David Grahame-Smith

BMJ 2011; 343 doi: (Published 04 October 2011) Cite this as: BMJ 2011;343:d6378
  1. Jeffrey Aronson

David Grahame Grahame-Smith was the clinical pharmacologists’ clinical pharmacologist. He was a perceptive clinician, an innovative progenitor of elegant basic and clinical experiments, an inspiring teacher and solicitous mentor, and a voice of wisdom on medicines policy.

Clinical pharmacology in translation

Long before the word “translation” was introduced into medical science, Grahame-Smith developed a paradigm that showed that clinical pharmacology is a supremely translational discipline, building his scientific philosophy as a basic and clinical pharmacologist on four simple questions:

  • Is the medicine properly formulated?

  • If taken or administered appropriately, can it reach its sites of action?

  • If it does, can it exert its pharmacological actions there?

  • If it can, how are those actions translated into benefit for the patient?

The pharmacological principles that link the last two of those questions encompass actions at the molecular level, actions on cells, tissues, and organs, and outcomes in the whole individual. He applied to this simple schema a deep understanding of both biochemical pharmacology and clinical medicine. It was an important tenet to him that basic experiments should inform clinical practice and that clinical results should …

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