Clinical pharmacology is a rapidly evolving medical discipline that plays a crucial role in optimizing drug therapy, ensuring patient safety, and improving therapeutic outcomes. Despite significant advances in drug development, pharmacokinetics, pharmacodynamics, and personalized medicine, modern clinical pharmacology faces numerous challenges that complicate the rational use of medications in clinical practice. These challenges include increasing polypharmacy, drug–drug interactions, variability in individual drug responses, adverse drug reactions, antimicrobial resistance, limitations of clinical trials, and insufficient integration of pharmacogenomics into routine care. Additionally, the growing burden of chronic diseases and aging populations further intensify the complexity of pharmacotherapy. This review aims to analyze the most актуальные (pressing) problems in contemporary clinical pharmacology, focusing on issues related to drug safety, efficacy, personalized therapy, and pharmacovigilance. Particular attention is paid to the gap between experimental research and real-world clinical practice, as well as future directions for improving rational pharmacotherapy.

clinical pharmacology, drug safety, polypharmacy, pharmacogenomics, adverse drug reactions, pharmacovigilance, personalized medicine.

Brunton, L. L., Hilal-Dandan, R., & Knollmann, B. C. (2023). Goodman & Gilman’s The Pharmacological Basis of Therapeutics (14th ed.). McGraw-Hill.

Aronson, J. K. (2022). Medication errors: Definitions and classification. British Journal of Clinical Pharmacology, 88(1), 12–22.

World Health Organization. (2023). Pharmacovigilance: ensuring the safe use of medicines. WHO Press.

Roden, D. M., McLeod, H. L., Relling, M. V., et al. (2019). Pharmacogenomics. The Lancet, 394(10197), 521–532.

Maher, R. L., Hanlon, J., & Hajjar, E. R. (2014). Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety, 13(1), 57–65.

van der Graaf, P. H., & Benson, N. (2022). Systems pharmacology. Nature Reviews Drug Discovery, 21, 781–797.

Edwards, I. R., & Aronson, J. K. (2020). Adverse drug reactions. The Lancet, 356(9237), 1255–1259.

Lesko, L. J., & Schmidt, S. (2021). Clinical pharmacology in drug development. Clinical Pharmacology & Therapeutics, 109(4), 883–890.