Syllabus of M.D. Pharmacology 

 P.G. Curriculum 

M.D. Pharmacology

Index

1. Goal     
2. Objectives       
3. Syllabus           
4. Teaching Program     
5. Skills    
6. Thesis              
7. Assessment    
8. Job responsibilities     
9. Suggested books       
10. Model Test Papers     
     

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Curriculum 

M.D. Pharmacology

 

• The composition of the department in terms of faculty strength; other staff, laboratory equipment and number of PG residents will be as per MCI regulations. 

1. Goals

The aims of MD course in Pharmacology are:

•  To train a medical graduate to be a Pharmacologist who is well versed with the basic principles of Pharmacology and is up to date with the recent advances.
•  Acquisition of skills related to teaching, research methodology and corporate world.
•  Knowledge of elementary statistics and its applications.
•  Overall development of skills and personality of the PG resident.  Broaden the scope of Pharmacology from bench to bed side.

2. Objectives

At the end of the MD course in Pharmacology, the student should be able to:

•  Recognize the importance of Pharmacology as a key branch in health sciences
•  Utilize the acquired knowledge in teaching, research and industry.
•  Plan and organize projects using managerial and leadership skills.
•  Understand and apply ethical principles involved in animal and human experiments.
•  Handle animals to conduct experiments e.g. screening of various drugs
•  Perform qualitative and quantitative identification and estimation of drugs in different samples of body fluids.
•  Develop skills as a self-directed learner, recognize continuing educational needs; use appropriate learning resources and be able to critically analyze relevant published literature  
• Design protocol for clinical trials
• Incorporate  knowledge of information  technology in medical sciences
•  Function as a productive member of a team engaged in research, education and industry
•  Play the assigned role in the implementation of national health programs effectively, including planning of drug procurement and distribution.

3. Syllabus

3.1. Theory

 Clinical and Basic Sciences as applied to Pharmacology

•  Central Nervous System
•  Autonomic Nervous System
•  Cardiovascular System
•  Hematopoietic System 
•  Kidney/Renal System

 Endocrinology

•  Respiratory System
•  Gastrointestinal System
•  Microbial resistance
•  Regulation of cell growth and differentiation

 General Pharmacology

•  Important landmarks in the growth and development of Pharmacology, important contributions of renowned Indian and foreign Pharmacologists 
•  Principles and modes of drug administration, source, nature and preparations of drugs 

 Qualitative and Quantitative Pharmacokinetics

 Pharmacodynamics

•  Drugs interactions, Adverse drug reactions
•  Methods of new drug development
•  Factors modifying drug response
•  Pharmacogenetics and pharmacogenomics
•  Structure-activity relationship of important group of drugs
•  Preclinical evaluation of new drugs and toxicity studies

 Systemic Pharmacology

•  Autonomic nervous system
•  Central nervous system
•  Cardiovascular system
•  Hematopoietic system
•  Respiratory system

 Autacoids

 Gastrointestinal system

•  Renal pharmacology
•  Endocrine pharmacology

 Chemotherapy

 Miscellaneous: Vitamins, heavy metals, vaccines & sera, antiseptics etc.

•             Clinical Pharmacology & Therapeutics
•  Rational basis of therapeutics (P-drug concept, Essential drugs)
•  Rational drugs
•  Human and Population Pharmacokinetics Clinical drug evaluation  Clinical trial designing
•  Clinical trial ethics
•  Medico-legal aspects of clinical trials
•  Pharmacovigilance 
•  Drugs and Cosmetics Act
•  Data archiving and management
•  Drug audit (Pharmacoepidemiology, Pharmacoeconomics) 
•  Evidence Based Medicine
• Statutory and legal requirements for conduct of clinical trials (including drug schedules)  
• Quantitative and Experimental Pharmacology
•  Study design
•  Biostatistics
•  Bioassay
•  Drug-receptor interactions and response including pD_x and pA_x values.
•  Step up and step down methods for LD
• CPCSEA
• Alternatives to animal experiments (cell culture, cell lines)

 Screening for Pharmacological activity with special reference to the following activities:

•  Analgesic-Antipyretic
•  Anticonvulsant
•  Sedative-hypnotics
•  Anti-psychotic
•  Anti-depressant
•  Anti-parkinsonian
•  Anti-diabetic 
•  Autonomic
•  Anti-anginal
•  Anti-arrhythmic
•  Hypotensive
•  Diuretic
•  Hypoglycaemic
•  Anti-inflammatory
•  Anti-secretory 
•  Anti-allergic
•  Local anesthetic
•  Smooth muscle 
•  Anti-fertility
•  Anti-cancer 

 

3.2. Practical

 Experimental Pharmacology:

•  Handling of animals, collection of blood and urine samples. 
•  Assembly of organ bath and setting of thermostat.

 Isolated tissue preparations:

 To prepare log dose response curve of a suitable drug on:

• Guinea pig ileum.
• Guinea pig tracheal chain o Guinea pig vas deferens o Frog rectus abdominis  o Rabbit atrium o Rat colon o Rat uterus o Rat gastric fundus o Rat anococcygeus muscle
•  To perform four-point bioassay of a suitable drug on: o Guinea pig ileum o Guinea pig vas deferens o Rat colon o Rat uterus o Rat gastric fundus o Frog rectus abdominis
•  To prepare cumulative log dose response curve of a suitable drug on rabbit aorta.
• To study the stimulatory and depressant effects of drugs on rabbit gut.  To study the effect of coronary vasodilator drug on perfused rabbit heart (Langendroff’s technique).
•  Determination of ED₅₀ of histamine on guinea pig ileum.
•  Determination of ED₅₀ of acetylcholine on frog rectus abdominis muscle.
•  Determination of pD2 values of histamine on guinea pig ileum.
•  Determination of pD2 value of acetylcholine on frog rectus abdominis muscle.
•  Determination of pA2 value of acetylcholine on guinea pig ileum.
•  To study the effect of unknown drugs using rabbit eye. 
• To study the stimulatory and depressant effects of drugs on Blood Pressure of rat.
•  Screening Tests on animals to study the following activities:

 

•  Motor in-coordination
•  Anxiolytic effect
•  Despair behavior
•  Anticonvulsant effect
•  Diuretic activity
•  Spontaneous motor activity
•  Analgesic effect
•  Conditioned Avoidance Response
•  Antipsychotic effect
•  Anti-inflammatory effect

 

 Clinical/human experiments:

•       To study the effect of following activities in healthy human volunteers:
• To demonstrate the use of any model as an experimental tool on human subjects without administration of any drug/beverage for evaluation of analgesic activity, psychomotor function, cardiac parameters (HR, BP)

 Physical stress

 Mental stress  To determine lung volumes  To perform:

•  EEG
•  Nystagmography 
•  Spirometry 
•  ECG
•  Treadmill test/Bicycle ergometry/Master Step test  Psychomotor tests

 

 Chemical analysis:

• To do chemical estimation of various drugs including sulphonamides and salicylates, chemical identification of alkaloids, glycosides and basic chemical parameters like blood sugar levels, blood urea levels, lipid profile etc.

 

 Computer Aided Learning (CAL) Program:

• Proficiency in using CAL programs for demonstration of effects of drugs on animals.

 

 Statistics

 Use of calculators and electronic spread sheets for understanding of:

•  Elements of data collection and presentation of data
•  Measures of central tendency and dispersion
•  Non parametric tests
•  Parametric tests (including ANOVA) 
•  Correlation and regression

4.  Teaching Program

• Acquisition of practical competencies being the keystone of postgraduate medical education, postgraduate training is skill oriented.
• Learning in postgraduate program is essentially self directed and primarily emanating from clinical and academic work. The formal sessions are merely meant to supplement this core effort.

 

4.1. Teaching sessions

• The postgraduate students should attend all undergraduate classes taken by their teachers and colleagues and should also be involved in supervised undergraduate teaching. In addition, there should be daily sessions of formal teaching. Each MD student has to present seminars, Journal clubs, Drug Reviews and perform practicals. He/she should be allotted time for thesis related work.  

4.2. Teaching Schedule

• Following is the suggested departmental teaching schedule:

 

               Item                                                               Frequency

1. Thesis work     Once a week
2. Journal club/Drug review       Once a week
3. Practical           Once a week

(Experimental/Chemical/Human)

4. Seminar           Once a week
5. Statistical exercise      Once a fortnight
6. Pharmacokinetic exercise      Once a fortnight
7. Theory test      Once a month
8. Grand viva       Once a year

Note:

•  All PGs are supposed to attend the sessions.
•  All the teaching sessions  shall be assessed by the faculty members at  the end of each session and marks should be given out of 10 (for participant) & 100 (for presenter) and kept in the office for the purpose of calculation of internal assessment
• Attendance of the residents at various sessions (including central sessions) should be at least 75%

5. Skills:

The candidates should be conversant with the following techniques:

•  Weighing technique (chemicals & animals)
•  Handling of equipment
•  Handling of small animals including various anaesthetic techniques.
• Recording of  blood pressure (In vivo and Computer Assisted Learning program)
• Administration of drugs/chemicals to animals (parenteral and enteral routes)
•  Screening of drugs using appropriate models 
•  Isolated tissue preparations for log dose response curve and bioassay
•  Use of Cartesian and log graph paper
•  Use of various methods to evaluate drug effects in humans
• Elementary principles of common chemical techniques such as colorimeter, spectrophotometer, flame photometer etc.
•  Use of appropriate statistical techniques to analyze the results 

6. Thesis

•  Every candidate shall carry out work on an assigned research project under the guidance of a recognized Postgraduate Teacher; the project shall be written and submitted in the form of a Thesis.
•  Every candidate shall submit thesis plan to the University within the timeframe specified by the university.
•  Thesis shall also be submitted to the University within the time frame stipulated by the University.
•  The student will: (i) identify a relevant research question; (ii) conduct a critical review of literature; (iii) formulate a hypothesis; (iv) determine the most suitable study design; (v) state the objectives of the study; (vi) prepare a study protocol; (vii) undertake a study according to the protocol; (viii) analyze and interpret research data, and draw conclusions; (ix) write a research paper

7. Assessment

• All the PG residents should be assessed daily also periodically for their academic activities by all teachers.

7.1. General Principles

•  The assessment should be valid, objective, and reliable
•  It should cover cognitive, psychomotor and affective domains
• Formative, continuing and summative (final) assessment should also be conducted in theory as well as practicals. In addition, thesis should also be assessed separately

 

7.2. Formative Assessment

• The formative assessment should be continuous as well as end-of-term. The former is to be based on the feedback from the departmental faculty. End-ofterm assessment should be held at the end of each semester (upto the 5^th semester). Formative assessment will not count towards pass/fail at the end of the program, but will provide feedback to the candidate.

 

7.3. Internal Assessment

• The performance of the Postgraduate student during the training period should be monitored throughout the course and duly recorded in the log books as evidence of the ability and daily work of the student. Marks should be allotted out of 100 as followed.

                          Sr. No.                      Items                                              Marks

  1.                     Personal Attributes                            20        2.            Practical Work                                               20

3. Academic activities                              20
4. End of term theory examination          20
5. End of term practical examination           20  

1. Personal attributes

 

 Behavior and Emotional Stability: Dependable, disciplined, dedicated, stable in emergency situation shows positive approach.

 Motivation and Initiative: Takes on responsibility, innovative enterprising, does not shirk duties or leave any work pending.

 Honesty and Integrity: Truthful, admits mistakes, does not cook up information, has ethical conduct, exhibits good moral values, loyal to the institution.  

 Interpersonal Skills and Leadership Quality: Gets on well with colleagues and paramedical staff, is respectful to seniors, has good communication skills. 

 

2. Practical Work:

 Availability: Punctual, available continuously on duty, responds promptly on assignments and take proper permission for leave. 

 Diligence: Dedicated, hardworking, does not shirk duties, leaves no work pending, does not sit idle, competent in practical work.

 Academic ability: Intelligent, shows sound knowledge and skills, participates adequately in academic activities, and performs well in oral presentation and departmental tests.  

 Performance: Proficient in presentations and discussion during academic sessions in the department.

 

3. Academic Activity: Performance during presentation at Journal club/Seminar/Case discussion/Stat meeting and other academic sessions.  Proficiency in skills as mentioned in job responsibilities.  

 

4. End of term theory examination: Written test conducted at end of 1^st, 2^nd year and 9 months

 

5. End of term practical/oral examination: Practical exam and viva examination at end of 2 years and 9 months

 

•   Marks for personal attributes and work done should be given annually by all the consultants under whom the resident was posted during the year. Average of the three years should be put as the final marks out of 20.

 

• Marks for academic activity should be given by the all consultants who have attended the session presented by the consultant. 

 

•  The Internal assessment should be presented to the Board of examiners for due consideration at the time of Final Examination   

7.4. Summative Assessment

•  Ratio of marks in theory and practicals will be equal
•  The pass percentage will be 50%
•  Candidate will have to pass theory and practical examination separately.

 

A. Theory Examination (Total =400) 

                                                                                         Title                                                               Marks

          Paper 1:       Clinical and other Basic Sciences as related to Pharmacology    100

Paper 2: General & Systemic Pharmacology             100 Paper 3: Experimental & Clinical Pharmacology    100

          Paper 4:       Recent Advances in Pharmacology                                                 100

 

B. Practical Examination and Viva voce (Total =400) 

            Sr. No            Exercise                                                                                              Marks

1. Spotting 40
2. Long Experiment (e.g. bioassay etc.) 60
3. Screening methods (animal models) 40 4 Screening methods (human models) 40

5          Chemical Pharmacology      40 6     Thesis Presentation 40

            7                     Evaluation of teaching abilities (Microteaching)                             40

             8.                   Viva voce                                                                                           100

                                                                         

8. Job Responsibilities

•  To maintain a log book on daily basis
•  To maintain daily record of post graduate activities including:
• Practical exercis
• Statistics exercises
• Pharmacokinetic exercises
•  PG  teaching schedule
•  To maintain the laboratory equipment allotted to them
•  To prepare and organize undergraduate and postgraduate practicals

 

9. Suggested Books & Journals

9.1. Core books

                 Title of Book                                                                              Author

       Goodman & Gilman’s  The Pharmacological Basis of           Goodman and Gilman Therapeutics

                        Basic and Clinical Pharmacology                                         BG Katzung

                         Pharmacology                                                                        Rang,Dale, Ritter and

                                                                                                                       Moore

     

 

9.2. Reference books

                        Applied Therapeutics                                             Kimble, Young, Corelli and

Alldredge

           Basic Statistical Methods     Downie and Heath    Clinical Pharmacology            Bennett and Brown

                        Fundamentals of Experimental Pharmacology    Ghosh M.N.

                        Principles of Pharmacology                                   Paul L Munson

                         Screening Methods                                                Vogel and Vogel

                        Text books of Pharmacology                                 Bowman and Rand

 

9.3. Monographs

•  Martin Dale’s Extra Pharmacopoeia
•  Other Pharmacopoeias

 

9.4. Journals:

•  Annual Review of Pharmacology and Toxicology  
•  British Journal of Pharmacology
•  British Medical Journal
•  Drugs
•  European Journal of Clinical Pharmacology 
•  Indian Journal of Pharmacology
•  Japanese Journal of Clinical Pharmacology
•  Journal of Anesthesiology and Clinical Pharmacology
•  Journal of Association of Physicians of India
•  The Lancet 
•  The New England Journal of Medicine
•  Trends in Pharmacological Sciences

 

10. Model Test Papers

 

 

Paper-I

Clinical and other Basic Sciences as related to Pharmacology

Max. Marks:100

 

Time: 3 hrs

 

• Attempt ALL questions
• Answer each question & its parts in SEQUENTIAL ORDER
• ALL questions carry equal marks
• Illustrate your answer with SUITABLE DIAGRAMS

 

1. Discuss briefly the status of hormone replacement therapy in post menopausal women.
2. Describe the clinical significance of apoptosis. Discuss the mechanism of  action of drugs modifying apoptosis.
3. Discuss the management of nosocomial infections.            
4. Describe the composition of blood substitutes and explain their therapeutic  uses.
5. Outline the present status of purinergic receptors.  
6. Describe the pharmacotherapy of obesity.  
7. Define antimicrobial resistance and discuss methods for its prevention. 
8. Elaborate the modern approaches to receptor characterization and  classification.
9. Discuss the current approaches in the management of osteoporosis.  
10. Discuss briefly the pathophysiological basis of the management of essential  hypertension with the help of suitable illustrations.

  

Paper-II

General & Systemic Pharmacology

Max. Marks:100

 

• • Attempt ALL questions
  • Answer each question & its parts in SEQUENTIAL ORDER
  • ALL questions carry equal marks
  • Illustrate your answer with SUITABLE DIAGRAMS

 

1. Give an account of the drugs modifying the Renin-angiotensin system. Discuss the clinical implications with special reference to cardiovascular system.
2. Explain the cell-cycle. Discuss the clinical implications of the drugs acting on  different phases of cell-cycle.
3. Define selective estrogen receptor modulators. Discuss their therapeutic  implications.
4. Discuss the current therapeutic status of metronidazole in different diseases.  
5. Enumerate newer antiepileptic drugs. Discuss their current therapeutic status  in seizure and non-seizure disorders.
6. Classify antidepressant drugs. Give an account of adverse effects of typical  and atypical antidepressants.
7. Discuss the principles of safe and effective antibacterial drug therapy.     
8. Define half life of a drug following first order kinetics. Discuss its derivation and  clinical importance.
9. Define therapeutic index and discuss its importance in therapeutics.  
10. Define pA         ₂ value. Describe the method of its calculation giving suitable examples.

 

 

 

Paper-III

Experimental & Clinical Pharmacology

Max. Marks:100

 

• • Attempt ALL questions
  • Answer each question & its parts in SEQUENTIAL ORDER
  • ALL questions carry equal marks
  • Illustrate your answer with SUITABLE DIAGRAMS

 

1. Define placebo. Give an outline of ethical considerations for its use in clinical trials.
2. Explain the role of genetic engineering in new drug development.             
3. Define LD         ₅₀ and ED₅₀. Discuss the methods for their calculation.
4. What is the significance of sample size in biomedical research? Give the  methods to calculate sample size using an appropriate hypothetical example.
5. Define the term ‘transgenic animals’. Elaborate on their use in drug research.  
6. Enumerate the drug schedules. Give a detailed account of Schedule Y.  
7. Discuss the significance of randomization in clinical trials. Elaborate on the  practicable methods of randomization.
8. Outline the evaluation of diuretic activity of a new compound in animal models.              
9. Discuss the phases of clinical trials. Give an outline of Phase V clinical trial  plan.
10. Outline the evaluation of a lead compound for its hypolipidemic activity in  animal models.

 

 

 

Paper-IV

Recent Advances in Pharmacology

Max. Marks:100

 

• • Attempt ALL questions
  • Answer each question & its parts in SEQUENTIAL ORDER
  • ALL questions carry equal marks
  • Illustrate your answer with SUITABLE DIAGRAMS

 

1. Discuss the recent advances in CRIE (Chemotherapy and Radiation Induced Emesis)
2. Define monoclonal antibodies. Describe the rationale for their use in  therapeutics.
3. Give an outline of the pathophysiology of bronchial asthma. Discuss the recent  advances in its management.
4. Compare the cyclo-oxygenase enzymes. Discuss the current status of COX-2  inhibitors in therapy.
5. Give an account of pharmacotherapy of cutaneous leishmaniasis.  
6. Describe the ethical considerations for the use of animals in biomedical  research. Discuss the alternatives to animal species in research.
7. Discuss the recent advances in the management of type 2 diabetes mellitus.     
8. Give a diagrammatic representation of the synthesis of eicosanoids. Describe  the newer therapeutic applications of prostaglandins.
9. Outline the pathophysiology of osteoporosis. Discuss the diagnostic and  therapeutic advances in the management of osteoporosis.
10. Describe the management of Premenstrual Dysphoric Disorder.