Clinical Pharmacology Department

3rd Year Medical Students

Student's Logbook

2016-2017

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Personal data

Student's name:

Student's ID:

Section number:

Section supervisors :

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Preface

Dear students

Welcome to the Department of Clinical Pharmacology at the beginning of the third year of medical education. The Department's mission is to enhance the international stature of Mansoura Faculty of Medicine by combining high quality teaching with internationally recognized research.

This booklet is a document of your attendance and your activities during the practical classes (experimental pharmacology and clinical cases).

Lastly, I wish you a fruitful and enjoyable study of clinical pharmacology during this year.

Head of the departmentProf. Dr. Hussein M. El-Beltagi

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Vision (what we want to become)

The department of clinical pharmacology, faculty of medicine, Mansoura university will be a premier academic model in the field of pharmacology and therapeutics in Egypt and Middle East. The faculty and staff will actively engage in education and research to identify and promote use of the best therapeutics.

جامعة ، الطب بكلية اإلكلينيكية الفارماكولوجيا قسم يتطلعالفارماكولوجيا مجال فى رائدا أكاديميا نموذجا يكون أن المنصورة

التدريس هيئة أعضاء ينخرط حيث االوسط والشرق مصر فى والدواءأمثل استخدام لضمان العلمى والبحث التعليم مجال فى بالقسم

للدواء.

Mission (the reason the department exist)

The clinical pharmacology department, faculty of medicine , Mansoura university will have excellence and leadership in five major core activities: education, research, clinical care, community service and faculty and staff development. We bridge basic medical sciences and clinical care through innovative and disciplined teaching of clinical pharmacology in an integrative manner.

جامعة ، الطب بكلية اإلكلينيكية الفارماكولوجيا قسم يسعىرئيسية انشطة خمسة فى والريادة التميز تحقيق إلى المنصورة : المجتمع وخدمة اإلكلينيكية والرعاية العلمى والبحث التعليم هى

الطبية العلوم بربط نهتم نحن التدريس، هيئة اعضاء وتنميةتدريس خالل من وذلك ، اإلكلينيكية بالرعاية األساسية

. وتكاملية مبتكرة بطرق اإلكلينيكية الفارماكولوجيا

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Course specificationFaculty : Medicine

Department : Clinical pharmacology

Programme(s) on which the course is given: MBBCH

Major or minor element of programmes: Major

Department offering the programme: Faculty of medicine

Department offering the course: Clinical pharmacology

Academic year/ level: Third year

Date of specification approval: 26-7-2010

A-Basic information Title: Clinical Pharmacology Code: CPHARM

Lectures: 120 hours Tutorial/Practical: 60 hours

Total: 180 hours

B- Professional information 1 - Overall Aims of Course

By the end of the course the students are expected1-To have knowledge and understanding of pharmacological basis of therapy including pharmacokinetics, mechanism, effects, side effects, interactions and use of drugs in treatment of common and life threatening illness as well as in prevention of diseases.

2-To develop skills of choosing proper drugs for different types of diseases based on evidence according to the patient's weight, age and health conditions.

3-To develop attitude of judicious use of drugs for patient's benefit and to avoid harmful effects of drugs by recognizing side effects of drugs as well as drug interactions.

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2-Intended Learning Outcomes of Course (ILOs)

A- Knowledge and Understanding

At the end of this course, students will be able to:-

A1- Define the pharmacokinetic, pharmacodynamic and pharmacotherapeutic properties of different groups of drugs affecting body systems.

A2- Record the adverse effects of commonly used drug groups, and their management.

A3- Describe drug interactions and contraindications of drugs in order to avoid harm to the patients.

A4- List clinically relevant age, sex and genetic related variations that affect response to drugs.

A5- Describe the mechanisms of action of drugs with regard pathophysiology of common diseases and recognize the rational for proper choice of drugs in treating them.

A6- Discuss the principles, indications, the relative advantages (benefits) disadvantages (risks) of various pharmacotherapy modalities.

A7- Recall the rational and general guidelines of the use of drugs in the proper dose in special population such as pediatrics, geriatrics, pregnancy and lactation and in cases of liver and/or kidney impairment.

A8- List drugs used in managing patients in life threatening situations.

A9- List drugs used in pre- and post-operative care in general & special situations.

B- Intellectual skillsAt the end of this course, students will be able to:-

B1- Design rational therapeutic strategies for both acute and chronic conditions that take into account the various variables that influence these strategies.B2- Choose the proper drug/s for the proper clinical situation in proper dosage.B3- Monitor the effectiveness and side effects of therapy.

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B4- Match proper drugs for selected important diseases based on patient's age, weight and health condition.

B5- Explain the importance of taking a comprehensive drug history of the patient.

C- Professional and Practical skillsAt the end of this course, students will be able to:-

C1- Calculate accurately drug’s dosage, bioavailability, plasma half life and volume of distribution in different patient populations.

C2- Distinguish different routes of administrations of drugs (intramuscular, intravenous, intradermal, subcutaneous and others).

C3- Observe, record and analyze the effect of drugs on biological tissues.C4- Report adverse drug effects and decrease drug-drug interactions.

D- General and Transferable skillsAt the end of this course, students will be able to:-

D1- Employ information technology effectively in the field of clinical pharmacology and search the internet for newly discovered drugs.

D2- Recognize the importance of life-long self-learning and give a strong commitment to it.

D3- Demonstrate respect to all patients irrespective to their socioeconomic levels, culture or religious beliefs and use language appropriate to the patient’s culture.

D4- Provide appropriate basic drug education to the patient and his family.

D5- Communicate effectively with other health care professionals to maximize patient benefits and minimize the risk of errors.

D6- Predict the possibility that clinical events are drug related.

D7- Recognize and effectively deal with unethical behavior of other members of healthcare team.

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Topic No. of hours

Lecture Tutorial/practical

General pharmacology-Pharmacodynamics Receptors, efficacy, potency, agonists and antagonists- Pharmacokinetics Absorption, distribution, metabolism & elimination of drugs - Sources and nature of drugs - Dosage forms and routes of drug administration. - Basis and ethics of prescription writing.-Chelators and heavy metals.

25 157

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10

2(practical)4(practical&skill)

2(practical)2(practical)

Autonomic pharmacology- Introduction - Acetylcholine receptors agonists and antagonists - Adrenoceptors activating drugs - Adrenoceptors blocking drugs - Neuromuscular blockers - Effect of stimulatory drugs on isolated heart. - Effect of inhibitory drugs on isolated heart. - Effect of stimulatory drugs on isolated intestine. - Effect of inhibitory drugs on isolated intestine. - Applied skeletal muscle pharmacology. - Applied ocular pharmacology. - Reversal of adrenaline action on blood pressure. - Reversal of acetylcholine action on blood pressure. -Effect of cholinesterase enzyme on A.ch.

31 1515

432

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2(practical)

2(practical)

2(practical)

2(practical)

1(practical)2(practical)2(practical)

2(practical)

1(practical)Autacoids & anti-inflammatory- Histamine, serotonin and antagonists - Prostaglandins and other eicosanoids - Polypeptides - NSAIDs - Rheumatic fever - Arthritis

12 83113

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2(tutorial)2(tutorial)

Renal pharmacology-Diuretics: loop, thiazides, k sparing and other diuretics

6 66

--

Cardiovascular pharmacology 18 12 68

Contents

- Antihypertensive drugs - Drug therapy of acute coronary syndrome - Drug therapy of heart failure - Antiarrythmic drugs

3333

2(tutorial)2(tutorial)2(tutorial)

Blood pharmacology- Agents used in treatment of anaemias - Drugs used in clotting disorders: anticoagulants, antiplatelets & fibrinolytics - Drugs used in hyperlipidemia

10 824

2

22(tutorial)

Respiratory pharmacology- Bronchodilators and other agents used in B.A. - Cough medications: antitussives, mucolytics & expectorants - Pharmacology of gases

6 42

1

1

22(tutorial)

Gastrointestinal pharmacology- Drugs used in peptic ulcer - Prokinetic drugs - Laxatives & antidiarrheal drugs - Antispasmodics & spasmolytics - Drugs of hepatic related disorders

10 611211

42(tutorial)

2(tutorial)

Endocrine pharmacology- Hypothalamic & pituitary hormones - Thyroid & antithyroid drugs - Corticosteroids and their antagonists - Gonadal hormones and their antagonists - Pancreatic hormones & antidiabetic agents - Drugs affecting bone & Ca homeostasis

19 15223332

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2(tutorial)

2(tutorial)CNS pharmacology- Sedatives-hypnotic drugs - Antiepileptic drugs - Antiparkinsonian drugs - Antipsychotic drugs & Lithium - Antidepressants - Narcotic analgesics & antagonists - Non narcotic analgesics: NSAIDs, paracetamol and others - General &local anesthetics - Drugs stimulating CNS- Treatment of pain

21 152

1.51.52221

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2(tutorial)2(tutorial)

2(tutorial)

ChemotherapyA) General Chemotherapy

- Principles of antimicrobial drug action - Penicillin and cephalosporins - Chloramphenicol and tetracyclines - Aminoglycosides and polymyxins - Sulphonamides and Quinolones -Urinary tract infection -Treatment of some selected infections B) Special Chemotherapy

19 15712112

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4

2(tutorial)2(tutorial)

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- Antifungal agents - Antiviral chemotherapy - Antimycobacterial drugs - Antiprotozoal drugs - Antihelminthic drugs - Cancer chemotherapy - Drugs and immune system

1211111

Locally acting drugs 3 1 2(practical)

Total 180 120 60

Teaching and learning methods:

1-Lectures: to provide knowledge of course contents and intellectual skills using overhead projectors, PowerPoint presentations &video simulations. Students are divided into 2 groups and each lecture is repeated2-Practical demonstration: to show major drug actions in experimental animals using computer programs, electronic Board and different forms of drugs also provided. Students are divided into 12 groups; each group has 2 hours practical session per week.3-Tutorials: to discuss clinical problems using clinical case scenarios and discuss facts and concepts in therapy (PBL) using video simulation and electronic board. Students are divided into 12 groups; each group has 2 hours practical session per week.4- Small group teaching: mini-lectures in the department where students are divided into 8 groups; each group has 2 hours per week.4- Discussion sessions during office hours.5- Virtual Lab: educate the students some experiments

Method Aimed ILOsA1 2 3 4 5 6 7 8 9 B1 2 3 4 5 C1 2 3 4 D1 2 3 4 5 6 7

Lectures √ √ √ √ √ √ √ √ √ √

Practical Demonstration

√

Tutorials √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

Small group teaching

√ √ √ √

Teaching and Learning Facilities

1) Lecture halls: provided with overhead projector & data show

2) Experimental & Tutorial classes: provided with data show, electronic board & internet line where we explain effect of drug on animal tissues, also discuss clinical cases

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3) Library: General library in the building of faculty where most recent textbooks are available.

4) Virtual lab: each group is 25 students for training on virtual animal experiments & formative exams.

Student Assessment Methods

A) Attendance criteria:Students need to attend at least 75% of practical and tutorial classes to sit for the final exam. Attendance cards are employed; one card for each student at a time and each student deliver his own card personally.B) Examinations

Type of Exam Aimed ILOsWritten Examination Knowledge & understanding

Intellectual skillsClinical case scenarios Examination Intellectual skills

Practical skillsPractical Examination (OSPE) Practical skills

Oral Examination (multistations) Intellectual skillsAttitude

Regular Continuous Examination ( Midyear & formative)

Knowledge & understandingIntellectual skillsPractical skills

Assessment schedule & Assessment weightingAssessment schedule Marks

(300) Weight %

- Mid year (MCQ) 50 17- Activities

- Student presentation- Log book

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3

-Practical Examination (OSPE)-Oral Examination (multistations)-Clinical case scenarios

202050

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- Final written Exam Short essay questions(2 papers, 75 marks for each)(each paper include 25 marks MCQs)

150 50

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List of References

Departmental book -Staff Members of Mansoura Clinical Pharmacology Department. Essential Books -Basic and clinical pharmacology "last Edition, edited by Katzung, Lange Medical Books. -Clinical Pharmacology " Laurence: D.R. last edition, Edited by Bennet, P.N. and MI Brown"Churchill Livingstone Edinburgh London and New York" Latest

Third Year Clinical Pharmacology Curriculum & Blueprint for written exam (2015/2016)

Topic Teaching hours

Relative weight

Marks MCQs Essay

General pharmacology 15 12.5 % 25 16 9Autonomic pharmacology 15 12.5 % 25 16 9

Autacoids & anti-inflammatory 8 6.6 % 13.3 7 7Renal pharmacology 6 5 % 10 5 5

Cardiovascular pharmacology 12 10 % 20 12 8Blood pharmacology 8 6.6 % 13.3 6 7

Respiratory pharmacology 4 3.3 % 7 3 4Gastrointestinal pharmacology 6 5 % 10 4 6

Endocrine pharmacology 15 12.5 % 25 11 14CNS pharmacology 15 12.5 % 25 10 15

ChemotherapyA) General Chemotherapy

B) Special Chemotherapy

1688

13.3 %6.6 %6.6 %

26.413.213.2

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Total 120 100 % 200 100 100

Course coordinator: ass. Prof. Mohamed-Hesham DabaHead of the department: Prof. Hussien M. El-Beltagi

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Part I:Prescribing Drugs

Intended Learning Outcomes (ILOs):

On completion of the course, students will be able to:- Identify drug sources and active ingredients.- Describe basic concepts of drug administration.- Identify basics of prescription writing and write and audit

prescriptions of some selected cases.  - Calculate and interpret drug dosages, drug bioavailability

and volume of distribution.

Classes: Sources of drugs Forms of drugs Locally-acting drugs Routes of drug administration (skill lab) Basics of prescription writing

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Date Topic Staff name & Signature

Questions and comments:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

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Self learning(According to the given assignments)

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Part II:Experimental Pharmacology

Intended Learning Outcomes (ILOs):

On completion of the course:Students will have a basic knowledge of autonomic pharmacology,

chemical transmitters regulating autonomic functions and important diseases affecting it.

Students will observe biological experiments on isolated organ preparations in department’s lab, to identify the effects of drugs.

Students will be able to perform those experiments through virtual lab and answer the questions given with each experiment.

Students will be able to identify an unknown drug through experimentation via the virtual lab.

Classes:(Department’s lab experiments’ demonstration +virtual lab activities)

Blood pressure of anaesthetized dog: effect of adrenaline Blood pressure of anaesthetized dog: effect of acetylcholine Isolated rabbit's heart: effect of stimulatory and inhibitory drugs Isolated rabbit's intestine: effect of stimulatory and inhibitory drugs Isolated frog's rectus abdominus preparation: effect of

neuromuscular blocking drugs The rabbit's eye: miotics and mydriatics

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DateExperiment

SignatureDemonstration Virtual lab

.

Questions and comments:(Answers of questions given through the virtual lab experiments)………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

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Self learning(According to the given assignment through the virtual lab)

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Part III:Clinical Cases

Intended Learning Outcomes (ILOs):

On completion of the course: Students will have a basic knowledge of the pathophysiology of

diseases, the key points in the treatment strategy, problems arising from the use of some drugs, special groups of patients.

Students will be able to identify the fine differences between individual drugs in the same group and recognize evidence based pharmacotherapy.

Students will be able to analyze clinical pharmacological problems and perform problem solving through short case scenarios.

Classes: Treatment of hypertension Treatment of congestive heart failure Treatment of ischemic heart disease Treatment of peptic ulcer Treatment of diarrhea Treatment of acute rheumatic fever Treatment of bronchial asthma Treatment of diabetes mellitus Treatment of thyrotoxicosis Treatment of urinary tract infections

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Date Topic Staff name & Signature

Questions and comments:…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

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Self learning(Problem solving through given short case scenarios with

comments on pharmacotherapy)……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

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Prescription writing, Auditing and Standard Treatment Protocols

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Self learning(Samples of prescriptions)

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Students’ feedback and formative exam results………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

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