Medical Pharmacology Course Objectives
(Listed by Subject Block)

Basic Principles:

1. Describe the two primary properties of a drug receptor, and how a receptor differs from an inert binding site.
2. List four different types of targets (receptors) by which drugs can interact to exert their biological effects.
3. Define the following drug properties: agonist, antagonist, partial agonist, affinity, efficacy, potency.
4. Describe a typical dose-response curve for a drug, and label the positions on the curve that are used to define drug potency and efficacy.
5. Describe several different signal transduction mechanisms by which agonists exert their effects.
6. Explain the difference between selectivity and specificity of drug effect, and which is more commonly observed.
7. Describe what is meant by the term Therapeutic Window.
8. Describe and explain the effect(s) of competitive and non-competitive antagonists on the dose-response curve for an agonist.
9. Explain how a quantal dose-response curve is constructed.
10. Explain what is meant by additive and synergistic drug effects.
11. Define the terms ED50, LD50, TD50 , and Therapeutic Index.

Pharmacokinetics:

1. Understand the importance of drug distribution with regard to efficacy and toxicity of drugs.
2. Explain how drug distribution may contribute to terminate the actions of some drugs.
3. Define the concepts of loading dose, maintenance dose, volume of distribution, clearance, elimination half-life.
4. Explain the difference between first-order, zero order and dose-dependent kinetics of drug elimination.
5. List examples of commonly prescribed drugs that follow zero-order, first-order and dose-dependent kinetics.
6. Describe the concept of "steady-state" with regard to plasma drug concentrations.
7. Explain the importance of different pharmacokinetic parameters on the duration of drug action.
8. Describe what is meant by a one-compartment and two-compartment model of drug distribution and elimination.
9. Explain the importance of drug distribution with regard to efficacy and toxicity of drugs.
10. Explain how drug distribution may contribute to terminate the actions of some drugs.
11. Explain the determinants of hepatic drug clearance.
12. Explain the difference between pre-systemic clearance (first-pass metabolism) and systemic clearance.
13. Explain the importance of plasma protein binding and hepatic blood flow with regard to hepatic clearance of drugs.
14. Explain the changes in hepatic drug clearance associated with liver disease.

Autonomic Pharmacology:

1. Describe the different roles of the sympathetic and parasympathetic divisions of the nervous system in homeostasis and general physiology.
2. Describe the physiological responses produced by activation of the sympatho-adrenal system in fight or flight situations.
3. Explain what tone is.
4. Apply knowledge of predominant tone to regulation of singly-innervated and dual-innervated organs.
5. Define the different cholinergic and adrenergic receptor subtypes, and describe their physiological roles.
6. List examples of selective cholinergic and adrenergic agonists and antagonists, and describe their effects on different organ systems.
7. Cite several examples of indirectly acting sympathomimetic drugs.
8. Describe the effects of autonomic drugs on vision (accomodation), and their use in the treatment of glaucoma.

Inflammation:

1. Explain the properties of autocoids, including biogenic amines, eicosanoides and their inhibitors, peptides and analogs, and smooth muscle/endothelial autocoids.
2. Explain the mechanisms of action, use and adverse effects of immunosupressive drugs and drugs used to treat acquired disorders of immune responsiveness.
3. Describe the mechanism of action, use, and adverse effects of drug used for the treatment of skin disorders (e.g. sunscreen, retin-A, methotrexate)

Anticancer Pharmacology:

1. List different types of drugs used to treat different forms of cancer.
2. Explain the mechanisms of action, use, and adverse effects of drugs used to treat different forms of cancer.

Cardiovascular Pharmacology:

1. Describe the mechanisms of action, use, and adverse effects of drugs used in the treatment of disorders of the cardiovascular system including:
   • coronary and peripheral vasodilators
   • antiarrhythmic drugs
   • antihypertensive drugs
   • drugs used to treat hypotension and shock
   • drugs altering cholesterol and lipid metabolism
   • inotropic drugs and other drugs used to treat heart failure

    

Renal Pharmacology:

1. Describe the mechanism of action, use, and adverse effects of drugs used in the treatment of disorders of the renal and urinary system including:
   • diuretics & antidiuretic drugs
   • drugs and fluids used to treat volume, electrolyte and acid-base disorders
   • drugs used to enhance renal perfusion (e.g. dopamine)
   • angiotensin converting enzyme inhibitors and angiotensin receptor antagonists

    

Respiratory Pharmacology:

1. Describe the mechanisms of action, use, and adverse effects of drugs used in the treatment of disorders of the respiratory system (e.g. expectorants, mucolytics, decongestants, cough suppressants, bronchodilators, anti-inflammatory drugs).

Hematopoietic Pharmacology:

1. Describe the mechanisms of action, use and adverse effects of drugs used to treat disorders of the hematopoietic system including:
   • blood and blood products
   • drugs stimulating erythrocyte production (erythropoietin)
   • drugs stimulating leukocyte production (e.g.G-CSF , GM-CSF)
   • anticoagulants, thrombolytic drugs
   • antiplatelet drugs
   • chelating agents

    

GI Pharmacology:

1. Describe the mechanisms of action, use, and adverse effects of drug used for the treatment of disorders of the gastrointestinal system including:
   • drugs used to alter GI motility (e.g. antidiarrheal drugs, antiemetics, prokinetics, cathartics)
   • fluid replacement (e.g. oral rehydration)
   • drugs used to treat peptic ulcer and gastroesophageal reflux (e.g. antacids, motility drugs, antibiotics)

CNS Pharmacology:

1. Describe the mechanisms of action, use, and adverse effects of drugs used to treat disorders of the nervous system including:
   • local and general anesthetics
   • hypnotics& anxiolytics
   • antipsychotics, antidepressants and mood-stabilizing drugs
   • anticonvulsants
   • analgesics
   • CNS stimulants (e.g. amphetamines)
   • antiparkinsonian drugs
   • neuromuscular junction blocking agents
   • antimigraine drugs
   • anticholinesterases
     
2. Describe the adverse effects of ethanol on the central nervous system.
3. Describe the mechanisms involved in the development of drug tolerance and drug dependence, and be able to cite examples that are clinically relevant.

Endocrine Pharmacology:

1. Describe the mechanisms of action, use, and adverse effects of drugs used for the treatment of the endocrine system including:
   • hormones and hormone analogs
   • stimulators of homrone production (e.g. sulfonylureas)
   • inhibitors of hormone production (e.g. thiouracils)
   • hormone antagonists
   • potentiators of hormone action (e.g. thiazolidinediones, demeclocycline)
   • antiobesity drugs (e.g. dexfenfluramine??? - not on the market)

    

Antimicrobial and Antiviral Pharmacology:

1. Describe the mechanisms of action, use, and adverse effects of drugs used for the treatment of infectious diseases including:
   • antibiotics
   • antifungal drugs
   • antimalarial drugs
   • antiparasitic drugs
   • antimycobacterial (e.g. antituberculosis) drugs
   • antiviral and anti-HIV drugs

    

Toxicology:

1. Describe special terms or acronyms which are used to define toxicity or safety.
2. Describe the basis of selective toxicity.
3. Describe the toxic effects of common household products.
4. Explain the basis for distinguishing acute vs. chronic toxicity.
5. Describe the general treatment of poisoning for specific agents
6. List at least one good chelating agent for each of the major heavy metals.
7. List antidotes for specific agents and their mechanisms
8. Describe the three aims of treatment of a poisoned patient.
9. Describe the general ways to prevent absorption of ingested drugs or chemicals.
10. Indicate the appropriate laboratory tests to determine whether a patient has been poisoned.
11. List the agents or procedures used to detoxify or eliminate poisons from the body after they have been absorbed..
    
    
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