Toxicology , Addiction Foundation of Manitoba

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1 PHRM , st Term Toxicology Credit hours: 3 Class hours Monday: 9:30 - :20 am (Apotex Centre, st floor LT # 64) Wednesday: 0:00 - :30 am (Apotex Centre, st floor LT #64) Friday: 9:30 - :20 am (Apotex Centre, st floor LT # 64) Course Coordinator: Dr. Silvia Alessi-Severini College of Pharmacy - Faculty of Health Sciences Apotex Centre Rm # 227 Voice: Silvia.Alessi-Severini@umanitoba.ca Office hours: Monday Friday, 9:00 am - 5:00 pm Course Contributors: Instructor Dr. Frank Burczynski Dr. Dennis Cote Dr. Sheri Fandrey Dr. Yuewen Gong Dr. Nick Honcharik Dr. Pat Honcharik Prof. Shirley Treacy Dr. Alberto Severini Mr. Jaden Brandt Ms Donica Janzen Contact Information , Pharmacy burczyn@cc.umanitoba.ca , Pharmacy cote2@cc.umanitoba.ca , Addiction Foundation of Manitoba sfandrey@afm.mb.ca , Pharmacy ygong@cc.umanitoba.ca , HSC Pharmacy nhoncharik@hsc.mb.ca , Pharmacy Department - Concordia Hospital phoncharik@wrha.mb.ca shirley.treacy@umanitoba.ca , National Microbiology Laboratory alberto.severini@phac-aspc.gc.ca Pharmacy, umbrand2@myumanitoba.ca Pharmacy, janzend6@myumanitoba.ca Dr. Silvia-Alessi Severini July 24, 207

2 Purpose of the course: This course provides Pharmacy students with basic toxicologic knowledge and concepts. The focus of the course is on the toxicology of prescription and non-prescription medications and drugs of abuse. Emphasis is given to the study of emergency treatment of the overdosed patient. Forensic aspects of common poisonings and drug overdoses are also discussed. Objectives: At the completion of this course, the student should be able to: apply basic concepts of toxicokinetics, toxicodynamics and medical management/treatment of drug toxicities; describe and identify important toxic responses in the body using an organ system and drug group/class approach; discuss and critique the relevant literature available for the assessment of toxicity of drug products; have an understanding of the medico-legal aspects of chemical substances on humans; be familiar and comfortable with the role of pharmacists in the prevention, diagnosis and treatment of poisonings. Background: Toxicology is a multi-disciplinary field that draws from a number of related medical disciplines such as biology, chemistry, anatomy, immunology, pathology, pharmacology, pharmacokinetics and physiology. It is assumed that each student has acquired a high level of competence in these fields and is prepared to apply this prior knowledge to achieve a comprehensive understanding of toxicology. It is the student s responsibility to review necessary sections of previous courses to supplement concepts discussed in class. Teaching and learning methods: The nature of this course is predominantly didactic; however, class participation is encouraged. Case studies are presented and discussed. Assessment: There will be a mid-term exam, a final exam and 2 take home assignments. Nature of the assignments will be discussed with the students on the first day of class (usually these assignments consist of a research paper on a toxicology topic of choice and Dr. Silvia-Alessi Severini July 24, 207 2

3 an exercise requiring drug metabolism calculations). Deadlines for submission will be negotiated between students and individual instructors; however, the paper is normally due one week after the end of classes and the drug metabolism exercise is due at the end of the third week of October). Exams will be comprised of both multiple-choice and written questions. Questions will follow a number of formats including short answers, calculations (where appropriate) and case studies. Mark Distribution: Midterm Examination 30% Final Examination 50% Assignments 20% (paper 5% - calculations 5%) Final Grades: 90% A % C % A 60-64% C 75-79% B % D 70-74% B < 50% F Please consult the University of Manitoba s Undergraduate Calendar for specific regulations regarding academic dishonesty, attendance, examinations and scholastic progress. All students are expected to attend class sessions unless previously excused. Recommended references: Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum NE. Goldfrank s Toxicologic Emergencies, 9 th edition, McGraw Hill, 20 Klaassen CD. Casarett & Doull s Toxicology The basic science of poisons, 8 th edition, McGraw Hill, 203 Olson KR, Poisoning & Drug Overdose, 6 th edition, McGraw Hill, 202 Shargel L, Wu-Pong S, Yu A. Applied biopharmaceutics & pharmacokinetics, 6 th edition, McGraw Hill 203 Section outlines and/or notes will also be provided when appropriate. Dr. Silvia-Alessi Severini July 24, 207 3

4 Meeting AFPC Educational Outcomes and NAPRA Competencies: Course Objectives At the completion of this course, the student should be able to:. apply basic concepts of toxicokinetics, toxicodynamics and medical management/treatment of drug toxicities 2. describe and identify important toxic responses in the body using an organ system and drug group/class approach 3. discuss and critique the relevant literature available for the assessment of toxicity of drug products 4. have an understanding of the medico-legacp3. aspects of chemical substances on humans SC3. 5. be familiar and comfortable with the role of pharmacists in the prevention, diagnosis and treatment of poisonings AFPC Educational Outcome (207) Achieved CP. CP.5 SC. SC.3 SC2.2 SC3. CP3. SC2.2 SC2.3 CP. PR2.2 CP. CP2. NAPRA Competency Achieved Learning Level (ICE Ideas, Connections, ) Performance Level (Novice, Functional, ) Connections Functional Dr. Silvia-Alessi Severini July 24, 207 4

5 Schedule: DATE # HOURS TOPIC INSTRUCTOR Sep 6 (W).5 hours Course Introduction/ general concepts Toxicokinetics/biotransformation Sep 8 (F) Toxicokinetics/biotrasformation 2 Management Principles/Toxidromes NH Sep (M) General methods for treating poisonings Acid/base abnormalities Sep 3 (W).5 Antineoplastic agents DC Sep 5 (F) Cardiac Glycosides Benzodiazepines Jaden Brandt Sep 8 (M) 2 Antiviral Agents AS Sep 20 (W).5 Antidepressant agents PH Sep 22 (F) 2 Acetaminophen Sep 25 (M) Salicylates Iron Sep 27 (W).5 Case discussions Sep 29 (F) 2 Drugs of abuse/toxic alcohols Oct 2 (M) 2 Midterm exam (0:00 :00) (room TBA) Oct 4 (W).5 Erythroxylum coca: why do things go better with FB Coke? Oct 6 (F) 2 Addictions and Pharmacist s Interventions SF Oct 9 (M) No lecture (Thanksgiving) Oct (W).5 Forensic toxicology - Overview ST Oct 3 (F) 2 Forensic aspects of drug abuse I ST Oct 6 (M) 2 Forensic aspects of drug abuse II ST Oct 8 (W).5 Forensic aspects of drug abuse III ST Oct 20 (F) 2 Medico-legal implications in common poisonings ST Oct 23 (M) Toxic responses of the liver Toxic responses of the kidney YG AH Oct 25 (W).5 Toxic responses of the eye and ear Oct 27 (F) 2 Toxic responses of the blood Donica Janzen Toxic responses of the skin Oct 30 (M) 2 Review Nov 2 2 Final exam 0:00 2:00 am Basement lecture theatre (07) Dr. Silvia-Alessi Severini July 24, 207 5