PHARMACOLOGY

Integrated educational activity

Course Sheet

Course code:

M4031

Academic Year of enrolment:

2020

Year of supply:

2023/2024

Degree:

Course of Single Cycle Degree 6 years in MEDICINE AND SURGERY

Moduls:

PHARMACOLOGY I - 4 credits
PHARMACOLOGY II - 8 credits

Location:

CHIETI

Credits:

Programme Year:

Cycle:

Single Annual Cycle

Hours of classroom activity:

150

Prerequisites:

As stated by rules of the Study Course

Objectives

The teaching is part of the specific objectives of the degree course aimed at training a professional figure able to: know and understand:
i. the principles of pharmacokinetics (the path of the drug within the human organism , assessed in its qualitative / quantitative aspects) and of pharmacodynamics (drug / target interactions and analysis of the dose-response relationship);
ii. the definition of generic or equivalent medicine;
iii. adequate knowledge on the pharmacological basis of the therapy, for the main classes of drugs, through the integration of data related to the pharmacokinetics, to the pharmacological effects in terms of dose-response relationship, to the molecular mechanism of action, to the interaction of the single classes of drugs with the physio-pathological and molecular mechanisms of the diseases for which the drugs are proposed, as well as the methods of administration and the undesirable side effects;
iv. the principles governing personalized drug therapies;
v. the phases of experimentation with a new drug and the methodology of clinical trials.

EXPECTED LEARNING RESULTS

At the end of the course, the student should to be able to:
i. acquire basic tools for knowledge of the most important drugs used in the medical practice;
ii. think, in quantitative terms, on specific pharmacokinetic and pharmacodynamic aspects of drug administration;
iii. integrate knowledges on the mechanism of action, efficacy and safety of drugs with knowledge on the physiology of drug targets and on the pathophysiology of processes modified by pharmacological treatment;
iv. know the side and toxic effects of drugs and their potential interactions.

The course will help to provide the student with tools that will allow him to:
i. enhance his ability to relate to inter-and multidisciplinary teams with other professional figures (psychologists, nurses, health assistants, etc.) who will be called to take care of the patient;
ii. provide explanations to patient and/or his family about the benefits and risks of drug therapy.

Finally, the student will develop skills in an independent study and will acquire the functional methodological tools for an autonomous update

Contents

The integrated course of Farmacology includes two sections:
1. General pharmacology: this section describes the principles that underlie the human-drug interactions and that in turn are divided into two chapters, the one related to Pharmacokinetics (the effects that the body has on drugs) and the one on Pharmacodynamics (the cellular and molecular mechanisms that underlie the therapeutic, unwanted and toxic effects of drugs).
2. Special Pharmacology: this section describes the characteristics of the individual classes of drugs.

Extended Syllabus

PHARMACOLOGY I (4 CFU) - Prof.ssa - Paola Patrignani

- INTRODUCTION TO THE PHARMACOLOGY COURSE.

- PHARMACODYNAMICS: Mechanisms of action of drugs. Use of omic technology for the study of drug efficacy and toxicity.

- PHARMACOKINETICS: Chemical-physical properties of drugs, Absorption, Distribution, Metabolism, Elimination. The main pharmacokinetic parameters. Therapeutic drug monitoring. Variability factors of drug response. Abnormal responses to drug administration. Role of genetics and epigenetics. Definition of equivalent or generic medicine.

- CELLULAR AND MOLECULAR PHARMACOLOGY: The pharmacology of systems. Receptors and signal transduction. Classes of receptors. Ionic transport. Transmission systems (cholinergic, catecholaminergic, serotonergic, histaminergic, purinergic, excitatory amino acids, inhibitory amino acids, opioid peptides, nitrous neuropeptides and arachidonic acid). Mechanisms of cellular interaction through the production of extracellular vesicles. Use of transgenic animal models for understanding the mechanism of action of drugs and their toxicity.

- INFLAMMATION DRUGS: Non-steroidal anti-inflammatory drugs. Steroid anti-inflammatory drugs. Gold salts, Penicillamine, Synthetic Antimalarials, Sulfasalazine. Biological drugs.

- PHARMACOLOGY OF THE IMMUNE SYSTEM: Immunostimulants and Immunosuppressants.

- CARDIOVASCULAR AND BLOOD SYSTEMS DRUGS: Antihypertensive drugs. Drugs for the treatment of ischemic heart disease. Heart failure drugs. Drugs for the treatment of cardiac arrhythmias. Drugs for cardiovascular risk prevention. Pharmacological treatment of vasculopathies. Hemostasis drugs. Antianemic drugs.

– DRUGS FOR RENAL SYSTEM: Drugs for the treatment of alterations in hydro-electrolyte exchange.

PHARMACOLOGY II (8 CFU)
- Prof.ssa Patrizia Di Iorio

DRUGS ACTING AT THE PERIPHERAL AUTONOMIC SYSTEM
Main classes of drugs acting at the parasympathetic nervous system: muscarinic receptor agonists and antagonists, anticholinesterase agents; at the sympathetic nervous system: sympaticomimetic drugs and antagonists of adrenergic receptors.

DRUGS ACTING AT THE NEUROMUSCULAR JUNCTION AND AUTONOMIC GANGLIA
Nicotinic receptor antagonists. Depolarizing agents.

DRUGS ACTING ON THE DIGESTIVE SYSTEM
Inhibitory drugs of gastric acid secretion, protective of gastric mucosa and anti-ulcer drugs.
Prokinetic agents. Laxatives and purgatives. Antidiarrheal and antispasmodic drugs.
Pharmacotherapy of inflammatory bowel diseases.
Emetic and antiemetic drugs

DRUGS ACTING ON THE RESPIRATORY SYSTEM
Drugs for the treatment of bronchial asthma and chronic obstructive pulmonary diseases.
H1-histamine receptor antagonists.
Antitussive agents. Respiratory stimulants and pulmonary surfactants.

DRUGS ACTING ON METABOLISM
Drugs for the treatment of obesity.
Drugs active on glucose homeostasis: pharmacotherapy of diabetes mellitus and hyperglycemia.
Pharmacotherapy of hypercholesterolemia and dyslipidemia.

HORMONES AND DRUGS ACTING ON THE ENDOCRINE SYSTEM
Thyroid and antithyroid drugs.
Hormones and drugs of the reproductive system.
Agents affecting calcification and bone turnover.

DRUGS ACTING ON THE CENTRAL NERVOUS SYSTEM
Treatment of central nervous system degenerative disorders.
Pharmacotherapy of depression and anxiety disorders.
Sedative-hypnotic drugs.
Pharmacotherapy of psychosis and mania.
Pharmacotherapy of epilepsia and seizures.
Opioid analgesics and palliative care. General anesthetics. Local anesthetics.

DRUG ADDICTION AND SUBSTANCES OF ABUSE
Psychobiological mechanisms and diagnostic criteria for drug addiction.
Addiction to opiates, alcohol, psychostimulants, hallucinogens, nicotine, cannabis and derivatives.

DOPING AGENTS
Prohibited substances.
Anabolic agents

CHEMOTHERAPY FOR MICROBIAL DISEASES
General considerations of antimicrobial therapy.
Beta-lactam antibiotics: penicillins, cephalosporins, carbapenems.
Aminoglycosides. Tetracyclines. Chloramphenicol. Macrolides. Lincosamides. Glycopeptides. Sulfonamides. Trimethoprim. Fluoroquinolones. Antituberculous agents: isoniazid, pyrazinamide, ethambutol.
Antiviral agents: antiherpesvirus agents, antiinfluenza angents, antihepatitis (HBV, HCV). Antiretroviral agents: anti-HIV.
Antifungal agents.

ANTINEOPLASTIC DRUGS
Alkylating agents: platinum coordination complexes, nitrogen mustards, nitrosuree.
Antimetabolites: folic acid analogs, pyrimidine analogs, purine analogs.
Topoisomerase inhibitors: Actinomycin D, anthracyclines, epidophyllotoxins.
Antimicrotubular agents: vinca alkaloids, taxanes.
Hormones and related agents: glucorticoids, antiestrogens, aromatase inhibitors, antiandrogens.
Inhibitors of signal transduction systems: inhibitors of BCR-ABL, EGFR, VEGFR, ALK, BRAF, MEK.
Cytotoxic monoclonal antibodies.
Immunotherapeutic drugs: Interleukine-2, interferon, monoclonal antibodies on immunological checkpoints.

DEVELOPMENT AND USE OF DRUGS
Drug pre-clinical and clinical trials (evaluation of drug safety, testing of drugs on humans, phases of clinical development of a drug).
Equivalent and biosimilar medicines.
Role of the Ethics Committees for the clinical trials of drugs. Methodological criteria, tasks and organization of pharmacovigilance.

Recommended Bibliography

The recommended textbooks are:
- Fumagalli - Clementi – AAVV-2016. Farmacologia generale e molecolare.
- Goodman & Gilman “Le basi farmacologiche della terapia. Il Manuale” 2° Ed. Zanichelli.
- “Farmacologia. Principi di base e applicazioni terapeutiche” E. Rossi, V. Cuomo, C. Riccardi. 4° Ed. Minerva Medica.
- L. L. Brunton, R. Hilal-Dandan, B. C. Knollmann “Goodman & Gilman Le basi farmacologiche della terapia” 13° Ed. 2019
- Govoni S., Spampinato A.M., Navarra P., et al. "Farmacologia". 2° Ed. Casa Editrice Ambrosiana.

Other important tools for the individual preparation are represented by the consultation of the "Medline" and some magazines of high scientific level and of pharmacological and pharmacological-clinical interest. Specific bibliographical indications can be provided during the course.

Teaching Methods

The course includes lectures and interactive lessons.
It is possible that some topics may be developed, in an integrated way, in collaboration with teachers belonging to the clinical area.

Evaluation methods

Verification of learning:

The learning will be evaluated through a final examination which is an oral test aimed at providing a balanced assessment of the achievement of the objectives of the Core Curriculum.

Contacts/More Information

Prof. Di Iorio receives the students after taking appointment to via email: by e-mail to patrizia.diiorio@unich.it
Prof. Patrignani receives the students on Wednesday from 3 pm to 6 pm, after taking appointment to establish via e-mail: paola.patrignani@unich.it

Università degli Studi
"G. d'Annunzio"

Chieti - Pescara

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