Foundational Pharmacological Principles
A.Y. 2024/2025
Learning objectives
The course intends to provide medical students with basic information on drugs' action, focusing on the general principles of pharmacodynamics and pharmacokinetics. To this aim, students will learn about the cellular and molecular targets of drug actions, with emphasis on how the pharmacological interference with these targets can produce a therapeutic outcome. Students will also learn on how a drug reaches its target in the body, crossing physiologic barriers, distributing into peripheral tissues, and eventually being metabolized and excreted.
Expected learning outcomes
Students will develop the aptitude to establish the appropriate pharmacotherapy on the basis of: - Pathogenetic mechanisms of disease - Mechanism of action of the drugs - Pharmacokinetic parameters for the choice of the dose, posology, administration routes -I ndividual characteristics of the patient (comorbidity, possible drug-drug interactions, pharmacogenetics).
Lesson period: Second semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Single session
Responsible
Course syllabus
Lecture 1: Pharmacodynamics. Classification of drug targets
· Describe membrane receptors
Lecture 2: Pharmacodynamics. Classification of drug targets
· Describe intracellular receptors
Lecture 3: Pharmacodynamics. Classification of drug targets
· Describe voltage-gated ion channels, pumps and transporters
Lecture 4: Pharmacodynamics. Quantitative drug-receptor interactions
· Describe binding curves
· Define the concept of affinity and Bmax.
· Describe dose-response relationships.
· Define the concepts of potency and efficacy.
· Define the concepts of agonist, antagonist, inverse agonist, partial agonist.
Lecture 5: Pharmacodinamics- Clinical applications
· Define the concepts of therapeutic index and therapeutic window
· Describe receptor desensitization and down-regulation
· Describe biased agonism
· Describe mechanisms of drug toxicity
Lecture 6: NO
· Enzymes
· Functions in endothelial, neuronal and inflammatory cells
Lecture 7: Arachidonic acid cascade
· Eicosanoids pathways
· COX1 and COX2
· NSAIDs and COXIBs
· Lipoxigenase and leukotriens
· Lipoxins, Resolvins, Protectins and Marensins
·
Lecture 8: Biologic drugs
· Recombinant proteins
· Monoclonal antibodies
· Decoy receptors
Lecture 9: Pharmacology of Autonomic Nervous System (ANS)
· Anatomical organization
· Neurochemistry
· Receptor distribution
· Drugs modulating ANS responses
Lecture 10: Pharmacogenetics and pharmacogenomics.
· Polymorphisms classification
· Genetic variations and PK
· Genetic variations and PD
Lecture 11: Pharmacokinetics-Absorption
· Describe physicochemical properties of biological membranes and physiologic barriers (e.g. blood-brain-barrier and blood-placental barrier)
· Describe administration routes, rationale and bioavailability
Lecture 12: Pharmacokinetics-Distribution
· Describe Volume of distribution and plasma protein binding
· Describe the role of transporters in drug distribution
Lecture 13: Pharmacokinetics-Metabolism
· Describe Oxidation/Reduction Reactions
· Describe Conjugation/Hydrolysis Reactions
Lecture 14: Pharmacokinetics-Excretion
· Describe clearance and elimination half-life
· Describe renal and biliary excretion
Lecture 15: Pharmacokinetics-Clinical applications
· Describe therapeutic dosing, frequency, half-life and factors altering the half-life
· Describe temporal trend of plasma concentration of drugs after single and multiple administrations
· Describe personalized pharmacokinetic (e.g. elderly, children, chronic kidney and liver diseases)
· Describe membrane receptors
Lecture 2: Pharmacodynamics. Classification of drug targets
· Describe intracellular receptors
Lecture 3: Pharmacodynamics. Classification of drug targets
· Describe voltage-gated ion channels, pumps and transporters
Lecture 4: Pharmacodynamics. Quantitative drug-receptor interactions
· Describe binding curves
· Define the concept of affinity and Bmax.
· Describe dose-response relationships.
· Define the concepts of potency and efficacy.
· Define the concepts of agonist, antagonist, inverse agonist, partial agonist.
Lecture 5: Pharmacodinamics- Clinical applications
· Define the concepts of therapeutic index and therapeutic window
· Describe receptor desensitization and down-regulation
· Describe biased agonism
· Describe mechanisms of drug toxicity
Lecture 6: NO
· Enzymes
· Functions in endothelial, neuronal and inflammatory cells
Lecture 7: Arachidonic acid cascade
· Eicosanoids pathways
· COX1 and COX2
· NSAIDs and COXIBs
· Lipoxigenase and leukotriens
· Lipoxins, Resolvins, Protectins and Marensins
·
Lecture 8: Biologic drugs
· Recombinant proteins
· Monoclonal antibodies
· Decoy receptors
Lecture 9: Pharmacology of Autonomic Nervous System (ANS)
· Anatomical organization
· Neurochemistry
· Receptor distribution
· Drugs modulating ANS responses
Lecture 10: Pharmacogenetics and pharmacogenomics.
· Polymorphisms classification
· Genetic variations and PK
· Genetic variations and PD
Lecture 11: Pharmacokinetics-Absorption
· Describe physicochemical properties of biological membranes and physiologic barriers (e.g. blood-brain-barrier and blood-placental barrier)
· Describe administration routes, rationale and bioavailability
Lecture 12: Pharmacokinetics-Distribution
· Describe Volume of distribution and plasma protein binding
· Describe the role of transporters in drug distribution
Lecture 13: Pharmacokinetics-Metabolism
· Describe Oxidation/Reduction Reactions
· Describe Conjugation/Hydrolysis Reactions
Lecture 14: Pharmacokinetics-Excretion
· Describe clearance and elimination half-life
· Describe renal and biliary excretion
Lecture 15: Pharmacokinetics-Clinical applications
· Describe therapeutic dosing, frequency, half-life and factors altering the half-life
· Describe temporal trend of plasma concentration of drugs after single and multiple administrations
· Describe personalized pharmacokinetic (e.g. elderly, children, chronic kidney and liver diseases)
Prerequisites for admission
To take the Foundation pharmacological principles exam, students must have already passed all the exams of the first year (Fundamentals of Basic Sciences, Cells, Molecules and Genes , Histology, Anatomy, Biochemistry, Fundamentals of biomedical imaging) and all the exams of second years (Functions 1 and 2, Microbiology, Genetics and Mechanisms of diseases).
Teaching methods
Lectures, seminars and innovative teaching methods
Teaching Resources
Goodman & Gilmans's The Pharmacological Basis of Therapeutics. Laurence L. Brunton, Bjorn C. Knollmann XIV edition McGraw Hill
Katzung's Basic & Clinical Pharmacology Todd W.Vanderah XVI Edition McGraw Hill
Principles of Pharmacology-The Pathophysiologic Basis of Drug Therapy David E. Golan, Ehrin J. Armstrong, April W. Armstrong IV Edition Wolters Kluwer
Katzung's Basic & Clinical Pharmacology Todd W.Vanderah XVI Edition McGraw Hill
Principles of Pharmacology-The Pathophysiologic Basis of Drug Therapy David E. Golan, Ehrin J. Armstrong, April W. Armstrong IV Edition Wolters Kluwer
Assessment methods and Criteria
Student assessment is based on an oral exam.
BIO/14 - PHARMACOLOGY - University credits: 3
Lessons: 30 hours
Professors:
Baldassarre Damiano, Fornasari Diego Maria Michele
Shifts:
Professor(s)