1999 Pharmacy Handbook - Pharmacology I

Pharmacology I

Introduction
General objectives
Syllabus
- Practical
Assessment

Introduction

Dr Ian Coupar
73 lectures, 10 tutorials and 54 hours of practical work
The principal aim of the pharmacology course is to provide students with a knowledge of systematic pharmacology based on drug groups and to extend physiological and pathophysiological concepts in relation to the uses of drugs, their mechanisms of action and their side effects.

General objectives

In this teaching program students are expected to develop:

understanding of principles of receptor differentiation, drug-receptor interactions and receptor transduction mechanisms; pharmacological mechanisms by which drugs of various classes may alter biochemical, physiological or pathophysiological parameters to produce therapeutic or unwanted effects;
abilities in the areas of observation and measurement of pharmacological processes; assessment and integration of pharmacological information as it relates to wanted and unwanted effects produced by drugs;
an appreciation of integrated physiological functions, pathophysiological sequelae and pharmacological perturbations as they affect bodily functions; the differing pharmacological approaches available for the treatment of individual diseases; the pharmacists' role in optimising drug therapy.

Syllabus

Pharmacology of neuroeffector systems. Humoral transmission. Historical background. Synthesis, storage, release, metabolism and termination of action of acetylcholine, noradrenaline and other transmitters. Modulation of transmitter release. Pharmacological actions of acetylcholine, noradrenaline and other neurotransmitters. Drugs which mimic and antagonise the muscarinic and nicotinic actions of acetylcholine. Skeletal neuromuscular function, myasthenia gravis, competitive and depolarising blocking drugs. Agonists and antagonists at [alpha]- and [beta]-adrenoceptors. Drugs affecting the synthesis, storage, release and inactivation of neurotransmitters. The role of calcium in transmission and effector organ function. Membrane stabilisers and labilisers. Local anaesthetics. Neurotoxins and muscle toxins.
Autacoids. Synthesis, storage, release, metabolism and pharmacological actions of substances such as histamine, 5-hydroxytryptamine, kinins, substance P, prostaglandins, leukotrienes and platelet activating factor. Substances released during anaphylaxis. Antigen-antibody reactions as they affect allergic and inflammatory states. Drugs used in the treatment of allergies, acute inflammatory conditions and collagen diseases.
Drug-receptor interaction. Receptors. Theories of drug action. Kinetics of drug-receptor interactions. The nature of agonists, antagonists, drug-receptor studies, receptor-response coupling, second messenger systems. Ion channels and their regulation.
Cardiovascular pathophysiology and pharmacology. Extension of cardiovascular anatomy and basic physiology covered in physiology to haemodynamics, pathophysiology and classes of drugs used to treat the different forms of hypertension. Cardiac output, its modulation, measurement and regulation. Circulation. Pressures and flow in arteries, capillaries and veins, the systemic circulation, nervous and humoral control, auto-regulation. Blood flow through special regions, the pulmonary, coronary, splanchnic, muscle and skin circulation. Integrative analysis of the circulation. Hypertension and its consequences. Antihypertensive drugs including: drugs acting on the sympathetic nervous system, angiotensin receptor antagonists, ACE inhibitors, calcium antagonists and potassium channel openers, mechanisms of action, side effects and clinical uses.
Renal physiology and pharmacology. Ultrastructure of the kidney. The formation of urine. Active transport systems in the nephron, competition, saturation and inhibition. Diuretics, mechanisms of action. Mobilisation of oedema fluid. Treatment of diuretic-induced hypokalemia. Aldosterone and the renin-angiotensin system, spironolactone. Renal disease and regulation of acid-base and water balance.
The central nervous system. Anatomy of the human brain, spinal cord and cranial nerves. Blood supply, cerebrospinal fluid. Location of sensory, motor and association areas. Somatic and autonomic reflex arcs. CNS transmitters and their function. Sensory pathways with particular relevance to pain. Pyramidal and extrapyramidal motor systems. Pharmacological control of motor function, tremor and spasticity. Medullary and hypothalamic function. Basic pharmacology of morphine and opioids, benzodiazepine receptor agonists and antagonists, phenothiazines, central muscle relaxants, antidepressants, hallucinogens and methylxanthines.

Practical

Practical classes are designed to provide experience through in vivo and in vitro experiments, seminars and discussion groups to illustrate and extend principles discussed in the lecture course.

Recommended texts

Ganong W F Review of medical physiology 18th edn, Appleton and Lange, 1997
Katzung B G Basic and clinical pharmacology 7th edn, Appleton and Lange, 1997
Rang H P and Dale M M Pharmacology 3rd edn, Churchill Livingstone, 1995
Victorian College of Pharmacy Pharmacology I laboratory manual VCP, 1999

Reference books

Clarke W G and others Goth's 'Medical pharmacology' 13th edn, Mosby, 1992
Goodman L S and Gilman A The pharmacological basis of therapeutics 9th edn, Macmillan, 1996
Laurence D R and Bennett P N Clinical pharmacology 8th edn, Churchill Livingstone, 1997
Lullmann H and others Pocket atlas of pharmacology Thieme, 1993
Netter F H Heart (Ciba collection of medical illustration, vol. 5) Ciba Foundation, 1969
Netter F H Nervous system (Ciba collection of medical illustration, vol. 1) rev. edn, Ciba Pharmaceutical, 1983-1986
Vander A J and others Human physiology 6th edn, McGraw-Hill, 1994

Assessment

Subject assessment will reflect the learning objectives outlined above. Methods of assessment will include:

Mid-year examination (June) (1.5 hours): 35%
Practical work: 15%

End-of-year examination (2 hours): 50%