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*Note
on course proficiencies*
YEAR 2
SEMESTER II
PHAR 5302
PHARMACODYNAMICS II
Course Description:
Chemistry, pharmacology and basic therapeutics of agents used
in management of pain, sleep disorders, epilepsy, disorders of
the central nervous system, and endocrine disorders.
Cr. 3. (3-0).
Prerequisite:
PHAR 5402, Pharmacodynamics I.
Course Proficiencies:
The student will be able to:
Module A – Anti-Infectious Agents
- Describe the sites and mechanisms
of action (using chemical structures where applicable) of various
classes of antibiotics and other antimicrobial agents:
- Antituberculin drugs
- Antileprosy drugs
- Sulfonamides
- 4-Quinolones
- Lactams (penicillins and cephalosporins)
- Macrolides
- Lincosamides
- Tetracyclines
- Amphenicols
- Peptide antibioticsAntifungal agents
(Azoles, allylamines, griseofluvin, etc)
- Selective antiprotozoal agents
- Selective anthelmintic
- Discuss, with chemical structures, the
physicochemical properties (pharmacokinetic properties) as they
relate to vitro chemical stability, absorption characteristics,
distribution in the body, coloration of body fluids, chelation,
pH and salt formation characteristics of the antibiotics and
other antimicrobial agents.
- Discuss the structural features of the
antibiotics and other antimicrobial agents as they relate to
physiochemical properties, mechanism of drug action, and therapeutic
application.
- Discuss metabolism (using chemical structures
where applicable) of the antibiotics and other
antimicrobial agents.
- Determine what information should be relayed
to patients regarding the most common agents used to treat the
various infectious diseases.
- List two clinically significant side-effects
for the most common infectious disease drugs.
- Select infectious disease drug therapy
based on an individual patient's history of allergies,
concomitant disease states and current medications.
- Describe characteristics of various infectious
diseases listing: causative organism, characteristics of the
organism, epidemiology, transmission, pathogenesis, and common
signs and symptoms of the disease.
Module B – Pharmacodynamics of Endocrine
Disorders
- Describe the hypothalamic and pituitary
hormones that are employed diagnostically and those employed
in the replacement therapy of endocrine deficiency states.
- Discuss the site and mechanism of action
of gonadotropin releasing hormone agonists in the treatment
of endometriosis, prostatic cancer and other conditions that
are supported by the presence of sex steroid hormones.
- Identify the causes and consequences of
hyperprolactinemia; provide rational treatment regimens that
are employed to manage this condition.
- Discuss the structural features of thyroxine
as they relate to therapeutic activity.
- Discuss the interaction of thyroid hormones
with thyroid hormone receptor protein and the physicochemical
properties and metabolism of thyroid hormones.
- List and discuss the physiochemical properties
of antithyroid agents (goitrogens, anions, propylthiouracil,
methimazole).
- List the major symptoms of hyperthyroidism;
distinguish between diffuse toxic goiter (Graves’ disease) and
toxic nodular goiter.
- Identify the sites and mechanisms of action
of antithyroid agents employed in the management of hyperthyroidism,
including propylthiouracil, methimazole, radioiodide-131, propranolol
and iodide ion.
- Discuss the syndrome of thyroid storm
and identify the sites and mechanisms of action of agents employed
specifically to treat this syndrome.
- List the primary symptoms of hypothyroidism
and distinguish between the major types of hypothyroidism with
regard to etiology.
- Describe the replacement therapy of hypothyroidism;
indicate forms of thyroid products available, the differences
between them and the advantages and disadvantages of these products.
- Describe the strategies employed in managing
hypothyroidism including thyroid function tests that are monitored
in the treatment of thyroid dysfunction; indicate the counseling
considerations utilized in patient education with regard to
the management of thyroid dysfunction.
- Identify the adverse drug effects, drug
interactions and patient considerations concerning antithyroid
agents.
- Identify the major causes and consequences
of hypercalcemic and hypocalcemic states.
- Discuss the agents employed in the management
of hypercalcemic states, including the calcitonins and the bisphosphonates;
indicate the sites and mechanisms of action of these agents
that suppress bone resorption.
- List the sources of hormones used in calcium
homeostasis.
- Describe the bioactivation of prohormonal
forms of vitamin D and the metabolism of the various vitamin
D analogs as these changes relate to biological activity.
- Discuss the properties and metabolism
of bisphosphonates employed to repress bone resorption.
- Compare and contrast the forms of vitamin
D available for the treatment of hypocalcemia with regard to
physicochemical properties, effectiveness, advantages and disadvantages.
- Compare and contrast the types of calcium
supplements.
- Distinguish between osteomalacia, osteopenia,
osteoporosis and Paget’s disease of bone with regard to etiologies
and manifestations.
- Discuss estrogen replacement therapy and
other pharmacologic approaches to the prevention of osteoporosis
in the postmenopausal female.
- List the types of diagnostic aids used
to identify diabetes.
- Identify the physiological systems that
are involved in controlling insulin secretion.
- Compare and contrast the various insulins
as to their physiochemical properties and therapeutic applications.
- Discuss the insulin-insulin receptor binding
interaction and its biological significance.
- List the major physiological actions of
insulin on carbohydrate, lipid and protein metabolism.
- Characterize the primary forms of diabetes
mellitus, distinguish between Type I and Type II forms of diabetes
mellitus and identify the diagnostic criteria for diabetes mellitus.
- Identify the major complications associated
with insulin therapy of diabetes mellitus and how they may be
prevented and managed. Distinguish between the signs and symptoms
of hypoglycemia and hyperglycemia and indicate how these syndromes
can be effectively managed.
- Distinguish between the types of oral antidiabetic
agents with regard to sites and mechanisms of action.
- Discuss the adverse effects, drug interactions
and contraindications of the oral antidiabetic agents.
- Discuss the patient education principles
that should be addressed with regard to the use of oral antidiabetic
agents.
- Discuss the structural features of the
sulfonylurea antidiabetics as they relate to physiochemical
properties, mechanism of drug action, and therapeutic application.
- Discuss the structure features of the
steroid hormones (including the sex hormones and corticosteroids)
as they relate to physiochemical properties, mechanism of drug
action, and therapeutic application.
- Classify a steroid into a hormone catagory
based upon a chemical structure.
- Discuss sites and mechanism of action
of the steroid hormones.
- Characterize the types of adrenal insufficiency
states and forms of adrenal hypersecretory states (Cushing’s
syndromes, primary and secondary aldosteronism) with regard
to etiology and clinical manifestations.
- Identify the drug therapies employed in
the management of adrenal insufficiency and adrenal hypersecretory
states.
- Distinguish between the various synthetic
glucocorticoids available for the therapy of chronic inflammations
and cite advantages and disadvantages of these compounds.
- Outline the menstrual cycle, identify
the hormones involved with the cycle and cite the functional
significance to each in the cycle.
- Identify the specific sites and mechanisms
of action of combination oral contraceptive agents; contrast
the mechanisms of action of the combination products with those
of the progestin-only products ("minipill").
- Indicate the major adverse reactions and
contra-indications of oral contraceptive products.
- Identify the types of injectable contraceptive
agents that are available.
- List additional therapeutic uses for estrogens
and progestins.
- Describe the types of agents employed
to induce ovulation and indicate the mechanisms of action of
these agents.
- Identify the therapeutic uses of androgens
and androgen antagonists; indicate the sites and mechanisms
of action of these agents.
Module C - CNS Disorders I
The student will be able to:
- Describe the mechanisms of action
of typical and atypical antipsychotics.
- Distinguish between typical and atypical
antipsychotics.
- Discuss the structure features of the
antipsychotic drugs as they relate to physiochemical
properties, mechanism of drug action, and therapeutic application.
- Discuss the relevant metabolism of the
antipsychotic drugs where such parameters are known.
- Select an appropriate antipsychotic based
upon a given clinical case.
- Make appropriate management decisions
pertinent to the adverse effects of antipsychotics, particularly
extrapyramidal symptoms.
- Relate the adverse effects profiles of
the conventional antipsychotics to their respective potencies
for the dopamine D2 receptor.
- Identify the basic clinical features and
the neurochemical basis for Parkinson's disease.
- Distinguish between the stages of physiological
sleep and contrast the effects of the various classes of hypnotic
agents with physiological sleep.
- Identify the common types and causes of
insomnia and list pharmacological and nonpharmacological regimens
that may be used to resolve these conditions.
- Discuss the structural features of the
hypnotic agents as they relate to physiochemical properties,
mechanism of drug action, and therapeutic application.
- Select a hypnotic agent based on an individual
patient's presentation of insomnia, history of allergies, age,
and concurrent medications.
- Discuss the mechanisms of action of the
major sedative/hypnotic drugs (including ethanol)
- Discuss the indications, adverse effects,
drug interactions, monitoring parameters, and patient education
of the sedative/hypnotics.
- Discuss the structural features of the
various anticonvulsants as they relate to physiochemical properties,
mechanism of drug action, and therapeutic application.
- Define the terminology and classification
of epileptic seizures and distinguish between the terms seizure,
epilepsy, convulsion, and status epilepticus.
- Identify different causes of seizure activity,
distinguish between the major seizure types and identify the
drugs used in the treatment and prevention of seizure disorders.
- Discuss the site and mechanisms of action
of the major anticonvulsant agents.
- Discuss the indications, adverse effects,
drug interactions, monitoring parameters, and patient education
of the anticonvulsant agents.
Module D
The student will be able to:
- Discuss the sites and mechanism
of action of the antiparkinson drugs.
- Discuss the physiochemical properties
of the antiparkinson drugs.
- Discuss the metabolism (indicating activity
of metabolites) of the antiparkinson drugs.
- Differentiate between symptomatic, neuroprotective,
and restorative treatment for Parkinson's disease and describe
a treatment algorithm for Parkinson patients.
- Describe the clinical features, prevalence,
etiology, and proposed pathogenesis of Alzheimer's disease.
- Describe the sites and mechanisms of drug
action of the agents used in the management of Alzheimer disease.
- List adverse effects, drug interactions,
monitoring parameters, and patient education associated with
the treatment of Alzheimer disease.
- Describe a treatment algorithm for Alzheimer's
patients.
- Discuss the physicochemical properties
of the drugs used to treat Alzheimers disease.
- Discuss the metabolism of the drugs used
to treat Alzheimer’s disease.
- Discuss the clinical features, etiology,
and prevalence of forms of depression and bipolar disorders.
- Describe the proposed mechanisms of action
of antidepressants.
- Describe the mechanisms of action of mood
stabilizers in the management of bipolar disorders.
- Differentiate among the different classes
of antidepressants with respect to adverse effects and drug
interactions.
- Discuss the structural features of the
antidepressant drugs (i.e. tricyclics, aryl and aryloxyalkylamines,
heterocyclic amines, MAOIs)as they relate to physiochemical
properties, mechanism of drug action, and therapeutic application.
- Discuss the metabolism of the antidepressant
drugs.
- Select an appropriate antidepressant based
upon a given clinical case.
- Select an appropriate mood stabilizer
based upon a given clinical case.
- Recognize clinically significant antidepressant
drug interactions as well as the most likely antidepressants
to be involved.
- Identify the various stages of anesthesia
and discuss the factors that influence depth of anesthesia.
- Discuss the physicochemical properties
of the general anesthetics based upon the chemical structure.
- Discuss the metabolism of general anesthetics,
indicating activity of the metabolites where known.
- Discuss the physicochemical properties
of the local anesthetics.
- Discuss the structural features of the
local anesthetics as they relate to physiochemical properties,
mechanism of drug action, and therapeutic application.
- Discuss the metabolism of local anesthetics,
indicating activity of the metabolites where known.
- Identify sites, mechanisms of action,
and therapeutic uses of the various CNS stimulants.
- Evaluate the activities of CNS stimulants
relative to each other based on their chemical structures.
- Differentiate among the different CNS
stimulants in terms of metabolism, presence of active metabolites,
and time to onset of therapeutic effects.
- Describe the primary clinical features
of the types of attention deficit disorder (ADD).
- Identify the types of pharmacological
agents employed to manage ADD.
- Discuss the sites, mechanisms of action,
and major adverse effects of ADD medications.
- Identify the pharmacological agents used
in weight reduction programs.
- Indicate the sites, mechanisms of action,
major adverse effects, and limitations of agents used in weight
reduction programs.
- Discuss the metabolism of anorexic agents.
- Discuss the uses and limitations of anorexients
as adjuncts in weight reduction programs.
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