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 new drug discovery.

Any pharmacotherapy textbook covering the topics of the course can be used, provided it is an updated latest edition. For example: Goodman and Gilman, The pharmacological basis of therapeutics, Ed. McGraw-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 textbooks (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 solving 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 integrate skills and knowledge gained in previous years of their curriculum studiorum for understanding therapy. Students, at the end of this course, are able to inform people about the correct use and choice of drugs, and to understand 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 are prerequisites for the course of preclinical pharmacology and pharmacotherapy: physiology, pathology, cellular and molecular pharmacology.

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

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.

The final exam consists of a 30-40 minute discussion on selected course topics, mainly aimed at evaluating the students' knowledge, their ability to logically connect concepts, their problem-solving ability and communication skills, together with the use of appropriate terminology. Students are strongly encouraged to attend examination sessions before actually deciding to be examined.

Preclinical Pharmacology: in search for new drugs. Target identification and validation in drug discovery. Pharmacogenetics/genomics applied to drug discovery. In vitro and in vivo models in research and drug discovery.
Pharmacotherapy. 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 neuromuscular junction. Cholinergic agonists and antagonists and cholinesterase inhibitory drugs; adrenergic agonists and antagonists; pharmacology of neuromuscular 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. NSAIDs, paracetamol, opiates (SAO, LAO, ROO), treatment of neuropathic pain. Headache and migraine therapy.
Immune system and inflammation. Glucocorticoids, immunosuppressive agents and immunostimulants. Antihistaminic drugs. Anesthesia: local and general anesthetics.
Cardiovascular system and kidney. Drugs for the treatment of cardiac insufficiency and myocardial ischemia. Antiarrhythmic drugs. Drugs acting on the renin-angiotensin-aldosterone system. Antihypertensive agents. Diuretics. Drugs acting on the blood. Anticoagulant and antiplatelet drugs. Fibrinolytics.
Endocrine system and metabolism. Therapy of osteoporosis and diabetes. Antidyslipidemic drugs.
Respiratory system. Bronchodilators and agents used in the treatment of asthma. Antitussive agents and mucolytics.
Gastrointestinal system. Agents used for the control of gastric acidity and treatment of peptic ulcers. Agents used for diarrhea and constipation. Antiemetics and proemetics. Prokinetic agents.
Biotech drugs: peculiarities of biotech drugs vs small molecules. Adverse reactions to biotech drugs. Immunogenicity of biotech drugs. Therapeutic proteins: insulins and insulin analogs, GH and GH antagonist, CSFs, interferons, erythropoietins, tPAs. Evolution and innovation of therapeutic proteins, biobetters. Glycoengineering and pegylation. RNA-based therapeutics. Aptamers. Advanced therapies: gene therapy and cellular therapy. The use of stem cells in human 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 common human diseases. Moreover he/she should be able to critically understand the most modern preclinical approaches aimed at discovery of new pharmacological entities in therapeutic areas of high medical need. Last but not least, he/she should be able to understand, share and use the appropriate pharmacotherapy terminology and its correct application in clinical practice.