Medical Pharmacology _ Course Introduction.pptx

PRESENTATION FOR Medical Pharmacology _ Course Introduction.pptx

1. Medical Pharmacology – Course Introduction Universidad Central del Caribe School of Medicine Iris K. Salgado Ph.D. 1

2. Presentation Outline Objectives Syllabus Discussion Teams Channel Elentra 2

3. Objectives 3

4. Course General Information: Description 4

5. Course General Information: Description 5

6. Course General Information: Diversity Statement 6

7. Course General Information 7

8. Course General Information: Course / Clerkship Changes from the most recent Evaluation: More NBME Questions: The course will include more NBME-style questions in assessments. New Evaluation Methods and Weight Distribution : In this new academic year, new assessment methods are added to the course dynamic. Indeed, the grading system and the weight distribution are updated for a comprehensive evaluation. Improved Communication: The Course Director and faculty are compromised to continue enhancing their communication with the students. These changes aim to provide integrated medical pharmacology education that aligns with the student’s needs and academic goals. 8

9. Course Faculty Name, Title(s) Office Hours (F2F) Virtual Office Hours Iris K. Salgado Villanueva Ph.D. Assistant Professor Pharmacology Department Office Tuesday 2:00pm – 4:00pm Availability for meeting and real-time chat – MS-Teams: Thursday 2:00 pm – 4:00pm 787-798-3001x.2047 [email protected] Name, Title(s) Office Hours (F2F) Virtual Office Hours José L. Torres Ph.D. Associate Professor [email protected] Pharmacology Department Office#118 Monday; 2:00 pm – 4:00pm Availability for meeting and real time chat – MS-Teams, Thursday 2:00pm – 4:00pm José A. Quidgley Ph.D. Associate Professor [email protected] Pharmacology Department Office Wednesday; 8:00 am – 10:00 am Availability for real time chat – MS-Teams. Walter I. Silva Ph.D. Adjunct Professor [email protected] Flexible availability upon previous agreement by MS Teams Availability for real time chat – MS-Teams 9

10. Course Faculty Course Activities Hours Lectures 86 Case Discussion 14 Quizzes 6 Large group discussion 2 Total Direct Instructional Hours 108 Out of class academic load 186 Total course academic load 294 10

11. Competencies, Goals, General and Specific Objectives 11

12. Competencies, Goals, General and Specific Objectives 12

13. Competencies, Goals, General and Specific Objectives 13

14. Competencies, Goals, General and Specific Objectives 14

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16. Treatment of Congestive Heart Failure (CHF) Dr. Héctor M. Maldonado Pharmacology Department UCC-School of Medicine [email protected] COURSE GOAL, GENERAL OBJECTIVES AND SPECIFIC LEARNING OBJECTIVES EXAMPLE 16

17. Cardiovascular System: Management of Acute and Chronic Heart Failure Drug Classes and Drugs to consider (Major or Prototype Drugs Capitalized) A. Renin-Angiotensin Aldosterone System B. Other Peptide Systems ACE Inhibitors Angiotensin Receptor Blockers Angiotensin Receptor Blockers Aldosterone Antagonists ANP Agents CAPTOPRIL ENALAPRIL LISINOPRIL LOSARTAN valsartan candesartan LOSARTAN valsartan candesartan SPIRONOLACTONE EPLERENONE nesiritide C. Sympathetic Agents D. PDE Inhibitors E. Vasodilators Antagonists Agonists Inamrinone , milrinone HYDRALAZINE ISOSORBIDE DINITRATE NITROGLYCERIN Combination of hydralazine and isosorbide dinitrate ( BiDil ) used in African Americans nitroprusside CARVEDILOL METOPROLOL bisoprolol DOBUTAMINE dopamine F. Diuretics G. Cardiac Glycosides FUROSEMIDE, Thiazides DIGOXIN Topics Specific Learning Objectives Number of Questions Physiology and pathophysiology Introduction to cardiac inotropism Describe the acute inotropic, dromotropic, and chronotropic effects of catecholamines (e.g. epinephrine, norepinephrine, dopamine, isoproterenol). Discuss lusitropic actions of catecholamines as they relate to normal and abnormal cardiac function. Compare and contrast the management of acute and chronic heart failure. Discuss preventing cardiac remodeling at the onset of heart failure. Describe the basic pathophysiology of heart failure and the cardiac and extracardiac compensatory mechanisms that are activated. Discuss the role of genetics and ethnicity in the pathophysiology of heart failure and in the regulation of responsiveness to agents used in heart failure. 0-1  Knowledge Objectives in Medical Pharmacology . Sponsored by the Association of Medical School Pharmacology Chairs Committee. 17

18. Cardiovascular System: Management of Acute and Chronic Heart Failure Mechanism of action Describe the effects of digoxin on myocardial contractility. Explain the ionic basis for the mechanism of action of digoxin: discuss the roles of Na+, K+- ATPase inhibition and the Na+/Ca2+ exchanger. Describe the electrophysiologic effects of digoxin on atrial and ventricular muscle and specialized conducting tissue. Explain the significance of direct and indirect (autonomic) actions of digoxin. Describe the positive inotropic effects of the β-adrenoceptor-agonists and phosphodiesterase inhibitors. Explain the effects of adrenoceptor antagonists and ACE-inhibitors on cardiac function and ventricular remodeling in the setting of heart failure. 2-3 Actions on organ systems Describe the hemodynamic actions of digoxin in the failing and the normal heart. Describe the extracardiac actions of digoxin. Explain the effects of vasodilators, loop diuretics and β-blockers on preload and afterload. Explain the effects of vasodilators on renal and coronary perfusion. Describe the extracardiac actions of the adrenoceptor agonists, adrenoceptor antagonists, phosphodiesterase inhibitors and ACE-inhibitors. Pharmacokinetics Describe the routes of administration, the extent of oral absorption and bioavailability, the routes of elimination and extent of biotransformation of digoxin and other drugs used in heart failure. Contrast the pharmacokinetics of digoxin in young and old patients. Describe the time-course of the cardiac actions of digoxin (onset and duration of action). Explain the concept of digitalization (loading dose) and maintenance therapy. Review the "plateau principle" with regard to maintenance therapy without a loading dose. Adverse effects, drug interactions and contraindications Describe the cardiac (delayed depolarizations and arrhythmias) and extracardiac manifestations of digoxin toxicity (digoxin levels > 2.0 ng/mL are associated with toxicity). Discuss the potential for low levels (0.4-0.8 ng/mL) to reduce mortality in acute decompensated heart failure. Describe the significance of changes in serum electrolyte levels (potassium, sodium, calcium, magnesium) with regard to digoxin toxicity. Discuss the potential adverse effects with concomitant use of diuretics (both potassium-sparing and potassium depleting) in the elderly or in patients with congestive heart failure, hypothyroidism and renal disease. Describe the interactions of digoxin and quinidine, verapamil, and other relevant drugs. Describe the cardiac and extracardiac side effects and limitations of the antagonist agents, vasodilators, phosphodiesterase inhibitors, and ACE-inhibitors. 2-3 Therapeutic uses Describe the use of digoxin in congestive heart failure and in atrial arrhythmias. Describe the role of adrenoceptor agonists, adrenoceptor antagonists, vasodilators, diuretics and ACE-inhibitors in the treatment of acute and chronic heart failure. Discuss the use of atrial natriuretic peptide agonists in the management of acute severe heart failure unresponsive to other agents. 18

19. Cardiovascular System: Management of Acute and Chronic Heart Failure Notes Objectives for Renin-angiotensin aldosterone agents are covered under vasoactive peptides. Objectives for Sympathetic nervous system drugs are covered under Autonomic Nervous System. Clinical Pharmacology The latest Cochrane Review indicates that ACE inhibitors and ARB drugs do not reduce total morbidity and mortality in patients with heart failure. With the increased likelihood of impaired renal perfusion in association with heart failure, a loop diuretic (furosemide) is likely to be a prudent choice to relieve congestion. There is a reasonable consensus that beta-receptor adrenergic blocking drugs are becoming the pharmacological treatment of choice for this pathological state. 0-1 Relevance USMLE topic: Cardiovascular System; Renal/Urinary System- Abnormal Processes- Metabolic and Regulatory Disorders (Systolic and diastolic dysfunction, low-and high output heart failure, systemic hypertension) Principles of Therapeutics: Mechanisms of action, use, adverse effects of drugs for treatment of disorder of cardiovascular system-Inotropic agents and treatment of heart failure AAMC Medical School Objectives: Project Report X Patient Safety-Table 1 Topic C: Drug treatment of common conditions and diseases Total Number of Questions 6-8 19

20. Summary Table: Drugs Used in Heart Failure Drug Mechanism of action Indications/ contraindications Pharmacokinetics Side effects Comments Diuretics: Furosemide, other loop diuretics Spironolactone Reduces preload, edema by powerful diuretic action on thick ascending limb in nephron; vasodilating effect on pulmonary vessels Antagonist of aldosterone in kidney plus poorly understood reduction in mortality Acute and chronic heart failure, especially acute pulmonary edema; other edematous conditions, hypercalcemia Chronic heart failure, aldosteronism Oral, parenteral Duration: 2–4 h Oral; Duration: 24–48 h Ototoxicity; hypovolemia, hypokalemia Hyperkalemia; gynecomastia Eplerenone: similar to spironolactone but lacks gynecomastia effect Angiotensin-converting enzyme (ACE) inhibitors and receptor blockers: Captopril Blocks angiotensin-converting enzyme, reduces AII levels, decreases vascular tone and aldosterone secretion. Reduces mortality Heart failure, hypertension, diabetes Oral; short half-life but large doses used Duration: 12–24 h Cough, renal damage, hyperkalemia, contraindicated in pregnancy Benazepril, enalapril, others: like captopril Losartan, candesartan, others: angiotensin receptor blockers; benefits not documented as well as those of ACE inhibitors Positive inotropic drugs: Cardiac glycosides: digoxin Sympathomimetics: dobutamine Inhibits Na + /K + ATPase sodium pump and increases intracellular Na + , decreasing Ca 2+ expulsion and increasing cardiac contractility Beta1-selective sympathomimetic, increases cAMP and force of contraction Chronic heart failure, nodal arrhythmias Acute heart failure Oral, parenteral Duration: 40 h Parenteral; Duration: a few minutes Arrhythmogenic! Nausea, vomiting, diarrhea, visual and endocrine changes (rare) Arrhythmias Katzung & Trevor ’ s Pharmacology: Examination and Board Review. 20

21. Summary Table: Drugs Used in Heart Failure (Continuation) Drug Mechanism of action Indications/ contraindications Pharmacokinetics Side effects Comments Beta blockers: Carvedilol, metoprolol, bisoprolol Poorly understood reduction of mortality, possibly by decreasing remodeling Chronic heart failure Oral Duration varies Cardiac depression Vasodilators : Nitroprusside Hydralazine + isosorbide dinitrate Nesiritide Rapid, powerful vasodilation reduces preload and afterload Poorly understood reduction in mortality Atrial peptide vasodilator, diuretic Acute severe decompensated failure Chronic failure in African Americans Acute severe decompensated failure IV infusion Duration: a few minutes Oral Parenteral Duration: a few minutes Excessive hypotension; thiocyanate and cyanide toxicity Headache, tachycardia Renal damage, hypotension Katzung & Trevor ’ s Pharmacology: Examination and Board Review. 21

22. Thyroid and Antithyroid Drugs Iris Salgado Ph.D. Pharmacology Department UCC- School of Medicine 22

23. Thyroid and anti-thyroid drugs Objectives Drugs to consider Thyroid Hormone Iodide metabolism Synthesis, storage, release, and interconversion of TH. Regulation of thyroid Gland Pharmacodynamics Pharmacokinetics Drugs used to treat pathologies associated with Hypothalamus-Pituitary-Thyroid Gland Hypothyroidism Pharmacotherapy Levothyroxine Liothyronine Liotrix Hypothyroidism Coma Treatment Hyperthyroidism Pharmacotherapy Anion Inhibitors Thioamides Iodides Radioactive Iodide Adrenergic Receptor Blockade Thyroid Storm management Thyroid nodules management Thyroid carcinoma management Thyroid hormone and pregnancy Thyroid hormones interactions with other drugs Summary tables and case study 23

24. Objectives Physiology and pathophysiology Outline the regulation and the key steps in thyroid hormone synthesis and peripheral conversion. Explain the mechanisms by which thyroid hormones regulate cellular function. Describe the signs/symptoms of hypothyroidism (myxedema) and hyperthyroidism: consequences of the disease that can alter drug therapy for other concurrent diseases. Understand the thyroid hormone regulation during pregnancy. 24

25. Objectives Pharmacokinetics Provide the pharmacokinetic rationale for selecting the most appropriate form of thyroid hormone as replacement therapy. Identify the best index of adequate replacement therapy with thyroid hormone. Provide the pharmacokinetic rationale for selecting the most appropriate anti-thyroid drug for treating hyperthyroidism. 25

26. Objectives Explain the pharmacodynamics and pharmacokinetics for the following drugs: Iodide ( Lugol ) Levothyroxine Levothyroxine Triiodothyronine (Liothyronine) Monovalent anions: Perchlorate (ClO4 − ), Pertechnetate (TcO4 − ), and thiocyanate (SCN − ). Methimazole potassium Propylthiouracil Propranolol Radioactive Iodine 131 I 26

27. Objectives Adverse effects, drug interactions, and contraindications Describe the adverse effects, drug interaction and contraindications of anti-thyroid medications and identify those that are potentially life-threatening. Therapeutic Uses Describe the rationale and order of drugs’ administration given to treat thyroid storm. Provide the rationale for the uses of drugs/radioiodine in treating hyperthyroidism; explain their mechanism(s) of action; consequences of radioiodine use. 27

28. Drugs to consider Diltiazem Iodide ( Lugol ) Levothyroxine Levothyroxine Triiodothyronine (Liothyronine) Monovalent anions: Perchlorate (ClO4 − ), Pertechnetate (TcO4 − ), and thiocyanate (SCN − ). Methimazole potassium Propylthiouracil Propranolol Radioactive Iodine 131 I 28

29.  Drug Therapeutic Uses Clinical Pharmacology Recombinant Human TSH Agonist for the TSH Receptor Thyrotropin alpha Thyrotropin Alfa binds to the thyrotropin receptors found on any residual thyroid cells or tissues. This stimulates radioactive iodine uptake for better radio diagnostic imaging. Stimulate radio iodine reuptake and thyroglobulin release in patients with thyroid cancer after thyroidectomy. Prepare patients for radio iodine ablation of thyroid remnants after thyroidectomy for thyroid cancer. Allows assessment of residual or recurrent thyroid cancer without stopping levothyroxine and becoming clinically hypothyroid Allows radioiodine therapy of thyroid remnants without stopping levothyroxine and becoming clinically hypothyroid. IM injection Route of elimination: kidney and liver t1/2: 25 ± 10 hours Thyroid Preparations Levothyroxine (T4) Liothyronine (T3) Levothyroxine is the preparation of choice for the maintenance of plasma T4 and T3 in hypothyroid patients. Activation of nuclear receptors results in gene expression with RNA formation and protein synthesis. Administered oral and parenteral. t1/2: 7 days - allows convenient once-daily administration. Interactions with certain foods and drugs can impair its absorption, thyroxine should be administered on an empty stomach (30 minutes before meals or 1 hour after meals or at bedtime). The toxicity of thyroxine is directly related to the hormone level (i.e., symptoms of hyperthyroidism)). In children: restlessness, insomnia, and accelerated bone maturation and growth. In adults: increased nervousness, heat intolerance, episodes of palpitation and tachycardia, or unexplained weight loss may be the presenting symptoms. Chronic overtreatment with T4 particularly in elderly patients, can increase the risk of atrial fibrillation and accelerated osteoporosis. Liothyronine(T3) Liothyronine is used for the treatment of hypothyroidism coma. It isn't used for the maintenance of thyroid hormone replacement therapy. Activation of nuclear receptors results in gene expression with RNA formation and protein synthesis Administered oral and parenteral. Shorter half-life (24 hours) and duration of action. Difficulty in monitoring by conventional laboratory methods. Interactions with certain foods and drugs can impair its absorption, should be administered on an empty stomach (30 minutes before meals or 1 hour after meals or at bedtime). Toxicity: Like those of Levothyroxine but should be considered Liothyronine(T3) is a ctive hormone and consequently greater risk of cardiotoxicity 29

30. Course Itinerary – First Semester 30 EVENT PROFESSOR DATE/TIME Course Introduction Dr. Iris Salgado 08-03-23; 9:00 am – 10:00 am Introduction to Pharmacology Dr. Walter Silva 09-12-23; 8:00 am – 10:00 am Gen. Pharmacology Principles & Drug Administration Dr. Walter Silva 09-12-23; 10:00 am – 12:00 pm Pharmacology of Drug Action Dr. Walter Silva 09-13-23; 8:00 am – 10:00 am Factors Influencing the Action of Drugs Dr. Walter Silva 09-13-23; 10:00 am – 12:00 pm Problem Set Dr. Walter Silva Independent Study Antibiotics I and II Dr. José L. Torres 09-14-23; 8:00 am – 10:00 am Antibiotics III Dr. José L. Torres 09-14-23; 10:00 am – 12:00 pm Antivirals Dr. José L. Torres 09-15-23; 8:00 am – 10:00 am Antifungal Agents Dr. José L. Torres 09-15-23; 8:00 am 11:30 am General Principles Exam II Proctors: Pharmacology Staff (~88-90 questions) Monday, 09-18-23; 8:00 am – 12:00 pm Anti-anemics Dr. José A. Quidgley 10-03-23; 1:00 pm-3:00 pm Anti-coagulants Dr. José A. Quidgley 10-03-23; 3:00 pm-5:00 pm Cancer Chemotherapeutic I Dr. José A. Quidgley 10-05-23; 1:00 pm-3:00 pm Cancer Chemotherapeutic II Dr. José A. Quidgley 10-05-23 ; 3:00 pm-5:00 pm Hematopoietic Exam Proctors: Pharmacology Staff Tuesday, 10-10-23; 8:00 am – 12:00 pm Treatment in Respiratory Disease Dr. José L. Torres 10-12-23; 2:00 pm-4:00 pm Anti-mycobacterial Drugs Dr. José L. Torres 10-13-23; 1:00 pm – 3:00 pm Quiz Respiratory System Pharmacology Staff 10-19-23; 8:30 am – 9:00 am Respiratory System - Case presentations (1) Pharmacology Staff 10-19-23; 10:00 am – 12:00 pm Respiratory Exam Proctors: Pharmacology Staff Tuesday; 10-24-23; 8:00 am-12:00 pm Renal Diuretics Dr. José A. Quidgley 10-30-23; 10:00 am - 12:00 pm Renal Exam Proctors Monday; 11-6-23; 8:00 am-12:00 pm Gastrointestinal Tract (GIT) System I Dr. José A. Quidgley 11-09-23; 2:00 pm – 4:00 pm GIT System II Dr. José A. Quidgley 11-10-23; 1:00 pm – 3:00 pm Anti-parasitic Dr. José L. Torres 11-15-23; 8:00 am – 10:00 am Quiz GIT System I, II Pharmacology Staff 11-16-23; 8:00 am – 9:00 am GIT - Case Presentations (2) Pharmacology Staff 11-16-23; 9:00 am – 12:00 pm GIT Exam Proctors Monday; 11-20-2023; 8:00 – 12:00pm Musculoskeletal Pharmacology (MSK)* Dr. José A. Quidgley 11-29-23; 8:00 am – 9:30 am MSK Pharmacology* Dr. José A. Quidgley 11-30-23; 10:00 am – 11:30 am Quiz MSK Pharmacology Staff 12-01-23; 9:00 am – 10:00am MSK Exam Proctors: Pharmacology Staff Monday; 12-04-2023; 8:00am –12:00pm Self-Reflection I Submission Dr. Iris K. Salgado Tuesday; 12-06-2023

31. Course Itinerary – Second Semester 31 EVENT PROFESSOR Central Nervous System (CNS) I Pharmacology Dr. Walter I. Silva CNS II Pharmacology Dr. Walter I. Silva CNS III Pharmacology Dr. Walter I. Silva Quiz CNS I and II Dr. Walter I. Silva CNS: Anesthetics Dr. Walter I. Silva CNS: Case Presentations Pharmacology Staff CNS Pharmacology Exam Pharmacology Staff Cholinergic and Adrenergic Drugs Dr. Walter I. Silva Drugs to treat dyslipidemia (Hypercholesterolemia Drugs) Dr. José A. Quidgley Anti-hypertensive drugs Dr. José A. Quidgley Quiz Cardiovascular System Pharmacology Pharmacology Staff Drugs to treat Angina and Coronary Artery Diseases Dr. José A. Quidgley Congestive Heart and Failure Pharmacology Dr. José A. Quidgley Anti-arrythmia Drugs Dr. José A. Quidgley Quiz Cardiovascular System Pharmacology*II Pharmacology Staff Case Presentations Cardiovascular System Pharmacology Pharmacology Staff Cardiovascular System Pharmacology Exam Pharmacology Staff Hypothalamic & Pituitary Hormones (HPX) Pharmacology Dr. Iris Salgado Thyroid Hormones Pharmacology Dr. Iris Salgado Pancreatic Hormone & Anti-diabetic Agents Dr. Iris Salgado Quiz HPX and TH Pharmacology Pharmacology Staff Adrenocorticosteroids, agonists, and antagonists Dr. Iris Salgado Gonadal Hormones and Inhibitors Dr. Iris Salgado Quiz (Pancreatic Hormones and Adrenocorticosteroids) Pharmacology Staff Case Presentations Endocrine Pharmacology Pharmacology Staff Exam Endocrine Pharmacology Pharmacology Staff Autacoids #1Histamines, Serotonin & Alkaloids Dr. Iris Salgado Autacoids #2 Vasoactive Peptides Dr. Iris Salgado Autacoids #3 Eicosanoids Dr. Iris Salgado Quiz - Autacoids Dr. Iris Salgado Others: Toxicology Dr. José L. Torres Others: Drug Interactions Dr. Walter I. Silva Others: Prescriptions Writing Dr. José L. Torres Others: Geriatrics and Pediatrics Dr. José L. Torres Exam Others Pharmacology Staff NBME Shelf Exam – Final Exam Pharmacology Staff Self-Reflection II Submission Dr. Iris K. Salgado

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33. Course Policies and Regulations 1. Netiquette UCC students demonstrate their professionalism using the following netiquette commitment for online interactions: Find a quiet place, free from distractions (pets, TV, media, other people). Maintain a respectful, compassionate, and professional demeanor in speaking, writing, and appearance. Stay on mute unless otherwise indicated. Please click the “Raise your hand” button when you want to contribute. Please refrain from using your devices during the first session, other than looking up unknown medical terms. The class dynamics increase when you reflect upon the case and activate prior knowledge, make connections and propose your own explanations. Videos need to remain “ON” to promote focus. Eye contact should be maintained. Refrain from chewing gum, drinking, or eating while on camera. Avoid emotionally charged language: Keep calm and use appropriate communication strategies. Use professional language, and avoid capital letters and bold characters. Write clearly and concisely. Communicate your ideas or concerns as effectively as possible. Take a few minutes to review what you have written before you post. 33

34. Course Policies and Regulations 2. Basic Student Responsibilities Students must attend all scheduled academic activities and exhibit appropriate behavior. Class attendance will be corroborated daily by signing the attendance sheet or registering in Elentra™ by the course director. The Department will keep a permanent record of students’ attendance and will submit it to the Registrar’s Office periodically, as required. In case of irregularities in attendance (unjustified absences, multiple, repetitive, or prolonged absences, etc.) the Office of the Counselor and the Dean of Admissions and Students Affairs will be notified. Participation standard: minimum number of postings per week in discussion and any standards for quality of participation. The Faculty of the School of Medicine will meet students based on scheduled appointments. Students will not be permitted to make appointments during course hours. The designated Class Representative will be the ONLY authorized person to meet with the Course Director to discuss class matters concerning the course administration. A professor has the right to refuse the recording of his/her lectures in any form of technology by students, (see below). 34

35. Course Policies and Regulations 3. Course Academic Integrity Policy Please refer to the “ Politica de Derecho de Autor y Uso Académico ” found at www.uccaribe.edu /library. Keeping academic integrity is essential for a successful learning environment. It is the responsibility of each student to help maintain a successful learning environment. Each professor reserves the right to dismiss from the classroom or the exam room any student, who is judged by the professor during a scheduled course activity as being disruptive, to interfere with the process of learning or the evaluation of learning. Any such incident will be documented in writing and signed by the professor. The signed written report of the incident will be submitted to the Course Coordinator. Any student who is witnessed by two or more proctors during an examination as possessing, obtaining or providing surreptitious information related to material on the exam may be dismissed from the examination. Any such incident will be documented in writing and signed by the proctors. The signed written report of the incident will be submitted to the Course Coordinator. Any student who is proven to have memorized or recorded in any way exam questions or answers during an exam or providing this information to other students is in violation of course policy and will receive no credit for the examination. Any such incident will be documented in writing by the Course Coordinator. 35

36. Course Policies and Regulations 4. Student Instructional Activity Attendance Policies Attendance to all scheduled courses and educational activities is required. Experience has shown that student exam performance is higher among students who consistently attend class. The student is encouraged not to miss this opportunity. Attendance to all clinical application exercises and community curricular experiences is compulsory and will be monitored. In order to be excused from a clinical application exercise, the student must provide the Course Coordinator with a written, signed excuse which explains the cause for the absence. This excuse must be provided no later than three days after the student returns to the institution. Validation of this excuse is at the discretion of the Course Director. There will be no make-up activity offered for a missed clinical application exercise or quiz even if the student presents a valid written excuse for the absence. A student who misses an exercise will be held responsible for the material that was presented in the exercise. 36

37. Course Policies and Regulations 5. Student Examination Attendance Policies  The dates of the exams and quizzes, as they appear in the class schedule, will not be changed . These are final and officially scheduled academic activities.  No make-up will be offered for absence to announced written quizzes.  Any student who is absent from an exam must submit a justified medical or legal excuse no later than three days after returning to classes. He/she must take a make-up exam which will be arranged in terms of the time and date with the Course Director. If the student fails to show up for the make-up exam without a valid justification, he/she will be awarded a zero . (Please see the Rules for Student Evaluation and Promotions, Section I. A. 4. Absence from an examination, make-up and justification ”).  The discussion of exam questions with the faculty will be conducted ONLY by prior arrangement with the professor. The student should submit his/her challenge to the questions in writing and be prepared to discuss it. The question should be properly referenced. The primary reference should be the lecture handouts and assigned textbooks. (Refer to Sample Challenge Form in the Appendix at the end of this syllabus).  In the case of NBME exams, there is no opportunity to take a view or review questions.  Student’s grades will be reported on the ElentraTM course site. Grades will not be reported to third parties or by phone.  All coursework is to be completed no later than the date of the final examination . Where this is not possible because of illness or any serious reason, the student will receive a temporary grade of Incomplete (I) for the course. The registration of any student with incomplete coursework (a grade of incomplete) will be provisional and dependent on removal of the incomplete grade before the deadline (the last day of the third week of classes of the following semester as set in the official School of Medicine Academic Calendar). An incomplete grade will automatically become a Failure (F) if it is not removed by the deadline.  37

38. Course Policies and Regulations During examinations: Exams will start on time; students will not be allowed to start the exam after 15 minutes of starting. Examinees who are admitted late must finish at the same time as the other examinees.  Examinees will be escorted to and from the restrooms.  Additional testing time will not be allowed to make up for time lost during absence from the room.  Restrooms will be periodically checked for examination-related materials.  For paper exams: the exam booklet and answer sheet should be collected and then returned to the examinee when he or she is ready to resume testing.  Examinees will not be permitted to bring personal belongings (cell phones, watches, hats, bags, etc.), into the seating area of the testing room. All materials, except pencils and erasers (exam paper) or markers, must be deposited in the area designated for personal belongings.  Questions regarding examination content will not be answered.  For paper exams: examinees are not to be given extra time to transfer answers from the exam booklet to the answer sheet when time is called . Examinees will immediately approach and warn that the announcement has been made to stop, signaling the end of the examination.  The following irregular behavior will not be permitted during examinations:  Copying answers from another examinee.  Possessing notes or making notes on anything other than the exam booklet or answer sheet.  If the proctor observes and/or is made aware of behavior that indicates that an examinee is copying answers from another examinee, permitting his/her answers to be copied, or providing or receiving unauthorized information about the content of the examination, the following actions should be taken:  Allow the examinee to continue the examination session . Confirm the observation with at least one other proctor. Remove the examinee’s exam booklet and answer sheet. Prepare a report and submit it to the Discipline Committee of the Institution.  38

39. Course Policies and Regulations 6. Provisions for Students with Disabilities  The course will make all necessary reasonable accommodations for any student who has a medically certified disability requiring special provisions for learning or the evaluation of learning. The student has the responsibility to promptly request accommodation following the institutional procedures established by the office of the Dean of Admissions and Student Affairs.  7. Permission to use and record lectures:  Recording refers to any audio or visual recording of a teaching session including lectures, laboratory practices, and case discussions, among others, made with any type of audio or visual recorder.  39

40. Assessment Methods and Weight Distribution Grade Range A 100 - 88 B 87-78 C 77 - 68 F 67 -0 Component Weight Summative (points) Formative Exams 70% 250 – 320   NMBE Subject exam- Final Examination 16% ~100   Summative Quizzes 5% ~90 -110   Oral group presentation based in a case study 5% ~80 -120   Professionalism 4% 70   Formative questions     X 40

41. Assessment Description and Specific Rules Exams The primary objective of each exam is to assess the student’s understanding of the course material and learning objectives covered from the previous exam or the start of the course for the initial exam. On average, there will be approximately (2-5) multiple-choice questions per lecture hour, totaling of approximately 250-340 questions. It is essential to note that according to the institutional policy, there will be no exam retakes allowed. In the event of a student's absence from an exam, they must provide a valid, written excuse along with appropriate evidence within three days of returning to classes. A make-up exam will be scheduled for the student by the course and year coordinator. Whenever possible, NBME customized exams will be utilized to evaluate the course content. NMBE Subject Exam- Final Examination A final comprehensive written exam, National Board Shelf Subject Exam, will be offered at the end of the course. The same attendance policy described for the “Summative Exams” applies to this evaluation. For details see www.nbme.org 41

42. NBME Foundation: Clinically relevant basic science principles and concepts Diagnosis: Knowledge pertaining to history, exam, diagnostic studies, and patient outcomes. Prevention: Health maintenance, disease prevention, and surveillance for disease recurrence Management: Medical or surgical treatment strategies, including pharmacotherapy 42

43. Pharmacology Subject Exam - Content Outline General Principles of Foundational Science (25%–30%) Pharmacodynamic and pharmacokinetic processes Anti-microbial Bacteria Antibacterial agents Viruses Antiviral agents Fungi Antifungal agents Parasites Antiparasitic agents 43

44. Pharmacology Subject Exam - Content Outline Immune System (1%–5%) Blood & Lymphoreticular System (1%–5%) Behavioral Health (5%–10%) Nervous System & Special Senses (5%–10%) Skin & Subcutaneous Tissue (1%–5%) Musculoskeletal System (1%–5%) Cardiovascular System (5%–10%) Respiratory System (5%–10%) Gastrointestinal System (5%–10%) Renal & Urinary System (5%–10%) Pregnancy, Childbirth, & the Puerperium (1%–5%) Female Reproductive & Breast (1%–5%) Male Reproductive (1%–5%) Endocrine System (5%–10%) Multisystem Processes & Disorders (5%–10%) 44

45. 2020 Pharmacology Subject Examination 45

46. 2020 Pharmacology Subject Examination 46

47. 2021 Pharmacology Subject Examination 47

48. 2021 Pharmacology Subject Examination 48

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51. Assessment Description and Specific Rules Oral group presentation based in a case study Each student will participate in 2-3 announced group oral presentations based on case studies focused on related pharmacological concepts and body systems. Students must prepare a (powe r- point, keynote) presentation with didactic material for each case discussion. 51

52. Criteria Exemplary-Excellent (5) Proficient- Good (4) Competent- Satisfactory (3) Need Improvement - Developing (2) Unsatisfactory- Inadequate (1) SCORE Clinical Reasoning 5 Demonstrates exceptional clinical reasoning skills, effectively integrating pharmacological knowledge to analyze and solve complex clinical problems in the case study. 4 Shows strong clinical reasoning skills, correctly applying pharmacological concepts to evaluate clinical scenarios presented in the case study 3 Displays adequate clinical reasoning skills but may overlook some aspects of pharmacology in problem-solving within the case study. 2 Struggles with clinical reasoning, making errors in applying pharmacological principles to clinical situations in the case study. 1 Fails to demonstrate adequate clinical reasoning and frequently misapplies pharmacological knowledge in the case study. Drug knowledge 5 Exhibits extensive knowledge of pharmacological agents, mechanisms of action, indications, contraindications, and adverse effects relevant to the case study. 4 Shows good understanding of drug information but may miss some details or provide incomplete explanations within the context of the case study. 3 Demonstrates basic knowledge of drugs but lacks in-depth understanding of mechanisms and side effects as they apply to the case study. 2 Displays limited drug knowledge, omitting crucial information and lacking clarity in explanations within the context of the case study. 1 Lacks fundamental drug knowledge, providing incorrect or irrelevant information for the case study. Integration of Concepts 5 Skillfully integrates multiple pharmacological concepts and applies them coherently to the case study, demonstrating a comprehensive understanding. 4 Integrates relevant pharmacological concepts effectively but may miss some connections or offer disjointed explanations within the context of the case study. 3 Attempts to integrate concepts but struggles to establish clear connections between pharmacology and the case study. 2 Struggles to integrate concepts, resulting in disjointed explanations and limited connections to the case study. 1 Fails to integrate pharmacological concepts, presenting isolated information without relevance to the case study. Evidence-Based Practice 5 Strongly supports arguments and decisions with up-to-date evidence from reputable sources relevant to the case study. 4 Generally, provides evidence-based arguments, but may not consistently use the latest or most relevant sources within the context of the case study. 3 Uses some evidence to support arguments but may rely on outdated or less reliable references for the case study. 2 Rarely supports arguments with evidence, and sources used lack credibility and relevance to the case study. 1 Fails to utilize evidence-based practice, relying solely on personal opinions or unverified information for the case study. Diagnostic and Therapeutic Skills 5 Demonstrates exceptional diagnostic and therapeutic skills, accurately identifying treatment options and their appropriateness for the case study 4 Shows good diagnostic and therapeutic skills but may overlook some viable treatment options or their nuances within the context of the case study. 3 Displays basic diagnostic and therapeutic skills but may struggle to prioritize appropriate treatments effectively for the case study. 2 Struggles with diagnostic and therapeutic skills, resulting in inadequate treatment choices and potential risks for the case study. 1 Fails to demonstrate adequate diagnostic and therapeutic skills, leading to inappropriate or harmful treatment decisions for the case study. Professional Communication 5 Communicates findings and recommendations effectively, using clear and concise language suitable for a medical context within the case study. 4 Communicates well but may need more clarity in some areas or use slightly ambiguous language within the context of the case study. 3 Communication is adequate but may lack structure or use language not entirely appropriate for a medical setting within the case study. 2 Communication is often unclear or confusing, hindering the effective conveyance of findings and recommendations for the case study. 1 Communication is severely flawed, making it challenging to understand findings and recommendations for the case study. Engagement and Delivery 5 Delivers the case study presentation with exceptional engagement, maintaining the audience's interest and attention throughout. Utilizes appropriate visual aids effectively. 4 Engages the audience well but may occasionally lose their attention or lack some enthusiasm in delivery during the presentation. Utilizes visual aids effectively. 3 Keeps the audience reasonably engaged, but improvements are needed in maintaining interest and using visual aids effectively during the presentation. 2 Struggles to engage the audience, resulting in reduced interest and limited use of visual aids during the presentation. 1 Fails to engage the audience effectively, leading to disinterest and ineffective use of visual aids or their absence during the presentation. Group Collaboration 5 Demonstrates exceptional collaboration within the group, actively contributing to discussions, sharing responsibilities, and fostering a cohesive team dynamic. 4 Participates well in group collaboration, but there may be occasional lapses in active involvement or coordination of tasks within the group. 3 Contributes adequately to group collaboration but may need some improvement in engagement or coordination with team members. 2 Struggles with group collaboration, leading to incomplete contributions, lack of coordination, or difficulty in working with team members. 1 Fails to collaborate effectively within the group, resulting in minimal contributions, lack of coordination, or negative interactions with team members. TOTAL 52

53. Criteria Exemplary-Excellent (5) Proficient- Good (4) Competent- Satisfactory (3) Need Improvement - Developing (2) Unsatisfactory- Inadequate (1) SCORE Clinical Reasoning 5 Demonstrates exceptional clinical reasoning skills, effectively integrating pharmacological knowledge to analyze and solve complex clinical problems in the case study. 4 Shows strong clinical reasoning skills, correctly applying pharmacological concepts to evaluate clinical scenarios presented in the case study 3 Displays adequate clinical reasoning skills but may overlook some aspects of pharmacology in problem-solving within the case study. 2 Struggles with clinical reasoning, making errors in applying pharmacological principles to clinical situations in the case study. 1 Fails to demonstrate adequate clinical reasoning and frequently misapplies pharmacological knowledge in the case study. Drug knowledge 5 Exhibits extensive knowledge of pharmacological agents, mechanisms of action, indications, contraindications, and adverse effects relevant to the case study. 4 Shows good understanding of drug information but may miss some details or provide incomplete explanations within the context of the case study. 3 Demonstrates basic knowledge of drugs but lacks in-depth understanding of mechanisms and side effects as they apply to the case study. 2 Displays limited drug knowledge, omitting crucial information and lacking clarity in explanations within the context of the case study. 1 Lacks fundamental drug knowledge, providing incorrect or irrelevant information for the case study. Integration of Concepts 5 Skillfully integrates multiple pharmacological concepts and applies them coherently to the case study, demonstrating a comprehensive understanding. 4 Integrates relevant pharmacological concepts effectively but may miss some connections or offer disjointed explanations within the context of the case study. 3 Attempts to integrate concepts but struggles to establish clear connections between pharmacology and the case study. 2 Struggles to integrate concepts, resulting in disjointed explanations and limited connections to the case study. 1 Fails to integrate pharmacological concepts, presenting isolated information without relevance to the case study. Evidence-Based Practice 5 Strongly supports arguments and decisions with up-to-date evidence from reputable sources relevant to the case study. 4 Generally, provides evidence-based arguments, but may not consistently use the latest or most relevant sources within the context of the case study. 3 Uses some evidence to support arguments but may rely on outdated or less reliable references for the case study. 2 Rarely supports arguments with evidence, and sources used lack credibility and relevance to the case study. 1 Fails to utilize evidence-based practice, relying solely on personal opinions or unverified information for the case study. 53

54. Criteria Exemplary-Excellent (5) Proficient- Good (4) Competent- Satisfactory (3) Need Improvement - Developing (2) Unsatisfactory- Inadequate (1) SCORE Diagnostic and Therapeutic Skills 5 Demonstrates exceptional diagnostic and therapeutic skills, accurately identifying treatment options and their appropriateness for the case study 4 Shows good diagnostic and therapeutic skills but may overlook some viable treatment options or their nuances within the context of the case study. 3 Displays basic diagnostic and therapeutic skills but may struggle to prioritize appropriate treatments effectively for the case study. 2 Struggles with diagnostic and therapeutic skills, resulting in inadequate treatment choices and potential risks for the case study. 1 Fails to demonstrate adequate diagnostic and therapeutic skills, leading to inappropriate or harmful treatment decisions for the case study. Professional Communication 5 Communicates findings and recommendations effectively, using clear and concise language suitable for a medical context within the case study. 4 Communicates well but may need more clarity in some areas or use slightly ambiguous language within the context of the case study. 3 Communication is adequate but may lack structure or use language not entirely appropriate for a medical setting within the case study. 2 Communication is often unclear or confusing, hindering the effective conveyance of findings and recommendations for the case study. 1 Communication is severely flawed, making it challenging to understand findings and recommendations for the case study. Engagement and Delivery 5 Delivers the case study presentation with exceptional engagement, maintaining the audience's interest and attention throughout. Utilizes appropriate visual aids effectively. 4 Engages the audience well but may occasionally lose their attention or lack some enthusiasm in delivery during the presentation. Utilizes visual aids effectively. 3 Keeps the audience reasonably engaged, but improvements are needed in maintaining interest and using visual aids effectively during the presentation. 2 Struggles to engage the audience, resulting in reduced interest and limited use of visual aids during the presentation. 1 Fails to engage the audience effectively, leading to disinterest and ineffective use of visual aids or their absence during the presentation. Group Collaboration 5 Demonstrates exceptional collaboration within the group, actively contributing to discussions, sharing responsibilities, and fostering a cohesive team dynamic. 4 Participates well in group collaboration, but there may be occasional lapses in active involvement or coordination of tasks within the group. 3 Contributes adequately to group collaboration but may need some improvement in engagement or coordination with team members. 2 Struggles with group collaboration, leading to incomplete contributions, lack of coordination, or difficulty in working with team members. 1 Fails to collaborate effectively within the group, resulting in minimal contributions, lack of coordination, or negative interactions with team members. TOTAL 54

55. Oral group presentation based on a case study O'Brien CE, Franks AM, Stowe CD. Multiple rubric-based assessments of student case presentations. Am J Pharm Educ. 2008 Jun 15;72(3):58. doi: 10.5688/aj720358. PMID: 18698367; PMCID: PMC2508736. Kaur G, Rehncy J, Kahal KS, Singh J, Sharma V, Matreja PS, Grewal H. Case-Based Learning as an Effective Tool in Teaching Pharmacology to Undergraduate Medical Students in a Large Group Setting. J Med Educ Curric Dev. 2020 May 13;7:2382120520920640. doi: 10.1177/2382120520920640. PMID: 32435693; PMCID: PMC7223199. Gorman, L. (2019), A New Rubric to Formatively and Summatively Assess Case-Based Learning (CBL) of Pharmacology and Pathology in Preclinical Learners. The FASEB Journal, 33: 803.4-803.4. https://doi.org/10.1096/fasebj.2019.33.1_supplement.803.4 55

56. Assessment Description and Specific Rules Professionalism Professionalism is conducting exemplifying responsibility, integrity, accountability, excellence, and communicating effectively and appropriately toward a productive performance. This evaluation includes a rubric that gathers the basis of UCC's professionalism description and the Accreditation Council for Graduate Medical Education (ACGME) (2019). Additionally, students must submit two Course Reflections. Course Reflection is a self-assessment activity that encourages students to think critically about various aspects of their learning experience, including attendance, attitudes, professionalism, and interactions with professors and peers. This reflection must be written in a standard one-page Word or Pages format, using single spacing and a font size of 11, with a minimum of 250 words and no more than 600 words (~ one page). The students must submit it via email and the deadlines are the following: First semester - two days after the last Pharmacology exam (MSK) Second semester - two days after the Pharmacology (Subject) Shelf exam. After both periods, submissions will not be accepted. Overall, Course Reflection is an important part of the learning process, offering students an opportunity to assess their experiences, learn from them, and develop academically and personally. 56

57. Criteria Excellent (5) Good (4) Satisfactory (3) Need Improvement (2) Unsatisfactory (1) SCORE Respect and Communication 5 Consistently shows respect to peers, instructors, and staff. Demonstrates excellent communication skills in all interactions. Actively listens and responds professionally. 4 Generally respectful but may occasionally show lapses. Communication is effective but could be improved in some areas. Listens actively but may interrupt occasionally. 3 Usually respectful, but there are some instances of unprofessional communication. Communication skills need more refinement. Listens but may not always respond appropriately. 2 Demonstrates some disrespectful behavior and communication issues regularly. Requires significant improvement in communication skills and listening. 1 Consistently displays disrespectful behavior and poor communication skills. Communication is detrimental to the learning environment. Timeliness and Accountability 5 Always punctual for classes, meetings, and assignments. Submits work on time and takes responsibility for actions. 4 Generally punctual but may have occasional lateness. Submits work on time but may need reminders for accountability. 3 Mostly meets deadlines but occasionally submits work late. Requires frequent reminders for accountability. 2 Often late for classes, meetings, or assignments. Difficulty in meeting deadlines and taking responsibility. 1 Consistently late for classes, meetings, or assignments. Little to no accountability for actions. Preparedness and Engagement 5 Always well-prepared for classes and actively participates in discussions, group work, and activities. Consistently goes beyond the minimum requirements. 4 Usually well-prepared but may occasionally lack in-depth knowledge. Participates in discussions and group work but might be more passive at times. 3 Generally prepared but may have some gaps in knowledge. Engages in discussions and group work but does not actively contribute. 2 Frequently unprepared for classes and shows limited engagement in discussions and group work. 1 Consistently unprepared for classes and rarely participates in discussions or group work. Ethical Conduct 5 Demonstrates strong adherence to ethical standards, academic integrity, and professional conduct. 4 Mostly upholds ethical standards but may have minor lapses. 3 Generally, works in a team but may struggle with collaborative tasks. Requires more guidance and effort in supporting group members. 2 Frequent ethical violations and academic misconduct. Needs significant improvement in understanding professional ethics. 1 Consistently demonstrates unethical behavior and academic misconduct. Lacks understanding or willingness to adhere to professional conduct. Teamwork and Collaboration 5 Excels in collaborating with peers and instructors, displaying effective teamwork and supporting group members. 4 Usually works well in a team but may encounter challenges occasionally. Offers support to group members but may need guidance on collaboration. 3 Demonstrates moderate adaptability but lacks initiative. May require encouragement to seek additional learning tasks. 2 Often faces difficulties in collaborating within a team. Lacks support for group members. 1 Consistently fails to collaborate effectively and negatively impacts team dynamics. Adaptability and Initiative 5 Demonstrates high adaptability, proactively seeking opportunities for learning, and taking initiative in extra tasks. 4 Usually adaptable but may be hesitant to take initiative at times. Shows some willingness to seek learning opportunities. 3 Demonstrates moderate adaptability but lacks initiative. May require encouragement to seek additional learning tasks. 2 Struggles to adapt to new situations and rarely takes initiative. Needs significant support and encouragement. 1 Consistently resistant to change and shows no initiative in pursuing additional learning tasks. Professional Growth 5 Actively seeks feedback, reflects on performance, and shows significant professional growth throughout the course. 4 Generally receptive to feedback and reflects on performance occasionally. Demonstrates some professional growth. 3 May require more encouragement to seek feedback and reflect on performance. Shows limited professional growth. 2 Often defensive to feedback and lacks self-reflection. Minimal professional growth during the course. 1 Consistently dismissive of feedback and shows no professional growth. TOTAL 57

58. Professionalism Eldredge JD, Schiff MA, Langsjoen JO. Effectiveness of a question formulation rubric with second-year medical students: a randomized controlled trial. J Med Libr Assoc. 2023 Apr 21;111(1-2):591-598. doi: 10.5195/jmla.2023.1529. PMID: 37312805; PMCID: PMC10259616. Accreditation Council for Graduate Medical Education (ACGME). (2019). ACGME Common Program Requirements. Retrieved from: https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_2019-07-01.pdf Epstein, R. M., & Hundert, E. M. (2002). Defining and assessing professional competence. JAMA: The Journal of the American Medical Association, 287(2), 226-235. General Medical Council (GMC). (2018). Outcomes for graduates. Retrieved from: https://www.gmc-uk.org/-/media/documents/dc11326-outcomes-for-graduates-2018_pdf-75040796.pdf Swick, H. M., Szenas , P., Danoff , D., & Whitcomb, M. E. (2006). Teaching professionalism in medical education. JAMA: The Journal of the American Medical Association, 296(9), 1154-1159. Cruess , S. R., Cruess , R. L., & Steinert, Y. (2016). Teaching medical professionalism: supporting the development of a professional identity. Cambridge University Press. 58

59. Student Progress Reports and availability of grades A progress report with details of the students’ performance from the course director or assigned faculty will be given to all students at the middle and at the end of the course. The report will include both formative and summative results and a narrative description of student performance with pertinent recommendations. The reports are intended to improve academic performance and will be posted in the courses learning management system (ElentraTM). The individual student’s exam grade and cumulative course performance will be posted on the secure student ElentraTM course site within four days after each unit examination (unless technical problems prevent meeting this deadline). Errors in grades: If a student suspects that an error was made in calculating his/her unit exam grade, this should be immediately brought to the attention of the Course Director. For paper exams, the student may check his/her answer sheet and the exam key in the presence of a department staff member. Course final grades and scores: final course percentage and final course letter grade will be posted on the secure student ElentraTM course site within one day after the ECAF survey answer rate is at least 80%. A student whose cumulative performance after each unit exam is below the minimum performance required to pass the course will be so notified. In addition, the Office of the Dean of Admissions and Student Affairs activate available student support services. Remediation: Summer Remedial Course A student that obtains a final percentage of less than 67.44% will fail the course. Please refer to the Student Rules and Regulations class 2023. Students that are eligible and authorized to take the summer remedial course should contact the UCC Registrar. Other Policies Related to Student Evaluation. After reading this Syllabus, every student must download, sign, and submit before the first unit examination the "Student Certification of Receipt of Course Materials" that is at the end of this Syllabus. Any student, who does not submit the Certification before the first examination, will not be eligible to sit for the examination 59

60. Course and teaching evaluation by students (End of Course Assessment Form -ECAF Student opinion about this course is an essential factor in evaluating and improving the course by recognizing both its strengths and its weaknesses . At the completion of the course, the students will have the opportunity to evaluate both the course itself and the teaching by certain professors in the course using pre-determined criteria. This evaluation is conducted by the Office of Dean for Academic Affairs. The evaluations are kept anonymous and will not affect student grades in the course in any way. The professors of this course encourage each student to participate conscientiously in this process. For the student to receive a final grade in this course, the student must complete the course evaluation questionnaire. The Course Director will withhold both the posting of student’s final course grades on the Elentra TM course website and the submission of final course grades to the Registrar's Office, until the Course Director receives official notice from the Office of Dean for Academic Affairs that a response rate of 80% or higher of students enrolled in the course has been reached. The individual student questionnaire responses will remain anonymous and will be viewed only by authorized personnel in the Office of Dean for Academic Affairs. The Course Director will receive from the Office of Dean for Academic Affairs only a summary of statistics from the entire class on each evaluation criterion and anonymous individual comments from members of the class. 60

61. Required Books, References, and Equipment Required books Katzung &Trevor’s Pharmacology: Examination and Board Review, 13e. 2021. ISBN 978-1-260-11712. Betram G. Katzung , Marieke Kruiderinf -Hall, Rupa Lalchandani Tuan, Todd W. Vanderah , Anthony J. Trevor. Lange Medical Books/McGraw-Hill. ( https://accessmedicine.mhmedical.com/content.aspx?bookid+3058&sectionid=255303787) Additional recommended textbooks: Katzung , B.G. Basic and Clinical Pharmacology, 15e. 2022. Lange Medical Books/McGraw-Hill. Pharmacotherapy: A Pathophysiologic Approach.Dipiro , J.T., Talbert, R.L., Yee, G.C., Matzke, G.R., Wells, B.G., and Posey, M., 12e. 2023. McGraw-Hill/Appleton & Lange Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 14 e. 2023. ISBN 978-1-264-25807-9. Hardman, J.G., and Limbird , L.E. (Last Edition).  14e. 2022 McGraw-Hill Lippincott's  illustrated reviews: P harmacology , 8e. 2022. Karen Whalen, Richard Finkel, Thomas A. Panavelil 61

62. Books 62

63. Required Books, References, and Equipment The University library has active subscriptions to scientific journals, books and databases to make your task to seek information. Consult with the librarian or personnel designated to help you. The list of all the resources could be checked online or at the front desk in the library premises. Additional Resources https://accessmedicine.mhmedical.com/searchresults.aspx?q=pharmacology Other learning resources: https://www.usmle.org/prepare-your-exam/step-1-materials/step-1-content-outline-and-specification https://www.aspet.org/aspet/education-careers/teaching-resources http://pharmacologyeducation.org https://www.msdmanuals.com/professional/clinical-pharmacology/pharmacodynamics/chemical-interactions https://www.mededportal.org 63

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65. APPENDIX 1   SCHOOL OF MEDICINE UNIVERSIDAD CENTRAL DEL CARIBE     STUDENT CERTIFICATION OF RECEIPT OF COURSE MATERIALS     I, THE UNDERSIGNED STUDENT, HEREBY CERTIFY THAT I ACCESSED, READ & UNDERSTOOD THE 2023-24 UCC #_____________________________F OR MEDICAL STUDENTS COURSE SYLLABUS .     NAME (PLEASE PRINT): _   SIGNATURE: _   DATE OF RECEIPT: _           PLEASE PRINT OUT AND COMPLETE THIS PAGE AND THEN RETURN IT TO THE COURSE COORDINATOR OR THE ASSISTANT COURSE COORDINATOR BEFORE THE FIRST EXAMINATION.   STUDENTS WHO DO NOT SUBMIT THIS PAGE BEFORE THE FIRST EXAMINATION WILL NOT BE ELIGIBLE TO SIT FOR THE FIRST EXAMINATION. 65

66. Conclusions As we embark on this educational journey in pharmacology, let us remember that the knowledge gained here is not only critical for medical professionals but also for patients who must be informed advocates of their healthcare. Understanding pharmacology empowers us to make well-informed decisions and contribute to better health outcomes for all. May this course foster a deep appreciation for the science of pharmacology and inspire us to use this knowledge responsibly and compassionately in the pursuit of optimal patient care and the advancement of medical science. Wishing you all a successful and enriching learning experience ahead! 66

67. Thank you! Office Hours (F2F) Virtual Office Hours Iris K. Salgado Villanueva Ph.D. Assistant Professor Pharmacology Department Office Tuesday 2:00pm – 4:00pm Availability for meeting and real-time chat – MS-Teams: Thursday 2:00 pm – 4:00pm 787-798-3001x.2047 [email protected] 67