LEARNING OUTCOMES

The course of General Pharmacology aims at providing students with the basic principles of the interaction of drugs with the different biological targets of the human body. Students will acquire a solid knowledge of pharmacodynamics and pharmacokinetics, the basis of variability in drug response and the main mechanisms and effects of drug-drug interactions.

AIMS AND LEARNING OUTCOMES

The module of General Pharmacology will provide students with a solid knowledge of pharmacodynamics and pharmacokinetics, the basis of variability in drug response and the main mechanisms and effects of drug-drug interactions.

Pharmacodynamics regards the study of how drugs affect the human body, with a particular focus on the mechanisms of drug action (e.g. interaction with receptors, enzymes, transporters), the relationships between drug concentration at the action site and the resulting effects, the time-course as well as the intensity of therapeutic and adverse effects. 

Pharmacokinetics, instead, is dedicated to the study of the processes of the so-called ADME, that is how a drug enter the human body (Absorption), how it is distributed in its different parts (Distribution), how it is biotransformed by different types of enzymes (Metabolism) and how it is eliminated from our body (Excretion). 

Variability in drug response deals with studies aimed at identifying the genetic and non genetic factors that can modify the expected effects of a medicine, including drug-drug interactions.

TEACHING METHODS

Lessons with active learning techniques engaging students with scientific questions and reasonings, during which all the module topics will be illustrated in details. The teaching material used during the lectures will be available for students on the AulaWeb website. 

In case of any emergency that does not allow in-class lessons (e.g. Covid-19 pandemic, hydrogeologic emergency), lessons  will be given electronically using the Microsoft Teams online platform. The teacher will promptly inform students of any changes by AulaWeb and the UNIGE website (https://corsi.unige.it/corsi/8452)

SYLLABUS/CONTENT

Module introduction. Introduction to pharmacology. Definition of drug. Drug specific and nonspecific effects.

Pharmacodynamics
Mechanisms of drug action. Receptors: classification, macromolecular structures and signal transduction systems. Other drug targets (enzymes, transporters, ion channels). Drug-receptor interaction, binding affinity and selectivity. Binding studies: saturation and displacement curves, calculation of Ki according to Cheng-Prusoff. Receptor theories: occupational and allosteric models. Full, partial and inverse agonists. Agonist potency (EC50) and efficacy (EMAX). Competitive and non-competitive antagonists. Positive and negative allosteric modulators. Dose-response curves and linearization methods. Calculation of the pA2 with the method of Schild. The main receptor subtypes. Receptor desensitization, up and down regulation. Receptor Reserve.

Pharmacokinetics
Drug passage across the cell membrane. Routes of drug administration. Drug absorption, distribution, metabolism and elimination. Factors affecting drug absorption, distribution, metabolism and elimination. Clinical pharmacokinetics: mono- and bi-compartmental models. Bioavailability. Apparent volume of distribution, clearance and plasma half-life. Drug kinetics after single and repeated doses. Loading dose and maintenance dose.

Variability in drug response
Predictable and unpredictable factors. Individual variability. Gender pharmacology. Genetic alterations: pharmacogenetics and pharmacogenomics. Genetic polymorphisms and variability in drug response. Variability of response to repeated drug administration: allergy, tolerance and tachyphylaxis. Drug resistance.

Drug-drug interactions
The importance and problems of drug interaction studies. Concept of clinically relevant interaction. Mechanisms of interaction at the pharmaceutical, pharmacokinetic and pharmacodynamic level. Herb-drug and food-drug interactions. 

RECOMMENDED READING/BIBLIOGRAPHY

Textbooks

Clementi, Fumagalli. General and molecular pharmacology. Principles of drug action. Ed. Wiley

Clark, Finkel, Rey, Whalen. Pharmacology. Ed. Lippincott

Hitner, Nagle. Pharmacology: an introduction. Ed. McGraw-Hill

Goodman & Gilman. The pharmacological basis of therapeutics. Ed. Brunton, Chabner, Knollmann.