Ateneo - UPO

This course centers on describing the biological foundations of infectious diseases that rationalize the clinical application of the primary classes of antimicrobial agents.

Govoni S, Spampinato SM, Navarra P, et al. - Farmacologia, Casa Editrice Ambrosiana, Second Ed. (2023); F. Rossi, V. Cuomo, C. Riccardi – Farmacologia, Edizioni Minerva Medica, last ed; B.G. Katzung, S.B. Master, A.J. Trevor – Farmacologia Generale e Clinica, Piccin, last ed; Goodman & Gilman – Le Basi Farmacologiche della Terapia. Il manuale, Zanichelli, last ed; H.P. Rang, M.M. Dale, J.M. Ritter, Farmacologia, Casa Editrice Ambrosiana, last edition

The goal of the course is to provide basic knowledge of the pharmacokinetic, pharmacodynamic, and clinical aspects of molecules used to treat infectious diseases, and to provide the critical tools for understanding therapeutic decisions.

None. It is strongly suggested that the student has already positively performed the following courses: Biochemistry, Physiology, Pathology, Microbiology, Anatomy

The course contents will be transmitted through oral presentations supported by explanatory multimedia about the different topics included in the program. It will stimulate the active participation of the student through the recall of concepts already addressed in other courses, which relate to various aspects of the drug and the disease.

Within the same exam session, students may retake the examination only if at least three weeks have elapsed since their previous unsuccessful attempt.
Students with physical disabilities, Learning Disabilities or Special Education Needs can request specific services and tools via the Staff Sviluppo e Coordinamento Carriere e Servizi alle Studentesse e agli Studenti, consulting the University webpage: https://www.uniupo.it/en/services/services-students-physical-or-learning-disabilities Students with disabilities, learning disabilities or special education needs, once they have contacted the University Staff, can refer to the tutor in charge of the course to define the examination modalities, concerning academic aspects.

Oral examination.
Oral examination is performed by asking to the student some questions related to topics indicated in the course programme and given during the specific classes. To obtain positive results, the student must show a sufficient level of knowledge and of associative capabilities related to the different arguments; he/she must show that he understood and knows the critical concepts of the various topics. Greater levels of knowledge together with a demontrated capability of application of this background to the practice leads to an evalutation superior to that required for the minimal score. To obtain a high level of evaluation the student has to be able to utilize his/her knowledge to debate deeply some of the critical aspects of the different topics.

General principles of antimicrobial therapy regarding drug selection based on pharmacokinetic/pharmacodynamic (PK/PD) profiles, host-dependent factors, and the biological characteristics of the pathogen. Bactericidal versus bacteriostatic agents; concentration-dependent versus time-dependent therapeutic efficacy. Mechanisms of drug resistance and associated clinical challenges.Antibacterial AgentsCell Wall Synthesis Inhibitors:Beta-lactams: Penicillins, Cephalosporins (1st to 5th generation), Monobactams (Aztreonam), and Carbapenems (Imipenem, Meropenem).Glycopeptides & Lipoglycopeptides: Vancomycin, Teicoplanina, Dalbavancin.Fosfomycin.Cyclic Lipopeptides: Daptomycin (specifically targeting resistant Gram-positive pathogens).BacitracinProtein Synthesis Inhibitors (Ribosomal Targets):Aminoglycosides (30S subunit inhibitors): Gentamicin, Amikacin, Tobramycin.Tetracyclines & Glycylcyclines (30S subunit inhibitors): Doxycycline, Minocycline, Tigecycline.Macrolides & Ketolides (50S subunit inhibitors): Azithromycin, Clarithromycin, Telithromycin.Lincosamides: Clindamycin.Oxazolidinones: Linezolid, Tedizolid (critical for Methicillin-Resistant Staphylococcus aureus - MRSA).Nucleic Acid Synthesis Inhibitors:Fluoroquinolones (DNA gyrase & Topoisomerase IV inhibitors): Ciprofloxacin, Levofloxacina, Moxifloxacin.Rifamycins (RNA polymerase inhibitors): Rifampicin (cornerstone of anti-tuberculosis therapy).Nitroimidazoles: Metronidazole (targeting anaerobic bacteria and protozoa).Antimetabolites (Antifolates):Sulfonamides & Dihydrofolate Reductase Inhibitors: Co-trimoxazole (Sulfamethoxazole/Trimethoprim).Cell Membrane Disruptors:Polymyxins: Colistin (Polymyxin E) and Polymyxin B (utilized as last-line therapy for pan-drug-resistant Gram-negative bacteria).Antifungal AgentsAzoles: Topical Imidazoles (Ketoconazole, Clotrimazole) and Systemic Triazoles (Fluconazole, Voriconazole, Posaconazole, Isavuconazole).Polyenes: Amphotericin B (including liposomal formulations) and Nystatin.Echinocandins (Glucan synthesis inhibitors): Caspofungin, Micafungin, Anidulafungin.Allylamines: Terbinafine.Antimetabolites: Flucytosine.Antiviral AgentsAnti-Herpesvirus Agents: Acyclovir, Valacyclovir, Ganciclovir, Foscarnet.Anti-Influenza Agents: Neuraminidase inhibitors (Oseltamivir, Zanamivir) and Endonuclease inhibitors (Baloxavir marboxil).Antiretroviral Therapy (ART for HIV):NRTIs & NNRTIs (Nucleoside/Non-Nucleoside Reverse Transcriptase Inhibitors).Protease Inhibitors (PIs) and Integrase Strand Transfer Inhibitors (INSTIs).Direct-Acting Antivirals (DAAs) for HCV: NS3/4A, NS5A, and NS5B inhibitors (e.g., Sofosbuvir, Glecaprevir/Pibrentasvir).Anti-SARS-CoV-2 Agents: Nirmatrelvir/Ritonavir, Remdesivir.Antiparasitic AgentsAntimalarials: Chloroquine, Artemisinina derivatives, Atovaquone/Proguanil.Antihelminthics: Albendazole, Mebendazole, Ivermectin, Praziquantel.

Ideally, at the end of the course the student has to know the pharmaco-therapeutical approach to the different pathologies, and has be able to give advices to patients and to develop control capabilities. Finally, he/she should have enough skills to follow the continuous evolution of pharmacology and pharmacotherapy.