Jordan University of Science and Technology
Faculty of PHARMACY
Department of CLINICAL PHARMACY
Second Semester 2008/2009
Course Syllabus
Course Information
Course Title
Pharmacology 2
Course Number
Pharm342
Prerequisites
Pharm341
Course Website
Instructor
Dr.Naseer Al-rawi
Office Location
Office Phone #
Office Hours
E-mail
Teaching
Assistant(s)
Course Description
This course aims to introduce comprehensive pharmacological approach for the following topics:
1- Diuretics
2- Vasopressin and other agents affecting the renal conservation of water
3- Renin and Angiotensin system and agents affecting this system
4- The treatment of heart failure
5- Antiarrhythmic drugs
6- Antianginal drugs
7- Antihypertensive drugs
8- Drugs affecting the blood
9- Antihyperlipidemic drugs
10- Autacoids & Autacoids’ Antagonists
11- Drugs affecting the respiratory system
12- Gastrointestinal and antiemetic drugs
Textbook
Title
1-Lippincott’s Illustrated Reviews: Pharmacology
Author(s)
Richard D. Howland and Mary J. Mycek
Publisher
Lippincott Williams & Wilkins
Year
2006
Edition
3rd
www.lww.com/medstudent
Book Website
Other references
2-Goodman & Gilman’s The Pharmacological Basis of Therapeutics.
11th edition, 2006. McGraw-HILL.
www.AccessMedicine.com
Assessment
Assessment
Expected Due Date
First Exam
TBA
30%
Second Exam
TBA
30%
Final Exam
TBA
40%
Assignments
Percentage
Participation
Attendance
Course Objectives
1- Diuretics: this chapter first describes renal anatomy and physiology, then
introduces diuretics with regard to chemistry, mechanism of action, site of
action, effects on renal hemodynamic, and effects on urine composition, and
finally, integrates diuretic pharmacology with a discussion of mechanism of
edema formation and the role of diuretics in clinical medicine. Therapeutic
applications of diuretics are expanded on in chapters which cover
hypertension and heart failure. The pharmacological profile of the following
drug groups will be considered: carbonic anhydrase inhibitors, loop agents,
thiazides, and potassium-sparing agents.
2- Vasopressin and other agents affecting the renal conservation of water: this
chapter describes the physiological mechanisms that regulate plasma
osmolality, discusses the diseases that perturb those mechanisms, and
examines pharmacological approaches for treating disorders of water
balance. The pharmacological profile of the following drug groups will be
considered: naturally occurring vasopressin-like peptides, synthetic
vasopressin peptides, and nonpeptide agonists. Vasopressin receptor
antagonists including peptide antagonists and nonpeptide antagonists will be
considered too.
3- Renin and angiotensin: this chapter discusses the biochemistry, molecular
and cellular biology, and physiology of the rennin-angiotensin system, the
pharmacology of drugs that interrupt this system, and the clinical utility of
inhibitors of the rennin-angiotensin system. Therapeutic applications of drugs
covered in this chapter also are discussed in chapters on myocardial
ischemia, hypertension, and heart failure. Pharmacological profile of the
following drug groups will be considered: converting enzyme inhibitors,
angiotensin receptor blockers (SARTANS), and renin inhibitors.
4- Antihypertensive drugs: learning objectives include current views on etiology
of hypertension, mechanisms for normal blood pressure regulation, what are
the major determinants of blood pressure? How do baroreceptor mechanisms
regulate blood pressure? How does the kidney regulate blood pressure?
What elevates blood pressure in “essential hypertension”? This chapter also
discusses problems in antihypertensive therapy, and the rationale for using
drug combinations. The pharmacological profile of the following drug groups
will be considered: sympatholytics, vasodilators, calcium channel blockers,
ACE inhibitors, angiotensin receptor blockers, and diuretics.
5- Antianginal drugs: this chapter explains the pathophysiological basis of
angina pectoris, the main difference between classic and variant angina, the
major and minor determinants of myocardial oxygen demands and coronary
blood flow. The objectives of treatment will be discussed. The
pharmacological profile of the following drug groups will be considered:
nitrates and nitrites, calcium channel blockers, β-adrenergic blockers.
6- Congestive heart failure: learning objectives include answers for the following
questions: what are the causes and major hemodynamic effects of congestive
heart failure? How does congestive heart failure alter activity of the
sympathetic nervous and renin-angiotensin systems? How are the 4 main
factors affecting cardiac performance altered during congestive heart failure?
The strategy of treatment will be discussed, and the pharmacological profile
of the following drug groups will be considered: cardiac glycosides and other
positive inotropic drugs, β-adrenergic agonists, vasodilators, and ACE
inhibitors.
Percentage
10%
5%
5%
10%
5%
5%
7- Antiarrhythmic drugs: learning objectives include key answers for the
following aspects: what ionic and electrophysiological changes are associated
with normal cardiac rhythm? How might arrhythmias result from the effects of
resting potentials on action potentials? What factors may precipitate or
exacerbate arrhythmias? Explain how disturbances either in impulse
formation (by a latent pacemaker or ectopic focus), or in impulse conduction
(during reentry or “circus movement”) result in arrhythmias. What guidelines
can be used to decide whether arrhythmias should be treated? What are
general principles of antiarrhythmic therapy? What are the major mechanisms
of action of antiarrhythmic drugs? The pharmacological profile of the following
drug groups will be considered: sodium channel blockers (class I), βadrenergic blockers (class II), potassium channel blockers (class III), calcium
channel blockers (class IV), adenosine, magnesium, and potassium.
10%
8- Hypolipidemic drugs. Learning objectives: How does hyperlipemia differ from
hyperlipoproteinemia? What are the atherogenic lipoproteins? Describe the
major characteristics of: VLDL, LDL, HDL, and chylomicrons. What are the
primary hypertriglyceridemias and how do they differ from each other? What
are the primary hypercholesterolemias and how do they differ from each
other? What are the most common causes
of secondary
hyperlipoproteinemia? What dietary measures should be initiated before
using drugs for treatment of hyperlipoproteinemia? The pharmacological
profile of the following drug groups will be considered: niacin, fenofibrate,
gemfibrozil, bile acid-binding resins, and HMG-CoA reductase inhibitors
(STATINs).
10%
9- Drugs affecting the blood: this chapter describes drugs that are useful in
treating three important dysfunctions of the blood: thrombosis, bleeding, and
anemia. Thrombotic disorders include acute myocardial infarction, deep-vein
thrombosis, pulmonary embolism, and acute ischemic stroke. Bleeding
disorders include hemophilia. Iron-deficiency anemia and sickle-cell disease
will be overviewed. The pharmacological profile of the following drug groups
will be taken into consideration: platelet inhibitors, anticoagulants,
thrombolytic agents, drugs used in treatment of bleeding, drugs used in
treatment of anemia and sickle-cell disease.
10- Autacoids and their antagonists:
A- Histamine: this part describes the following properties of histamine:
distribution and storage, synthesis and release, metabolism and
elimination, receptor classification, post-receptor second messengers
which are activated, pharmacological actions on airway smooth muscle,
exocrine glands, cardiovascular system, and sensory nerve endings. The
basic pharmacology and clinical uses of H1-receptor antagonists and H2receptor antagonists will be discussed.
B- Eicosanoids: this part provides knowledge about the fundamental
biochemistry of eicosanoids, classes of eicosanoids, and the main
pharmacological actions of PGE2, PGF2-alpha, PGI2, TXA2, and
leukotrienes on: vascular, airway, uterine, GI smooth muscle,
microvascular permeability, platelet function, sensory nerve endings,
gastric and intestinal secretions, and temperature regulating centre. It
also describes post-receptor second messengers which are activated,
and the ways to inhibit synthesis of eicosanoids. The main clinical uses of
eicosanoids and inhibitors of eicosanoids synthesis, especially their use
in inflammation, obstetrics, and GI ulcers, will be highlighted.
10%
10%
11- Bronchodilators and other agents used in asthma. Learning objectives:
 Understand the pathogenesis of bronchial asthma
 Know the mediators released from mast cells
 Understand the role of the autonomic nervous system in control of
bronchial motor tone
 Understand how pulmonary function tests can be used to evaluate
patients with asthma
 Explain the pharmacological profile of drug groups used in treating
asthma including: sympathomimitics, antimuscarinic agents, mast cell
stabilizers, aerosol corticosteroids, methylxanthines, oral corticosteroids,
monoclonal antibody, and leukotrienes antagonists.
 Understand the bases for selecting therapeutic agents in bronchial
asthma, depending on the severity and duration of the symptoms.
 Understand the approach to treatment of acute and severe asthma.
 Understand the bases for more aggressive anti-inflammatory therapy in
asthma, including potential use of methotrexate.
12- Gastrointestinal and antiemetic drugs. This chapter describes drugs used to
treat three common medical conditions involving the gastrointestinal tract:
peptic ulcers and gastro-esophageal reflux disease (GRED), chemotherapyinduced emesis, and diarrhea and constipation. Drugs used to treat peptic
ulcer disease include: H2-Histamine receptor blockers, inhibitors of protonpump, antimicrobial agents, prostaglandins, antimuscarinic agents, mucosal
protective agents, and antacids. Drugs used to treat chemotherapy-induced
nausea and vomiting include: phenothiazines, butyrophenones, 5-HT3
serotonin receptor blockers, benzamides, benzodiazepines, corticosteroids,
cannabinoids, and substance P/neurokinin-1 receptor blocker. Antidiarrheals
and laxatives are overviewed too.
10%
10%
Teaching & Learning Methods
1- Class lectures and lecture notes are designed to achieve the course objectives.
2- You should read the assigned chapters before class and participate in class and do whatever it
takes for you to grasp this material. Ask questions. Ask lots of questions.
3- You are responsible for all material covered in the class.
4- Please communicate any concerns or issues either in class or at my office hours.
Learning Outcomes: Upon successful completion of this course, students will be able
to
Related Objective(s)
Reference(s)
1, 2, and 3: Discuss the pharmacological properties of Ch.22 (Ref.1), Ch.29 and
drugs affecting the renal system.
30 (Ref.2).
4, 5, 6, 7, 8, and 9: Discuss the pharmacological Ch.16, 17, 18, 19, 20, and
properties of drugs affecting the cardiovascular system.
21 (Ref.1).
10, 11, and 12: Discuss the pharmacological properties of Ch.27, 28, and 42 (Ref.1)
drugs affecting the respiratory and gastrointestinal
systems.
Useful Resources
1234-
British Journal of Pharmacology
British Journal of Clinical Pharmacology
New England Journal of Medicine
Online Merck Manuel of Diagnosis and Therapy
Course Content
Week
Topics
Chapter in Textbook
(handouts)
1
Diuretic drugs
22 Ref.1
2
Diuretic drugs
22 Ref.1
3
Vasopressin and other agents affecting renal
conservation of water
29 Ref.2
4
Renin-Angiotensin system and agents affecting
this system
30 Ref.2
5
Antihypertensive drugs
19 Ref.1
6
Antianginal drugs
18 Ref.1
7
The treatment of heart failure
16 Ref.1
8
Antiarrhythmic drugs
17 Ref.1
9
Antiarrhythmic drugs
17 Ref.1
10
Antihyperlipidemic drugs
21 Ref.1
11
Antihyperlipidemic drugs
21 Ref.1
12
Drugs affecting the blood
20 Ref.1
13
Autacoids & Autacoids’ antagonists
42 Ref.1
14
Drugs affecting the respiratory system
27 Ref.1
15
Gastrointestinal and antiemetic drugs
28 Ref.1
Additional Notes
1- Exams
 The format for the exams is generally (but NOT always) MCQs and essay
questions.
 Grades will not be given out via e-mail.
2- Makeup Exams
 Makeup exams should not be given unless there is a valid excuse.
 Arrangements to take an exam at a time different than the one scheduled
MUST be made prior to the scheduled exam time.
3- Cheating
 The commitment of the acts of any form of cheating and deceit is dishonest
and will not be tolerated. Standard JUST policy will be applied.
4- Attendance
 Excellent attendance is expected.
 JUST policy requires the faculty member to assign ZERO grades (35) if a
student misses 10% of the classes that are not excused.
5- Workload
 Average workload student should expect to spend is 3 hours per week.