Guideline of Pharmacology for International Student

I Character and Objective of the Course

1. Character of the Course: Basic Medical Course.

2. Preparatory Course: Physiology, biochemistry, and pathophysiology.

3. Textbook: Pharmacology (5th edition), Michelle A. Clark, Richard

Finkel, Jose A. Rey, Karen Whalen. LWW.com.

4. Objective of the Course: Master pharmacological effects, mechanism of

action, clinical uses, and adverse effects of the main and typified drugs.

II Contents and requirements of teaching

Unit I: Introduction to pharmacology

Chapter Content Hours

1 Pharmacokinetics 4

2 Pharmacodynamics 4

Chapter 1 Pharmacokinetics

Teaching requirements

Master

1. Absorption of drugs

1) The first-pass elimination

2) Bioavailability

2. Distribution of drugs

1) One-compartment open model and two-compartment open model.

2) Volume of distribution

3) Binding to plasma proteins

4) Blood-brain barrier.

3. Biotransformation of drugs

1) Enzyme inducers

2) Enzyme inhibitors

4. Excretion of drugs

1) Clearance

2) First-order kinetics and zero-order kinetics

3) Drug half-life (t1/2)

4) The steady-state drug concentration (Css)

3) Hepatoenteral circulation

Familiar with

Drug permeation across membranes:

1) Lipid diffusion and influence of PH on drug absorption.

2) The properties of filtration, facilitated diffusion and active transport.

Understanding

1. Influencing factors of absorption, distribution, metabolism, and

excretion.

2. The cytochrome P450 system (microsomal mixed-function oxidases).

3. Concentration-time curves.

Chapter 2 Pharmacodynamics

Teaching requirements

Master

1. Basic action of drugs:

1) Excitation and inhibition

2) Therapeutic action

3) Adverse reaction (side reaction, toxic effect, allergic reaction, residual

reaction, dependence).

2. Dose-response relationship (dose-response curves):

1) Graded dose-response relations: efficacy, potency.

2) Quantal response relations: LD50, ED50, the therapeutic index.

3. Agonists and antagonists

1) Agonists: full agonists, partial agonists.

2) Antagonists: competitive antagonists, noncompetitive antagonists.

Understanding

1. Drug receptor theory

2. Mechanism of drug action

Unit II: Drugs affecting the autonomic nervous system

Chapter Content Hour

3 The autonomic nervous system 2

4 Cholinergic agonists 2

5 Cholinergic antagonists 2

6 Adrenergic agonists 2

7 Adrenergic antagonists 2

Chapter 3 The Autonomic Nervous System

Teaching requirements

Master

Nerve：classification (according to transmitter).

Familiar with

Nervous system: anatomy, function.

Understanding:

Transmitter: acetylcholine and noradrenaline (synthesis/storage/release/

termination).

Receptor：classification.

Drug：classification.

Chapter 4 Cholinergic agonists

Teaching requirements

Master

Pharmacological effects, action mechanism, and therapeutic uses of

pilocarpine.

Familiar with

Pharmacological profiles and therapeutic uses of reversible

anticholinesterases (physostigmine, neostigmine).

Understanding

1. Neurotransmission at cholinergic neurons and cholinoceptors.

2. Pharmacological properties of bethanechol, carbachol, irreversible

anticholinesterases, and reactivators.

Chapter 5 Cholinergic antagonists

Teaching requirements

Master

Pharmacological actions, therapeutic uses, and adverse reactions of

atropine.

Familiar with

Pharmacological properties of scopolamine.

Understanding

1. Pharmacological properties of ipratropium and tiotropium.

2. Pharmacological properties of succinylcholine and D-tubocurarine.

3. Pharmacological properties of cholinesters and stimulating ganglionic

drugs.

Chapter 6 Adrenergic agonists

Teaching requirements

Master

The pharmacological actions, clinical applications, and adverse reactions

of epinephrine and dopamine.

Familiar with

Pharmacokinetics, pharmacological effects, clinical applications, and

adverse reactions of norepinephrine and isoproterenol.

Understanding

Pharmacological properties of metaraminol.

Chapter 7 Adrenergic antagonists

Teaching requirements

Master

Pharmacological properties, therapeutic uses, and adverse effects of

β-adrenoceptor antagonists.

Familiar with

Classification and representative drug of β-adrenoceptor antagonists.

Understanding

Pharmacological properties, therapeutic uses, and adverse effects of

phentolamine.

Unit III Drugs affecting the central nervous system

Chapter Content Hour

8 Neurodegenerative Diseases 2

9 Anxiolytic and hypnotic drugs 2

12 Antidepressants 1

13 Antipsychotic drugs 2

14 Opioids 2

15 Epilepsy 1

41 Anti-inflammatory drugs and autacoids 2

Chapter 8 Neurodegenerative Diseases

Teaching requirements

Master

Pharmacological effects and uses of L-dopa.

Familiar with

1. Mechanism of action and uses：carbidopa, selegiline, tolcapone.

2. Pharmacokinetics, adverse effects, and drug interaction of L-Dopa.

Understanding

1. Pathophysiology and clinical manisfestations of Parkinson’s disease.

2. Classification of treatment of AD, mechanism of action, and

representative drugs.

Chapter 9 Anxiolytic and hypnotic drugs

Teaching requirements

Master

Pharmacological effects, mechanism of action, and clinical uses of

diazepam.

Familiar with

1. Pharmacokinetics and adverse effects of benzodiazepines and

barbiturates.

2. Pharmacological effects of novel benzodiazepine receptor agnoists.

Understanding

1. Clinic uses of flumazenil.

2. Pharmacological effects of chloral hydrate.

Chapter 12 Antidepressants

Teaching requirements

Master

Pharmacological effects, mechanism of action, and clinical uses of

imipramine.

Familiar with

Mechanism of action and uses: fluoxetine, desipramine.

Chapter 13 Antipsychotic drugs

Teaching requirements

Master

1. Pharmacological effects, mechanism of action, clinical uses, and

adverse effects of chlorpromazine.

2. Pharmacological effects, mechanism of action, and clinical uses of

lithium carborate.

Familiar with

1. The action characters of phenothiazines, thioxanthines, and

butyrophenones.

2. Mechanism of action and uses of clozapine.

Chapter 14 Opioids

Teaching requirements

Master

Pharmacological effects, uses, and adverse effects of morphin and

pethidine.

Familiar with

1. Action characters of codeine, fentanyl, methadone, and pentazocine.

2. Action and uses of naloxane.

Understanding

Tolerance and physical dependence of opioid.

Chapter 15 Epilepsy

Teaching requirements

Familiar with

1. Pharmacological effects, uses and adverse effects of phenytoinn sodium,

carbamazepine, sodium valproate, primidone, ethosuximide, phenobarbital,

and benzodiazepines.

2. Effect of carbamazepine on peripheral neuralgia.

3. Pharmacological effects, mechanism, and uses of magnesium sulfate..

Understanding

Classification of epilepsy.

Chapter 41 Anti-inflammatory drugs and autacoids

Teaching requirements

Master

1. The effects and their respective mechanisms of NSAIDs.

2. The pharmacological effects, therapeutic uses, and adverse reactions of

acetaminophen and aspirin.

Understanding

The characteristics of effects, clinic uses, and advantages of selective

COX-2 inhibitors (celecoxib).

Unit IV Drugs affecting the cardiovascular system

Chapter Content Hour

16 Heart failure 4

17 Antiarrhythmics 3

18 Antianginal drugs 2

19 Antihypertensives 4

21 Hyperlipidemias 1

22 Diuretics 2

Chapter 16 Heart failure

Teaching requirements

Master

1. Pharmacological effects, mechanism of action, clinical uses, and

adverse reactions of angiotension-converting enzyme inhibitors (enalapril).

2. Pharmacological effects, mechanism of action, and clinical uses of AT1

receptor antagonists (losartan).

3. Pharmacological effects, mechanism of action, clinical uses, and

adverse reactions of cardiac glycosides (digoxin).

Familiar with

1. Pharmacological effects, mechanism of action, and clinical uses of

β-adrenergic receptor antagonists (metoprolol).

2. Pharmacological effects and mechanism of diuretics (thiazides and loop

diuretics).

Understanding

1. Pathophysiology of congestive heart failure: regulation of sympathetic

nervous system activity.

2. Ventricular remodeling in CHF.

3. The rennin-angiotensin system activation.

Chapter 17 Antiarrhythmics

Teaching requirements

Master

Pharmacological effects, clinical uses, and adverse effects of quinidine,

lidocaine, propafenone, propranolol, amiodarone, and verapamil.

Familiar with

1. Mechanisms of antiarrhythmic drug action.

2. Classifying of antiarrhythmic drugs.

3. Pharmacological effects, mechanism of action, and clinical uses of

procainamide and phenytoin sodium.

Understanding

1. Principles of cardiac electrophysiology.

2. Common arrhythmias and their mechanisms.

Chapter 18 Antianginal drugs

Teaching requirements

Master

1. Mechanism of action, therapeutic uses, and adverse effects of nitrates

(nitroglycerin).

2. Mechanism of action and therapeutic uses of Ca2+

channel blockers and

β adrenergic receptor antagonists.

Familiar with

The advantage of concomitant use of nitrates and β-blocking agents.

Understanding

Pathophysiology and classification of angina pectoris.

Chapter 19 Antihypertensives

Teaching requirements

Master

Mechanism of action, therapeutic uses, and adverse effects of angiotensin

converting enzyme inhibitors (ACEI), angiotensin Ⅱ-receptor antagonists, Ca2+

channel blockers, βadrenergic antagonists, and α1 adrenergic antagonists.

Familiar with

Mechanism of action, therapeutic uses, and adverse effects of mixed adrenergic

antagonists, centrally acting agents, diuretics, direct vasodilators, and K+

ATP

channel openers.

Understanding

Classification of antihypertensive drugs.

Chapter 21 Hyperlipidemias

Teaching requirements

Familiar with

Mechanism of action and therapeutic uses of HMG-CoA reductase inhibitors,

cholestyramine, fibrates, and nicotinic acid.

Understanding

1. Definition and classification of hyperlipoproteinemia.

2. Adverse effects of HMG-CoA reductase inhibitors, cholestyramine, fibrates,

and nicotinic acid.

Chapter 22 Diuretics

Teaching requirements

Master

1. Sites of action, mechanism of action, clinical uses, and adverse effects of

loop diuretic (furosemide).

2. Sites of action, mechanism of action, clinical uses, and adverse effects of

hydrochlorothiazide.

3. Sites of action, mechanism of action, clinical uses, and adverse effects of

potassium-sparing diuretics (spironolactone and amiloride).

Familiar with

1. Pharmacokinetics of hydrochlorothiazide and loop diuretic.

2. Clinical uses of osmotic agents and carbonic anydrase inhibitor.

Understanding

Mechanism of action, clinical uses, and adverse effects of bumetanide.

Unit V Drugs affecting the blood and other systems

Chapter Content Hour

20 Blood drugs 3

27 Respiratory system 1

28 Gastrointestinal and antiemetic Drugs 2

Chapter 20 Drugs acting on the blood system

Teaching requirements

Master

1. Anticoagulation features, mechanisms, clinical applications, and adverse

reactions of heparin and warfarin.

2. Pharmacological effects and clinical applications of folic acid and

vit-B12.

Familiar with

1. Antiplatelet mechanism of aspirin, dipyridamole, and abciximab.

2. Pharmacological effects of streptokinase and urokinase.

3. Pharmacological effects of VitK and PAMBA.

Understanding

Pharmacological effects and application of erythropoietin, GM-CSF, and

TPO.

Chapter 27 Drugs acting on respiratory system

Teaching requirements

Familiar with

Pharmacological effects and mechanisms, clinical use, and adverse

reactions of aminophylline and adrenergic receptor agonists.

Understanding

1. The types of anti-asthmatic drugs, representative drug of each type.

2. Pharmacological effects and mechanisms, clinical use, and adverse

reactions of glucocorticoids, M receptor blockers, and mast cell stabilizing

drugs.

Chapter 28 Gastrointestinal and antiemetic Drugs

Teaching requirements

Master

Pharmacological effects and clinical uses (H2 receptor blockers and

H+-K

+-ATPase inhibitor).

Familiar with

1. The classification of inhibitors of gastric acid secretion and

representative drugs.

2. Pharmacological effects and clinical uses (M receptor blockers, gastrin

receptor antagonist, mucosal protective agents).

Unit VI Drugs affecting the endocrine system

Chapter Content Hour

23 Drugs acting on thyroid 1

24 Insulin and other glucose-lowering drugs 2

26 Adrenal hormones 3

Chapter 23 Drugs acting on thyroid

Teaching requirements

Master

1. Pharmacologic effects and therapeutic uses of thyroid hormone.

2. Classification of antithyroid agents.

3. Pharmacologic effects, therapeutic uses, and adverse reactions of

thioureas.

Familiar with

Pharmacologic effects, therapeutic uses, and adverse reactions of iodine,

radioiodine, and β adrenergic receptor antagonists.

Understanding

Synthesis, release and regulation of thyroid hormone.

Chapter 24 Insulin and other glucose-lowering drugs

Teaching requirements

Master

1. Pharmacological effects, clinic uses and adverse reaction of insulin.

2. Pharmacokinetics, mechanism, clinic uses, and adverse reaction of oral

hypoglycemic agents.

Familiar with

Pharmacokinetics and mechanism of insulin.

Understanding

Pharmcological effects and clinic uses of insulin sensitizer.

Chapter 26 Adrenal hormones

Teaching requirements

Master

The pharmacological effects, anti-inflammatory mechanism, clinical

application, and adverse reactions of glucocorticoids.

Familiar with

1. Dosage and schedule of glucocorticoids.

2. Structure-activity relationships of adrenocorticosteroids.

Understanding

Pharmacokinetics of glucocorticoids.

Physiological regulation of glucocorticoids.

Unit VII Chemotherapeutic drugs

Chapter Content Hour

30 Principles of antimicrobial therapy 1

31 Cell wall inhibitors 2

32 Protein synthesis inhibitors 5

33 Quinolones, folic acid antagonists 2

Chapter 30 Principles of antimicrobial therapy

Teaching requirements

Master

1. Terminology.

2. Classification and mechanisms of antibacterial drugs (targets).

3. Mechanisms that bacteria produce drug resistance to agents and

mothods of avoiding drug resistance.

Understanding

Knowing the relationships among the human body, pathogenic

microorganism and antiinfective drugs.

Chapter 31 Cell wall inhibitors

Teaching requirements

Master

1. Mechanisms of action of beta-lactams.

2. Antibacterial spectrum, therapeutic uses, and adverse effects of

penicillin G. The measures used to prevent the anaphylactic shock of

penicillin G.

3. Pharmacologic characteristics of semi-synthetic penicillins such as

acid-stable penicillins, penicillinase-resistant penicillins, broad-spectrum

penicillins, and antipseudomonal penicillins.

4. Pharmacologic characteristics, therapeutic uses, and adverse effects of

cephalosporins of 4 generations.

Understanding

1. Pharmacokinetics of both penicillin G and cephalosporins, and

drug-resistant mechanisms.

2. Pharmacologic characteristics of carbapenems and beta-lactamase

inhibitors.

Chapter 32 Protein synthesis inhibitors

Teaching requirements

Master

1. Mechanisms of action, antibacterial spectrum, therapeutic uses, and

adverse effects of macrolides, lincomycin, and clindamycin.

2. Mechanisms of action, antibacterial spectrum, therapeutic uses, and

adverse effects of aminoglycosides.

3. Mechanisms of action, therapeutic uses, and adverse effects of

tetracylines and chloramphenicol.

Understanding

1. Pharmacokinetics of aminoglycosides, tetracylines, and

chloramphenicol.

2. Pharmacologic characteristics of glycopeptide vancomycin.

Chapter 33 Quinolones, folic acid antagonists

Teaching requirements

Master

Mechanisms of action, therapeutic uses of quinolones, sulfonamides, and

trimethoprim.

Familiar with

Antibacterial spectrum and adverse effects of quinolones, sulfonamides,

and trimethoprim.

Understanding

Pharmacokinetics of quinolones and sulfonamides.