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Clinical Pharmacology

10062412

Course lecturers
Dr. Samy Hammady, M.D.; Samihammadi2000@yahoo.com.
Tel: (02) 5270000 Ext 4149.
Dr. Layla Borham, M.D. borhaml@hotmail.com.
Tel: (02) 5270000 Ext 4273
Department of Pharmacology and Toxicology
Faculty of Medicine
Umm Al-Qura University
When you have questions, concerns, or suggestions, please contact Dr. Samy Hammady, for male
section or Dr. Layla Borham, for female section by e-mail, call for an appointment, or catch them
before or after class or lab.

Course Description and Organization


The course is designed to give the students basic and clinical knowledge on the cardiovascular
and central nervous system pharmacology with specific consideration of drugs used in different
CVS and CNS disorders. Also the course gives the basic and clinical knowledge on endocrine
pharmacology and the drugs or agents used to correct endocrinal disorders. The course gives a
sound knowledge of pharmacology of many important groups of chemotherapeutic agents used in
the treatment of infectious diseases and cancer.
The overall objectives of this course are to provide students with:
1. a clinical background in pharmacology, including the application of basic pharmacological
data on clinical disease cases.
2. an understanding of how the basic principles of pharmacology are integral to effective
diagnosis, prevention and treatment of different diseases, and
3. opportunities to work in teams to begin to develop an approach to evaluate clinical cases to
determine the therapeutics of different diseases and to formulate an appropriate treatment
plan.

Lectures
Each lecture is accompanied by a PowerPoint presentation. Information from the presentation and
assigned reading is important for mastering the learning objectives which are the primary focus
of exam questions.

Seminars and Conferences:


Selected topics are chosen for further study and students or student groups assigned to present
and discuss them. These periods can be used to review covered material and further clarify
lecture or reading assignments, or to informally test the level of learning of the students by
selective questions and problems.

Review Sessions
Review sessions will be scheduled prior to each exam. The time and format for each session will
be arranged via the students coordinators.

Course Objectives:
- On completion of the course, students will be able to:
Provide a sound knowledge of the actions of many important groups of drugs used in medicine.
Acquaint with the pathogenesis of cardiovascular disorders.
Demonstrate knowledge of the pharmacodynamics, pharmacokinetics therapeutic uses and
adverse effects of drugs used for treatment of hypertension, angina, heart failure, and
arrhythmia.
Acquaint students with pharmacodynamics, pharmacokinetics, clinical uses and adverse effects
of drugs used in the treatment of central nervous system disorders.
Demonstrate knowledge regarding the pharmacology of non steroidal anti-inflammatory drugs
and drugs used to treat gout.
Provide

students

with

information

concerning

chemistry,

pharmacological

effects,

pharmacokinetics, toxicity, mechanism of action and therapeutic application of drugs used in


endocrinal disorders, and chemotherapeutic drugs.

Prior Knowledge and Skills Required for This Course


The ability to fully comprehend and appreciate the fundamentals of clinical pharmacology
requires a background in basic pharmacology, and have some clinical knowledge and
experiences.

Roles and Responsibilities of the Students and Lecturers


Students are expected to;
1. Use all available resources to accomplish the learning objectives in each lecture and case-based
discussion and exercise session, including:
a. Attending all lecture and case-based discussion sessions.
b. Reading textbook assignments.
c. Participating in lecture and case sessions by answering questions posed in class and asking
questions when information is unclear or more information is needed.
d. Performing assigned exercises working individually or in groups, as directed.
e. Submitting completed assignments on or before the stated deadlines for timely feedback.
f. Optimizing their learning strategies by trying the suggested tips and/or other ideas, and
working with others.
g. Asking for help from the course manager when they need it or even think they might need
it.
2. Notify the course manager as soon as they can if they are seriously ill or have an emergency
that prevents them from attending the case sessions or an exam.
3. Provide constructive feedback regarding the course on evaluation forms that will be provided
at the end of the semester.
4. Adhere to the faculty academic and professional rules.

Lecturer is expected to:


1. Provide clear and informative lecture notes with learning objectives that focus on important
points,
2. Give clear, informative, and stimulating 50-minute lectures with PowerPoint or other visual
aids to enhance the learning experience for students.
3. Answer questions either in or outside class or via e-mail or telephone.

4. Compose thoughtful and fair exam questions that assess student learning and application of
the course content.
5. Directing the case sessions and facilitators to provide an effective learning experience in
small group, team-oriented sessions.
6. Providing answers and explanations to student inquiries regarding any aspect of the course.
7. Providing advice and assistance to students for improving their learning strategies and
performance in the course.
8. Reviewing and implementing appropriate changes in the course based on student feedback
and evaluations.

Learning Resources
Required Textbook:

1- Basic and Clinical Pharmacology, (2006) 10th edition, Bertram G. Katzung. McGraw-Hill
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The most current and authoritative information available


Concise and thorough introduction to basic and clinical pharmacology
All chapters rigorously updated with the latest drug information and references
New chapter on botanicals (herbal medications) and nutritional supplements
Features include special-interest boxes and lists of common preparations and dosage
information
More than 600 illustrations and tables
Ideal pharmacology text for medical students and students in other health-related professions
Basic and clinical pharmacology from the most authoritative source
Organized by drug groups and prototypes
Mechanism of action and toxicities of traditional and newer drugs
Treatment strategies and drugs of choice for all major diseases

2- Lippincott's Illustrated Reviews: Pharmacology (2005) 3rd edition. Mary J Mycek, Richard
A Harvey, Pamela C Champe.
o Third Edition enables rapid review and assimilation of large amounts of complex information
about the essentials of medical pharmacology.
o Pharmacology features an outline format, over 500 full-color illustrations, cross-references to
other titles in the series, and over 125 review questions.
o New and expanded material on steroid hormones, poisons, drugs for obesity, osteoporosis,
erectile dysfunction, anti-inflammatory drugs, and autacoids.
o Innovative Concept Maps, a tool for visualizing the connections between concepts.
o Material is represented in a hierarchical fashion with the most general concepts at the top of
the map and the more specific, less general concepts arranged beneath.
o End of Chapter Summaries of the most important/clinically significant testable information.

3- Goodman and Gillman's Pharmacological Basis of Therapeutics: (2005).11th edition


Laurence Brunton, John Lazo, Keith Parker.
o The undisputed leader in medical pharmacology, without equal.
o Updated to reflect all critical new developments in drug action and drug-disease interaction.
o This is the desert island book of all medical pharmacologyif you can own just one
pharmacology book, this is it.

Tips for Learning


1. Briefly review your lecture notes before the lecture to get an idea of the material that will be
covered, the degree of difficulty of the material, and how much detail is included in the notes.
Look at the learning objectives to get an idea of the most important information that you are
responsible for learning and that will serve as the focus for exam questions.
2. Attend the lectures. Each lecture is composed of PowerPoint presentation, and sometimes
interactive class activities. The lecture presentations re-enforce, enhance, and clarify the
lecture concepts.
3. Keep up! Review the lecture as soon as you can after the lecture to make sure you understand
the material; pay particular attention to the learning objectives. Read the required textbook for
additional and alternative presentations of information. If you have questions, or just dont
get it, ask for help.
5. Be an active learner! Consolidate the most important concepts and facts into a form that
YOU are most likely to understand and retain. Be creative and make it fun! Divide the work
with your study partners and share your study-aids. Try giving a minilecture to yourself (on
the car or while youre walking) or to your study partnerscan you discuss the important
points in your own words without looking at your notes? You will remember your own
version of the information better than trying to memorize your lecturers version.
6. If you do not do well on the first exam, please contact your lecturer immediately to determine
how to improve your learning strategy.

Course evaluation
There will be three quizzes, seminar and clinical case presentations, and theory exams for each
semester, and the questions will focus on the learning objectives, students are expected to master
from material presented in the lectures and textbook.
The format of the examinations will typically include multiple-choice questions with one best
answer, short essay questions, and clinical cases.
Quiz 1 (in week 5) covers material from Lecture 1 through 4.
Quiz 2 (in week 9) covers material from Lecture 5 through 8.
Quiz 3 ( in week 13) covers material from Lecture 9 through 12.

Seminar and clinical case presentations (in weeks 15,16).


Final theory Exam (in week 17, 18) cover material from lecture 1 through 14.
Summative Evaluation and Grading
Final grades are based on grades earned for each of the 3 periodical quizzes, seminar and clinical
case presentations and final theory exam in each semester.
Distribution of the marks for these exams are as follow:
Quiz 1 (10 marks) 10% of final grade.
Quiz 2 (10 marks) 10% of final grade.
Quiz 3 (10 marks) 10% of final grade.
Seminar and clinical case presentations (20 marks) 20% of final grade.
Final theory exam (50 marks) 50% of final grade.
The Final End Year Evaluation and Grading will be the sum of:
First semester (40 %)
Second semester (50 %)
Final oral exam 10%.
Letter grades are based on the following final numeric grades:
A Excellent 90 100 (A+: 95%, A 90 %)
B Very Good 80 89 (B+: 85%, B: 80 %)
C Good 70 79 (C+: 75%, C: 70 %)
D Fair 60- 69 (D+: 65%, D: 60 %)
F Fail 59 and below

Course content:
Major Topics of the course:
A. Drugs acting on the cardiovascular system (10 hours).
B. Drugs acting on the central nervous system (11 hours).
C. Endocrine pharmacology (9 hours).
D. Chemotherapy (12 hours).

Detailed Contents:
First Semester
Week
No

Clinical case
discussion

Topic

A. Drugs acting on the cardiovascular system:


1

Notes

Hypertension

Hypertension and antihypertensive drugs


- Types and Grades of hypertension.
- Classes of hypertension
- Complications of hypertension
- Pathogenesis of hypertension
- Classification of antihypertensive drugs.
- Detailed study of antihypertensive drugs.
Hypertension and antihypertensive drugs
- Clinical Guidelines in treatment of hypertension.
- Hypertension in elderly people, and pregnant women.
Ischemic heart diseases and anti-ischemic drugs
- Blood supply of the heart
- Pathophysiology of ischemic heart diseases
- Types of ischemia
- Detailed study of anti-ischemic drugs.
- Clinical Guidelines in treatment of ischemic heart
diseases
Heart failure and drugs used in management
- Pathophysiology of heart failure
- Compensatory mechanisms and their failure.
- Factors affecting performance of the heart.
Heart failure and drugs used in management
- Classification and detailed study of drugs used for
treatment of heart failure.
- Clinical Guidelines in treatment of HF

Ischemic heart
diseases

Heart failure

Cardiac dysrhythmias and antiarrhythmic drugs


- Normal rhythm of the heart.
- Types of arrhythmias.
- Mechanisms of arrhythmogenesis
- Vaughan-Williams classification of antiarrhythmic
drugs.
Cardiac dysrhythmias and antiarrhythmic drugs
- Detailed study of antiarrhythmic drugs.
- Clinical Guidelines in treatment of cardiac arrhythmia.

Shock and ECG


for arrhythmia

First
periodic
exam
(10 marks)
(week 1week 4)

B. Drugs acting on the central nervous system:


8

Introduction
- Neurotransmitters in the brain, their anatomic
distribution, function and disorders resulting from
deficit or excess.

Epilepsy

Epilepsy and antiepileptic drugs


- Pathophysiology of epilepsy
- Types of epilepsy
- Detailed study of Antiepileptic drugs.
9

10

11

12

13

Second
periodic
exam
(10 marks)
(week 5week 8)

Anxiolytic sedatives and hypnotic drugs.


- Anxiety state
- Classification of antianxiety drugs.
- Detailed study of sedative-hypnotic drugs.

Psychopharmacology
- Types of psychosis
- Depression and antidepressant drugs
- Schizophrenia, mania and neuroleptic drugs.
- Lithium.
Parkinsonism and drugs used in management
- Pathophsiology of Parkinsonism
- Classification of antiparkinsonial drugs
- Optimization of L-dopa therapy.
Narcotic analgesics
- Pathophsiology of pain.
- Morphine receptors.
- Classification of narcotic analgesics.
- Detailed study of narcotic analgesics.
- Drug addiction, withdrawal syndrome and treatment
Nonsteroidal anti-inflammatory drugs and Gout
- The inflammatory response.
- Detailed study of NSAIDs.
- Pathogenesis of gout.
- Drugs used for treatment of gout.

10

Hallocinogens
and CNS
stimulants abuse

Drug abuse and


addiction

Third
periodic
exam
(10 marks)
(week 10week 12)

14

Anesthesia and anesthetic drugs


General anesthetics
- Classification of general anesthetics
- Mechanism of general anesthetic action.
- Detailed study of inhalation and IV general anesthetics.

Parkinsonism

Local anesthetics
- Modes of the sodium channels.
- Detailed study of local anesthetics
15, 16
17, 18

Seminar and Clinical Case Presentations


End First Term Theory Exam.

Second Semester
Week
No

Clinical case
discussion

Topic

A. Endocrine pharmacology:
1

Review of physiology of endocrine function.


Pituitary and hypothalamic hormones.
Diabetes insipidus
Thyroid, and antithyroid drugs

Parathyroid hormones.
Agents that affect bone mineral homeostasis.
Calcium homeostasis and treatment of osteoporosis.
Suprarenal cortical hormones and abnormalities
Corticosteroids: uses and adverse effects

- Pancreatic hormones
- Insulin
- Oral antidiabetic agents

Hypo-function
of pituitary gland

Hyper-function
of pituitary gland

Hypothyroidism

- Male Gonadal hormones and inhibitors.


- Female Gonadal hormones, inhibitors, and
contraception.
- Hormonal replacement therapy
- Male and female fertility drugs

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Notes

First
periodic
exam
(10 marks)
(week 1week 4)

B. Chemotherapy:

Hyperthyroidism

General principles of antimicrobial therapy and


resistance
Beta-lactam antibiotics
- penicillin, cephalosporines, cephamycins, monobactams

Protein synthesis inhibitors.


- Tetracycline, chloramphenicol, macrolides,
aminoglycosides.

10

DNA- gyrase inhibitors.


- Aminoglycosides and streptomycin
- Sulphonamides and sulphons.

11

- Treatment of tuberculosis and leprosy

12

13

14

15, 16
17, 18

DM Type I
Second
periodic
exam
(10 marks)
(week 5week 8)
DM Type II

Antiprotozoal drugs
- Antiamoebics , antileishmania , antitrypanisoma.
- Drugs for guirdiasis, trichmoniasis, and Plasmodium.
Anthelminthic agents.
- Parasitic nematodes
- Parasitic trematodes
- Parasitic cestodes
- Antiviral drugs.
- Antifungal drugs.

- Cancer chemotherapy and immunosuppressants

Hypo-function of
suprarenal gland

Third
periodic
exam
(10 marks)
(week 10week 12)
Hyper-function
of suprarenal
gland

Seminar and Clinical Case Presentations


Final Theory Exam.

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