Of the Course in Pharmacology for Medical Students

EXPLANATORY REMARKS OF SYLLABUS

of the course in Pharmacology for medical students,

Faculty of Medicine, MedicalUniversity of Sofia

1. Course of studies – 3rd year
2. Semesters (Terms) – 5th and 6th
3. Examination – the end of the 6th semester
4. Full course of lectures and seminars – 165 hours

Timetable of the lectures and seminars

Semesters (Terms) / Lectures / Seminars
V (15 weeks) / 45 hrs (3 hr weekly) / 45 hrs (3 hrs weekly)
VI (15 weeks) / 30 hrs (2 hr weekly) / 45 hrs (3 hrs weekly)
Altogether: 165 hrs / 75 hrs / 90 hrs

According to the plan of education of medical students in the University of Sofia, for the pharmacology are allocated 165 hours, during the 5th and 6th semesters (75 hr lectures and 90 hr seminars). The examination is at the end of the 6th semester. During the 5th semester the students have 3 hours both lectures and seminars each week, whereas during the 6th semester the lectures are 2 hours and seminars 3 hours weekly.

The lectures precede the seminars as a rule and they begin with the subjects of General pharmacology like pharmacokinetics, pharmacodynamics and the factors that modify the drug kinetics and actions.

The lectures are given by highly experienced and internationally educated teachers. For the first time in Medical University of Sofia as early as 1996 in the Department of Pharmacology started the process of computer demonstration of the lectures and some of the seminars, using the program PowerPoint in a Slide Show regime.

The subject of the lectures in Special pharmacology was selected in a way to promote both vertical and horizontal integration of the matter, studied in the other basic and clinical disciplines, and to facilitate its understanding by the students.

In the lectures and seminars is given special attention to the drugs used in the treatment of socially important disease, like atherosclerosis, arterial hypertension, thromboembolic diseases, infections (including AIDS), neoplastic diseases, psychoses, osteoporosis, diabetes mellitus, anaemias, gout, erectile dysfunction etc.

As a rule we name the drugs according to their International nonproprietary (generic) names, which facilitate the use of the acquired knowledge in any country of the world. During the course of pharmacology basically we stress on the pharmacodynamics of the drugs, their pharmacokinetics (bioavailability, binding to the blood proteins, plasma half-live, elimination out of body; therapeutic indications, mode of administration and interaction with other medicaments and food ingredients. Special attention is given to the expected undwanted reactions (including during pregnancy and lactation) and contraindications.

The last lectures include the basic drug interactions, the unwanted drug reactions and the acute poisonings and principles of antidotal therapy.

The lectures incorporate the full theoretical course of pharmacology, whereas the seminars – 95% of it.

During the weekly practical work and seminars the students study the drug forms, the principles of drug prescription, the basic problems of general pharmacology and almost all groups of drugs.

The experimental work consists of the next basic elements: a.) introductory test (up to 20 min) with marks /; b.) seminar (up to 60 min), evaluated in the range from 2 to 6 (where 2 is faile, and 6 is exellent); c.) demonstrations of drug preparations, video films, slides, etc. in a specially prepared room (up to 30 min); d.) resolve of prescription tasks (up to 30 min) with actually doing prescription. Most of the training practical work is with pharmacotherapeutic direction.

Each student is ask to prepare at the end of the both semesters a short report in written form (5 min), which is to be presented in seminar, discussed and evaluated by his colleagues and the assistant professor.

During the practical exercises the students prepare a protocol, in which they write the unit discussed, the classification of the drugs and the prescriptions that are done. As a part of the colloquium the assistant professor evaluates and signs the protocols written during the corresponding cycle.

If the student is absent from a given practical exercise or seminar, he is obliged to accomplish it in an extra time, after a written permission form the office of the Dean of the Medical Faculty. In such case the student have to prepare written report on the corresponding unit that was missed, with every part of the exercise (tables, literature etc.) and the prescription problems solved.

The conspectus for both theoretical and practical examinations incorporates basic units from prescription of the drugs and all problems of general and special pharmacology.

Every semester the students have two colloquia. They include: a.) prescription of all drug forms and problems of general pharmacology; b.) neurotropic drugs (without anaesthetics and analgesics); c.) cardiovascular drugs and drugs affecting blood; d.) antibacterial and antiparasitic drugs. The last three colloquia consist of solving tests, answering two theoretical questions and doing 810 prescriptions.

The examination in pharmacology includes solving of written test during 20 min, practical examination and theoretical examination. The students have 60 min for prepearing of both practical and theoretical examination. They are not allowed to leave the room during the each part of the examination.

The test includes problems from prescription, general and special pharmacology. Each question is marked with “X” (sign of positive answer). The test is evaluated according to 6 step system. If 60% of answers are correct, the mark is satisfactory (3).

The practical examination includes writing prescription tasks and short written argumentation for the selection of the drugs that were prescribed.

The theoretical examination is combined – both written and oral. It has three questions, one of which must be answer in written form, and the other two as short written plan that includes the classification of the drugs and writing the representative in Latin and/or in English language.

The final assessment of the examination consist of the average mark during the whole year (the marks of the colloquia are multiplied by two), the mark of the test, the mark of the practical examination, and the mark of the theoretical examination (multiplied by three). If the student failed on the test and the practical examination he is not entitled to continue on theoretical examination.

The individual choice of each student of the test, practical and theoretical questions as well as the examining commission is based on lottery principle. The commission consists of assistant professor and full or associate professor.

The examination starts at exactly 8 AM on the day determined by the Dean of the Medical Faculty. Five min prior the beginning of the examination the students are obliged to take their seats in the corresponding room.

Marked prescription order for the practical examination and paper for the theoretical examination are given to each student by the Department of Pharmacology.

The program of pharmacology, used in the Department of pharmacology in Medical University Sofia, is harmonized with the programs of the leading European universities.

EDUCATIONAL PLAN

of the lectures in pharmacology for medical students, 5th semester  3rd year

Week / Lectures
I. / 1. Object and branches of pharmacology. Relationships with other sciences. Historical review. Definition of drug. Stages in development of new drugs.
II. / 2. Transmembrane transport of drugs. General pharmacokinetics.
II. / 3. General pharmacodynamics.
III. / 4. Factors affecting the action and kinetics of the drugs. Peculiarities after multiple drug administration.
III. / 5. Cholinergic neurotransmission and mechanisms of its pharmacological modulation. Cholinomimetics (cholinergic agonists).
IV. / 6. M-cholinolytics (anticholinergic agents). Neuromuscular blocking agents. Muscle relaxants with central action.
V. / 7. Adrenergic neurotransmission and mechanisms of its pharmacological modulation. Adrenomimetics (adrenergic agonists).
V. / 8. Adrenolytics (adrenergic blocking agents).
VI. / 9. Histamine antagonists. Serotonin agonists and antiserotoninergic drugs. Drugs affecting renin-angiotensin-aldosterone system. Antimigraine drugs.
VII. / 10. Mechanisms of the neurotransmission in the central nervous system and its pharmacological modulation. Sedatives and Hypnotics.
VII. / 11. General and local anaesthetics.
VIII. / 12. Neuroleptics. Anxiolytics. Abuse of benzodiazepines – principles of the treatment.
IX. / 13. Antidepressants. Antimanic agents. Psychostimulants. Nootropic drugs.
IX. / 14. Anticonvulsants. Antiparkinsonic agents.
X. / 15. Opioid analgetics. Abuse of opioids – principles of the treatment.
XI. / 16. Nonsteroidal anti-inflammatory drugs and nonopioid analgesics.
XI. / 17. Antihypertensive drugs.
XII. / 18. Antianginal drugs. Antiarrythmic (antidysrrhythmic) drugs..
XIII. / 19. Antidyslipidemic drugs. Capillarotonic and venotonic drugs.
XIII. / 20. Calcium channel antagonists. Peripheral vasodilators.
XIV. / 21. Drugs for treatment of heart failure. Diuretics.
XV. / 22. Antihemorrhagics. Antithrombotics.
XV. / 23. Drugs affecting haemopoiesis. (1h)

EDUCATIONAL PLAN

of the seminars in pharmacology for medical students, 5th semester  3rd year

Week / Seminars
I. / 1. The object of pharmacology. Drogues. Drug – definition and names. Drug preparations. Pharmacopoeia. Prescription – construction and principles of order writing. Drug information.
II. / 2. Solid dosage forms. Semisolid dosage forms.
III. / 3. Liquid dosage forms. Air form formulations.
IV. / 4. Pharmacokinetics.
V. / 5. Pharmacodynamics. Factors affecting the action and kinetics of the drugs.
VI. / 6. Colloquium on drug prescription and general pharmacology.
VII. / 7. Cholinergic neurotransmission. Cholinomimetics (cholinergic agonists). Muscarinic cholinolytics. Neuromuscular blockers.
VIII. / 8. Adrenergic neurotransmission. Adrenomimetics (adrenergic agonists). Adrenolytics.
IX. / 9. Local anaesthetics. General anaesthetics. Hypnotics. Sedative drugs.
X. / 10. Neuroleptics. Anxiolytics.
XI. / 11. Antidepressants. Antimanic agents. Psychostimulants. Nootropic drugs.
XII. / 12. Antiepileptics. Antiparkinsonic agents.
XIII. / 13.Colloquium on neurotropic drugs (without analgesics and NSAIDs).
XIV. / 14. Opioid analgesics. Antihistaminic drugs.
XV. / 15. Nonsteroidal anti-inflammatory drugs and nonopioid analgesics.

EDUCATIONAL PLAN

ofr the lectures in pharmacology for medical students, 6th semester  3rd year

Week / Lectures
I. / 24. Antibiotics – classification. Beta-lactams.
II. / 25. Aminoglycosides. Tetracyclines. Amphenicols. Macrolides and ketolides. Lincosamines. Other antibiotics.
III. / 26. Sulfonamides. Antituberculosis drugs. Antileprosy drugs. Principles of the rational antibiotic therapy.
IV. / 27. Quinolones. Antiviral drugs.
V. / 28. Antifungal agents. Antiprotozoal drugs. Antihelmintic drugs.
VI. / 29. Drugs affecting respiratory system. Uteroactive drugs.
VII. / 30. Drugs affecting gastroinstestinal system.
VIII. / 31. Hypothalamic and hypophyseal hormones. Glucocorticoids. Mineralcorticoids.
IX. / 32. Thyreoactive drugs. Antidiabetic drugs. Antihypoglycemic drugs.
X. / 33. Central gonadoactive drugs. Estrogens and antiestrogens. Progestins. Hormonal contraceptives. Androgenes and antiandrogenes. Drugs affecting erectile dysfunction. Steroidal anabolics.
XI. / 34. Vitamins – clinical applications.. Drugs that influence calcium and phosphorous exchange. Antigout drugs.
XII. / 35. Antitumor agents. Immunomodulators.
XIII. / 36. Drug interactions.
XIV. / 37. Adverse drug reactions.
XV. / 38. Principles of antidotal therapy.

EDUCATIONAL PLAN

of the seminars in pharmacology for medical students, 6th semester  3rd year

Week / Seminars
I. / 16. Antihypertensive drugs. Peripheral vasodilators.
II. / 17. Antiarrythmics. Antianginal drugs.
III. / 18. Drugs for treatment of heart failure. Diuretics.
IV. / 19. Drugs acting on haemopoiesis and blood coagulation
V. / 20.Colloquium on drugs affecting cardiovascular function, haemopoiesis and blood coagulation.
VI. / 21. Beta-lactams.
VII. / 22. Aminoglycosides. Tetracyclines. Amphenicols. Macrolides and ketolides. Lincosamides. Glycopeptides.
VIII. / 23. Sulfonamides. Antimycobacterial drugs. Quinolones. Principles of the rational antibiotic therapy.
IX. / 24. Antiviral drugs. Antifungal agents. Antiprotozoal drugs and antihelmintic drugs.
X. / 25.Colloquium on antimicrobial drugs.
XI. / 26. Drugs affecting respiratory system. Utreoactive drugs.
XII. / 27. Drugs affecting gastroinstestinal system.
XIII. / 28. Hormonoactive drugs: thyreoactive drugs , antidiabetic drugs, glucocorticoides.
XIV. / 29. Antitumor agents. Immunomodulators.
XV. / 30. Drug interactions. Adverse drug reactions. Principles of antidote therapy.

RECOMMENDED LITERATURE

1. Boyadjieva, N. (editor). Basic and clinical pharmacology with toxicology. ARSO, Sofia, 2015.
2. Varadinova, M., Boyadjieva, N. Pharmacology and pharmacotherapy at a glance. ARSO, Sofia, 2015.
3. Katzung BG (еditor). Basic& Clinical Pharmacology. 13th Edition. The McGraw-Hill Companies, Inc. (Lange Medical Books), New York, 2015.
4. Rang, HP, Ritter, JM, Flower, RJ, Henderson, G (eds.). Pharmacology. 8th Edition. Elsevier, 2016.
5. Mycek, M. J., R. A. Harvey, and P. C. Champe (eds.). Pharmacology Lippincott’s Illustrated Reviews. Lippincott Williams & Wilkins, Philadelphia, 2015.
6. Tripathi KD. Essentials of Medical Pharmacology. 7th Edition. Jaypee Brothers. New Delhi, 2013.

Headof the department

"Pharmacology and Toxicology":

Assoc.prof. Dr. R. Nikolov, DM

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