Syllabus of Pharmacology
Introduction
- The characteristics, goal and mission
Pharmacology is an essential course that contributes basic theory, elementary knowledge and scientific principals to diseases prevention and rational use of drug. It is also a double bridge that links medicine and pharmacy, basic medicine and clinical medicine. The scope of pharmacology involves function sciences (physiology, pathology, biochemistry and molecular biology), morphology (human anatomy, embryology, parasitology) and clinic (internal medicine, surgery, gynecology, pediatrics) and many other disciplines. Pharmacology is characterized by wide range of contents and profound theories, making it an indispensable course for medical and pharmaceutical research as well as clinical and production practice. The goal of pharmacology includes: 1) to clarify the action of drug and underlying mechanism, support rational use of drug, maximization of drug effect and avoidance from adverse effect; 2)to develop new drug and novel purpose of existing drug; 3) to provide supports and methods for other life science researches.
- Basic requirements for teaching
1)Pharmacology theory
The theory of pharmacology has its vertical extent and connections with other parallel disciplines. Learning of pharmacology theory should be on the basis of knowledge on physiology, biochemistry, microbiology, immunology, physiopathology, etc. Its close relationship with clinical practice extends the width and depth of pharmacology.
The goal of teaching includes:
Deliver basic theory and principals;
Discover new drug and explore cell physiological, biochemical and pathological process;
Introduce the latest progress and basic research ideas and means;
Initiate scientific way of thinking, in terms of drug usage and basic pharmacology research.
2)Pharmacology experiment
Pharmacology is an experimental science, of which the theory is obtained from the experimental studies, including nonclinical and clinical study. It is the experimental studies that accumulate the rich content of pharmacology, and promote the development of modern pharmacology. This is why experiments represent a critical role in pharmacology teaching. To improve the teaching effect, we modified and rearranged traditional pharmacology experiments to a new set of experiments ranging from micro to macro, from qualitative to quantitative, from system organ to cellular and molecular level that reflects modern developments. New research means and results and new concepts and theories are incorporated in these experiments. The students are trained to apply knowledge to practice during the designing, independent conducting, analyzing and discussing of the experiments. In the experiments, we encourage students to think independently, design the experiments themselves and put thinking into practice. That enables students to integrate what they learned in the classroom with practice, and achieved desirable results.
3. Schedule and content
The teaching schedule is set to accommodate the actual situation of our college. There are 2 portions:
1) Basic pharmacology is scheduled on fourth grade or fifth grade. A total of 90 classes are taught by faculty of pharmacology department. The content includes general pharmacology, efferent system pharmacology, central nervous system pharmacology, cardiovascular pharmacology, internal organs and hormone systems pharmacology and pharmacology of chemotherapeutic drugs, etc. General introduction covers the general principles of pharmacology, including pharmacodynamics, pharmacokinetics and drug interaction. For each organ systems, the pharmacodynamic (such as the pharmacological effects of drugs, drug action mechanisms, drug clinical use and adverse reactions) and pharmacokinetic (in vivo drug processes) characteristics of drugs are detailed.
2) Clinical pharmacology is scheduled on seventh grade. The textbook and the lectures are presented by PUMCH department of clinical pharmacology. 90 classes are divided into 70 classes of theory (6 lectures) and 20 classes of experiments, except for 2 classes of examination.
4. Teaching method and characteristics
Theories:
1) Lecture. Various teaching methods are furnished in pharmacology lectures. Multimedia courseware in aid of blackboard is the common way of teaching. Animations are also used to illustrate the mechanism of drugs, making the abstracts lively and easy to understand.
2) “Problem based learning” (PBL) mode. The core of PBL is group discussion, with a typical group of 25 students. The teacher will give a case briefing and then a question is forwarded. The students will speak in turn to address the question. At the present stage, all PBL class are hosted by professors and the topic of PBL class circles antibiotics and endocrine system drugs. The key of PBL teaching is steering the discussion, thus a successful PBL class calls for more preparation work.
3) English-Chinese teaching. For Eight-year medical students, the lectures are given in English, with Chinese annotations on key points. PPTs are present in English (or mainly in English with Chinese annotations on medical vocabulary). Experiments are taught in English. The experience of English-Chinese teaching indicate a positive effect that can be enhanced by perseverance.
Experiments:
1)Comprehensive experiments, which include:
Experimental skills training, including commonly used functional and versatile experimental technique and skills, and traditional physiology, pathophysiology and pharmacological experiments (e.g., receptor dynamics and pharmacokinetics experiments).
Integrated function experiments, in which a combination of normal function measurements, physiological stimulates assessments, pathological model preparation and drug effect evaluations, are performed.
Enlightenment experiment, specifically, receptor binding assay and Adenylate cyclase activity assay. These 2 experiments are designated to train medical students scientific literacy and molecular pharmacology research methods, especially on receptor theory. Enlightenment experiments need 6 to 8 classes to complete.
2)Exploratory experiment. The students will choose a subject and design the protocol by themselves under directions of teacher. A summary report should be prepared after study execution and data analysis. The subject should be intermediate in difficulty and duration.
3)Scientific research practice. For higher grade students, the faculty can admit 1-2 students for scientific research practice. We believe that scientific research practice is helpful in making a doctor to be a medical researcher. Through participation in research activities, not only a student’s thinking skills and practice experience is added, but also knowledge, sense of innovation and motivation of a student is activated.
The experiment and practice program list above in all will advantage the teaching of pharmacology. The students will benefit from these programs in aspects of self learning capacity and problem-resolving ability. A comprehensive training of designing, executing and analyzing cultivate the student’s awareness of integrating theory with practice and a scientific attitude of seeking truth from facts.
5. Textbook and reference
1)Yang baofeng. Pharmacology, 6th Edition. People’s medical publishing house, 2003.
2)Xu shuyun. Clinical Pharmacology, 3rd Edition. People’s medical publishing house, 2004.
3)Yang shijie. Pharmacology, 1st Edition. People’s medical publishing house, 2001.
4)Hardman JG, Limbird LE. Goodman &Gilman’s .The Pharmacological Basis of Therapeutics, Tenth edition, USA: McGraw-Hill Company,New York, 2001.
5)In-house teaching materials of pharmacology experiments.
Chapter1 introduction of pharmacology
1.Purpose
Understand the pharmacology disciplines, the development history of pharmacology. Understand the pharmacology study object, study method and mission in medicine and medical research status, grasp the basic rules of the pharmacological effects.
2. hours: 2 hours
3. Teaching content：
(1)overview of pharmacology：outline of pharmacology development
(2)The significance of pharmacology：The content of basic pharmacology (3)receptor：outline of receptor development，essential conception of receptor (4) drug label（chemical name，common name，trade mark）
(5)research methods in pharmacology
(6)drug discovery and clinical drug evaluation
(7) The new drug definition and classification
(8)The main approaches and find new drug evaluation of basic requirements (principle and content )
(9) preclinical evaluation： Including pharmacokinetic and pharmacodynamic and toxicology research
(10)clinical drug evaluation：including phase1，2，3 trials
(11)factors affecting drug effects and principles of rational using drugs
Chapter2 pharmacodynamics
1.Purpose
Understand the basic function, drug dependent, structureactivity relationship, drug treatment principle and scope, safety and index poison effect.
2. hours: 2 hours
3. Teaching content：
(1) The basic function of drugs,：changes in the level of organ function and the reform of the humoral ingredients.
(2)The basic rules of the drug：selectivity，dose-effect relationship of drug，dose，LDso，ED50，therapeutic index,adverse reaction
(3) The principle of drugs, the second messenger ，receptors, information across the membrane
Chapter3pharmacokinetics
1 purpose：
Grasp the relation between Transmembrane transpor and process of drug in the body.grasp the conception of Bioavailability,compartment，apparent volum of distribution，pharmacodynamics ,plasma drug concentration and Half-life
2.Hhours: 2 hours
3. Teaching content：
(1)Transmembrane transport
(2) Process of drug in the body
(3)Absorption： Bioavailability，first-pass effect
(4)Distribution，drug-plasma protein binding，organ blood flow Barriers,apparent volume of distribution
(5)Excretion：renal excretion,biliary excretion
(6)Biotransformation,enzymes involved in drug biotransformation
(7) Plasma drug concentration and Half-life
(8)First-order rate process,Zero-order rate process
Chapter 4 General of autonomic drugs
- Purpose:
Grasp the classification of theautonomic drugs pharmacology; the main transmitters and receptors’ classification, type, distribution; autonomic transmitters’ synthesis, transport, reserve, release and metabolism.
- Credits：2 credit hours
- Content：
(1)Classify autonomic nerve by transmitter and describe their physiological function; the biosynthesis, storage, release and metabolism of adnephrin and acetylcholine.
(2)Classify autonomic nerve system by transmitter receptor; the distribution and function of α- and β-adrenoreceptor, M and N cholinergic receptor and other receptors.
(3)The General action principle of autonomic nerve system drugs: influence on the receptor directly or influence on the biosynthesis, transport and storage of the transmitter.
Chapter 5 Cholinomimetic drugs
- Purpose:
Grasp the conception and classification of the choline receptor agonists; understand the N-like and M-like function of acetylcholine. Grasp the pharmacological action, clinical application and adverse reaction of carpiline and neostigmine.
- Credits：0.7 credit hours
- Content：
(1)Conception and classification of the choline receptor agonists.
(2)N-like and M-like function of acetylcholine
(3)The M-like function (ocular function) induced by pilocarpine
(4)Anti-cholinesterase drugs’ pharmacological action, in vivo process, characteristics and clinical application of physostigmine and neostigmine
Chapter 6 Organophosphate poisoning and cholinesterase drugs
- Purpose:
Understand the principle, symptom, prevention and cure of organophosphate poisoning; Grasp the mechanism of action and clinical application of alexipharmic
- Credits：0.7 credit hours
- Content：
(1)The mechanism of the inhibition of cholinesterase induced by organophosphate; the appearance of acute poisoning, N-like and M-like function, the symptom of central nerve, the treatment of acute poisoning, the function and application of atropine.
(2)Cholinesterase drugs: the mechanism of the resurrection of Cholinesterase induced by pralidoxime iodide, and synergy and adverse rection of atropine.
Chapter 7 Anticholinergic agents aimed on M-Cholinergic receptor
- Purpose:
Grasp the characteristics, action and adverse reaction of atropine, anisodamine, hyoscine.
- Credits：2 credit hours
- Content：
(1)Atropine’s competitive blocking function on M-Cholinergic receptor, and its function characteristics, clinical application, adverse reaction, toxic symptom and rescue principle.
(2)Anisodamine, hyoscine’s function characteristics on central and periph, clinical application and the comparison of them and atropine.
Chapter 8 Anticholinergic agents aimed on N-Cholinergic receptor
- Purpose:
Understand the ganglion (N1 and N2 receptor) blockers’ pharmacological function and clinical application. Grasp the two major kinds of anticholinergic agents aimed on N2-Cholinergic receptor (skeletal muscle relaxant).
- Credits：0.6 credit hours
- Content：
(1)Ganglion blockers selective block the N-receptor. The characteristics, use, major adverse reaction and contraindication of mecamylamine.
(2)Skeletal muscle relaxant’s effect on N2-receptor, the different mode of action between of the non-depolarizing muscular relaxants and depolarizing muscular relaxants and their characteristics, drug interaction and application.
(3)Celocaine’s action characteristics, in vivo process, clinical application and adverse rections
Chapter 9 Adrenomimetic
- Purpose:
Grasp the conception and classification of the adrenergic receptor agonists. Understand the mechanism and pharmacological function of drug active αreceptor, β1 receptor and β2 receptor. Grasp adrenalin, noradrenalin and isoprenalin’s function, application, adverse reactions and contraindication. Understand the action characteristics and application of dopamine, ephedrine, Alamin, between hydroxylamine and dobutamine.
- Credits：0.7 credit hours
- Content：
(1)The chemical structure and SAP of Adrenomimetic.
(2)Noradrenalin: the absorption of different DDS, the main elimination ways, the effect of MAO and COMT in the metabolism of CA. the major targets of noradrenalin are αand β1 receptors. Its effect on cardiovascular system and clinical application, adverse reaction and prevention and cure.
(3)Adrenalin: Active α and β receptors. Its pharmacological function, clinical application, side effects and contraindication. Grasp drenalin, noradrenalin and isoprenalin’s pharmacological function, reaction, adverse reaction and contraindication.
(4)Isoprenalin: Active β1 and β2 receptors
(5)Familiar with Inter-hydroxylamine, dopamine, ephedrine, phenol D-dopa’s function characteristics and application.
Chapter 10 Adrenoreceptor antagonist
- Purpose:
Understand the blocking function on αand βreceptor, and the classification, characteristics and Pharmacological action ofαand βreceptor antagonist.
- Credits：0.7 credit hours
- Content：
Grasp the function mechanism, clinical meaning, action and use of adrenoreceptor antagonist phentolamine, phenol cumming and tolazoline.
Chapter 11 Local Anesthetics
1. The purpose of requirements:：
Grasp the pharmacological action, mechanism of action and clinical application of local anesthetics
2.Hours: 0.5 hours
3. Teaching content：
(1)Essential conception of Local Anesthetics，Fashion of Local Anesthetics action，Mechanism of Local Anesthetics action。
(2) Understant the fashion of Local Anesthetics action:surface anesthesia、infiltration anesthesia，conduction anesthesia，subarachnoidal，epidural anesthesia.
(3)Grasp the pharmacokinetic characteristics of Local Anesthetics such as procaine、tetracaine、lidocaine
Chapter12 Introduction of Central nervous system（CNS）Pharmacology
1.Objective and Requirements
Master the classification of CNS drugs and their mechanism of action.
2.Hours: 2 hours
3.Teaching Content:
(1)From the point view of anatomy,biochemistry and physiology of CNS to comprehend its transmitter , β receptor as well as its characteristics of pharmacological effects.
(2)Main function of CNS.
(3)Transmitter and receptor of CNS.
(4)Pharmacological Characteristics of CNS.
(5)The Classification of CNS by mechanism of action.
Chapter 13 General Anesthetics
1.Objective and Requirements
To master clinical indicators of narcotic phasesand their physiological basis, the commonly used pharmacology of general anesthetics, the principle and effect of combined anesthesia medication and herbal anaesthesia.
2.Hours: 1.5 hours
3.Teaching Content:
(1)Concept of general anesthetics. The clinical indicators and pharmacological basis of phases of general anesthesia.
(2)Pharmacological characteristics of commonly used inhalationanaesthetics such as ether, halothane and nitrous oxide: the role of strength, induction period, recovery period,advantages, disadvantages and safety.Concept of minimum effective alveolar gas concentration.The pharmacological action and clinical application of commonly used intravenous anesthetics such as thiopental, ketamine, Sodium Oxybate etc.
(3)Concept of combined anesthesia:preanesthetic medication,induction of anaesthesia, basal anesthesia, dissociation anesthesia, neuroleptanalgesia, hypothermic anesthesia, muscle relaxant and the principle of herbal anaesthesia.
Chapter 14Antianxietics & Sedative Hypnotics
- Objective and Requirements
Comprehend the drug metabolism feature of benzodiazepine (BZDP), Master the BZDP and barbiturates drugs from their mechanism of action, clinical application and adverse reaction. Comprehend the effective feature of other sedative hypnotics.
- Hours: 2 hours
- Teaching Content:
(1)Concept of sedative hypnotics.Compare the similarities and differences which between pharmacological sleep and physiological sleep.
(2)Drug metabolism feature of BZDP: drugs action of site and mechanism, and tolerance, addiction and other adverse reaction of drugs such as apauvin, chlordiazepoxide, estazolam etc.
(3)Barbiturates: pharmacokinetic characteristics of drugs such as agrypnal, amobarbital,secobarbital and penthiobarbital sodium and their mechanism of drug action and clinical application.
(4)Other sedative hypnotics feature of action
Chapter 15 Antiepileptic & Anticonvulsant Drug
- Objective and Requirements
Comprehend the classification of epilepsia and its etiopathogenesis,
Master the pharmacological action of diphenylhydantoin sodium and drug’s anti-epileptic mechanism, the pharmacological action of ethosuximide, magnesium sulfate,carbamazepine and BZDP , and their use and adverse reaction.
- Hours: 1.5 hours
- Teaching Content:
(1)Classification of epilepsia.
(2)Mechanism of action and clinical application of antiepileptic, and adverse reaction and therapeutic principle.
(3)Barbiturates & BZDP: the relationship of antiepileptic effect with Brain Stem ascending reticular activation system and brain GABA. The feature of barbital barbitone, apauvin, desoxyphenobarbital(PPM).
(4)Hydantoins: thepharmacological action and adverse reaction of diphenylhydantoin sodium.
(5)Succinimide:the pharmacological action and adverse reaction of ethosuximide (ES).
(6)Others: mechanism of action and clinical application of valproate sodium，apauvin and arbamazepine.
(7)Anticonvulsant: anticonvulsant effect and clinical application of magnesium sulfate.
Chapter 16 Anti-Parkinson Drug
- Objective and Requirements
Master pharmacological action, clinical application, adverse reaction of anti-parkinsonism drugs.
Comprehend the application of anticholine drugs treating Parkinson's disease.
Comprehend the pharmacology basis of anti-Parkinson's disease combined medication.
- Hours:1.5 hours
- Teaching Content:
(1)Pathological change and clinical situation of Parkinson's disease.
(2)Larodopa(L-dopa,LD): mechanism of action, pharmacological action and clinical application.
(3)Anticholine drugs: the therapy effect and principle of Parkinson's disease and its adverse reaction.
(4)Other: the feature of drug action of Bromocriptine (Brc.) and adamantanamine (AM).