Pathophysiology and Pharmacotherapy II
| Code: | MI245143 | Acronym: | FPFTER2 |
| Keywords | |
|---|---|
| Classification | Keyword |
| OFICIAL | Health Sciences |
Instance: 2024/2025 - 1S 
| Active? | Yes |
| Web Page: | https://moodle.up.pt/course/view.php?id=1952 |
| Responsible unit: | Pharmacology Laboratory |
| Course/CS Responsible: | MSc in Pharmaceutical Sciences |
Cycles of Study/Courses
| Acronym | No. of Students | Study Plan | Curricular Years | Credits UCN | Credits ECTS | Contact hours | Total Time |
|---|---|---|---|---|---|---|---|
| MICF | 171 | MICF - Transition Study Plan 2023/24 - 2024/25 - 2025/26 | 5 | - | 6 | 52 | 162 |
Teaching Staff - Responsibilities
| Teacher | Responsibility |
|---|---|
| Maria da Glória Correia da Silva Queiróz | |
| Jorge Manuel Moreira Gonçalves |
Teaching - Hours
| Theoretical classes: | 2,00 |
| Laboratory Practice: | 2,00 |
| Type | Teacher | Classes | Hour |
|---|---|---|---|
| Theoretical classes | Totals | 1 | 2,00 |
| Maria da Glória Correia da Silva Queiróz | 1,00 | ||
| Jorge Manuel Moreira Gonçalves | 1,00 | ||
| Laboratory Practice | Totals | 9 | 18,00 |
| Maria da Glória Correia da Silva Queiróz | 8,50 | ||
| Joaquim António Faria Monteiro | 6,00 | ||
| Patrocínia Maria Pinto de Castro e Rocha | 1,50 | ||
| Jorge Manuel Moreira Gonçalves | 2,00 |
Teaching language
Portuguese and englishObs.: Suitable for English-speaking students
Objectives
The Physiopathology and Pharmacotherapy II is part of a sequence of UCs that include Pharmacology I and II and Physiopathology and Pharmacotherapy I.As a whole, these UCs have the general objective of learning helping the student to:
- Understand the way in which drugs work in humans.
- Understand the factors that condition the permanence of drugs in the body and to know the methods that allow to calculate the doses and adjust the dosage regimens to guarantee the maintenance of the appropriate concentrations to obtain the desired therapeutic effects.
- Understand the occurrence of adverse reactions and explain those resulting from predictable pharmacodynamic responses.
- Understand the inter-individual variability in response to drugs in function of genetic and non-genetic factors.
- To know the most explored pharmacological targets for therapeutic purposes, the most representative drugs in each group and the contexts in which they are used clinically.
- Understand the general aspects of the pathologies that are the main indications of each group of drugs.
1. Understand the pharmacodynamic fundamentals resulting from the performance in each target;
2. Know the main pharmacological effects resulting from this action, regardless of whether they are explored for therapeutic purposes or may be classified as adverse reactions to the current therapeutic indications;
3. Understand the disease and the therapeutic objectives of the various pharmacological interventions;
4. To know the reference drugs of each class and the pharmacodynamic and pharmacokinetic limitations that have conditioned and/or will condition the appearance of new drugs in the group;
5. To know the current therapeutic indications and future perspectives of new drugs or new indications.
In this context, the curricular unit of Pathophysiology and Pharmacotherapy II has as specific objectives, to assist the student to obtain a pathophysiological and pharmacotherapeutic knowledge, consistent and critical, suitable for graduation in Pharmaceutical Sciences in the areas of cancer and infection; special protocols used in the treatment of chronic infectious diseases and associated symptoms; to know the main groups of drugs used in the areas covered, their mechanisms of action and adverse reactions, as well as particularities about their clinical use.
Learning outcomes and competences
As the main learning outcomes, students are expected to acquire knowledge and develop the ability to:1. Demonstrate detailed knowledge of pharmacological targets and reference drugs.
2. Be able to critically assess the state of the art in each of the pathophysiological and pharmacological areas addressed; 3. Know the conditions present in the access and use of reference drugs.
4. Demonstrate a deep knowledge of the recent advancement of research in each of the areas and are able to gather relevant information and to transmit it in written and oral form.
5. Develop inter-group and intragroup work dynamics and demonstrate the ability to communicate and discuss pharmacological knowledge through different forms of communication and before different audiences.
Contribution of learning outcomes to the objectives of the MICF
Contribution to the Pharmaceutical Act
a) Interpret and evaluate medical prescriptions;
b) Information and consultation on medicines for human use, subject and not subject to medical prescription, with health professionals and patients, in order to promote their correct use;
c) Monitoring of drugs and the establishment of individualized dosing schedules;
d) Interpretation of biological analyzes.
Contribution to Table 2 of Directive 2005/36 EC
e) adequate knowledge of the metabolism and effects of medicines, the action of toxic substances and the use of medicines;
f) adequate knowledge to assess scientific data on medicines, in order to be able to provide adequate information based on that knowledge.
Contribution to the competencies defined in the document “FIP Global Competency Framework”:
"1.1 Emergency response
1.1.1 Participate in responding to public health emergencies
1.2 Health promotion
1.2.2 Advice on health promotion, control and prevention of diseases and healthy lifestyles
1.3 Advice and Information on Medicines
1.3.1 Counseling the patient / population on the safe and rational use of drugs (including selection, use, contraindications, storage, and adverse effects of drugs with or without a prescription)
2.6 Patient diagnosis and counseling
2.6.4 Assess, validate and produce health education information, medication counseling and health care
2.6.5 Discuss and agree with patients on the appropriate use of medicines, taking into account their preferences.
4.1 Communication skills
4.1.2 Communicate effectively with healthcare professionals and patients' relatives
4.1.3 Adjust communication to the patient's needs
4.1.4 Appropriate communication skills, including through electronic and digital platforms
4.3 Digital skills
4.3.1 Identify, manage, organize, store and share digital information
4.3.2 Critical analysis, evaluation and interpretation of digital information and its sources
4.3.3 When applicable, participate in digital health services, promote health with digital technologies
4.8 Quality assurance and research in the workplace
4.8.1 Application of research results and application in the analysis of risks / benefits (example pre-clinical, clinical research, trials, experimental data and risk assessment)."
Working method
PresencialPre-requirements (prior knowledge) and co-requirements (common knowledge)
Students must have knowledge about physiology, microbiology, immunology and the general mechanisms of action of drugs and their general cycle in the body.Program
1 Introduction to oncology.
1.1 What is cancer? Our perception of this disease over the last hundred years.
1.2 Cancers and tumours, classification methods. Benign tumours and malignant tumours. Solid and liquid. Primary and secondary.
1.3 The different perspectives on a disease: the view of the doctor, the pharmacist and the patient and their family. Ethical and quality considerations for cancer patients. Shared decision-making with the patient. Average life expectancy and managing expectations.
2. Cancer epidemiology.
2.1 Basic definitions: incidence, prevalence and mortality.
2.2 Global and regional incidence. Incidence rates by type of cancer. Geographical variations and trends. Factors influencing trends. Concept of prevalence and its importance. Prevalence by type of cancer and by region. Impact of advances in treatment on prevalence.
2.3 Risk factors: modifiable and non-modifiable. Primary and secondary prevention strategies.
3. Pathophysiology of cancer.
3.1 The process of carcinogenesis. Hyperplasia, dysplasia and neoplasia. Possible mechanisms involved in the appearance of histological changes. Epithelial-mesenchymal transition and mesenchymal-epithelial transition and similar forms of differentiation that occur in non-epithelial cells. From cell proliferation to tumour formation. Typical organization of benign and malignant solid tumours (cancers). Types of cells present in tumours; tumour cells, inflammatory cells, adipocytes. Extracellular matrix of solid tumours. Blood and lymphatic vessels in tumours: their formation, regulation and function. The tumour microenvironment and its importance in controlling access and the action of inflammatory cells in the tumour.
3.2 The interpretation of carcinogenesis through the different hypotheses.
3.2.1 Genetic hypothesis: the role of mutations and genetic instability in tumour formation. Oncogenes and tumour suppressor genes.
3.2.2 Epigenetic hypothesis: the main transcription and post-translational alteration pathways that regulate cell differentiation and proliferation and their possible relationship with tumorigenesis.
3.2.3 Metabolic hypothesis: the Warburg effect and its relationship with metabolic changes in tumour cells. Evolution of the metabolic hypothesis: from mitochondrial dysfunction to metabolic reprogramming.
3.2.4 Atavistic hypothesis: the atavistic hypothesis of carcinogenesis and the scientific bases that support it.
3.2.5 Towards a synthesis model of carcinogenesis: the relationship between genetic, epigenetic and metabolic alterations that can lead to an evolutionary regression of the cell from a complex multicellular organism to a primitive organism.
3.3 Cellular and molecular biology of cancer.
3.3.1 Molecular bases of carcinogenesis. Possible molecular bases to explain alterations in the epithelial-mesenchymal and mesenchymal-epithelial transition in carcinogenesis. Hypoxia-induced factor (HIF) as a potential inducer of metabolic reprogramming. HIF-1 and HIF-2. Modes of regulation of HIFs and their effects on transcription. Genes regulated by HIFs. How metabolic reprogramming can influence the regulation of gene expression: cases of influence on p53 and BRCAs. Influence of metabolic reprogramming on cell proliferation, extracellular matrix formation and angiogenesis.
3.3.2 Changes in the relationship with the outside of tumour cells. Changes in the composition of the cytoplasmic membrane in tumour cells. Role of cytoplasmic membrane rafts in membrane dynamics. Types of endocytosis and ways of transferring and distributing endocytosed cargo. Clathrin and caveolin pathways.
Involvement of tubulin in vesicular trafficking. Role of molecular motors and low molecular weight GTPases. Influence of altered membrane dynamics on canonical and non-canonical modes of cell signalling caused by extracellular messengers. Impact of metabolic alterations on intracellular vesicular trafficking to the membrane and possible relationship with exosomes.
3.3.3 The immunosuppressive tone of the tumour.
Immunogenic activity of tumours. The creation of an immunosuppressive environment in the tumour. Low molecular weight substances present in the tumour microenvironment that prevent immune recognition: adenosine and metabolites of indoleamine 2,3-dioxygenase (IDO).Negative regulators of immunity: role of PD-1, CTLA-4.
3.3.4 Cellular quiescence in cancer. Concept of quiescence. Metabolic pathways associated with quiescence. Impact of quiescence on response to therapy.
3.3.5 Metastasisation. The process of metastasis formation. Likely sites of metastasis and secondary tumour formation.
4. Pharmacological and non-pharmacological treatment of cancer.
4.1 Non-pharmacological treatments.
Radiotherapy and surgery.
The position of cancer chemotherapy in relation to non-pharmacological treatments.
4.2 Principles of cancer chemotherapy.
History and evolution of chemotherapy.
Rationale for the use of drug combinations in cancer chemotherapy.
Treatment regimens in cancer chemotherapy.
Drugs used in cancer chemotherapy and ways of grouping them. Classification based on site and mechanism of action. Synthesis of the pharmacological profile of chemotherapy drugs, with presentation of mechanisms of action, special aspects of pharmacokinetics, safety, adverse reactions, safety in preparation and social and pharmacoeconomic dimensions: alkylating drugs and platinum complexes; antimetabolites; purine analogues and related inhibitors; tubulin polymerisation modifiers; topoisomerase inhibitors; intracellular kinase inhibitors; angiogenesis inhibitors; protein turnover modulators; PARP inhibitors; targeted therapies (EGFR; HER2; VEGF); antibodies against surface antigens; hormone therapy; oestrogen receptor modulators; aromatase inhibitors; progesterone receptor agonists; gonadotrophin release modulators.
5. Therapeutic schemes according to the Guidelines.
6. Therapeutic research in cancer and the opportunity to use repositioned drugs in oncology.
7. Chemotherapy of infectious diseases.
7.1 Criteria for selecting antibiotherapy and antivirals. Guidelines used in the treatment of infectious diseases.
7.2 Symptomatology, diagnostic tests, pathophysiology and treatment of common infections in different systems:
a. Infections of the central nervous system (meningitis);
b. Respiratory tract infections (pneumonia, influenza);
c. Infections of the cardiovascular system (endocarditis);
d. Infections of the genitourinary tract (cystitis and pyelonephritis);
e. Infections of the gastrointestinal tract (diarrhoea, H. pylori ulcers);
f. Sexually transmitted infections (gonorrhoea, chlamydia and syphilis);
g. Diabetic foot infection.
7.3 Infectious diseases with special treatment protocols:
a. Tuberculosis;
b. Human immunodeficiency virus (HIV) infection;
c. Hepatitis C virus (HCV) infection.
Mandatory literature
Bertram G. Katzung; Basic & clinical pharmacology. . ISBN: 978-1-260-45231-0Joseph T. DiPiro; Pharmacotherapy. ISBN: 0-07-136361-0
Carol Mattson Porth; Pathophysiology.. ISBN: 0-397-54723-4
Laurence L. Brunton; Goodman & Gilman.s the pharmacological basis of therapeutics. ISBN: 978-1-264-25807-9
Comments from the literature
Appropriate additional bibliography will be provided for each chapter through the Moodle platform.
Teaching methods and learning activities
Theoretical classes will serve as a general presentation of concepts, referring students to independent work to delve deeper into each topic, based on scientific articles made available for this purpose.
Practical laboratory teaching will complement theoretical training, with the aim of ensuring that students select and use reliable sources of information in a careful manner, are familiar with the general aspects that determine the use of the main drugs used to treat the pathologies addressed, the therapeutic limitations of each pharmacotherapeutic group, and develop communication skills that will enable them to interact solidly with other health professionals on topics related to the use of medicines.
The aim of practical laboratory teaching is to prepare students to respond to real-world situations independently, with the presentation of clinical cases on pathologies/groups of drugs addressed in this course.
E-LEARNING PLATFORM
Within this scope of the eLeraning @UP project, a UC page is organized on the Moodle platform, where pedagogical content and essential communication tools for the learning process are made available.
On this page you will find not only the contents in pdf format of all the slides of the classes, but also scientific articles, complementary bibliography, class schedules and links of interest within the scope of the UC.
Communication with students is facilitated by the Moodle platform's notices tool and by email.
Discussion forums may be created on the work proposed for resolution by students, thus allowing the sharing of knowledge and the clarification of doubts.
keywords
Health sciences > Medical sciences > Medicine > OncologyHealth sciences > Pharmacological sciences
Health sciences > Pharmacological sciences > Clinical pharmacology
Health sciences > Medical sciences > Medicine > Infections
Evaluation Type
Distributed evaluation with final examAssessment Components
| designation | Weight (%) |
|---|---|
| Exame | 70,00 |
| Trabalho escrito | 15,00 |
| Teste | 15,00 |
| Total: | 100,00 |
Amount of time allocated to each course unit
| designation | Time (hours) |
|---|---|
| Estudo autónomo | 120,00 |
| Frequência das aulas | 30,00 |
| Trabalho laboratorial | 30,00 |
| Total: | 180,00 |
Eligibility for exams
The attendence of students to theoretical classes is not mandatory. The assistance of students to practical classes is mandatory and students whose attendance is less than 3/4 of the classes actually taught are considered without frequency, provided that they represent more than 50% of the classes provided.Calculation formula of final grade
The assessment will cover all subjects taught in theoretical and practical/laboratory classes.It consists of the sum of the assessment for the laboratory component (maximum score of 6 points) with the grade for the in-person participation and the theoretical component (maximum score of 14 points).
The assessment of the laboratory component will be based on the grades obtained in summative tests carried out at the end of each lesson or module, with the lowest grade in the formative tests being excluded from the calculation of the final grade..
The assessment for the theoretical component will be carried out in a final exam in accordance with the official assessment calendar. It will consist of a questionnaire with multiple-choice and/or short-answer/experimental questions.
If there are no technological or logistical limitations, the final exam will be carried out on a computer, through the Moodle platform.
For approval in the course, a minimum mark of 6.50 is required in the theoretical component (mark from 0 to 14) and a final mark (theoretical + laboratory) of 9.50 (mark from 0 to 20).
Special assessment (TE, DA, ...)
In this case, they will only have to make a final exam that will have the maximum quotation of 20 values.
If you choose to take only a final exam, it will cover all subjects taught in practical and theoretical classes.
Students should communicate their decision at the beginning of the semester to the responsible teacher.
Classification improvement
In the Season of Appeal, students can only improve the classification of the theoretical component.The improvement of the laboratory component can only be done by a new frequency of the UC.
Observations
Mobility StudentsIn addition to those who can quickly develop Portuguese language comprehension skills, mobility students with fluency in English are accepted.
The UC is taught in Portuguese, however the bibliography is in English and the teachers provide support in English.
In addition, mobility students can request, and will be attended to in their request, the assessment in English.
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