Chem. Res. Toxicol. 2006, 19, 164-172 The Greater Reactivity of Estradiol-3,4-quinone vs Estradiol-2,3-quinone with DNA in the Formation of Depurinating Adducts: Implications for Tumor-Initiating Activity Muhammad Zahid, Ekta Kohli, Muhammad Saeed, Eleanor Rogan, and Ercole Cavalieri* Eppley Institute for Research in Cancer and Allied Diseases, Uni V ersity of Nebraska Medical Cen
Microsoft word - pharmacology mbbsCURRICULUM AND SYLLABUS UNDER THE NEW REGULATIONS FOR THE M.B.B.S.
COURSE OF STUDIES OF PHARMACOLOGY.
A. Didactic Lectures 40hrs
I. General Consideration & Basic Principles 15hrs
(Introduction, Historical perspective, Pharmacokinetic principles, Pharma- codynamics, Issues
relating to pharmacotherapeutics, Essential Drugs concept, Steps in New Drug Development: Ethics and
II. Autonomic Pharmacology 6hrs
(Introduction, Historical Perspectives, classification of drugs affecting ANS, Muscarinic receptor
agonists and antagonists, Adrenergic receptor agonists and antagonists).
III. Autacoids &Related Pharmacology 3hrs
(Introduction, Eicosanoids & NSAIDs, Histamine &Antihistaminics, Bradykinin & its antagonists,
Renin-angiotensin system, 5HT & its antagonists).
IV. Neuropharmacology 16hrs
(Benzodiazepines, Barbiturates, Anticonvulsants, Antiparkinsonian drugs, Neuroleptics, Anxiolytics,
Lithium, Antidepressants, General Anaesthetics, Skeletal Muscle Relaxants, Local Anaesthetics, Opioid &
Non-Opioid analgesics, Pharmacotherapy of pain & Gout).
B. Group Dynamics 40hrs
(This includes continuous assessment of each student through Item Cards).
I. Problem based Learning/Tutorials 25hrs
In these small group sessions (comprising of 25 students and one teacher facilitator in each group) the
students will be required to resolve specific problems that would be designed by the faculty members of the
department addressing issues covered in the didactic lectures in this semester.
II. Student’s seminar to be arranged. 15hrs
C. Practicals / Demonstration 40hrs
(All practical hours must be small group sessions. Students are required to maintain required to maintain
record books which will be continuously assessed by teacher).
I. Prescription writing
Principles & format 2hrs
Abbreviations used, Weights & Measures 2hrs
Rational Selection of a Drug while prescribing
(WHO P-drug concept) 4hrs
Writing specific problem-led prescriptions
for common ailments. 10hrs
(A list of such specific problem-led prescriptions are given in Annexure-1. These may be revised as per
the need of the day )
II. Therapeutic problem-solving addressing the issues of clinically relevant 10hrs
adverse drug reactions (ADR’s) and adverse drug interactions (DI’s).
(Coloured photographs of some typical ARD’s may be used additionally).
(A list of such therapeutic problems are given in Annexure-2).
Compounding & Dispensing of some common dosage forms eg. Mixture, 12 hrs
Lotion/ ointment, Powder, etc.
I) Alkali mixture/S.S. of Magsulph
III) ORS Powder
IV) Calamine lotion
V) Atropine sulphate ointt.(1%)
VI) Gamma-benzene hexachloride ointment(1%).
A. Didactic Lectures 30hrs
V. Renal Pharmacology. 4hrs
Diuretics & Anti Diuretics
Drugs for acid –base & Electrolyte balance.
VI. Cardiovascular Pharmacology. 9hrs
Angina pectoris, Myocardial infraction ,Cardiac arrhythmias, Hyperlipidemias, Hypertension, Heart
VII. Gastrointestinal Pharmacology 6hrs
Antiemetic & Prokinetic agents, Drugs for portal hypertension, Pancreatitis, Gall stones, Ulcerative colitis.
VIII. Haemato-pharmacology. 4hrs
Haematinics, Coagulants & Anticoagulants,Antithrombotics, Fibrinolytic, Antiplatelet agents.
IX. Endrocrine Pharmacology. 7hrs
Insulin & Oral hypoglycemic agents, Thyroid and anti thyroid drugs,Corticosteroids, Oral
contraceptives, Vitamin D, Parathormone, Calcium homeostasis.
B. Group Dynamics 30hrs
I. Problem-based learning / Tutorials similar to 3rd Semester. 20hrs
II. Integrated teaching –learning / Student’s seminar.
Topics like Anaemia, Hypertension, Angina pectoris, Peptic ulcer, Oral contraceptives, Rickets, Diabetes
mellitus etc. should be dealt in integrated sessions involving other para-clinical (and clinical) disciplines like pathology, Microbiology, Community Medicine etc. In such seminars students will take active part and teachers of different disciplines will act as facilitators. The seminars hours will be treated as common credit hours for the para –clinical disciplines that are directly involved in the concerned topic of discussion .For the logistic convenience, these sessions will not be required to attend at a time. Each session will be of 2 hours duration. They may be scheduled to be held on the last Saturday of each month. The minimum number of such
integrated sessions will be 5 in this semester.
C. Practicals /Demonstrations 30hrs
I. Prescription writing. 6hrs
Writing specific problem led prescriptions (for common aliments)
II. Therapeutic problem solving 4hrs
Similar to 3rd Semester
III. Demonstration of different dosage forms, formulations and delivery systems.
Tablets, Scored tablets, Capsules, Coated tablets, Drug suspensions, Suppositories, Enema,
Eyedrops, Injectables(Ampoules & Vials), Transdermal systems(NTC Patch), Fluid transfusion bottles
(Glass vs plastics), Blood Transfusion sets & Donor sets syringes (Tuberculin, Insulin,2 ml, 5 ml, 10 ml,
50ml,) (Glass vs Disposable)
Needles –different sizes.
Scalp vein sets
Inhalers, Spacer devices, Nebulizers.
Different types of packaging: Blister packs, Coloured bottles.
IV. Experimentals. 14hrs
Demonstration of drug effects
A. Animal experiments 8hrs
1.Effects of mydriatics &miotics in Rabbit’s eye.
3.Guinea pig ileum
B. Actual patient situation 6hrs
Visit to the indoor/ in patient’s deptt.
(General medicine, Pediatrics, or Maternity ward.) to oversee the drug prescribing and
A. Didactic Lectures 30hrs
X.Respiratory System Pharmacology 2hrs
Pharmacotherapy of Cough
Drug therapy of Bronchial Asthma.
XI. Chemotherapy & Anti-infectives 14hrs
General consideration ,Antiseptics and disinfectants
B-lactam antibiotic, Aminoglycosides, Tetracyclines, Chloromphenicol, Macrolides, Quinolones &
Sulphenamides, Antiamoebic, Anti tubercular, Anti fungal and Antiviral drugs with pharmacotherapy of
XII. Cancer Chemotherapy 2hrs
Principles & general consideration
Treatment approach in some common malignancies.
XIII. Immunopharmacology 1hrs
Immuno suppressants & Immunostimulants .
Vaccines & Sera.
XIV. Toxicology 3hrs
Drug overdose & poisoning
Heavy metals & Metal antagonist
Environmental toxicants & Drug dependence, Drug abuse, Adr monitoring
XV. Miscellaneous 8hrs
Vitamins & minerals
Drugs & uterine motility
Drugs used in medical emergencies
Rational use of drugs/Rational therapy
Drug prescribing in Pregnancy, Infants and Children, Geriatric patients and Hepato-renal
B. Group Dynamics 30hrs
I. Problem-based learning / Tutorials 20hrs
II. Integrated learning / Students seminar 10hrs
Similar to that in 4th Semester.
Seminar topics: Bronchial asthma, Rational use of antibiotics, Tuberculosis, Malaria, Worm
infestations, Management of poisons, Vaccine preventable diseases, Acute Respiratory Infection and
Diarrhoeal Disorders in Children.
C. Practicals/Demonstrations 30hrs
I. Prescription writing
Writing specific problem related prescription ( for common aliments ) 8hrs
II. Therapeutic problem solving 6hrs
III. Pharmacy 10hrs
a) Criticism of prescription 6hrs
b) Developing critical appraisal skill in scanning information from 4hrs
i) Pharmaceuticals Promotional Literature
ii) Package Inserts/ Patient Information Leaflets
iii) Published Documents in Independent Medical Journals.
IV. Experimentals 6hrs
Actual Patient Situation
a) Visit to the General Emergency to oversee the management of any one Medical/Surgical
b) Visit to the surgical Operation Theatre to over see the effects of drugs used anaesthetic practice.
Annexure-1. (A list of problem-led prescriptions)
1. A drug for “TYPHOID FEVER”.
2. A drug for “BACILLARY DYSENTRY”.
3. A drug for “DUDENAL ULCER”.
4. A drug for “AMOEBIC DYSENTRY”.
5. A drug for “TONIC CLONIC SEIZURES”.
6. PURGATIVE FOR RADIOLOGICAL EXAMINATION.
7. A drug for “MULTI-BACILLARY LEPROSY”.
8. A drug for “TINEASIS”.
9. A drug for “URINARY TRACT INFECTION”.
10. A drug for “ACUTE BACTERIAL CONJUNCTIVITIS”.
11. A drug for “FILARIASIS:”
12. A drug for “ACUTE GOUT”.
13. A drug for “NAUSEA AND VOMITING”.
14. A drug for “UNCOMPLICATED PULMONARY TUBERCULOSIS.”
15. A drug for “MIXED WORM INFESTATION”.
16. A drug for “MIGRAINE”.
17. A drug for “SYPHILIS”.
18. A drug for “GONORRHOEA”.
19. A drug for “ACUTE ATTACK OF ANGINA PECTORIS”.
Annexure-2 (DRUG INTERACTION)
1. Amoxicilin & Clavulanic Acid.
2. Metronidazole& Ethylalcohol .
3. Ciprofloxacin &Theophylline.
4. Aspirin &Warfarin.
5. Rifampicin & Cobined OCP.
6. Chloroquine & Alkali mixture.
7. Sucralfate &Antacid.
8. L-dopa & Pyridoxine.
9. Propranolol & Verapamil.
10. Digoxin & Hydroclorothiazide.
11. Chlorpropamide & Dicommurol.
12. Gentamycin & gallamine.
13. Lithium & Thiazide.
14. Propranolol & Insulin.
15. Enalapril & Spironolactone.
Annexure-3 (THERAPEUTIC PROBLEMS )
1. A 10 year old school girl suffering from mild exercise induced bronchial asthma has been treated with a metered does inhaler containing 500 μ g of Terbutaline per inhalation as and when required, which effectively controls the individual attack. However, she has attacks of wheezing every 3 to 4 weeks occurring during exercise even after above treatment schedule. What treatment should now be given to reduce the frequency of attacks? 2. A 16 years old girls has admitted to the emergency department with severe short of breath. She is diagnosed as acute bronchial asthma. She has been using metered dose inhalation of Salbutamol, Ipratropium and Beclomethasone. In spite of the above treatment, the present attack is not controlled. 3. A 69 year old woman suffering from congestive heart failure has been treated with 0.25 mg Digoxin tablet daily for last 3 months. But the heart failure is not controlled adequately. What will be the treatment to control the heart failure adequately? 4. A 45 year old male patient with history of smoking presented with exertional retrosternal compressing pain radiating to the left arm and lasts for 2-5 minutes. The pain is relieved after taking rest. After proper investigation, he has been diagnosed as a case of stable angina pectoris. What will be the treatment to control the attack? 5. A 45 old patient suffering from angina pectoris was on treatment with isosorbide dinitrate. He is admitted to the hospital with severe chest pain and sweating and diagnosed to be a case of acute myocardial infarction. What will be the management of this patient? 6. An overweight middle aged man is found to be hypertensive while attending a clinic for medical cheek up. His B.P. is 170/105 mm of Hg on two successive observations. What will be the treatment for this patient? 7. A 58 year old man with history of severe hypertension for 20 years, which was well controlled with medication. He stopped taking drugs for a prolonged period. His blood pressure is found to be 240/135 mm of Hg with papillaedema. What will be the management of this case? 8. A 25 year old lady is brought to emergency unit by her family members. She is unconscious with constricted pupils and froth coming out of her mouth. She is reported to consume an organo-phosphorus insecticide. How will you manage the case? 9 A middle aged person was watching T.V. in dark ,suddenly develops pain in right eye, vomiting and blurring of vision. On examination, right pupil is dilated, sluggishly reacting to light with raised intra-ocular pressure. The condition is diagnosed as a case of acute congestive glaucoma. What will be the medical management of this clinical condition? 10. A 20 year old diabetic man on insulin therapy suddenly developed fever and Missed his usual doses of insulin and became unconscious. What measures will you take to manage this condition? 11. A middle aged diabetic patient with oral anti-diabetic agent (Tolbutamide) underwent prolonged exercise and missed his usual breakfast. He developed unconsciousness, respiratory distress and profuse sweating with tachycardia. How will you manage the case? 12. A person is willing to travel an endemic area of malaria. What chemoprophylaxis has to be given to him? Subsequently, he developed chloroquine-resistant malaria. How will you manage the case? 13. A male patient develops fever with chill and rigor. P. vivax is found in his blood smear. What will be the management of this case? 14. A woman in 2nd trimester pregnancy is found to be moderately anemic on routine antenatal check- up. What will be the management of this case ? 15. A 6 year old boy while playing in a village ground was beaten by a snake. The snake was identified as a poisonous one. How will you manage this case? 16. A patient with chronic psychiatric illness was treated with largactil (chlorpromazine) for a prolonged period. He developed tremor, bradykinesia and rigidity What treatment should be given to the patient without stopping the drug ? ITEM CARD OF PHARMACOLOGY
CONTINUOUS DAY-TO-DAY ASSESSMENT
ROLL NO: BATCH: SESSION
Signature of teacher-in-charge Signature of the H.O.D.
I. GENERAL PHARMACOLOGY
Historical considerations, Steps of drug development, Dosage forms, Drug delivery systems Routs of drug administration, Pharmacokinetics, Phamacodynemics, Factors affecting therapeutic outcome, Drug prescribing in altered physiological states
(Pregnancy and lactation, neonates and
elderly, hepatic and renal impairment),
Essential drugs concept, Rational use of
drugs and Good prescribing practice.
II. AUTONOMIC PHARMACOLOGY
Basic considerations, Muscarinic&
Adrenergic receptor agonists and antagonists.
III. AUTACOIDS & RELATED
Eicosanoids, Histamine & antihistaminics,
5HT & drugs used in Migraine, Kinins and
Benzodiazepines & Barbiturates, Drug treatment of Parkinsonism & Epilepsy, Neuroleptics & Anxiolytics, Antidepressants & Lithium, Drugs used in Anaesthetic practice including Neuromuscular blocker, Opioids & non-opioid analgesics and Pharmacotherapy. EXAMINER
I. Prescription writing
II.Therapeutic problem solving
V. Criticism of prescription
FOURTH SEMESTER: THEORETICALS
I. RENAL PHARMACOLOGY
Diuretics & Antidiuretics, Drugs for BHP; Drugs
for ACID-BASE and Electrolyte imbalance,
II. CARDIOVASCULAR PHARMACOLOGY
Drug therapy of CHF, Hypertension,
Hyperlipidemias, Cardiac Arrhythmias and in
Ischaemic heart diseases.
Drug treatment for peptic ulcer, laxatives &
antidiarrhoeals, Antiemetics & prokinetics agents
and drugs for portal hypertension, pancreatitis,
Gallstones and ulcerative colitis.
Iron, folic acid, Treatment of anaemias, Heparin and anticoagulants; Antithrombotic and fibrinolytic & antiplatelet agents. V. ENDOCRINE PHARMACOLOGY
Insulin & Oral hypoglycemics, Thyroid & antithyroid drugs, Estrogens & Antiestrogens, Oral contraceptives, Androgens & antiandrogens, Corticosteroids, Calcium, Vitamin D, Parathormone & calcitonin. FOURTH SEMESTER: PRACTICALS
FIFTH SEMESTER: THEORETICALS
I. RESPIRATORY SYSTEM
II. CHEMOTHERAPY & ANTI-
Beta-lactam antibiotics, Quinolones &
Tetracyclines, Chloramphenicol &
Macrolides, Drug therapy of
tuberculosis and leprosy, Antivirals and
drug treatment of AIDS, Antifungals,
Anthelmintics & antiamoebics and drug
treatment of malaria & Kala-azar.
III. CANCER CHEMOTHERAPY
Principles & general considerations &
Methotrexate, Cyclophosphamide, vinca
alkaloids and Corticosteriods and others
Vaccines & sera, Immuno modualators. V. TOXICOLOGY
Heavy metal poisoning & drug poisoning &
treatment, Drug dependence & treatment
and ADR monitoring center & poisoning
Drugs & uterine motility and Vitamins & Nutrients FIFTH SEMESTER: PRACTICALS
ASSESSMENT OF STUDENTS:
Practical …….15 marks
Assessment of theoretical and practical are to be done through day-to-day assessment (Weekly
/fortnightly) through ITEM CARDS and THREE PERIODICAL Examination at the end of 3rd ,4th & 5th
Assessment for practical will also be done through day to day evaluation of the students’ performance in the
Practical Record Book. No Marks should be separately allocated for Practical Record Book- but its
maintenance must be made mandatory.
Marks of Theory + oral and Practical are to be computed separately.
Periodical Institutional Assessment Examination:
Final Internal Assessment: PHARMACOLOGY
Continuous day to day
Total Internal Assessment
Theory/oral(a) Practical(b) Theory/oral(c) Practical(d) Theory/oral(a+c) Practical(b+d)
Signature of thePrincipal Signature of the H.O.D
Module of Questions:
Paper-I Total : 40 Marks
4.Renal Pharmacology including Acid-base and fluid-electrolyte balance 8.Toxicology including Heavy metals antagonist Q. 1Applied part of Pharmacology(Therapeutics) 10 marks (Each question to be answered in a separated answer script) Explain why? Short note; Mechanism of action. Compare and Contrast; Effects of etc; Short questions of above types may be set for the examination. No question shall carry more than 3 marks. Paper-II
1. Pharmacology of Central nervous system. 4. Skeletal muscle relaxants and local anaesthetics. 7. Anti infective and cancer chemotherapy. 8. Antiseptics, Disinfectants and ecto -parasiticides. Q. 1. Applied part of Pharmacology (Therapeutics.) 10 marks
Q.2 + Q.3 + Q.4 30 marks
Shall be of Explain Why? Short Notes; Mechanism of action, Compare and Contrast; Effects of etc; Short questions of above types may be set for the examination. No question shall carry more than 3 marks. PHARMACOLOGY ORAL: 15 marks
PHARMACOLOGY PRACTICAL: Total 25 marks
1. Prescription-one Total
Oral Crossing- 2
2. Pharmacy- one item
Preparation & Labeling- 2
Oral Crossing- 2
3. Therapeutic Problem – One
Correct interpretation of
In writing 2
Oral Crossing 2
4. Drug interaction-one
Interpretation in writing- 2
Oral Crossing- 2
5. Experimental Pharmacology
Chart and diagram on
Experiments demonstrated Identification-2
In Practical classes & Interpretation-2
charts on pharmacokinetics
6. Sample based Knowledge testing- 2
Two samples per question in writing
7. Criticism of prescription - 3 ( Oral table)
Practical Notebooks- Two
One-Therapeutics Record Book-Containing patterns utilization of drugs in emergency and in-patient
Practical Note-books must be submitted in practical Examination- without which students are NOT
ALLOWED to appear.
The figure in the margin indicate full marks.
Candidates are required to give their answer s in their own words as far as practicable.
1. Outline the therapeutic regime for a case of hypertension with reference to the advantages and
disadvantages of ACE inhibitors.
How do you treat a case of anaemia in Pregnancy (Early pregnancy term & late pregnancy )?
How will you treat Drug induced anaemias ?
2. Explain why (any three)
a) salbutamol is used in bronchial asthma.
b) Presumide is called high ceiling diuretic.
c) Dimercaprol is used in heavy metal poisoning.
d) Atropin substitues are used in Drug induced Parkinsoniism.
3.What are the effects of (any three) :
a) atropine on eye
b) aspirin on platelrt function.
c) Mannitol in the treatment of oedema.
d) Digoxin in atrial flutter.
4. Write short notes on (any four) :
a) fixed does combination
b) sublingual route of administration
c) 'P' - drug concept
d) zero-order kinetics of drug elimination
Full marks - 40
Time - 2 hrs
The figures in the margine indicate full marks
Candidate s are required to give their answer s in their own words as far as practicable
1. Discuss briefly the drug treatment of Chloroquin sensitive and Chloroquin resistant falcifarum
malaria. How will you treat a case of cerebral malaria.
Describe the drug treatmant of acute thyrotoxicosis. How do you prepare the Patient for surgery ?
a) oxotocin is used for induction of labour.
b) Calvulanic acid combined with amoxicillin.
c) Morphine is contradicted in head injury.
d) Allopurinol is used in chrinic gout.
3.What are the effects of (any three) :
a) iodides and iodine in thyroid disorders.
b) Benzhexol in parkinsonian disease.
c) Morphine in respiratory function.
d) Methotrexate in autoimmune disorders.
4.Write short notes on any four of the following :
e) Emergency contraceptives.
Oral Health Fact Sheet for Dental Professionals Children with Type 1 Diabetes Diabetes type 1 is a disease in which the body does not produce insulin, resulting in a high level of sugar in the blood. (ICD 9 code 250.0) Prevalence Manifestations Clinical of untreated diabetes • Increased risk of dental caries due to salivary hypofunction• Accelerated tooth eruption with increasin