached after 3 to 5 times its half-life. In steady state and in linear pharmacokinetics, AUC τ =AUC ∞ . Models have been developed to simplify conceptualization of the many processes that take place in

16456-410: The structure of the substrate or receptor site on which it acts: this is called the structural activity relationship (SAR). When a useful activity has been identified, chemists will make many similar compounds called analogues, to try to maximize the desired medicinal effect(s). This can take anywhere from a few years to a decade or more, and is very expensive. One must also determine how safe the medicine

16592-433: The study of medicine in traditional China into a field with its own scholarly associations, journals, graduate programs, and debates with each other. Many distinguish "medicine in traditional China" from the recent traditional Chinese medicine (TCM), which took elements from traditional texts and practices to construct a systematic body. Paul Unschuld, for instance, sees a "departure of TCM from its historical origins." What

16728-429: The term 身 , and observing the history from the perspective of cosmology rather than biology. In Chinese classical texts, the term 身 is the closest historical translation to the English word "body" because it sometimes refers to the physical human body in terms of being weighed or measured, but the term is to be understood as an "ensemble of functions" encompassing both the human psyche and emotions. This concept of

16864-511: The traditional principles of acupuncture are deeply flawed. "Acupuncture points and meridians are not a reality", the review continued, but "merely the product of an ancient Chinese philosophy". In June 2019, the World Health Organization included traditional Chinese medicine in a global diagnostic compendium, but a spokesman said this was "not an endorsement of the scientific validity of any Traditional Medicine practice or

17000-407: The trapezoidal rule, the area estimation is highly dependent on the blood/plasma sampling schedule. That is, the closer time points are, the closer the trapezoids reflect the actual shape of the concentration-time curve. The number of time points available in order to perform a successful NCA analysis should be enough to cover the absorption, distribution and elimination phase to accurately characterize

17136-438: The two terms are frequently confused. Pharmacology, a biomedical science , deals with the research, discovery, and characterization of chemicals which show biological effects and the elucidation of cellular and organismal function in relation to these chemicals. In contrast, pharmacy, a health services profession, is concerned with the application of the principles learned from pharmacology in its clinical settings; whether it be in

17272-410: The universe can be divided into. Primordial analogies for these aspects are the sun-facing (yang) and the shady (yin) side of a hill. Two other commonly used representational allegories of yin and yang are water and fire. In the yin–yang theory , detailed attributions are made regarding the yin or yang character of things: The concept of yin and yang is also applicable to the human body; for example,

17408-633: The upper part of the body and the back are assigned to yang, while the lower part of the body is believed to have the yin character. Yin and yang characterization also extends to the various body functions, and – more importantly – to disease symptoms (e.g., cold and heat sensations are assumed to be yin and yang symptoms, respectively). Thus, yin and yang of the body are seen as phenomena whose lack (or over-abundance) comes with characteristic symptom combinations: TCM also identifies drugs believed to treat these specific symptom combinations, i.e., to reinforce yin and yang. Strict rules are identified to apply to

17544-405: Was almost never used after it was found to cause nephrotoxicity in a number of patients. However, it was then realized that it was possible to individualize a patient's dose of ciclosporin by analysing the patients plasmatic concentrations (pharmacokinetic monitoring). This practice has allowed this drug to be used again and has facilitated a great number of organ transplants. Clinical monitoring

17680-633: Was defined by a domination or remission of yang in terms of yin. These two distinctions are imperative when analyzing the history of traditional Chinese medical science. A majority of Chinese medical history written after the classical canons comes in the form of primary source case studies where academic physicians record the illness of a particular person and the healing techniques used, as well as their effectiveness. Historians have noted that Chinese scholars wrote these studies instead of "books of prescriptions or advice manuals;" in their historical and environmental understanding, no two illnesses were alike so

17816-580: Was established for similar reasons and also provided both Western and Chinese medical care. By 1935, English-language newspapers in Colonial Singapore already used the term "Traditional Chinese Medicine" to label Chinese ethnic medical practices. In 1950, Chinese Communist Party (CCP) chairman Mao Zedong announced support of traditional Chinese medicine; this was despite the fact that Mao did not personally believe in and did not use TCM, according to his personal physician Li Zhisui . In 1952,

17952-519: Was great interest in the West for what is now called traditional Chinese medicine (TCM). TCM is said to be based on such texts as Huangdi Neijing (The Inner Canon of the Yellow Emperor), and Compendium of Materia Medica , a sixteenth-century encyclopedic work, and includes various forms of herbal medicine , acupuncture , cupping therapy , gua sha , massage (tui na) , bonesetter (die-da) , exercise (qigong) , and dietary therapy. TCM

18088-435: Was later absorbed by Daoism . Philosophical texts influenced TCM, mostly by being grounded in the same theories of qi , yin-yang and wuxing and microcosm-macrocosm analogies. Yin and yang are ancient Chinese deductive reasoning concepts used within Chinese medical diagnosis which can be traced back to the Shang dynasty (1600–1100 BCE). They represent two abstract and complementary aspects that every phenomenon in

18224-617: Was not regulated. The establishment in 1870 of the Tung Wah Hospital was the first use of Chinese medicine for the treatment in Chinese hospitals providing free medical services. As the promotion of Western medicine by the British government started from 1940, Western medicine started being popular among Hong Kong population. In 1959, Hong Kong had researched the use of traditional Chinese medicine to replace Western medicine. Historians have noted two key aspects of Chinese medical history: understanding conceptual differences when translating

18360-437: Was not yet popular, and Western medicine doctors were mostly foreigners; local residents mostly relied on Chinese medicine practitioners. In 1841, the British government of Hong Kong issued an announcement pledging to govern Hong Kong residents in accordance with all the original rituals, customs and private legal property rights. As traditional Chinese medicine had always been used in China, the use of traditional Chinese medicine

18496-478: Was re-created in response to Western medicine. In 1968, the CCP supported a new system of health care delivery for rural areas. Villages were assigned a barefoot doctor (a medical staff with basic medical skills and knowledge to deal with minor illnesses) responsible for basic medical care. The medical staff combined the values of traditional China with modern methods to provide health and medical care to poor farmers in remote rural areas. The barefoot doctors became

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