Medicine and Surgery

Contents: Principles of Pharmacodynamics Definitions of potency, efficacy, receptor agonists (full and partial) and antagonists, orthosteric agonists and antagonists, negative and positive allosteric modulators, super agonist, receptor reserve, habituation and tolerance, physical and motivational dependency. Classification of G-protein coupled receptors. Classification of G proteins. AGS and RGS. GRKs and arrestins: their role in receptor desensitization and internalization. Signal transduction mechanisms: focus on the adenylate cyclase/cAMP pathway and polyphosphoinositide hydrolysis. Pharmacology of nitric oxide. Pharmacology of phosphodiesterases and drug treatment of erectile dysfunction. Dopaminergic, adrenergic, serotonergic, histamine: role in physiology and pathology. Muscarinic and nicotinic receptors. Pharmacology of cholinesterases. Voltage-sensitive calcium channels. Principles of Pharmacokinetics Drug absorption, distribution, metabolism, and elimination. Bioavailability and AUC. Phase I reactions of drug metabolism: cytochrome-P450 (CYP1A1, 1A2, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, 3A4, 3A5, 3A7, 4F2), dihydropyrimidine dehydrogenase, alcohol dehydrogenase, epoxide hydrolase. Phase II reactions: glucuronidation and UGT, SULTs, amino acid conjugation, N-acetyltransferases, TPMT, COMT, GSH-transferases. Efflux pumps with focus on mdr-1 (glycoprotein-P). Selected themes of endocrine pharmacology and pharmacology of the gastro-intestinal system Drug treatment of GH deficiency and acromegalia. Drug treatment of hyperprolactinaemia. Clinical pharmacology of the adrenal cortex. Insulin receptors. Drug treatment of type-1 and type-2 diabetes (IDDM and NIDDM): short- and long-acting insulins, sulphonylureas, metformine, rosiglitazone, incretins, DPP-IV inhibitors, SGLT2 inhibitors. Ovary cycle and contraceptives. Drug treatment of hyper- and hypothyroidism. Anti-acid drugs (proton pump inhibitors and H2 receptor antagonists). Drug treatment of chronic inflammatory bowel disorders (IBDs). Drug treatment of HBV and HCV infections. Drugs used in inflammation, cardiovascular and lung disorders, and bacterial and viral infections Antiarrhythmic drugs, diuretics, antihypertensive drugs, drugs used in the treatment of heart failure. Antiinflammatory drugs: NSAIDs and corticosteroids. Biological drugs used in autoimmune disorders. General principles of antibiotic resistance. Pharmacology of microbioma. Pharmacological aspects of social microbiology. -lactamic antibiotics. Aminoglicosides. Glycopeptidic and lipopetidic antibiotics. Tetracyclines. Inhibitors of 50 S ribosomal subunit. Fluoroquinolones. Drugs used in the treatment of HIV infection. Pharmacology of neurological and psychiatric disorders. Drugs used in the treatment of: migraine, Parkinson’s disease, epilepsy, Alzheimer’s disease, and multiple sclerosis. Drugs used in the treatment of schizophrenia, major depression, anxiety, and bipolar disorders.

Requirements: Human Physiology, chemistry and biology.

Mandatory attendance

Evaluation methods: Oral exam including power point presentation of a scientific article.

Suggested textbooks: Goodman and Gilman: XII Edition in English

Contents: Fondamenti di Pharmacology Key words in pharmacology, names of drugs, classification of the drugs, EU reglementation of drugs; Drug absorption, distribution, metabolism, and elimination; diffusion of the drugs; way of administration; secondary effects; 4 types of receptors; agonist/antagonist; dopaminergic, adrenergic, serotonergic, glutamate, histamine and glucocorticoid receptors: role in physiology and pathology; development of a new medication; preclinic study until the registration and commercialisation; ethical experimentation and its reglementation; Talidomide; example of a preclinical experimentation using an animal model; epigenetic animal model. Stress and endocrine pharmacology Introduction of stress and GAS response; homeostasis and allostasis load; clinical pharmacology of the adrenal cortex. Glucorticoid receptors; Hypothalamo-pituitary-adrenal axis and response to stress. Individual differences in the response to stress; stress and chances in medicine studies; from homeostasis to pathology; bio-behavioral disorders and stress; Early life stress programs the phenotype in the adult; PRS animal model; Stress and anti-stress endocrine systems. Drug addiction Compulsive drug taking; different kind of drugs and different kind of users; the reward circuit; DA system; individual difference in drug taking; factor of vulnerability; stress and drug addiction; animal model of drug addiction; comorbidity depression and addiction; Ethanol consumption. Pharmacology of neurological and psychiatric disorders. Animal model definition; animal model of stress-related diseases such as sleep inflammation and gastro-intestinal disorders; neuropharmacology in the PRS animal model; animal model of Alzheimer disease.

Requirements: Human Physiology, chemistry and biology.

Suggested textbooks: Goodman and Gilman: XII Edition in English and 10 scientific articles.

mandatory

Evaluation methods: Oral examination of the course and the presentation of a scientific article with slide. Moreover, written exam on 10 report cards of scientific articles given during the course for each student.