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Department of Pharmacology Poznan University of Medical Sciences Guidance and syllabus for the course of pharmacology 4-year Doctor of Medicine Programme Poznań 2016/17 1 Course coordinator: dr hab. Przemysław Mikołajczak, prof. UM is available most Tuesday’s between 11.30-12.30 an appointment should be made by e-mail ([email protected]) Schedule coordinator and students affairs: dr hab. Marzena Dworacka, prof. UM is available most Thursday’s between 12.00-13.30 an appointment should be made by e-mail e-mail address: [email protected] Pharmacology Department website: farmakologia.ump.edu.pl Recommended textbook Katzung BG. Basic & Clinical Pharmacology, 13th edition. 2015. Supplementary textbooks Lippincott's Illustrated Reviews: Pharmacology. Harvey RA, Howland RD, Mycek MJ, Champe P., 5th edition, 2015 2 DETAILED SYLLABUS OF PHARMACOLOGY The required scope of information that students should learn with regard to each drug and drug category/class includes: classification; mechanism of action; therapeutic indications; adverse effects; contra-indications. Each topic related to clinical pharmacology issues shall be supplemented with case study analyses. Topic Description and details Prescription writing, component parts of the prescription, drug names, abbreviations, incompatibilities. Drugs formulations, routes of administration The prescription, drug names and generic substitution, equivalence: chemical, pharmaceutical, biologic and therapeutic. Component parts of the prescription. Dosage calculation. Drug formulations (oral and parenteral drug formulations). Routes of drug administration (oral and parenteral routes of drug administration and the choice of most optimal route of drug administration) Pharmacodynamics Macromolecular nature of drug receptors. Relations between drug concentration and response. Signalling mechanisms and drug actions. Relation between drug dose and clinical response. Pharmacokinetics Passage of drugs across membranes, absorption, distribution, excretion, pharmacokinetic parameters (rate of absorption, bioavailability, volume of distribution, rate of elimination, clearance, half-life), absorption and elimination occurring simultaneously, multicompartment distribution. Role of biotransformation in drug disposition, first pass effect, microsomal mixed function oxidase system- phase I reactions, phase II reaction, factors affecting drug metabolism, principles of therapeutic drug monitoring Pharmacogenetics and Pharmacogenetics/pharmacogenomics - pharmacogenetics general mechanisms of drug of drug metabolism. General mechanisms of drug interaction interactions (classification of drug interactions, mechanisms of drug interactions, factors influencing drug interactions, drug interaction used in pharmacotherapeutics) Autonomic adrenergic For repetition: functional characteristics of autonomic agonists, antagonists nervous system, neurotransmitters, signal transduction and second messengers. Spectrum of action of sympathomimetic drugs. Mode of action of sympathomimetic drugs. Basic pharmacology of sympathomimetic drugs (identification of adrenoreceptors, receptor selectivity, molecular mechanism of sympathomimetic action, adrenoreceptor polymorphisms, pharmacokinetics, organ system effects, therapeutic uses, toxicity – catecholamines, phenylephrine, ephedrine, midodrine, methoxamine, xylomethazoline, amphetamine, methylphenidate, modafinil, phenylpropanolamine, 3 dexmedetomidine, apraclonidine, dobutamine, isoproterenol, terbutaline) Basic pharmacology of the alpha-receptor antagonist drugs (mechanism of action, pharmacologic effects, clinical applications – tolazoline, ergot derivatives, phenoxybenzamine, prazosin, terazosin, doxazosin, tamsulosin, indoramin, urapidil). Basic pharmacology of the beta-receptor antagonist drugs (pharmacokinetics, pharmacodynamics, clinical pharmacology, toxicity – propranolol, metoprolol, atenolol, nadolol, timolol, betaxolol, pindolol, carvedilol, esmolol, sotalol). Autonomic cholinergic Spectrum of action of cholinomimetic drugs. Mode of action agonists, antagonists of cholinomimetic drugs. Basic pharmacology of the directacting cholinoreceptor stimulants (pharmacokinetics, mechanism of action, organ system effects – acetylcholine, betanechol, carbachol, cevimeline, pilocarpine). Basic pharmacology of the indirect-acting cholinomimetics (pharmacokinetics, mechanism of action, organ system effects – cholinesterase inhibitors). Therapeutic uses and toxicity of cholinomimetics. Cholinesterase regenerators. Basic pharmacology of the muscarinic receptor-blocking drugs (pharmacokinetics, mechanism of action, organ system effects, therapeutic applications, adverse effects, contraindications – atropine, clidinium, cyclopentolate, dicyclomine, darifenacin, solifenacin, trospium flavoxate, glycopyrrolate, homatropine, l-hyoscyamine, ipratropium, methanteline, oxybutynin, scopolamine, tropicamide). Principles of chemotherapy. For repetition: classification of microbes. General principles and limitations of chemotherapy in outpatient and hospital practice. The basic terms: antibiotics, bacteriostatic and bactericidal effect, synergism, antagonism, additive result, the empiric and definitive therapy, MIC, MIB, SBT, resistance to antibiotics. Postantibiotic effect. The principles of antimicrobial agents selection. The antimicrobial prophylaxis. Superinfections. Therapy with combination of drugs. General classification of antimicrobial agents. Antiviral agents Drugs used in treatment of herpes viruses (idoxouridine, vidarabine, trifluridine, acyclovir, gancyclovir, famciclovir, foscarnet); Anti-HIV drugs (nucleoside antiretroviral agents, nonnucleoside antiretroviral agents, protease inhibitors). Interferons. Drugs used in the treatment of influenza (amantadine, neuraminidase inhibitors, ribavirin). Mechanisms of action, main adverse effects. -Lactam antibiotics. Penicillins, cephalosporins, carbapenems, monobactams. Mechanism of action, classification, spectrum of antimicrobial activity, pharmacokinetics, examples of preparations, side effects, therapeutic use. Case studies. Non--lactam antibiotics I. Macrolides, ketolides, tetracyclines, glycylcyclines, lincosamides, chloramphenicol, streptogramines, oxazolidinones, Mechanisms of action, classification, 4 spectrum of antimicrobial activity, pharmacokinetics, examples of preparations, side effects, therapeutic use. Case studies. Non--lactam antibiotics II. Aminoglycosides, polymyxines, glycopeptides. Mechanisms of action, classification, spectrum of antimicrobial activity, pharmacokinetics, examples of preparations, side effects, therapeutic use. Case studies. Antifungal agents. Quinolones, sulfonamides, antiseptics. Antiparasites antihelmintes Antifungal agents. Introduction: classification of fungal infections. Classification of antifungal agents. Mechanisms of action, spectrum of antifungal activity, pharmacokinetics, examples of preparations, side effects, therapeutic use. Case studies. imidazoles, Mechanisms of action, classification, spectrum of urinary antimicrobial activity, pharmacokinetics, examples of preparations, side effects. and Drugs used in the treatment of Amebiasis, Giardiasis, Trypanosomiasis, Leishmaniasis, Trichomoniasis, Toxoplasmosis, Malaria (treatment and prophylaxis) Mechanism of action, classification, spectrum of antimicrobial activity, pharmacokinetics, side effects. Drugs used in the treatment of helminthic infection – Ascariasis, Taeniasis, Trichinellosis, Hookworm, Flukes and Pinworm infection, Cutaneous larva migrans. Mechanisms of action, main adverse effects. Case studies. Drugs used in the treatment of Leprosy. Mechanisms of action, main adverse effects. Drugs affecting homeostasis. Vitamins Agents used anaesthesia calcium Introduction: hormonal regulators of calcium homeostasis; the therapeutic use of hormones affecting calcium homeostasis (teriparattide, vitamin D, calcitonin, estrogens, SERMs); non-hormonal agents affecting calcium homeostasis: bisphosphonates, denosumab, strontium, fluorides, cinacalcet, thiazides, loop diuretics. Mechanisms of action, main therapeutic use and adverse effects. Pharmacotherapy of: hypocalcemia, hypercalcemia, and osteoporosis. Introduction: classification of vitamins (water and fat soluble vitamins). Water soluble vitamins: group of vitamin B, niacin, vitamin C, fat soluble vitamins: vitamin A, D, E, K. Physiological function, therapeutic use, toxicity. in general Introduction: principles of general anaesthesia (theories of anaesthetic action, behavioural manifestation of anaesthesia, uptake and distribution of inhalation anaesthetics, elimination and metabolism of anaesthetic gases, chemical properties of inhalation anaesthetics, pharmacological effects of inhalation anaesthetics). Inhalation agents (nitrous oxide, halothane, enflurane, isoflurane, desflurane, sevoflurane, αadrenergic agonists). Intravenous agents (barbiturates, propofol, ketamine, etomidate, benzodiazepines, opioids). Anaesthetic properties, adverse effects. Anaesthetic adjuvants and premedication. Anticholinesterases used in anaesthesia. Antagonists for central and respiratory depression. Neuromuscular blocking drugs (nondepolarizing 5 drugs, depolarizing drugs). Local anaesthetics Opioid analgesics antagonists Local anaesthetics. Mechanism of action. Pharmacologic effects. Pharmacokinetics, adverse effects, techniques of anaesthesia, uses in dentistry, drug selection for parenteral administration (procaine, lidocaine, mepivacaine, prilocaine, articaine, bupivacaine), agents limited to surface application (benzocaine, tetracaine, dyclonine, chlorobutanol, cocaine, lidocaine/prilocaine). and Classification of opioids (agonists, mixed agonistsantagonists, antagonists). Mechanism of action. Acute and chronic effects, central and peripheral. Spectrum of clinical uses of opioids on the basis of their pharmacological properties: as analgesics, antitussives, antidiarrheal drugs. Toxicity and side effects of opioids. Pharmacological properties and clinical use of specific agents: strong agonists (morphine, methadone, meperidine, fentanyl and its subgroup), weak to moderate agonists (codeine, tramadol), mixed agonists-antagonists (buprenorphine, pentazocine), antagonists (naloxone, naltrexone). NSAIDs. Drugs used in gout. Skeletal muscle relaxants. Miscellaneous agents for rheumatoid arthritis. Drugs used to treat gout Drugs affecting coagulation. Sedative-hypnotics. Classification of NSAIDs based on their chemistry and mechanism of action (nonselective inhibitors of COX, preferential and selective inhibitors of COX2). Pharmacological properties, side effects and clinical use of aspirin, acetaminophen and other NSAIDs. Drugs used in acute attack of gouty arthritis (colchicine, NSAIDs, glucocorticoids). Drugs used in chronic therapy of hyperuricemia: uricosurics (probenecid, sulphinpyrazone) and inhibitors of uric acid synthesis (allopurinol, febuxostat) - mechanism of action, clinical use, side effects and contraindications. Spasmolytic agents acting on skeletal muscles – diazepam, baclofen, tizanidine, gabapentine, idrocilamide, riluzole, dantrolene. Disease Modifying Antirheumatic Drugs (DMARDs): methotrexate, cytotoxic agents, antimalarials, gold salts, D-penicilamine, sulfasalazine, anti-TNF drugs, inhibitors of Interleukin–1 and Interleukin-6, leflunomide mechanism of action, pharmacological effects, side effects. The use of NSAIDs and glucocorticoids in the treatment of RA. Repetition: mechanisms of blood coagulation and fibrinolysis. Basic pharmacology and clinical use of anticoagulant drugs: heparins (HMWH and LMWH), direct thrombin inhibitors, factor X inhibitors, oral anticoagulants, antiplatelet agents (aspirin, thienopyridine derivatives and reversible ADP receptor antagonists, blockers of platelet GP IIb/IIIa receptors), fibrinolytic drugs (streptokinase, urokinase, alteplase and other 2nd generation drugs). Hemostatic agents: local measures (clotting factors - thrombin, fibrin glue, astringents and styptics), systemic measures (clotting factors: factor VIII and factor IX), vitamin K, fibrinolytic inhibitors (aminocaproic acid). Benzodiazepines and barbiturates. Mechanism of action, 6 Antianxiety drugs. classification, spectrum of antianxiety activity, pharmacokinetics, examples of preparations, side effects. Benzodiazepine antagonists: Flumazenil. Newer drugs for anxiety and sleep disorders: Buspirone, Zolpidem, Zaleplon. Mechanism of action, spectrum of antianxiety activity, pharmacokinetics, side effects. Other antianxiety drugs (Antidepressants, Antipsychotics, Anticonvulsants, Antihistamines, Beta-blokers). Mechanism of action, spectrum of antianxiety activity, examples of preparations, pharmacokinetics, side effects. Case studies Antipsychotic drugs. Basic pharmacology of antipsychotics (neuroleptics: phenothiazines, thioxanthenes, butyrophenones; atypical antipsychotics: dibenzodiazepines dihydroindolones, benzoisoxazoles, other drugs) - pharmacological effects, extrapyramidal effects, seizure threshold, other central nervous system actions, pharmacokinetics, adverse effects, general therapeutic uses. Antidepressant drugs Basic pharmacology of antidepressants (tricyclic antidepressants, selective serotonin reuptake inhibitors, MAO inhibitors, secondand third-generation antidepressants) – mechanisms of action, pharmacologic effects, pharmacokinetics, adverse effects. Lithium salts, other normothymic agents- mechanisms of action, pharmacologic effects, pharmacokinetics, adverse effects. General therapeutic uses. Antiparkinson drugs Pathophysiology of Parkinson’s disease. Drugs used in parkinsonism (pharmacokinetics, clinical use, adverse effects, contraindications): levodopa, carbidopa, dopamine agonists (bromocriptine,, pramipexole, ropinirole), MAO inhibitors (selegiline, COMT inhibitors (entacapone, tolcapone), amantadine, muscarinic antagonists (benztropine, biperiden, orphenadine, procyclidine,). Strategies therapy of parkinsonism. Neuroprotective therapy. Drug-induced parkinsonism. Drugs used in other movement disorders (tremor, Huntington’s disease, other forms of chorea, balismus, athetosis&dystonia, tics, drug-induced dyskinesis, Wilson’s disease - penicillamine). Basic mechanism of action of antiseizure agents. Anticonvulsant drugs (phenytoin, carbamazepine, phenobarbital, lamotrigine, gabapentin, tiagabine, topiramate, zonisamide ethosuximide, valproate, benzodiazepines). Most common adverse effects. Drugs used in partial seizures and in generalized seizures. Drugs for status epilepticus treatment. smooth Biological function of angiotensin, kinins, endothelins, nitric oxide. Drugs acting on smooth muscles-pharmacokinetics, mechanism of action, organ system effects, clinical uses, toxicity - the ergot alkaloids, nitrates and nitrites, hydralazine, minoxidil, diazoxide, nitroprusside sodium, papaverine, drotaverine, calcium-channel antagonists, ACE inhibitors. Antiepileptics Drugs acting muscle. on 7 Antineoplastic drugs Immunopharmacology Principles of cancer chemotherapy. Combination therapy. Chemotherapeutic agents – mechanisms of action, adverse effects: (alkylating agents, antimetabolites, antibiotics, vinca alkaloids, hormonal agents, enzymes, platinum complexes, podophyllotoxins, camptothecins, taxoids, others. Retinoids, arsenic trioxide, biologic response modifiers (interferons, aldesleukin, oprelvekin), thyrosine kinase inhibitors, protease inhibitors, matrix metalloproteinase inhibitors, monoclonal antibodies (rituximab, trastuzumab, gemtuzumab ozogamicin, ibritumomab, tositumomab, alemtuzumab, bevacizumab). Components of the immune system. Immunotherapeutic agents (immunophilin ligands, glucorticosteroids, thalidomide, cytotoxic drugs, cytokines, interferones, antibody preparations, immunostimulants). Mechanisms of action, main adverse effects. Antianemic hematopoietic drugs. and Introduction: classification of anemias. Drugs used in the stimulating therapy of deficiency anemias: iron, vitamin B12, folic acid. Principal elements of their pharmacokinetics, therapeutic use, main adverse effects, examples of preparations, case studies. Hematopoietic growth factors: erythropoietin, myeloid growth factors (G-CSF, GM-CSF, pegfilgrastim), megakaryocyte growth factors (IL-11, thrombopoietin). Mechanisms of action, therapeutic use, main adverse effects. Antihyperlipidemic drugs Inhibitors of HMGCoA reductase, fibric acid derivatives, bile acid-binding resins, inhibitors of intestinal sterol absorption - mechanism of action, pharmacokinetics, clinical uses, adverse reactions. Treatment with drug combinations. Drugs used in therapy of Introduction: definition, patophysiology and classification of myocardial insufficiency. heart failure (HF). Positive inotropic drugs used in HF: cardiac glycosides, beta-adrenoreceptors stimulants (dopamine, dobutamine), bipyridines (milrinone), levosimendan. Pharmacokinetic, mechanism of action, interaction with potassium, calcium, magnesium and other drugs (cardiac glycosides), therapeutic use, main adverse effects and toxicity (cardiac glycosides). Drugs without positive inotropic effects used in HF: diuretics, aldosterone antagonists, ACE-Is, ARBs, beta-blockers, ivabradine, vasodilators (nitrates, hydralazine, nesiritide); their principal pharmacodynamics activity effective in the therapy of HF, main adverse effects Management of acute and chronic HF Antianginal drugs. Pathophysiology of angina, risk factors. Basic pharmacology of drugs used to treat angina: nitrates (pharmacological effects, pharmacokinetics, clinical use, routes of administration, adverse effects, tolerance); angiotensin converting enzyme inhibitors; calcium channel blockers; mechanisms of action and pharmacological activity responsible for their use in therapy of angina, clinical use, adverse effects. 8 Antiarrhythmic drugs. Introduction: electrophysiology of normal cardiac rhythm, mechanisms of arrhythmias. Sodium channel-blocking drugs (class 1): quinidine, procainamide, disopyramide – subgroup 1A, lidocaine, mexiletine – subgroup 1B, flecainide, propafenone, moricizine – subgroup 1C. Betaadrenoreceptor-blocking drugs (class 2). Drugs that prolong effective refractory period by prolonging action potential (class 3) – amiodarone, sotalol, dofetilide, ibutilide. Calcium channel-blocking drugs (class 4) – verapamil, diltiazem, bepridil. Adenosine. Digoxin. Magnesium and potassium salts. Links between electrophysiology of the heart and mechanisms of antiarrhythmics action, cardiac and extracardiac effects, adverse effects. Diuretics. Background: general mechanisms of renal epithelial transport. Loop diuretics; thiazides and thiazide-like drugs; carbonic anhydrase inhibitors; osmotic diuretics; K+-sparing agents. Pharmacokinetics, pharmacodynamics, clinical indications, adverse effects. Antidiuretic hormone antagonists. Case study Introduction: definition of arterial hypertension and its classification. Diuretics used as antihypertensive agents, adrenolytic agents; diuretics; angiotensin converting enzyme inhibitors; calcium channel blockers; angiotensin receptor antagonists; centrally acting antihypertensive agents; vasodilators, ganglionic blockers. Mechanisms of action and pharmacological activity responsible for their use in therapy of hypertension, adverse effects. Case study. Antihypertensive drugs. Hypothalamic and pituitary Hypothalamic releasing and inhibiting hormones gland hormones. (pharmacokinetics, clinical pharmacology, toxicity - GHRH, GHRPS, somatostatin, octreotide, pegvisomant, TRH, CRH, GNRH, gonadorelines, cetrorelix); pituitary hormones (pharmacokinetics, clinical pharmacology, toxicity – somatotropin, thyrotropin, corticotrophin, FSH, LH, prolactin, dopamine agonists, oxytocin, vasopressin). Thyroid and antithyroid Thyroid physiology. Thyroid hormones (pharmacokinetics, drugs. mechanism of action, effects - levothyroxin, liothyronine, liotrix). Antithyroid drugs (pharmacokinetics, pharmacodynamics, toxicity, clinical use – thioamides, anion inhibitors, iodides, iodinated contrast media, radioactive iodine, adrenoreceptor-blocking agents). Management of hypothyroidism, hyperthyroidism, non-toxic goiter, thyroid neoplasma. Adrenocortical hormones. Glucocorticoids (naturally occurring and synthetic): pharmacokinetics, pharmacodynamics (mechanism of action, physiologic effects, metabolic effects, catabolic and antianabolic effects, anti-inflammatory and immunosuppressive effects, other effects). Synthetic corticosteroids (pharmacokinetics, diagnosis and treatment of disturbed adrenal function - adrenocortical insufficiency, adreonocortical hypo- and hyperfunction, use of glucocorticoids for diagnostic purposes, toxicity, contraindications, selection of drug & dosage schedule). Mineralocorticoids – 9 aldosterone, deoxycorticosterone, fludrocortisone (mechanism of action, physiologic effects, metabolism, pharmacologic effects. Antagonists of adrenocortical agents – synthesis inhibitors & glucocorticoid antagonists (metyrapone, aminoglutethimide, ketoconazole, mifepristone, mitotane, trilostane). Mineralocorticoid antagonists (spironolactone, eplerenone). Estrogens, progestins and The gonadal hormones and inhibitors. The ovary (estrogens, antiestrogens. Androgens and progestins, other ovarian hormones, oral contraceptives; antiandrogens. inhibitors and antagonists; ovulation- inducing agents). Pharmacokinetics, clinical pharmacology, toxicity. The testis (androgens and anabolic steroids, antiandrogens, chemical contraception in men). Pharmacokinetics, clinical pharmacology, toxicity. Insulin and oral antidiabetic Introduction: diabetes mellitus and hyperglycemia – drugs. definition and classification. Insulin – biological properties, principal types and duration of action of insulin preparations, species of insulin, insulin delivery systems, adverse effects. Conventional and intensive insulin treatment. Antidiabetic agents: sulfonureas, glucosidase inhibitors, meglitinides, phenylalanine derivatives, biguanides, thiazolidinediones, incretin analogs, phlozines. Mechanisms of action, pharmacological effects, adverse effects, therapeutic uses. Principles of therapy of patients with diabetes type 2. Glucagon – biological properties and therapeutic use. Respiratory pharmacology I Drugs used to treat asthma (sympathomimetic agents, (Treatment of asthma and methylxanthine drugs, antimuscarinic agents, corticosteroids, chronic bronchitis) cromolyn and nedocromil, leucotriene pathway inhibitors, antiIgE monoclonal antibodies). Agents used to support or stimulate respiration (oxygen, doxapram). Steps and principles of management of chronic and acute bronchial asthma. Cases. Respiratory pharmacology II Tuberculostatics (isoniazide, rifampin, ethambutol, (Treatment of tuberculosis, pyrazynamide, streptomycin, ethionamide, capreomycin, mucokinetic and antitussive cycloserine, PAS, kanamycin & amikacin, ciprofloxacin & agents) levofloxacin, rifabutin, rifapentine – pharmacokinetics, clinical uses, adverse reactions). Drugs used to improve ventilation (antitussives, opioid analgesics, benzonatate, dextrometorphan, nasal decongestants, intranasal steroids, expectorants, mucolytics). Mechanisms of action, main therapeutic uses and adverse effects. Drugs used in peptic ulcer Introduction: physiology of acid secretion, pathophysiology disease. of peptic ulcer disease. Antacids, drugs affecting HCl secretion (H2-receptor antagonists, proton pump inhibitors, prostaglandin analogs), mucosal protective agents (sucralfate, colloidal bismuth compounds, prostaglandin analogs). Mechanisms of action, main therapeutic uses and adverse effects. Case studies. Therapy of H. pylori related ulcers. Other drugs used in Drugs stimulating gastrointestinal motility (cholinomimetic agents, metoclopramide, domperidone, cisapride); laxatives 10 gastrointestinal disorders. (bulk-forming agents, softeners, stimulant and osmotic laxatives); antidiarrheal agents (opioid agonists, colloidal bismuth compounds, kaolin and pectin, octreotide); antiemetic agents (serotonin 5-HT3 antagonists, dopamine antagonists phenothiazines, H1 antagonists, anticholinergics, antagonist of NK1 – aprepitant, cannabinoids); pancreatic enzyme supplements; bile acids used in gallstones therapy - pharmacokinetics, clinical uses, adverse reactions. Drugs of abuse. Problems of terminology (abuse, addiction, tolerance, sensitization, dependence). Types of substance (drug) dependence, major categories of drugs of abuse (opioids, cocaine, amphetamine, phencyclidine, cannabis-relateddisorders, hallucinogens, alcohol, nicotine addiction, inhalants and gases). Abstinence syndrome, therapy of withdrawal syndrome. General principles (hazard and risk, routes of exposure, duration of intoxication). Principles for therapy of poisoning. Specific toxicants (heavy metal intoxication and chelators, air pollutans, solvents, insecticides, fumigants, herbicides, rodenticides) and examples of specific antidotes. Toxicology. Drug therapy in pregnancy Drug therapy in pregnancy (pharmacokinetics, and during lactation pharmacodynamics, teratogenic drug actions). Drug use during lactation. Special aspects of pediatric Drug therapy in infants and children (pharmacokinetics, and geriatric pharmacology pharmacodynamics, pediatric dosage forms and compliance, pediatric dosage). Pharmacological changes associated with aging. The use of major drug groups in elderly people. Adverse drug reactions in the elderly. Practical aspects of geriatric pharmacology. Drugs used in dermatology Dermatologic vehicles. Topical antibacterial agents (bacitracin&gramidicin, mupirocin, polymyxin&sulfate, neomycin&gentamicin, topical antibiotics in acne (clindamycin, erythromycin, metronidazole, sodium sulfacetamide). Antifungal agents (topical azole derivatives, cyclopirox olamine, naftifine&terbinafine, butenafine, tolnaftate, nystatin&hotericin). Topical antiviral agents (acyclovir, valacyclovir, penciclovir, famciclovir). Immunomodulators (imiquimod, tacrolimus&pimecrolimus). Ectoparasiticides (lindane, crotamiton, sulfur, permethrin, malathion). Agents affecting pigmentation (hydroquinone&monobenzone, trioxsalen%methoxsalen). Sunscreens. Acne preparations (retinoic acid&derivatives, isotretinoin, benzyl peroxide, azelaic acid). Drugs for psoriasis (acitretin, tazarotene, calcipotriene). Antiinflamatory agents (topical corticosteroids, alefacept, tar compounds). Keratolytic & destructive agents (salicylic acid, propylene glycol, urea, podophyllum resin & podofilox, fluorouracil, aminolevulinic acid). Antipruritic agents (doxepin, pramoxine). Trichogenic&antitrichogenic agents (minoxidil, finasteride, eflornithine). Antiseborrhea agents. 11 2016-2017 Pharmacology Course Regulations 2nd Year of 4-Year MD Programme in English 1. The goal of this course of pharmacology is to provide students with knowledge of drugs that are useful in prevention, diagnosis, and treatment of human diseases. 2. The material of the course will be presented through lectures and seminars. During the seminars students must be prepared to discuss corresponding topics covered during the lecture. 3. Attendance: Student’s attendance at the seminars is mandatory– only 1 unjustified absence during the whole course will be accepted. Each student must be present with the group they have been assigned to. Each absence during the seminar must be justified by a duly authorised document (sick leave receipt, University’s letter, letter from other authorities, other) Students with unjustified absences have to take the integrative test independent on their component tests results. 4. Completion of the course of seminars (earning a credit): o Students’ progress shall be evaluated on an ongoing basis based on the results of Component Tests carried out at the end of each seminar. o The whole course of the seminars is considered successfully completed and the student earns a credit if the following condition is met: A student gains a minimum grade of 3.0 calculated as a mean value from all the Component Tests they wrote (each student must take the Component Test at the end of the seminar). o The student whose absence during a seminar is justified as explained above need not take the Component Test from the seminar he failed to attend. o Each student who fails to obtain a minimum grade of 3.0 as mentioned above is given a chance of taking the Integrative Test to improve. The Integrative Test can be taken once. A passing grade at the Integrative Test gives the student the credit equivalent with successful completion of the course of seminars. Failure to pass the Integrative Test is equivalent to failure to complete the course of pharmacology. 5. Completion of the whole course of pharmacology (Final Grade): The mean grade of all the Component Tests a student wrote (or the grade from the Integrative Test, if passed), together with the result of the Final Exam, shall be the basis for calculation the Final Grade from the pharmacology course, as follows: FINAL grade =Final exam grade (e.g.NBME grade) x 0.6 + seminars mean grade x 0.4 The Final Exam must be passed to qualify for pharmacology course completion. If a student fails to pass the Final Exam, they are still allowed two attempts at the Final Exam. If a student does not pass the Final Exam on any attempt, the failing grade is each time entered in their Index and Examination Card. 6. Grading scale: 5.0 = Very Good; 4.5 = Better than Good; 4.0 = Good; 3.5 = Fairly good; 3.0 = Satisfactory; 2.0 = Unsatisfactory. 12