Nutrition, Pharmacology and Toxicology

Pharmacokinetics
· drug absorption, distribution, metabolism and excretion
· Phase I and II reactions
· Pharmacogenomics
Pharmacodinamics
· Classification of drug targets and mechanisms of action
· Interaction and efficacy parameters
· Therapeutic and adverse effects
Drug development
· Preclinical and clinical studies of kinetics, efficacy and toxicity
· Pharmacovigilance
· Ethical issues in drug development
· General causes of drug failure
Dyslipidemias
· Atherosclerotic process
· Lipid and lipoprotein metabolism
· Classification of dyslipidemias and pharmacological targets
· Pharmacological management: statins, ezetimibe, PCSK9 inhibitors, PPAR-alpha agonists
· Dietary intervention: omega-3 fatty acids, phytosterols, fibers, berberine, red yeast rice
Obesity
· Prevalence and classification
· Regulation of food intake
· Pharmacological management: sympathomimetics, orlistat, GLP1-R agonists, setmelanotide
· Emerging targets: leptin, white and brown adipose tissue
· Dietary intervention: caloric restriction, fibers, omega-3, polyphenols
Diabetes
· Diagnosis and classification
· Mechanisms of glycemic control
· Pharmacological management: insulin, solfonylureas, GLP-1R agonists, DPP-4 inhibitors, metformin, PPAR-gamma agonists, SGLT-2 inhibitors
· Dietary intervention: low-carbohydrate diet, fibers, olive oil
Hypertension
· Determinants of arterial pressure: role of sodium, renin-angiotensin system and sympathetic nervous system
· Pharmacological management: renin inhibitors, ACE-inhibitors, AT1 receptor antagonists, loop diuretics, thiazides, K+-sparing agents, beta-blockers, Calcium channel blockers
· Dietary intervention: weight loss, sodium restriction, DASH and Mediterranean diet, potassium, alcohol, cocoa flavonoids, garlic, beetroot, omega-3
Platelet aggregation and blood coagulation
· Platelets and coagulation factors
· Mechanisms of hemostasis
· Anti-aggregant drugs: acetylsalicylic acid, thienopyridines, thrombin receptor antagonists, gpIIb/3a antagonists
· Anticoagulant drugs: heparins, direct inhibitors of thrombin and Xa, warfarin
· Drug-food interactions: vitamin K, garlic, ginkgo, ginseng, ginger, omega-3, vitamin E, olive oil
Gout
· Regulation of serum uricemia and gout pathogenesis
· Pharmacological management: anti-inflammatory drugs, colchicine, uricosurics, xantine oxidase inhibitors, uricase
· Dietary intervention: weight loss, alcohol, purine-rich foods, diary products, fructose, coffee, vitamin C
Anemias
· Red blood cell production
· Role of erythropoietin, iron, vitamin B12 and folic acid
· Classification of anemias and oral/parenteral treatment of nutritional deficiencies
· Dietary sources of iron, vitamin B12 and folic acid and their bioavailability
· Effect of Helicobacter pylori infection
Heart failure
· Definition, classification, pathogenesis and prognosis
· Pharmacological management: RAAS inhibitors, ARNIs, diuretics, beta-blockers, digoxin, SGLT-2 inhibitors
· Dietary intervention for HF prevention: control of body weight, arterial pressure and glycaemia
· Dietary intervention for HF management: preservation of body weight, nutritional deficiencies, restriction of water and sodium intake, supplementation with aminoacids, coQ10, iron, omega-3, carnitine, creatinine and vitamins
Gastroesophageal reflux and peptic ulcer
· Regulation of gastric secretion
· Role of Helicobacter pylori and anti-inflammatory drugs
· Pharmacological management: proton pump inhibitors, H2 receptor antagonists, misoprostol, sucralfate and antacids
· Dietary intervention: weight loss, elimination diets, probiotics for Helicobacter pylori infection
Alteration of gastrointestinal motility
· Mechanisms of peristalsis regulation
· Classification, causes and consequences of altered GI motility
· Pharmacological management: prokinetics, laxatives, antidiarrheal, antinauseant and antiemetic agents
· Dietary intervention: elimination diets, FODMAP diet, probiotics and fibers
Non-alcoholic fatty liver disease
· Pathogenesis, diagnosis and classification
· Dietary intervention: weight loss, beneficial components of the Mediterranean diet, vitamin E, silybum marianum
Food-drug interactions
· Pharmacokinetic interactions
· Pharmacodynamic interactions
· Effect of meals, fibers, calcium-containing foods on drug absorption
· Enzymatic inductors and inhibitors: grapefruit, St. John's Wort, flavonoids
· Pharmacodynamic interactions: potassium- and tyramine-rich foods, licorice
Design of dietary intervention studies
· Key parameters of randomized controlled studies
· Inclusion and exclusion criteria
· Selection of intervention strategy, of the active treatment and of the control treatment
· Adherence and compliance: impact and measurement.