PHARMACOLOGY
- Overview
- Assessment methods
- Learning objectives
- Contents
- Full programme
- Bibliography
- Teaching methods
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The prerequisites are those considered by the degree course and include the main notions of anatomy, biochemistry, pathology and physiology and all the other proponed by the degree program
Oral examination.
At the end of the course the student will be able to evaluates and describes, on the basis of the knowledges of pharmacodynamic and pharmacokinetic characteristics, the properties of a drug and to be able to individuate the therapeutic strategies considering the chemical structure and the target of the drug, in addition the knowledge about the pharmacokinetic properties will be used to be able to consider the therapeutic and toxicologic effects
The course (in the first semester) is divided into 4 areas of discussion:
1. pharmacodynamics concerning structure-action relationships, the mechanism of action, the dose-response relationship and the measure of the pharmacological effect, the evaluation of efficacy and potency, pharmacodynamic interactions.
2. pharmacokinetics concerning the modalities and constants of drug transfer in the body, routes of administration, metabolic transformations, pharmacokinetic models and calculations, pharmacokinetic interactions.
3. toxicology concerning the principles of general toxicology, side effects and adverse drug reactions and their assessment, criteria for assessing the risk-benefit ratio, the mechanisms of drug addiction.
4. drug development, pharmacotoxicological experimentation and drug regulation, concerning the origin and experimentation of molecules of pharmacological interest; the characteristics, requirements and procedures for registering medicinal products; the statute of limitations. In this context the fundamental principles of pharmacovigilance and pharmacoepidemiology will also be discussed.
Pharmacodynamics
1. General principles of pharmacodynamics: mechanisms of action of drugs, structure-action relationship. Evaluation and measurement of the pharmacological effect - Concentration-effect relationship - Principles of biological dosage - Power relationships - Therapeutic index.
2. Receptor mechanisms of drug action. Receptor theories. Stimulus-response relationship and signal transduction mechanisms. Drug / receptor interaction: affinity, efficacy and intrinsic activity. Receptor states. Receptor regulation.
3. Definition and types of antagonism between drugs: competitive antagonism, partial agonists. Evaluation and measurement of antagonism.
4. Cellular and molecular pharmacology of receptor systems: adrenergic, cholinergic, dopaminergic, GABAergic, serotoninergic, glutamatergic, histaminergic, opioid.
Cellular and molecular pharmacology of ion channels: Na +, K +, Ca2 +, Cl-.
6. Cellular and molecular pharmacology of enzyme systems, with examples.
7. Toxicology - Pharmacological and toxicological aspects of drug dependence. Substances of abuse and drug addiction. Poisonings and antidotes.
Pharmacokinetics
1. General pharmacokinetic principles: linear and nonlinear kinetics. Drug transport mechanisms through biological barriers. Compartmental and physiological models used in clinical pharmacokinetics. Plasma concentration curve analysis.
2. Absorption, routes of administration of drugs and pharmaceutical forms. Bioavailability and its determination. First pass effect.
Distribution, drug-protein binding and tissue binding. Distribution volume and its determination. Blood-brain and hemato-placental barrier.
4. Drug elimination kinetics. Renal clearance and systemic clearance. Drug excretion and metabolism. Enzyme induction and inhibition. Active metabolites.
5. The therapeutic regime and the methods for its determination. Multiple dose regimen. Accumulation, "steady-state" and "loading-dose". Drug monitoring in body fluids.
Fraction and free concentration. Monitoring of free drug concentration.
6. Special aspects - Pharmacogenetics: factors and variability of the pharmacological response.
7. Special aspects - General principles of pediatric and geriatric pharmacology: pharmacokinetic and pharmacodynamic aspects. Criteria for the administration of drugs during pregnancy and lactation. Pharmacological interferences with laboratory data.
Drug development, pharmacotoxicological testing and drug regulation
1. Origin and classification criteria of drugs: the ATC system. The search for new drugs and the innovation of pharmaceutical products. Toxicology - Adverse drug reactions: classification criteria. Allergic reactions and immunotoxicity of drugs.
2. Preclinical drug-toxicological testing. Requirements for the admission of new preparations for human experimentation. Toxicology - Evaluation of drug toxicity: acute toxicity and toxicity after repeated administration. Mutagenic and carcinogenic effects. Fetal toxicity and teratogenesis.
3. Principles and phases of clinical trials of drugs. Ethical aspects of human experimentation. Examples of experimental protocols.
4. Adverse drug reactions. Monitoring of adverse reactions and pharmacovigilance. Pharmacoepidemiology: the market and consumption of drugs, DDD. Principles of pharmacoeconomics.
5. Principles of pharmaceutical legislation: national legislation and Community legislation. Addiction Legislation. Pharmacopoeias and Therapeutic Manuals. Pharmaceutical products: specialties, medicines, galenic products.
6. The prescription of drugs. The recipe: types, characteristics and formalisms.
7. Drugs and sporting activities: pharmacological doping, CIO / WADA regulations, Italian law.
- Rossi F, Cuomo V, Riccardi C Farmacologia – Principi di base e applicazioni terapeutiche, Edizioni Minerva Medica, Torino
- Rang HP, Dale MM, Ritter JM Farmacologia, Casa Editrice Ambrosiana, Milano
- Golan DE et al. Principi di Farmacologia – Le basi fisiopatologiche delle malattie, Casa Editrice Ambrosiana, Milano
- Katzung BG Farmacologia generale e clinica Piccin, Padova
- Howland MD, Mycek MJ Le basi della farmacologia, Zanichelli, Bologna
- Birkett DJ Elementi di farmacocinetica, Piccin, Padova
Frontal lesson with the help of slides and scientific literature.
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