Interview with MD Medical School of Pharmacy dean

Daily Record, The (Baltimore), Aug 3, 2002 by Nancy Kercheval

So is this becoming a reality anytime soon?

It has been in the governor's capital improvement plan for a decade. There have been various reasons why it has slipped from year to year -- anything from the new law school being championed by governors to the head of the queue to now we have terrific infrastructure problems in the Dental School that moved that ahead. We're tops on the list now. We're in the governor's budget for the fiscal year '06. But we are working very hard to see if we can't get that moved up. I'd like to do planning immediately so that we could build it as soon as we can. If it stays on the current calendar we won't see it until the year 2010 and that's too long.

Are there any initiatives on the federal level?

Actually there are a couple of things with regard to the feds. We entertained a delegation of staff members from the Maryland federal delegation recently. I was talking to them much like I just did with you and also demonstrating some of this automated dispensing equipment, which we've got in the lab down there. But we have three initiatives going with the feds to try to get $2 million in appropriations earmarked for the Pharmacy Hall addition, which we think if we can get from the feds we can use to leverage the state dollars.

Then we have $1 million that we have requested to start a Center for Excellence in Medication Use. That is a project that would really harness together many of the things that we've got going in the school of pharmacy that are aimed at dealing with that $177 billion problem of inappropriate use of drugs. You can have the best darn drugs in the world, but if you don't use them right you've got problems. If a drug is powerful enough to reduce your blood pressure or to kill cancer, or to deal with diabetes or to fight off the immune system so you can undergo a kidney transplant, those are pretty potent agents. If you screw up in the way you use them, either through ignorance or lack of attention or whatever, you've got problems. And that is what the Center for Excellence in Medication Use is supposed to look at.

So last year, $177 billion was spent to deal with the misadventures of medications. But only $144 billion was spent on the actual drugs.

There are 85,000 different dosage forms of drugs. Doctors are very good with the drug therapy that they use all the time. But particularly as you get into older patients, older patients generally don't come in with just one condition. And, therefore, you may have a cardiologist that knows everything that there is to know about cardiology, but then you add diabetes to the mix and it becomes a little more complicated. If you then have a diabetic that has got arthritis, it's even more complicated because there are different drugs for all those conditions. And my pharmacology professor always used to say, 'Anytime you put more than two drugs into a human being at the same time, you no longer have a treatment, you have an experiment.'

DR. DAVID A. KNAPP

Title: Dean

School: University of Maryland School of Pharmacy