GENERAL AND SPECIAL PHARMACOLOGY
Learning outcomes of the course unit
The course is aimed to the knowledge of drug effects, either beneficial or otherwise, in order to properly conduct drug therapy and patient care.
Knowledge of foundaments of Biochemistry, Physiology and General Pathology are required
Course contents summary
The course provides the necessary elements for the knowledge of the effects of drugs, for a rational use of those in the clinical setting and for an effective control of adverse responses.
GENERAL PHARMACOLOGY. Pharmacology as a medical science. Concept and definition of active substance and medicinal preparation, definition of drug and its origins, chemical nature, nomenclature of drugs, equivalent drugs. Actions and effects of drugs: therapeutic and toxic activity of molecules.
Principles of pharmacodynamics: mechanism of drugs action and interaction with the components of the organism. Concept of site of action and receptor. Receptor-acting drugs: drugs on receptors of the autonomic nervous system. Agonist and antagonist drugs, active drugs at the level of ion channels, membrane transporters, enzyme inhibitors. Tolerance and drug dependence.
General principles of pharmacokinetics: Routes and methods of drug delivery, Absorption, distribution, metabolism and elimination, concept of bioavailability, volume of distribution and clearance.
Factors that influence the response to drugs: race, age, sex, patient pathologies. Drug interactions with food and specific components of the diet. Interactions between medicaments of clinical relevance. Pharmacogenetics and idiosyncrasies.
SPECIAL PHARMACOLOGY. Chemotherapy. Basic principles of antibacterial action and main pharmacological classes. Concept of bactericidal and bacteriostatic action, spectrum of action and selective toxicity. Main mechanisms of action of antibacterials. Host toxicity from antibacterial drugs.
General aspects on antiblastic drugs, their preparation, administration, side effects. Alkylating drugs; platinum compounds and derivatives; antimetabolites; Vinca alkaloids, Epipodofillotoxins, taxanes. Generalities on biological drugs and target therapy, monoclonal antibodies.
Cardiovascular System Drugs and Hematostatics:antithrombotic prophylaxis and heparin therapy, oral anticoagulant therapy, antiplatelet therapy. Antihypertensive drugs: diuretics, vasodilators, ACE inhibitors and beta-blockers.
Central Nervous System Drugs: General information on neurotransmission; Aspecific depressants: general anesthetics, hypnotic-sedative (benzodiazepines). Local anesthetics.
Analgesic drugs. Pain: types and classification. Nociceptive and neuropathic pain, WHO assessment scale, clinical application of assessment scales. Oncologic pain: pathophysiological mechanisms, systems and receptors involved. Pain pathways, nociceptors, synapses, neurons.
NSAIDs: Classification, mechanism of action, side effects, drug interactions, literature analysis. Main chemical classes: salicylates, propionic acid derivatives, arylacetic acid, oxicami, coxibs, arylsulfonamides. Specific COX-2 inhibitors. Paracetamol: generality, peculiarity, side effects.
Opiates: mechanisms of analgesic action, pharmacokinetics, pharmacodynamics, clinical uses, routes of administration, toxicity, literature analysis. Main pharmacological classes and prototypes: morphine, codeine, fentanyl, buprenorphine, hydromorphone, oxycodone, methadone; associations with NSAIDs. New opiates: tramadol, tapentadol. Adjuvants.
Nursing management of the patient with pain: control of the state of consciousness, vital parameters, side effects from drugs, alternative routes of drug administration.
Neuromuscular blocking drugs. Competitive curarizing agents and succinylcholine.
Gastrointestinal Tract Drugs: antiulcer and gastroprotectors, purgatives, spasmolytics, prokinetic drugs.
Antidiabetic drugs. Insulin, insulin analogues, oral hypoglycemic agents.
Clayton – Stock: Fondamenti di farmacologia per infermieri. Terza Edizione (o successiva). Ed. Edises.
Assessment methods and criteria
The achievement of the objectives of the course will be performed by an oral exam. Through general and specific questions relative to the program of the course, the level of knowledge relative to the properties of therapeutic drug and their correct use in the clinical setting will be determined. Moreover, the ability of the student to contribute with autonomy of judgment and professional approach to an appropriate care plan will be also assessed.