2015/2016

2017/2018

DM270

BIO/14 (FARMACOLOGIA)

DIPARTIMENTO DI MEDICINA MOLECOLARE

MEDICINA E CHIRURGIA (IN LINGUA INGLESE)

PERCORSO COMUNE

3°

Primo Semestre (02/10/2017 - 19/01/2018)

2

16 ore di attività frontale

English

ORALE

FELETTI FAUSTO - 2 CFU

Current prerequisite courses are Chemistry, Biology, Biochemistry, Anatomy and Physiology.
Basics of basic mathematics already used in chemistry and physics courses. Students need to have some background in chemical kinetics, i.e. zero and first order processes.

The learning objectives of the course are: 1) understand the meaning of the primary pharmacokinetic parameters (distribution volume and clearance, bioavailability) and secondary ones (elimination rate constant, half-life, etc). 2) Determine primary and secondary pharmacokinetics parameters from concentration-time data. 3) Understand the influence of the route of administration and the various therapeutic regimens on the plasma concentration-time profile and predict the effect on it of clearance and distribution volume changes, and other specific patient characteristics. 4) Understand the role of pharmacokinetic drug monitoring in choosing the correct dosage regimen in each individual patient.

Introduction to pharmacokinetics: absorption, distribution and elimination (metabolism and excretion), disposition. Clinical pharmacokinetics, pharmacodynamics, kinetic homogeneity, models. Exponents and logarithms. Meaning of differential calculus, differential equations, integral calculus. AUC determination by trapezoidal rule. Orders of kinetic: first- and zero-order kinetics, Michaelis-Menten kinetic. Pharmacokinetics models: one-compartment and multiple compartments models. Non compartment model. Concentration-time curves, linear plots, semi-log plots. i.v. (bolus) single dose administration. Pharmacokinetic parameters associated with models and their calculation: C0, volume of distribution, clearance, elimination rate constant, half-life. Factors affecting drug distribution: characteristics of drug, characteristics of barrier to be crossed, regional blood flow, drug plasma and tissue protein binding, physiological factors and disease states. Blood-brain barrier and placenta transfer of drugs. Clearance: total plasma or blood clearance, organ clearance, extraction ratio. Well-stirred model of hepatic clearance, low and high hepatic extraction ratio drugs, renal clearance. Bioavailability. Route and frequency of administration: i.v. continuous constant rate infusion with and without reaching steady state; extra vascular administration and related parameters, single and multiple doses. Generic drugs, biotechnological and biosimilar drugs. Therapeutic drug monitoring, definition. Therapeutic ranges and reference ranges. TDM procedure, assay methods. Examples of drugs monitored. Theoretical background needed to make clinically useful TDM. Individual therapeutic concentration. Examples of drug with non-linear kinetics.

Presentations (PowerPoint) front-facing lectures projected on-screen and insights using the blackboard.

Goodman and Gilman's The Pharmacological Basis of Therapeutics (Laurence Brunton, Bruce Chabner, Bjorn Knollman, authors), Twelfth Edition, New York McGraw-Hill, 2011.
Harvey RA, Clark MA, Finkel R, Rey JA, Whalen, K. Lippincott’s illustrated reviews: Pharmacology, 5th Edition, Lippincott, Williams & Wilkins), 2011.
M. Fuccella, E. Perucca, C. Sirtori - Farmacologia Clinica. UTET 2006.

Written examination consisting of multiple choice and open questions primarily based on didactic material covereded in the course. Graphics is emphasized: the student must know how to draw plasma concentration - time curves, etc.

The lecturer will provide .pdf presentations and other study materials of the topics discussed.
It is also available on request for explanations to groups or individual students by appointment.