GOALS The MHAM College of Medicine Inc, Inc. offers the medical program leading to a degree of Doctor whose graduates are:

Transcription

1 Southwestern University - Matias H. Aznar Memorial College of Medicine Inc. Redemptorist Plaza, Camputhaw Cebu City VISION SWU-MHAM College of Medicine is a leading medical institution, anchored in excellence, committed to produce globally competitive medical professionals, imbued with knowledge in research and community service. MISSION Provide state-of-the-art facilities; Nurture a community of competent medical experts in all fields of specialization; Strengthen a research- and evidenced-based learning; To use information technology approach to teaching; To enhance learning core competencies and training; Strengthen the practice of community-oriented and universally-accepted health care; To forge linkages/partnership with government and non-government agencies in the service of the community; To provide opportunities for a medical career to economically challenged but deserving students; To produce competent, compassionate, and committed physicians; 1

2 GOALS The MHAM College of Medicine Inc, Inc. offers the medical program leading to a degree of Doctor whose graduates are: Trained in highest scientific and ethical standards of medical education Responsive to the current health needs of the people in the community and globally Updated with the latest therapeutic modalities and health related technologies Proficient in the conduct of globally competitive medical research which is attuned to the prevailing health conditions in the community In pursuit of lifelong disposition of professional advancement and learning 2

3 Southwestern University - Matias H. Aznar Memorial College of Medicine Inc. Redemptorist Plaza, Camputhaw Cebu City CORE VALUES PROFESSIONALISM We observe a polite behaviour and courteousness; adhere to a high sense of ethical standards in the performance of our duties and responsibilities in the work place. RESPECT We act with deep admiration, giving due regards and high esteem to everyone. ONENESS We stand united in all our endeavours and uphold the good name, honour and integrity of the institution. LEADERSHIP We act as role model, do things that will work best in the institution and provide policy directions that are relevant to the needs of the time in order to fulfill our ultimate goals INTEGRITY We adhere to the highest ethical code of conduct in our dealings with others and exercise our duties and responsibilities with correlative obligation to preserve human dignity. FAIRNESS We are impartial, reasonable, transparent and free from discrimination in the performance of our duties and responsibilities. EXCELLENCE 3

4 We pursue the highest standard of quality service in all program of engagements and undertakings for the attainment of the Vision and Mission of the institution Southwestern University - Matias H. Aznar Memorial College of Medicine Inc. Redemptorist Plaza, Camputhaw Cebu City Institutional Outcome A graduate of SWU-MHAM CM is expected to be a : Proficient Physician who adheres to the highest ethical conduct in the care of patients, seasoned with and analytical Program Outcome Upon completion of the MD program the graduate should be able to : Demonstrate capability in the diagnosis and treatment of health conditions of people without discrimination with respect to their nationality, race, socio-economic status, gender, culture, beliefs and creed. (CHED 1,2,8,9,10) (SWU-MHAM Core Values 2, 6, 7) Course Outcome Upon Completion of Basic medical sciences. () The student should be able to; Demonstrate competency and effective in discussing and explaining the following : The basic principle of Medical The standard classification of drugs based on intentionally accepted nomenclature. The basic principles of the different pharmacologic disciplines The principles of therapeutics, drug action and interactions. (CHED 1,2) SWU MHAM 2,6,7 4

5 Leader who has exemplary moral values which are deeply anchored in his/her religious convictions and work best for the betterment of the community Manager who has a good working relationship with people coming from different sectors in the community Researcher who can engage in innovative research activities and utilize research findings in improvement of health care delivery. Leads and manage health care teams in the community through utilization of an interdisciplinary approach, health information dissemination and adherence to ethical, professional, legal, national and international standards in the delivery of health care (CHED 3,5,8,9,10) SWU-MHAM Core Values 1,4,5,6 Initiate planning, organizing, implementation and evaluation of healthcare programs using systembased approach, and observes the principles of social accountability. (CHED 5,6,7,10) (SWU-MHAM Core Values 1, 5) Adhere to the ethical standards in the conduct of research; communicate research findings and apply these findings to improve health care delivery. (CHED 2,4,6,8) (SWU-MHAM Core Values 1,5) Effectively and Efficiently work with other health professionals especially in Collaborating in PharmacoTherapeutic teams, community awareness forums and research projects (CHED 2,3,5,8,9,10) (SWU MHAM 1,4,5,6) Initiate Planning and Organizing a symposium Research forum Review Committee for Essential Drugs Community information awareness regarding the use and abuse of drugs, and alternative medicine. (CHED 5,6,9,10 (SWU MHAM 1,5) Utilizes research in Investigating the various endogenous medicinal plants, their active compounds, action, mechanisms and effects Correlating the concepts and principles of Rational Drug use and Evidence Base pharmaco therapeutics in a clinical 5

6 Setting (CHED 4,6,8)(SWU-MHAM 1,5) Teacher who has deep dedication and passion to transfer knowledge and ; and include values in the molding of medical professionals. Engage oneself and inspire others to continue personal and professional development (CHED 7) (SWU MHAM M Core Values 1) Facilitate a small group Convey clear and relevant information In written and oral on focused topics, case studies utilizing different types of audiovisual to resources to their faculty and to their fellow students To patients regarding a content and instructions in a written prescription (CHED 2) (SWU MHAM 1) Update oneself by regularly attending pharmacology and Toxicology symposium, research forum, Drug symposium and be able to apply such knowledge for his/her professional advancement in order to educate patients and deliver quality healthcare. (CHED 7) (SWU MHAM 1) 6

7 Nationalist who instills to the community and country Demonstrate love for one s countrymen, national heritage and culture (CHED 9) (SWU-MHAM Core Values 3) Demonstrate a love of Filipino heritage by: Promoting our natural plants that have medicinal potential Exhibiting an attitude of service to our community (CHED 9,10)(SWU-MHAM 3) Adhere to national, international and legal standards in regulation of drugs (CHED 9,) (SWU-MHAM 3) 7

8 Southwestern University - Matias H. Aznar Memorial College of Medicine Inc. Redemptorist Plaza, Camputhaw Cebu City SYLLABUS IN PHARMACOLOGY AND TOXICOLOGY MEDICINE -2 ND YEAR I. Course Title: and Toxicology II. III. Course Description: This course deals with the drugs and their mechanisms of action discussed at the cellular and molecular level It also deals with proper identification and fundamental principles of action mechanisms relating to the different branches such as pharmacognosy, pharmacokinetics, pharmacodynamics, pharmacotherapeutics, posology, toxicology, pharmacogenetics, teratogenic pharmacology, and pharmacovigilance. Additionally, the students will be trained to comprehend the subject with the end view of motivating them to explore vast and interesting field of pharmacology. Unit Credits 16 Units (8 units per semester) 7 hours per week IV. Venue Audio visual room 2 and 3 V VI Entry Competencies Medical Students should have prior knowledge in Human Anatomy, Medical Physiology and Biochemistry Learning Outcomes: Following the Outcome based curriculum, and Toxicology will be geared Towards making second year medical student achieve the following learning outcome 8

9 Learning outcomes Level of Emphasis 1. Demonstrate clinical competence Demonstrated 2. Communicate effectively Practiced 3. Lead and manage health care teams Practiced 4. Engage in Research Activities Practiced 5. Collaborate within inter-professional teams Introduced 6. Utilized systems based approached to healthcare Introduced 7. Engage in continuing personal and professional Practiced development 8. Adhere to ethical,professional and legal standards Practiced 9. Demonstrate nationalism, internationalism and dedication Practiced to service 10. Practice the principles of social accountability Introduced VII. Course Objectives : Students who have completed this course should be able to: 1. Demonstrate competency and effective in discussing and explaining the following : 1.1 The basic principle of Medical 1.2 The standard classification of drugs based on intentionally accepted nomenclature. 1.3 The basic principles of the different pharmacologic disciplines such as: pharmacokinetics, pharmacodynamics, Pharmacotherapuetics and toxicology 1.4 The principles of drug action and interactions. 9

10 2. Convey clear information 2.1. In written and oral on focused topics, case studies utilizing different types of audiovisual to resources to their faculty and to their fellow students 2.2. To patients regarding a content and instructions in a written prescription 3. Initiate Planning and Organizing a 3.1 symposium 3.2 Research forum 4. Utilizes research in 4.1 Investigating the various endogenous medicinal plants, their active compounds, action, mechanisms and effects 4.2 Correlating the concepts and principles of Rational Drug use and Evidence Base pharmacotherapeutics in a clinical Setting 5. Effectively and Efficiently work with other health professionals especially in Collaborating in research projects 6. Update oneself by attending 6.1 A pharmacology and Toxicology symposium 6.2 A research forum 6.3 Drug symposium 7. Adhere to national, international and legal standards in regulation of drugs 8. Demonstrate a love of Filipino heritage by: 8.1 Promoting our natural plants that have medicinal potential 8.2 Exhibiting an attitude of service to our community 9. Practice the principles and relevance of RATIONAL DRUG USE in the delivery of health care to the patient and to the community 10. Practiced the principles of social accountability by monitoring and reporting adverse effects and toxicity of drugs 10

11 At the end of the grading period, the student should be able to: 1.1. Explain the development of pharmacology as a science Discuss what is pharmacology, the subdivisions of pharmacology and the disciplines that interface with it. UNIT I INTRODUCTION OF PHARMACOLOGY 1. History of pharmacology - The disciplines of pharmacology 3.5 hours -s -Basic and -Clinical -oral recitation -unit examination -Short essays -Posttest MCQ, 2.1. Explain and describe the physical processes underlying drug kinetics Discuss the four mechanisms by which small molecules (drugs) cross cell membranes Analyze the process of binding of drugs to plasma proteins Explain the effect of fats and other tissues on the accumulation of drugs Discuss the process of drug absorption according to the: Major routes of drug 2.Pharmacokinetic of Drugs a. Routes of administration b. Different Pharmacokinetic Processes -absorption -protein binding -distribution c. Routes of drug 3.5 hrs -s -Basic and -Clinical -oral recitation -unit examination -Short essays -Posttest MCQ, 11

12 administration Explain the different factors affecting absorption through gastrointestinal tract and other routes Analyze concepts of bioavailability and bioequivalence Discuss the distribution of drugs in the body: Explain the four body fluid Compartments and the concept of Bloodbrain-barrier Discuss the concept of volume of distribution Explain the special drug delivery systems Explain the concept of first-pass (pre-systemic) metabolism 2.9. Discuss Biliary excretion and enterohepatic recirculation. administration d.bioavailability e. bioequivalence f. Half Life g.enterohepatic recycling h, Kinetics of drug absorption i..volume of Distribution j. Drug clearance k. Special drug delivery systems. -s -Basic and -Clinical quizzes -oral recitation -unit examination -short essy Posttest MCQ, 3.0. Estimate the half life of a drug based on it s clearance and volume of Quizez on analytical 12

13 distribution 3.1 Solve a case in patients with impaired renal or liver requiring dosage adjustment. -Basic and -Clinical problem solving problem-solving assessment tools ( 4.1. Discuss the process of drug metabolism according to: The two kinds of reactions (Phase 1 and Phase 2) The concept pf stereo-selectivity 4.2. Explain the mechanism by which drugs inhibit the P450 enzymes or increase the activity of microsomal enzymes and oxygenating systems (induction) and identify the drugs that are inducers and inhibitors 4.3. Recognize and list the drugs that are affected by inducers and inhibitors 4.4. Predict the effect on drugs that are affected by an inducers or by an inhibitor 4.4. Present clinical cases of drug induction, drug inhibition and drug excretion 3. Biotransformation and Drug Excretion a. Type of drug metabolic reactions - PHASE 1 reactions - PHASE 2reactions b. Drug metabolizing enzyme system - Inducers - Inhibitors 3.5 hours -s -Basic and -Clinical -oral recitation -unit examination Posttest MCQ, 13

14 4.5. Explain the process of drug and metabolite excretion: Discuss Renal excretion of drugs and metabolites. 4.6.Correlate clinical cases of drug overdose with renal clearance c. Renal excretion of drugs - Factors affecting the renal excretion of drugs -renal clearance of basic drugs -renal clearance of acidic drugs 5.1. Explain the four protein targets for drug action receptors, ion-channels, enzyme and transport proteins Discuss and differentiate among the four types of receptors according to location, effectors, and molecular structure. 5.3.Classify drugs according to it s receptor type 5.4.Explain the control of receptor expression Present clinical diseases linked to receptor malfunction. 5. Receptors a.ligand gated / ion channel receptors b.g- protein coupled receptors c.tyrosine kinase linked receptors d.intranuclear / steroid receptors e.ppar receptors f. Receptor downregulation g. Receptor upregulation 3.5 hrs -Interactive -Basic and -Clinical -Netters illustrated -oral recitation -Posttest MCQ -minute paper 14

15 6.1. Review basic genetic concept Explain the mechanism by which genetic variations may cause adverse drug reaction and idiosyncratic reactions 6.3. Discuss and give examples of singlegene pharmacokinetic disorders Discuss the potential benefits of Pharmacogenetics. 6. Clinical a.pharmacogenetics - genetic variations for drug reactions, idiosyncratic reactions -single gene pharmacokinetic disorders 3.5 hours Small group Rang and Dales -Netters Illustrated graded oral Posttest MCQ, 6.5. Explain the potential benefits of pharmacogenomics 6.5. Evaluate currently available pharmacogenomic tests and their potential benefits. 6.4 Review and critique research paper on pharmacogenomics 6.6. Present a case of genetic variations b. pharmacogenomics, and personalized medicine -Interactive Rang and Dales -Netters Illustrated graded oral -long exam MCQ 15

16 1.1. Review and identify the locations and types of acetylcholine receptors in the major organ systems (CNS, autonomic ganglia, eye, heart, vessels, bronchi, gut, genitourinary tract, skeletal muscle, exocrine glands) Describe the effects of acetylcholine on the major organs. 1.3 Classify the different Cholinergic Agonist 1.3. Relate the different pharmacokinetic properties of the various choline esters, cholinesterase inhibitors and cholinomimetic alkaloids to their chemical properties and pharmacokinetic profile Explain in detail the mechanism of action of cholinomimetic / cholinergic agonist 1.5 Analyze the pharmacologic differences of direct acting and indirectly acting cholinomimetic agents 1.4. Recognize naturally occurring UNIT II DRUGS ACTING ON THE AUTONOMIC NERVOUS SYSTEM 1. Cholinergic agonist / a. Cholinoceptor Activating drugs -direct acting cholinergic agonist - choline esters - naturally occurring Alkaloids -indirectly acting -Choline esterase inhibiting -reversible -irreversible 3.5 hours -Interactive -Interactive ) 5. Netter s Illustrated 2. Rang and Dale -oral recitation -unit examination -Posttest MCQ, -Posttest MCQ, 16

17 alkaloids and their botanical sources 1.4. Discuss the major clinical uses of cholinomimetic agonists Differentiate the pharmacodynamic of direct-acting and indirect-acting cholinomimetic agents Recognize the major signs and symptoms of (1) organophosphate insecticide poisoning and (2) acute nicotine toxicity. 1.8.Research and Present local cases of organophosphate /insecticide poisoning 1.7 Formulate a management plan in the treatment of organophosphate insecticide poisoning and give the rationale for such treatment 1.8 Dessiminate information to communities on organophosphate/insecticide poisoning c. Organophosphate poisoning -insecticides -agents use in Chemical Warfare 5. Netter s Illustrated 17

18 2.1 Discuss the mechanism of action of antimuscarinics 2.2 Explain effects of atropine on the major organ system 2.3. Identify the major clinical indications and contraindications for the use of muscarinic antagonists 2.4.Recognize naturally occurring antimuscarinic agents and their botanical sources 2.4. Classify the different muscarininc agent promoted for each uses : to produce mydriasis cycloplegia, to treat parkinsons, peptic ulcer and asthma 2.6. Describe the signs,symptoms and treatmernt of atropine poisoning 2.7 Present a case of poisoning due to atropine or other naturally occurring antimuscarinic alkaloid especially in the Philippine setting 2.8. Formulate a treatment plan in cases of poisoning of atropine and give the rationale of the antidote 2. Cholinoceptor Blockers a. Antimuscarinics 3.5 hours Interactive -Interactive 5. Netter s Illustrated -oral recitation - s -Posttest MCQ, 18

19 2.9.Dessimiate information of the toxicity of naturally occurring antimuscarinic alkaloids Explain the mechanism of action and effects of the ganglionic blocking nicotinic antagonist 2.6 Conduct an information drive of the ill effects of nicotine. b. Ganglionic blocking nicotinic antagonist 3.1. Discuss the transmission process at the neuromuscular end plate and the points at which drugs can modify this process Identify the major nondepolarizing neuromuscular blockers and one depolarizing neuromuscular blocker; compare their pharmacokinetics Compare the difference between depolarizing and nondepolarizing blockers from the standpoint of tetanic and posttetanic twitch strength Describe the method of reversal of 3. Skeletal Muscle Relaxants - Neuromuscular blocking agents -direct acting skeletal muscle relaxant -centrally acting skeletal muscle relaxant 3.5 hours -Interactive 5. Netter s Illustrated -Posttest MCQ, 19

20 nondepolarizing blockade Explain the mechanism of action of the major drugs used in the treatment acute and chronic skeletal muscle spasticity and describe their mechanisms List tissues that contain significant numbers of alpha receptors of the ᾳ 1, ᾳ 2, types List tissues that contain significant numbers of β 1 or β 2 receptors Describe the major organ system effects of a pure alpha agonist, a pure beta agonist, and a mixed alpha and beta agonist. Give examples of each type of drug Describe a clinical situation in which the effects of an indirect sympathomimetic would differ from those of a direct agonist List the major clinical application of the adrenoceptor agonist Compare the different sympathomimetics according to: 4. Sympathomimetics -direct acting sympathomimetic -indirectly acting sympathomimetic -mixed acting sympathomimetic 3.5 hours -Interactive Posttest MCQ, Mechanism of action 20

21 Clinical Application Pharmacokinetics Toxicities and Drug Interaction 4.7. Present a case of the effect of sympathomimetics of vascular resistance, blood pressure and heart rate. 5.1 Discuss the effects of an alpha blocker 5.2 Discuss the effects of a beta blocker 5.3 compare the effects of the different beta blockers 5.4 compare the pharmacokinetics of the different beta blockers 5.5 describe the clinical indications and toxicities of alpha and a beta blockers 5.6 Present a case of hypertension using the different kinds of adrenoceptor blockers 5. adrenoceptor blockers -Alpha blockers (selective and non-selective) -Beta blockers (selective and non-selective) 3.5 hours -Interactive -long exam MCQ, 21

22 1.1. Classify the major types of diuretics and relate them to their sites of action Explain two drugs that reduce potassium loss during sodium dieresis Discuss a therapy that will reduce calcium excretion in patients who have recurrent urinary stones Discuss a treatment for severe hypercalcemia in a patient with advance carcinoma Explain a method for reducing urine volume in nephrogenic diabetes insipidus List the major applications and the toxicities of thiazides, loop diuretics, and potassium-sparing diuretics. UNIT III CARDIOVASCULAR DRUG 1. Diuretic Drug 3.5 hours -Interactive Posttest MCQ, 22

23 2.1. Classify the four major groups of antihypertensive drugs and give examples of drugs in each group Explain the compensatory responses to each of the four major types of antihypertensive drugs Classify the major sites of action of sympathoplegic drugs and give examples of drugs that act at each site Classify the three mechanism of action of vasodilator drugs Discuss the differences between the two types of angiotensin antagonist 2.6. List the major toxicities of the prototype antihypertensive agents Explain why some combinations of Antihypertensive drugs are rational and appropriate and others are not Critic a journal of hypertensive case 2.9. Present a case of hypertension Formulate a drug management in a 2. Drugs used in Hypertension 3.5 hours -Interactive Philippine Posttest MCQ, 23

24 hypertensive patient Attend a seminar on the management of hypertension 3.1. Discuss the pathophysiology of effort angina and vasospastic angina Explain the major determinants of cardiac oxygen consumotion Discuss the strategies for relief of angina pain Contrast the therapeutic and 3. Vasodilators and the Treatment of Angina 3.5 hours -Interactive -oral recitation - Posttest MCQ, 24

25 adverse effect of nitrates, beta-blockers, and calcium channel blockers when used for angina Explain why the combination of a nitrate with a beta-blocker or a calcium channel blocker may be more effective than either alone Explain why the combination of a nitrate and sildenafil is potentially dangerous Contrast the effects of medical therapy and surgical therapy of angina Attend a drug symposium involving treatment of angina 3.9. Conduct a community seminar regarding the cause and prevention of angina 3.5 hours s 4.1. Discuss the strategies and list the major drug groups used in the treatment of congestive heart failure Explain the probable mechanism of action of digitalis. 4.Drugs used in treatment of congestive heart failure 3.5 hours -Interactive - - Posttest MCQ - Essay questions -- 25

26 4.3. Explain the nature and mechanism of digitalis s toxic effects on the heart List some positive inortropic drugs that have been invested as digitalis substitutes Discuss the beneficial effects of diuretics, vasodilators, ACE inhibitors, and other drugs that lack positive inortropic effects in congestive heart failure Present a case of congestive heart failure 4.7. Formulate different management strategies in the management of congestive heart failure 5.1. Explain the distinguishing features of the four major classes of antiarrhythmic drugs and adenosine List two or three of the most important drugs i each of the four classes List the major toxicities of those drugs. 5. Antiarrhythmic Drugs 3.5 hours -Interactive Philippine 5. Netter s Illustrated s graded oral -Posttest MCQ, 26

27 5.4. Discuss the mechanism of selective depression by local anesthetic antiarrhythmic agents Explain how hyperkalemia, hypokalemia, or an antiarrhythmic drug can cause an antihythmia 6.1. Review the proposed role of lipoproteins in the formation of atherosclerotic plaques Discuss the dietary management of hyperlipoproteinemia Classify the four main classes of drugs used to treat hyperlipidemia and describe their mechanism of action, effects upon serum lipid concentration, and adverse effects Propose a rational drug treatment regimen based on a set of baseline serum lipid values Collaborate with professional the merits of combined drug therapy for hyperlipedemia Educate patients on hyperlipidemias 5. Netter s Illustrated 6. Drugs used in the treatment of Hyperlipidemias 3.5 hours -Interactive -Role playing 5. Netter s Illustrated Posttest MCQ, 27

28 7.1.Classify the major classes of anticlotting drugs and compare their utility in venous and arterial thromboses Discuss the four types of anticoangulants and their mechanisms of action Explain why the onset of warfarin saction is relatively slow Compare the oral anticoangulants, standard heparin, and low-molecularweight heparins in terms of their pharmacokinetics, mechanisms, and toxicities Give several examples of warfarin s role in pharmacodynamic drug interactions Diagram the role of activated platelets at the Site of a damaged blood vessel wall and show where the major four classes of antiplatelet drugs act Compare the pharmacokinetics, clinical uses and toxicity of the major 7. Drugs Used in Coangulation disorders 3.5 hours -Interactive 5. Netter s Illustrated Posttest MCQ, -long exam MCQ 28

29 antiplatelet drugs Classify the different drugs used to treat Disorders of excessive bleeding Review the major organ system effects of histamine and serotonin Discuss the pharmacology of the two generations and three subgroups of H 1 antihistamines; list prototypical agents for each subgroup Explain the pharmacology of H 2 antihistamines; identify the four members of this group Discuss the action, indication, and toxicity of sumatripan Discuss one 5-HT 2 and one 5-HT 3 antagonist and their major applications Anticipate the major organ system effects of the ergot alkaloids Discuss the major clinical applications and toxicities of the ergot drugs Critically appraised relevant literatures regarding the use of ergot UNIT IV AUTOCOIDS AND DRUG WITH IMPORTANT ACTIONS ON INFLAMMATION 1. Histamine, Serotonin, and the Ergot Alkaloids 3.5 hours -Interactive -Interactive Philippine graded oral graded oral Posttest MCQ, 29

30 alkaloids Formulate an inventory of health diseases associated with histamine, etc. and give the plan of management Name an antagonist of angiotensin at its receptor and at least two drugs that reduce the formation of angiotensin II Outline the major effects of bradykinin and atrial natriuretic peptide Discuss the functions of converting enzyme(peptidyl dipeptidase, kininase II) Compare two potent vasoconstrictor peptides based on their pharmacokinetics Discuss the effects of vasoactive intestinal peptide, substance P, and calcitonin gene-related peptide Review the major effects of PGE 2 PGF 2ἀ, LTB 4, LTC 4, and LTD Discuss the synthesis and the effects 2.Vasoactive Peptides 3.5 hours -Interactive 3. Prostaglandins and other Eicosanoids 3.5 hours -Interactive 5. Netter s Illustrated graded oral graded oral 30

31 of thromboxane and prostacyclin in the vascular system Categorized the currently available therapeutic antagonists of leukotrienes and prostaglandins and their targets (receptors or enzyme) Explain the different effects of aspirin on prostaglandin synthesis and on leukotriene synthesis. 5. Netter s Illustrated 4.1. Review the enzyme responsible for the synthesis of nitric oxide in tissues Identify the major beneficial and toxic effects of endogenous nitric oxide Explain two drugs that cause release of endogenous nitric oxide Discuss two drugs that spontaneously or enzymatically break down in the body to release nitric oxide 4. Nitric Oxide, Donors, and Inhibitors 3.5 hours -Interactive graded oral Contrast the functions of COX-1 and COX Discuss the effects of aspirin and 5. Nonsteroidal Antiinflammatory Drugs, Acetaminophen, and Drugs 3.5 hours -Interactive 31

32 other NSAID on prostaglandin synthesis Contrast the actions and toxicity of aspirin, the older nonselective NSAIDS and the COX-2-selective drugs Identify the toxic effects of aspirin Classify the different DMARDs and compare their mechanism of action and toxicity with those of the NSAIDs Contrast the treatment of acute and chronic Gout Discuss the mechanism of action and toxicity of three different drug groups used in gout Explain the effects and the major toxicity of acetaminophen and its treatment Critically appraised relevant literature on NSAID Educate patients and family regarding prognosis and management of the different kind of arthritis Promote in the community in collaboration with LGUs the use of Used in Gout -long exam MCQ 32

33 natural plants available for the treatment of anti-inflammatory conditions Identify the major types of voltagegated and ligand-gated ion channels in neuronal membranes Categorized the criteria for accepting a chemical as a neurotransmitter Discuss the mechanism by which drugs module synaptic transmission Categorized the major excitatory and major inhibitory central eurotransmitters Identify the major receptor subtypes of CNS neurotransmitters. UNIT V DRUGS THAT ACT IN THE CENTRAL NERVOUS SYSTEM 1. Introduction to CNS 3.5 hours -Interactive graded oral 2.1. Categorized the major chemical classes of sedative-hypnotics Discuss the pharmacodynamics of benzodiazepines and barbiturates, including their mechanisms of action Compare the pharmacokinetics of commonly used benzodiazepines and 2.A. Sedative-Hypnotic Drugs -Barbiturates -Benzodiazepines - Z drugs 3.5 hours -Interactive 33

34 barbiturates and discuss how differences among them affect clinical use Explain the clinical uses and adverse effects of sedative-hypnotics Compare the distinctive properties of buspirone, zolpidem, and zaleplon Classify the different anti-anxiety agents Compare the pharmacokinetic of the different anti-anxiety agent Critically appraised research literatures regarding the benzodiazepines and other drugs used as hypnotic agents Conduct a research on endogenous plants that have potential sedative hypnotic property. 2.B. Anti-anxiety agents 3.5 hours 10 hours -Interactive -Laboratory researches 3.1. Classify the major drugs used for partial seizures, generalized tonic-clonic seizures, absence and myoclonic seizures, and status epilepticus Explain the mechanisms of 3. Antiseizure / Antiepileptic agents 3.5 hours -Interactive - graded oral 34

35 antiseizure drug action Discuss the main pharmacokinetics and adverse effects of major antiseizure drugs Identify new antiseizure drugs and their important characteristics Explain the factors that must be considered in designing a dosage regimen for an antiseizure drug Classify the main inhalation anesthetic agents and describe their pharmacodynamics properties Discuss the relationship of the blood: gas partition coefficient of an inhalation anesthetic with its speed of onset of anesthesia and its recovery time State the factors that influence inhalation anesthetic biodisposition Discuss the main pharmacokinetic and pharmacodynamic characteristics of the intravenous anesthetics. 4. General Anesthetics -Inhalational general anesthetics -Intravenous general anesthetics 3.5 hours -Interactive - graded oral 35

36 5.1.Discuss the mechanism of blockade of the nerve impulses by local anesthetics 5.2. Discuss the relationship between ph, pk a, and the speed of onset of local anesthetics Summarize the factors that determine the susceptibility of nerve fibers to blockade List the major toxic effects of the local anesthetics Explain use-dependent blockade by local anesthetics. 5. Local Anesthetics -Esters Local Anesthetics -Amides Local Anesthetics 3.5 hours -Interactive 36

37 6.1. Discuss the neurochemical imbalance underlying the symptoms of parkinson s disease Explain the mechanisms by which levodopa, dopamine receptor agonists, selegiline, and muscarinic blocking drugs alleviate parkinsonism Discuss the therapeutic and toxic effects of the major antiparkisonism agents Identify the compounds that inhibit dopa decarboxylase and catechol-omethyltransferase and muscarinic blocking drugs alleviate parkinsonism Identify the chemical agents and drug that cause parkinsonism symptoms Identify the drugs used in management of tremor, Hungtington s disease, drug-induced dyskinesias, and Wilson s disease Critically appraised relevant research literature of the new 6. Drugs used in Parkinsonism and other movement Disorders. 3.5 hours -Interactive 5. Netter s illustrated - 37

38 modalities Attend seminars regarding Parkinson s disease and management. 3.5 hours 7.1. Discuss the pharmacodynamics of older antipsychotic drugs and relate 7. Antipsychotic Drugs and 3.5 hours -Interactive -oral recitation 38

39 these characteristics to their clinical uses Compare and identify the main characteristics and clinical uses of newer atypical antipsychotic drugs List the major adverse of the antipsychotic drugs Explain the pharmacokinetics and pharmacodynamics of lithium. Lithium 8.1. Explain the probable mechanism and the major properties of tricylic antidepressants Discuss the toxic effects that occur during chronic therapy and with an acute overdose of tricyclic antidepressants Identify the second-and thirdgeneration heterocyclic antidepressants and their distinctive properties Contrast and identify the selective serotonin reuptake inhibitors and list their major characteristics. 8. Antidepressants -Tricyclic Antidepressants (TCA) -Heterocyclic Antidepressants -Monoamine oxidase Inhibitors -Selective Serotonine Re-uptake Inhibitors (SSRI) 3.5 hours -Interactive graded oral 39

40 8.5. Discuss the therapeutic use and toxic effects Of MOA inhibitors 8.6. Identify the major drug interactions associated with antidepressant drugs Present a case study of depression and its treatment Educate family and patient who has depression regarding the prognosis, management Formulate health and wellness plan for patients with depression. -Interactive 9.1.Review the endogenous opioid peptides List the receptors activated by opioid analgesics and the endogenous opioid peptides Categorize the major opioid agonists according to thier analgesic 9. Opioid Analgesics and Antagonists 3.5 hours -Interactive 40

41 efficacy Differentiate the effects opioid receptor antagonists and mixed agonistantagonists Discuss the main pharmacodynamic and pharmacokinetics properties of agonist opioid analgesics and list their clinical uses Compare the main adverse effects of acute and chronic use of opioid analgesics Discuss the clinical uses of the opioid receptor antagonists List two opioids used for antitussive effects and one used for antidiarrheal effects. 9.9 Explain the different government requirement sin prescribing a narcotic Discuss the pharmacodynamics and pharmacokinetics of acute ethanol -Interactive 10. Alcohols 3.5 hours -Interactive Philippine - quizzes 41

42 ingestion List the toxic effects of chronic ethanol ingestion Describe the fetal alcohol syndrome Discuss the treatment of acute and chronic ethanol over dosage Outline the pharmacotherapy of (a) the alcohol withdrawal syndrome and (b) alcoholism Discuss the mechanism of the toxicity and treatment of acute poisoning with (a) methanol and (b) enthylene glycol. Philippine 10.7 Conduct community awareness programs about the ill effects of alcohol 1,5 hrs Health education in the community Textbooks. Basic and -Clinical Group participation And Rating Scale with Rubric Classify and describe the major 11. Drugs of Abuse 3.5 hours -Interactive - Long exam MCQ 42

43 actions of drugs that are commonly abused Describe the major signs and symptoms of overdose with, and withdrawal from, CNS stimulants Explain the general principles of the management of overdose of commonly abused drugs Identify the most likely causes of death from commonly abused agents Adhere to Legal standards in the use of substances of abuse Collaborate with different health professional and NGO s in conducting campaign and seminars directed towards educating the youth about drug abuse Review the major hypothalamic releasing hormones Discuss the major anterior pituitary hormones and their effects. UNIT VII ENDOCRINE DRUGS -Interactive - 43

44 1.3. Discuss the major posterior pituitary hormones and their effects Describe the major drugs used as substitutes for the natural hypothalamic and pituitary hormones Identify the drugs that are used for treatment of acromegaly and hyperprolactinemia Identify the principal drugs used in the treatment of hypothyroidism Identify the principal drugs used in the treatment of hyperthyroidism and compare the onset and duration of their action Sketch the biochemical pathway for thyroid Hormone synthesis and release and indicate the sites of action of antithyroid drugs Discuss the major toxicities of thyroxine and the antihtyroid drugs Correlate research findings with the mechanism of action of anti-thyroid drugs. 1. Hypothalamic and Pituitary Hormones 3.5 hours 2.Thyroid and Antithyroid Drugs 3.5 hours -Interactive 44

45 2.6. Present a case of hyper and hypo thyroidism and its management Collaborate with LGUs in conducting community education regarding thyroid diseases its prevention and management Discuss the major naturally occurring glucocorticosteroid and its actions Compare several synthetic glucocorticoids and the differences between these agents and the naturally occurring hormone Explain the actions of the naturally occurring mineralocorticoid and one synthethic agent in this subgroup List the indications for the use of corticosteroids in adrenal and nonadrenal disorders. 3. Corticosteroids and Antagonist 3.5 hours -Interactive Discuss the hormonal changes that occur during the menstrual cycle Identify three estrogens and four progestins. Describe their pharmacologic 4. Gonadal Hormones and Inhibitors -Female Hormone agonist and 3.5 hours -Interactive 45

46 effects, clinical uses, and toxicity List the benefits and hazards of oral contraceptives List the benefits and hazards of postmenopausal estrogen therapy Discuss the uses of sex hormones and their antagonists in the treatment of cancer in women and men. antagonist -Male Hormone agonist and antagonist 4.6. Explain the toxic effects of anabolic steroids used to build muscle mass Define the terms SERM and mixed agonists Compare two SERMS and their unique properties Review the effects of insulin on the liver, on muscle, and on adipose tissue Compare the types of insulin preparations and their durations of action Explain the major hazards of insulin therapy Discuss the prototypes and their 5. Pancreatic Hormones, Antidiabetic Agents, and Hyperglycemic Drugs. 3.5 hours -Interactive - graded oral 46

47 mechanisms of action, toxicities of the four major classes of oral antidiabetic agents Give three examples of rational drug combinations for treatment of type 2 diabetes mellitus Explain the clinical uses of glucagon Review the epidemiology of diabetes and obesity in the Philippines Attend seminars and drug symposia regarding diabetes and new modalities in treatment Critically appraised relevant literatures regarding the management and treatment of diabetes mellitus Conduct community education regarding the diabetes, prevention and management options, and prognosis of the disease Conduct research on endogenous plant that is useful in the management of diabetes. 5. Netter s Illustrated 6Understanding Research methods: An Overview of the essentials 7. Access to library and Online library collections. 47

48 6.1. List the agents useful in the treatment of hypercalcemia Identify the major and minor regulators of bone mineral homeostasis Discuss the major effects of parathyroid hormone and vitamin D derivatives on the intestine, the kidney, and bone Attend seminars on osteoporosis Conduct community health education regarding osteoporosis. 6. Drugs that Affect Bone Mineral Hemeostasis. 3.5 hours 3,5 hours 3.5 hours -Interactive Philippine Long exam MCQ, 1.1. Discuss the mechanism of antibacterial action of beta-lactam antibiotics Explain the mechanisms underlying the resistance of bacteria to beta-lactam antibiotics Identify the four important drugs in each subclass of penicillins and describe their antibacterial activity and clinical uses Identify the four subclasses of cephalosporins and describe their UNIT VIII CHEMOTHERAPEUTIC AGENTS 1. Beta-Lactam Antibiotics and Other Cell Wall Synthesis Inhibitors 3.5 hours -Interactive 48

49 antibacterial activities and clinical uses List the major adverse effects of the penicillins and the cephalosporins Explain the important features of aztreonam, imipenem, and meropenem Discuss the clinical uses and toxicities of vancomycin, fosfomycin, and bacitracin Explain the mechanisms of action of these inhibitors of bacterial protein synthesis Explain the mechanisms responsible for clinical bacterial resistance to these 2. Chloramphenicol, Tetracyclines, Macrolides, Clindamycin, Streptogramins, and Linezolid. 3,5 hours -Interactive 49

50 drugs List the major clinical uses of these drugs Discuss the pharmacokinetics features of these agents that are most relevant to their clinical use Identify the main toxic effects of these drugs Critically appraised relevant research literature regarding the use of antibiotics Explain the mechanism of action of amino glycosides antibiotics and the mechanisms by which bacterial resistance to this class of drugs occurs Identify the major clinical applications of aminoglycosides and describe their main toxic effects Discuss the pharmacokinetics of this drug class, with special reference to the importance of renal clearance and its relationship of toxicity. 3.5 hours 3. Amino glycosides 3.5 hours -Interactive 5. Internet sources 6. Published Researches 7. e-journals ) (2014) (2014) 50

51 4.1. Discuss the mechanism of antibacterial action of sulfonamides and trimethoprim on bacterial folic acid synthesis and the mechanisms involved in bacterial resistance to the antifolate drugs. 4.2.Identify the major clinical uses of sulfonamides and trimethoprim, singly and in combination, and describe their pharmacokinetic properties and toxic effects Discuss the mechanisms of action of the fluoroquinolone antibiotics and the mechanisms involved in bacterial resistance to these agents Identify the major clinical uses of fluoroquinolones and describe their pharmacokinetic properties and toxic effects Explain the special problems associated with chemotherapy of mycobacterial infections Discuss the pharmacodynamic and 4. Sulfonamides, Trimethoprim, and Fluoroquinolones. 3.5 hours -Interactive 5. Antimycobacterial Drugs 3.5 hours -Interactive 5. Netter s Illustrated 51

52 pharmacokinetic properties of the firstline drugs used in tuberculosis (isoniazid, ethambutol, pyrazinamide, rifampin, and streptomycin) Identify the second-line drugs used in tuberculosis and list their limitations Identify the drugs used in leprosy and in Atypical mycobacterial diseases and describe their major toxic effects Critically appraise relevant research regarding the treatment of tuberculosis and leprosy Evaluate DOH programs regarding tuberculosis prevention and treatment Conduct community education regarding tuberculosis and leprosy, its impact in the community and its prevention and treatment Explain the mechanism of action of the major drugs used for fungal infections Discuss the clinical uses and 6. Antifungal Agents 3.5 hours -Interactive 5. Netter s Illustrated 6. e- journals 7. Published research 8. Internet sources 52

53 pharmacokinetics of amphotericin B, flucytosine, fluconazole, itraconazole, ketoconazole, griseofulvin, and terbinafine Identify the toxic effects of the major antifungal drugs Identify the main topical antifungal agents Identify the main steps in viral replication Explain the mechanism of action and of resistance of the major antiherpes drugs Discuss the pharmacokinetic properties, the clinical uses, and the toxic effects of the antiherpes drugs Explain the mechanism of action and Resistance of the major antiretroviral drugs Discuss the pharmacokinetic properties, the clinical uses, and the toxic effects of the antiretroviral drugs. 7. Antiviral Chemotherapy and Prophylaxis 3.5 hours -Interactive Philippine 5. Netter s Illustrated 53

54 7.6. Identify the significant antiviral properties of amanitadine, neuraminidase, inhibitors, interferons, and ribavirin Explain the antibacterial actions, clinical uses and toxicities of metronidazole, mupirocin, and polymyxins Compare nitrofurantoin, methenamine, and nalidixic acid as urinary antiseptics and describe their toxic effects Correlate research findings of the treatment of urinary tract infection with the mechanism of the disease Analyze the serum drug levels or bactericidal titers in antimicrobial chemotherapy Identify the antimicrobial drugs that require major modifications of dosage when renal or hepatic function change, or when dialysis is used Explain the reasons for use of 8. Miscellaneous Antimicrobial Agents and Urinary Antiseptics 3.5 hours -Interactive 9. Clinical Use Antimicrobials 3.5 hours -Interactive - 54

55 antimicrobial drugs in comination and the probable mechanism involved in drugs synergy Discuss the principles underlying valid antimicrobial chemopropylaxis and give examples of commonly used surgical and nonsurgical prophylaxis Choose the appropriate drug of choice in certain infections using the SANE criteria Discuss the mechanism of drugs whose targets are enzymes unique to parasites, ie, not found in host cells Explain the mechanisms of drugs whose targets are enzymes indispensable to parasites but not to their hosts Explain the mechanisms of drugs whose targets are biomedical functions common to Host and parasites cells. 5. Netter s Illustrated 10. Basic Principles of Antiparasitic Chemotherapy 3.5 hours -Interactive 11.1 Classify the major of antiprotozoal drugs 11. Antiprotozoal Drugs 3.5 hours -Interactive 55

56 11.2. Discuss the pharmacodynamic and pharmacokinetic properties of the major antimalarial drugs (chloroquine, mefloquine, quinine, primaquine, and the antifolate agents) Discuss he pharmacodynamic and pharmacokinetic properties of the major anebicides (diloxanide, emetine, iodoquinol, and metronidazole). List other clinical applications of metronidazole Identify the drugs useful for prophylaxis and treatment of pneumocytosis and toxoplasmosis and know their toxic effects Identify the major drugs used for trypanosomiasis and leishmaniasis and know their toxic effects. -Interactive ) (2014) 5. Netter s Illustrated 5. Netter s Illustrated 56

57 -long exam MCQ Identify the drugs of choice for treatment of common infections caused by nematodes, trematodes, and cestodes Explain the mechanism of action of the important pharmacokinetic features, and the major toxic effects of anthelmintics drugs Differentiate the features of important anthelmintics Conduct community education regarding prevention of anthelmintic disease. 12. Anthelmintic Drugs 3.5 hours -Interactive 57

58 1.1. Compare the primary features of cell-mediated and humoral immunity Discuss the different immunosuppressants and describe the mechanism of action, clinical uses, and toxicities Discuss the mechanism of action, clinical uses, and toxicities and antibodies used as immunosuppressants Identify the major cytokines and other immunomodulating agents and know their clinical applications. UNIT IX Immunopharmacology 3.5 hours -Interactive 2.1. Discuss the relevance of cell cycle kinetics to the modes of action and clinical uses of anticancer drugs Classify the major subclasses of anticancer drugs, and explain the mechanisms of action of the main drugs in each subclass, and describe the 2.Cancer Chemotherapy 3.5 hours Interactive 58

59 mechanism by which tumor cells develop drug resistance. 2.3.Select the drugs used in regimens for treatment of the more common neoplastic diseases and describe their pharmacokinetics and their toxic effects Explain the rationale underlying the strategies of combination drug chemotherapy and rescue therapies Observe the administration of anticancer agents in a clinical setting 2.6. Critique a research paper in the therapy of different cancer using new and modern modalities of treatment 2.7. Attend symposium regarding cancer and its treatment Conduct awareness of the different kinds of cancer. -Interactive -Conferences -Symposiums 5. Symposium speakers -oral recitation -long exam MCQ 59