Факультет иностранных студентов, 6 курс

G.P. Faculty. Year 6

Topic 1

linical pharmacology of medications used for Ischemic Heart Disease (IHD)

Control questions:

1. Physiology of coronary blood flow and myocardial metabolism regulation. Role of bioactive compounds (e.g. NO, endotelin) produced by endothelial cells.
2. Classification of drugs used in angina pectoris (AP).
3. Organic nitrates (ON): classification, PD, PK depending on chemical structure, drug formulation and route of administration (oral, sublingual, IV, transdermal).
4. ADRs of ON: prevention and management. Main mechanisms of tolerance to PD effects of ON.
5. Indications and contraindications for ON.
6. Nytroglycerine: PD, PK, drug formulations, indications.
7. Isosorbide dinitrate and isosorbide mononitrate: PD, PK, drug formulations, indications in comparison with nitroglycerine.
8. Beta-adrenergic blocking agents (BAB): classification, PD, PK properties. Role of selective binding to beta₁-adrenoreceptors, membrane-stabilizing action, intrinsic sympathomimetic action, presence of additional alpha-blocking activity and lipid solubility.
9. Indications related to cardiovascular disorders, absolute and relative contraindications for BAB.
10. ADRs and drug interactions of BAB.
11. Propranolol: PD, PK, indications.
12. Metoprolol, Atenolol, Bisoprolol, Carvedilol: peculiarities of PD, PK and safety.
13. Calcium channel blockers (CCB): classification, PD depending on chemical structure and generation.
14. Nifedipine and Amlodipine: PD, PK, indications and contraindications.
15. Verapamil: PD, PK, indications and contraindications in comparison with dihydropiridines.
16. Diltiazem: PD, PK, indications and contraindications in comparison with verapamil and nifedipine.
17. Pharmacotherapy of different types of AP (angina of effort, Prinzmetal’s angina and unstable angina): relief of symptoms and long-term treatment.
18. Place of ON and BAB in therapy of acute myocardial infarction.

Topic 2

Clinical pharmacology of medications used for Arterial Hypertension (AH) and Congestive Heart Failure (CHF)

Control questions:

1. Pathophysiological changes in patients with AH and CHF. Aims and main principles of pharmacotherapy.
2. Classification of drugs used in AH.
3. Classification of drugs used in CHF.
4. Angiotensin converting enzyme inhibitors (ACEI): PD, PK depending on chemical structure. Indications for ACEI (AH, CHF, ICD and diabetic nephropathy).
5. ADRs and contraindications for ACEI.
6. Captopril and Enalapril: peculiarities of PK, PD and tolerance.
7. Angiotensin receptor blockers (ARB): PD, ADRs and indications as compared to ACEI.
8. Losartan: PD, PK, indications and contraindications.
9. Centrally acting hypotensive drugs (clonidine, methyldopa): PD, PK, safety profile and use in AH treatment.
10. Diuretics: classification according to intensity of action and site of action.
11. Thiazide and thiazide like diuretics: PD, indications and ADRs.
12. Hydrochlorthiazide, Chlorthalidone and Indapamide: peculiarities of PK, PD and safety profile.
13. Loop diuretics: PD, indications and ADRs in comparison with thiazide diuretics.
14. Furosemide, Torsemide, Ethacrinic Acid: peculiarities of PK, PD and safety profile.
15. Potassium sparing diuretics (spironolactone, amiloride, triamterene): PD, PK, indications and ADRs.
16. Carbonic anhydrase inhibitors (acetazolamide): PD, PK, therapeutic indications and contraindications.
17. Complications of short-term and long-term diuretic therapy.
18. Digitalis glycosides: mechanism of action, cardiovascular and extracardiac effects.
19. Digoxin: PD, PK, indications and methods of administration.
20. ADRs and contraindications for digitalis glycosides. Drug interactions.
21. Recognition and treatment of overdigitalization. Risk factors of digitalis toxicity.
22. Principles of drug choice in AH. Management of AH in special population (elderly patients, pregnant, etc.). Use of drug combinations.
23. Principles of pharmacological treatment of CHF.

Topic 3

Clinical pharmacology of drugs influencing on bronchial obstruction

Control questions:

1. General information on bronchial asthma: classification, pathophysiology, diagnostics, differential diagnostics.
2. Treatment steps for achieving control in patients with bronchial asthma.
3. Modification of asthma therapy: “step-up” and “step-down” therapy.
4. Management of asthma exacerbations.
5. Management of severe asthma exacerbations in acute care settings.
6. Management of bronchial asthma during pregnancy.
7. Antiasthmatic agents: a conception of controllers and relievers.
8. Characteristics (PD, PK, adverse reactions) and role of selected agents in the treatment of bronchial asthma:
   
   • inhaled and systemic glucocorticosteroids,
   • selective/non-selective long and short acting beta-2-agonists,
   • leukotriene modifiers,
   • cromoglycates,
   • anticholinergics,
   • methylxanthines.
9. Inhaler devices for patients with bronchial asthma.

Topic 4

Clinical and pharmacological principles of choice of antimicrobial agents for the treatment of different infections (2 days)

Control questions:

For day 1

1. Principles of empiric antimicrobial therapy, choice of the route of administration and dosage regimens. Consequences of inappropriate use of antimicrobials.
2. Time and methods of evaluation of efficacy of antimicrobial therapy. Possible causes of inefficacy.
3. Choice of antimicrobials for the treatment of infections caused by Gram(+) microorganisms:
   a) staphylococci, including
   methicillin-resistant strains;
   b) streptococci and pneumococci;
   c) enterococci.
4. Choice of antimicrobials for the treatment of infections caused by Gram(-) microorganisms:
   а) Haemophilus influenzae;
   b) Enterobacteriaceae;
   c) P. aeruginosa.
5. Choice of antimicrobials for the treatment of infections caused by anaerobic bacteria:
6. Choice of antimicrobials for the treatment of infections caused by Chlamydia spp. and Mycoplasma spp.
7. Choice of antimicrobials for the treatment of infections caused by protozoa (Trichomonas vaginalis, Giardia lamblia, Entamoeba hystolitica).
8. Choice of antimicrobials for the treatment of fungal infections:
   а) local infections caused by Candida spp.;
   б) systemic mycoses.
9. Antimicrobials for the treatment of viral infections: influenza, herpes simplex.

For day 2

1. Choice of antimicrobials for the treatment of upper respiratory tract infections (streptococcal pharyngitis, acute otitis media, acute sinusitis).
2. Choice of antimicrobials for the treatment of lower respiratory tract infections (acute exacerbation of COPD, community-acquired pneumonia, nosocomial pneumonia).
3. Choice of antimicrobials for the treatment of infective endocarditis.
4. Choice of antimicrobials for the treatment of urinary tract infections (acute cystitis, acute pyelonephritis, chronic prostatitis).
5. Choice of antimicrobials for the treatment of bacterial meningitis.
6. Choice of antimicrobials for the treatment of infectious diarrhea.
7. Use of antimicrobials for the treatment of tuberculosis.

Topic 5

Clinical pharmacology of medications for the treatment of gastro-intestinal disorders: antiulcer medications, prokinetics, antidiarrheal agents

Control questions:

1. Main drugs used for the treatment of peptic ulcer disease.
2. Antacids: classification, PD, PK, indications, adverse reactions, drug interactions.
3. Н₂-receptor antagonists: PD and their place in the management of peptic ulcer disease.
4. Cimetidine, ranitidine: differences in adverse reactions and drug interactions.
5. Pirenzepine: PD, PK, indications, adverse reactions as compared to atropine.
6. Citoprotectors (colloidal bismuth subcitrate, sucralfate): characteristics of PD, PK, indications, adverse reactions, drug interactions.
7. Proton pump inhibitors (omeprazole): PD, PK, indications, adverse reactions.
8. Rationale schemes for Helicobacter pylori eradication.
9. Prokinetics (metoclopramide, domperidone, cisapride): differences in PD, PK; indications, adverse reactions, drug interactions.
10. Loperamide: PD, PK; indications, contraindications, adverse reactions.