FROM MOLECULE TO OUTCOME: EVIDENCE BASED MEDICINE AND PHARMACOLOGY APPLIED THERAPEUTICAL PRACTICES IN MEDICAL LEARNING

Introduction:
The current clinical decision ideally follows the systematic critical evaluation of the best available evidence associated with adequate clinical knowledge. In this scenario, the actual practical medicine are the knowledge of pharmacokinetics and pharmacodynamics, the principles of evidence-based medicine, building the reasoning for building clinical questions and the main mechanisms of action of the classes of the drugs. Current clinical practice requires basic knowledge of evidence-based medicine (EBM) and, therefore, skills to evaluate a scientific article, define efficacy, effectiveness and efficiency, and to incorporate and practice its results in light of the knowledge of the classes therapeutically interactions, their clinically relevant interactions and contraindications.
The robust results from clinical research should be part of current medical teaching, associating the principles of pharmacology with the clinical and therapeutic knowledge applied to the patient at the bedside.

Methodology:
We have integrated teaching practices involving the weekly exposure and discussion of three clinical cases that demand the decision based on the best evidence therapies as well as the knowledge of their respective pharmacological classes and their mechanism of action. As a practical study tool, students should construct their active search strategies and problem based analysis on the following steps: formulate clinical questions (PICO-MIC), locate the information available in the literature; critically evaluate the relevant information then use critically for the clinical decision. The formulation of the questions involves the PICO-MIC Acronym
P Patient
I Intervention
C Comparison
O Outcomes
M Mechanism of action
I Interactions
C Contraindications

With the use of the acronym, the student, in addition to making the decision regarding therapy, encounters other classes of drugs and their mechanisms of action and interaction, developing a critical, applied and significant study.After finding the best evidence about the theme, students should present a summary for discussing, at class, and answer the final decision about therapeutical propose.

Conclusion:
Teaching new medicine students how could find the correct answers for accurate decision based on presentation of the original research results is needed to make evidence-based decisions and to ensure that limited healthcare resources are used effectively and safely. Evidence-based principles should be followed in reviewing therapies and practices, including alternative therapies.