13880 - Pharmacology and Pharmacotherapy

Learning outcomes

The aim of this course is the knowledge for mechanisms of drugs action, their use in therapy, the adverse effects and the more important pharmacological interactions. During the course each class of drug used will be examined. Students, at the end of this course, are capable to dispense drugs, to mage pharmacovigilance and to form and inform people about the correct use of drugs. The student will be capable to characterize drug interactions and to evaluate adverse reactions to drugs.After completing this module, students gain understanding the main pharmacological and pharmacotherapeutic mechanisms of drug interactions. They are capable to refer to relevant databases and websites, in order to better dispense medicines, to be informed and updated. In addition, students know and are capable to evaluate the suitable experimental approach (in vitro models) for screening, mechanisms of action definition and pharmacological characterization of new drugs.

Course contents

Module of Pharmacology and Pharmacotherapy - Teacher: Prof. Santi Spampinato

Introduction to pharmacology

Elements of Pharmacosurveillance

Periferic nervous system and neuromuscolar junction

         

Anatomy and general function of the periferic nervous system

        

Cholinergic agonists and antagonists and cholinesterase inhibitory drugs

         

Adrenergic agonists and antagonists

        

Pharmacology of neuromuscolar transmission



Local anesthetics



Drugs affecting uterine motility



Drugs used in the treatment of migraine



Drugs acting at Central nervous system

 level

Anatomy and general functions of the central nervous system

        

General Anesthetics



Drugs effective in the therapy of the epilepsies



Drugs for Parkinson desease



Drugs used in the treatment of psychoses



Treatment of depressive disorders



Opioids: agonists and antagonists



Treatment of the anxiety disorders



Treatment of central nervous system degenerative disorders



Drug abuse



 

Cardiovascular and renal system



Drugs for the treatment of cardiac insufficiency and della ischemia myocardial



Antiarrhythmic drugs



Drugs acting on the Renin and angiotensin

 system        

Antihypertensive agents and the drug therapy of hypertension



Diuretics



Immune system and inflammation



Histamine, bradykinin and their antagonist



Lipid-derived autacoids: eicosanoids e PAF



Nonsteroidal Antiinflammatory drugs



Glucocorticoids



Immunosuppressive agents and immunostimulants

 

Drugs acting on the blood

 

Hematopoietic agents



Anticoagulant – Thrombolytic – Antiplatelet – Antifribinolytic drugs

         

Drugs used in the treatment of anemia



Drugs capable to modify plasmatic lipid levels



Drugs acting on the bronchial function



Bronchodilatators and other agents used in the treatment of asthma



Antitussive agents and mucolitics

 

Drugs affecting gastrointestinal function



Agents used for control of gastric acidità and treatment of peptic ulcers

 

Agents used for diarrhea – costipation – Antiemetics and prokinetic agents



Hormones and hormone antagonists



Hypothalamic and pituitary hormones



 Estrogens, progestins, androgens and their antagonists



Pancreatic hormones – oral hypoglycemic agents



Agents affecting calcification and bone turnover



Thyroid and antithyroid drugs






Module of Chemotherapy - Teacher: Dr. Andrea Bedini

Antimicrobial agents: general considerations. Mechanism of action of different antimicrobial agents. Resistance to antimicrobial agents. Therapy with combined antimicrobial agents.

Antimicrobial agents:Penicillins, Cephalosporins, Other beta-lactam antibiotics, Carbapenems, Quinolones, Macrolides, Aminoglycosides, Vancomycin, Teicoplanin.

Chloramphenicol, Tetracyclines, Sulfonamides, Trimethoprim-sulfamethoxazole.

Drugs used in chemotherapy of tuberculosis and leprosy:Streptomycin, Isoniazid, Ethambutol, Rifampin, Pyrazinamide, Dapsone, Clofamizine.

Antifungal agents:Amphtericin B, Imidazoles and Triazoles, Fluconazole, Griseofulvin, topical antifungal agents.

Drugs used in chemotherapy of malaria: Chloroquine and congeners, Diamonopyrimidines, Mefloquina, Primaquine, Proguanin, Quinine, Artemisin and derivatives.

Drugs used in the chemotherapy of protozoal infections:amebiasis, leishmaniasis, trypanosomiasis, toxoplasmosis.

Antiviral agents:Aciclovir and its congeners, Vidarabine, Ribavirine, Fomivirsen, Oseltamivir, Zanamivir, Interferons, Lamivudin.

Antiretroviral agents:reverse transcriptase inhibitors; protease inhibitors.

Antihelintiasis drugs

Antineoplastic agents:Alkylating agents, Antimetabolites, Natural products, Hormones and antagonists, Miscellaneous agents. New trends in antineoplastic therapy.

Antiseptic drugs.

Module of Drug Activities - Teacher: Dr. Donatella Canistro

Pharmacological Drug interactions at pharmacological and pharmacotherapeutic level.

General aspects. Pharmacotherapeutic relevance. Pharmacotherapeutic profile of positive (clinical indications) and negative (adverse reactions) consequences. Risk factors and risk categories.

Mechanisms. Chemical-physical interactions. Pharmacokinetic interactions (absorption, distribution, metabolism, elimination). Pharmacogenetics and genetic polymorphisms. Pharmacodynamic interactions: additive or summation, potentiation, synergism, antagonism (antagonism functional, pharmacological, pharmacokinetic, chemical).

Specific topics. Pharmacological and pharmacotherapeutic profile of the most frequent drugs interactions. Pharmacological and pharmacotherapeutic profile of the interactions between drugs and some foods. Pharmacological and pharmacotherapeutic profile of the interactions between drugs and alcohol.

Practical support. Databases and websites available for information and updates regarding drug interactions. Suggestions to avoid the negative consequences of drugs interactions. 

In vitro models for the pharmacological profile of new potential drugs. From illness to biological target.

Pharmacological in vitro tests(isolated organ and cell cultures). Evaluation of the pharmacological effects on the CNS, peripheral and autonomous. Evaluation of the pharmacological effects on the gastro-intestinal tract and on kidney functionality. Evaluation of the pharmacological effects on the cardiovascular and reproductive systems. Evaluation of pharmacological blood effects. Pharmacological profile of CYP450 modulation and metabolic clearence.

Readings/Bibliography

Module of Pharmacology and Pharmacotherapy Module of Chemotherapy

Clementi F., Fumagalli G. Farmacologia Molecolare e Cellulare. II Edizione, UTET.

Pratt, W.B:, Taylor, P. Farmacologia - Meccanismi d'azione dei farmaci. Zanichelli.

 Katzung B.G. Farmacologia Generale e Clinica. Piccin. Edizione italiana sulla X in lingua inglese.

 Katzung B.G., Trevor A.J. Farmacologia. Quesiti a scelta multipla e compendio della materia. Edizione Italiana sulla V Edizione in lingua inglese. Piccin, 2000. [Eventualmente come integrazione al testo precedente].

 Rang, Dale, Ritter. Farmacologia. IV Edizione, Casa Editrice Ambrosiana.

 Testi da utilizzare per approfondimenti

Goodman e Gilman. The Pharmacological Basis of Therapeutics. XI Ed. MacGraw-Hill, 2010.

 Testi consigliati (per Chemioterapia):

 B.G.Katzung, Farmacologia generale e clinica.

Golan D.E. Principi di Farmacologia- Casa Editrice Ambrosiana.

Rang, Dale, Ritter, Farmacologia, Casa Editrice Ambrosiana, 1998

 Mycek, Harvey, Champe, Farmacologia, Zanichelli

Module of Drug Activities

Garattini S., Nobili A. Interazioni tra farmaci: una valutazione della loro rilevanza clinica. Selecta Medica Edizioni.

Date teaching material is also available at AMS Campus - AlmaDL - University of Bologna (username and password required). 

Teaching methods

Lessons in classroom, (PC - connection to specific web sites), followed by interactive sessions on PC (computer room), in which the professor will show queries and issues that students must solve using the information gained in class.

Assessment methods

Module of Pharmacology and Pharmacotherapy

 Only for students who attend the classes there will be two optional tests during the course: one during the first semester (November) long 120 minutes and one in May long 90 minutes. The first test relates to anatomy and general function of the autnomous nervous system; cholinergic agonists and antagonists; cholinesterase inhibitory drugs; adrenergic agonists and antagonists; pharmacology of neuromuscolar transmission; local anesthetics; drugs affecting uterine motility; drugs used in the treatment of migraine. The second optional test is focused on durgs acting on endocrine functions. Hypothalamic and pituitary hormones.

Estrogens, progestins, androgens and their antagonists.
Pancreatic hormones and oral hypoglycemic agents.

Agents affecting calcification and bone turnover
.
Thyroid and antithyroid drugs.



The first test in progress consists of 10 open-ended questions, and the second test consists of 6 open-ended questions. The minimum grade to pass each test is 18/30. Students who pass a test in progress can take the final exam written, by 30 December, without answering the questions on topics of the test in progress. The marks obtained in the first test in progress (November) allows the students to take the final exam written, without responding to these test subjects, by 30 December of the following year. The grade obtained in the second test (May) allows the students to take the final exam written, without responding to these test subjects, by 30 December of the year in which the test is performed.

Students should enroll in tests in progress by Almaesami.

Module of Chemotherapy

Students who attend classes can take a test in progress on the topics of the program of chemotherapy in April. The topics are listed below. Antimicrobial agents: general considerations. Mechanism of action of different antimicrobial agents. Resistance to antimicrobial agents. Therapy with combined antimicrobial agents. Antimicrobial agents: Penicillins, Cephalosporins, Other beta-lactam antibiotics, Carbapenems, Quinolones, Macrolides, Aminoglycosides, Vancomycin, Teicoplanin. Chloramphenicol, Tetracyclines, Sulfonamides, Trimethoprim-sulfamethoxazole. Drugs used in chemotherapy of tuberculosis and leprosy:Streptomycin, Isoniazid, Ethambutol, Rifampin, Pyrazinamide, Dapsone, Clofamizine. Antifungal agents:Amphtericin B, Imidazoles and Triazoles, Fluconazole, Griseofulvin, topical antifungal agents. Drugs used in chemotherapy of malaria: Chloroquine and congeners, Diamonopyrimidines, Mefloquina, Primaquine, Proguanin, Quinine, Artemisin and derivatives. Drugs used in the chemotherapy of protozoal infections:amebiasis, leishmaniasis, trypanosomiasis, toxoplasmosis. Antiviral agents. Antihelintiasis drugs. Antineoplastic agents. New trends in antineoplastic therapy. Antiseptic drugs.

The topics are dealt with chemotherapy, for those who do not support or do not pass the test in progress, in a separate written test that must be passed before the end of the written examination. This is valid for five months, after which - if the student fails the written final exam, the test must be re-claimed. The written test results in a vote of thirty. The minimum grade to pass the test is 18/30.

 

Module of Drug Activities

There will be a test in progress at the end of the module (January). The test consists of a written examination with questions (5) with an opened answer. The objectives are here reported. Pharmacological Drug interactions.General aspects: Pharmacotherapeutic relevance. Pharmacotherapeutic profile of positive (clinical indications) and negative (adverse reactions) consequences. Risk factors and risk categories. Mechanisms: Chemical-physical interactions. Pharmacokinetic interactions (absorption, distribution, metabolism, elimination). Pharmacogenetics and genetic polymorphisms. Pharmacodynamic interactions: additive or summation, potentiation, synergism, antagonism (antagonism physiological or functional, pharmacological, pharmacokinetic or biochemical, chemical). Specific topics: Pharmacological and pharmacotherapeutic profile of the most frequent drugs interactions. Pharmacological and pharmacotherapeutic profile of the interactions between drugs and some foods. Pharmacological and pharmacotherapeutic profile of the interactions between drugs and alcohol. Practical support: Databases and websites available for information and updates regarding drug interactions. Suggestions to avoid the negative consequences of drugs interactions. In vitro models for the pharmacological profile of new potential drugs: From illness to biological target. Pharmacological in vitro tests(isolated organ and cell cultures): Evaluation of the pharmacological effects on the CNS, peripheral and autonomous. Evaluation of the pharmacological effects on the gastro-intestinal tract and on kidney functionality. Evaluation of the pharmacological effects on the cardiovascular and reproductive systems. Evaluation of pharmacological blood effects. Pharmacological profile of CYP450 modulation and metabolic clearence. For those that do not enroll in or do not pass the test in progress, the topics of the module will be included in the final written test examination. The results of ongoing tests are valid up to December 30th of the year in which the test has been passed.

Students should enroll in tests in progress and examination by Almaesami.

 Final exam

The final examination takes place in two stages: a written test, lasting 3 hours and an oral examination. The written test consists of 4 open-ended questions on topics of the autonomic nervous system:anatomy and general function of the periferic nervous system; cholinergic agonists and antagonists; cholinesterase inhibitory drugs; adrenergic agonists and antagonists; pharmacology of neuromuscolar transmission; local anesthetics; drugs affecting uterine motility; drugs used in the treatment of migraine. Three open-ended questions on topic of drugs acting on endocrine functions. Hypothalamic and pituitary hormones.

Estrogens, progestins, androgens and their antagonists.
Pancreatic hormones and oral hypoglycemic agents.

Agents affecting calcification and bone turnover
.
Thyroid and antithyroid drugs.
 20 open-ended questions on the following topics.
General Anesthetics. Drugs effective in the therapy of the epilepsies. Drugs for Parkinson desease. Drugs used in the treatment of psychoses. Treatment of depressive disorders. Opioids: agonists and antagonists. Treatment of the anxiety disorders. Treatment of central nervous system degenerative disorders. Drug abuse. Drugs for the treatment of cardiac insufficiency. Antiarrhythmic drugs. Drugs acting on the Renin and angiotensin

 system. Antihypertensive agents and the drug therapy of hypertension. Diuretics. Histamine, bradykinin and their antagonist. Lipid-derived autacoids: eicosanoids and PAF. Nonsteroidal Antiinflammatory drugs. Glucocorticoids. Immunosuppressive agents and immunostimulants. Hematopoietic agents. Anticoagulant – Thrombolytic – Antiplatelet – Antifribinolytic drugs. Drugs used in the treatment of anemia. Drugs capable to modify plasmatic lipid levels. Bronchodilatators and other agents used in the treatment of asthma. Antitussive agents and mucolitics. Agents used for control of gastric acidità and treatment of peptic ulcers. Agents used for diarrhea – costipation – Antiemetics and prokinetic agents.
 Three open questions on the topics of the module of Drug Activity.  Pharmacological Drug interactions. General aspects: Pharmacotherapeutic relevance. Pharmacotherapeutic profile of positive (clinical indications) and negative (adverse reactions) consequences. Risk factors and risk categories. Mechanisms: Chemical-physical interactions. Pharmacokinetic interactions (absorption, distribution, metabolism, elimination). Pharmacogenetics and genetic polymorphisms. Pharmacodynamic interactions: additive or summation, potentiation, synergism, antagonism (antagonism physiological or functional, pharmacological, pharmacokinetic or biochemical, chemical). Specific topics: Pharmacological and pharmacotherapeutic profile of the most frequent drugs interactions. Pharmacological and pharmacotherapeutic profile of the interactions between drugs and somefoods. Pharmacological and pharmacotherapeutic profile of the interactions between drugs and alcohol. Practical support. Databases and websites available for information and updates regarding drug interactions. Suggestions to avoid the negative consequences of drugs interactions. In vitro models for the pharmacological profile of new potential drugs: from illness to biological target. Pharmacological in vitro tests (isolated organ and cell cultures). Evaluation of the pharmacological effects on the CNS, peripheral and autonomous. Evaluation of the pharmacological effects on thegastro-intestinal tract and on kidney functionality. Evaluation of the pharmacological effects on the cardiovascular and reproductive systems. Evaluation of pharmacological blood effects. Pharmacological profile of CYP450 modulation and metabolic clearence.

During the test it is not allowed the use of support materials such as textbooks, notes, computer media.

The written examination is given as vote of thirty. The minimum score for admission to the oral is 18/30.

Students who pass the written exam must take the oral exam on the date indicated. This is the presentation of four arguments derived from different sections of the program afforded in the written exam. Students that afford the written examination within the period of validity of the tests already done during the course do not answer, in the written exam, to questions related to topics of-course tests. The result of the written test determines admission to oral examination. For the oral examination, students must be present at the appointed time. Such information and the outcome of the written test, will be placed on the website of  the teacher.

In case of failure of the oral exam, the student must again face the final written examination in a subsequent appeal.

The final grade for the whole course is calculated as a weighted average of the marks obtained in the tests in progress (if supported and still valid at the time of the oral exam), in the final written and oral examination.

Teaching tools

Projector - PC - connection to specific web sites. The educational material presented in class will be made available for the students in electronic format, on http://campus.unibo.it. Username and password are reserved for students enrolled at the University of Bologna.

Office hours

See the website of Santi Mario Spampinato

See the website of Andrea Bedini

See the website of Donatella Canistro