Combined Bachelor's + Master's degree in Medicine and Surgery

Pharmacology (2019/2020)

Course code
4S01147
Credits
9
Coordinator
Guido Francesco Fumagalli

Teaching is organised as follows:
Unit Credits Academic sector Period Academic staff
FARMACOLOGIA GENERALE E SPECIALE 8 BIO/14-PHARMACOLOGY 1° semestre, 2° semestre 1°- 5° anno Guido Francesco Fumagalli
Roberto Leone
FARMACOVIGILANZA 1 BIO/14-PHARMACOLOGY 1° semestre Roberto Leone

Learning outcomes

General aims
Aim of the course is education in pharmacology, i.e. reach a firm understanding that a drug is a tool intended to modify the wellbeing of the patients by interacting with molecular components of the cells and tissues. This interaction leads to modulation of physiological and pathological processes responsible of health and disease.
The student will learn to use his/her knowledge in basic biomedical sciences with the goal of understanding the mechanism of action of a compound and the generation of therapeutic and toxic effects and adverse reactions.
The student will appreciate the links connecting the effects (beneficial and adverse) with the plasmatic levels of a drug. Accordingly, he will learn the basic principles guiding the generation of appropriate plasma levels and their temporal changes and the effects of individual properties of the patient (genetic, metabolic, presence of diseases) on these dynamic changes and will consider conditions for decreasing appearance of adverse drug reactions.
During the course teachers and students will explore the properties (mechanisms of action, therapeutic, adverse rections, pharmacokinetic) of classes of drugs active on the Nervous System (Central, Periferal and Autonomic), on the Cardiovascular, the gastrointestinal and the endocrine systems; the pharmacological modulation of inflammatory, immune, infective and oncological processes will also be addressed.

Specific aims
At the end of the course the student will:
know the rationale of therapies in order to select and use drugs on the basis of the pathology, the health of the patient, the scientific evidences of effectivness. He/she will also be able to monitor the efficacy of the therapy, the generation of positive symptoms and of adverse reactions.
know the classification of drugs also in the context of the National Health System, how to prescribe a drug and the use of appropriate data bases also in the context of the Italian National Health System.
kown the preclinical and clinical development of drugs, the organization of clinical studies and will be able to critically read the results of clinical studies and the use of their results in the daily practice
understand the basic pharmacodynamic principles governing drug-receptor interaction and the generation of the effects with focus on signal transduction generated by activation/inhibition of drug receptors such as enzymes, ion channels, receptors for endogenous mediators with special interest to ligand activated ion-channel, G protein coupled receptors and intracellular receptors.
understand the basic principles of pharmacokinetics and know how to use PK criteria and data to establish individualized therapeutic regimens
know their epidemiology and understand the etiopathogenetic mechanisms of adverse drug reactions and how to report them
know for each class of drug the mechanism(s) of action and the symptoms generated in order to monitor efficacy and possible toxicity of the therapy;
know the major differences between drugs belonging to a same class of drugs and the criteria for the selection for individualized therapy
know the pharmacological properties, as described above, of the following classes of drugs:
• active on the autonomic, peripheral and central nervous system
• used in pulmunary diseases
• active on the cardivascular system
• active on the metabolic/endocrine systems
• used for the control of infectious diseases
• used to control inflammatory conditions
• active on the immune system
• used in oncology

Syllabus

Drug and placebo definition; historic and modern views of drugs
Bioequivalent and biosimilar drugs
Drug classification in Pharmacology and by the National Health System
Drug development, clinical trials and postmarketing monitoring
Pharmacodynamics: drug-receptor interaction, signal transduction and effect generation
Pharmacokinetics: general principles, absorption, distribution, elimination and drug metabolism
Pharmacogenetics and drug therapy individualization
Pharnmacogenetics and biotransformation of drugs
WHO and EMA definitions of Adverse Drug Reaction (ADR)
International Classification of ADR, their epidemiology and pathogenetic mechanisms
Drugs interactions and ADRs in special conditions (pregnancy. breastfeeding, elderly, infants)
The reasons and objectives of Pharmacovigilance, the legislation and the reporting
Drugs acting on the autonomic system
Drugs acting on the respiratory system
Drugs active on the gastrointestinal system
Drugs affecting platelet aggregation, the coagulation system including fibrinolytic agents
Drugs for the control of dislipidemic states
Drugs acting on the Periferal and the central Nervous System
Drugs interacting with autacoids
Pharmacology of the inflammation
Drugs for the cardiovascular system and the therapies of cardiovascular disorders
Ipoglicemic drugs including insulin
Drugs active on the immune system
Drugs used for the control of infections
Antineoplastic therapies

Assessment methods and criteria

Oral exam with question on general principles as well as on specific drugs and/or classes of drugs in a therapeutic context

Reference books
Author Title Publisher Year ISBN Note
F. Rossi, V. Cuomo, C. Riccardi Farmacologia (Edizione 3) Minerva Medica 2017 978-88-7711-881-3
Lüllmann H, Mohr K., Farmacologia e tossicologia, ultima ed. (Edizione 5) Piccin ed. Padova  
B. G. Katzung & A. J. Trevor Farmacologia Generale e Clinica (Edizione 10) Piccin-Nuova Libraria 2017 978-88-299-2847-7
Clementi Fumagalli Farmacologia Generale e Molecolare (Edizione 5) Edra 2018 978-88-214-4436-4
Goodman & Gilman The pharmacological basis of therapeutics (Edizione 13) McGraw-Hill Education 2017 9780071624428
Caputi, De Ponti, Pagliaro Reazioni avverse a farmaci Cortina Editore 2009 978-88-6030-278-6




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