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Course Title: Pharmacology Course Number: BMS 6400

Credits: 4

Period 1:
Start Date: December 7th, 2010
End Date: January 10th, 2011

Course Director: Georg Petroianu, MD, PhD


Contact Number: 305-348-1486, Alt: 305-607-1454 Email: Georg.petroianu@fiu.edu

Office Hours: By appointment only

Participating Faculty:

Name: Email: Phone:


Yerko Berrocal, MD yberroca@fiu.edu 305-807-7886
Jenny Fortun, PhD jfortun@fiu.edu 305-348-1487

COURSE DESCRIPTION:

This course is an introduction to the basic principles of pharmacology and to the primary classes of drugs
including the prototypic agents. The main goal of the medical training (curriculum) is to develop the
diagnostic and therapeutic skills (competencies) required by a basic doctor. Safe and effective
prescribing is such a core competency. In addition learning should provide an appropriate framework
fostering the ability to assimilate information about new drug development that will occur throughout a
professional career (self-directed learning). The Pharmacology teaching is designed with this final goal
(to attain a core competency) in mind and reflects the paradigm shift from a process focused education
to an outcome oriented education.

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The main characteristics of the Pharmacology teaching at FIU COM are:

1. A “three touch” approach with an introduction (Basic Pharmacology Course)


offered in Y1, reinforcement in a clinical context during subsequent years
(Organ System) and application in the Clinical Course. The introductory course
looks at drugs mainly from a molecular/cellular/ basic science perspective.
During the reinforcement period (organ System) the emphasis is on drug use in
the clinical context while during the final period (application) treatment plans,
multidrug interactions and prescription skills are highlighted.

2. Focus on Core Drugs & Therapeutic Problems (Student Formulary). “Medical


students are often overwhelmed by the large number of drugs that they
encounter during their training. This can be rather demoralizing and may lead to
lack of clarity and objectivity in learning. In an attempt to tackle this problem,
schools generate a list of core drugs that could be considered as the ‘student
formulary’ and would help to prioritize learning. The list comprises 100 - 150 key
drugs that are in common usage, used to treat common illnesses, representative
of important drug classes, and that a newly qualified doctor might be expected
to initiate or prescribe under the direction of a senior doctor”.

3. Provide a broad overview of the available drugs and drug classes. The focused
(selective) approach has its limitations due to many reasons, the main being
lacks of consensus on what are “core drugs”. Furthermore USMLE –the standard
for required medical knowledge- favors superficial familiarity with a wide range
of drugs over detailed knowledge of a few. Lippincott’s Illustrated
Pharmacology Review became the de facto Student Formulary. Additionally for
legal reasons it appears less advisable to apodictically assign levels of
importance to FDA approved drugs.

4. Using in addition to traditional format lectures also Problem Based Learning


(PBL) and Case Based Learning (CBL). While during the Basic Pharmacology
Course (introduction) offered in Y1 traditional format lectures are predominant,
over time the balance shifts to PBL and CBL. All clinical case to be used in the
Organ System units will include some Pharmacology content and could involve
the Department.

5. Using frequent formative and summative examinations scheduled early in order


to allow time for remedial action if needed. The format of the examination is
adapted to the “three touch” approach: introduction, reinforcement and
application. For the Basic Pharmacology Course (introduction) offered in Y1 the
format of the examinations is MCQ. For the Pharmacology component of the
various Organ System units (reinforcement) a mixture of MCQs and assignments
is used, while for the clinical component MCQs, assignments and viva’s are
used.

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COURSE OBJECTIVES:

At the end of this course students will be able to

1. Define key terms: Drug, drug receptor, agonist, antagonist, affinity and intrinsic activity,
selectivity, dose response, structure activity relationship, pharmacokinetics, time action
relationships, dose response relationship, efficacy, potency, tolerance, drug metabolism,
toxicity.
2. Identify drug groups by suffix
3. Develop a foundation for continuing education about drug therapy and the ability to evaluate
new drugs.
4. Develop a rational approach to drug use in therapy.
5. Describe the factors affecting absorption, distribution, metabolism and elimination (ADME) of
drugs as well as drug toxicity and interactions.
6. Describe the principles of pharmacodynamics (PD) including structure activity relationships, the
chemical properties of drugs affecting specificity of action, efficacy, potency, dose response
relationships and dose, time response relationships.
7. Describe the principles of loading dose and maintenance dose.
8. Explain how drugs work and recognize the major receptor families that mediate drug actions at
the cellular and membrane level.
9. Describe drug actions on non receptor targets including enzymes and nucleic acids.
10. Describe receptor dynamics, up and down regulation and the effect on therapy.
11. Explain factors of age, gender, development, disease and genetics in drug effects.
12. Compare the factors affecting population responsiveness versus individual responsiveness to
drugs.
13. Describe the implications of multiple drug therapy (drug-drug interactions) and relationships
between drugs and nutritional substances/food (food-drug interactions)

REQUIRED TEXTBOOKS OR READINGS:

1. Harvey, R. A., Champe, P. C., Finkel, R., Cubeddu, L., & Clarke, M. A. (2008). Lippincott's
Illustrated Reviews: Pharmacology, 4th Edition (Fourth Edition.). Lippincott Williams & Wilkins.
ISBN-13: 978-0781771559

RECOMMENDED TEXTBOOKS OR READINGS:

2. Goodman, L. S., Limbird, L. E., Milinoff, P. B., Ruddon, R. W., & Gilman, A. G. (1996). Goodman
and Gilman's: The Pharmacological Basis of Therapeutics (9th ed.). McGraw-Hill (Tx).
ISBN-13: 978-0071422802
3. Kim, Sandra I., and Todd A. Swanson. Board Review Series Pharmacology (Flash
Cards). Lippincott Williams & Wilkins, 2004. Print. ISBN-13: 9780781747967

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EVALUATIONS:

MID Term Exam: 40%


Final Exam: 60%
TOTAL: 100%

Student achievement will be assessed by multiple choice USMLE style objective exams.

 MID Term Exam (40%):


80 MCQ USMLE style objective exams

 Final Exam (60%):


80 MCQ + 100 MCQ NBME USMLE style objective exams

 TOTAL: 260 MCQ

Attendance Policy:
 Class: Attendance is not required but recommended. However, YOU will be responsible for
obtaining information presented in class from FELLOW COLEAGUES.

Remediation Policy:
 Exams: Only extreme cases of hardship will be considered as sufficient reason for missing an
exam. A viva voce remedial exam (make up exam) will be offered in spring (exact dates to be
announced by Medical Education)

COURSE POLICIES:

Course grades:
The final grade in this course will be a number on a scale of 75-100. A final grade that is below 75 is an
unsatisfactory performance in this course and will be recorded as unsatisfactory “U.”

Remediation of Unsatisfactory Performance


A student who performs below the satisfactory level will be notified by the Office of Medical Education
to meet with the Course Director for the purpose of developing a remediation plan. Remediation of
unsatisfactory performance will proceed with a formal remediation plan established by the course
director and the student. The plan will be formalized with a signed agreement titled “Remediation Plan
for Unsatisfactory Performance”, a standard document stipulating the expectations for work to be
performed, the measures to be used to assess competency, and the time period for the remediation.
The student, course director, and the Associate Dean for Curriculum must approve the coursework
remediation plan and sign the agreement.

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Upon satisfactory performance per the agreement the course director will report the satisfactory
achievement for the course and a grade of “75” will be awarded. Failure to complete the plan for
remediation (i.e., work not completed or performed at an unsatisfactory level) will be reported to the
E&P Committee for action.

Incomplete Work in a Course:


If a student is unable to complete required work in a course, the student may request permission to
continue study with an incomplete status for the course. This requires formal notification by the Course
Director to both the Executive Associate Dean for Student Affairs and the Associate Dean for Curriculum,
providing the information that an incomplete has been given with an explanation for the incomplete.
The registrar will enter a grade of “I” on the record.

Make up for Incomplete Course Work:


A plan to make up incomplete course work will be created by the Course Director and approved by the
student and the Executive Associate Dean for Student Affairs and the Associate Dean for Curriculum.
The formal plan (“Plan for Completing Course Requirements”) will describe the activities, assessment
and time period to complete the work. When completed, the course director will report the grade
earned.

Academic Misconduct:
The Florida International University Herbert Wertheim College of Medicine is a community dedicated to
generating and imparting knowledge through excellence in teaching and research, rigorous and
respectful exchange of ideas, and community service. All students should respect the right of others to
have an equitable opportunity to learn and to honestly demonstrate the quality of their learning.
Therefore, all students are expected to adhere to a standard of academic conduct, which demonstrates
respect for themselves, their fellow students, and the educational mission of the Florida International
University. All students are deemed by the University to understand that if they are found responsible
for academic misconduct, they will be subject to the Academic Misconduct procedures and sanctions, as
outlined in the Student Handbook. Students who plagiarize or cheat can be charged with academic
misconduct. Penalties for academic misconduct can include up to dismissal from the University. The
University's Code of Academic Integrity can be found at:
http://www.fiu.edu/provost/polman/sec2/sec2web2-44.htm

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Weekly Schedule:

The weekly class schedule is subject to change, and students will be notified either in class or by e-mail.

Day Time/ Topic


# Location
1 Tuesday AM 8:00-9:00
7-Dec An introduction to drugs (I)
AM 9:00-10:00
(Pharmacokinetics: ADME)
AM An introduction to drugs (II)
10:00-11:00
AM (Pharmacokinetics: ADME)
LUNCH

2 Wednesday AM 8:00-9:00
8-Dec AM An introduction to drugs (III)
9:00-10:00
(Pharmacodynamics: PD)
AM An introduction to drugs acting at the
10:00-11:00
sodium channel
AM An introduction to drugs acting on the
11:00-12:00
chloride channel (GABA receptor)
LUNCH

3 Thursday AM 8:00-9:00
9-Dec AM An introduction to drugs acting at the
9:00-10:00
calcium channel
AM An introduction to drugs acting at the
10:00-11:00 potassium channel

AM An introduction to drugs acting at


11:00-12:00
Excitatory Amino Acid (EAA) receptors
LUNCH

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4 Friday AM 8:00-9:00
10-Dec AM 9:00-10:00 Case I & II
AM 10:00-11:00
AM 11:00-12:00
LUNCH

5 Monday AM 8:00-9:00
13-Dec AM An introduction to drugs acting at the
9:00-10:00
opioid receptor
AM An introduction to drugs acting on
10:00-11:00
Serotonin Receptors and Pumps (I)
AM An introduction to drugs acting on
11:00-12:00
Serotonin Receptors and Pumps (II)
LUNCH

6 Tuesday AM 8:00-9:00
14-Dec AM 9:00-10:00 An introduction to drugs acting on
Histamine Receptors
AM 10:00-11:00 An introduction to drugs acting on
Dopamine Receptors (I)
AM
LUNCH

7 Wednesday AM 8:00-9:00
15-Dec AM 9:00-10:00 An introduction to drugs acting on
Dopamine Receptors (II)
AM 10:00-11:00 Drugs acting on cytosolic receptors:
steroid pharmacology
AM 11:00-12:00
LUNCH

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8 Thursday AM 8:00-9:00
16-Dec AM 9:00-10:00 Drugs acting at cytosolic PPAR receptors:
An introduction to drugs acting at the
peroxysome proliferator activator
receptor.
AM 10:00-11:00 Drugs acting at tyrosine kinase
receptors: Pharmacology of insulin.
AM 11:00-12:00 Cycloxygenase (COX) & lipoxygenase
(LOX) inhibitors
LUNCH

9 Friday AM 8:00-9:00
17-Dec AM 9:00-10:00 Case III & IV
AM 10:00-11:00
AM 11:00-12:00
LUNCH

10 Monday AM 8:00-9:00
20-Dec AM 9:00-11:00 MID Term Exam
AM
AM
LUNCH

11 Tuesday AM 8:00-9:00
21-Dec AM 9:00-10:00 Inhibitors of Na reabsorption: Diuretics
Angiotensinogen Converting Enzyme
AM 10:00-11:00
(ACE) inhibitors
AM
LUNCH

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12 Wednesday AM 8:00-9:00
22-Dec AM 9:00-10:00 Phosphodiesterase (PDE) inhibitors
AM 10:00-11:00 HMG CoA reductase inhibitors
AM 11:00-12:00 Nitric Oxide Donors and Inhibitors
LUNCH

13 Monday AM 8:00-9:00
3-Jan AM 9:00-10:00 Anti-Cholinesterase Drugs
AM 10:00-11:00 Drugs acting on Muscarinic Receptors
Drugs acting on Alpha Adrenergic
AM 11:00-12:00
Receptors
LUNCH

14 Tuesday AM 8:00-9:00
4-Jan Drugs acting on Beta Adrenergic
AM 9:00-10:00
Receptors
Drugs acting on GABA Receptors:
AM 10:00-11:00
Introduction to Volatile Anesthetics
AM
LUNCH

15 Wednesday AM 8:00-9:00
5-Jan Drugs Acting at the Nicotinic Receptor:
AM 9:00-10:00
Depolarizing Muscle Relaxants
Drugs Acting at the Nicotinic Receptor:
AM 10:00-11:00
Non Depolarizing Muscle Relaxants
AM 11:00-12:00 Other Drugs
LUNCH

16 Thursday AM 8:00-9:00

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6-Jan AM 9:00-10:00 Drugs affecting coagulation (I)
AM 10:00-11:00 Drugs affecting coagulation (II)
AM 11:00-12:00 Other Drugs
LUNCH

17 Friday AM 8:00-9:00
7-Jan AM 9:00-10:00 Case V & VI
AM 10:00-11:00
AM 11:00-12:00
LUNCH

18 Monday AM
10-Jan AM
AM
8:00-2:00 Final Exam
AM
PM
PM

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