Department of Clinical Pharmacology, Pharmacology and Toxicology
University of Belgrade School of Medicine, Belgrade, Serbia, Yugoslavia


Contact: Zoran Todorovic, Assistant Professor, E-mail

PHARMACOLOGY AND TOXICOLOGY
(UNDERGRADUATE COURSE, SPRING AND FALL SEMESTER, FOURTH YEAR)

 

The aims of Pharmacology and Toxicology curriculum are multiple:

  • mastering specific knowledge on drugs: origin, pharmacokinetics, pharmacodynamics, therapeutic use, adverse effects, interactions
  • mastering the technique of drug prescription
  • introduction into basic principles of rational pharmacotherapy that should be further systematized in clinical subjects
  • understanding of basic principles of toxicology and the most frequent acute and chronic intoxication the physician potentially encounters in primary health care

During the course medical student should build his/her own attitudes toward drugs including the awareness of ethical, social and economic aspects of drug use both in individuals and larger groups (pregnant women, children, the elderly, patients with renal failure etc.) or population in general.

 

GENERAL PHARMACOLOGY (12 hours)
Introduction: Development of pharmacology as scientific discipline; areas of pharmacology. The term drug, origin, drug development. Drug forms and routes of administration.

Pharmacokinetics: Drug transport through biological membranes; absorption, bioavailability, distribution of drugs in the body, biotransformation and drug elimination. Understanding of basic pharmacokinetic parameters and modalities of kinetics having regulatory significance for drug dosage.

Pharmacodynamic: Drug classes. Characteristics of drug effects on various body levels (general, organs, tissues, cell, subcellular organelles). The mechanisms of drug action and receptor theory. Quantitative aspects of drug effects. Factors influencing drug effects. Repeated drug administration alterations. Drug interactions (synergism and antagonism).

Adverse effects: Causes, frequency, types and significance. The relationship between benefits and risks during therapy. Allergic reactions to drugs. Drug-induced dependency.

PHARMACOLOGY OF THE AUTONOMIC NERVOUS SYSTEM (10 hours)
Cholinergic and anicholinergic drugs: Acetylcholine and other cholinergic drugs with direct effect. Cholinesterase inhibitors (reversible and irreversible). Myasthenia gravis treatment. Fungal intoxication. Anticholinergic drugs. Synthetic replacements for belladonna alkaloids.
Adrenergic and antiadrenergic drugs: Catecholamines. Adrenergic bronchodilatators. Adrenergic vasoconstrictors. Antiadrenergic drugs (adrenoceptor alpha and beta blockers, adrenergic neuron blocking drugs, ganglionic blocking agents).

Others: Histamine and H1-antihistamines. Serotonin and serotonin antagonists.
 

PHARMACOLOGY OF THE CENTRAL NERVOUS SYSTEM (16 hours)
Neurohumoral transmitters in the CNS as the bases for the drug development and use.
Psychopharmacologic drugs: Antipsychotic drugs. Antidepressants. Anxiolytics. Sedatives and hypnotics. Psychostimulants. Hallucinogens. Ethanol.

Neuropharmacologic drugs: Types of anesthesia. General anesthetics. Inhalation anesthetics. Intravenous anesthetics. Miorelaxants. Local anesthetics. Analgesics. Treatment of Parkinson's disease. Antiepileptics.

PHARMACOLOGY OF CARDIOVASCULAR SYSTEM (10 hours)
Antihypertensive drugs: Classification and mechanisms of action. Diuretics. Alpha and beta adrenoceptor blockers. ACE inhibitors and angiotensin receptor blockers. Calcium antagonists. Other antihypertensives. Pharmacotherapy of hypertension.

Drugs used in treatment of angina pectoris: Organic nitrates and other vasodilatators. Beta adrenoceptor blockers in angina pectoris. Calcium antagonists in angina pectoris. Pharmacotherapy of angina pectoris. Primary and secondary prophylaxis of myocardial infarction.

Antiarrhythmic drugs: Arrhythmias and classification of antiarrhythmics. Class I antiarrhythmics (quinidine, procainamide, disopyramide etc.). Beta adrenoceptor blockers as antiarrhythmics. Class III antiarrhythics (amiodarone, sotalol etc.). Calcium antagonists as antiarrhythmics.

Drugs used in treatment of heart failure: Cardiotonics. ACE inhibitors. New inotropic drugs. Vasodilatators etc.

Diuretics: Classification. Thiasides. Loop diuretics. Potassium sparing diuretics. Carbonic anhydrase inhibitors. Other diuretics. 
Drugs used in treatment of hyperlipoproteinemias: Hyperlipoproteinemias and classification of drugs. Ion exchange resins (cholestiramine and cholestipol). Fibrates. Statins (lovastatin, simvastatin, pravastatin). Other drugs.

PHARMACOLOGY OF RESPIRATORT TRACT (2 hours)
Antitussive agents: Expectorants. Mucolytics. Antitussive drugs.
Bronchial asthma treatment: Selective beta2 adrenoceptor antagonists. Methylxanthines. Inhalation glucocorticoids. Other drugs.
Oxygen therapy: Oxygen and gas mixtures.

PHARMACOLOGY OF GASTROINTESTINAL TRACT (4 hours)
Drug used for peptic ulcer treatment: HCl secretion inhibitors. Antacids. Protectives. Spasmolytics.
Drugs affecting GIT motility: Laxatives. Antidiarrheal drugs.
Other drugs: Appetite stimulants and depressants. Digestives. Oral rehydration solutions. Emetics and antiemetics. Henodeoxycholic acid. Mesalazine and other drugs used in treating ulcerative colitis.

BLOOD AND TISSUE PHARMACOLOGY (6 hours)
Antianemic drugs: Iron. Vitamin B12. Folic acid.
Blood coagulation:  Coagulation factors. Heparin. Oral anticoagulants. Fibrinolytics and antifibrinolytics. Platelet aggregation inhibitors. Vitamin K.
Water and electrolytes: Infusion solutions. Blood replacements. Plasma replacements. Infusions for parenteral nutrition.
Immunopharmacology: Immunosuppressants. Immunomodulators.

PHARMACOLOGY OF VITAMINS (2 hours)
Vitamins as drugs: Vitamin A. Vitamin E. Vitamin D. B complex vitamins. Vitamin C. Anti-vitamins. General principles of vitamins use.

PHARMACOLOGY OF HORMONES (8 hours)
Mechanisms of hormone action. Hormones as physiologic regulators and pharmacotherapeutic agents.
Hypothalamic and hypophysial hormones: Growth hormone. Somatostatins. Prolactin. ACTH. TRH. Gonadotropins. Hypothalamic-releasing hormones. Vasopressin and oxytocin.
Thyroid and parathyroid hormones and related drugs: Thyroxin. Antithyroid drugs. Parathormone. Calcitonin. Other drugs.

Insulin and other antidiabetics: Animal and human insulins. Oral antidiabetics.

Steroid hormones: Glucocorticoids. mineralocorticoids. Estrogens. Gestagens. Hormonal contraceptives. Ovulation inducers. Anabolics. Antiandrogens.

CHEMOTHERAPY (12 hours)
Antiinfection drugs: Antimicrobial action. Bacterial resistance to antibiotics. General principles of antimicrobial therapy. Penicillins. Cephalosporins. Tetracyclines. Aminoglycosides. Chynolones and fluorochynolones. Macrolides. Sulfonamides. Uroantiseptics. Antifugal drugs. Antiviral drugs. Amebicides. Antimalarials. Antiparasitic drugs.

Antiseptics and disinfectants: Classification and mechanisms of action. Detergents. Alcohols. Phenols. Aldehydes. Acids. Halogens and their complexes. Heavy metals and their salts. Others.
Chemotherapy of malignant diseases: General mechanisms of action and classification of cytostatics. Alkylating agents. Antimetabolites. Hormones. Radioactive isotopes. Antibiotics. Principles of cytostatics use.

CLINICAL PHARMACOLOGY (4 hours)
Discovery and development of new drugs. Pre-clinical testing. Clinical trials (principles, methods, types and techniques of investigations). Surveillance and therapeutic evaluation of drugs after their registration. Official regulation of medicines.

TOXICOLOGY (6 hours)
Basic principles of toxicology: Toxins and drugs. Toxicology. Classification of toxins. Types of drug toxicity. Acute and chronic intoxications and antidotes. Carbon monoxide, cyanide, heavy metals, acid and alkali intoxication. General principles in treatment of acute intoxications. Chelating agents. Environmental toxins: Pesticides. Insecticides. Herbicides. Others.

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