Pharmacology, pharmacodynamics, molecular mechanisms of drug effects, pharmacokinetics, monitoring of drug plasma levels and drug effects, side effects of drugs, system- and disease-oriented drug groups.
Cíl předmětu - angličtina
Poslední úprava: MAT89030 (15.10.2012)
Knowledge and skills to be acquired: prescription, general knowledge of the basic principles of pharmacology - pharmacokinetics, pharmacodynamics. Special knowledge of basic principles of pharmacology - knowledge of the groups of drugs according to anatomical systems and their diseases, including clinical indications and adverse effects.
Literatura
Poslední úprava: MUDr. Nikolina Kutinová Canová, Ph.D. (03.11.2021)
Recommended text books (select, only one of the following) :
1. Basic and Clinical Pharmacology, 14th edition, B.G.Katzung (editor), The McGraw Hill Companies, 2017.
2. Lippincott’s illustrated reviews: Pharmacology, 5th edition R.A. Harvey, Clark M.A, R. Finkel, J.A. Ray, K.W. Whalen (eds.), Lippincott Williams & Wilkins, 2018.
3. Katzung & Trevor,s Pharmacology. Examination & Board Review, 9th edition, A. J. Trevor, B.G. Katzung, S.B. Masters, The McGraw Hill Companies, 2017.
5. Goodman & Gilman’s Manual of Pharmacology and Therapeutics, L.L. Brunton, K.L. Parker (eds.), D.K Blumenthal., I.L Buxton., McGraw-Hill, 2014.
Metody výuky - angličtina
Poslední úprava: MUDr. Olga Bartošová, Ph.D. (02.10.2020)
Teaching consists of lectures and seminars. Student attendance at lectures is recommended, student attendance at seminars is compulsory.
Požadavky ke zkoušce - angličtina
Poslední úprava: MUDr. Olga Bartošová, Ph.D. (17.07.2020)
Conditions for Pharmacology Seminars (Credits)
Maximum two absences
Successful passing of all tests
Active presence on practical lessons
Examination rules for students of General Medicine at the Institute of Pharmacology in the subject Pharmacology
Announcement of examination
The examination dates will be set during the regular examination period of the winter semester and in the first two weeks of the summer semester. All dates will be announced in the 5th week of the semester. All dates are entered in the SIS, together with the information specifying the start of registration and the deadlines for (un)registraion. This number of dates will be definitive.
In 5th week of winter semester, further preterms and terms will be announced for the regular examination period of the winter semester. All dates are entered in the SIS, together with the information specifying the start of registration and the deadlines for (un)registraion. No additional examination terms will be issued.
Rules for registration for exams and cancellation.
The start of registration for specific examination dates will be entered in SIS, and it will be different in particular groups of terms.
For the pre-term and regular terms, registration is possible from the 7th week of the winter semester.
Students can log in to only one examination date. Registration for an exam is not conditional upon obtaining the credit but taking the exam is, apart from the credit in the given subject, also limited by completion of any subject that is specified as a (pre)requisite. A student who fails to meet the given requisites will be deleted from the list for the term before examination, of which he/she will be informed by e-mail. This deletion will not reduce the number of terms further available for the student. A student can only take the exam if registered for the term in SIS, and when all requisites for the exam have been met.
Failure to turn up for examination and apology.
The student who fails to turn up for the examination that he/she has registered for cannot register for another examination date.The student must apologise to Dr. Olga Bartošová, omato@lf1.cuni.cz, tel. 224 968 030, 224 96 4133 in writing or in electronic mail, giving and substantiating the reasons for the apology.The student will be informed about acceptance of the apology and also deleted from the original list so that he/she can register for another date.The principal teacher of the subject can require specification of the apology or its reasons if he/she finds the apology insufficient.
Re-examinations
A student can take an examination for three times as a maximum, i.e. the student is entitled to two re-examinations, and no extraordinary terms beyond that are allowed. However, if the student does not exploit the above options within the set examination dates, this does not entitle him/her to a special date of examination to be appointed for him/her personally. No more examination dates (“terms”) will be set. Further, no examinations can be taken after the end of the second part of the regular examination period in September, or after the last term announced.
Rules pertaining to the course of examination.
The exam consists of two parts.
1) prescription writing – two brand name drugs with the using of Pharmindex (time limit 20 minutes)
2) The student draws a triplet of exam questions, is entitled to 15-20 minutes of preparation, and then takes the exam. Recommended study materials are published using SIS.
Institute of Pharmacology, First Faculty of Medicine Charles University Final examination questions (pharmacology) for the year 2019/2020, (4th year)
1. a. Clinical trials (objectives and characteristics of individual phases). b. The relevance of the autonomic nervous system to clinical pharmacology and therapeutics using clinical examples to illustrate your answers (agonist’s antagonists, cholinergic receptors, adrenergic receptors, clinical use of adrenergic agonists and antagonists). c. Describe drugs useful in the treatment and prophylaxis of migraine headache (asymptotic phase, prodromal phase and headache phase).
2. a. The relationship between dose, plasma level and drug effect (examples of TDM). b. Treatment of poisoning. c. Drugs affecting bone and mineral homeostasis, drug treatment of osteoporosis.
3. a. Pharmacokinetic principles and use in clinical practice, calculation of pharmacokinetic parameters, bioavailability and optimization of dosage regimen. b. Treatment of pain. c. Major groups of drugs used in heart failure describing various targets and actions.
4. a. Transport mechanisms of drugs across biomembranes, various processes, compartmental pharmacokinetic models, zero and first order kinetic of elimination, drug absorption and bioavailability, Clinical relevance. b. Drugs in general anesthesia. c. Drugs used in hypo- and hyperthyroidism.
5. a. Active and passive transport across biomembranes (including transport of ions and organic compounds in kidney’s tubules. b. Sedative hypnotic drugs. c. Describe the appropriate drug treatment(s) for major common skin diseases; give major adverse effects of these drugs.
6. a. Routes of drug administration (relationship between mode of administration to speed and duration of effect, and relation to drug pharmacokinetics). Give graphical illustrations. b. Benzodiazepines, mode of action, molecular pharmacology, effect at organ level, adverse effects and therapeutic uses. c. Anticoagulants and fibrynolytics, therapeutic indications.
7. a. Main pharmacokinetic parameters affecting plasma drug level at steady state, rate constant of elimination, volumes of distribution, half-life time, total body clearance, renal and nonrenal clearance. b. Clinically important alcohols and their antagonists (drugs used to treat alcohol withdrawal, drugs to treat alcohol dependence, drugs used to treat acute methanol or ethylene glycol intoxication). c. Diuretics (classification, mechanism of action and therapeutic applications).
8. a. Drug distribution in the organism (volume of distribution and half life time, clearance etc., examples and significance for dosage adjustment). b. Drugs used for treatment of epilepsy, mode of action, principles of antiepileptic administration, drug of choice and recent development in epilepsy drug treatment. c. Drugs used for the treatment of respiratory tract diseases; the modes of action, adverse effects and clinical use of drugs employed in the management of chronic asthma.
9. a. Drug biotransformation and significance for drug elimination, pharmacological and toxicological drug effects (types of biotransformation, enzyme induction and inhibition with examples). b. Drug treatment for parkinsonism, potential drug use in other neurodegenerative diseases. c. Classification of antihypertensive drugs, status of beta-blockers among these drugs, and various clinical usefulness of beta-blockers.
10. a. Drug elimination mechanisms (rate constants of elimination, half lifetime, total body clearance, renal and nonrenal clearance). b. Discuss the difference in pharmacological profile between ACE inhibitors and AT1-receptor blockers. c. Describe the pharmacology of drugs used in the treatment of angina pectoris including adverse effects.
11. a. A dosage regimen is a plan for drug administration. An optimal dosage regimen results in the achievement of therapeutic levels of the drug in the blood without exceeding the minm toxic concentration. Define maintenance dose, loading dose and how to calculate, therapeutic window and how to adjust the dose when elimination is altered by disease. b. Centrally-acting skeletal muscle relaxants and neuromuscular blocking agents, therapeutic uses and side effects. c. Major groups of drugs used in heart failure describing various targets and actions.
12. a. Elimination of drugs. b. Describe the probable mechanisms of action and major characteristics of tricyclic antidepressants, SSRIs, SNRIs, and serotonin 5-HT receptor antagonists. c. Drug therapy of diabetes mellitus.
13. a. Significance of pharmacokinetic for optimizing drug dosage (relation between dose, concentration and drug effect, bioavailability, and therapeutic monitoring of blood levels). b. Neuroleptics, antidepressants (including selective serotonin release inhibitors SSRI and selective noradrenaline release inhibitors SNRI). c. Describe gonadal hormone agonists and antagonists: estrogens, antiesterogens SERMs (selective estrogen-receptor modulators), progestins, androgens and antiandrogens, hormonal contraceptives adverse effects.
14. a. Drug concentration-time course in the blood, single and multicompartmental model system for drug distribution. b. An overview on drugs affecting behavior. Antianxiety drugs (molecular pharmacology and clinical uses). c. Describe drugs appropriate for myasthenia gravis and therapeutic uses of cholinesterase inhibitors.
15. a. Relationship between dose, plasma level of drug and effect (examples of monitoring drug plasma levels). Demonstrate with graphical presentations. b.Outline drugs used for psychosis and bipolar disorders (classic and newer agents, adverse effects etc.). c. Severe unwanted effects of antibiotic (allergic reactions, toxicity on nervous system, hematopoesis, cardiovascular and respiratory system with examples).
16. a. From your pharmacodynamics and drug-receptor interactions define: Efficacy, potency, therapeutic index, graded dose response, quantal dose-response, spare receptors. Give examples and graphical representation whenever possible. b. Outline pharmacologic strategies for dopaminergic therapy and other drugs used in Parkinson’s disease, mode of action, adverse effects. c. Androgens and anabolic steroids, drugs used in prostatic hyperplasia.
17. a. Signaling mechanisms and drug action. b. On the basis of opioids’ interaction with relevant receptor(s), classify these drugs with their mechanisms of action, pharmacodynamics, acute and chronic effects. c. Corticosteroids.
18. a. Quantitative aspect of drug-receptor interaction with graphical illustrations. b. Nonopiate analgesics, and nonsteroidal anti-inflammatory compounds. c. Hormonal and nonhormonal drugs that are useful in the treatment of bone miniral disorders (e.g. osteoporosis, rickets, osteomalacia, Paget’s disease).
19. a. Define receptor-effector complex, graded dose response, quantal dose response relationships, antagonists and the difference between a pharmacologic antagonist and allosteric agonist/antagonist. b. Discuss the concept of antidotes in he treatment of drug and heavy metal poisoning, giving examples. c. Describe local and systemic antifungal agents in clinical applications.
20. a. Therapeutic window, therapeutic index, individual variability in patient sensitivity to the drugs. b. Drugs employed in the management of acute and chronic bronchial asthma attacks. c. Effects of nitric oxide, and potential use of NO donors and inhibitors.
21. a. The classic drug-receptor interactions and the involvement of signaling across the membrane with examples. b. The adverse effects of corticosteroids. c. Classification of immunosuppressive and imunomodulating agents including cytokines and clinical uses.
22. a. Define intrinsic activity and affinity of a drug, competitive and noncompetitive antagonism and partial agonism (with graphical illustration). b. Outline drugs that mimic or block the effects o hypothalamic and pituitary hormones. c. Antifungal and antiviral drugs.
23. a. Factors modifying drug response. b. The sympathomimetic bronchodilators are drugs of choice in acute asthma.Compare the properties of direct- and indirect- acting sympathomimetics relative to the therapeutic goals in asthma. Outline drugs used in bronchial asthma and antitussive agents.
c. Uterotonics and tocolytics.
24. a. Adverse reactions to drugs. b. Outline major drug groups used as antihypertensive medications. c. Drugs used in the treatment of tuberculosis.
25. a. Receptor hypersensitivity and receptor desensitization (mechanisms, give examples). b. Treatment of poisoning. c. Drugs for acid-peptic disease, drugs for inflammatory bowel disease and antiemetics.
26. a. Define receptor-effector complex, graded dose response, quantal dose response relationships, antagonists and the difference between a pharmacologic antagonist and allosteric agonist/antagonist. b. Parasympathomimetics (direct and indirect acting compounds). c. Classify beta-lactam antibiotics and other cell wall synthesis inhibitors: mode of actions and adverse effects.
27. a. Main sites of drug actions (receptors, calcium channels, enzymes... etc.). b. Local anesthetics, overview, uses, toxicity. c. Treatment of Helicobacter pylori infection, acid-suppressant drugs, drugs in the treatment of reflux oesophagitis.
28. a. Signaling mechanisms and drug action. b. The relevance of the autonomic nervous system to clinical pharmacology and therapeutics using clinical examples to illustrate your answers. (Agonists antagonists, cholinergic receptors, adrenergic receptors, clinical use of adrenergic agonists and antagonists). c. Chemotherapy of cancer, classification of cytostatics, new development in anticancer drugs, resistance to the cytotoxic effects of anticancer agents.
29. a. Describe the stages of new drug development. Outline experimental and clinical research involved. b. Antihypertensive agents, overview, ACE inhibitors (effect after chronic use, undesired effects). c. Comment and classify typical and atypical sedative hypnotic drugs.
30. a. Relationship between dose and effect (define types of doses, therapeutic dose, toxic dose, therapeutic index. etc.). Illustrate your answer graphically. b. Skeletal muscle relaxants and clinical uses. c. Drug treatment for acid-peptic diseases; inflammatory bowel disease, laxatives, antispasmodics.
31. a. A dosage regimen is a plan for drug administration. An optimal dosage regimen results in the achievement of therapeutic levels of the drug in the blood without exceeding the minimum toxic concentration. Define maintenance dose, loading dose and how to calculate, therapeutic window and how to adjust the dose when elimination is altered by disease. b. Congestive heart failure, cardiotonic drugs and other drugs with positive inotropic effect (importance, indications and risks), role of ACE inhibitors. c. Laxatives and antidiarrheal drugs.
32. a. Alteration in drug effects after chronic administration (tachyphylaxis, tolerance and drug dependence). b. Medications for the treatment of cardiac arrhythmias. c. Anti cancer hormone therapy.
33. a. Drug dependence (examples of drug abuse). b. Outline major drug groups used as antihypertensive medications. c. Tocolytics and uterotonics (compounds that stimulates uterine motility), classification and therapeutic uses.
34. a. Describe adverse drug reactions and drug interactions. b. Antihypertensive drugs, classification, mode of action, advantages and disadvantages of individual agents. c. Immunosuppressive agents, relation between immunosuppressive therapy and cancer chemotherapy.
35. a. Relation between drug dose and clinical response with graphical illustrations. b. Describe major adverse effects of NSAIDs. c. Drugs to the treatment of hyperlipidemias.
36. a. Teratogenic and carcinogenic effects of drugs. b. Inhibitors of calcium ion channels pharmacologic profile and clinical pharmacology. c. Chemotherapy of cancer, classification of cytostatics, adverse effects.
37. a. Drug use and special dosage adjustments for children and elderly. Changes in drug pharmacokinetics (absorption, bioavailability, distribution and elimination). b. Diuretics and uses in edematous and nonedematous indications. c. Mechanism of action and therapeutic indications of various anticoagulents and antiplatelet drug.
38. a. Untoward and side effects of drugs (give examples). b. Summarize drugs that modulate immune function (mechanism of action, clinical applications, pharmacokinetics and toxicities. c. Drugs for constipation and diarrhoea.
39. a. Phases of new drug development including preclinical and clinical testing. b. Toxicity of some metals and their derivatives and relevant antidotes (Pb, Hg, As, Cd, Fe). c. The modes of action, adverse effects and clinical use of drugs employed in the management of chronic asthma. Drug use in other respiratory diseases.
40. a. Pharmacokinetics and other differences between children and adults. Polypharmacy in the elderly. b. Histamine blockers, clinical uses and side effects. c. Chemotherapy of mycobacterial.
41. a. A dosage regimen is a plan for drug administration. An optimal dosage regimen results in the achievement of therapeutic levels of the drug in the blood without exceeding the minimum toxic concentration. Define maintenance dose, loading dose and how to calculate, therapeutic window and how to adjust the dose when elimination is altered by disease. b. Classification of antihypertinsive drugs, status of beta-blockers among these drugs, and various clinical usefulness of beta-blockers. c. Fluoroquinolones and quinolones and other drugs used for treatment of urinary tract infections.
42. a. Clinical pharmacokinetics, monitoring of drug plasma level and dosage adjustment. Describe phases of drug biotransformation with important clinical consequences. b. The use of ACE inhibitors in cardiovascular disease. c. Antiviral drugs.
43. a. Sources of drug information and type of information about available drugs. b. Describe the pharmacology of drugs used in the treatment of angina pectoris including adverse effects. c. Discuss drug treatments of urinary tract infections (UTIs) with the appropriate mechanisms of action.
44. a. Classify cholinergic receptors and subtypes, agonists and antagonists. b. Opioids analgesia. c. Describe drugs useful in the treatment and prophylaxis of migraine headache (asymptotic phase, prodromal phase and headache phase).
45. a. Drug use and risks before and during pregnancy and during breast-feed feeding. b. Local anesthetics, overview, uses, toxicity. c. Neuroleptics, antidepressants (including selective serotonin release inhibitors SSRI).
46. a. Types of immune reactions due to drug applications (drug allergy, idiosyncrasy etc.), demonstrate your answers with clear examples. b. Thrombolytics (fibrinolytics and their antagonists). c. Antiemetics.
47. a. Drug intoxication and general principles in patient treatment and specific antidotes. b. Drugs used in the treatment of tuberculosis. c. Drugs used to combat malaria, amebiasis, toxoplasmosis and anthelmintic drugs (against nematodes, trematodes and cestodes).
48. a. Blood, plasma, blood substitutes, parenteral nutrition. b. Pharmacotherapy of neurodegenerative diseases. c. Antimicrobial combinations, advantages and disadvantages, example of synergism and antagonism of individual combinations.
49. a. Special features of drug use (pregnancy, lactation, childhood, old age). b. Sympathetic nervous system - sympathomimetics. c. Fluoroquinolones and quinolones and other drugs used for treatment of urinary tract infections.
50. a Factors affecting response to drugs (give examples). b. Psychopharmacology - classification, division. c. Classify and describe the pharmacological profiles of major drugs used in ophthalmology.
Examination on prescription writing (General medicine)
part of the exam is prescription of recipe
1. - Rp. A drug for the tretment of chemotherapy-induced nausea and vomiting
- Rp. Antimicrobial agent in ophthalmology
2. - Rp. A drug that reduces cholesterol levels
- Rp. Antidepressant drug
3. - Rp. New oral anticoagulants
- Rp. A drug for the treatment of oxyuriasis (for a child b.w. 20 kg)
4. - Rp. Glaucoma (eye drops)
- Rp. A drug for hypertension (medium potency)
5. - Rp. Antibacterial drug combination for external use
