31-2: Clinical Pharmacology for the Lower Extremity Professional: An Update

Editorial

In her 1978 work of critical theory, Illness as a Metaphor, Susan Sontag offered the following: “Everyone who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick.”

It is essential that the lower extremity provider, when making decisions regarding which medications to prescribe, employs the knowledge of pharmacology, adverse medication effects as well as drug interactions. Physicians are trained to realize that medication response is not the same in every patient. It must be acknowledged that pharmacological regimens do not exist in a vacuum. The science of pharmacology and pharmaceutical manufacturing continually evolves and advances. It is crucial that healthcare providers select agents of therapy based on up-to-date information.

In this issue’s feature article, I included the phrase “Veneni dextera dextrae Tempus” — Latin for “Right drug right time” — as a metaphor for the available clinical-based evidence within the evolving science of pharmacology. It is imperative that clinicians familiarize themselves and stay updated on how given medications may act differently depending on patient factors and pathophysiology. For this reason, the feature article encompasses a review of tools to assist in prescribing newer medications with an exploration of critical elements that affect patient response.

This issue’s abstracts and commentaries pertain to updated relevant pharmacology issues, some that may be controversial in the context of evolving ideology for enhancing medication response while mitigating negative interactions.

The first audio lecture is centered on avoiding drug injury and responsibilities of the lower extremity physician in detailing medical and legal aspects that the lower extremity specialist should consider so to avoid drug-induced injury. The second audio presentation focuses on new medications that have reshaped treatment options in our realm of care. This lecture explores medications that have recently come to market, noting each agent’s pharmacology, directions for use, adverse drug profile and cost to patients. This issue reviews many of the advances and updates regarding the changing viewpoints of pharmacotherapy, so that the practicing foot and ankle specialist can select appropriate pharmacological agents for their diverse patient population with confidence.

Robert G. Smith, DPM, MSc, RPh