Pharmacology and clinical biochemistry

A.Y. 2017/2018
Lesson for
5
Max ECTS
50
Overall hours
SSD
BIO/12 BIO/14
Language
Italian
Learning objectives
- Al termine del corso lo studente dovrà:
1. Possedere conoscenze sui meccanismi d'azione di farmaci e tossici a livello molecolare, cellulare e a livello di sistemi complessi;
2. Conoscere i principali parametri e variabili di farmacocinetica;
3. Delineare il quadro generale del metabolismo cellulare;
4. Conoscere e spiegare a livello molecolare, subcellulare, cellulare e tissutale il meccanismo biochimico dei fenomeni biologici normali.

Course structure and Syllabus

Active edition
Yes
Responsible
Biochimica clinica e biologia molecolare clinica
BIO/12 - CLINICAL BIOCHEMISTRY AND MOLECULAR BIOLOGY - University credits: 2
Lessons: 20 hours
Professor: Paroni Rita Clara
Farmacologia
BIO/14 - PHARMACOLOGY - University credits: 3
Lessons: 30 hours
Farmacologia
Syllabus
PROGRAM:
PART I

INTRODUCTION TO PHARMACOLOGY
Drugs, risks and benefits of their use
Preparations and pharmaceutical formulations of drugs: tablets, Solutions, Suspensions, Elixirs, Syrups, Granules, Tablets, Effervescent tablets, Chewable tablets, Drops, Foams, Creams, Ointments, Percutaneous Patches. Preparations for controlled release
How different formulations may influence drug effect
Pharmacokinetics and pharmacodynamics properties of drug

DRUGS CLASSIFICATION
Classification of Drug according to the International Pharmacopeia
Drug development: pre-clinical and clinical drug development
Role of sanitary staff in clinical trials

DRUG PHARMACOKINETICS
Dose-response curves
How plasma concentrations and effect are related
Therapeutic range of drug blood levels and toxic levels
Minimal effective concentration (MEC) and maximal tolerated dose (MTD)
Latency, intensity and duration of drug's effect

DRUG ADMINISTRATION
Route of drug's administration and criteria for a proper choice
Influence of administration route on latency, intensity and effect duration
Maintenance of constant drug plasma levels: intravenous infusion, loading dose, therapeutic regimen, maintenance dose, repeated administrations

DRUG ABSORBANCE
How drugs overcome of cell membranes: passive and facilitated diffusion, active and passive transports, phagocytosis and pinocytosis.
Factors affecting drug absorbance

DRUG DISTRIBUTION
Distribution volume
Factors affecting distribution volume

DRUG METABOLISM
Biotransformation of drugs: physiological significance and its consequences
Phase I and phase II reactions
Factors affecting biotransformation of drugs
Enzymatic inhibition and induction

DRUG BIOAVAILABILITY
Bioavailability and bioequivalence
Factors affecting bioavailability
First-passage effect

DRUG ELIMINATION
Main routes of drug elimination: biliary and renal excretion;
Minor routes of drug excretion
Factors affecting drug elimination

PHARMACOKINETIC PARAMETERS
Clinical relevance of drugs bioavailability, plasma half-life, distribution volume and renal clearance

PHARMACODYNAMICS
Principle of pharmacodynamics
Drug targets: classification and characteristics
Agonist and antagonist properties of drugs
Potency, efficacy and their clinical relevance

ADVERSE DRUG REACTIONS
ADRs: classification and causes

INTERINDIVIDUAL VARIABILITY IN DRUGS RESPONSE
Factors underlying individual variability: genetic features, gender, age, pathology conditions
Drug interactions and related consequences
Intolerance, idiosyncrasy and hypersensitivity



PART II

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAID)
Mechanism of action
Pharmacological effects: antipyretic, analgesic, anti-inflammatory effects
Therapeutic use
Adverse effects

STEROIDEAL ANTINFLAMMATORY DRUGS
Synthesis and physiological control of endogenous glucorticoids
Pharmacological effects and mechanism of action
Adverse drug reactions and contraindications
Therapeutic use

VITAMINS
Vitamins: classification and therapeutic uses of main vitamins (vitamin K, D and B)

CONVENTIONAL AND NON-CONVENTIONAL DRUGS
Conventional medicine and alternative medicine
Interactions between phytochemicals and drugs used in orthodox medicine

PHARMACOLOGICAL MANAGEMENT OF ANGINA AND ISCHEMIC ATTACK
Pathophysiology of angina and ischemic heart
Mechanism of action, pharmacological effects, pharmacokinetic features, adverse effects of: organic nitrates, anticoagulants, antiplatelet drugs, fibrinolytic agents, calcium channel blockers, adrenergic -blockers

PHARMACOLOGICAL MANAGEMENT OF HEART FAILURE AND HYPERTENSION
Mechanism of action, pharmacological aspects, pharmacokinetics and adverse effects of: vasodilators, ACE-inhibitors, angiotensin receptor antagonists, calcium channel blockers, adrenergic receptor blockers, diuretics (thiazides, loop diuretics, potassium-sparing diuretics)


ENDOCRINE SYSTEM

o ANTIDIABETIC DRUGS
Insulin: synthesis and secretion; metabolic actions of insulin, the interaction between insulin and its receptor
Glycemia control and types of diabetes
Pharmacological management of diabetes
Insulin: synthesis and secretion, metabolic actions, formulations, pharmacokinetics, adverse effects, clinical uses
Oral hypoglycemic drugs: biguanides; sulphonylureas, thiazolidinediones; α-glucosidase inhibitors: mechanism of action, pharmacological aspects, pharmacokinetics and adverse effects

o ANTIDYSLIPIDEMIC AGENTS
Classification of dyslipidemia (Frederikson/WHO)
Pharmacological treatment of dyslipidemia
Pharmacological features, pharmacokinetics, mechanism of action, adverse effects, contraindications of following drugs: statins, fibric acid derivatives, bile-acid resins, niacin, ezetimibe

DRUGS FOR HEMATOPOIETIC SYSTEM DISORDERS
Pharmacological features and clinical uses of: iron, folic acid, vitamin B12 and erythropoietin
Lesson period
First semester
Assessment methods
Esame
Assessment result
voto verbalizzato in trentesimi