1148 - PHARMACOLOGY
Academic Year 2018/2019
Free text for the University
PIER LUIGI ONALI (Tit.)
- Teaching style
- Lingua Insegnamento
|[40/39] MEDICINE AND SURGERY||[39/00 - Ord. 2015] PERCORSO COMUNE||10||100|
The aims of the course are:
- to learn the fundamental principles of drug action and the various molecular and cellular mechanisms which mediate the therapeutic effects and the aversive drug reactions;
- to understand that the efficacy of drug therapy is evaluated through the analysis of laboratory and clinical data obtained by studying the patient pathological condition;
- to understand how the pharmacokinetic processes, the genetic profile,and the pathological condition can affect the outcome of pharmacological therapy;
- to raise awareness of the constant evolution in drug development and clinical use and of the consequent need to continuously update the knowledge on the use of drugs for a good clinical practice;
- The course is designed to provide the students with the basic understanding of medical pharmacology which is required for an appropriate and rational use of drugs in the clinical practice.
The students must have passed the exams of Pathology and Physiopathology.
Volume of distribution,plasma half-life and clearance of a drug. Drug absorption, distribution, metabolism and elimination. Bioavailability. Mono-and multi-compartment models.Pharmacokinetic mechanisms of drug interaction.Routes of drug administration and methods of drug delivery. Bioequivalence.Single and repeated administration of drugs. First-order and zero-order elimination kinetics.Dosing rate. Therapeutic window. Loading dose.Genetic determinants of individual drug response. Phases of drug metabolism. Inhibition and induction of drug metabolism. Polymorphisms in drug metabolizing enzymes. Drug elimination by the liver and the kidney. Drug-receptor interaction. Receptor agonists and antagonists. Relationship between drug concentration and drug action.Metabotropic and ionotropic receptors. Receptor signal transduction. Receptor adaptation. Population pharmacodynamics. Adrenergic transmission and drugs acting on catecholamine synthesis. Adrenergic receptors. Agonists and antagonists of alpha- and beta-adrenergic receptors. Direct and indirect sympathomimetic amines. Drugs acting on monoamine transporters. Muscarinic acetylcholine receptors and their agonists and antagonists. Acetylcholinesterase inhibitors. Nicotinic receptors. Pharmacological actions of nicotine. Drugs acting at the neuromuscular junction and autonomic ganglia. Serotonin receptor agonists and antagonists. Drugs used to treat Parkinson’s disease and other neurodegenerative disordes. Antipsychotic and antidepressive drugs. Mood stabilizers. Antiepileptic drugs. Hypnotics and sedatives. Drug of abuse. Drugs used to treat drug addiction. Opiods analgesics. Opioid receptor antagonists. Local anesthetics. Nonsteroid anti-inflammatory,antipyretic and analgesic drugs. Drugs used in the pharmacotherapy of gout. Histamine receptors and their antagonists. Drugs used to treat bronchial asthma and chronic obstructive pulmonary disease. Drugs used to treat gastro-duodenal ulcers and gastroesophageal reflux disease. Drugs used to treat motility disorders of the bowel. Drugs used to treat blood hypertension. Osmotic diuretics. Thiazide and thiazide-like diuretics.Loop diuretics. Potassium-sparing diuretics. Drugs used to treat myocardial ischemia. Drugs used to treat congestive heart failure. Anti-arrhythmic drugs. Anticoagulant, fibrinolytic and antiplatelet drugs. Drugs used to treat dyslipidemia.Insulin and oral hypoglycemic agents. Metformin and glitazones. Incretins and DPP-4 inhibitors. Alpha-glucosidase and sodium-glucose co-transportes inhibitors. Corticosteroids. Estrogens, progestins. Androgens. Drugs acting on bone turnover. General principles of anti-microbial therapy. Rational selection of an antimicrobial agent. Mechanisms of action of antibiotics. Mechanisms of resistance to antimicrobial agents. Prophylactic use of antimicrobial agents. Use of antibiotics during pregnancy. Trimethoprim-sulfamethoxazole. Fluoroquinolones. Natural and semisynthetic penicillins.Cephalosporins.Carbapenems and monobactams. Beta-lactamase inhibitors and their association with beta-lactam antibiotics. Vancomycin and teicoplanin. Aminoglycosides. Tetracyclines and glycylcyclines.Macrolides and ketolides. Chloramphenicol. Quinupristin/dalfopristin. Linezolid and tedizolid. Daptomycin. Drugs used to treat tuberculosis. Antiviral agents.Drugs used in the chemotherapy of neoplastic diseases. Fundamental principles of toxicology. Teratogenicity and poisoning. Principles of clinical pharmacology: drug monitoring and aversive reactions. General principles of pharmacovigilance. Drug interactions. General principles of pharmacoeconomics. General principles of pharmacotherapy.
Course for students with odd number:
The teaching activity will include lectures covering the topics of the Pharmacology course (about 100 hours) and tutorial sections (about 12 hours) dedicated to the general discussion. At the end of the first semester, each student will be interviewed to test the learning level. Moreover, the course will invite qualified persons to hold a seminar on specific pharmacological issues.
Verification of learning
Course for students with even number: Written multiple choice test at the end of the first semester followed by a final oral exam.
Course for students with odd number: Discussion on the topics presented in the first semester followed by a final oral exam.
The exam will test the student’s knowledge of the pharmacology topics included in the program, with particular attention to the mechanisms of action of the drugs and the drug interactions. Moreover, the student shall demonstrate the ability to assess the clinical utility of the dugs. The exam will also evaluate the student’s use of scientific terminology and presentation skills. The vote (from 0/30 to 30/30) will be determined at the end of the final oral exam by the Committee.
Goodman & Gilman's, The Pharmacological Basis of Therapeutics, 12th edition, McGraw Hill.
Site of interactive teaching: teaching rooms at Cittadella Universitaria di Monserrato, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, - SP 8, Km 0.700, 09042 Monserrato, and the hospital San Giovanni di Dio, via Ospedale 46, Cagliari.
Office hours: from Monday to Friday upon prior appointment.
At the end of the course students will be provided with the slides used in the lectures.