GMC Domains

• THE DOCTOR AS A SCHOLAR
  • TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: ANATOMY (TD 8.1)
    • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Medical knowledge: BIOCHEMISTRY (inc. Metabolism) (TD 8.3)
    • Medical knowledge: CELL BIOLOGY (TD 8.4)
    • Medical knowledge: MOLECULAR BIOLOGY and GENETICS (TD 8.5, 8.6)
    • Medical knowledge: PATHOLOGY (TD 8.7)
    • Medical knowledge: CANCER
    • Medical knowledge: IMMUNOLOGY and INFLAMMATION (TD 8.8)
    • Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
    • Medical knowledge: PHARMACOLOGY (TD 8.10)
    • Medical knowledge: NUTRITION (TD 8.11)
    • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
  • TD 9: APPLICATION OF PSYCHOLOGICAL PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
  • TD 10: APPLICATION OF SOCIAL SCIENCE PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: SOCIOLOGY (TD 10 a-e)
  • TD 11. PRINCIPLES, METHODS AND KNOWLEDGE OF POPULATION HEALTH
    • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
  • TD 12; APPLICATION OF SCIENTIFIC METHOD AND APPROACHES TO MEDICAL RESEARCH
    • Medical knowledge: EPIDEMIOLOGY
    • Medical Knowledge: SCIENTIFIC METHOD & RESEARCH
• THE DOCTOR AS A PRACTITIONER
  • TD 13: CARRY OUT A CONSULTATION WITH A PATIENT
    • Clinical skills: HISTORY (TD 13 a-b)
    • Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
    • Clinical skills: MENTAL STATE EXAMINATION (TD 13 d)
  • TD 14: DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS
    • Clinical skills: INTERPRETING FINDINGS AND INITIAL ASSESSMENT (TD 14 a-b)
    • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Clinical skills: SURGERY and ANAESTHETICS (TD 14 g)
    • Clinical skills: SUPPORTING PATIENTS and IDENTIFYING ABUSE and NEGLECT (TD 14 h-i)
    • Clinical Skills: CARE OF PATIENTS AND RELATIVES AT END OF LIFE (TD 14 j)
  • TD 15: COMMUNICATE EFFECTIVELY WITH PATIENTS AND COLLEAGUES
    • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Clinical skills: MANAGING INFORMATION (TD 15 c)
  • TD 16: PROVIDE IMMEDIATE CARE IN MEDICAL EMERGENCIES
    • Emergency Management of Patients (TD 16 b-e)
  • TD 17: PRESCRIBE DRUGS SAFELY, EFFECTIVELY AND ECONOMICALLY
    • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
  • TD 18: CARRY OUT PRACTICAL PROCEDURES SAFELY AND EFFECTIVELY
    • Clinical skills: DIAGNOSTIC PROCEDURES (TD 18 a)
    • Clinical skills: THERAPEUTIC PROCEDURES (TD 18 b)
  • TD 19: USE INFORMATION EFFECTIVELY IN A MEDICAL CONTEXT
    • Clinical skills: EVIDENCE BASED MEDICINE
• THE DOCTOR AS A PROFESSIONAL
  • TD 20: BEHAVE ACCORDING TO ETHICAL AND LEGAL PRINCIPLES
    • Professional issues: ETHICS and LAW (TD 20 a-g)
  • TD 21: REFLECT, LEARN AND TEACH OTHERS
    • Professional Issues: PERSONAL LIMITS OF CARE (TD 21e)
    • Professional issues: LEARNING (TD 21 a-d)
    • Professional issues: TEACHING AND MENTORING (TD 21 f)
  • TD 22: LEARN AND WORK EFFECTIVELY WITHIN A MULT-PROFESSIONAL TEAM
    • Professional issues: WORKING IN TEAMS (TD 22 a-c)
  • TD 23: PROTECT PATIENTS AND IMPROVE CARE
    • Professional issues: DUTIES OF A DOCTOR (TD 23 a-b)
    • Professional issues: MEDICAL FRAMEWORK IN THE UK (TD 23 c)
    • Professional issues: RISK MANAGEMENT and PATIENT SAFETY (TD 23 d)
    • Professional issues: GOVERNANCE, QUALITY MATTERS and AUDIT (TD 23 e)
    • Professional issues: PERSONAL ATTITUDES and SELF CARE (TD 23 f-j)

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TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE: Medical knowledge: PHARMACOLOGY (TD 8.10)

Index

• General Principles of Clinical Pharmacology and Therapeutics
• Cardiovascular Pharmacology
• Respiratory Pharmacology
• Metabolism (GI, Endocrine and Renal)
• Human Development (Child Health, Sexual Health, O&G, Healthcare of the Elderly)
• Brain and Behaviour (Psychiatry, Neuroscience and Ophthalmology)
• Locomotor (Musculoskeletal and Dermatology)
• Infection
• Cancer and Immunosupression

• General Principles of Clinical Pharmacology and Therapeutics
  • Pharmacological Principles - General
    1. Know what is meant by the term selective toxicity and distinguish between an antibiotic and antimicrobial agent (CSP3)
    2. Understand and know the principles of good prescribing including the most commonly prescribed drugs.
    3. Know the indications for use of anti-emetic drugs and those most commonly used.
    4. List sites of action of antimicrobials with examples (CSP3)
    5. Discuss selectivity of drug actions
    6. List mechanisms of resistance and factors predisposing to increased resistance (CSP3)
    7. Relate how being weak acids or weak bases influences a drugs activity
    8. Describe the forces used between a drug and its receptors
    9. Know about the increasing importance of antifungals in medicine and some examples of these agents (CSP3)
    10. Compare efficacy and potency
  • Pharmacokinetics and Pharmacodynamics
    1. Describe drug binding sites giving examples of both site and drug that attaches to it.
    2. Define and explain Pharmacokinetics/Pharmacodynamics (CSP3)
    3. 4. Outline how the body composition and organ metabolic changes impact on pharmacology
    4. Understand uses of PK-PD Modelling (CSP3)
    5. Be able to define and discuss the following: affinity; full agonist; partial agonist; neutral agonist; inverse agonist; pure antagonist; potency; efficacy; selectivity; specificity; reversible; irreversible; competitive; non-competitive
    6. Note G-protein-coupled receptors (GPCRs) compose largest group of drug binding sites
    7. Explain some of the mechanisms of actions which underlie both the beneficial and harmful effects of these drugs
    8. Be able to define pharmacokinetics and pharmacodyamics (GEP/BB)
    9. Define Hysteresis and how it is modelled (CSP3)
    10. Explain how long-term corticosteroid therapy disrupts endogenous corticosteroid secretion (GEP/DGM)
    11. Discuss selectivity of drug action
    12. Understand the importance of Pharmacoeconomics (CSP3)
    13. Understand what is meant by structure-action relationships
    14. Distinguish and define pharmacokinetics /pharmacodynamics; liberation; absorption; volume of distribution; distribution; exretion; metabolism; clearance; half life
    15. Understand how outcomes can be improved through use of pharmacodynamics (CSP3)
    16. Distinguish and define half life; narrow / wide therapeutic window; zero order kinetics; first order kinetics; peak levels; trough levels; bioavailability; loading dose, maintenance dose
    17. Compare and contrast routes of drug administration
    18. Define absorption and the various mechanisms
    19. Understand what is meant by pharmacokinetics
    20. Describe various methods of drug formulation resulting in its liberation
    21. Discuss the factors influencing pharmacokinetics
    22. Understand how and where drugs act - give examples
  • Drug Receptor Interactions
    1. Describe how the volume distribution of a drug is calculated and the factors that affect the distribution of a drug in the body (FM1)
    2. Define the terms: agonist, antagonist, EC50, efficacy and potency
    3. Describe the four major classes of receptors (FM1)
    4. Draw idealised concentration vs response curves to distinguish between drugs of high and low potency and/or high and low efficacy
    5. Describe how drug activity can be modified by changes in receptor interactions (FM1)
    6. Describe, with a clinical example, the characteristics of competitive antagonism
    7. Distinguish competitive antagonism from non-competitive and physiological antagonism
  • Drug Absorption and Elimination
    1. Explain drug absorption with reference to the pH-partition hypothesis, as applied to aspirin
    2. Define the term apparent volume of distribution and discuss why drugs have different values for this; explain pre-systemic (first pass) metabolism
    3. Briefly describe the ways in which drugs are eliminated from the body
  • Safe Prescribing and Drug Administration
    1. Understand unit conversion and be able to express percentage concentrations (CSP3)
    2. To increase your awareness of the prevalence of medication incidents in the NHS
    3. Define and identify the steps involved in Drug reconciliation (CSP3)
    4. Define the 10 principles of safe prescribing (CSP3)
    5. By using suitable drug examples discuss the advantages and disadvantages of the following routes of administration: oral, intravenous; intramuscular; subcutaneous; sublingual; rectal; transdermal; inhalation
    6. Recall and describe what BRAINS&AIMS stands for and use the format when presenting a drug.
    7. Focus main learning about drugs ie pharmacology / prescribing (BRAINS&AIMS) around the top 100 Drugs you are most likely to prescribe as a junior doctor
    8. Describe the main routes of drug administration (FM1)
    9. Appreciate the danger of misprescribing.
    10. Interpret drug dosing information in the BNF (CSP3)
    11. Define prescribing error
    12. Classify the error
    13. Learn about key features of other drugs eg interesting mechanisms that help understand underlying physiology; dangerous drugs that may have been prescribed by someone else and affect your patients
    14. Calculate weight-related doses (CSP3)
    15. To highlight the importance of patient safety and how prescribing error is one of the major causes of harm to patients.
    16. Define displacement volume
    17. Identify how to use the BNF to access information about drug treatments (CSP3)
    18. Define in which patients this is needed and where it should be documented (CSP3)
    19. Understand how crucially important they are through illustrated examples
    20. Understand the inputs to the EQUIP enquiry quoted in the lecture, including those concerning the source & frequency of errors.
    21. Identify the routes of administration that lead to 1st pass metabolism and how this contributes to the activity of a drug (FM1)
    22. Keep a portfolio of all the drugs you have learnt about / seen being used in a patient; it takes a long time to build up a good knowledge base so start now and keep revising and building; accept minor modifications if the list changes over time
    23. Calculate IV flow rates for drug infusions (CSP3)
    24. State the difference between formulations of medicine (CSP3)
    25. List the common causes of prescribing errors
    26. Recognise how phase I and phase II reactions contribute to the drugs elimination (FM1)
    27. Know how to record Allergy status (CSP3)
    28. Understand the EQUIP recommendations quoted in the lecture.
    29. Be aware of recent prescribing errors that have occurred in NHS trusts
    30. Manage the above through a series of worked examples (CSP3)
    31. Identify other sources of information about drugs (CSP3)
    32. Describe how dosage regimes affect the activity of a drug (FM1)
    33. Understand the requirements of “Tomorrow’s doctors” regarding prescribing skills of doctors.
    34. Understand the risks involved after seeing a video of a medication incident (CSP3)
    35. Understand the principles of prescribing (CSP3)
    36. Understand the format, syllabus, purpose & significance of the Prescribing Skills Assessment.
    37. Recognise the factors that affect drug interactions (FM1)
    38. Guidelines and policies for antimicrobial prescribing in general (CSP3)
  • Pharmacological Emergencies
    1. Define the ABCDE approach to enable systematic management of emergencies
    2. Recognise the different types/routes of drug poisoning
    3. Understand how and when to use activated charcoal
    4. Understand the acute management principles of the following emergencies: Myocardial infarction, Cardiac failure, Arrythmias, Respiratory failure
    5. Recognise the clinical features of commonly encountered poisoning/overdose scenarios
    6. Understand the management principles of paracetamol, aspirin, opiate and benzodiazepine overdose
  • IV Fluids and Prescribing
    1. State the distribution of fluids in a healthy subject
    2. State the contents of commonly prescribed fluids
    3. State the daily fluid / electrolyte requirements of a healthy 70kg subject
    4. State symptoms and signs consistent with fluid depletion / overload
    5. State potential adverse events related to intravenous fluid therapy
    6. Recognise situations where fluid therapy differs from a healthy subject
    7. Formulate an appropriate intravenous fluid prescription
  • Drug Monitoring (inc. Therapeutic Drug Monitoring)
    1. Be able to apply therapeutic drug monitoring to the following: Vancomycin Digoxin Gentamicin Phenytoin (CSP3)
    2. Be able to distinguish between the following: Narrow therapeutic window, Half life, Wide therapeutic window, Zero order kinetics, First order kinetics, Trough levels (CSP3)
    3. Demonstrate the ability to appropriately adjust dosage regimens by the use of therapeutic drug monitoring (CSP3)
    4. Describe how to obtain information needed to evaluate plasma drug concentrations e.g. time of sample, history of drug administration, concurrent drug therapy, accurate sample (CSP3)
    5. Know that other drugs that may also require therapeutic drug monitoring e.g. Ciclosporin, lithium (CSP3)
    6. Know the impact of pharmacogenetics on drug dosing, give examples (CSP3)
    7. Recognize the differences between wide and narrow therapeutic windows (CSP3)
    8. Understand the rationale of therapeutic drug monitoring as a guide to therapy and outline areas where it is useful (CSP3)
  • Specialist Drugs
    1. Describe the different groups of antiretroviral drugs and their mode of action (I&I 4)
    2. To understand the new biological for RA (LOC2)
    3. Describe examples of the most commonly prescribed antiretroviral drugs including major side-effects and interactions of therapy (I&I 4)
    4. Describe why adherence to ARVs is important (I&I 4)
    5. Review the specific details of development of ARV resistance (I&I 4)
    6. Consider specific difficulties associated with ARVs that have an impact on adherence and resistance including: bioavailability; side-effects (short and long-term); confidentiality; interactions (I&I 4)
  • Adverse Drug Reactions
    1. Describe other unwanted effects arising from long-term therapy with glucocorticoids
    2. Be able to inform the patient of common and serious adverse effects and advise them on what to do.
    3. Define adverse drug reactions (ADRs) (CSP3)
    4. Define and distinguish between pharmacodynamic and pharmacokinetic interactions (CSP3)
    5. Be able to describe different forms of pharmacokinetic interaction: absorption/distribution/metabolism/excretion (CSP3)
    6. To understand the side-effects and how newer drugs can reduce side effects (LOC2)
    7. Be able to prevent adverse drug reactions (ADR's). Using the BNF, learn common and serious ADRs for key drugs prescribed by FY1's; avoid harmful interactions; use prophylaxis if necessary; be aware of susceptible patients; use the appropriate dose regimen
    8. Understand that drug interactions are mostly unwanted and increase patient risk although some are beneficial (CSP3)
    9. To understand the side-effects and how newer drugs can reduce side effects (GEP/M&P)
    10. Give graphic illustrations of some of the serious side effects of corticosteroid use
    11. Know and identify which patients / patient groups have increased susceptibility to adverse effects of certain drugs (A SAD GAP - Age, Sex, Diseases, Genetic, Altered Physiology, pregnancy); take necessary precautions, avoid such drugs or adjust doses
    12. Be able to use appendix 1 of the BNF in order to look up information regarding drug interactions (CSP3)
    13. Know how to classify adverse drug reactions using DOTS - Dose - dependent (Type A); independent (Type b); Time dependent; Independent; Susceptible patients
    14. Know how to diagnose an adverse drug reaction (ADR) and be able to differentiate a suspected ADR from known common and serious ADRs
    15. Know how to treat adverse drug reactions (ADR): stop drug; supportive and /or specific treatments if indicated eg for anaphylaxis
    16. Know which adverse reactions (ADRs) to report and how.
  • Drug Interactions
    1. To describe the basic principles of anti-HIV therapy, including major side-effects and interactions of therapy (I&I 4)
    2. Define pharmacodynamic interactions ie what drugs do to the body.
    3. Define pharmacokinetic interactions ie what the body does to the drug - absorption, distribution, metabolism, excretion
    4. Know how to avoid harmful (adverse) interactions
    5. Know how to identify potential or actual interactions by looking up in Appendix I in the BNF and learning common and important interactions by understanding the mechanisms
    6. Know key drugs that modify pharmacokinetic processes
    7. Use beneficial interactions
    8. Give examples of antimicrobial side effects and interactions (CSP3)
  • Evidence Based Pharmacology
    1. Be aware of the various milestones and pitfalls in drug development (FM1)
    2. Be able to describe the levels of evidence and recommendations for drug therapeutic strategies
    3. Define the phases of clinical trials
    4. Discuss attempts to produce new drugs which work in the same way as steroids but without the side-effects
    5. Be able to describe, discuss and assess harm:benefit ratio
    6. Highlight the central importance of volunteer and patient safety
    7. Understand the importance of the consent process throughout a clinical trial
    8. Be able to define the following: Randomised trial; double blind; multi-centre; placebo-controlled; cohort study; case control study; systematic review/meta-analysis; case-series; risk:benefit ratio; phase 1,2,3,4 trials
    9. Provide an overview of the widespread use of corticosteroids in clinical medicine
    10. Understand the importance of the ten principles of safe prescribing within clinical trials
    11. Understand the limitations of using information from clinical trials eg extrapolating results to individual patients
    12. Be aware of the importance of clear diagnosis and documentation of this
    13. Use evidence obtained from studies to guide drug selection
    14. Understand the need to share the patient’s ideas, concerns and expectations of treatment
    15. Use sources such as BNF, NICE Guidelines, Clinical Evidence, Cochrane Database, medical journals, PubMed to guide drug selection
    16. Be aware that making sure that the patient understands the equipoise that lies at the heart of a comparative trial “what is the question?”
    17. Understand the need to make sure that the patient understands their role in the trial and what is expected from them
    18. Be aware of the need for a clear understanding of medication history and previous adverse reactions or allergies
    19. Be aware of paper and electronic case report forms, study monitoring and audit Be able to describe the roles of endpoint committees and data safety monitoring boards in endpoint trials
    20. Distinguish between audit and regulatory inspection
    21. Be able to describe a clinical trial which has changed clinical practice and guidelines
• Cardiovascular Pharmacology
  • General Outcomes for Cardiovascular Pharmacology
    1. Briefly describe how drugs may be used for treatment of hypertension and angina. (CR1)
    2. Describe the actions of the main groups of treatments used to prevent heart disease.
    3. List the common types of drugs used to control hypertension.
    4. Describe the newer anti-thrombotic agents, e.g. fondaparinux, direct thrombin inhibitors, antiplatelet drugs and thrombolytic agents (CR2)
  • Anticoagulation
    1. Explain the mechanism of action of Heparin, Warfarin, Aspirin and Stroptokinase; indicate under what circumstances it is appropriate to administer them (GEP/CO2)
  • Heart Failure
    1. Understand what is meant by acute and chronic heart failure
    2. Appreciate NICE guidance for chronic heart failure
  • Anaemia
  • IV Fluids
  • Cardiac Arrest and Anti-dysrhythmics
  • Cardiovascular Risk (inc. Hypertension)
    1. Define Essential/Secondary hypertension and CV risk
    2. Understand the difference between primary and secondary prevention of cardiovascular disease
    3. Manage the Therapeutics of hypertension using BHS Guidelines: Non-pharmacological measures; Drug treatment of hypertension
    4. Know the Clinical Pharmacology of the main classes of anti-hypertensives (Thiazides, ACEi & ARBs, CCBs, ?-blockers, MR antagonists)
  • Ischaemic Heart Disease
  • Blood Transfusion
• Respiratory Pharmacology
  • General Outcomes for Respiratory Pharmacology
    1. List and describe the actions of the autonomic nervous system on bronchial smooth muscle and secretory mucosa, relating these actions to the microscopic structure of the airway.
    2. List and give mode of action of agents which induce bronchoconstriction and bronchosecretion.
    3. Outline the consequences of antigen interaction with fixed mast cell antibody and the actions of mediators released from mast cells. (CR1, GEP/CO2)
  • Oxygen and Respiratory Support
    1. Understand the indications and rationale for long term oxygen therapy (LTOT)
  • Asthma and COPD
    1. Discuss the role of pharmacological and non-pharmacological interventions in preventing asthma exacerbations (CR3)
    2. Explain, in terms of modes of action, how various agents can be used in the management of asthma, indicating possible side effects. (CR1, GEP/CO2)
  • Altitude Sickness
• Metabolism (GI, Endocrine and Renal)
  • Diabetic Non-Emergencies
  • Thyroid Disease
  • Adrenal Disease
  • Inflammatory Bowel Diseases
  • Liver Disease
    1. Define the key changes (Pharmacodynamics/pharmacokinetics) in liver disease?
    2. Understand how these changes alter handling of, and responses to drugs?
    3. Manage altered prescribing in liver disease?
    4. Recognise which drugs are potentially damaging to the liver (hepatotoxic) and how?
    5. Recognise which drugs are beneficial in liver disease?
  • PUD, GORD and Dyspepsia
    1. Explain the mechanism of action of a named proton pump inhibitor used in the treatment of ulceration
    2. Outline the use of H2 blocking drugs in the treatment of gastric ulceration
  • Diabetic Emergencies
  • Renal Tract Disease
    1. Be familiar with drugs that are mostly or exclusively renally cleared
    2. Understand the different locations in the nephron that drugs that act on the kidney work
    3. Be familiar with commonly prescribed nephrotoxic drugs and how to monitor them and patients safely
    4. Understand the different types of ADRs on the kidney
    5. Be able to dose-adjust important drugs for patients will renal failure
    6. Know important drugs that are used for bladder and prostate disease
  • Vomiting, Constipation and Diarrhoea
• Human Development (Child Health, Sexual Health, O&G, Healthcare of the Elderly)
  • Contraception and HRT
    1. Describe to a patient methods of emergency contraception, indications and guidance for use (I&I 4)
    2. Demonstrate basic knowledge of currently available contraceptive methods and be able to communicate to patients the mechanisms of action and failure rate (I&I 4)
    3. Manage under supervision or refer as appropriate the contraceptive needs of a patient presenting with a medical condition which may contraindicate the method s/he is currently using (I&I 4)
  • Breastfeeding
  • Prescribing for Children
  • Prescribing for the Elderly
    1. Outline how the body composition and organ metabolic changes impact on pharmacology
  • Pregnancy and Labour
    1. Discuss the pharmacology relevant to the complications of labour (GEP/HD, HD2)
• Brain and Behaviour (Psychiatry, Neuroscience and Ophthalmology)
  • Synaptic Transmission
    1. Describe the neuronal structures involved in synaptic transmission. (BB2)
    2. Describe how the action potential is propagated down a myelinated and unmyelinated axon
    3. Review the various types of receptors (FM1)
    4. Be able to explain how changes in axon diameter and myelination affect the conduction velocity of axons (FM1)
    5. Describe the main steps involved in neurotransmission. (BB2)
    6. Recall how synapses integrate excitatory and inhibitory signals (FM1)
    7. Recall how 2nd messengers transduce for GPCRs
    8. Describe the effects of neurotransmitters at postsynaptic level. (BB2)
    9. Describe how the action potential is converted into a chemical signal at the synapse (FM1)
    10. List and classify major types of neurotransmitters. (BB2)
    11. Describe how sensory information is integrated and a motor response initiated if appropriate (FM1)
    12. Explain why pre-synaptic calcium is important for chemical transmission (FM1)
    13. Review the basic mechanisms underlying neuronal excitability. (BB2)
    14. Compare the effects of excitatory and inhibitory neurotransmitters on the post-synaptic membrane potential (FM1)
  • Dopaminergic Systems
    1. Demonstrate knowledge of therapeutics, pharmacokinetics, side effects and interactions for carbidopa / levodopa (NEURO4)
    2. Describe the dopaminergic pathways in the central nervous system. (BB2)
    3. List and characterise the main types of dopaminergic receptors. (BB2)
    4. Describe the mechanism of action of drugs that act on dopaminergic systems. (BB2)
    5. Review the main circuits involved in the control of movement. (BB2)
  • 5-HT Transmission
    1. Describe the 5-HT pathways in the central nervous system. (BB2)
    2. List and characterise the main types of 5-HT receptors. (BB2)
    3. Describe the mechanism of action of drugs that act on 5-HT systems. (BB2)
  • Drug Dependence and Addiction
    1. Recognise the clinical effects of drugs of abuse
    2. Understand why supportive care is the mainstay of management of drugs of abuse usage
    3. Explain mechanisms underlying pharmacodynamic and pharmacokinetic tolerance. (BB2)
    4. Give examples of major drugs that cause dependence and induce tolerance. (BB2)
  • Psychosis
    1. Describe the pharmacology of typical and atypical antipsychotic drugs
  • Migraine and Dementia
    1. Be able to describe the use of memantine and its rationale.
    2. Be able to discuss new therapeutic approaches in Alzheimer's disease.
  • Depression and Anxiety
    1. Review the neurobiology of depression.
    2. Describe the mechanism of action of benzodiazepines.
    3. Describe the pharmacology of tricyclic antidepressants
    4. Discuss the use of benzodiazepines as anxiolytics, hypnotics and sedatives.
    5. Describe the pharmacology of monoamine oxidase inhibitors
    6. Describe the pharmacology of selective serotonin reuptake inhibitors.
    7. Compare the pharmacological profile of barbiturates and benzodiazepines.
    8. Describe non-benzodiazepine hypnotics and anxiolytics.
  • Epilepsy
    1. Demonstrate knowledge of therapeutics, pharmacokinetics, side effects and interactions for Carbamezapine, Phenytoin & Valproate (NEURO4)
    2. Describe the mechanisms of action, pharmacokinetics and adverse effects of anticonvulsant drugs.
  • Parkinsonism
    1. Demonstrate knowledge of therapeutics, pharmacokinetics, side effects and interactions for carbidopa / levodopa (NEURO4)
• Locomotor (Musculoskeletal and Dermatology)
  • Hypercalcaemia and Osteoporosis
  • Joint and Skin Disease
    1. Recognise and be able to distinguish between: eczema, psoriasis, dermatitis, acne, ulcer, warts
    2. Safely treat common skin conditions
    3. Be familiar with the following medications: aqueous cream and emollients, benzoyl peroxide, vitamin A analogues, tetracyclines, erithromycin and other antibiotics, dithranol, octenisan, topical corticosteroids, vitamin D preparations
    4. Describe important adverse effects or complications of common therapies employed in the treatment of Psoriasis; Eczema and Lichen planus (DERM4)
    5. Recognise that some drugs are for use under only specialist advice and direction
    6. Recognise dermatological adverse reactions
• Infection
  • Bacterial Infection
    1. Antimicrobial therapy (LOC2)
  • Tuberculosis
  • Viral, Parasitic and Fungal Infections
• Cancer and Immunosupression
  • General

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