Total marks – 300

Formative assessment marks=10

  • Written = 90

[MCQ=20 (Multiple True False-10 + SBA-10),

SAQ+SEQ = 70

Making a total of 100 marks

  • Structured Oral Examination (SOE) = 100
  • Practical: 100 OSPE =40 (08 procedure stations, each having 05 marks]

Traditional =60 (Prescription writing 10, Drug interaction 05 x 02 =10,

Tracing and plotting = 10, Integrated teaching and Case report = (5+15) = 20,

Practical notebook =10)

 

Term I

A. GENERAL PRINCIPLES OF PHARMACOLOGY

 

Lectures:

01: Introduction to Pharmacology

 

02: Drug Compendia (Information sources)

Pharmacopoeia, Formulary, Treatment guidelines (BP, INN, BNF, and BDNF)

 

03. Drug Administration

Routes, drug delivery, and formulations for local & systemic effects

 

04: Drug Absorption

Transfer of drugs across cell membrane & specialized barriers, Factors influencing absorption

 

05: Bio-availability

Studies to compare Bio-equivalence & to monitor therapy

 

06: Drug Distribution

Vd, Plasma protein & tissue binding, redistribution

 

 07: Drug Metabolism

Where, why, and how of bio-transformation, hepatic microsomal enzymes- induction & inhibition Genetic influence on Drug metabolism (Pharmacogenetics)

08: Drug Elimination

Routes, Renal Excretion & Factors Influencing Renal Excretion

 

09: Clinical Pharmacokinetics

Vd, Cl, First & Zero order kinetics of Elimination, t½, Steady state concentration, loading dose & maintenance dose

 

10: Pharmaco-Dynamics:

Specific and non-specific mechanisms Receptors involved Second messenger system Enzyme mediated drug action

 

11: Quantitative aspects of drug action Dose-response relationships & curves Therapeutic Index and window-importance Information obtained from D-R curves Agonists – efficacy, potency, shift of curves Antagonists – efficacy, potency, shift of curves

 

12: Individual variations in drug responses

 

13. Drug Interaction at different levels

 

14: Drug Safety and Pharmacovigilance

Adverse drug reactions: Types, detecting & managing ADR ADR monitoring & reporting

Core Contents

A. AUTONOMIC PHARMACOLOGY

 

Lectures

 01: Introduction

Organization of ANS – sympathetic, parasympathetic, and enteric NS. Transmitters in ANS (ACh, NA, NANCs) Co-transmission, pre and postsynaptic modulation Cholinergic neurotransmission & drugs modifying the events, Cholinergic receptors

 

02: Cholinergic Drugs

Effects of the stimulation of Cholinoceptors Classification of cholinergic drugs – cholinoceptor agonists and anti-cholinesterase

 

03: Drugs for Glaucoma

Role of Cholinergic drugs compared to other drugs

 

04: OPC insecticide poisoning

Manifestation & management

 

 05: Anti-cholinergic Anti-muscarinic

Atropine and atropine substitutes

06: Anti-cholinergic anti-nicotinic

Classification – Neuromuscular blockers & their role as skeletal muscle relaxants during anesthesia Ganglion blocker (names only) (No-6 red part to be deleted)

 

07: Adrenergic neurotransmission

Drugs modifying the events Adrenergic receptors Effects of stimulation of adrenoceptors

 

08: Adrenergic Drugs

Classification Adrenergic inotropic agents & their role in therapy Role of Adrenaline, Noradrenaline, Isoprenaline, Dopamine, and dobutamine in therapy Adrenergic vasoconstrictors, nasal decongestants

 

09: Selective β2 agonists as Bronchodilators, Other bronchodilators

used in bronchial asthma

 

 10: α–adrenoceptor antagonist

Role of selective α1 antagonist in therapy

11: β- adrenoceptor antagonist

Role of β blockers in therapy

 

Renal & Cardiovascular Pharmacology Lectures:

 

01: Diuretics

Classification of diuretics: based on sites & mechanism of action and efficacy Pharmacology of Thiazides, Loop, Potassium-sparing diuretics: their role in therapy edema and hypertension

 

02: Drugs used in hypertension

Epidemiology and pathophysiology of hypertension, Objectives of anti-hypertensive therapy, Classification of anti-hypertensive drugs. Pharmacology of Diuretics, b blockers, Ca channel blockers, ACE inhibitors, Angiotensin receptor antagonists, blockers, methyl dopa, Vasodilators Principles of selection of drug in different clinical situations

 

03: Drugs used in congestive cardiac failure

Pathophysiology of heart failure Objectives of therapy Drugs used in CCF: Diuretics, ACE inhibitors & ARBs, Selective b-blockers, (Additional) Cardiac glycosides, vasodilators, Phosphodiesterase inhibitors.

 

04: Antianginal drugs

Pathophysiology of angina, Objectives of therapy Drugs used in angina: Nitrates, β- blockers, Ca2+ channel blockers.

 

05. Antiarrhythmic Drugs

Pathophysiology of arrhythmia Pharmacology of antiarrhythmic drugs

 

HEMATOPOIETIC PHARMACOLOGY

Lectures:

 

01: Anticoagulants & Thrombolytics

Pathophysiology of thrombo-embolism Pharmacology of Anti-coagulants: Heparin and LMW heparin, warfarin. Pharmacology of thrombolytics: Streptokinase, Alteplase, Rerelease etc.

02: Antiplatelet drugs

Pharmacology of low-dose aspirin, clopidogrel, glycoprotein IIb/IIIa inhibitors and their role in therapy

 

03: Lipid-regulating drugs

Pharmacology of statins. fibrates, nicotinic acid, resins etc.

 

 04: Drugs for anemia

Pathophysiology of anemia Pharmacology of hemopoietic iron, folic acid, vit B12 Pharmacology of erythropoietin

 

Endocrine Pharmacology

Lectures

 

01: Endocrine Pancreas and control of blood glucose

Islet hormones, control of blood glucose Diabetes mellitus – types, diagnostic criteria, monitoring Insulin & preparations Oral Hypoglycemic agent’s Hypoglycemic reactions & management

 

02: Adrenal cortex and drugs used in therapy

Adrenocortical hormones: synthesis & blockers; Control of secretion, mechanism of action Pharmacological actions, uses, and preparations Adverse effects

 

03: Reproductive system

Hormonal control of female reproductive system Estrogens & anti-estrogens Progesterone & anti-progesterone Hormone replacement therapy (HRT) Drugs used for contraception

 

04: The Uterus

Drugs that stimulate uterine contraction (oxytocic) Drugs that inhibit uterine contraction

 

05: The Thyroid

Synthesis, storage & secretion of thyroid hormones Thyroid functions & regulations Abnormalities of thyroid function Drugs used in the disease of the thyroid

 

Gastrointestinal Pharmacology

Lectures

 

01: Drugs used in Peptic ulcer

Pathophysiology of peptic ulcer Therapeutic goal and approach Antacids, H2- blockers, Proton pump inhibitors, gastric cytoprotective agents, Helicobacter pylori eradication regimen Gastroprokinetic drugs and other agents

 

02: Drugs to treat diarrhea

Epidemiology, Principles of management Fluid and electrolyte replacement Selection of route and preparations ORS and different IV fluids Role of Antimicrobial drugs Antimotility drugs

 

 03: Drugs used in helminthiasis

 04: Laxatives

 

05: Drugs for Inflammatory Bowel Diseases (IBS) & irritable bowel syndrome (IBS)

 

06: Anti-emetic and Pro-kinetic drugs

Term II

Pharmacology Practical 

Pharmacology Tutorial

 

Central Nervous System

Lectures

 

01: Introduction to CNS Drugs

Neurotransmitters of CNS (distribution, ion channel) general characteristics of CNS drugs

 

02: Opioid analgesic

Pathophysiology of pain, Pain pathway, endogenous opioids, and opioid receptors Opioids: morphine, codeine, pethidine, tramadol, and fentanyl are used as analgesics compared. Role of morphine in myocardial infarction and pulmonary edema. Other clinical uses of opioids

 

03: Anxiolytics and hypnotics

Pathophysiology of sleep Benzodiazepines and other non-BDZ sedative-hypnotics Centrally acting muscle relaxants

 

04: Antidepressant drugs

Neurochemical basis of depression TCAs, SSRIs, MAOIs, and other atypical antidepressants, Antimanic drugs

 

05: Antipsychotic drugs

Neurochemical basis of psychosis Pharmacology of antipsychotic drugs:

 

06: Local anesthetic

Drugs, mechanism of action, techniques of local anesthesia, uses and hazards

 

07: General anesthetics

Principles of General Anesthesia pre-anesthetic medication, Balanced Anesthesia Induction & Maintenance: Intravenous anesthetics &Inhalation anesthetics (nitrous oxides, halothane, flurries)

 

08: Skeletal muscle relaxation

Depolarizing and non-depolarizing

 

09: Antiparkinsonian Drugs

Pathophysiology of Parkinson’s diseases Pharmacology of antiparkinsonian drugs

 

10: Antiepileptics/Anticonvulsants

Pathophysiology of epilepsy Pharmacology of antiepileptic drugs

 

Autacoids and drugs used in inflammation

Lectures:

 

01: Autacoids

Definition and lists of autacoids

Histamine: synthesis, storage & release, pharmacological actions & physiological role

Histamine antagonist: H1 antagonists: classification, role in allergic conditions & other clinical uses and adverse reactions

H2-receptor antagonists: role in peptic ulcer (covered with GIT Pharmacology)

 

02: Ecosanoids Prostaglandins, Leukotrienes, Platelet Activating Factor (PAF) Synthetic pathways & antagonists’ Physiological roles, pharmacological actions and possible clinical uses of synthetic analogs and antagonists

03: NSAIDs / Non-opioid analgesics delete red part* of the line Paracetamol (mechanism of antipyretic and analgesic action, adverse effects) Other NSAIDs (mechanism of action, adverse effects and precaution) Selective COX-II inhibitors

 04. Drugs for Migraine

 

CHEMOTHERAPY

Lectures:

 

01: Introduction

General concept, Mode of action & Classification of antimicrobials Principles of antimicrobial therapy

 

02: Drug Resistance Mechanism of development of drug resistance by microbes

 

03: Cell wall synthesis inhibitors Penicillin’s Cephalosporins Other b-lactams Non b-lactam antibiotics

04: Protein Synthesis Inhibitors

Aminoglycosides

Tetracyclines

Macrolides

Chloramphenicol

Newer Protein synthesis inhibitors

 

05: Sulfonamides & Cotrimoxazole

Sulfonamides combinations, Topical uses Cotrimoxazole

 

06: Quinolones & Fluoroquinolones

 

07: Anti Amoebic Drugs:

Metronidazole and other uses of Metronidazole

 

08: Drugs used in Tuberculosis

 

09: Drugs used in Leprosy

 

10: Drugs used in Malaria & Kala-Azar

 

11: Drugs used in Fungal Infections

 

12: Drugs used in Viral Infections

 

13: Cancer Chemotherapy

 

14. Anti-Helminthic Drugs

 

CLINICAL PHARMACOLOGY

Lectures:

 

01: Rational Prescribing

General Principles, cusses & consequences of irrational prescribing, Measures to prevent irrational prescribing

 

02: Essential Drug concept

Definition, Selection criteria, Essential Drug List Rationale for prescribing from this Drug List

 

03: ‘P’ Drug concept

Definition, Selection criteria, selection of ‘P’ Drug for some clinical situations 04: Drug selection for some special clinical conditions: Pregnancy, Lactating mother, elderly, children, renal/hepatic failure or impairment 05: Anti-microbial resistance and how to overcome the indiscriminate use of antimicrobials

GENERAL PRINCIPLES OF PHARMACOLOGY

 

1. Prescription writing

Format, legal & ethical aspects, drug nomenclature, compliance and Exercise on Prescription Writing

2. Drug Dosage Formulations

Source & Routes of drug administration Drug Formulation & Delivery Techniques Exercise on Drug Dosage Formulations

 

3. Clinical Pharmacokinetics Study of Time-Plasma Concentration Curves Determination of t½, Vd, Cl, Ke, steady-state concentration, Loading & Maintenance dose

4. Study of Pharmacodynamics

 

I. Study of Dose-Response Relationship

Construction of Log Dose-Response Curves

II. Study of Drug Antagonism

Construction of Log Dose-Response Curves in Presence of Antagonists

 

5. Adverse drug Reaction

Exercise on ADRs reporting & monitoring

 

AUTONOMIC PHARMACOLOGY

 

1. Interpretation of Tracings on Blood Pressure

Demonstration of the presence of Autonomic receptors

2. Study of Effect of Drugs on Skeletal Neuromuscular Junction

Demonstration of the presence of Nicotinic receptors & effect of competitive reversible & irreversible neuromuscular blockers on them

 

CLINICAL PHARMACOLOGY

 

1. Drug Information Sources

A comparative study of the ‘Prescribing information of Drugs’ as provided by the Manufacturers’ Product Literature and the authentic Drug Compendia (British National Formulary/ Bangladesh National Formulary)

 

2. Essential Drug Concept Exercise on Selection Essential Drugs

 

3. ‘P Drug’ Concept

Exercise on selection ‘P Drugs for different clinical situations & preparation of student formulary

 

4. Prescription Audit

Exercise on ‘Prescription Audit’ using INRUD indicators

 

ContentsTerm I

General Pharmacology:

Pharmacokinetics and Pharmacodynamics

Autonomic Pharmacology:

  • Review of Cholinergic–Anticholinergic drugs
  • Revives of Adrenergic–Antiadrenergic drug
  • Drugs Acting on Renal & CVS
  • Review on Endocrine drug
  • Drugs for Bronchial asthma, PUD, Anemia

 

Term II

  • Drugs used in Anxiety, sleep disorder
  • Drugs used in depression, epilepsy and parkinsonism
  • Autacoids & NSAIDs
  • Chemotherapy for specific infections: Shigellosis, Enteric fever, ARIs, UTIs, malaria, tuberculosis, fungal infections
  • RUM: Principles of Rational prescribing & means to resist pressure for irrational prescribing, Essential Drug Concept