Learning objectives
To acquire knowledge about therapeutic and/or adverse effects of drugs, when administered to the patient.
Prerequisites
Basic knowledge of anatomy, physiology, biochemistry, microbiology and general pathology.
Course unit content
The course provides the knowledge of drugs and their effects when used in the clinical setting.
Full programme
GENERAL PHARMACOLOGY. The pharmacology as a medical science: concept of active compounds and pharmaceutics, origin of drugs, chemistry and nomenclature of medicaments; generic drugs. Actions and effects of drugs: therapeutic and toxic activity of molecules.
Principles of pharmacodynamics: mechanism of drug actions and drug interaction with the constituents of the organism. Sites of action and receptors. Drugs acting at receptors of the autonomic nervous system. Agonist and antagonist drugs, drugs affecting ion channels, membrane transporters and enzymes. Tolerance and dependence. Elements of pharmacogenetics and of idiosyncratic responses.
Principles of pharmacokinetics. Routes of drug administration, absorption, distribution, metabolism and excretion, bioavailability. Concept of volume of distribution and clearance. Factors that affect drug responses: race, age, gender, diseases of the patient, drug interactions with food and with specific components of the diet. Clinically relevant drug-drug interactions.
CHEMOTHERAPY. Basic principles of action of antibacterial agents. Bacteriostatic and bactericidal effects, spectrum of activity and selective toxicity. Main mechanisms antibacterial actions and major pharmacological classes. Toxicity from antibacterial drugs.
Generality on antineoplastic drugs, their preparation, administration, side effects. Targeted therapy, monoclonal antibodies and new antitumor medicaments.
Cardiovascular system drugs: Physiology and pharmacology of hemostasis: old and novel antithrombotic drugs, antithrombotic prophylaxis, heparin therapy, oral anticoagulant therapy, antiplatelet therapy. Thrombolysis. Medication of hypertension: diuretics, vasodilators, ACE inhibitors and beta-blockers. Hypolipidemic drugs.
Drugs affecting heart and coronary system: digitalis and other positive inotropic drugs, nitroderivatives and antiarrhythmic drugs.
Central nervous system drugs: Physiology of neurotransmission; Specific and non-specific CNS depressants: general anesthetics, hypnotic-sedatives (benzodiazepines and barbiturates), morphine and congeners.
Analgesic drugs: Local anesthetics and systemic analgesics. NSAIDs: classification, mechanism of action, side effects, drug interactions, analysis of the literature. Main NSAID classes: salicylates, propionic acid derivatives, arilacetic acid derivatives, arilsulfonammides, coxibs, oxicams. Paracetamol: general effects, side effects.
Opiates: mechanisms of analgesic action, pharmacokinetics, pharmacodynamics, clinical uses, routes of administration, toxicity, literature analysis. Main opioid classes and prototypes: morphine, codeine, fentanyl, buprenorphine, hydromorphone, oxycodone, methadone. NSAIDs-opiate association. New opiates: tramadol tapentadol and adjuvants. Nursing management of the patient with pain: control of consciousness, vital signs, side effects of medications, alternative ways of drug delivery.
Neuromuscular blocking drugs. Curare derivatives and succinylcholine.
Drugs affecting gastrointestinal tract: prokinetics, antispastics, purgatives, anti-ulcer and gastroprotective drugs.
Antiinflammatory drugs. Corticosteroids and disease-modifying drugs.
Antidiabetic drugs. Insulin and orally active glucose-lowering drugs.
Bibliography
"Principi di farmacologia"
H. Hitner, B. Nagle. Zanichelli.
"Le basi della farmacologia"
M.A. Clark, R. Finkel, et al. Zanichelli.
"Fondamenti di farmacologia per infermieri", Clayton, Stock. EdiSES.
Further information on the textbooks will be provided in class.