Introduction to Therapeutics

Objectives

1. To familiarize students with the basic principles and vocabulary of pharmacology. What are drugs? How are they administered? How are they absorbed, distributed, metabolized and eliminated? What time-related factors determine effective drug levels and, thus, single versus multiple dosing?
   
   
2. To familiarize students with distinct classes of drugs and their appropriate therapeutic use. What are their mechanism(s) and duration of action? Their cardinal side and major toxic effects? Their significant drug interactions? What special considerations are requisite for prescribing drugs for the elderly, for children, for pregnant mothers, and for patients with certain diseases?
   
   
3. To alert students to the fact that pharmacology is a body of knowledge which is constantly changing as a function of scientific advances in several disciplines. Thus, information is provided concerning sources of up-to-date data regarding new drugs and their therapeutic indications.
   
   
4. To foster a creative and flexible but ethical approach to the use of drugs as therapeutic agents. Using case studies, we will discuss pharmacotherapy in a clinical context, particularly as it relates to pathogenesis, in order to reinforce basic pharmacological principles and problem solving skills. A concerted effort will be made throughout the year to interface with the Neuroscience, Mechanisms of Human Disease, and other courses with the objective of reinforcing the concepts being taught.
   
   
5. In addition, this course will also illustrate major non-pharmacological therapeutic approaches to the treatment of specific diseases.

Organization of Course

The course is divided into two sections. The first section (August 2 - October 1) focuses on the principles of pharmacology and clinical neuropsychopharmacology. The second section (October 11 - December 17) concentrates on cardiovascular-renal pharmacology, and anti-infective drugs.

All lectures will be 50 minutes in duration and will be presented in Room 390. Small group case analyses will last 90 minutes and take place in assigned locations.

Small Group Case Analyses

The purpose of the small group sessions is to apply basic pharmacological principles and drug information in a clinical context. Using various case vignettes/session, we will discuss the use of different classes of drugs to treat distinct medical conditions. We will address such issues as drug selection, compliance, side effects, effective drug levels and dosing, cost, and drug interactions.

The case vignettes and associated study questions will be placed in your mailboxes one week before the small group session. After reviewing the materials presented in the lectures and completing the reading assignments, you should be able to develop responses to the study questions. During the small group session, the facilitator will not only solicit your input regarding a given case based on the study questions, but pose additional questions.

Individual small group assignments, room numbers, and the names of the group facilitators will be posted.

Exams and Grading Policy

1. There will be four exams. These exams will contain United States Medical Licensing Exam (USMLE-Step 1) type multiple choice and matching questions, (3 questions per lecture and 3 questions per small group case analyses conference), and will be non-cumulative.
   
   
2. The exams will be held on Monday, August 30; Friday, October 1; Monday, November 22; and the week of December 13th. The place of the exams will be announced.
   
   
3. Final grades will be based on the percent correct of the answers for the four exams:

The final grade will be compiled such that an Honors grade for the entire course will be any score greater than or equal to 1 SD above the mean of the class; a High Pass will be from the mean up to 1 SD from the mean, and a Pass will be from the mean down to 2 SDs or lower than a 70%, which ever favors the student.

Preparation for Examination

In order to assist students in preparing for exams, study questions have been provided:

1. At the end of each lecture outline there is a list of review questions based on the material covered in the lecture and associated assigned reading.
   
   
2. USMLE type questions with explanations can be found at the end of each chapter in Katzung and Trevor's Examination and Board Review (4th/5th edition). These chapters are entitled and correlated with the assigned chapters in the textbook.

Students who are able to successfully answer these review questions should do well in the course exams.

Remediation Policy

Students who miss exams for legitimate reasons which have been ascertained by the Associate Dean of Student Affairs will be given the opportunity to take make-up exams on an individualized basis. The course remediation comprehensive exam will be offered in June, 2000.

Textbooks

• Katzung, B.G. Basic and Clinical Pharmacology (7th Ed.) Appleton and Lange: Norwalk, CT, 1997. Revised every two years.
  
  
• Katzung, B.G. and A.J. Taylor. Pharmacology: Examination and Board Review (4th or 5th Ed.) Appleton and Lange: Norwalk, CT, 1995.
  
  
• Goldman, H.H. Review of General Psychiatry (4th Ed.) Appleton & Lange: Norwalk, CT, 1995.

Additional Information Sources

1. Texts
   1. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th Edition. MacMillan: N.Y., 1996. Revised every five years.
   2. Pratt, W.B. and Taylor, P. (Eds). Principles of Drug Action. (3rd Ed.) Churchill Livingstone: N.Y., 1990.
      
      
2. Physicians Desk Reference (PDR), in library
   
   
3. Evaluative Sources
   1. Medical Letter
   2. AMA Drug Evaluations (6th Edition), 1986. In 1990 it became available as a subscription newsletter, published quarterly. ($116/year, renewals $75/year).
   3. Hansten, P.D. and Horn, J.R., Drug Interactions (6th Edition), Lea and Febiger: Philadelphia, 1989 (quarterly update service available).
      
      
4. Reviews
   1. Annual Reviews of Pharmacology and Toxicology
   2. Pharmacological Reviews
   3. Trends in Pharmacological Sciences
      
      
5. Journals
   
   J. Pharmacology and Experimental Therapeutics, J. Cardiovascular Pharmacology, Neuropharmacology, Psychopharmacology, J. Clinical Pharmacology, British J. Pharmacology, Clinical Pharmacology and Therapeutics, New England Journal of Medicine
   
   
6. Compendia
   1. The United States Pharmacopeia
   2. The National Formulary

Therapeutics Faculty

Therapeutics Faculty