Ateneo - UPO

Pharmacotherapy- the treatment of disease through the administration of medications- is a course that introduces students to the main drug classes currently available for the treatment of major human diseases. A basic understanding of treatment options available for such disease states is also developed during this course through the discussion, for each drug, of mechanism of actions, side effects, contraindications and limitations in their use in specific patient subpopulations. Anatomy, physiology, pathophysiology, genetics, cellular and molecular biology, clinical biochemistry aspects related to the presentation and management of such diseases will also be discussed during the course since they are essential to understand the rational basis of therapeutic interventions. Physicochemical and biological principles of dosage forms and drug delivery strategies used to treat specific human disorders will also be reviewed. The course will extensively evaluate and discuss, in an integrated manner, all the variables (genetic and non genetic) that regulate interaction between drugs and human body and that ultimately affect, in an individual manner, therapeutic actions as well as side effects and toxicity of clinically relevant drugs. Altogether, the student will be able to understand the rationale upon which drug therapy decisions are based. Moreover the course includes a module which covers modern aspects of preclinical pharmacology which are critical for recent drug approvals.

It is strongly recommended to deepen knowledge thorugh textbook reading. Any pharmacotherapy textbook covering the topics of the course can be used, provided it is an updated edition. For example: Goodman and Gilman, The pharmacological basis of therapeutics. Ed. MacGraw-Hill, 13th edition; B.G. Katzung, Farmacologia generale e clinica, Piccin; Howland and Mycek, Le basi della farmacologia, Zanichelli; Rang, Dale, Ritter, Farmacologia, Casa Editrice Ambrosiana. For topics which may not be covered by booktexts (i.e. preclinical pharmacology and biotechnological drugs), bibliographic references will be provided.

This course provides students with an integrated approach to understanding principles of and solve problems related to pharmacological treatment of human diseases. Pharmacotherapy enables students to discover connections across multiple disciplines (among others, anatomy, physiology, pathology, biochemistry), see them applied in clinical therapy and to integrate skills and knowledge gained in previous years of their curriculum studiorum for understanding therapy. Students, at the end of this course are formed and can inform people about the correct use and choice of drugs, and should be capable of understanding drug interactions and adverse reactions. In addition, students will be able to critically evaluate the experimental approaches for screening, mechanisms of action definition and pharmacological characterization of new drugs.

The following exams: physiology, pathology, cellular and molecular pharmacology are prerequisites for the course of preclinical pharmacology and pharmacotherapy.

Teaching is given in the form of classroom lectures, focused group works and discussions of case studies which will allow the students to critically contribute in the topic understanding. Additionally, every year seminars or workshop on specific topics will be organized with national and international experts; student attendance is mandatory since they will be actively involved in the discussion with experts.

In the last three years, the use of Kahoot as an innovative teaching method was introduced and experimented with great success (as deduced from the students' course evaluations). This is a (self)learning platform that students access in the classroom with their mobile phone (via a free app) to take part into a test (10-40 multiple choice questions, with a fixed time) prepared by the teacher on the topics covered in classroom. Sometimes the test (8-10 questions) is given just at the end of the lesson, sometimes (30-40 questions) after the conclusion of a complex topic that required more than one lesson or when it is necessary to logically relate concepts together acquired on apparently distinct topics. Through an entertaining competition among participants (for each question the student obtains an immediate correct/wrong evaluation, his/her own score and the first 5 positions in the classroom ranking are revealed), the students can immediately if the answer is correct/wrong, their performance and if they have understood the complex concepts and topics carried out in the classroom. On the other hand Kahoot use allows the teacher to: i) reiterate the most complex concepts explained in the classroom through new examples and questions; ii) logically linking new information together; iii) re-explaining a concept in the case of negative answers; iv) have an immediate understanding of the comprehension of the students on the topics covered. In addition, at the end of each test, the lecturer collects all the students correct/incorrect answers and these data allow to monitor progress during the entire course both in the learning upgrades of the students and to realize if some topics should be resumed in class and/or integrated.

If the case of a new COVID19 emergency, live lessons will be carried out through Google meet/Zoom and also recorded and uploaded them on DIR, for specific requests. Periodically and/or upon student request, question time will be organized on Google meet.

The final exam consists in a 30-40 min discussion on selected course topics and will be mainly aimed at evaluating the ability of the students to prove not only their knowledge but also their ability to logically connect concepts, their problem solving ability and their communication skills, together with the use of appropriate terminology. Students are also strongly encouraged to attend examination sessions, before they actually decide to be examined.

Upon request, the students can also assess their preparation before the exam by taking self-evaluation tests on different course topics which were prepared by the teacher and available on the platform Kahoot.

Variability in the individual response to drugs: genetic and non genetic factors. Pharmacogenetics and Pharmacogenomics: applications in therapy. Adverse drug reactions (ADR). Interaction between drugs, between drug and natural products, drugs and food. Drugs of Peripheral nervous system and neuromuscolar junction. Cholinergic agonists and antagonists and cholinesterase inhibitory drugs; adrenergic agonists and antagonists; pharmacology of neuromuscolar transmission.
Pharmacotherapy of major psychiatric disorders. Anxiolytics, Antidepressants, Mood stabilizers, Antipsychotics. Pharmacotherapy of major neurological disorders. Parkinson’s disease. Anticonvulsant drugs. Benzodiazepines and other sedative-hypnotic drugs. Pain as a symptom or as a disease. NSAID, paracetamol, opiates (SAO, LAO, ROO), treatment of neuropathic pain and breakthrough pain. Headache and migraine therapy. Glucocorticoids, Immunosuppressive agents and immunostimulants. Antiistaminic drugs. Local and general anesthetics. Drugs for the treatment of cardiac insufficiency and myocardial ischemia. Antiarrhythmic drugs. Antihypertensive agents. Anticoagulant and antiplatelet drugs. Fibrinolitics. Therapy of osteoporosis and diabetes (type 1 and 2). Antidislipidemic drugs. Bronchodilatators and agents used in asthma. Agents used for the control of gastric acidity and treatment of peptic ulcers. Agents used for diarrhea and constipation. Antiemetics and proemetics. Principles of antibiotic use in therapy. Biotech drugs: Peculiarities of biotech drugs vs small molecules. Adverse reactions to biotech drugs. Immunogenicity of biotech drugs. Duscussion of some therapeutic proteins: insulins and insulin analogs, GH and GH antagonist, CSFs, interferons, erithropoietins, tPAs. Evolution and innovation of therapeutic proteins, biobetters. Glicoingegnerization and pegylation. Monoclonal antibodies. Nucleic acids as drugs. Principles of Advanced therapies: gene therapy and cellular therapy.

The student is expected to apply acquired knowledge and competence for the identification and understanding of the most appropriate and safe therapeutic choices in relevant human diseases. Moreover students should be able to critically understand the most modern approaches aimed at discovery of new pharmacological entities in therapeutic areas of high medical need. Last but not least, students should be able to understand, share and use the appropriate pharmacotherapy terminology and its correct application in clinical practice.