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8/23/2019 POSTGRADUATE MEDICAL EDUCATION IN PHARMACOLOGY
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POSTGRADUATE MEDICALEDUCATION IN
PHARMACOLOGYBy
Professor Ranjit Roy Chaudhury**
National Professor of Pharmacology (National Academy ofMedical Sciences) &Chairman Task Force for Research
Apollo Hospitals Educational and Research Foundation
Kolkata10th December 2009
** Former Professor and Head, Dept. of Pharmacology, Dean andActing Director
Postgraduate Institute of Medical Education and Research, Chandigarh
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G A P
Pharmacological expertise needed
and
Availability of pharmacologists
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G A P
Type of specialized pharmacologicalexpertise needed
and
Type of pharmacological expertiseavailable
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GLOBAL LEADERSHIP
Drug discovery
International health care
Clinical trials
Traditional medicine research
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DRUG DISCOVERY
New molecules coming from Indianlaboratories
40+ molecules at different stages of clinicaltrials in India
Interesting leads sold to the foreigncompanies
Essential to have drug developmentexpertise in India
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TYPES OF PHARMACOLOGICAL
EXPERTISE NEEDEDImmunopharmacology
Biochemical pharmacology
Pharmacogenetics
Molecular pharmacology
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INTERNATIONAL HEALTH CARECost of Carrying Out
Procedure USA India Thailand Singapore
Coronary arterybypass surgery
$70,000-133,000
$7,000 $22,000 $16,300
Bypass surgerywith heart valve
replacement
$75,000-140,000
$9,500 $25,000 $22,000
Hip replacement $33,000-57,000
$7,200 $12,700 $12,000
Kneereplacement
$30,000-53,000
$7,200 $11,500 $9,600
Prostate surgery(TURPprocedure)
$10,000-16,000
$3,600 $4,400 $5,300
Gastric bypass $35,000-52,000
$9,300 $13,000 $16,500
Face-lift $10,500-16,000
$4,800 $5,000 $7,500
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CLINICAL TRIALSWhy India?
Availability of a large population of patients
Large variety of diseases prevalence
Availability of naive patients, 299 medicalcolleges, competent clinicians with fluencyin english
Greatly reduced cost for carrying out clinicaltrials
Relatively strong drug regulatory agency
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CLINICAL TRIALS IN INDIA
BOON Ethical transparent trials
or
BANE Unethical trials exploitingpoor and illiterate
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PREPARATIONS BY ICMR FORDRUG DEVELOPMENT /
CLINICAL TRIALSAdvanced Centres
NIRRH, Mumbai Reproductive ToxicologyNIN, Hyderabad Toxicology
JIPMER, Pondicherry Genotoxicology
- Reverse PharmacologyRegional Research Institute, Jammu
Standardization
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PREPARATIONS BY ICMR FORDRUG DEVELOPMENT /
CLINICAL TRIALSAdvanced Centres
RMRC, Belgaum Traditional medicine
Himalayan Institute, Palampur Cultivationof medicinal plants
Bose Institute, Kolkata Plant genomeresearch
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CLINICAL TRIAL CENTRES
NIZAMs Institute, Hyderabad -Pharmacodynamics
CMC, Vellore Centre for evidence basedmedicine
Vivekananda Yoga Kendra Effect of yoga
Nair Hospital, Mumbai Clinical Trials
KEM Hospital, Mumbai Clinical Trials
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CENTRES FOR CLINICAL TRIALSOF TRADITIONAL REMEDIES
AIIMS, New Delhi
PGIMER, ChandigarhBHU, Varanasi
Medical Colleges Cuttack
- Trivandrum
- Chennai
- Kottayam
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INSTITUTE ETHICSCOMMITTEE
To protect patient/public from exploitation
Committee needed at all centres whereclinical trials are being carried
No trial to be carried out till proposalcleared by Ethics Committee
and
Placed in Register of Clinical Trials, ICMR
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CLINICAL PHARMACOLOGISTin Institutional Ethics
CommitteesInformed Consent
Use of Placebo
Ownership of data
Rights of patient after completion of trial
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TRADITIONAL MEDICINE
Kolkata
Col. R. N. Chopra
Dr. B. B. Dikshit
Dr. B. Mukherjee
School of tropical medicine,Kolkata
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RESEARCH
Resources Technology Bio-diversity
North Yes Yes No
South No No Yes
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GOLD STANDARD
For Synthetic DrugControlled
Comparative
Placebo
Double-Blind
RandomizedMulti-centred
Clinical trial
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OTHER DESIGNS MAY BEAPPROPRIATE FOR
TRADITIONAL MEDICINES
Observational pharmacology trials
Open trials
Single blind studies
Sample of one trials
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RATIONAL USE OF MEDICINESADVANTAGES
Better therapeutics
Reduction of side effects- Inappropriate dose
- Inappropriate duration of treatment- Interactions
Reduction in cost of medication- Individual- Family
- Community
- Country
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THE DELHI MODEL
Rajasthan
Himachal Pradesh
Uttar Pradesh
Haryana
Mumbai Corporation
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OTHER ORGANIZATIONSUSING CONCEPT OF
RATIONAL USE OF MEDICINES
Helpage
Family Planning Association
National Rural Health Mission
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NEED FOR PHARMACOLOGISTS
Development of drug policySelection of drugs to be used in country
Drug regulation
Drug discoveryCarrying out clinical trials
Corporate and government hospitals
Research in traditional medicines
Pharmacovigilance
Memberships/Chair Ethics Committees
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NEED FOR PHARMACOLOGISTS
Traditional role as professors ofpharmacology in medical colleges
and
in drug research institutes
and
in drug regulatory agenciesand
in pharmaceutical industry
D M COURSE IN CLINICAL
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D.M. COURSE IN CLINICALPHARMACOLOGY AT PGI,
CHANDIGARHTeam: Professor Ranjit Roy Chaudhury
Professor V. S. MathurProfessor P. L. SharmaDr. K. S. RaghavanDr. S. K. Garg
Collaboration: Professor P. K. Devi
Professor R. N. ChakravartyGuidance and
Support: Professor P. N. ChhuttaniProfessor K. L. Wig
Professor Santokh Singh Anand
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D.M. CLINICALPHARMACOLOGY
Open to pharmacologists and cliniciansafter receiving first advanced degree
Two year course
Clinical attachment
WHERE ARE THEY 36 TILL
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WHERE ARE THEY 36 TILLDECEMBER 2009
India and Abroad
Professors of clinical pharmacology
Medical Directors/Vice-Presidents inpharmaceutical houses
Heads of drug regulatory agencies
Heads of divisions in research institutes
Academic staff of medical colleges
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D.M.S QUALIFYING EVERYYEAR
PGIMER, Chandigarh - 2
KEM, Mumbai - 2
Nizams, Hyderabad - 2
A.I.I.M.S - 1
Others - 2
- 10
DNB in clinical pharmacology 4 to 5
TOTAL 15 per year
NEED - 100 per year
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OTHER TRAININGPROGRAMMES
Masters in pharmacology from collegesof pharmacy
Masters course in pharmaceuticalmedicine run by KEM Hospital, Mumbai
90 trainees each year
WHY IS THERE SO MUCH
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WHY IS THERE SO MUCHNEED?
Healthcare IndustryAt present 20 billion dollars
In ten years 45 to 63 billiion dollars
+ 9.00 billion dollars
If health insurance comes in
Clinical trial turnover
1.0 billion dollars by 2015
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INTERNATIONAL HEALTHPatients from Abroad
1999 10,000
2004 180,000Annual growth rate 25 to 30%
ExampleApollo HospitalsIn last five years 60,000
from 55 countries
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M.D. COURSE OF A.I.I.M.SContains
Molecular biology in pharmacology
Clinical pharmacology and recent
advancesDrug regulations
Drug development process
Clinical trials
Therapeutic drug monitoring
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AREAS WHICH COULD BEADDED
Drug delivery systems
- Transdermal drug delivery
Ocular pharmacology
Pharmacovigilance
Regulations regarding IPRPharmacogenetics
Genomic pharmacology
PHARMACOLOGY
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PHARMACOLOGYPOSTGRADUATES
More needed- Scaling up
Different expertise needed- Broaden curriculum horizons
NEED tremendous
No time to lose
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