Syllabus - VETERINARY CLINICAL PHARMACOLOGY - VM 8784

1. CATALOGUE DESCRIPTION

Course Description. This course concentrates on principles of therapeutic decision making with emphasis on selection of appropriate drug, the risks and benefits of drug treatment, monitoring the course of therapy in an individual patient, and the economic impact of therapeutic decisions. Study of drugs based on therapeutic objectives and the effect of the disease process on pharmacokinetics and pharmacodynamics. Pre: third-year standing in the DVM curriculum (2H, 2C)

2. OBJECTIVES

Having successfully completed this course, the student will be able to:

• Locate pharmaceutical regulatory information in the available literature and on the internet and apply it to selection of drug therapy for veterinary patients.
• Develop specific therapeutic objectives for individual patients with a variety of different diseases.
• Choose drug therapy for veterinary patients based on specific therapeutic objectives.
• Discuss the pros and cons of a given therapeutic regime based on the beneficial effects, toxicities and costs of therapeutic agents.
• Evaluate the progress of therapy in a variety of veterinary patients and for a variety of therapeutic agents.


3. PREREQUISITES AND COREQUISITES

Third-year standing in the DVM curriculum.

4. TEXTS AND SPECIAL TEACHING AIDS

Required texts

None

Recommended texts

USPDI
Textbook used in VM 8274 (Fundamentals of Veterinary Pharmacology)
Current Veterinary Medicine (Species-Appropriate to Student Interests)
Veterinary Drug Handbook - Plumb

Other materials

Complete set of lecture notes (printed and web based)
http://www.fda.gov/cvm
http://cpharm.vetmed.vt.edu/vm8784/default.htm

5. COURSE DETAILS
1. Introduction:
Course leader: Wilcke Credits: 2 Semester: 6 Core, track, or elective: core Contacts: Lectures: 23 Labs: 4 (1/2 hour each)
2. Schedule:

Lectures

Introduction to Therapeutics - Cost Benefit Analysis, Sources of Information
Regulations - Animal Drug Availability Act (Changes in efficacy evidence, Veterinary Feed Directive Drugs, Flexible labeling, Drugs for "Minor Species"), Animal Medical Drug Use Clarification Act (Extra-label drug use, Labeling, Records, Withdrawal periods for food animal, prohibitions).
Pharmacokinetics 1 - General Principles, Modeling clinical patients, Pharmacokinetic Constants
Pharmacokinetics 2 - Effects of Disease, Dehydration, shock, blood loss, Renal and hepatic failure
Pharmacokinetics 3 - Therapeutic Drug Monitoring (Aminoglycosides, Phenobarbital, Digoxin, Theophylline)
Antimicrobial Therapy 1 - General principles, Interpretation of Susceptibility Testing
Antimicrobial Therapy 2 - Clinical Pharmacology of Antimicrobials (Mechanisms of action, Susceptibility profiles)
Antimicrobial Therapy 3 - Selection of Antimicrobials (Dose Forms, Pharmacokinetics, Tissue Penetration, Cost)
Antimicrobial therapy 4 - Antimicrobial Dosage Regimes (Patient factors, Site of Infection, Immune Status)
Antimicrobial Therapy 5 - Therapy for Infections (by System) (Genito-urinary tract, respiratory tract, Skin and Soft tissue infections)
Antimicrobial Prophylaxis - (General Principles, Surgery, Dentistry, Urinary Tract)
Clinical Pharmacology of Glucocorticoids 1 - (Mechanisms, Adverse effects, Dose Forms)
Clinical Pharmacology of Glucocorticoids 2 - (Replacement Therapy, Therapy for Inflammatory Disease, Therapy for Immune Disease, alternate day therapy)
Non-Steroidal Anti-Inflammatory Drugs - (Clinical Pharmacology, Musculoskeletal Disorders Endotoxemia)
Respiratory System Therapeutics - (Expectorants, Cough suppressants, Bronchodilators, Asthma, Collapsing Trachea, COPD)
Gastrointestinal Therapeutics - (Analgesics, Emesis and antiemesis, Gastritis, Enteritis, Colitis)
Cardiovascular Therapeutics 1 - (Therapeutic principles of congestive heart failure)
Cardiovascular Therapeutics 2 - (Congestive Heart Failure, Cardiac Glycosides, Dobutamine / Dopamine, Amrinone)
Cardiovascular Therapeutics 3 - Congestive Heart Failure (Vasodilators, ACE inhibitors).
Cardiovascular Therapeutics 4 - Diuretics (Congestive heart failure, edema, equine idiopathic pulmonary hemorrhage, portal hypertension)
Cardiovascular Therapeutics 5 - Principles of Antidysrhythmic Therapy
Cardiovascular Therapeutics 6 - Clinical Pharmacology of Antidysrhythmic agents
Urinary Tract Dysfunction - Incontinence, Dysuria

Labs

Decision Analysis
Sources of Drug Information
Susceptibility Data
Antimicrobial Pharmacokinetics
Therapeutic Drug Concentration Monitoring

Exams

4 x 30 minute

Final

A term paper will be assigned in place of a final examination. Students are asked to critically evaluate the approach to therapy in a specific case of their choosing. The assignment asks the student to identify all therapeutic objectives (drug and non-drug) then discuss the pros and cons for the therapeutic options available for a single objective. Finally, the student selects among the pharmacological options and describe the costs and methods used to evaluate therapeutic success or failure.

3. Clothing, special equipment

Refer to Student Handbook.

4. Grading Policies and Standards

Refer to Student Handbook.

Grades will be calculated from 4 in-class exams account for 1/4 of total grade, reports for 5 labs account for 1/4 of the total grade and 1 final term paper accounts for the remaining 1/2 of the total grade. Grading scale employed is that stated in the Student Handbook.

5. Attendance Policy

Refer to Student Handbook.

6. Disabilities, Professionalism, Academic Misconduct, Honor Code, Drop/Add Policy

Refer to Student Handbook