Skip to main content

Status of Safety Pharmacology and Present Guidelines

  • Reference work entry
  • 987 Accesses

“The adverse drug reactions which the standard toxicological test procedures do not aspire to recognize most of the functional side-effects. Clinical experience indicates, however, that these are much more frequent than the toxic reactions due to morphological and biochemical lesions…” (Gerhard Zbinden 1979)

1 I.B.1. Origins of Safety Pharmacology

Serious injury and/or death of volunteers and patients participating in early clinical trials are rare and thus very disturbing when they occur (Marshall 2001a; 2001b; Miller 2000). The organ systems and functions most frequently responsible in these events are the central nervous (seizure), cardiovascular (hypotension, hypertension, and arrhythmia), respiratory (asthma/bronchoconstriction), and renal (glomerular filtration) systems, and the result is almost always a critical care emergency (Kinter et al. 1997). The origins of safety pharmacology are grounded upon observations that organ functions (like organ structures) can be...

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   389.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Ackerman MJ (1998) The long QT syndrome: Ion channel diseases of the heart. Mayo Clinic Proceedings 73:250–269

    Article  PubMed  CAS  Google Scholar 

  • Anderson ME, Al-Khatib SM, Roden DM, Califf RM (2002) Cardiac repolarization: Current knowledge, critical gaps and new approaches to drug development and patient management. American Heart Journal 144:769–781

    PubMed  CAS  Google Scholar 

  • Baldrick P, Bamford DG, Tattersall ML (1998) An assessment of two gastric transport models currently used in safety pharmacology testing. Human and Reproductive Toxicology 17:1–7

    Article  CAS  Google Scholar 

  • Bass AS, Williams PD (2003) Status of international regulatory guidelines on safety pharmacology. In: Williams PD, Bass AS (eds) Safety Pharmacology, pp 9–20

    Google Scholar 

  • Batey AJ, Doe CPA (2003) A method for QT correction based on beat-to-beat analysis of the QT/RR interval relationship in conscious telemetered beagle dogs. Journal of Pharmacological and Toxicological Methods 48:1–9

    Google Scholar 

  • Bunting PB, Siegl PKS (1994) Models used to assess cardiovascular function in general pharmacology. Drug Development Research 32:256–259

    Article  CAS  Google Scholar 

  • Calamari D (2003) Strategic survey of therapeutic drugs in the rivers Po and Lambo in Northern Italy. Environmental Science and Technology 37:1241–1248

    Article  CAS  Google Scholar 

  • Cavero J, Crumb W (2005) ICH S7B draft guideline on the non-clinical strategy for testing delayed cardiac repolarisation risk of drugs: a critical analysis. Expert Opin. Drug Saf. 4:509–530

    Article  PubMed  Google Scholar 

  • Chiu PJS (1994) Models used to assess renal function. Drug Development Research 32:247–255

    Article  CAS  Google Scholar 

  • De Ponti F, Poluzzi E, Montanaro N (2001) Organising evidence on QT prolongation and occurrence of torsades de pointes with non-antiarrhythmic drugs: A call for consensus. European Journal of Clinical Pharmacology 57:185–209

    Article  PubMed  Google Scholar 

  • Gad SC (2004) Safety pharmacology in pharmaceutical development and approval. CRC Press, Boca Raton

    Google Scholar 

  • Green MD (1995) An FDA perspective on general pharmacology studies to determine activity and safety. Drug Development Research 35:158–160

    Article  CAS  Google Scholar 

  • Haggerty GC (1991) Strategy for and experience with neurotoxicity testing of new pharmaceuticals. Journal of the American College of Toxicology 10:677–687

    Google Scholar 

  • Hammond TG, Carlsson L, Davis AS et al. (2001) Methods of collecting and evaluating non-clinical cardiac electrophysiology data in pharmaceutical industry: Results of an international survey. Cardiovascular Research 49:741–750

    Article  PubMed  CAS  Google Scholar 

  • Haverkamp W, Breithart G, Camm AJ et al. (2000) The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: Clinical and regulatory implications. Cardiovascular Research 47:219–233

    Article  PubMed  CAS  Google Scholar 

  • Hondeghem LM, Carlsson L, Duker G (2001) Instability and triangulation of the action potential predict serious proarrhythmia, but action potential duration prolongation is antiarrhythmic. Circulation 103:2004–2013

    PubMed  CAS  Google Scholar 

  • Huggett DB, Khan IA, Foran CM, Schlenk D (2003) Determination of beta-adrenergic receptor blocking pharmaceuticals in United States wastewater effluent. Environmental Pollution 121:199–205

    CAS  Google Scholar 

  • Igarashi T, Nakane S, Kitagawa T (1995) Predictability of clinical adverse reactions of drugs by general pharmacology studies. Journal of Toxicological Sciences 20:77–92

    PubMed  CAS  Google Scholar 

  • Japanese Guidelines for Nonclinical Studies of Drugs Manual (1995) Yakuji Nippo, Ltd, Tokyo

    Google Scholar 

  • Kinter LB (2003) Safety pharmacology of the renal and gastro-intestinal systems. In: Williams PD, Bass AS (eds) Safety pharmacology: A practical guide. TherImmune Research, Gaithersburg, MD, pp 99–116

    Google Scholar 

  • Kinter LB, Dixon LW (1995) Safety pharmacology program for pharmaceuticals. Drug Development Research 35:179–182

    Article  CAS  Google Scholar 

  • Kinter LB, Gossett KA, Kerns WD (1994) Status of safety pharmacology in the pharmaceutical industry–1993. Drug Development Research 32:208–216

    Article  CAS  Google Scholar 

  • Kinter LB, Johnson DK (1999) Remote monitoring of experimental endpoints in animals using radiotelemetry and bioimpedance technologies. In: Hendriksen CFM, Morton DB (eds) Proceedings of the international conference on humane endpoints in animal experiments for biomedical research. The Royal Society of Medicine Press, London, pp 58–65

    Google Scholar 

  • Kinter LB, Johnson DK (2003) Safety pharmacology of the cardiovascular system. In: Williams PD, Bass AS (eds) Safety pharmacology: A practical guide. TherImmune Research, Gaithersburg, MD, pp 67–98

    Google Scholar 

  • Kinter LB, Murphy DJ, Mann WA et al. (1997) Major organ systems toxicology: An integrated approach to pharmacodynamic safety assessment studies in animals. In: Williams PD, Hottendorf GH (series eds) & Sipes IG, McQueen CA, Gandolfi AJ (vol. eds) Comprehensive toxicology. Vol 2. Toxicology Testing and Evaluation. Elsevier, New York, p 155–168

    Google Scholar 

  • Kinter LB, Valentin JP (2002) Safety pharmacology and risk assessment. Fundamental and Clinical Pharmacology 16:175–182

    Article  PubMed  CAS  Google Scholar 

  • Kopin DW, Furlong ET, Meyer MT et al. (2002) Pharmaceuticals, hormones, and other organic wastewater contaminants in U.S. streams 1999–2000: A national reconnaissance. Environmental Science and Technology 36(6):1202–1211

    Article  Google Scholar 

  • Kramer K, Kinter LB (2003) Evaluation and application of radiotelemetry in small laboratory animals. Physiological Genomics 13:197–205

    PubMed  Google Scholar 

  • Kramer K, Mills PA, Kinter LB, Brockway BP (1998) History of laboratory telemetry and the state of the art of fully implanted radiotelemetry for monitoring laboratory animals. Laboratory Animal 27:40–46

    Google Scholar 

  • Kurata M, Kanai K, Mizuguchi K et al. (1997) Trends in safety pharmacology in the US and Europe. Journal of Toxicological Sciences 22:237–248

    Google Scholar 

  • Lacroix P, Provost D (2000) Basic safety pharmacology: the cardiovascular system. Therapie 55:63–69

    PubMed  CAS  Google Scholar 

  • Lufy J, Bode G (2002) Integration of safety pharmacology endpoints into toxicology studies. Fundamental and Clinical Pharmacology 16:1–103

    Article  Google Scholar 

  • Lumley CE (1994) General pharmacology, the international regulatory environment, and harmonization guidelines. Drug Development Research 32:23–232

    Article  Google Scholar 

  • Malik M, Camm AJ (2001) Evaluation of drug-induced QT interval prolongation. Implications for drug approval and labelling. Drug Safety 24:23–351

    Article  Google Scholar 

  • Marshall E (2001a) Volunteer's death prompts review. Science 292:2226–2227

    Article  PubMed  CAS  Google Scholar 

  • Marshall E (2001b) Procedures faulted in fatal asthma trial. Science 293:405–406

    Article  PubMed  CAS  Google Scholar 

  • Mattsson JL, Spencer PJ, Albee RR (1996) A performance standard for chemical and functional observation battery examinations of rats. Journal of the American College of Toxicology 15:239–254

    Google Scholar 

  • Miller HI (2000) Gene therapy's trials and tribulations. The Scientist 14:16–18

    Google Scholar 

  • Mojaverian P (1996) Evaluation of gastrointestinal pH and gastric residence time via the Heidelberg Radiotelemetry Capsule: Pharmacological application. Drug Development Research 38:73–85

    Article  CAS  Google Scholar 

  • Morgan DG, Kelvin AS, Kinter LB et al. (1994) The application of toxicokinetic data to dosage selection in toxicology studies. Toxicologic Pathology 22:112–123

    Article  PubMed  CAS  Google Scholar 

  • Mortin LI, Horvath CJ, Wyand MS (1997) Safety pharmacology screening: Practical problems in drug development. International Journal of Toxicology 16:41–65

    Article  CAS  Google Scholar 

  • Moser VC (1991) Application of a neurobehavioral screening battery. Journal of the American College of Toxicology 10:661–669

    Google Scholar 

  • Moss AJ (1999) The QT interval and torsade de pointes. Drug Safety 21:5–10

    Article  PubMed  CAS  Google Scholar 

  • Murphy DJ (1994) Safety pharmacology of the respiratory system: Techniques and study design. Drug Development Research 32:237–246

    Article  CAS  Google Scholar 

  • Murphy DJ (2002) Assessment of respiratory function in safety pharmacology. Fundamental and Clinical Pharmacology 16:183–196

    Article  PubMed  CAS  Google Scholar 

  • Olsen H, Betton G, Robimson D et al. (2000) Concordance of the toxicity of pharmaceuticals in humans and animals. Regulatory Toxicology and Pharmacology 32:56–67

    Article  Google Scholar 

  • Omosu M, Komine I, Becker RH, Schölkens BA (1988) General pharmacology of Ramipril. Arzn. Forsch/Drug Res 38:1309–1317

    CAS  Google Scholar 

  • Porsolt RD, Lemaire M, Durmuller N, Roux S (2002) New perspectives in CNS safety pharmacology. Fundamental and Clinical Pharmacology 16:197–207

    Article  PubMed  CAS  Google Scholar 

  • Porsolt RD, Picard S, Lacroix P (2005) International Safety Pharmacology Guidelines (ICH S7A and S7B): Where do we go from here? Drug Develop. Res. 64:83–89

    Article  CAS  Google Scholar 

  • Proakis AG (1994) Regulatory considerations on the role of general pharmacology studies in the development of therapeutic agents. Drug Development Research 32:233–236

    Article  Google Scholar 

  • Redfern WS, Carlsson L, Davis AS (2003) Relationships between preclinical cardiac electrophysiology clinical QT interval prolongation, and torsade de pointes for a broad range of drugs: Evidence for a provisional safety margin in drug development. Cardiovascular Research 58:1–44

    Article  Google Scholar 

  • Ross JF, Mattsson JL, Fix AS (1998) Expanded clinical observations in toxicology studies: Historical perspectives and contemporary issues. Regulatory Toxicology and Pharmacology 28:17–26

    Article  PubMed  CAS  Google Scholar 

  • Sarlo K, Clark ED (1995) Evaluating chemicals as respiratory allergens: Using a tier approach for risk assessment. Methods in Immunotoxicology 2:411–426

    CAS  Google Scholar 

  • Shah RS (2005a) Drugs, QT interval prolongation and ICH E14. Drug Safety 28:115–125

    Article  PubMed  Google Scholar 

  • Shah RS (2005b) Drugs, QT interval prolongation and final ICH E14 guideline. Drug Safety 28:1008–1028

    Google Scholar 

  • Spence S, Soper K, Hoe CM, Coleman J (1998) The rate-corrected QT interval of conscious beagle dogs: A formula based on analysis of covariance. Toxicological Sciences 45:247–258

    Article  PubMed  CAS  Google Scholar 

  • Thomas SHL (1994) Drugs, QT interval abnormalities and ventricular arrhythmias. Adverse Drug Reactions and Toxicology Reviews 13:77–102

    CAS  Google Scholar 

  • Valentin JP, Bass AS (2004) personal communication

    Google Scholar 

  • Viskin S (1999) Long QT syndromes and torsade de pointes. Lancet 354:1625–1633

    Article  PubMed  CAS  Google Scholar 

  • Webster R, Leischman D, Walker D (2002) Towards a drug concentration effect relationship for QT prolongation and torsades de pointes. Current Opinion in Drug Discovery and Development 5:116–126

    CAS  Google Scholar 

  • Williams PD (1990) The role of pharmacological profiling in safety assessment. Regulatory Toxicology and Pharmacology 12:238–252

    Article  PubMed  CAS  Google Scholar 

  • Williams PD, Bass AS (2003) Safety pharmacology: A practical guide. TherImmune Research, Gaithersburg, MD

    Google Scholar 

  • Zbinden G (1979) Pharmacological methods in toxicology. Pergamon Press, Elmsford, NY, p 613

    Google Scholar 

  • Zbinden G (1984) Neglect of function and obsession with structure in toxicity testing. Proceedings of the 9th International Congress of Pharmacology 1:43–49

    Google Scholar 

  • S7A Safety Pharmacology Studies for Human Pharmaceuticals http://www.ich.org/LOB/media/MEDIA504.pdf

    Google Scholar 

  • S7B The Nonclinical Evaluation of the Potential for Delayed Ventricular Repolarization (QT Interval Prolongation) By Human Pharmaceuticals (Step 5, May 2005) http://www.ich.org/LOB/media/MEDIA2192.pdf

    Google Scholar 

  • E14 The Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs (Step 5, May 2005) http://www.ich.org/LOB/media/MEDIA503.pdf

    Google Scholar 

  • S6 Preclinical Safety Evaluation of Biotechnology-Derived Pharmaceuticals http://www.ich.org/LOB/media/MEDIA503.pdf

    Google Scholar 

  • Points to consider: The Assessment of the Potential QT Interval Prolongation by Non-Cardiovascular Medicinal Products http://www.emea.eu.int/pdfs/human/swp/098696en.pdf

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Franz J. Hock .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag Berlin Heidelberg New York

About this entry

Cite this entry

Hock, F.J. (2006). Status of Safety Pharmacology and Present Guidelines. In: Vogel, H.G., Hock, F.J., Maas, J., Mayer, D. (eds) Drug Discovery and Evaluation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29804-5_2

Download citation

Publish with us

Policies and ethics