MBBS Pharmacology Curriculum

S.No.  Contents of the Topics Learning Objectives

(At the end of the training program the student should be able to)

 

Teaching guidelines Methodology Time  (Hrs)
  THEORY
A General Pharmacology

 

1. INTRODUCTION: Pharmacology -a foundation to clinical practice Define the following terms: pharmacology, pharmacodynamics, pharmacokinetics, pharmacotherapy, drug, Clinical pharmacology, Pharmacy, Pharmacotherapeutics, toxicology, essential drugs

 

Introduction to & history of Pharmacology & related sciences, , Scope , role of drugs as one of the modalities to treat diseases, definition ,nature and sources of drugs; subdivisions of pharmacology. Toxicology,  Pharmacy, rational pharmacotherapy, drug  nomenclature Student interactive sessions (SIS) on Power point presentation,

Seminars , tutorials

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2. Routes of drug administration

 

List factors governing choice of the routes of drug administration,

to identify the merits & demerits of different routes of drug administration

Local & systemic routes of drug administration Student interactive sessions (SIS )presentation,

Seminars & tutorials

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3. Pharmacokinetics

 

Describe the factors that govern the absorption of drugs

Explain the effect of pH on drug absorption.

Explain ion trapping.

Define bioavailability and bioequivalence.

Describe the various factors that affect drug distribution.

List the major mechanisms responsible for drug metabolism.

Describe how metabolism affects drug structure and function.

Explain the first-pass effect.

List Phase I and Phase II reactions of drug metabolism.

List the main organs involved in drug metabolism.

Describe the main features and properties of the cytochrome P450 enzyme family.

Explain how drugs are chemically altered by cytochrome P450 enzymes.

Explain the clinical relevance of enzyme induction and enzyme inhibition.

List the main drugs that can act as inhibitors and inducers of cytochrome P450 isoenzymes.

Outline the main molecular mechanisms of cytochrome P450 induction.

Explain the clinical relevance of the induction of drug transporters.

List examples of toxic metabolism (eg acetaminophen).

List the main factors that can affect drug metabolism  (genetic, diet & environmental, age, diseases, drug-drug interactions)

Define clearance, volume of distribution, extraction ratio, bioavailability, half-life, loading dose and maintenance dose.

Calculate the volume of distribution given a loading dose and the plasma drug concentration at time zero.

Explain the difference between first-order and zero-order kinetics of drug elimination.

List examples of drugs that follow zero-order kinetics.

Describe the concept of steady-state with regard to plasma drug concentrations.

Explain the importance of different pharmacokinetic parameters for the duration of drug action.

Calculate the drug plasma levels reached after a given number of half-lives during drug administration.

Calculate the drug plasma levels reached after a given number of half-lives when drug administration is discontinued.

Use pharmacokinetic concepts and principles to design a rational dosage regimen.

Calculate a loading dose to achieve a target plasma drug level given the drug’s volume of distribution.

Given a drug’s elimination clearance, calculate the maintenance dose needed to achieve or maintain an average steady-state drug level using either a continuous infusion or a fixed-dose, fixed-time interval regimen.

Define Therapeutic drug monitoring.

Enumerate indications of Therapeutic drug monitoring

Enumerate strategies to prolong drug effect

 

Absorption- process of absorption, drug transport mechanisms, Bioavailability, Bioequivalence, factors affecting absorbtion, Distribution- factors affecting distribution, Plasma protein binding, Blood Brain Barrier, organ blood flow , Biotransformation- Role of drug biotransformation, 1st pass metabolism, Phases of Biotransformation, Pharmacogenetics, Excretion- organs of excretion, Quantitative Pharmacokinetics, Fundamental & derived Pharmacokinetic parameters, Drug clearance, single, continous & multiple dose Pharmacokinetics, Kinetics of Elimination, steady state principle, Loading dose & maintance dose, Therapeutic drug monitoring, prolongation of drug effect, Relevance of Pharmacokinetics in clinical practice Power point presentation, PBL,

Seminars & tutorials Student interactive sessions (SIS)

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4. Pharmacodynamics Define the term pharmacodynamics

Distinguish between Drug effect & drug action

Enumerate different kinds of receptor & non-receptor mediated mechanism of action of drugs

Describe non-receptor mediated drug interactions eg., with enzyme, transporter protein & Ion channels.

Define receptor and list the different classes of receptors with which drugs interact.

Classify receptors

Define agonist, antagonist, full agonist, partial agonist, and inverse agonist.

Define selectivity and specificity

Describe graded and quantal dose-response curves for a drug. Define KD, Emax, EC50, ED50, TD50 and LD50.

1.       Describe and explain the effect(s) of competitive and non-competitive antagonists on the dose-response curve for an agonist.

2.       Explain what is meant by additive and synergistic drug effects

Define efficacy and potency.

Describe the different mechanisms of receptor and non-receptor antagonism.

Define Fixed Dose Combinations

Describe desensitization, tachyphylaxis, tolerance and resistance. Explain the mechanisms that underlie such phenomena.

Explain therapeutic index and therapeutic window.

Enumerate factors modifying drug response

Mechanism of actions of drugs, Non-receptor mediated drug action, enzyme inhibition, Ions channels & transporter protein drug interactions, receptor classification, signal transduction- G-protein- coupled receptors, Ligand gated ion channels, membrane bound enzymes, Nuclear receptors, receptor & diseases, receptor regulation, drug tolerance, Log dose response curves (LDRC), combined effects of drugs, drug synergism & antagonism, Dose & dosage regimens, Factor modifying drug responses- age, gender, race, genetic factors, pathological & psychological factors, environment & diet, drug tolerance  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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5. Adverse drug Reactions Define Adverse Drug reaction(ADR) & Adverse drug events

Classify different types of Adverse Drug reactions

Describe the differences between type A and type B adverse drug reactions.

Describe the protocol for treatment of poisoning

Discuss the different kinds of drug-drug interactions (pharmacokinetic, pharmacodynamic and drug-herb interactions) in the context of drug toxicity.

Describe Pharmacovigilance & Pharmacovigilance programme of India.

Discuss the use of drugs in pregnancy with respect to the FDA pregnancy categories

Different types of ADRs, hypersensitivity reactions, Idiosyncratic reactions, genetically determined ADRs, Treatment of Poisonings, Organ toxicity, Drug dependence, Photosensitivity, Teratogenicity, Pharmacokinetic & Pharmacodynamic drug interactions, Factors affecting drug safety, Pharmacovigilance  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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6. New drug discovery & clinical trials Describe the drug discovery process.

Describe drug screening and toxicity testing.

Describe clinical drug evaluation and regulatory approval.

Describe the several phases involved in the investigation of a new drug and discuss the characteristics of each of the phases.

Describe the drug approval process

Define orphan drugs.

 

Approaches to drug discovery, Pre-clinical studies, Clinical trials- PhaseI-IV  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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B Autonomic nervous system Pharmacology
1 Introduction:

General considerations

Define the following terms: organization and function of ANS-autonomic afferents,central connections,autonomic efferents,enteric nervous system, describesteps of neurohumoral transmission,cotransmission.

 

 

Teach students regarding impulse conduction,transmitter release,transmitter action on post-junctional membrane,explain terms like EPSP and IPSP.Role of cotransmitters.

 Power point presentation,

Seminars & tutorials

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2  Cholinergic system and drugs

 

 To explain Synthesis of acetylcholine, concept ofcholinoceptors,cholinergicdrugs,anticholinesterases.pharmacological actions of ACH and anticholinesterses Types of cholinergic receptors,Location and function.drugs having action like Ach.therapeutic uses of cholinergic drugs.therapeutic uses of anticholinesterases,poisoning and its treatment.myasthenia gravis-management.role of anticholinesteraes in management of myasthenia gravis  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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3 Anticholinergic drugs,drugs acting on autonomic ganglia

 

 

Elaborate Pharmacological actions of atropine,atropine substitutes.therapeutic uses of atropine and its synthetic substitutes.

Atropine and its substitutes-uses,use of atropine substitutes as mydriatics,anti-secretory,anti-spasmodics,action on urinary bladder,role in parkinsonism,motion sickness,as cardiac vagolytics.role of atropine in poisoning caused due to muscarinic drugs.treatment of smoking cessation.  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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4 Adrenergic system and drugs Describe Adrenergic drugs,pharmacological actions of noradrenaline,therapeutic uses of adr and adrenaline like drugs. Adrenergic receptors,location,function served,synthesis of dopamine,adrenaline and noradrenaline, actions of Noradrenaline on its receptors.therapeutic classification of adrenergic drugs.salient features of dopamine,dobutamine,amphetamines,ephedrine.uses of adrenergic drugs as pressor agents,cardiac stimulants,bronchodilators,nasal decongestants,CNSstimulants,anorectics,uterine relaxants and vasodilators  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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5 Anti-adrenergic drugs

 

Adrenergic receptor antagonists-α-receptor antagonists and β-receptor antagonists.therapeutic uses.

 

α-blockers ,classification,general actions on various systems and their uses.their role in conditions like pheochromocytoma and benign hypertrophy of prostrate and hypertension,β-blockers ,classification,propranolol and its uses,role of other β blockers in hypertension,angina,congestive heart failure,cardiac arrthythmias,myocardial infarction,thyrotoxicosis,migraine,anxiety,glaucoma,essential tremor.combined α and β blockers and uses.  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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6 Drugs for glaucoma α-agonists,β-blockers.explain role of these drugs for treatment of glaucoma Types of glaucoma.cause of its occurrence.role of drugs like α agonists and β blockers ,prostaglandin analogues in treatment of glaucoma  Power point presentation,

Seminars & tutorials

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C Drugs for cough & Bronchial Asthma
1 Introduction:

Cough

Describe the following terms:

1.Demulcents,

2. Expectorants – Bronchial secretion enhancers & Mucolytics

3.Antitussives – Opioids, non opioids, anti histamines, peripheral acting

4.Adjuvant antitussives

 

Introduction to physiology of cough, the different etiologies of cough and their treatment approach – pharyngeal demulcents- lozenges, cough drops ;expectorants – Bronchial secretion enhancers- potassium citrate, guaiphenesin; mucolytics- Bromhexine, Ambroxol, Acetyl cysteine; Antitussives – Opioids- codiene, non opioids- dextromethorphan,antihistamines-chlorpheniramine, pheripheral actind drugs- prenxdiazine

 

 Power point presentation. Student interactive sessions (SIS) 1
2 Bronchial Asthma

 

Explain the physiology of bronchial asthma,

Describe the physiology of COPD

Identify the types – Intrinsic & extrinsic,

Classify the various approaches to treatment

Describe the mehanism of action , pharmokinetics and ADR of the following drugs-

1.Sympathomimetics

2.Methyl Xanthines

3.Anticholinergics

4.Leukotriene antagonists

5.Mast cell stabilizers

6.Corticosteriods

7.Anti IgE antibody

Treatment of emergancy- Status asthamaticus

Bronchial asthma- introduction with pathophysiology,types of asthma, COPD – pathophysiology, ; approaches ot their treatment, Classification of the drugs

1.Bronchodilators – beta 2 agonists -salbutamol,terbutaline,salmeterol; methyl xanthines- theophylline,aminophylline & their TDM; anticholinergics- Ipratropium bromide

2.Leukotriene antagonists – montelukast, zafirlukast

3.Mast cell stabilizers- Sodium cromoglycate, ketotifen

4.Corticosteriods- a) systemic- hydrocortisone;b) Inhalational – beclomethasone,budisonide

5.Anti IgE antibody – Omalizumab,

Mechanism of action, pharmacokinetics ,ADR & uses of the above

mentioned drugs

Types of inhaled asthma medication and various instruments used for inhalation

Choice of treatment according to severity of asthma – mild, moderate & severe

Treatment of status asthamaticus

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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D Autacoids
1 Histamine and antihistaminics Physiology and pathophysiology of histamine. Describe the synthesis, storage and release of histamine. Describe the metabolism and elimination of histamine. Identify the major classes of histamine receptors – H1, H2 (with mention of H3 and H4) and discuss their tissue distribution and function. Molecular mechanism of action of each drug in each drug class. Actions on organ systems Pharmacological effects of the drugs in each class on various organ systems. Differentiate the histamine receptor subtypes responsible for mediating the effects of histamine in each organ system.

Pharmacokinetics of the second generation antihistamines. Adverse effects, drug interactions and contraindications of the drugs in each class. Describe the clinically important drug interactions of the drugs in each class. Describe the principal contraindications of the drugs in each class. Therapeutic uses of the antihistamines in allergies, sedation, and motion sickness.

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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2 5-Hydroxytryptamine (5-HT), its antagonists & Drug therapy of Migraine Physiology and pathophysiology of 5-Hydroxytryptamine. To identify different 5-HT receptors. Ergot alkaloids and triptans. Drug therapy and prophylaxis of Migraine. Synthesis, storage and release of serotonin.

Describe the metabolism and elimination of serotonin.

Identify the major types of serotonin receptors relevant to therapeutic drugs acting in the brain, the vasculature and the g.i. tract.

Describe the roles of serotonin in migraine, carcinoid syndrome, and in the CNS

(emesis; mood disorders and other psychiatric conditions, covered with CNS

drugs).

Differentiate the use of these drugs in migraine (prophylaxis vs. abortive therapy) and as antiemetic agents.

 Power point presentation,

Seminars & tutorials presentation

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3 Prostaglandins, Leukotrienes

(Eicosanoids) and Platelet

Activating Factor

Describe chemistry, biosynthesis and

degradation of prostaglandins and Leukotrienes.

Describe actions and pathophysiological roles of prostaglandins, thromboxanes and

Prostacyclins.

 

Explain the molecular mechanism of action of each drug in each drug class.

Describe the pharmacological effects of the drugs in each class on various organ

systems.

Differentiate drugs inhibiting leukotriene synthesis (zileuton) from leukotriene action at CysLT1 receptors (zafirlukast).

Describe the clinical utility of prostaglandin analogs.

describe the synthesis, degradation and action of Platelet Activating Factor

  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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4 Nonsteroidal Antiinflammatory

Drugs and Antipyretic-Analgesics

Outline the physiological basis of temperature control and peripheral sensory pain fibers.

Outline the pathophysiology of acute and chronic inflammation.

Explain the molecular mechanism of action of each drug in each drug class.

Differentiate the effects on pain, fever, and inflammation of the drugs in each class.

Classification of the NSAIDs

Physiology and Pathophysiology of pain and inflammation

Explain the molecular mechanism of action of each drug in each class.

Classification of NSAIDs

Nonselective COX inhibitors

Preferential COX-2 inhibitors

Selective COX-2 inhibitors

Analgesic-antipyretics with poor anti-inflammatory action

Differentiate the mechanisms of action of acetylsalicylic acid, acetaminophen, and

NSAIDS.

Describe the metabolism of and mechanism of toxicity of acetaminophen

Describe the principal adverse effects of the drugs of each class.

Describe consequences of protein binding, zero order metabolism, and irreversible

inhibition related to acetylsalicylic acid.

Describe the clinically important drug interactions of the drugs of each class.

Describe the principal contraindications of the drugs of each class.

Therapeutic uses

Differentiate the use of these drugs in treatment of pain, fever, and inflammation.

Describe the principles of treatment for acetaminophen toxicity.

Describe the principles of treatment for salicylate toxicity.

Choice of NSAIDs in different conditions

Analgesic combinations

 Power point presentation,

Seminars & tutorials

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5 Antirheumatoid and antigout drugs Rheumatoid arthritis

Describe the likely mechanisms of antirheumatic action of the Disease modifying antirheumatic drugs(DMARDS).

List the routes of administration of drugs in each class.

Describe the main adverse effects of the drugs of each class.

 

Gout

Describe the causes and pathophysiology of acute gouty arthritis and chronic gout.

Classify the various approaches to treatment

Describe the mechanism of action , pharmacokinetics and ADR of the drugs used in acute and chronic gout

Disease modifying antirheumatic drugs(DMARDS)

Nonbiological and biological agents

Adjuvant drugs

Corticosteroids: Prednisolone and others

Describe the clinically important drug interactions of the drugs of each class.

Describe the principal contraindications or precautions of the drugs of each class.

Outline the use of the NSAIDS and DMARDS in arthritic disorders.

 

Describe the mehanism of action , pharmokinetics and ADR of arugs used in acute gout : NSAIDs, Colchicine, Corticosteroids

In chronic gout : Uricosurics – Probenecid, Sulfinpyrazone

Synthesis inhibitors : Allopurinol, Febuxostat

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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E Peripheral Nervous System (PNS) Pharmacology
1 Local anesthetics Discuss the mechanism of action, adverse effects, pharmacokinetic properties, uses, drug interactions and contraindications of local anesthetics.

List the significant differences between amide and ester-type local anesthetics.

List the common adverse effects of local anesthetics and indicate appropriate treatments should they occur.

Describe the common routes of administration of local anesthetics.

Describe methods used to restrict local anesthetics to a desired site of action and indicate how these methods reduce adverse effects.

 

Classification of Local anesthetics (LA); Mechanism of action, Pharmacological actions, Pharmacokinetics, drug interactions,  contraindications, ADRs & therapeutic uses of Lignocaine; distinctive features of some of the LA; Types of Local anesthesias  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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2 Skeletal muscle relaxants Describe the mechanism of action, pharmacokinetic properties, actions, uses, adverse effects and drug interactions of nondepolarizing and depolarizing neuromuscular blockers.

Describe the mechanism of action, uses and adverse effects of Central Skeletal Muscle relaxants

Classification of skeletal muscle relaxants; Mechanism of action, Pharmacological actions, Pharmacokinetics, drug interactions,  contraindications, ADRs & therapeutic uses of skeletal muscle relaxants  Power point presentation,

Seminars & tutorials

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F CNS Pharmacology
1. Introduction to CNS Pharmacology 1.       Define neurotransmitters,

Describe different major receptor superfamilies & the major chemical classes of excitatory and inhibitory neurotransmitters

Principles of neurotransmission, neurotransmitter synthesis & metabolism, excitatory & inhibitory neurotransmission, Neurotransmitters & receptors  Power point presentation,

Seminars & tutorials

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2. General Anaesthetic Define the terms “general anesthesia” and “balanced anesthesia.”

Describe the objectives of general anesthesia, the characteristics of an ideal anesthetic, and the stages of general anesthesia.

List the drugs commonly used in combination with inhalation anesthetics in balanced anesthesia.

Describe the mechanisms of action, adverse effects, drug interactions and contraindications of general anesthetics.

Define MAC and explain how MAC is used in anesthesiology.

Describe how physical properties of inhaled anesthetics influence potency and onset.

 

MECHANISM OF GENERAL

ANAESTHESIA, MAC, STAGES OF ANAESTHESIA, PHARMACOKINETICS OF

INHALATIONAL ANAESTHETICS, Properties of an ideal anaesthetic, Classification of General Anaesthetic agents (GA), Inhalational & Intravenous general Anaesthetic drugs, CONSCIOUS SEDATION, complications of GA, drug interactions, Pre-anaesthetic medication

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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3. Alcohol Describe the mechanisms of action, pharmacological actions, l adverse effects, drug interactions and contraindications & uses of Ethyl alcohol.

 

 

Ethanol & other forms of Alcohol, Mechanism of action, Pharmacological actions of Ethanol, Pharmacokinetics, drug interactions & contraindications of ethanol, Toxicity, guidelines of safe drinking, Ethanol dependence & it’s treatment, Clinical uses of ethanol, Methyl alcohol Poisoning  Power point presentation,

Seminars & tutorials

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4. Sedative-hypnotics and anxiolytic drugs Define sedation and hypnosis.

Describe the structure and function of the GABA-A receptor.

Describe the effects of various sedative/hypnotic drugs on GABAergic transmission and their differences in their binding sites on the GABA-A receptor.

Describe the actions of agonists, antagonists and inverse agonists at the GABA-A receptor.

Explain the uses of flumazenil.

Describe the pharmacokinetics properties of benzodiazepines.

Compare and contrast the effects of barbiturates, benzodiazepines, and non-benzodiazepine benzodiazepine-receptor agonists on induction and maintenance of sleep  and their adverse effects.

Explain why drugs acting at benzodiazepine receptors have replaced barbiturates as the sedative-hypnotics of choice.

List the therapeutic uses of benzodiazepines, barbiturates and non-benzodiazepine benzodiazepine-receptor agonists.

Describe the mechanism of action, actions, uses and adverse effects of buspirone, ramelteon , chloral hydrate and other drugs used as sedative-hypnotics or anxyolytics..

 

Definitions of Sedative & hypnotics, Classification of sedative & hypnotics, Barbiturates- pharmacological actions, mechanism of action, pharmacokinetics, therapeutic uses, adverse effects, drug interactions; Benzodiazepines- pharmacological actions, mechanism of action, pharmacokinetics, classification, therapeutic uses, adverse effects, drug interactions; NON-BENZODIAZEPINE HYPNOTICS, Management of Insomnia, Benzodiazepine antagonists;  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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5 Antiepileptic Drugs List the major types of seizures.

List the major classes of antiepileptic drugs and the seizures against which they are effective.

Describe the mechanism of action, indications, adverse effects & contraindications of antiepileptic drugs.

Discuss the risks of antiepileptic drugs during pregnancy.

List the antiepileptic drugs that induce P450 enzymes.

Discuss other therapeutic uses of antiepileptic drugs.

Describe the main non-pharmacological antiepileptic therapies.

 

Epilepsies- definitions & types, classification of Anti-epileptic drugs, mechanism of action, indications, adverse effects & contraindications of antiepileptic drugs. TREATMENT OF EPILEPSIES

 

 Power point presentation,

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6 Antiparkinsonian Drugs Discuss the etiology and pathophysiology of Parkinson’s disease.

Describe the molecular mechanism of action, adverse effects, drug interactions and contraindications of the drugs used in Parkinson’s disease.

Describe the rationale for the use of the different classes of drugs used in Parkinson’s disease

Parkinsonism- pathophysiology & signs & symptoms; CLASSIFICATION- Antiparkinsonian Drugs; mechanism of action, adverse effects, drug interactions and contraindications of the drugs used in Parkinson’s disease; Treatment of Parkinson’s disease.  Power point presentation,

Seminars & tutorials

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7 Antipsychotic and Antimanic Drugs Describe schizophrenia and discuss the theories regarding its neurochemical basis.

List the major antipsychotic agents.

Describe the mechanism of action of antipsychotic drugs

Contrast the major properties of the conventional antipsychotics with those of the atypical antipsychotics.

Contrast the adverse effects of conventional antipsychotics with those of the atypical antipsychotics.

Describe neuroleptic malignant syndrome and its management and treatment.

Compare the effectiveness of classical and atypical antipsychotics in the treatment of both positive and negative signs of schizophrenia.

List the main uses of antipsychotic drugs.

Describe Bipolar disorder and discuss the theories regarding its neurochemical basis.

List the drugs used in the treatment of Mania

Describe the mechanism of action, adverse effects, drug interactions and uses of Lithium.

Discuss the current therapeutic status of atypical antipsychotics & Anti-epileptics in the treatment of Bipolar disorder

 

Pathophysiology of Psychosis & mania; classification of Antipsychotic drugs; Pharmacological actions & Pharmacokinetics of Chlorpromazine; distinctive features of other Anti-psychotic drugs, atypical antipsychotics (second generation); mechanism of action, adverse effects, drug interactions & therapeutic uses of antipsychotic drugs; classification of Antimania drugs (Mood stabilizing drugs); ); mechanism of action, adverse effects, drug interactions & therapeutic uses of Lithium; Use of alternatives to lithium (eg valproate, carbamazepine, lamotrigine, atypical antipsychotics

 

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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8 Antidepressant and Antianxiety

Drugs

Describe the monoamine hypothesis of depression. Describe its strenghts and weaknesses.

List the major classes of antidepressant drugs and their primary cellular targets: MAOIs, TCAs, SSRIs, SNRIs,  SARIs, NDRIs,

Describe the mechanism of action, actions, pharmacokinetic properties, uses, adverse effects, contraindications and drug interactions of the major classes of antidepressant drugs.

Describe the features of the main anxiety disorders.

List the drugs used for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder and performance anxiety; describe their mechanism of action, primary effects and adverse effects.

Outline the goals of therapy for each type of anxiety disorder.

Explain why antidepressants have replaced benzodiazepines as the drugs of choice for most anxiety disorders

 

monoamine hypothesis of depression, classification of Antidepressant drugs; Pharmacological actions, Mechanism of action, Pharmacokinetics, adverse effects & drug interactions of TCAs; distinctive features of some TCAs; Mechanism of action, adverse drug reactions & drug interactions of MAOI, SSRIs, SNRIs,  atypical antidepressants, SARIs & NDRIs. Therapeutic uses of Antidepressant drugs.

Anxiety- signs & symptoms, classification of drugs used in anxiety; treatment of anxiety

 

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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9 Opioid analgesics & antagonists Identify characteristics of the different types of pain: nociceptive, inflammatory, neuropathic, and functional.

Describe the clinical presentation of pain.

Explain the molecular mechanism of action of opioid analgesics.

List the different types of opioid receptors and their signalling mechanisms.

Describe the physiological effects of each receptor type.

Discuss the mechanisms of spinal, supraspinal and peripheral analgesia.

Discuss the classification of opioids in strong agonists, partial agonists, mixed agonists-antagonists and antagonists.

Describe the receptor type activity of major opioids.

Describe the organ system effects of morphine and other major opioids.

Describe the pharmacokinetic properties of opioids.

List the uses, adverse effects, contraindications and drug interactions of opioid analgesics.

Explain how agonist-antagonists and partial agonists differ in their utility and adverse effect profile when compared to strong agonists.

Discuss the main properties of the following specific agents: morphine, heroin, meperidine, fentanyl, methadone, codeine, oxycodone, propoxyphene, tramadol, diphenoxylate, loperamide, pentazocine, nalbuphine, buprenorphine, naloxone, naltrexone and dextrometorphan.

 

Definition of Pain & analgesia; Opioid receptors, ENDOGENOUS OPIOID PEPTIDES, Morphine- mechanism of action, pharmacological actions, Pharmacokinetics, Adverse drugs reactions (ADRs), precautions & contraindications, drug interactions; CLASSIFICATION OF OPIOIDS, distinctive features of some of the opioids, therapeutic uses of Morphine & it’s congeners, Opioid agonists- antagonists  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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G  CVS Pharmacology
1. Cardiac Electrophysiological Considerations Define impulse generation,

Conduction,describe terms like refractory period and excitability,learn about autonomic influences on cardiac electrophysiology and contractility

Action potential in automatic and non automatic fibres.characteristics of fast channel and slow channel action potentials.autonomic effects on action potential duration  Power point presentation,

Seminars & tutorials

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2. Drugs affecting Renin- Angiotensin System and Plasma Kinins Describe Renin-angiotensin system and how this system is important for regulating plasma volume,blood pressure and electrolyte balance,angiotensin receptors and transducer mechanisms,ACE inhibitors and therapeutic uses,angiotensin receptor blockers and therapeutic uses,renin inhibitors Pathophysiological roles of renin angiotensin.its actions on CVS,smooth muscles,adrenal cortex,kidney,CNS,peripheral  sympathetic structures,inhibitors of ACE enzyme.individual drugs .differences between ACE inhibitors and ARB’S.Their role in cardiovascular diseases like hypertension,CHF,myocardial infarction,diabetic nephropathy  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

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3. Cardiac Glycosides And Drugs for Heart Failure Elaborate on cardiac glycosides,pharmacological actions,mechanism of action of digitalis,current status in CHF  and cardiac arrhythmias.role of diuretics,vasodilators,β-blockers in above said conditions Teaching students in detail about mechanism of action of digitalis on cardiac myocytes,blood vessels,kidney ,CNS,Pharmacokinetic features,adverse effects,precautions and contraindications, therapeutic use in CHFand Arrthymias.role of other drugs in these conditions  Power point presentation,

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4. Anti Arrthymic Drugs Learn about types of  cardiac arrthymias.classification of anti-arrthymics Individual drugs used in various types of arrthymias.mechanisms by which these drugs help to treat arrthymias.  Power point presentation,

Seminars & tutorials

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5. Anti – Anginal And Anti Ischaemic Drugs Define angina,pathogenesis of angina.drugs useful in angina-classification with special reference to nitrates,their mechanism of action.,adverse effects,contraindications,role of other drugs in angina like β- blockers,calcium-channel blockers,potassium channel openers.role of these drugs in MI.special mention of other drugs like ivabradine,trimetazidine,ranolazine Types of angina.nitrates-mechanism of action in angina,pharmacokinetics,adverse effects,tolerance,dependence and interactions with nitrates.classification of nitrates depending on their duration of action,individual drugs.role of nitrates in MI,LVF,CHF,biliary colic,esophageal spasm,cyanide poisoning.mechanism of action of β-blockers inangina,calcium-channel blockers,pharmacological actions and role in angina,various drug combinations in angina.individual calcium channel blockers with special reference to those useful in angina,their adverse effects and contraindications,potassium  channel openers,drugs affecting cardiac metabolism like ivabradine,trimetazidine,ranolazine,oxyphedrine.drug therapy in MI.

 

 Power point presentation,

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6 Anti Hypertensive Drugs  Define hypertensionClassification of anti-hypertensive drugs.individual drugs.treatment of hypertension,combinations given,combinations avoided. Diuretics and their mechanism of action,ACE inhibitors,angiotensin receptor blockers,direct renin inhibitors,calcium channel blockers and β-blockers,α-blockers,α+β blockers,central sympatholytics and vasodilators wth special reference to their role in hypertension.treatment of hypertensive urgencies and emergencies  Power point presentation,

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H Endocrine pharmacology
1 Hypothalamic and pituitary hormones List the anterior pituitary and hypothalamic hormones.

Describe the link between hypothalamic, pituitary and target gland hormones.

Describe the receptors for anterior pituitary and hypothalamic hormones and the signalling mechanisms associated with them.

Describe the mechanism of action, uses, adverse effects and contraindications of growth hormone and growth hormone antagonists.

Describe the mechanism of action, uses, adverse effects and contraindications of the gonadotropins.

Describe the mechanism of action, uses, adverse effects and contraindications of gonadotropin-releasing hormone, its analogs and its antagonists.

Describe the mechanism of action of prolactin. Describe the symptoms associated with abnormal prolactin release. Describe the mechanism of action, effects, uses, toxicity and contraindictions of dopamine agonists.

Describe the mechanism of action, effects and uses of thyroid-stimuling hormone and of thyrotropin-releasing hormone.

Describe the mechanism of action, effects, uses, toxicity and contraindictions of the posterior pituitary hormones and their antagonists.

 

Hormones & endocrinal glands, Sites and mechanisms of hormone action; Growth hormone- Physiological functions, regulation of secretion, Pathological involvements, preparations, therapeutic uses & adverse drug reactions; GH Inhibitors, Prolactin- Physiological functions, regulation of secretion, Pathological involvements; Prolactin inhibitors- therapeutic uses & adverse drug reactions; GONADOTROPINS- Physiological functions, regulation of secretion, Pathological involvements, preparations, therapeutic uses & adverse drug reactions; GONADOTROPIN RELEASING HORMONE (GnRH): preparations, therapeutic uses & adverse drug reactions;

THYROID STIMULATING HORMONE

(TSH, THYROTROPIN)- Physiological functions, regulation of secretion, Pathological involvements; ADRENOCORTICOTROPIC HORMONE

(ACTH, CORTICOTROPIN)- Physiological functions, regulation of secretion, Pathological involvements;

 Power point presentation,

Seminars

1
2 Thyroid Hormones and

Thyroid Inhibitors

Outline the regulation and the key steps in thyroid hormone synthesis, secretion and peripheral metabolism .

Describe the chemical structure of thyroxine, triiodothyronine and reverse triiodothyronine

Describe the pharmacokinetic properties of thyroid hormones.

Explain the mechanism of action of thyroid hormones.

Describe the physiological effects of thyroid hormones.

Describe the major manifestations of thyrotoxicosis and hypothyroidism.

Describe the preparations of thyroid hormones currently available.

Describe the mechanism of action, primary effects and adverse effects of antithyroid drugs.

Explain the rationale for the use of propranolol in the treatment of hyperthyroidism.

Describe the therapeutic uses of thyroid and antithyroid drugs.

 

Thyroid hormones- chemistry & synthesis, transport, metabolism & excretion, regulation of secretion, Pharmacological actions, Mechanism of action & therapeutic uses & ADRs.

Thyroid inhibitors- classification, mechanism of action, ADRs,  therapeutic uses & preparation & doses. Treatment of Thyroid storm

 Power point presentation,

Seminars & tutorials

2
3 Insulin, Oral Hypoglycaemic

Drugs and Glucagon

Describe the effects of insulin and glucagon on metabolism.

Describe the pathophysiology of diabetes mellitus type 1 and type 2.

Describe the mechanism of action, effects, uses, adverse effects & drug interactions of the agents used in the pharmacotherapy of type 1 and type 2 diabetes.

Describe the mechanism of action, effects, uses & adverse effects of glucagon.

Explain the goals of therapy for diabetes & Outline the drug treatment of Diabetic ketoacidosis, T1DM & T2DM

 

Pathophysiology of T1DM & T2DM; Insulin- Physiological actions, regulation of secretion, mechanism of action, Pathological involvements, sources & preparations of Insulin, Fate of Insulin, Classification, Human Insulin & analogues, Insulin Resistance, therapeutic uses, drug interactions & adverse drug reactions of Insulin;

Newer Insulin delivery devices;

ORAL HYPOGLYCAEMIC DRUGS- mechanism of action, drug interactions, ADRs & therapeutic uses; Status of oral hypoglycaemics in diabetes mellitus;

Glucagon- Mechanism of action, regulation of secretion, physiological actions & therapeutic uses

Treatment management of Hypoglycaemia, Diabetic ketoacidosis, Non-ketotic hypergycaemic coma, T1DM & T2DM;

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

3
4 Corticosteroids Explain the physiologic regulation of the hypothalamic-pituitary-adrenal axis.

Describe the major steps in the biosynthesis of steroids.

List the natural and synthetic adrenocortical steroids.

Describe the mechanism of action of corticosteroids.

Describe the actions of corticosteroids on intermediary metabolism, growth and development, electrolyte homeostasis, immune and inflammatory responses.

Describe the pharmacodynamic properties of natural and synthetic corticosteroids. Compare and contrast the glucocorticoid versus the mineralocorticoid activity of the natural and synthetic corticosteroids.

Describe the regulation of aldosterone synthesis and release by angiotensin II.

List the main natural and synthetic mineralocorticoids.

List the adrenocortical antagonists and discuss their mechanism of action, uses, and adverse effects.

Describe the diagnostic and therapeutic uses of corticosteroids.

Describe the therapeutic uses, adverse effects, drug interactions and contraindications of corticosteroids.

Explain the rationale for slow withdrawal following chronic therapy with glucocorticoids

Corticosteroids- Biosynthesis, Physiological actions, mechanism of action, chemistry & related activity, Pharmacokinetics, preparations, classification, distinctive features of some of the corticosteroids, therapeutic use, ADRs, contraindication & drug interactions of corticosteroids; strategies to prevent HPA axis suppresion  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

2
5 Gonadal hormones & inhibitors List the sources of androgens and describe the regulation of their secretion.

Describe the metabolism of testosterone to active and inactive metabolites.

Discuss the importance of dihydrotesterone formation and binding to androgen receptors in the prostate gland and other organs.

Describe the effects of androgens on growth and development.

Describe the mechanism of action, uses, adverse effects and contraindications of androgens.

Describe the androgen preparations available.

Describe the mechanism of action, effects, uses, adverse effects and contraindications of the androgen recepor antagonists, the inhibitors of androgen synthesis and the inhibitors of 5α-reductase)

Describe the gametogenic and steroidogenic functions of the ovary and their regulation by gonadotropins.

List the main properties of natural and synthetic estrogens.

Describe the mechanism of action of estrogens.

Describe the pharmacokinetic properties of estrogens.

Describe the main effects of estrogens on: cardiovascular function, metabolism, electrolyte and water balance, blood coagulation, reproductive function, plasma proteins and blood lipids.

Describe the main uses, adverse effects and contraindications of estrogens.

List the main estrogen preparations available.

Describe the estrogen antagonists, the Selective Estrogen Receptor Modulators (SERM) and the inhibitors of estrogen synthesis. Discuss their pharmacologic effects and uses.

List the main natural and synthetic progestins.

Describe the pharmacokinetic properties of progestins.

Describe the mechanism of action and main effects of progestins.

Describe the main uses, adverse effects and contraindications of progestins.

Describe the mechanism of action, effects, uses and adverse effects of antiprogestins.

List the different contraceptive methods available and compare their effectiveness.

Discuss combination and progestin-only contraceptives.

Explain what is meant by monophasic, biphasic or triphasic combination contraceptives.

Describe the mechanism of action, adverse effects and contraindications of contraceptives.

Describe the organ system effects of contraceptives.

Discuss the beneficial effects of contraceptives.

Describe the adverse effects, contraindications and cautions of contraceptives.

Describe advantages and disadvantages of various contraceptives, including both oral and non-oral formulations.

Describe the receptors targeted by the oxytocics and the sensitivity of the uterus to the various oxytocics during the three trimesters of pregnancy.

State the usual route(s) of administration, onset and duration of action of the various oxytocic agents.

State the usual route(s) of administration as well as onset and duration of action of the various tocolytic agents.

Describe the potential adverse effects of the oxytocic agents in the mother (uterine, extrauterine) and in the infant.

Describe the clinical use of the individual oxytocics.

Identify the potential benefits and risks of administering tocolytic agents to the mother and baby.

ANDROGENS- classification, Physiological actions, regulation of secretion, mechanism of action, Pathological involvements, preparations, Pharmacokinetics, Classification, therapeutic uses, contraindications & adverse drug reactions; Anabolic steroids- preparations, ADRs Therapeutic uses; Anti-androgens- ADRs & therapeutic uses, drugs for erectile dysfunction;

Estrogens & Progestins- classification, Physiological actions, regulation of secretion, mechanism of action, Pathological involvements, preparations, Pharmacokinetics, Classification, therapeutic uses, contraindications & adverse drug reactions, ANTIESTROGENS AND SELECTIVE

ESTROGEN RECEPTOR MODULATORS

(SERMs)- mechanism of action, therapeutic uses & ADRS; Aromatase inhibitors- ADRs & therapeutic uses; ANTIPROGESTIN;

Hormonal Contraceptives- types, therapeutic uses, ADRs, contraindications, drug interactions,

UTERINE STIMULANTS- classification, mechanism of action, pharmacokinetics, physiological actions, therapeutic uses & ADRs of  Oxytocin & Erogmetrine

UTERINE RELAXANTS- classification & therapeutic uses

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

4
6 Drugs Affecting Calcium Balance Describe the physiological actions of the hormonal regulators of calcium and phosphate homeostasis (PTH, vitamin D, FGF23, calcitonin, glucocorticoids and estrogens).

Describe the pharmacologic agents used in disorders of bone mineral homeostasis. Explain the molecular mechanism of action, effects, adverse effects and uses of drugs used in disorders of bone mineral homeostasis.

Describe the available preparations of calcitonin, vitamin D and calcium supplements

CALCIUM- physiological actions, absorption & excretion, preparations, therapeutic uses, ADRS; Parathormone- mechanism of action, physiological actions & therapeutic uses; Calcitonin- physiological actions, preparations & therapeutic uses; Vitamin D- physiological actions, deficiency states, preparations, pharmacokinetics, therapeutic uses, ADRs & drug interactions; Bisphosphonates-classification, mechanism of action & therapeutic uses; drug treatment of osteoporosis  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

1
I Gastrointestinal drugs Pharmacology
1 Drugs for Peptic Ulcer and Gastroesophageal Reflux Disease (GERD) To identify drugs used for the control of gastric acidity, peptic ulcer and Gastroesophageal Reflux Disease Introduction to gastric and duodenal ulcer, aggressive and defensive factors responsible for its causation, regulation of gastric acid secretion. Approaches for the treatment of peptic ulcer; Drug treatment of peptic ulcer- classification (proton pump inhibitors, H2 blockers, prostaglandin analogues, antacids, ulcer protectives) , mechanism of action, pharmacological actions, adverse drug reactions, contraindications, preparations, drug interactions, therapeutic uses/indications

Treatment of helicobactor pylori infection. Anti-H. pylori regimens.

Pharmacotherapy of GERD

 

 

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

1
2 Antiemetic, Prokinetic and Digestant Drugs

 

To outline various emetics and antiemetics, newer antiemetics, adjuvant antiemetics, prokinetic drugs, digestants and gallstone dissolving drugs To identify and describe the physiology of emesis/vomiting, to recognize various causative factors;

mechanism of action, pharmacological actions, adverse drug reactions, precautions, contraindications, preparations, drug interactions, therapeutic uses/indications of antiemetics (anticholinergics, H1 antihistaminics, neuroleptics, prokinetic drugs, 5HT3 antagonists), NK1receptor antagonists and adjuvant antiemetics

Digestants and gall stone dissolving drug (chenodiol and ursodiol)

 Power point presentation,

Seminars Student interactive sessions (SIS)

1
3 Drugs for Constipation and Diarrhoea

 

To identify Agents used for treating constipation.

To know the principles of management of diarrhoea

To know the difference between laxatives and purgatives, classification and mechanism of action of various purgatives. Bulk purgatives, stool softeners, stimulant and osmotic purgatives. Choice and use of purgatives, valid indications. Abuse of purgatives.

Pathophysiology of diarrhea, management of diarrhea, rehydration therapy, details rehydration, intravenous and oral rehydration, Rationale of ORS composition, New formula WHO-ORS, administration of oral rehydration therapy, use of zinc in paediatric diarrhea. Antimicrobial use in diarrhea, role of probiotic in diarrhea. Antisecretoy and antimotility agents in diarrhoea

Drugs used in inflammatory bowel disease. Appetite stimulants, drugs used in obesity. Drugs for biliary and pancreatic disease.

 Power point presentation,

Seminars

1
J Blood Pharmacology
1 Haematinics and Erythropoietin

 

Describe the factors that affect the formation of blood

Explain the absorption, transport, utiliztion, storage & excretion of Iron in the body

Classify the various preparations ,the doses  & ADRs of

1. Oral Iron

2. Parental Iron

List the uses of Iron

Explain the management of acute Iron poisoning

 

Explain the various maturation factors

Describe the metabolic functions, utilization, preparations, dose, deficiency symptoms, dietary sources, Uses  & ADRs of Vitamin B12

Describe the metabolic functions, utilization, preparations, dose, deficiency symptoms, dietary sources, Uses & ADRs of Folic acid

Describe types of Erythropoietin

Define the use of erythropoietin and its ADRs

 

 

 

 

Haematinics – substances required for formation of blood, etiology and types of anaemia,

Iron – distribution, absorption, factors facilitating absorption , factors impeding absorption, mucosal block ,Ferritin curtain, transport, utilization, storage & excretion of Iron from the body.;

Prepartions and dose of oral iron, ADRs of oral iron-.Ferrous sulphate, Ferrous gluconate, Ferrous fumarate, colloidal ferric hydroxide, carbonyl iron, ferrous succinate, iron calcium complex;

Preparations of parental iron- iron dextran, iron-sorbitol-citric acid, ferrous sucrose, ferric carboxymaltose – their Uses and ADRs;

Acute ironn poisoning- treatment

1. How to prevent futher absorption

2. Bind and remove iron already absorbed

3. Supportive measures

Other adjuvant haematinics- copper, pyridoxine, riboflavin,

Maturation factors-

Vitamin B12- daily requirement, metabolic functions, utilization, deficiency symptoms, preparations, dose, administration, uses & ADRs ;

Folic acid- daily requirement, metabolic functions, utilization, deficiency symptoms, preparations, dose, administration, uses & ADRs ;

Erythropoietin- Physiology, Types,  Uses & ADRS

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

2
2 Drugs affecting Coagulation, Bleeding & Thrombosis Classify  different types of coagulants

Descibe the actions and uses of Vitamin K

Describe – Antihaemophilic factor,  Desmopressin,  Adrnochrome monosemicarbazone, Rutin, Ethamsylate

Classify local haemostatics (Stypics)

Explain sclerosing agents

Discuss anticoagulants- both in vitro & in vivo-

a) Parental anticoagulant

b) Oral anticoagulant

Explain the actions, pharmacokinetics, Adverse effects & contraindications of heparin

Explain the actions, pharmacokinetics,  Adverse effects & contraindications of Low molecular weight heparin & Fondaparinux

Explain oral direct thrombin inhibitor

Classify heparin antagonist – protamine sulphate

Uses of anticoagulants

Explain the actions, pharmacokinetics,  Adverse effects  Dose regulation, Drug interactions &  contraindications of oral anticoagulant- warfarin

Classify Direct Factor Xa inhibitors- Rivaroxaban

Classify oral Direct thrombin inhibitor- Dabigatran etexilate

Classify fibrinolytics- enumerate their uses and contraidication

Classify antifibrinolytics

Classify antiplatelets and enumerate their uses

 

 

 

Physiology ofHaemostasis with both pathways, coagulants- vitamin K – K1 &K3;

Vitamin K – action, utilization, deficiency ,Use,  Adverse effects

Fibrinogen, Antihaemophilic factor, Desmopressin,;Adrenochrome monosemicarbazone;,  Rutin,; Ethamsylate;

Local haemostatics; Sclerosing  agents;

Anticoagulants- used in Vivo

Parenteral

A. Indirect thrombin inhibitors; Heparin, LMW Heparin,

B. Direct thrombin inhibitors

Oral

A. Coumarin derivatives- warfarin

B. Indandione derivative- Phenindione

C. Direct factor Xa inhibitors- RIvaroxaban

D. Oral direct thrombin inhibitor- Dabigatran

Used in Vitro -Heparin , Ca complexing agent

Actions ,pharmacokinetics, Adverse effects & contraindications of heparin, LMW heparin & Fondaparinux

Oral direct thrombin inhibitor-

Lepirudin, Bivalirudin, Argatroban

Heparin antagonist

Uses of anticoagulants

Explain the actions, pharmacokinetics,  Adverse effects  Dose regulations, Drug interactions & contraindications of oral anticoagulant- warfarin

Direct Factor Xa inhibitors- Rivaroxaban

Oral Direct thrombin inhibitor- Dabigatran etexilate

Fibrinolytics-  their uses and contraidication-Streptokinase, urokinase, Alteplase, Tenecteplase

Antifibrinolytics – Epsilon amino-caproic acid, tranexamic acid

Antiplatelets and enumerate their uses Aspirin, Dipyridamole, Ticlopidine, Clopidogrel, Prasugrel, Glycoprotein receptor antagonists, Abciximab,   Eptifibatide, Tirofiban

 

Seminars & tutorials Student interactive sessions (SIS) 3
3 Hypolipidaemic drugs Describe the types of hyperlipidemias (I, II, III, IV & V) and the alterations in serum lipids found in each type.

Describe the relationship between serum lipid levels and cardiovascular risk.

Describe the etiology of hyperlipidemias (primary vs secondary)

Describe the mechanism of action, adverse effects and indications of the various antihyperlipidemic agents.

Describe the pleiotropic effects of statins

Lipid transport, classification, mechanism of action, drug interactions, ADRs, contraindications & therapeutic uses of Hypolipidaemic drugs; Management of hypolipidaemic states.  Power point presentation,

Seminars  Student interactive sessions (SIS)

1
K Chemotherapy of microbial diseases
1 Principles of antimicrobial therapy

 

Define the terms: antibiotic, empiric antimicrobial therapy, selective toxicity, bacteriostatic and bactericidal.

Define MIC and MBC.

Describe the post-antibiotic effect (PAE)

Define chemotherapeutic spectrum.

Describe the basic principles of combination therapy with antimicrobial drugs.

Describe the terms synergism and antagonism and describe mechanisms of synergistic and antagonistic action.

Define bacterial resistance and describe the mechanisms involved in acquiring bacterial resistance.

Describe the basic principles of antimicrobial chemoprophylaxis.

Discuss potential adverse effects of antimicrobial drugs.

Discuss the classification of antimicrobial drugs based upon the mechanism of action and explain the modes of action of various antimicrobial drugs.

 

Definitions of chemotherapy, antibiotics & anti-microbial drugs, history of chemotherapy, classification of anti-microbial drugs, Selection of Anti-microbial agents, types of therapy with anti-microbial drugs, Anti- Microbial drug combinations, Chemoprophylaxis, Clinical failure of Anti- Microbial Therapy, Misuse of AMA

 

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

2
2 Folate antagonists and

Quinolones

Explain the mechanism of action of sulfonamides and trimethoprim.

Describe the pharmacokinetic properties, mechanism of acquired resistance, clinical uses, adverse effects and contraindications of sulfonamides and trimethoprim.

Discuss the antimicrobial synergy due to sequential blockade with co-trimoxazole

Describe the mechanism of action of fluoroquinolones.

Classify fluoroquinolones in groups according to their antimicrobial spectrum.

Describe the pharmacokinetics properties of fluoroquinolones

Describe the adverse effects and contraindications of fluoroquinolones.

 

 

Sulphonamides & co-trimoxazole- spectrum, mechanism of action, Resistance, classification of sulphonamides, Pharmacokinetics, ADRs, drug interactions, contraindications & Therapeutic uses.

Quinolones- Nalidixic acid- mechanism of action, ADRs, contraindications & uses; Fluoroquinolones- classification, mechanism of action, Resistance, spectrum, Pharmacokinetics, ADRs, contraindications, drug interactions & uses; distinctive features of some Fluoroquinolones.

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

3
3 Inhibitors of cell wall synthesis

 

β-lactam compounds, vancomycin, bacitracin).List the different classes of antimicrobial drugs that act by inhibiting cell wall synthesis

Describe the structural relationship of the penicillin molecule with antimicrobial activity.

Explain the mechanism of action of β-lactam antibiotics.

Classify penicillins according to their spectrum of antimicrobial activity (natural, antistaphylococcal, extended spectrum, antipseudomonal penicillins).

Describe the pharmacologic properties and uses of the penicillins in each class.

Explain the rationale for combining β-lactamase inhibitors with penicillins.

Explain the rationale of combining penicillins and aminoglycosides.

Describe the pharmacokinetic properties of penicillins.

Describe the repository penicillins.

Describe the adverse effects and contraindications of penicillins.

Discuss the stability of penicillins to acid or b-lactamase

Explain the mechanism of action of cephalosporins.

Describe the four generations of cephalosporins with specific examples and the differences in their antimicrobial spectrum, pharmacokinetic properties.

Describe the uses and adverse effects of cephalosporins.

Describe the spectrum, uses and adverse effects of carbapenems and monobactams.

Explain the rationale for combining imipenem with cilastatin.

Discuss the mechanism of action, uses and adverse effects of vancomycin and bacitracin.

Explain the terms cross-hypersensitivity.

β-lactam antibiotics:

PENICILLINS- chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses; SEMISYNTHETIC PENICILLINS- classification, therapeutic uses & distinctive features of some of the penicillins;

CEPHALOSPORINS- classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses; distinctive features of some of the cephalosporins

Monobactams & Carbapenems; other cell wall/ membrane antibacterial drugs- Glycopeptides, Bacitracin, cycloserine.

 Power point presentation,

Seminars & tutorials

3
4 Protein synthesis inhibitors

 

Discuss the mechanism of action of each class of protein synthesis inhibitors (Tetracyclines, Macrolides, Aminoglycosides, Spectinomycin, Clindamycin, Chloramphenicol, Streptogramins, & Oxazolidinones).

Explain the mechanism of acquired drug resistance.

Explain the rational basis for combination therapy with an aminoglycoside and a penicillin, cephalosporin, or vancomycin.

Describe the pharmacokinetic properties of each class of protein synthesis inhibitors.

Define concentration-dependent killing and time-dependent killing.

Discuss the postantibiotic effect of aminoglycosides.

Explain the importance of peak and trough levels of aminoglycosides.

Discuss the need for aminoglycoside dose adjustment in patients with compromised renal function.

Discuss the adverse effects of each class of protein synthesis inhibitors.

Describe drug interactions of macrolides due to inhibition of cytochrome P450 enzymes.

Describe the primary therapeutic indications of each class of protein synthesis inhibitors.

 

Protein synthesis inhibitors- chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses & distinctive features of some of the Protein synthesis inhibitors; Urinary antiseptics; drugs used in the treatment of sexually transmitted diseases.  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

5
5 Drugs for tuberculosis

 

List the first-line agents and the alternative second-line agents used for the chemotherapy of tuberculosis.

Describe the mechanisms of action, pharmacokinetic properties and adverse effects of the drugs used for the chemotherapy of tuberculosis.

Explain the drug interactions of rifampin with anticoagulants and other drugs, such as oral contraceptives.

Discuss the pharmacokinetic advantages of rifabutin over rifampin.

Describe the mechanism of resistance to the drugs used for the chemotherapy of tuberculosis.

Describe the recommended regimens used for chemotherapy of tuberculosis.

Describe the regimen recommended for chemoprophylaxis of tuberculosis.

Describe the drugs active against atypical mycobacteria.

 

Classification of 1st line anti-tuberculosis drugs- chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses of 1st line anti-tuberculosis drugs; classification of 2nd line anti-tuberculosis drugs- distinctive features of some. Treatment of tuberculosis, Short course chemotherapy of tuberculosis, chemoprophylaxis of tuberculosis; prophylaxis & treatment of MAC infection  Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

3
6 Antileprotic Drugs Describe the drugs used in the treatment of leprosy, their mechanism of action and adverse effects.

Describe the drugs used for reversing the lepra reactions and the erythema nodosum leprosum reaction.

Explain the WHO regimen for treatment of leprosy.

 

Classification of antileprotic drugs; chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses of Dapsone, Clofazamine & Rifampicin; Multi Drug Therapy of Leprosy (MDT); treatment of lepra- reaction  Power point presentation,

Seminars

1
7 Antifungal drugs Classify antifungal drugs by their mechanism of action and their clinical use.

Describe the mechanism of action of each class of antifungal drugs.

Describe the pharmacokinetic properties of the various antifungal drugs.

Describe the important adverse effects of the various antifungal drugs.

Discuss the potential drug interactions of griseofulvin and ketoconazole.

Describe the major therapeutic indications of antifungal drugs.

 

Classification of antifungal drugs; chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses of antifungal drugs; topical antifungal drugs  Power point presentation,

Seminars Student interactive sessions (SIS)

1
8 Antiviral drugs Classify antiviral drugs based upon their site of action.

Discuss the mechanism of action and adverse effects of agents used to treat HSV, VZV and CMV infections.

Discuss the mechanism of action and adverse effects of anti-hepatitis agents.

Discuss the mechanism of action and adverse effects of anti-influenza agents.

Describe mechanisms of resistance.

Discuss potential drug interactions.

Classify anti-HIV drugs based upon their site of inhibition in the viral replication cycle.

Discuss the mechanism of action and adverse effects of the different classes of anti-HIV drugs: nucleoside reverse transcriptase inhibitors, nucleotide reverse transcriptase inhibitors,  nonnucleoside reverse transcriptase inhibitors, protease inhibitors, reverse transcriptase inhibitors  and entry inhibitors.

Explain the use of combination of different classes of anti-HIV drugs.

Describe the various drug combinations used for the treatment of HIV infections.

Discuss clinically significant drug interactions pertaining to antiretroviral combinations.

Discuss the use of antiretroviral drugs in pregnancy

 

Classification of antiviral drugs; mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses of anti-herpes drugs, anti-influenza drugs, antihepatitis & antiretroviral drugs; HIV treatment principles and

Guidelines; Chemoprophylaxis of HIV infection

 Power point presentation &

Seminars

2
9 Antimalarial Drugs Outline the life cycle of the four Plasmodium species that cause malaria.

Describe the various locations in the life cycle of malarial parasites where the antimalarial drugs are effective.

Describe the mechanisms of action and pharmacokinetic properties of the antimalarial drugs.

Describe the adverse effects of the antimalarial drugs.

List the drugs of choice for treatment of uncomplicated and severe malaria.

List the drugs of choice for treatment of uncomplicated and severe malaria in pregnant women.

Describe the regimen for prophylaxis for chloroquine-sensitive and chloroquine-resistant areas.

Describe the regimen for prophylaxis for chloroquine-sensitive and chloroquine-resistant areas for pregnant women.

Discuss the WHO  Guidelines for Treatment of Malaria.

 

Classification of Antimalarial Drugs; chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses of Chloroquine, quinine, Mefloquine, primaquine, Artemisnin, Lumefantrine, Proguanil, Pyrimethamine

FDCs- Artemisnin Combination Therapies (ACT), Sulfonamide-pyrimethamine; Treatment of Malaria.

 Power point presentation,

Seminars & tutorials Student interactive sessions (SIS)

2
10 Antiamoebic and Other

Antiprotozoal Drugs

Describe the mechanism of action and adverse effects of drugs used for the treatment of amebiasis.

Describe the drugs of choice for the treatment of asymptomatic, mild to moderate and severe intestinal disease, and hepatic abscess due to E. histolytica.

Describe the opportunistic infections that commonly occur in AIDS patients and the drugs used for their prophylaxis and treatment.

Describe the drugs used for the treatment of giardiasis and leishmaniasis

Classification of Antiamoebic drugs; chemistry, classification, mechanism of action, Resistance, spectrum, preparations,  Pharmacokinetics, ADRs, contraindications, drug interactions & uses of Nitroimidazoles; distinctive features of other anti-protozoal drugs

Treatment of amoebiasis; Treatment of giardiasis and leishmaniasis

 Power point presentation,

Seminars Student interactive sessions (SIS)

2
11 Antiparasitic drugs List the drugs of choice and alternative drugs available for treatment of diseases due to various helminths.

Describe the mechanism of action, spectrum, indications, adverse effects & contraindications of the drugs used in the chemotherapy of commonly encountered helminthic infections.

 

Anthelmintics- classification; mechanism of action, spectrum, indications, adverse effects & contraindications of Anthelmintics drugs.  Power point presentation,

Seminars

1
12 Anticancer drugs Explain the role of chemotherapy in the management of patients with cancer.

Explain the concept of “cell kill” in cancer patients.

Classifiy anticancer drugs based on their cell cycle specificity.

Describe the principles and advantages of combination chemotherapy.

Explain the mechanisms of resistance to anticancer drugs.

Describe the mechanism of action and the common toxicities for each class of anticancer drugs.

List the major therapeutic indications of various anticancer drugs.

 

General principles in the use of anticancer drugs; ADRs of anti-cancer drugs; Classification of anti-cancer drugs, therapeutic uses of anticancer drugs  Power point presentation,

Seminars Student interactive sessions (SIS)

1
L Miscellaneous topics
1 Immunopharmacology Outline the main aspects of the immune response.

Define the general principles of immunosuppression.

Describe the mechanism of action, clinical uses and toxicities of immunosuppressant drugs.

Describe the mechanism of action, clinical uses and toxicities of immunostimulants.

Describe the different types of allergic reactions to drugs.

 

Classification of Immunosuppressant; Mechanism of action, ADRs, drug interaction & therapeutic uses of immunosuppressant drugs & immunostimulant drugs.  Power point presentation Student interactive sessions (SIS) 1
2 Chelating agents To enumerate chelating agents

List the chelating agent of choice and alternative drugs available for treatment of heavy metal Poisonings

 

Classification of chelating agents, mechanism of action & therapeutic use & ADRs of chelating agents  Power point presentation, seminars 1
3 Antiseptics & Disinfectants To define antiseptics & disinfectants

To classify antiseptics & disinfectants

To describe the mechanism of action, spectrum & factors affecting the use of germicidals

Classification of antiseptics and disinfectants, spectrum, mechanism of action & factors modifying the effects of germicidals; distinctive features  of antiseptics and disinfectants  Power point presentation, seminars 1
4 Drugs acting on skin & mucous membranes To Define & enlist demulscents, emollients, absorbents & protectives, Astringents, counter irritants, keratolytics, anti-seborrheics, melanizing agents, sunscreens, demelanizing agents

Enumerate drugs used in the treatment of Psoriasis, Acne

Enumerate Topical steroids

 

Demulscents, Emollients, absorbents & protectives, Astringents, counter irritants, keratolytics, anti-seborrheics, melanizing agents, sunscreens, demelanizing agents, drugs used in the treatment of Psoriasis, Acne; Topical steroids

 

 Power point presentation, seminars Student interactive sessions (SIS) 1
5 Vitamins Categorize & enumerate vitamins

Describe their source, physiological role, preparations availble, daily doses, therapeutic uses, ADRs & drug interactions

Classification of vitamins; chemistry, source, physiological role, preparations, daily doses, therapeutic uses, ADRs & drug interactions of vitamins  Power point presentation 1
6 Vaccines & sera Define & enumerate different types of vaccines

 

Bacterial & Viral vaccines; Mixed antigens; antisera and immune globulins  Power point presentation 1
7 Rational pharmacotherapy Define P-drug concept;

Define Rational use of Medicines

Describe merits & demerits of Fixed Dose Combinations (FDCs)

Enumerate clinically significant drug interactions

P-drug concept, Rational Drug Use & Essential Drug List (EDL), Criticism with reference to Fixed Drug Combinations (FDCs), Use and misuse of commonly used preparations: vitamins, antioxidants, enzymes etc.  Power point presentation Student interactive sessions (SIS) 1