Learning objectives
1. Knowledge and understanding. The course is finalized to the knowledge of pharmacokinetic and pharmacodynamic properties of the main drugs classes acting at the nervous system, smooth and skeletal muscle, cardiovascular, respiratory and immune systems. Such notions will allow the student to better understand the basic biometabolic events in the body and how exogenously-administered drugs substances modify them. Particular attention will be paid to the knowledge of mechanisms involved in cell excitability, cell proliferation and tissue repair.
2. Ability to apply knowledge and understanding. Students will be stimulated to elaborate the acquired notions in the whole animal and human being, and in vitro biological activity of the preparations or isolated cells. Such knowledge will focus on signs and/or symptoms that develop following the administration/intake of medicines, and to assess the effects they produce.
3. Making judgments. The student will acquire the knowledge for future planning of study protocols, aimed at the characterization of new molecules, as well as the ability to choose the correct medicament in specific patients.
4. Communication skills. Students will acquire the terminology to describe objectively the actions of drugs and biomathematician models currently applied to quantify the effect of drugs on the different organs and systems.
5. Learning ability. Students should be able to use the acquired knowledge to understand and re-elaborate the literature regarding drugs, the use them in the treatment of specific conditions or for research purposes.
Course unit content
The course is aimed at understanding the effects of experimental as well as therapeutic drugs and their application in the clinical odontoiatric practice.
Full programme
General Principles. Concept of drug and drug action. Pharmacological and toxicological effects of drugs and their implications with their use in the clinical setting. Development of innovative drugs: Preclinical, Clinical (Phases 1-3) and Postmarketing (Phase 4) studies.
Pharmacokinetics. Routes of drug administration, kinetics of drug dissolution, absorption, distribution, metabolism and elimination (DADME). Drug kinetics after single or repeated administration, significance and interpretation of the various kinetic parameters: bioavailability, renal excretion, plasma protein binding, clearance, volume of distribution, half life, time to reach maximal concentration, maximal concentration attained.
Pharmacodynamics. Mechanisms of drug action and relationships between drug concentration and effect; Primary and secondary (adverse) drug effects. Receptor interaction, structure-activity relationship (agonist, antagonist, partial agonist, inverse agonist, allosteric modulators); receptor modulation by drug exposure, mechanisms of information tranfer between intra and extracellular compartments, second messengers, protein kinases.
Pharmacogenetics. Genetically determined variability of response to drugs, idiosyncratic responses.
Risk/benefit ratio of drugs – therapeutic index; adverse drug reactions (ADRs), tolerance and physical dependence; mechanisms of drug interactions with other drugs, environmental pollutants, food, herbal remedies, licit and illicit substances of abuse. Evaluation of drug and xenobiotic toxicity (dose-effect and time-effects relationships)
Specic drug effets. Drugs interfering with Autonomic Nervous System, Cholinergic- (muscarinic and nicotinic) agonists and antagonists; adrenergic (alpha and beta) agonists and antagonists, Agents active at autonomic ganglia.
Drugs interfering with Somatic Nervous System: neuromuscolar blockers: non-depolarizing (benzylisochinolines and aminosteroidal) and depolarizing (succinylcholine) compounds.
Drugs affecting Central Nervous System. Neurotransmitters, neuromodulators and neurohormones and their receptors
Drugs for suppression of Pain: General Anesthetics, Narcotic and Non-Narcotic analgesics, Local Anesthetics.
Drugs for Anxiety and Hypnotics
Drugs for Inflammation and Fever: drugs affecting Prostaglandins, thromboxanes, prostacyclins. Non steroidal anti-inflammatory drugs, COX-1 and COX-2 inhibitors; steroidal anti-inflammatory drugs (glucocorticoids).
Drugs acting on Cardiovascular System. Antihypertensive, antiarrhythmic and inotropic agents. Drugs applied in angina, cardiocirculatory collapse, myocardial infarction, syncope)
Drugs interfering with coagulation: inhibitors of platelet aggregation; anticoagulants (parenteral and oral), thrombolitics; anti-hemorrhagics.
Local and systemin hemostatics.
Drugs acting on Immune System
Anti histamine H1 receptor antagonists.
Drugs affecting the gastrointestinal system: antiacids and antisecretory medicaments, procynetic and spasmolytic drugs.
Antibacterial Chemotherapy General principles of Antibacterial Chemotherapy with particular regard to the treatment of Odontogenic Infections and Prophylaxis Prior to Dental Procedures. Antibacterial Chemotherapy: Drug Resistance, Pharmacokinetics and Pharmacodynamics of Antibiotics.
Classes of antibacterials: Beta-lactam antibiotics (Penicillins, Cephalosporins, Carbapenems, Monobattams); Glycopeptides; Tetracyclines; Chloramphenicol; Macrolides; Lincosamides (clindamycin); Aminoglycosides; Fluoroquinolones; Metronidazole; Sulfonamides, trimetoprim-sulfametoxazole. Mechanism of action, clinical uses, selective toxicity, Hypersensitivity and resistance mechanisms.
Anti-tuberculosis drugs: general principles and strategies. Pharmacological properties of individual drugs and adverse effects.
Antifungal Chemotherapy Amphotericin B, Nystatin; Imidazoles and triazoles; Griseofulvin. Topical antifungal drugs.
Antiviral Chemotherapy Drugs active against herpesviruses; drugs active against retroviruses; other antiviral drugs.
Cancer Chemotherapy General principles of cancer chemotherapy and therapeutic strategies.
Classes of anti-cancer drugs: Alkylating agents, Antimetabolites, Topoisomerase inhibitors; Vinca alkaloids, Antibiotics. Hormone therapy. Target therapy. Mechanism of action, clinical uses, selective toxicity, resistance mechanisms
Drugs for Odontoiatric Emergencies
Non Cardiovascular (acute allergic reactions, asthma attack, hemorrhage, hypoglycemia, local anesthetic reactions, seizures)
Bibliography
Amico-Roxas M, Caputi AP, Del Tacca M. Farmacologia in odontoiatria. EDRA, 2017.
Katzung GB, Trevor AJ. Basic and clinical pharmacology. XIII Edition. McGraw-Hill, 2015 (or newer release).
Teaching methods
The course will be held through lectures. In case the COVID-related emergence continues, frontal lessons will proceed remotely through the Teams platform (for instructions, see http://selma.unipr.it). Lessons will be carried out with the aid of iconographic material collected in PowerPoint files that, at the end of the course, will be made available to students on the Elly site at the course pages.
Assessment methods and criteria
Oral examen.
In case of the persistence of the health emergency, the exams will be conducted remotely, as follows:
remote oral questions, through the Teams platform (guide http://selma.unipr.it/).
Students with SLD / BSE must first contact Le Eli-che: support for students with disabilities, D.S.A., B.E.S. (https://sea.unipr.it/it/servizi/le-eli-che-supporto-studenti-con-disabilita-dsa-bes)
