Pharmacology, Clinical biochemistry and Diagnostic imaging

A.Y. 2021/2022
6
Max ECTS
60
Overall hours
SSD
BIO/12 BIO/14 MED/36
Language
Italian
Learning objectives
The teaching aims to provide students:
1. An introduction to the basic principles of General Pharmacology, as well as an overview of Clinical Pharmacology and Nutraceuticals
2. An in-depth study on the pharmacotherapy of diseases where nutrition plays a role and on drug-drug, drug-herbs and drug-food interactions.
3. An overview of the role, purpose and potential of Laboratory Medicine in health protection, in disease prevention and monitoring, and in assessing the nutritional status of a patient
4. The basic knowledge to interpret biochemical-clinical profiles correlated to the main metabolic diseases and the nutrition and dietary behavior.
5. The basic knowledge to inform individuals undergoing diagnostic imaging or radiation treatment about the risks associated with the use of radiation and about practices aimed at preventing unnecessary exposure to radiation.
Expected learning outcomes
At the end of this Teaching Course the student will:
1. Know the main pharmacokinetic and pharmacodynamics parameters and variables;
2. Possess knowledge on the mechanisms of action of drugs and toxic products at the molecular, cellular and complex systems level;
3. Have a general knowledge of the main procedures of the Clinical Biochemistry Laboratory that characterize the pre-analytical, analytical and post-analytical phase
4. Have a knowledge on the main biochemical-clinical profiles associated with some major metabolic diseases and the nutritional status of the patient
5. Have a general knowledge of radiation protection in order to be able to work in an environment where there is ionising radiation.
Course syllabus and organization

Single session

Responsible
Prerequisites for admission
Basic knowledge of biology, human anatomy, general biochemistry, human physiology, pathophysiology, and general pathology are required.
Assessment methods and Criteria
The methods used to achieve and ascertain the effective achievement of the learning outcomes expected by the student are:
- written test with multiple choice quizes (for the part of Clinical Biochemistry)
- the evaluation parameters include the number of correct answers provided and the appropriateness in providing a brief and logical justification of the answer given for some fundamental questions indicated by the teacher
- oral examination with questions of general pharmacology, special and clinical pharmacology
- the evaluation parameters include: framing ability and general presentation of the topic, demonstration of knowledge of the use and clinical indications of the drugs, in addition to their mechanism of action, description of the side effects of the drugs.
Clinical biochemistry and molecular biology
Course syllabus
· Clinical Biochemistry: introduction, aims, definitions
o Laboratory intervention levels. Concepts of diagnostic test and its purposes (screening, diagnostic study, disease monitoring)
· The pre-analytical phase and its sources of variability
o Preparation of the subject / patient
o Sampling, treatment, transport, delivery and storage of biological samples: blood, urine, feces, spinal cephalus liquid (liquor), pouring liquids into serous cavities, synovial fluid, amniotic fluid, seminal fluid, gastric juice, sweat.
· Acceptability criteria of a biological sample
o Post-analytical variability and Reporting
· Quality control
o Analytical variability
· Concept of total analytical variability and its components
o Types of errors. Reliability of a dosage method
o Biological variability and factors influencing it
o Analytical goals
· Reference values
o Concept of reference interval
o Concept of decision values
o Concept of critical difference
· Diagnostic logic:
o clinical sensitivity and specificity
o predictive values
· Deepening of some topics chosen by the teacher and with particular reference to the pathologies related to the subject of the Degree Course (for example: monitoring of diabetes, nutritional status, lipoproteins and lipids, cholesterol metabolism and dyslipidemias, liver function, biochemistry of saliva ... etc.)
Teaching methods
Lectures and analysis/discussion of clinical case reports, with the help of iconographic material, partially made available on UniMI computer platforms. Quiz and classroom surveys using computer platforms to review the most important topics. The consultation of the material presented during the lectures does not replace the study on textbooks.
Teaching Resources
· Gaw et al. Clinical Biochemistry, Elsevier Masson, 2014, 3rd edition
· Elisabetta Albi, Tommaso Beccari, Samuela Cataldi Essential clinical biochemistry. From the laboratory to clinical pathology pictures. Publisher: Zanichelli, 2019, 1st edition
· M. Ciaccio, G. Lippi Biochimica Clinica e Medicina di Laboratorio, Edises; 2017, 2nd edition
· G. Federici Medicina di laboratorio Milano, Mc Graw Hill, 2014
· Lw Janson, Me Tischler - Il quadro d'insieme- Biochimica Clinica. Ed. It. Mario Plebani, Piccin, 2015
Pharmacology
Course syllabus
· General concepts of Pharmacology.
o Definition of drug and origin of drugs. Therapeutic, side and toxic effects. Placebo and Nocebo effect. Drug development and pharmacovigilance. Introduction to drug legislation and pharmacoeconomics.
· Pharmacokinetics
o Absorption, distribution, metabolism, excretion; concepts of bioavailability, half-life and steady state plasma concentration.
· Pharmacodynamics
o Site of action of drugs; receptors and signal transduction mechanisms; dose-effect relationship; concepts of drug potency and efficacy, agonism and antagonism, desensitization and hypersensitivity, therapeutic index.
o Variability factors in drug response. Drug interactions: pharmacokinetic and pharmacodynamic aspects. Interactions between drugs and foods and between drugs and herbal and non-conventional preparations. Use of the DynaMed Plus® database.
· Clinical Pharmacology:
o Pharmacological therapy of dyslipidaemias: statins and other cholesterol lowering drugs
o Pharmacological therapy of diabetes mellitus: insulins and oral hypoglycemic agents
o Pharmacological therapy of arterial hypertension
o Drugs of the gastrointestinal system
o Antiemetic drugs
o Pharmacological therapy of peptic ulcer and gastroesophageal reflux disease
o Anxiolytic-hypnotic and antidepressant drugs
o Pharmacological approaches to the treatment of eating disorders
o Pharmacological approaches to obesity therapy
o Nutraceutical principles
o Food supplements and their rational therapeutic use
Teaching methods
Lectures and analysis/discussion of clinical case reports, with the help of iconographic material, partially made available on UniMI computer platforms. Quiz and classroom surveys using computer platforms to review the most important topics. The consultation of the material presented during the lectures does not replace the study on textbooks.
Teaching Resources
· Taglialatela, Conforti, Cuzzolin, Leone, Mattioli, Moretti, Pignataro, Vanzetta; Farmacologia per le lauree triennali e magistrali; Editore Idelson-Gnocchi (Sorbona); 2019; isbn 978-88-79476690
Capitoli 1-8 e capitoli 11, 14, 23, 24, 28, 33, 34, 35, 36, 44.
· Taglialatela, Conforti, Cuzzolin, Leone, Mattioli, Moretti, Pignataro, Vanzetta; Farmacologia per le lauree triennali e magistrali; Editore Idelson-Gnocchi (Sorbona); 2019; isbn 978-88-7947669
Chapters 1-8 and chapters 11, 14, 23, 24, 28, 33, 34, 35, 36, 44.
Diagnostic imaging and radiotherapy
Course syllabus
∙ Structure of the atom
∙ Classification of nuclides
∙ Definition of radiation
∙ Electromagnetic radiation
∙ Wave length and frequency
∙ Photons
∙ The electromagnetic spectrum
∙ X and γ rays
∙ Use, production and detection of the electromagnetic spectrum
∙ The corpuscular radiation
∙ Ionizing radiation
∙ Characteristic X-rays
∙ Bremsstrahlung X-rays
∙ X-ray production in diagnostics
.Spectrum of an X-ray tube
∙ X-rays: production in radiotherapy
∙ Nuclear stability and radioactivity
∙ Radioactive decay
∙ The law of radioactive decay
∙ Average life and half-life
∙ Activities
∙ Alpha, beta-, beta +, gamma decay
. Electronic capture decay
∙ The various types of radiation in the interaction with matter
∙ Interaction of alpha and beta charged particles
∙ Collision
∙ Bremsstrahlung
∙ Interaction of alpha particles
∙ Bragg curve
∙ Interaction of beta particles
. Positron-matter interaction: annichilation
∙ Interaction of beta particles
∙ Photoelectric effect, compton, pair creation
∙ Attenuation of a beam of x and gamma radiation
∙ Attenuation law
∙ Detection system
.Dose equivalent to an organ
∙ Effective dose to the whole body
∙ Non-ionizing radiation: application examples
∙ MRI, laser, ultrasound
RADIO PROTECTION IN THE SANITARY ENVIRONMENT
∙ D.lgs.187 / 2000
. Principle ALARA
∙ Principle of justification
∙ Optimization process
∙ Reference diagnostic levels
∙ Equipment acceptability criteria
∙ Protection during pregnancy and lactation
∙ Main exclusive responsibilities of the operator
∙ Responsibility of the RIR
∙ Responsibility of the medical specialist
∙ Expert responsibility in medical physics
∙ Purpose of radiation protection
.Dose limits for members of the public
∙ Classification criteria for workers
∙ Exposed workers in categories A and B
.Dose limits for exposed workers
∙ Physical and medical surveillance
∙ Classification of areas
∙ Internal and external exposure
∙ Sources of risk in radiological activities
∙ Personal protective equipment
∙ Safety in radiological activity
.Traditional radiographic procedures for radiation protection standards
∙ Dental radiology radiation protection standards
∙ Mammography radioprotection standards
.TAC radiation protection standards
∙ Radioscopy and interventional radiology radiation protection standards
∙ Sources of risk in radiotherapy radiation protection standards
∙ Sources of risk in brachytherapy radiation protection standards
∙ Sources of risk with unsealed radioactive substances
∙ In vitro diagnostic procedures
∙ General planning principles
∙ Radioactive waste
RADIOBIOLOGY
∙ Study of the action and effects of ionizing radiation on biological structures
∙ Experimental techniques of radiobiology
∙ Sequences of events of radiobiological interest
∙ Radiation cell damage
IMAGE DIAGNOSTIC TECHNIQUES
PHYSICAL AND BIOLOGIOCHE BASES OF NUCLEAR MEDICINE.
Teaching methods
Inserire.
Teaching Resources
· Slides
Clinical biochemistry and molecular biology
BIO/12 - CLINICAL BIOCHEMISTRY AND MOLECULAR BIOLOGY - University credits: 2
Lessons: 20 hours
Professor: Paroni Rita Clara
Diagnostic imaging and radiotherapy
MED/36 - IMAGING AND RADIOTHERAPY - University credits: 1
Lessons: 10 hours
Professor: Maioli Claudio
Pharmacology
BIO/14 - PHARMACOLOGY - University credits: 3
Lessons: 30 hours
Professor: Nisoli Enzo