Learning outcomes of the course unit
To know the basic principles of general pharmacology and the processes that regulate the concentrations of drugs in the different compartments of body after the dosing and the events consequent on interaction of the drug with its primary site of action. To know the pharmacology of drugs modifing the neuromuscular function and of drugs used for the therapy of inflammatory diseases of joints.
To make the student able to valuate the therapeutic and toxicological aspects related to the use of the drug above described.
Course contents summary
Introduction to pharmacology; definition and scope of pharmacology; definition of drug. Principles of pharmacodynamics: molecular targets and mechanism of drug action. Drugs acting at receptor level: agonists and antagonists; partial agonists; relationship between agonist concentration and response. Pharmacokinetics: routes of administration; absorption, transfer of drugs across the blood brain barrier and across the placenta. Binding of drugs to plasma proteins, distribution of drugs into body tissues. Drugs biotransformation. Factors affecting drugs biotransformation. Excretion of drugs: renal, biliary, fecal and pulmonary excretion; excretion by other routes. Pharmacokinetics parameters: bioavailability; volume of distribution; half life, clearance. Factors that affect therapeutic outcome: drug-drug interactions, physiological and pathological factors. Tolerance and resistance. Drugs toxicity: adverse drug reactions.
Clinical pharmacology. Drugs affecting the neuromuscular function: competitive and depolarizing agents, botulinum toxin; centrally acting muscle relaxants: agents affecting GABA-ergic system. Drugs used for the therapy of myasthenia gravis. Antiparkinsonian agents. Drugs used in the treatment of pain: opioid and non-opioid analgesics, local anaesthetics. Drugs acting as antiinflammatory agents employed in the treatment of rheumatoid arthritis and gout. Non steroidal antiinflammatory drugs: non selective and selective COX inhibitors. Steroidal antiinflammatory drugs (glucocorticoids); antirheumatoid drugs (DMARDs: disease modifying antirheumatoid drugs); drugs used in gout (colchicine, allopurinol, uricosuric agents). Generalities of drugs used for treatment of spinal lesions. New drugs used for treatment of osteoarthritis: condroprotective agents.
General pharmacology. What is pharmacology. Drugs. Basic pharmacodynamics: sites and mechanisms of action, agonists and antagonists, partial agonists, the dose-effect relationship.
Basic pharmacokinetics: how drugs reach their site of action, routes of administration, drug adsorption. Drug-protein binding and drug biodistribution.
Drug biotransformation. Drug excretion. Pharmacokinetic parameters: bioavailability, apparent distribution volume, plasma drug half-life, clearance. Conditions modifying drug effects: drug interactions, the importance of patient conditions. Tolerance and resistance. Drug toxicity:
collateral and unwanted events.
Neuromuscular drugs: depolarizing and competitive blocking agents, botulinum, central (GABAergic) and preripheral myorelaxant agents. Drugs for myasthenia gravis: anticholinesterase drugs, steroids, immunosuppressant drugs.
Analgesic drugs: opiates and non-opiate analgesics; local anesthetics.
Antiinflammatory drugs: NSAIDs, non-selective COX inhibitors; COX-2 preferential and COX2-selective NSAIDs; steroids (glucocorticoids).
Antirheumatic drugs (DMARDs), antigout drugs (colchicine, allopurinol, uricosuric agents).
Drugs for Arthrosis: condroprotective drugs.
Farmacologia: Dale, Haylett "Elementi di farmacologia; Compendio per l'esame. Ed. Mediche Scientifiche Internazionali EMSI;
Rang, Dale, Ritter, Flower "Farmacologia" 6° edizione 2008, Edizioni Elsevier;
Mycek " "Le basi della farmacologia" 3° Edizione Italiana 2007, Zanichelli Editore
Assessment methods and criteria