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Comilla Medical College
Comilla; Ban.gladesh
Name of the student:
Phase-II : Second Professional MBBS
Students In-course Evaluation Card
Batch: Com January / July 20
Photograph
Class Roll No. : Section: Session: Class started on : . .
Local Address :
0IS0uBBIICuBIS Date of Birth: / / ... Single /Married
Father's Name:
Occupation /Designation :
Address Phone No. :
Mother's Name:
Occupation /Designation:
Address Phone No. :
Permanent Address :
Academic Record:
Name of Name of Institution with District & Board Year Marks Division
Exam. IGPA I Grade
sse
Hse
Date of Admission : # M /20 *In "*"""**...Medical College.
1st Prof. MBBS class started on : / 20 - Migrated : No / Yes
1st Prof. MBBS Passed on : Januar / July 20 ~ . Attempt : 1st / 2nd / 3rd / 4th Regular / Irregular
Place : . Honours in: 1. 2. 3. mm
2nd Prof. Exam. due on : Januar /July 20 *Passed on : Januar /July 20 Exam. Roll. . M
Initial of the Student Assigned Teacher Head of the Department
C

Department of Pharmacology & Therapeutics
Com ilia Medical College, Comilla.
Course Ofered :
The Department offers two years graduate program for Phase-II MBBS (3rd and 4th year)
students in Pharmacology & Therapeutics as designed by the Bangladesh Medical &
Dental Council and approved by the University of Chittagong. The offered course begins
after the students have successfully completed their First Professional MBBS Examination.
Course Description :
Pharmacology is the science which deals with the all aspects of drugs. Drugs are
chemicals usually used to treat diseases. Pharmacology is therefore the study of what
drugs do to the body (dynamics) and what body does to the drugs (kinetics). Use of
drugs always benefits the patients but there are also some risks of adverse effects. The
knowledge of Pharmacology is essential for using the drugs rationally and ethically.
Course Objectives:
The objective is to provide community oriented and need based education to produce
doctors who will be competent to:

describe the pharmacological effects, mechanisms of action,
kinetic characteristics and adverse effects of drugs.

understand and apply the basic principles and concepts that form the scientific
basis for rational, effective, safe and economic use of drugs in clinical practice.

understand and apply the principles of rational therapeutic decision making and prescribing.

understand and apply the "Concept of Essential Medicine" in the community
oriented health care delivery service.

recognize and manage the drug reactions, interactions and problems due to
misuse and abuse of drugs.
Recognize the implications of polypharmacy and other means of irrational
prescribing, identify influences favoring irrational prescribing and develop means
to resist them.

identify and assess objectively the drug information sources.
evaluate the ethical and legal issues in drug prescribing, development,
manufacturing and marketing.

acquire methods of learning needed for evaluation of existing and new drugs and
to follow the trends and approaches in pharmacological research.
develop attitude for continuous self learning and self assessment throughout the
whole of practicing life.
Manual for Conduction of 2nd Professional MBBS Examination
based on BMDC Curriculum 2002
1. Name of the Exam: Second Professional MBBS Examination
2. Name of the Subject: Pharmacology & Therapeutics
3. Duration & Core contents:
3.1. Duration:

Two academic years [inclusi on of month s of 1 st Prof. MSSS Examination]

Time of exam: At the end of 3Yyears from the commencement of
1st Professional MBBS Course (Phase I)

Four terms - each of six months duration

Assessment Card -Total 3 Cards

Term examination: Total 3 term examination, one at the end of each term

Type of term examination: Theoretical, Oral and Practical
3.2 Summary of the Core Contents:
1st Year of 2nd Year of
2nd Professional group 2nd Professional group
[ 3rd year] [ 4th year]
Components Term I Term II Term III Term IV
Teaching Teaching Teaching Teaching
hours hours hours hours
Lectures 35 38 27 ----
Practical & 24 20 06 Block
Demonstrations
Placement
Tutorials 12 12 06 Block
Placement
Clinical 00 10 20 Block
Pharmacology
Placement
Total 71 80 59 ----
Total
100
50
30
30
210
4. Summary of Assessments in Pharmacology & Therapeutics
C t d It' M k D' t 'b f f S d P f ' I MBBS E f omponen s an s ar s IS n u Ion 0 econ ro esslona xamlna Ion
Theoretical Oral Practical Total
100 100 100 300
Theoretical
:
100
Formative
Assessment MCQ SAQ : Marks - 70
Gr.- A Gr. - B Gr.- C Gr.- D
Marks: 10 Marks: 20
17.5 17.5 17.5 17.5
Oral Marks: 100
BOARD - 1 BOARD - 2
Topics as allocated Topics as allocated
- for group A & B for group C & D
Marks: 50 Marks: 50
Practical Marks: 100
TRADITIONAL CLINICAL CASE EXPERIMENTAL
OSPE
lExperimental & Therapeutics) REPORTS NOTE BOOK
40 30 20 10
5. Theoretical Examinations:
Contents & Grouping of the Topics in Theoretical (MCQ &SAQ) and Oral
Examination:
Theoretical : S A Q : 70 Marks
Groups A : 17.5 B : 17.5 C : 17.5
D : 17.5
General Autonomic CNS drugs Chemotherapy
Pharmacology Pharmacology Autacoids Gastro-
TOPICS
Endocrine Renal and & NSAIDs Intestinal
Pharmacology Cardiovascular Respiratory Pharmacology
Special Topics Hemopoietic Pharmacology
Pharmacology
Oral Board -1
Board -
2
Boards 50 Marks
50 Marks
The Topics will be exchanged according to the groups between the Boards on every alterate day
6. Pre requisites for eligibility to appear in 2nd Professional MBBS Examination:
I. Has passed the 1 st Professional MBBS Examination
II. Has undergone a course of regular studies of 2 academic years (inclusion of
months of 1 st Professional MBBS Examination)
III. Three term cards must be completed
IV. Three term examinations (in-course assessment) must be completed
V. Minimum 75% attendance in lectures, tutorials and practical classes separately
VI. A good conduct certificate from the head of the Department.
Course Organization
Lecture:
Practical
Tutorial:
Clin. Pharma :
Evaluation:
Practical:
Tutorial:
Clin. Pharma :
Evaluation:
35 hrs
24 hrs
12 hrs
08 hrs
12 hrs
04 hrs
12 hrs
04 hrs
Tutorial 20 hrs
Clin. Pharma : 04 hrs
Evaluation: 12 hrs
Practical
Tutorial:
Evaluation:
General principales of Pharmacology: 12 hrs
Autonomic Nervous System: 09 hrs
Renal & Cardiovascular Pharmacology: 12 hrs
Antianemics : 02 hrs
Review of 1S
[
End Term Exam: 02 hrs
CNS Pharmacology: 15 hrs
Autacoids & Anti-infiammator drugs: 10 hrs
Endocrine Pharmacology: 08 hrs
Revision Classes on Topics Topics of Term I : 15 hrs
Review of 2n
a
End
GI Pharmacology:
Chemotherapy:
Revision Classes on Topics of Ter II : 15 hrs
Prescripton writing 02 hrs
Dosage formulations: 02 hrs
Drug Delivery Techniques: 02 hrs
Pharmacokinetic Study: 06 hrs
Pharmacodynamic Study: 06 hrs
Study of CV Effects of Drugs: 06 hrs
Study of Drugs in Human Volunteer:
Exercise on Statishtical Analysis:
Demonstration of anesthetic Procedure:
Interpretation of Trachings :
04 hrs
Principles of Pharmacology:
Drug Management of Hypertension:
Drug Management of IHDI :
Dnug Management of Heart Failure:
Autacoids:
Drug Management of Asthma:
Analgesics & Anti-inflammatory agents:
Anxiolytics & Antidepressants:
Antipsychotics & Antidepressants:
Corticosteroids :
Antidiabetic drugs:
Hormonal Contraceptives:
Drug Management of Diarrhea:
Dnug Management of PUD & GERD :
Principles of Chemotherapy:
Beta Lactams & Others :
Aminoglycosides & Other Protein
Synthesis Inhibitors:
Quinolones :
Standard Treatment Protocols of TB.
Malaria, ARI, STDs and Enteric Fever:
06 hrs
02 hrs
02 hrs
02 hrs
02 hrs
02 hrs
02 hrs
02 hrs
02 hrs
02 hrs
06 hrs
Hyperension
04 hrs
Heart Failure:
ITEM Exam: 06
Reports on
Experiments: 06
Case Report: 02
Assignment: 01
Repors on
Experiments: 05
Case Report: 01
End Term Exam :
October - November
End Term Exam
March - April
Assignment
03
01
01
Course content
A. Lecture Topic
I. General principle of pharmacology: 12hours
Introducing the subject: Evolution of drug use, scope and place of pharmacology in medicine
Pharmacodynamics: Mechan ism of drug action
Pharmacodynamics: Quantitativ e aspects of drug action: dose -response relationships
Pharmacodynamics: Individual variations in drug response
Pharmacodynamics: Clinical evaluation of drug response: beneficial vs adverse drug reactions (ADRs)
Pharmacokinetics: Drug absorption, bioavailability
Pharmacokinetics: Routes of drug administration, their advantages and disadvantages
Pharmacokinetics: Drug distribution, volume of distribution (Vd)
Pharmacokinetics: Drug biotransformation
Pharmacokinetics: Drug excretion, plasma half -life, drug clearance
Principles of dosage regimen determination
II. Autonomic pharmacology:10 hours
Neurotransmission & neurotransmitters in ANS & enteric neurons
Cholinergic drugs
Anticholinesterases: Organophosphorus insecticide poisoning
Antimuscarinic drugs: Atropine & others
Anti nicotinic drugs: Ganglion neuromuscular blockers
Sympathomimetics: beta1 - agonist & drug management of cardiogenic shock
Sympathomimetics: beta2 - agonist & drug management of bronchial asthma
Sympatholytics: Adrenoceptor blockers
Syrratholytics: Adrenergic neuron blockers & central sympatholytics
III. Renakardiovascular pharmacology: 12 hours
Diuretics
Drug management of hypertension
Drug management of heart failure
Antiarrhythmic drugs
Antianginal drugs
Drug management of IHD
Drug management of thromboembolic disorders: Antiplatelets, anticoagulants & thrombolytics
Lipid lowering drugs
IV. Hematinics: 02 hours
Hematinics: Iron
Hematinics: Folic acid & vitamin
B 12
V. Central nervous system pharmacology: 15 hours
Central neurotransmitters & their pharmacological importance
Opioid analgesics: Endogenous opioids
Opioid analgesics: Morphine & related drugs
General anesthetics: Inhalational agents
General anesthetics: Intravenous agents
Anesthetic adjuncts
Local anesthetics
Antiepileptics & anticonvulsant
Psychopharmacology: Pharmacological concept of psychological disorders
Drugs used in anxiety & sleep disorders
Antipsychotics
Antidepressant drugs
Problem of drug abuse I addiction & its management
VI. Endocrine pharmacology: 10 hours
Drug management of diabetes mellitus: Insulin
Drug management of diabetes mellitus: Oral antidiabetic drugs
Estrogens & Progestins: Hormone Replacement Therapy
Estrogens & Progestins: Hormonal contraceptives
Drugs acting on uterus : Oxytocics and Tocolytics
Corticosteroids: Physiology & Pharmacology
Drugs used in thyroid disorders: Thyroid hormones and Antithyroid drugs
VII. Autacoids & antiinflammatory drugs: 08 hours
Histamine: Physiology & Pharmacology
Histamine antagonists
Prostaglandins: Physiology & Pharmacology
Nonste roidal antiinflammatory drugs (NSAIDs) / Non - opioid analgesics
Steroidal antiinflammatory drugs
VIII. Gastrointestinal pharmacology: 05 hours
Drug management of peptic ulcer & GERD
Antidiarrheal drugs: Drug management of diarrheal diseases
Purgatives & laxatives: Drug management of constipation
Antiemetic drugs: Drugs used in nausea and vomiting
IX. Antimicrobials & Chemotherapy: 21 hours
Introduction: Classification & problems of microbial resistance to drugs
Microbiologic profile of common infections
Microbial ce II-wall synthesis inhibitors: Penicillins
Microbial cell -wall synthesis inhibitors: Cephalosporins & others
Microbial protein synthesis inhibitors: Aminoglycosides, Macrolides & Lincosanides
Microbial protein synthesis inhibitors: Tetracyclines & Chloramphenicol
Microbial nucleic acid synthesis inhibitors: Sulfonamides & Cotrimoxazole
Microbial nucleic acid synthesis inhibitors: Quinolones
Antimycobacterial drugs: Pharmacotherapy of tuberculosis
Antimycobacterial drugs: Pharmacotherapy of leprosy
Antiproto zoal drugs: Pharmacotherapy of Kala -azar & amebiasis
Antiprotozoal drugs: Pharmacotherapy of malaria
Anthelmintics: Drug management of helminthiasis
Drug used in fungal infections
Drug used in viral infections
Antiseptics & Disinfectants
Principles of anti microbial drug use
Cancer chemotherapy
X. Special Topics: 05 hours
Principles of Pharmacotherapy
Development of new drugs: International & Bangladesh perspective
RUM: Rational Prescribing: Assessing risk - benefit ratio & cost- benefit ratio
RUM: Rational Prescribing in pregnant women, renal & hepatic impairment
RUM: Essential drug concept, National Drug policy (NDP)
B. Practical Class Topics:
1. Prescription writing: Legal & ethical aspects, drug nomenclature
2. Dosage formulations & drug delivery systems.
3. Pharmacokinetic study : Time-concentration curve, Determination of volume of distribution,
clearance & t 1/2
4. Pharmacodynamic study: Dose-response relationship, Construction of dose response curves and
comparisons of E max & Therapeutic Index
5. Pharmacodynamic study: Drug antagonism between acetylcholine & atropine
6. Study of cardiovascular efect of drugs: Interpretation of tracings: Cholinergic &
anticholinergic sAdrenergic & antiadrenergics 1 Histamine & antihistaminics
7. Study of the drug effects on skeletal muscle: Interpretation of tracings
8. A comparative study of the " Prescribing information ofdrugs" as provided by the manufacturers'
product literatures and the official drug compendia (BNF/BDNF)
9. Preparation & dispensing of ORS
10. Exercise on selection of Rational 1 Riority (" P") drugs
11. Prescription audit
12. Statistical analysis of experimental studies
C. Tutorial Class Topics:
1. General principles of pharmacology: Pharmacodynamics & pharmacokinetics
2. Drug management of diabetes mellitus
3. Corticosteroids
4. Hormonal contraceptives
5. Pharmacology of cholinergic neurotransmission
6. Pharmacology of adrenergic neurotransmission
7. Drug management of hypertension
8. Drug management of hear failure & cardiogenic shock
9. Drug management of IHD
10. Drug management of glaucoma
11. Analgesics & Antinflammatory agents
12. Anxiolytics& Anti-epileptics
13. Antipsychotics & Antidepressants
14. Autacoids: Histamine & Anthistaminics, Prostaglandins
15. Drug management of bronchial asthma
16. Drug management of diarrhoea, nausea & vomiting
17. Drug management of PU & GERD
18. Principles of chemotherapy
19. Beta lactams & others
20. Aminoglycosides & other microbial protein synthesis inhibitors
21. Quinolones and other microbial nucleic acid synthesis inhibitors
22. Chemotherapy & standard treatment protocols for malaria, TB, EF, ARt, STDs
23. Principles of pharmacotherapy: Rational Use of medicine (RUM)
RUM: Rational Prescribing: Assessing risk- benefit ratio & cost - benefit ratio
RUM: Rational Prescribing in pregnant women, renal & hepatic impairment
RUM: Essential drug concept & National Drug policy (ND
D. Clinical Pharmacology Case Repor Topics:
1. hypertension
2. Heart failure
3. Bronchial asthma
4. Peptic ulcer
\
Term: 1
Assessment Card : I
Item
GP-l
GP-2
AP-l
A-2
CV-l
CV-2
CV-3
H























General Principles of Pharmacolog
Autonomic Pharmacolog
Topic
Role and scope of Pharmacolog
Drug Administration & Special Deliver Techniques
Dosage Formulations and Routes of Drug Administration
Pharmacokinetics: Absorption, Bioavailability, Distribution,
Biotransformation and Excretion
Clinical Pharmacology
Pharmacodynamics : Molecular and cellular action of drugs
Quantitative aspects of drug action
Adverse Drug Reactions (ADRs). Drug-drug Interaction
Drug safety and Pharmaco-vigilance
Cholinergic Neuro-transmission
Cholinomimetics : OPC POisoning and Management
Drugs for Glucoma
Atropine and Atopine substitute
Skeletal Muscle Relaxant
Adrenergic Neuro-transmission
Adrenergic Drugs: Sympathomimetic inotropics
Vasoconstrictor and Decongestants
Selective 2 Agonist and Other drugs used in Br: Asthma & COPD
Selective a Antagonists and Antagonists
Diuretics and Drugs used in Hypertension
Anti-anginal. Anticoagulants, Anti-platelets, Thrombolytics
Drugs used in Heart Failure
Anti-arrhythmic drugs
Lipid lowering drugs
Anti-anaemic drugs
Average score i Item Exams
Date Written Oral
Term-I
Examination
Attendance From _________ _ to
Lectures
Held Attended Percentage Held
Renal and Cardiovascular Pharmacolog
Antianemics
Date Written Oral Initial
Practical Total Result
Practicals and Tutorials Total
Attended Percentage
/
Term: II
Assessment Card : II
Central Nervous System Pharmacolog
Endocrine Pharmacolog
Autacoids and Drugs used in Inflammation
Gastroinnstral Phaacolog
Item Topic

Drugs used in Anxiety and Sleep Disorders
CNS-I
Benzodiazepine & Non-benzodiazepine
CNS-2

Anti-psychotics, Anti-depressants and Anti-convulsants
CNS-3

Analgesics, Anesthetics and Drug dependence

Autacoids
A-I
Prostaglandin Inhibitors and NSAIDs


Drug used in Peptic ulcer diseases

Gastroesophaseal Refux disorder (GERD)
GT-I

Drugs used in Diarrhoea and Constipation

Drugs used in Vomiting

Endocrine Pancreas and Diabetes Mellitus
EP-I

Hypoglycemic Drugs

Adrenal cortical Hormones and anti-infammatory Steroids

Oestrogen and Anti-oestrogen

Progesterone and Anti-progesterone
EP-2 Hormonal Contraceptives and HRT
Drugs Stimulating and Inhibiting Uterine Contraction
Thyroid Hormone and Anti-thyroid Drugs
Average score i Item Exams
Date Written
Term-II
Examination
Attendance From __ to
Lectures
Held Attended Percentage
Oral
Held
Date Written Oral Initial
Practical Total Result
Practicals and Tutorials Total
Attended Percentage
Item

AM-l



AM-2


AM-3


AM-4


AM-5


SP-l


SP-l


Term: III
Assessment Card : III
Chemotherapy : Special topics
Topic Date
General aspects of antimicrobial
Emergence and Transfer of Resistance
Principles of Antimicrobial Therapy
Chemotherapy
Beta Lactams, Sulfonamides, Quinolones,
Macrolides & Lincosamides-Streptogramins (MLS)
Tetracyclines, Chloramphenicol & Aminoglycosides
Antitubercular, Anti-malarial, Anti-Iaprotic,
Kala-azar, Amoebiasis
Filariasis and Helminthiasis
Antifungal, Anti-viral & Anti-neoplastic
Development of New drug
Concept of Essential Medicine
Rational use of Medicine
Drugs & Pregnancy
Immunopharacology & Pharmacogenomics
Average score in Item Exams
Written
Date Written Oral Practical
Term-III
Examination
Attendance From _______ _ to
Oral
Total
Lectures Practicals and Tutorials
Held Attended Percentage Held Attended Percentage
Initial
Result
Total
Expt. No.
Date

RP-l

RP-2

R-3
RP-4


RUM-l

RUM-2

D-l

D-2

D-3

D-4

D-5

K-l

CP-l
Seminar:
Serial
Reports on Experimental Pharmacolog
Experiments / Demonstrations / Assignments
CONTENTS
Name of the Experiment Marks Initial Remarks
Prescription Writing :
Format, Legal & ethical aspects; Drug Nomenclature, Compliance.
'Exercise on Prescription Writing'
Essential Drug concept :
Exercise on selection on 'Essential Drugs' for a community
Drug Information Sources :
A Comparative study of the 'Prescribing information of Drugs' as
provided by the Manufacturers' Product Literatures and the authentic
Drug Compendia (British or Bangladesh National Formular)
Drug Dosage Formulations :
'Exercise on 'Dosage Formulation'
Prescription Audit :
'Exercise on 'Prescription Audit using INRUD indicators'
P-drugs :
'Exercise on selection of P-drugs'
Isolated Guinea pig ileum preparation :
'Studies of dose-Response Relationships'
'Construction of L
O
Dose-Response Curves'
Isolated Frog Rectus / Isolated Guinea pig ileum preparation :
'Studies of drug Antagonisms'
'Log D-R Curves in presence of Antagonist'
Langendorf preparation : Isolated Mammalian heart :
Isolated Rabbit Heart Preparation
'Studies of the efects of drugs on isolated heart preparation'
Intact animal preparation : Anaesthetized Cat / Dog
'Studies of the effects of drugs on blood pressure
Intact animal preparation Anaesthetized Cat / Dog :
Studies of the effects of drugs on Skeletal Neuromuscular Junction
Clinical Pharmacokinetics :
Study of Time-Plasma Drug concentration Curves:
Determination of t Vd, Cl, Ke, steady-state Concentration,
loading and maintenance doses
The technique O2the double blind clinical trial :
Study of the effect of Glyceryl Trinitrate (GTN)
On blood pressure of normal humane volunteers
Average Marks alobtained (out of 10)
Date Topics Marks Remarks wt inital
Department of Pharmacology & Therapeutics
Clinical Pharmacology Case Report
Student's Name:
Class Roll:
Remark of the Batch Teacher:
Professor of Pharmacology & Therapeutics
Particulars of he Patient
Personal History
Patient's Name:
Educational Status:
Socioeconomic Status:
Date of Admission: '
History of Past Illness (including Drug History):
Description of Present Illness (History & Clinical Findings):
Investigations done with result:
Provisional Diagnosis:
Age:
Occupation
Ward / Bed:
Date of Discharge:
Therapeutic Problem (s):
( Drug Therapy given:
(mention the exact brand name written in the treatment sheet and
their corresponding generic)
Result I Outcome of the Treatment:
Daily Progress Repor
Day from With/Without Pulse Rate Blood RespiraHon Urinary Weight
Admission Drug (per minute) Pressure (in (per minute) Volume (in ml
mm of Hg) per hour)
Day 1
Day2
Day3
Day4
DayS
Day6
Day7
Make a Summar of the Case Report
Others
(stating personal history, complaints, clinical findings, repors of investigations done,
diagnosis made, treatment given & outcome yielded)
A. Discussion of therapeutic problem and drug therapy given :
1. Define the therapeutic problems of the case you have reported.
2. Did the drugs or treatment given address all the therapeutic problems?
Yes I No
Relate the treatmenUdrugs given to specific therapeutic problem
If no, explain why?
3. Was there any alternative for each drug given?
4. Were the choices appropriate considering the drugs given & the
alternatives?
B. Comments on Prescription :
1. Was the route of administration, dosage, frequency & duration of therapy
properly mentioned?
2. Was the patient warned abou t the possible adverse effects of each drug &
how to avoid them?
C. Report on Adverse Efects:
Was there any reported adverse effects in this case?
If yes, what are the clinical manifestations and how they have been managed?
D. Final Comments
E. Drug Discussion
Brief information about the drugs used in the therapy
(including generic name, International Nonproprietary Name, pharmacological
effects, mechanism of action, metabolism and elimination, important drug - drug
and drug - food interactions)
Signature of the Student
Reference:
B.G.Katzung
Basic & Clinical Pharmacology
P.N.Bennett
Clinical Pharmacology
H.P.Rang & M.M.Dale
Pharmacology
Work Notes