The third school year
(Duration：170 Hrs)
system Lectur experime PBL Semina Tota
e nt (Hrs l
(Hrs) (Hrs) ) rs (Hrs
(Hrs) )
The General Pharmacology 18 10
Autonomic nervous system 12 18
Central nervous system 22 4 10
Analgesics 7 4 5
Cardiovascular drugs 21 20
Diuretics 3 3 5
Thrombolytics/anti-coagulants/anti-pla
5
telets
Total 88 42 40 170
The fourth school year
(Duration：106 Hrs)
system Lecture experiment PBL Seminars Total
(Hrs) (Hrs) (Hrs) (Hrs)
(Hrs)
Drugs acting on 5 5
gastrointestinal tract
Autacoids 3
Drugs acting on 5
4
respiratory system
Drugs acting on endocrine
10
system
Drugs acting on uterus 2
Antimicrobial drugs 32
Drug treatment of heavy
5
metal poisoning
Drug treatment of 10
different types of shock
Prescription writing 5
Seminars 20
Total 56 0 30 20 106
The General Pharmacology
Introduction
Objectives:
The students are required:
1: be aware of the place of pharmacology in clinical medicine and the development of
pharmacology.
2: know objectives of learning pharmacology and the mission of pharmacology.
Duration: 2 school hours
Teaching content
1.1 The definition of Pharmacology, the definition of Pharmacodynamics and Pharmacokinetics,
the definition of Drug and Drug nomenclature.
1.2 The standard source of drug information, the source of drug, Chinese pharmacopoeias and
formularies.
1.3 The branches of pharmacology and the development of pharmacology
1.4 The basic and clinical evaluation of new drugs..
Pharmacodynamics
Objectives:
The students are required:
Know the defination of receptors, agonist and antagonist, Dose response curve, EC50, potency,
therapeutic index, adverse action.
Be able to apply the theory of Pharmacodynamics.
Duration: 7 school hours
Teaching content
1 Drug action, adverse action, mechanisms of drug action, receptors, agonist and antagonist.
2 Dose response curve, EC50, potency, the relationship of drug concentration and response or toxic
effect, structure-activity relationship,
3 Clinical significance of therapeutic index and drugs with small and large index
Pharmacokinetics
Objectives:
The students are required:
Be able to apply the theory of pharmacokinetics.
Know the meaning of Pharmacokinetic parameters, Half-time, Clearance, Vd, Bioavailability,
Bioequivalence, first-order elimination kinetics, zero-order elimination kinetics.
Duration: 7 school hours
Teaching content
1 Absorption of drugs and process involved in drug absorption, factors that modifying absorption.
Bioavailability and it‟s clinical significance and factors effecting it.
2 Drugs reservoirs, distribution and redistribution of drugs, blood plasma protein binding,
biotransformation and excretion of drug
3 Pro-drug, biotransformation of drugs, enzyme induce and enzyme inhibition, entero-hepatic
circulation.
4 Excretion of drugs
5 Pharmacokinetic parameters
Half-time, Clearance, Vd, Bioavailability, Bioequivalence, first-order elimination kinetics,
zero-order elimination kinetics
Factors effecting drugs action
Objectives:
The students are required:
Know the factors that can affect drugs‟ action.
Duration: 2 school hours
Teaching content:
1 Dosage and the route of administration, drug interaction
2 Age, sex, genetic factor, idiosyncrasy, placebo effect, tolerance, drugs resistance, dependence,
withdrawal syndrome, receptor desensitization, receptor hyper sensitization.
Drugs acting on autonomic nervous system
Cholinergic drugs
Objectives:
The students are required:
Be able to describe mechanism of action, pharmacological effects, therapeutic uses, adverse
effects of pilocarpine and neostigmine.
Be able to know the symptoms and mechanism of intoxication of organophosphorus
compounds and the mechanism of the drugs usd to treat intoxication of
organophosphorus compounds
Be aware of the synthesis, release, and metablism of NA and Ach.
Duration: 3 school hours
Teaching contents:
mechanism of action, pharmacological effects, therapeutic uses, adverse effects of pilocarpine
mechanism of action, pharmacological effects, therapeutic uses, adverse effects of and
neostigmine.
the symptoms and mechanism of intoxication of organophosphorus compounds
the mechanism of pralidoxime chloride to solve intoxication of organophosphorus
compounds
Anti-cholinergic drugs
Objectives:
The students are required:
Be able to describe mechanism of action, pharmacological effects, therapeutic uses, adverse
effects and contraindications of atropine.
Be able to know the mechanism of action, therapeutic uses, adverse effects of succinylcholine
Be aware of the effect of anisodamine on peripheral blood vessels and the effect of scopolamine
on central nervous system.
Be aware of the characteristic of homatropine, benactyzine, pirenzepine.
Duration: 3 school hours
Teaching contents:
mechanism of action, pharmacological effects, therapeutic uses, adverse effects and
contraindications of atropin.
The characteristics of atropin to treat intoxication of organophosphorus compounds
The characteristics of anisodamine and scopolamine
the mechanism of action, therapeutic uses, adverse effects of succinylcholine
Adrenergic drugs
Objectives:
The students are required:
Be able to describe mechanism of action, pharmacological effects, therapeutic uses, adverse
effects of NA, adrenaline, dopamine, isoprenaline , dobutamine, ephedrine.
Be able to know the characteristics of αreceptor agonist, α,βreceptor agonist, andβreceptor
agonist.
Be aware of the relationship between chemical structure and efficacy.
Duration: 3 school hours
Teaching contents:
The chemical stucture of adrenergic drugs
mechanism of action, pharmacological effects, therapeutic uses, adverse effects of αreceptor
agonist,for example, NA, metaraminol, phenylephine.
mechanism of action, pharmacological effects, therapeutic uses, adverse effects ofα,βreceptor
agonist, for example, adrenaline, dopamine, ephedrine.
mechanism of action, pharmacological effects, therapeutic uses, adverse effects of βreceptor
agonist, for example, isoprenaline, dobutamine.
Anti-adrenergics
Objectives:
The students are required:
Be able to describe mechanism of action, pharmacological effects, therapeutic uses, adverse
effects of phentolamine.
Be able to describe mechanism of action, pharmacological effects, therapeutic uses, adverse
effects of propranolol.
Be able to know the differences among αreceptor blockers andβreceptor blockers.
Duration: 3 school hours
Teaching contents:
mechanism of action, pharmacological effects, therapeutic uses, adverse effects of phentolamine,
tolazoline, phenoxybenzamine.
mechanism of action, pharmacological effects, therapeutic uses, adverse effects of propranolol,
atenolol, labetalol.
Central nervous system
Sedative- hypnotics
Objectives:
The students are required:
Know pharmacological actions, therapeutic uses, adverse effects of benzodiazepines and
barbiturates.
Be able to describe clinical pharmacokinetics of benzodiazepines and barbiturates.
Duration: 3 school hours
Teaching contents:
Definition of sedative-hypnotic drugs and difference between sleep and drug induced sleep.
Mechanism of action, pharmacological effects, therapeutic uses, adverse effects and clinical
pharmacokinetics of benzodiazepines and barbiturates.
Method for barbiturates overdose.
Other sedative-hypnotic drugs: buspirone, zolpidem, zaleplon, chloral hydrate.
Antiepileptics
Objectives:
The students are required:
Know mechanism of action, pharmacological effects, therapeutic uses and adverse effects of
Phenytoin, Carbamazepine, Phenobarbital .
Duration: 3 school hours
Teaching contents:
Definitions of epilepsy, generalized seizures and partial seizures.
Phenytoin: pharmacological actions, therapeutic uses, adverse effects and drug interactions.
Carbamazepine: pharmacological actions, therapeutic uses, adverse effects and drug interactions.
Phenobarbital: characteristics of treating epilepsy.
Clinical uses of other antiepileptics.
General anesthetics
Objectives:
The students are required:
Know pharmacological effects and clinical uses of general anesthetics.
Be able to explain pharmacological bases of combined anesthesia.
Know prophylaxis for anesthetic accident.
Duration: 2 class time, study by themselves.
Teaching contents:
Definition and classification of general anesthetics and their pharmacokinetics.
Signs and stages of anesthesia.
Pharmacological actions and clinical uses of ether, halothane and pentothal.
Prophylaxis for anesthetic accident.
Pharmacological bases, clinical uses, and contraindications of combined anesthesia.
Local anesthetics
Objectives:
The students are required:
Know the pharmacological effects and clinical uses of procaine, lidocaine, and tetracaine.
Know how to apply local anaethetics and how to terminate the effects of them.
Be aware of the adverse effects of local anethetics.
Duration: 2 class time, study by themselves.
Teaching contents:
The mode of action of local anaethetics at both molecular and whole neurone levels.
Drugs absorption, from injection site into the circulation, factors that affect the action of local
anaethetics.
Pharmacological effects and clinical uses of procaine, lidocaine, and tetracaine.
Adverse effects of local anaethetics and how to treat them.
Drugs for movement disorders/anti parkinsonism drugs
Objectives:
The students are required:
Be aware of pathogenesis of parkinsonism.
Know mechaniam of action, therapeutic uses, adverse effects, drugs interaction of L-dopa and
bromocriptine.
Duration: 3 class time.
Teaching contents:
Pathogenesis of parkinsonism.
L-dopa: mechaniam of action, therapeutic uses, adverse effects, drugs interaction.
L-dopa potentiator: AADC inhibitor:carbidopa, MAO-B inhibitor: selegiline, COMT inhibitor.
Dopaminergic receptor agonist: bromocriptine.
Alcohol
Objectives:
The students are required:
Be aware of pharmacokinetics of ethanol.
Be aware of pharmacodynamics of acute ethanol consumption and consequences of chronic
alcohol consumption.
Know management of acute alcohol intoxication and alcohol withdrawal syndrome.
Duration: 3 class time.
Teaching contents:
pharmacokinetics of ethanol.
pharmacodynamics of acute ethanol consumption and consequences of chronic alcohol
consumption.
Pharmacotherapy of alcoholism: disulfiram, naltrexone.
Pharmacology of other alcohols.
Drugs for migraine
Objectives:
The students are required:
Be aware of pathophysiology of migraine.
Know the mechaniam of action, therapeutic uses, adverse effects of drugs for migraine.
Duration: 3 class time.
Teaching contents:
Introduction of migraine.
Drugs for migraine:
1. Nonspecific analgesics: asprin, acetaminophen, caffeine and so on.
2. antiemetic drugs.
3. opioid.
4.Prophylactic/preventive agents:β-adrenergic blocker, antidepressants, calcium channel blockers,
miscellaneous.
Psychopharmacology
Antipsychotics/ Anti-depressants/Anti-mania
Objectives:
The students are required:
Know the pharmacological effects, therapeutic uses and adverse effects of chlorpromazine.
Be aware of characteristics and therapeutic uses of Anti-depressants/Anti-mania.
Duration: 3 school hours.
Teaching contents:
Antipsychotics : the classification of achizophrenia and antipsychotics, the mechanism of action,
clinicial uses and main adverse effects of chlorpromazine.
The differences between chlorpromazine and other antipsychotics.
Anti-depressants: mechanism of action, therapeutic uses, adverse effects, drug interactions and
contraindications of tricyclic antidetressants, the classic drug: imipramine.
Anti-mania: mechanisem of action, therapeutic uses, adverse effects of lithium carbonate.
Analgesics
Opioids
Objectives:
The students are required:
Be able to know the mechanims of action of morphine and pethidine, and know the differences
between their pharmacological effect, therapeutic uses, adverse effects and addiction.
Be able to know the way to solve over dose of morphine
Be aware of the clinical significance and distribution of opiate receptor.
Be aware of the subgroup of opiate receptor and the effect due to activation of each subgroup.
Duration: 3 school hours.
Teaching contents:
mechanism of action, pharmacological effect, therapeutic uses, adverse effect and addiction of
morphine and codeine, the way to solve over dose of morphine, the clinical significance and
distribution of opiate receptor, the subgroup of opiate receptor and the effect due to activation of
each subgroup.
Synthetic analgetics, mechanism of action, pharmacological effect, therapeutic uses, adverse
effect and addiction of Synthetic analgetics. Drugs in this group, pethidine, Tramadol.
Antagonist of opiate receptor, naloxone.
Non-steroidal anti-inflamatory drugs
Objectives:
The students are required:
be able to know the mechanism of action of Non-steroidal anti-inflamatory drugs.
Be able to know the mechanism of action, therapeutic uses, adverse effects and contraindications
of aspirin.
Be aware of the characteristics of other Non-steroidal anti-inflamatory drugs.
Duration: 2 school hours.
Teaching contents:
The mechanism of action, therapeutic uses, adverse effects and contraindications of aspirin, the
absorption , metabolism and excretion of aspirin, the way to avoid common adverse effect.
The characteristics and therapeutic uses of paracetamol.
Mechanism of action, therapeutic uses, adverse effects , contraindication and pharmacokinetics of
Phenylbutazone.
The therapeutic uses and contraindications of Indometacin, Meloxicam, Nimesulide.
Anti-gout drugs/ disease modifying antirheumatic drug
Objectives:
The students are required:
Be aware of the mechanism of action, therapeutic uses, adverse effect, and contraindications of
gold compound and penicillamine.
Be aware of mechanism of action, therapeutic uses, adverse effect, and contraindications of
allopurinol, probenicid, colchicine.
Duration: 2 school hours.
Teaching contents:
The mechanism of development of gout.
Disease modifying antirheumatic drug:, gold compound and penicillamine.
Anti-gout drugs: allopurinol, probenicid, colchicine.
Cardiovascular drugs
Anti-arrhythmic drugs
Objectives:
The students are required:
Know the phases of the action potential.
Be able to describe mechanism of action, pharmacological effects and therapeutic uses and
adverse effects of each group of anti-arrhythmic drug.
Duration: 5 school hours
Teaching contents:
Have a quick review of phases of the action potential.
The classification of anti-arrhythmic drugs:
Sodium channel blocker: ClassⅠ: ClassⅠa, quinidine, ClassⅠb, lidocaine, phenytoin, ClassⅠc,
propafenone.
Class Ⅱ: β-adrenoceptor blocker, propranolol.
Class Ⅲ: amiodarone.
Class ⅳ: calcium channel blocker: verapamil.
The mechanism, pharmacological actions and therapeutic uses and adverse effects of each group.
Inotropic Drugs/Drugs used in cardiac failure
Objectives:
The students are required:
Be aware of pathophysiology of cardiac failure
Know mechanism of action, pharmacological effects , therapeutic uses and adverse effects of the
cardiac glycosides.
Know the toxic effects of digitalis and method for digitalis overdose.
Know mechanism of action, pharmacological effects , therapeutic uses and adverse effects of
Angiotensin-Convertiong Enzyme Inhibitors.
Duration: 5 school hours
Teaching contents:
Pathophysiology of cardiac failure.
Mechanism, pharmacological effects, therapeutic uses, adverse effects of the cardiac glycosides.
The toxic effects of digitalis and method for digitalis overdose
Mechanism, pharmacological effects, therapeutic uses, adverse effects ofAngiotensin-Convertiong
Enzyme Inhibitors.
therapeutic uses of Diuretics and Vasodilators and Beta-Adrenoceptor Blockers:
Anti-hypertensive drugs
Objectives:
The students are required:
Be aware of etiology of hypertension.
Know classification of anti-hypertensive drugs and characteristics of each group.
Duration: 5 school hours
Teaching contents:
Etiology of hypertension.
Drugs used in hypertension: Diuretics, Direct vasodilators, ACEI and AT1-receptor antagonist,
α-adrenoreceptor blocker, calcium channel blocker,β-adrenoreceptor blocker.
Mechanism of acton, pharmacological effects, therapeutic uses and adverse effects of each group.
Anti-anginal drugs
Objectives:
The students are required:
Know mechanism of action, pharmacological effects, therapeutic uses and adverse effects of
nitrates.
Know therapeutic uses of calcium channel blockers and Beta-Adrenoceptor Blockers.
Explain the co-operation of each two groups of Anti-anginal drugs.
Duration:3 school hours
Teaching contents:
The characters of stable angina and unstable angina.
The mechanism of action, pharmacological effect, therapeutic uses and adverse effects of Nitrates
and Nitrites.
Therapeutic uses of calcium channel blockers and Beta-Adrenoceptor Blockers.
Combination of each two groups of anti-anginal drugs.
Drugs used in disorders of coagulation
Objectives:
The students are required:
Be able to describe mechanism of action, pharmacological effects, therapeutic uses and adverse
effects of heparin and warfarin and reversal of their actions.
Be able to explain how heparin and warfarin are monitored.
Be able to describe mechanism of action, pharmacological effects, therapeutic uses and adverse
effects of thrombolytic drugs.
Be aware of mechanism of action, pharmacological effects, therapeutic uses and adverse effects of
antiplatelet drugs.
Be aware of mechanism of action, pharmacological effects, therapeutic uses and adverse effects of
drugs used in bleeding disorders.
Duration: 5 school hours
Teaching contents:
Mechanism, pharmacological actions, therapeutic uses and adverse effects of heparin and warfarin
How to monitor heparin and warfarin and how to reverse their actions.
Thrombolytic drugs: streptokinase, urokinase.
Antiplatelet drugs: aspirin, clopidogrel, abciximab.
Drugs used in bleeding disorders: vitamin K.
Anti-hyperlipidemic drugs
Objectives:
The students are required:
Be able to indentify patients who require to treatment of hyperlipemia.
Be able to describe the drugs used in the treatment of hyperlipidemia and their therapeutic uses.
Duration: 3 school hours
Teaching contents:
Drugs used in treating hyperlipidemia: Niacin, Fibric acid derivatives, Bile acid-binding resins
Competitive inhibitors of HMG-CoA reductase.
Mechanism of action, pharmacological effects, therapeutic uses and adverse effects of each group.
Diuretics
Objectives:
The students are required:
Be aware of the production process of urine.
Know the classification of diuretics and the representative agents.
Be able to describe pharmacological actions, therapeutic uses, adverse effects, contraindications of
loop diuretics, thiazides, and potassium-sparing diuretics.
Know the therapeutic uses of osmotic diuretics.
Duration: 3 school hours
Teaching contents:
1. Have a quick review of renal tubule transport mechanism.
2 Loop diuretics: the mechanism of action, pharmacological actions, therapeutic uses and adverse
effects.
3. Thiazides: the mechanism of action, pharmacological actions, therapeutic uses and adverse
effects.
4. Potassium-sparing diuretics: the mechanism of action, pharmacological actions, therapeutic
uses and adverse effects.
5. Osmotic diuretics: the mechanism of action, pharmacological actions, therapeutic uses and
adverse effects.
Drugs acting on respiratory system
Objectives:
The students are required:
Be able to know the mechanism of action, pharmacological effect, therapeutic uses and adverse
effect of Sympathomimetic agents and Methylxanthine drugs, Cromolyn/nedocromil,
Antimuscarinic antagonists, Corticosteroids, Leukotriene pathway inhibitors.
Be aware of the therapeutic uses of expectorants, mucolytics, anti-tissives.
Duration: 4 school hours.
Teaching contents:
the mechanism of action, pharmacological effect, therapeutic uses and adverse effect of
Sympathomimetic agents and Methylxanthine drugs, Cromolyn/nedocromil, Antimuscarinic
antagonists, Corticosteroids, Leukotriene pathway inhibitors.
the principle of treatment of asthma.
the therapeutic uses of expectorants, mucolytics, anti-tissives.
Drugs acting on Gastrointestinal Tract
Objectives:
The students are required:
Be able to describe mechanism of action, pharmacological effects, therapeutic uses, adverse
effects of H2-receptor antagonists and proton pump inhibitors.
Be aware of the therapeutic uses of Antiemetic, purgatives, Laxatives, Antacids, Mucosal
protective agents.
Duration: 5 school hours
Teaching contents:
Anti Emetic
1. Anticholinergic drugs: Hyoscine
2. Antihistamines: Promethazine
3. dopamine receptor antagonists: Metoclopramide
4. 5-Hydroxytryptamine antagonists: Ondansetron
Drugs affecting motility of GIT
Metoclopramide, Cisapride, Erythromycin, Alosetron
Ulcer healing drugs
1. antacids
2. H2-receptor antagonists
3. proton pump inhibitors
4. antimuscarinic agents
5. mucosal protective agents
Purgatives/Laxatives:diphenoxylate, loperamide,castor oil, hydrophilic colloids.
Autacoid
Objectives:
The students are required:
Know the physiological and pathological effects of PG, TXA2, 5-HT, angiotensin and histamine.
Know the drugs that affect actions of autacoid by different ways.
Duration: 3 school hours, study by themselves.
Teaching contents:
Physiological and phathological effects of AA, PG, TXA2, 5-HT, PAF, NO and histamine .
The metabolism of autacoid.
Theraputic uses and phamacological actions of drugs that affect the actions o f autacoid.
Drugs acting on endocrine system
Thyroid/parathyroid drugs
Objectives:
The students are required:
Be able to know the mechanism of action, pharmacological effect, therapeutic uses and adverse
effect of methimazole, propylthiouracil, carbimazole.
Be able to know the mechanism of action, pharmacological effect, therapeutic uses and adverse
effect of iodines and radioactive iodine.
Be aware of the synthesis and transportion of thyroid and the physiological effect of it.
Duration: 2 school hours.
Teaching contents:
The synthesis and transportion of thyroid.
the mechanism of action, pharmacological effect, therapeutic uses and adverse effect of
methimazole, propylthiouracil, carbimazole.
the mechanism of action, pharmacological effect, therapeutic uses and adverse effect of iodines
the mechanism of action, pharmacological effect, therapeutic uses and adverse effect of
radioactive iodine.
Pancreatic hormones and oral antidiabetic agent
Objectives:
The students are required:
Be able to know the mechanism of action, pharmacological effect, therapeutic uses and adverse
effect of insulin and oral antidiabetic agent.
Duration: 3 school hours.
Teaching contents:
The physiological effect of insulin.
The mechanism of action, pharmacological effect, therapeutic uses and adverse effect of different
insulin preparations, and the way to prevent the development of adverse effect.
The mechanism of action, pharmacological effect, therapeutic uses and adverse effect of
tolbutamide, metformin, rosiglitazone.
Adrenocorticoids
Objectives:
The students are required:
Be able to know the pharmacological effect, therapeutic uses, adverse effects, contraindications of
glucocorticoid and the way to prevent the presence of adverse effects.
Be aware of the physiological effect of glucocorticoid, and the pharmacokinetics of
glucocorticoid.
Be aware of the relationship between of structure and efficacy, and the mechanism of
glucocorticoid
Duration: 3 school hours.
Teaching contents:
The structure-efficacy relationship and physiological effect of glucocorticoid
the pharmacological effect, therapeutic uses, adverse effects, contraindications of glucocorticoid
and the way to prevent the presence of adverse effects.
The characteristics of hydrocortisone, cortisone, prednisone, prednisolone, dexamethasone.
The effect of ACTH and mineralocorticoids.
Sex hormones/hormonal contraception
Objectives:
The students are required:
Be able to know the pharmacological effect, and therapeutic uses of sex hormone.
be aware of the physiological effect of sex hormone.
Duration: 2 school hours.
Teaching contents:
Pharmacological effect, therapeutic uses, adverse effect of estrogens.
Pharmacological effect, therapeutic uses, adverse effect of progestogens.
Pharmacological effect, therapeutic uses, adverse effect of androgens.
The mechanism and therapeutic uses of contraceptions
Drugs acting on uterus
Objectives:
The students are required:
Be able to know pharmacological effect, therapeutic uses and contraindications of oxytocin and
ergot
Be aware of the effects of prostaglandins and pituitrin.
Duration: 2 school hours.
Teaching contents:
The characteristics of smooth muscle contraction of uterus.
Pharmacological effect, therapeutic uses and contraindications of oxytocin and ergot
The effects of prostaglandins and pituitrin.
Pharmacological effect, therapeutic uses and contraindications of terbutaline, ritodrine.
General theory of antibacterial drugs
Objectives:
The students are required:
1: know the meaning of chemotherapy and the development history of antibacterial drugs
2: know the commonly used terms of antibacterial drugs.
3:.be able to describe the common mechanisms by which antimicrobials work
4:.know examples of an antibiotic working by each mechanism
5: be able to outline mechanisms of microbial resistance to antibacterial drugs and the implications
of this for prescribing
6: understand the board principles governing use of antibacterial drugs.
7: know advantage and disadvantage of combination of antibacterial drugs.
8: know how to use antibacterial drugs in the condition of hepatic inadequacy and renal
inadequacy.
9: know the reasons of therapeutic failure of antibacterial drugs.
Duration: 3 school hours
Teaching content
1 the history of discovery of antibacterial drugs
2 the mutual relationship among antibacterial drugs, host and pathogen.
3 the definition of chemotherapy and the commonly used terms of antibacterial drugs
(antibacterial drugs, antibiotics, antibacterial spectrum, antibacterial activity, bacteriostatic drugs,
bactericidal drugs, resistance, chemotherapeutic index)
4 mechanisms of action of antibacterial effect of commonly used antibacterial dugs and examples
of an antibiotic working by each mechanism.
The mechanisms of action include:
4.1 inhibiting formation of bacterial cell wall;
4.2 inhibiting bacterial protein synthesis;
4.3 inhibiting nucleic acid synthesis;
4.4 altering the permeability of cytoplasmic membranes;
4.5 interfering metabolism of folic acid
5 mechanisms of microbial resistance to antibacterial drugs and the implications of this for
prescribing.
6 the board principles governing use of antibacterial drugs: according to indications (antibacterial
spectrum), susceptibility test, and so on.
7: advantage and disadvantage of combination of antibacterial drugs.
8: how to use antibacterial drugs in the condition of hepatic inadequacy and renal inadequacy.
9: the reasons of therapeutic failure of antibacterial drugs.
β-lactam Antibiotics
Objectives:
The students are required:
1: know the development of penicillins and cephalosporins.
2: understand the mechanism of action of antibacterial effect ofβ-lactam antibiotics.
3: know characteristics of the β-lactamase inhibitors.
4: know the antibacterial spectrum, indications, adverse effects and prevention and management of
adverse effects of penicillin G.
5: know the characteristics of antibacterial activity and the main indications of semisynthetic
penicillins and cephalosporins.
Duration: 3 school hours
Teaching content
1 penicillins
1.1 penicillin G
The chemical and physical characteristics, antibacterial spectrum, antibacterial activity,
mechanism of action, relationship between mechanism of action of antibacterial effect and
antibacterial activity, resistance, pharmacokinetics, indications, adverse effects, prevention and
management of adverse effects of penicillin G and long acting preparations
1.2 semisynthetic penicillins
The characteristics of antibacterial activity and indications of Penicillinase-fast penicillins (e.g.
oxacillin), penbritins (e.g. ampicillin), antiaeruginosus Bacillus penbritins (e.g. piperacillin),
acid-fast penicillins (e.g. penicillin V) and antigram-negative rod penicillins (e.g. mecillinam)
2 cephalosporins
2.1 The resemblances and characteristics of the chemical structure and antibacterial spectrum
between cephalosporins and penicillins.
2.2 The antibacterial activity and mechanism of action of antibacterial effect of cephalosporins.
2.3 The characteristics and indications of every generation cephalosporins.
3 other β-lactam antibiotics
The characteristics of antibacterial activity and medication attention of cephalomycin,
sulfomycin, latamoxef.
4 β-lactamase inhibitors and compound preparations
The characteristics of antibacterial activity and medication attention ofβ-lactamase inhibitors
and compound preparations.
Macrolides，Lincomycins and Polypeptide antibiotics
Objectives:
The students are required:
1: understand the mechanism of action of antibacterial effect of macrolides and lincomycuns.
2: know the antibacterial spectrum of macrolides.
3: know characteristics of antibacterial activity, adverse effects and indications of erythromycin,
mydecamycin, acetylspiramycin, azithromycin, roxithromycin, albomycin, lincomycin,
clindamycin.
4: know the antibacterial spectrum, mechanism of action of antibacterial effect, indications and
adverse effects of polypeptide antibiotics.
Duration: 3 school hours
Teaching content
1 macrolides:
1.1 The mechanism of action of macrolides
1.2 The antibacterial spectrum of macrolides
1.3 The characteristics of antibacterial activity, adverse effects and indications of erythromycin,
mydecamycin, acetylspiramycin, Azithromycin, Roxithromycin, albomycin.
2 lincomycins
characteristics of antibacterial activity, mechanism of action of antibacterial effect, adverse
effects and indications of lincomycin and clindamycin.
3 polypeptide antibiotics
The antibacterial spectrum, mechanism of action of antibacterial effect, indications and
adverse effects of polypeptide antibiotics: vancomycin, teicoplanin and polymyxin.
Aminoglycoside Antibiotics
Objectives:
The students are required:
1: know the commonness of aminoglycoside antibiotics.
2: know antibacterial spectrum, indications, adverse effects and prevention and management of
adverse effects of streptomycin, gentamycin, kanamycin.
3: know the announcements and the drug interactions when administering these drugs.
Duration: 2 school hours
Teaching content
1 the commonness of aminoglycoside antibiotics:
chemical structure; antibacterial activity and spectrum; the mechanism of action of antibacterial
effect; pharmacokinetics; adverse effects
2 commonly used aminoglycoside antibiotics:
The characteristics of antibacterial activity and indications of streptomycin, gentamycin,
kanamycin, amikacin, tobramicin and neomycin.
Tetracyclines and Chloramphenicols
Objectives:
The students are required:
1: know the mechanism of action of antibacterial effect, antibacterial activity, indications, adverse
effects and prevention and management of adverse effects of tetracyclines and chloramphenicol.
2: know characteristics of antibacterial activity of deoxycycline, minocycline.
3: know the important items and the drug interactions for taking medicine.
Duration: 2 school hours
Teaching content
1 tetracyclines produced naturally:
The primary chemical structure, antibacterial activity and spectrum, the mechanism of action
of antibacterial effect, pharmacokinetics, adverse effects and prevention and management of
tetracycline.
2 semi-synthetic tetracyclines:
The characteristics of antibacterial activity, adverse effects and indications of deoxycycline,
minocycline.
3 chloramphenicols:
The characteristics of antibacterial activity, mechanism of action of antibacterial effect,
pharmacokinetics, adverse effects, indications and important items for taking chloramphenicol and
thiamphenicol.
Artificial antibacterial drugs
Objectives:
The students are required:
1: know the history of invention of quinolones and sulfonamides.
2: know the antibacterial activity, mechanism of action, primary indications, drug interaction,
adverse effects and important items for taking quinolones.
3: know the antibacterial activity, mechanism of action, indications, adverse effects of
sulfonamides.
3: know principle and meaning of combination of trimethoprim and sulfonamides
Duration: 3 school hours
Teaching content
1 quinolones:
1.1 the history of invention of quinolones.
1.2 the antibacterial activity, mechanism of action, indications, drug interaction, adverse effects
and important items for taking medicine of quinolones
1.3 combination of quinolones and antacid, theophylline, non-steroid anti-inflammatory drugs
1.4 the characteristics of antibacterial activity of norfloxacin, enoxacin, ciprofloxacin, ofloxacin,
lomefloxacin, sparfloxacin.
2 sulfonamides:
2.1 classification of sulfonamides.
2.2 the antibacterial activity, mechanism of action and clinical significance, indications, adverse
effects of sulfonamides
3 trimethoprim:
3.1 mechanism of action of antibacterial effect
3.2 the characteristic and principle of enhancing antibacterial effect of sulfonamides.
4 the characteristics of nitrofurans and nitroimidazoles
Antifungal drugs and Antiviral drugs
Objectives:
The students are required:
1: know the characteristics of antifungal activity, primary indications, adverse effects of
griseofulvin, amphotericin B, nystatin, clotrimazole, Ketoconazole, fluconazol, terbinafine,
flucytosine.
2: know the function characteristics and indications of commonly used antiviral drugs.
Duration: 2 school hours
Teaching content
1 classification of antifungal drugs
2 the antifungal activity, adverse effects and indications of commonly used antifungal drugs:
nystatin, amphotericin B, griseofulvin, clotrimazole, Ketoconazole, fluconazol, terbinafine,
flucytosine.
3 the function characteristics, indications and evaluation of commonly used antiviral drugs:
adamantanamine, acyclovir, valacyclovir, ribavirin, adenine arabinoside.
Antituberculosis drugs and antileprotic drugs
Objectives:
The students are required:
1: know the anti-TB effect, adverse effects and resistance of isoniazide, rifampicin, ethambutol,
para-aminosalicylic acid, pyrazinamide, streptomycin.
2: know using principle of antituberculosis drugs.
Duration: 3 school hours
Teaching content
1 antituberculosis drugs:
1.1 Isoniazide: selectively bactericidal effect on tubercle bacillus; resistance; transport and
transformation in vivo; adverse effects and prevention and management
1.2 Rifampicin: broadly antibacterial effect; anti-TB effect and mechanism of action; adverse
effect; indications; resistance
1.3 para-aminosalicylic acid: mechanism of action; adverse effect and prevention management;
indications; resistance
1.4 pyrazinamide: bacteriostatic or bactericidal effect on tubercle bacillus and antituberculotic
characteristics
1.5 streptomycin: bactericidal effect on tubercle bacillus; resistance; ibdications
1.6 rifandin: antituberculotic characteristics
1.7 ethambutol: anti-TB effect and mechanism of action; adverse effect
2 using principle of antituberculosis drugs: as early as possible; combination; sufficient quantum;
regular and long-term administration;
3 antileprotic drugs (self-study)
Antimalarial drugs
Objectives:
The students are required:
1: know the effects of antimalarial drugs on different period of history of malaria parasite
2: know mechanism of action, indications and adverse effect of all kinds of antimalarial drugs.
Duration: 2 school hours
Teaching content
1 the history of malaria parasite
2 antimalarial drugs used to control the symptoms of malaria:
2.1 the pharmacologic actions, the characteristics of antimalarial effect, the characteristics of
distribution in vivo, resistance, indications and adverse effects of chloroquine
2.2 the characteristics of antimalarial effect, indications, adverse effects and resistance of quinine,
artemisinin, artemether
3 antimalarial drugs used to control relapse and spread of malaria:
the characteristics of antimalarial effect, indications, adverse effects and resistance of
Primaquine.
4 antimalarial drugs used to prevent malaria:
the characteristics of antimalarial effect, indications, adverse effects and resistance of
pyrimethamine.
Antiamoebic drugs
Objectives:
The students are required:
1: know the pharmacological effects and indications of antiamoebic drugs.
2: know using principle of antiamoebic drugs.
Duration: 1 school hours
Teaching content
1 the history of amebic protozoa:
2 classification of antiamoebic drugs
3 pharmacokinetics, pharmacologic action, indications, adverse effects and important items for
taking of Metronidazole
4 The antiamoebic effect, mechanism of action, indications, adverse effects of emetine and
dehydroemetine.
5 The antiamoebic effect, indications and adverse effects of diloxanide
6 The antiamoebic effect, characteristic of pharmacokinetics, mechanism of action, indications of
paromomycin
7 The antiamoebic effect, characteristic of pharmacokinetics and indications of chlorine
8 mechanism of action of antiamoebic effect and indication of terramycin.
9 The using principle of antiamoebic drugs.
10 antitrichomonal drugs（self-study）
antischistosomal drugs and antifilarial drugs
Objectives:
The students are required:
1: know the main drugs used to prevent and treat schistosomiasis and filariasis
Duration: 1 school hours
Teaching content
1 antischistosomal drugs:
1.1 the antischistosomal effect and mechanism of action, indications, adverse effects of pyquiton:
1.2 the antischistosomal effect and mechanism of action, indications, adverse effects of antimony
potassium tartrate
2 antifilarial drugs:
the antischistosomal effect and mechanism of action, indications, adverse effects of Carbamazine
and ivermectin:
Drugs expelling intestinal worms
Objectives:
The students are required:
1: know the main drugs used to expel intestinal worms
2: know the antihelmintic effect, mechanism of action and adverse effect of the drugs.
3: know the using principle of drugs expelling intestinal worms
Duration: 1 school hours
Teaching content
1 the main drugs used to expel intestinal worms: mebendazol, albendazole, piperazidine,
levamisole, pyrantel, pyrvinium embonate, niclosamide, pyquiton
2 the antihelmintic effect, mechanism of action, adverse effects of of mebendazol, albendazole,
piperazidine, levamisole, pyrantel, pyrvinium embonate, niclosamide, pyquiton
Anticancer drugs
Objectives:
The students are required:
1: know kinesics of multiplication cycle of tumor cell.
2: know the meaning of kinesics of multiplication cycle of tumor cell for enhancing
pharmacodynamic effect
3: know mechanism of action, indications and adverse effects of all kinds of anticancer drugs.
Duration: 3 school hours
Teaching content
1 classification of anticancer drugs and the effect on multiplication cycle of tumor cell
2 mechanism of action, classification, indications and adverse effects of all kinds of anticancer
drugs:
2.1 anticancer drugs interfering nucleic acid synthesis: methopterin, purinethiol, fluorouracil,
cytosine arabinoside, hydroxycarbamide
2.2 anticancer drugs directly destroying DNA and inhibiting DNA replication: chlormethine,
cyclophosphamide, thiotepa, cis-diamminedichloroplatin, bleomycin, mitomycin
2.3 anticancer drugs interfering transcription and inhibiting RNA synthesis: actinomycin D,
adriamycin
2.4 other anticancer drugs: estrogen, androgen, adrenal cortex hormone, Tamofen
3 principle of design of tumor chemotherapy program: large dose; intermittent; drug combination
Interfering immune function agents
Objectives:
The students are required:
1: know mechanism of action, indications, adverse effects of immunosuppressive agents.
2: know the characteristics of commonly used immunosuppressive agents
3: know overview of immunopotentiating drugs
Duration: 3 school hours
Teaching content
1 the characteristics and indications of immunosuppressive agents and important items for taking
the agents: ciclosporin, tacrolimus, adrenal cortex hormone
2 the effects and indications of immunopotentiating drugs: BCG vaccine, levamisole, interleukin2,
interferon, thymosin
Clinical pharmacology/ therapeutics (PBL)
Drug treatment of peptic ulcer
Objectives:
The students are required:
Be aware of etiology of peptic ulcer.
Know combination and therapeutic uses of drugs being used to treat peptic ulcer.
Kow complications of peptic ulcer and how to handle them.
Duration: 5 school hours.
Teaching contents:
Questions:
1. describe the development of acid-peptic disease?
2. describe drugs used in acid-peptic desease and the representative of each type?
3. describe the mechanism of action,pharmacological effect, clinical use, and adverse effect of
sodium bicarbonate, cimetidine,omeprazole,sucralfate,misoprosol,bismuth?
4. describe the mechanism of action,pharmacological effect, clinical use, and adverse effect of
metoclopramide, domperidone, cisapride?
Clinical sketch 1
A 28-year-old man goes to his GP complaining of pain in his epigastrium,the pain occurs
whenever he eats spicy foods, but also at other times and, in particular,wakes him up at night.
What is the proper cause for pain in his epigastrium?
What is your opinion on his pain?
Clinical sketch 2
A 72-year-old woman taking diclofenac for her athritis presents to hospital for vomiting blood.
What is the proper cause for her vomiting?
What is your opinion on the treatment of her vomiting?
Clinical sketch 3
A 22-month-old child develops profuse diarrhoea. The mother is told this is infective
gastroentertitis and goes to see her GP to ask for an antidiarrhoeal agent and an antibiotic.
Do you think antidiarrhoeal agent and antibiotic are suitable for this case? And why?
If not, what is your opinion?
Clinical sketch 4
A 47-year-old woman has severe reflux oesophagitis confirmed on endoscopy, initial treatment
with ranitidine is partly successful, but she continues to have a lot of pain.
What‟s your opinion on the treatment?
Drug teatment of bronchial asthma
Objectives:
The students are required:
Be aware of pathogenesis of asthma.
Know drugs used to treat asthma, and their mechanism of action, pharmalogical effects, clinical
uses and adverse effects.
Know the therapy for asthma.
Duration: 5 school hours.
Teaching contents:
Questions:
1.Describe the pathophysiological process of athma?
2.Describe drugs used in the treatment of asthma and the representative of each type?
3. Describe the mechanism of action,pharmacological effect, clinical use, and adverse effect of
albuterol,theophyline, ipratropium, corticosteroids, cromolyn, zileuton?
Clinical sketch 1
A 60-year-old cigarette smoker developed asthma aged around 40. he is now on regular doses of
inhaled salbutamol, and can not drop his dose of oral prednisolone below 7.5mg daily. He develop
severe back pain suddenly. Radiographs confirm a collapsed thoracic vertebra and osteopenia.
What are the first line drugs for the treatment of asthma?
Why did the patient develop collapsed thoracic vertebra and osteopenia?
Clinical sketch 2
A 50-year-old smoker is admitted during the winter following a headcold. She now has severe
breathlessness, wheeze and a cough productive of copious green sputum. she is treated with β
2-agonist, systemic steroids and broad-spectrum antibiotics.
What is the proper cause for her symptom?
Do you think the treatment is suitable?
Clinical sketch 3
A 20-year-old woman is admitted with severe asthma and mild left-sided “sharp” chest pain. She
is hypoxic. Initial treatment is with inhaled 40% oxygen regular nebulised salbutamol and regular
i.v. hydrocortisone, she fails to improve and become exhausted. The doctor is asked to give a night
sedative to settle her down, this is declined. Auscultation reveals reduced breath sounds on the left
and a chest radiograph shows a pneumothorax. She is moved to the intensive care unit, a chest
drain is inserted and she is ventilated.
the patient is given first line drugs, but the symptom did not get relieved, why?
She asked for a night sedative, why did the docter refuse to give her a night sedative?
Drug treatment of epilepsy
Objectives:
The students are required:
Be aware of the classification of seisure types.
Know drugs that being used to treat partial seisures and generalized seisures.
Know the therapy for epilepsy.
Duration: 5 school hours.
Teaching contents:
Questions:
1. describe the classification of epilepsy?
2. describe the probable reasons for epilepsy?
3. describe drugs that can be used to treat epilepsy?
4.describe the characteristic (mechanism,clinical uses, adverse effects) of phenytoin, sodium
valproate , ethosuximide,diazepam?
Clinical sketch 1
A patient with long-standing epilepsy is admitted because of recurrent tonic-clonic seizures for the
preceding 12 hours. She is unconscious,stiff and is having repeated episodes of clonic limb
movements.
What kind of seizure did the patient develop?
If the patient came to you, what will you do next?
There are many drugs those are available to treat epilepsy, which one will be the first choice for
this patient?
Clinical sketch 2
An 18-month-old toddler is brought A&E by his distraught parents. He has been unwell for 2 days
with a viral illness and they have been “wrapping him up warm”. He is having generalised clonic
movements and his rectal temperature is 40℃.
What kind of seizure did the patients develop?
If the patient came to you, what will you do next?
Which will you treat first? Lower the body temperature or treat epilepsy?
There are many drugs those are available to treat epilepsy, which one will be the first choice for
this patient?
Drugs treatment of Parkinsonism syndrome
Objectives:
The students are required:
Be able to know the mechanism of action, therapeutic uses, adverse effects, contraindications of
drugs used to treat Parkinsonism syndrome.
Be aware of the mechanism of the development of parkinsonism syndrome.
Duration: 5 school hours.
Teaching contents:
Questions:
What‟s Parkinsonism? What is the symptom?
What „s the mechanism for development of Parkinsonism?
how many drugs that can be used to treat Parkinsonism?
Describe characteristic(mechanism, clinical uses, adverse effects) of Levodopa,
Carbidopa,Amantadine, Bromocriptine, Artane?
Clinical sketch 1
A 65-year-old man notices difficulty turning in bed rising from a chair, this symptoms worsens
and is accompanied by shaking and a tendancy to fall.
What disease did the patient probably develop?
Can you do your diagnosis just by the symptoms? Do you need some tests like physical
examination or lab test or imaging inspection?
If the patient is diagnosed with parkinsonism, what drug will you give the patient?
Clinical sketch 2
A 50-year-old schizophrenic has been on neuroleptic drugs for many years. He developed features
of parkinsonism.
Why did the patient develop features of parkinsonism?
There are a lot of drugs they are available to treat parkinsonism, which one will be the first choice?
And why?
Drugs treatment of rheumatic diseases
Objectives:
The students are required:
Be aware of etiology of rheumatic disease.
Know mechanism of action, therapeutic uses, adverse effects, contraindications and drug
interaction of drugs used to treat rheumatic diseases.
Duration: 5 school hours.
Teaching contents:
Questions:
What‟s osteoarthritis? What are the symptoms?
What‟ s Rheumatoid arthritis? What are the symtoms?
Discribe the prognosis of osteoarthritis and rheumatoid arthritis?
Discribe drugs that are used in the treatment of osteoarthritis and rheumatoid arthritis?
Discribe the mechanism, pharmalogical effects, clinical use and adverse effects of
aspirin,gold,sulfasalazine,glucocorticoids?
Clinical sketch 1
A 75-year-old woman with heart failure has painful,swollen knees,she takes ramipril and big doses
of furosemide for her heart failure. The doctor gives her indometacin for her knees.she is admitted
to hospital with severe pulmonary oedema and renal failure 2 weeks later.
What „s wrong with the patient‟s knees? Osteoarthritis or Rheumatoid arthritis?
Which group does indometacin belong to?
What are action mechanism ,clinical use, adverse effect of indometacin?
Why did the patient develpe severe pulmonary oedema?
Do you think renal failure is caused by indometacin?
If indometacin is not effective to relieve symptom, which drug will be the next choice?
Clinical sketch 2
A 50-year-old man develops an acutely painful big toe, his foot is red and swollen and he cannot
put on his shoe or walk. The doctor give him naproxen, the inflammation begins to settle with the
next 48 hours.
What disease did the patient probably develop? Rheumatoid arthritis or gout?
What examination will you ask the patient to do to do your diagnosis?
Describe the drugs that are effective to treat gout and mechanism of them?
Drugs treatment of ischaemic heart disease
Objectives:
The students are required:
be aware of the etiology and pathophysiology of ischaemic heart disease.
Know drugs used to treat ischaemic heart disease: nitrates, calcium channel blockers and
β-adrenoceptor blockers.
Know the combination of nitrates/ calcium channel blockers with β-adrenoceptor blockers.
Duration: 5 school hours.
Teaching contents:
Questions:
1.describe the classification of angina and the characteristic of each type?
2.describe the drugs that are used to treat angina?
3. describe the mechanism, pharmacological effect, clinical use, adverse effect of nitroglycerin,
propranolol, nifedipine?
Clinical sketch 1
A 70-year-old man gets chest pain on exertion, this has been diagnosed as angina but has been
stable for some time. One day he gets severe chest pain while sitting down, which is typical of his
angina, he uses his GTN (glyceryl trinitrate) spray, which gives transient relief but the pain recurs
within a matter of a few minutes. He uses the GTN spray again,but gets little relief.
What kind of angina did the patient develop ?
GTN spray wasn‟t effective to chest pain, do you have some advice on the treatment?
Clinical sketch 2
A patient with angina is treated initially with a beta-blocker and GTN as required. His angina
gradually deteriorates and a calcium channel blocker is added. This leads to initial improvement,
but again over a period of 12 months there is a deterioration and a long-acting oral nitrate is
added.
Why did the docter prescribe beta-blocker and GTN together?
what is the advantage of the combination of beta-blocker and GTN?
If the treatment is not effective, do you have some advice on the treatment?
Drug treatment of hypertension
Objectives:
The students are required:
Diagnosis and classification of hypehypertension.
Drugs used to treat hypertension and their characteristics.
Duration: 5 school hours.
Teaching contents:
Questions:
What‟s hypertension?
Discribe the classification of hypertension?
Discribe the drugs that are used to treat hypertension and the representative of each group?
Discribe the mechanism and characteristics of each group of antihypertensive drugs?
Clinical sketch 1
A 72-year-old woman has a blood pressure of 180/84mmHg. Her doctor is aware of this but is
reluctant to treat her because this blood pressure is normal for her age.
Do you think the doctor is right?
What‟s the target pressure for this patient?
Which drug will be the first choice for this patient?
What‟s your opinion on the treatment?
Clinical sketch 2
A patient presents with high blood pressure which is sustained on repeated readings. The doctor
initiates treatment with bendrofluethiazide and although this lowers blood pressure slightly, it is
still unsatisfactory. The doctor then adds in a second drug, atenolol, which again achieves some
lowering of blood pressure, but this remains unsatisfactory. The doctor adds in a third drug, a
calcium channel blocker, amlodipine. Satisfactory blood pressure is achieved on this.
Describe the frist line anti-hypertensive drugs?
It is hard to control blood pressure in many patients, do you have some advice on this?
What‟s white coat hypertension?
Treatment of congestiove heart failure
Objectives:
The students are required:
be aware of pathophysiology of congestive heart failure.
Know diagnosis of congestiove heart failure.
Know management of chronic heart failure and acute heart failure.
Duration: 5 school hours.
Teaching contents:
Questions:
What‟s congestive heart failure?describe the pathophysiologic process of congestive heart failure?
Describe drugs which are used to teat congestive heart failure?
Describe mechanism,pharmacological effect,clinical use,adverse effect of digitalis?
Describe the sign for withdrawal of digoxin, And how to treat toxic effect of digoxin, the way to
prevent cardiac glycosides intoxication?
Clincal sketch 1
A male patient aged 75 has previously had a myocardial infarction. He now finds that he gets
progressively shorter and shorter of breath when he exerts himself.his ankles tend to swell. He
feels generally tired,but has no chest pain.
What did the patient probably suffer from?
what examination did the patient need?
If the patient is diagnosed as cardiac failure, which drug will be the first choice?
Clinical sketch 2
The patient is treated with a standard dose of digoxin and his atrial fibrillation comes under
control. Subsequently he develops chronic renal failure with a decrease in his creatinine clearance.
He presents at the A&E department with a heart rate of 30 beats/min.
Why was the patient present a low heart rate?
What will you do to improve low heart rate?
Drug treatment of hyperlipidemia
Objectives:
The students are required:
Be aware of pathophysiology of hyperlipidemia.
Know pharmacokinetics, mechanism of action, thrapeutic uses/dosage and toxicity of drugs used
in hyperlipidemia.
Treatment with drug combinations.
Duration: 5 school hours.
Teaching contents:
Questions:
What is hyperlipidemia?
Describe the classification of hyperlipidemia, and the characteristic of each type?
Describe the drugs which are used to treat hyperlipidemia?
Describe the mechanism of action, pharmacological effect, clinical uses and adverse effects of
lovastatin, cholestyramine, gemfibrozil, niacin, probucol?
Clinical sketch 1
A 62-year-old man had a myocardial infarction but has now recovered. His serum cholesterol is
5.8mmol/L despite diet. His medications included aspirin and atenolol. He wonders if his
cholesterol should be treated.
What is your opinion on the patient‟s cholesterol?
What is your opinion on the treatment of hyperlipidemia?
If the patient‟ s cholesterol need to be treated, which drug will be the first choice? And why?
Drugs treatment of heavy metal poisoning
Objectives:
The students are required:
Be aware of toxicity of heavy metals, such as lead, arsenic, mercury.
Be aware of diagnosis of heavy metal poisoning.
Drug used in treatment of heavy metal poisoning：chelators.
Duration: 5 school hours.
Teaching contents:
Questions:
1.describe symptoms and diagnosing of iron poisoning, and drugs used in iron poisoning?
2.. describe symptoms, diagnosing of lead poisoning, and drugs used in lead poisoning?
3. describe symptoms and diagnosing of arsenic poisoning, and drugs used in arsenic poisoning?
4. describe symptoms and diagnosing for mercury poisoning, and drugs used in mercury
poisoning?
5 describe the principle of management of heavy metal intoxication?
Clinical sketch 1
A 2-year-old child is attracted to her mother‟s iron tablets by their pretty color. She swallows four
200mg capsules of ferrous sulphate. Her worried parents take her to A&E with severe abdominal
pain. Soon after arrival she develops signs of gastrointestinal bleeding. Her liver function tests
deteriorate thereafter, and the prognosis is guarded.
Do you think what child is suffering from?
What is your opinion on the treatment of this condition?
Clinical sketch 2
A 36-year-old lady, presents headache, dizziness, fatigue, rough skin like sandpaper, and
“raindrop” pattern of hyperpigmentation, and hyperkeratoses involving the palms and soles.
Laboratory check shows abnormal hepatic function. The ultrasonic check reveals hepatic cirrhosis.
And she has a history of taking a bezoar antidotal pills in long term to treat her constipation.
Do you think what the lady is suffering from?
if the patients comes to you, what will you do next?
Clinical sketch 3
A 4-year-old child plays a mercurial thermometer alone at home. He puts it into his mouth,
Suddenly the mercurial thermometer is broken, His parents don‟t know how to deal with it and
take him to the hospital in a hurry. The X-ray demonstrates small multiple high density metal-like
materials in his abdomen.
Do you think he need treatment? If yes, how to treat this patient, if no, why?
Clinical sketch 4
In 1925, a factory producing nitrogenous fertilizers and acetic acid was built at the Minamata
bay of Kumamoto county in Japan, and the factory directly discharge their industrial waste in sea.
In 1956, a strange disease occurred here. the cats here presented the symptoms of instability of
gait, spasm, paralysis, some of them jumped into the sea and died. Soon after, the natives also
presented the same symptoms. The doctors found that the cats and natives here often ate seafood.
Do you think what the cat and natives are suffering from?
Do you know how to deal with the patient?
Clinical sketch 5
A 6-year-old child complains anorexia, fatigue, and his growth seems to retarded. find out he
becomes easy to be excited, he respond slowly. his parents do metal refining in their own house,
and they don‟t take measure to improve their work condition and living condition. So his parents
take him to see their GP for suggestion.
Do you think what the child is suffering from?
Do you know how to deal with the patient?
Drugs treatment of oedema
Objectives:
The students are required:
Be aware of pathophysiology of oedema.
Be aware of causes of oedema.
Know drugs used in treatment of oedema: diuretics.
Duration: 5 school hours.
Teaching contents:
Questions:
Describe causes of oedema?
Describe physiopathologic process of formation of oedema?
Describe drugs that are used to treat oedema?
Describe the mechanism, pharmalogical effects, clinical use, adverse effects of furosemide,
thiazides, spironolactone, Amiloride, mannitol ?
Clinical sketch 1
A 56 years old woman, developed hypertension for 15 years, she did not take anti-hypertensive
drugs, one day, she found she could not put on her shoe, there were oedema in her ankle and
eyelid.
What „s wrong with this woman‟s ankle and eyelid?
What are you going to do primary diagnosis?
Which drug will be effective to treat oedema?
Clinical sketch 2
A 30 years old man caught a cold a few weeks ago, he felt pain in his waist, and the color of his
urine became darker. There were oedema in his ankle and eyelid. Urine test show hematuria and
proteinuria
What disease do you think the patient suffer from?
What examination will you ask the patient do for diagnosis?
Why did the patient suffer from oedema?
If the oedema does not respond to diuretic, can you administer albumin to this patient?
Clinical sketch 3
A 40 year old man developed hepatic cirrhosis, he suffered from symmetric oedema in his lower
legs.
Do you think diuretics are effective to the patient?
If the oedema does not respond to diuretic, can you administer albumin to this patient? And why?
Drug treatment of different types of shock
Objectives:
The students are required:
Be aware of classification of shock.
Know the pathophysiology of shock.
Know drugs used in treatment of shock and their characteristics.
Know the priciple of treat different types of shock.
Duration: 10 school hours.
Teaching contents:
Questions:
Discribe the classification and characteristic of shock?
Describe the principle of the treatment for shock?
Describe the drugs used in the treatment of shock, and the mechanism of them?
Clinical case 1
A 25-year-old man is brought to emergency department by ambulance on the next day after a
severe traffic accident. He is unconscious. His blood pressure is 78/48mmHg, heart rate 130 beats
per minute. There is no evidence of head trauma. The pupils are 2mm and reactive. He withdraws
to pain, cardiac examination reveals no murmurs, gallops, or rubs. The lungs are clear to
auscultation. The abdomen is tense with decreased bowel sounds. The patient shows cyanosis,
with thready pulses.
what‟s the diagnosis of the patient?
Do you think the patient need immediate treatment? and how to treat the patient.
What therapeutic measures are essential for the patient?
Clinical case 2
A 30-year-old woman, was given ceftazidime intravenously, during the process of infusion, she
was present with flushing, chest distress, tachypnea, insensible feeling of both upper extremities.
Physical examiniation showed indetectable BP, pulse, 105 /min, unconsciousness, cyanosis,
regular cardiac rhythm, the lung were clear, The abdomen was soft.
what‟ probable reason for the patient?
If you are responsible for this patient, what will you do next?
Clinical case 3
A 23-month-old girl baby, complained of fever for 2 days, vomiting and diarrhea for 1 day,
convulsion once, was admitted to hospital, T 39.2℃, P 200/min, R 60/min, BP 68/49mmHg,
physical examination show unconsciousness, pale, piebald skin, chilly extremities, tachypnea.
breath sounds become thick, no rales on auscultation, regular cardiac rhythm, no murmurs, blunt
cardiac sound, abdominal distention, liver and spleen were inpalpable, meningeal irritation sign
was positive.
Blood routine: WBC 6.4*10^9/L L 14.8% N 81.6% Hb 105g/L PLT 83*10^9/L CRP>160mg/L,
PH:7.309 k:3.8mmol/l Na 126mmol/l Cl 105mmol/l ABE-15.4mmol/l PaCO2:18.8mmHg PaO2:
96.4mmol/l.
stool routine: white blood cell 6—10 个/HP
What is the diagnosis for the patient?
What kind of therapeutic measures should be performed to the patient?
What are the drugs that can be used to treat the patient?
Prescription writing
Objectives:
The students are required:
Be able to know the general principles of prescription writing.
Be able to write prescription according to diagnosis.
Duration: 5 school hours.
Teaching contents:
general principles of prescription writing.
Guideline for rationale use of drugs
Practice 1
A 60-year-old patient named Holly pork with hypertension go to see his doctor to treat his
hypertension. the doctors prescribe drugs as following, please write down the priscription
according to the pattern we have discussed. These therapy will last for one week.
Oral Hydrochlorothiazide, tablet, 25mg/pill. 50mg once, twice a day
Oral Captopril, tablet, 25mg/pill, 25mg once, three times a day
Oral Amlodipine, tablet, 5mg/pill, 10mg once, once a day
write the prescription
Practice 2
A 20-year-old man complaind of running nose, cough, fever. His doctor prescribe him
aspirin.there are two preparations available, 25mg/pill, 0.3g/pill, the doctor told him he should
take the drugs after meal. The therapy should last for 3 day.
Which preparation should be choosed?
write the prescription.
Practice 3
A 70-year-old man with chronic heart failure go to see his doctor, his doctor prescribe him drugs
as follow.
Digoxin, tablet, 0.25mg/pill, 0.25mg once, and take it every 6h.
Captopril, tablet, 25mg/pill, 12.5mg once, three times one day.
Spironolactone, capsule, 20mg/capsule, 20mg once, three times one day.
Do you think the prescriptin is rational?
If not, do you have advice on the prescription?
Write prescription.
Clinicopharmacological seminars on rational drug therapy (Seminars)
Antibiotics
Objectives:
The students are required:
Be able to know the characteristic of each group of antibiotics
Be able to know the frequency, distribution of antibiotic prescribed in different clinical
settings/units.
Be able to know rational prescribing pattern of antibiotics
Duration : 5 school hours
Teaching contents:
Students are required to search informations and do presentation, these factors should be included:
Provisional diagnosis, investigation, empirical therapy, prescribing after culture and sensitivity.
Vitamins
Objectives:
The students are required:
Be able to know how to treat disease caused by vitamin defficiency
Be able to know disease caused by vitamin defficiency.
Duration : 5 school hours
Teaching contents:
Students are required to search informations and do presentation, these factors should be included:
Groups of vitamins prescribed
Vitamins prescribed on basis of therapeutic indication or empirical.
Single/mutiple vitamins prescribing.
Frequency of prescribing and rational use of vitamins.
Analgesics
Objectives:
The students are required:
Be able to know principle of rational use of analgesics.
Duration : 5 school hours
Teaching contents:
Students are required to search informations and do presentation, these factors should be included:
Frequency distribution of various groups of analgesics prescribed.
Single/multiple adverse drug prescription.
Non-specific indications of analgesics prescribed
Adverse drug reactions
Objectives:
The students are required:
Be able to prescribe drugs rationally
Be able to mornitor the drug therapy
Be able to observe drug interactions and adverse drug reactions
Be able to manage drug over dosage and poisioning.
Duration : 5 school hours
Teaching contents:
Students are required to search informations and do presentation, these factors should be included:
prescribe drugs rationally, for example: antibiotics, cytotoxic drugs, steroids.
mornitor the drug therapy
observe drug interactions and adverse drug reactions
manage drug over dosage and poisioning.