PST04211 Basic Pharmacology

NTA Level 4 • Semester 2 • PST04211 Description of Vitamins and Minerals Basic Pharmacology • Source Session/Topic 44 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 44: Description of Vitamins and Minerals Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of vitamins and minerals • List Contraindications of vitamins and minerals • Describe dose, dosage and course of vitamins and minerals • List side effects and adverse effects of vitamins and minerals • Describe interactions and precautions of vitamins and minerals Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and projector SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ 2 20 minutes Indications of Vitamins and Minerals Buzzing Presentation/ 3 20 minutes Contraindications of Vitamins and Minerals brainstorming Dose, Dosage and Course of Vitamins and 4 30 minutes Presentation Minerals Presentation/ Side Effects and Adverse Effects of Vitamins 5 20 minutes brainstorming and Minerals Interactions and Precautions of Vitamins and 6 15 minutes Presentation Minerals 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 282 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Vitamins and Minerals (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What are the vitamins and minerals listed in national essential medicine list • What are the indications of Vitamins and Minerals? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Vitamins are organic compounds and a vital nutrients that organisms require in limited amounts • Vitamins and minerals listed in national essential medicine list include: vitamin A, vitamin B complex, vitamin C, vitamin D, vitamin E, vitamin K, calcium and selenium • Indications of Vitamins and Minerals: o Vitamin A, is used for prevention and treatment of ocular defects known as xerophthalmia it is also used as a supplement where diet is known to be inadequate. o Vitamin B complex, is composed of nicotinamide, thiamine and riboflavin. It is used in management of vitamin B complex deficiencies, isoniazid induced neuropathy and penicillin induced neuropathy o Vitamin C is used in prevention and treatment of scurvy o Vitamin D, the term Vitamin D is used for a range of compounds which possess the property of preventing or treating rickets o Vitamin E is indicated for some neuromuscular abnormalities o Vitamin K is used for prevention and treatment of vitamin K deficiency bleeding o Calcium gluconate used in the management of hyperphosphataemia o Selenium is used in management of selenium deficiency PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 283 STEP 3: Contraindications of Vitamins and Minerals (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the Contraindications of Vitamins and Minerals? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Contraindication of vitamin and mineral o Vitamin A, is not contra indicated to any specific group of individual o Vitamin B complex, is not contra indicated to any specific group of individual but should be given with caution because it may cause anaphylactic shock when given by injection o Vitamin C is not contra indicated to any specific group of individual o Vitamin D is contraindicated to people with hypercalcaemia, metastatic calcification o Vitamin E is not contra indicated to any specific group of individual neonate weighing less than 1.5 kg o Vitamin K neonates, infants and women in their late pregnancy. o Calcium is contraindicated to people with all conditions associated with hypercalcaemia and hypercalciuria o Selenium is not contra indicated to any specific group of individual STEP 4: Dose, Dosage and Course of Vitamins and Minerals (30minutes) • Vitamin A, in prevention of vitamin deficiency, child 1 month–5 years, 5 drops daily (5 drops contain vitamin A approx. 700 units, vitamin D approx. 300 units, ascorbic acid approx. 20 mg) until the condition subside • Vitamin B complex, is usually formulated as a tablet contains combination of nicotinamide 15 mg, riboflavin 1 mg, thiamine hydrochloride 1 mg. The dose is usually 1–2 tablets daily • Vitamin C is given prophylactically at the dose 25–75 mg daily; therapeutic, not less than 250 mg daily in divided doses • Vitamin D, is given as oral supplement of only 10 micrograms (400 units) of Ergocalciferol, calciferol, vitamin D2 or colecalciferol daily • Vitamin E it is given as a supplement at the dose of 3 to 5mg daily until the condition subsides • Vitamin K 10–40 mg daily, adjusted as necessary; child 1–12 years, 5–10 mg daily, adjusted as necessary, 12–18 years, 10–20 mg daily, adjusted as necessary PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 284 • Calcium is presented as given orange flavored tablet of calcium carbonate at the dose of 2.5 g daily until the condition is corrected • Selenium is given by mouth or by intramuscular injection or by intravenous injection, 100–500 micrograms daily until the condition is corrected STEP 5: Side Effects and Adverse Effects of Vitamins and Minerals (20 Minute) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the side effects and adverse effects of Vitamins and Minerals ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE

NTA Level 4 • Semester 2 • PST04211 Description of Sera and Immunoglobulin Basic Pharmacology • Source Session/Topic 45 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 45: Description of Sera and Immunoglobulin Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of Sera and Immunoglobulin • List Contraindication of Sera and Immunoglobulin • Describe dose, dosage and course of Sera and Immunoglobulin • List side effects and adverse effects of Sera and Immunoglobulin • Describe interaction and precaution of Sera and Immunoglobulin Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and projector • Handout 32.1: Management of rabies for exposed individuals SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ 2 20 minutes Indications of Sera and Immunoglobulin Buzzing Presentation/ 3 10 minutes Contraindication of Sera and Immunoglobulin brainstorming Dose, Dosage and Course of Sera and 4 40 minutes Presentation Immunoglobulin Presentation/ Side Effects and Adverse Effects of Sera and 5 20 minutes brainstorming Immunoglobulin Interaction and Precaution of Sera and 6 05minutes Presentation Immunoglobulin 7 10 minutes Presentation Key Points 8 10 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 288 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Sera and Immunoglobulin (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following questions for 2 minutes • What are Sera and Immunoglobulins? • What are the indication of sera and immunoglobulins? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below Definition • Antisera o Refers to purified and concentrated preparations of serum of horses actively immunized against a specific antigen o Example are Tetanus antitoxin (ATS), Gas gangrene antitoxin (AGS), Diphtheria antitoxin (ADS), Antirabies serum (ARS) and Antisnake venom polyvalent • Immunoglobulins (lGs) o Refers to a separated human gamma globulins which carry the antibodies o They are more efficacious than the corresponding antisera o Example are normal human gamma globulin, Anti-D immunoglobulin, Tetanus immunoglobulin, Rabies immuneglobulin and Hepatitis-B immunoglobulin Indications • Gamma – Globulins Injection o Indications for its use are viral hepatitis A and B (prophylaxis), measles, mumps, poliomyelitis and chickenpox (prophylaxis and modification of course of illness), and has some beneficial action in burns  It is especially valuable in agammaglobulinemia, premature infants and in patients of leukemia or those undergoing immunosuppression PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 289 • Anti-D(Rho) Immunoglobulin Injection o Prevention of Rho(D) sensitisation to rhesus negative woman • Anti-rabies Immunoglobulin Injection o Post-exposure prophylaxis against rabies infection • Activated Prothrombin o Treatment of bleeding episodes • Factor VII o Treatment of bleeding episodes • Snake venom polyvalent Antiserum injection o Snake bite/Poisoning • Tetanus Immunoglobulin o Post-exposure prophylaxis and treatment of tetanus infection  Indicated for prophylaxis in non-immunized persons receiving a contaminated wound who are at high risk of developing tetanus STEP 3: Contraindications of Sera and Immunoglobulin (10 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the contraindications of sera and immunoglobulin? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • The immunoglobulins o Patients with a history of allergic reactions after administration of human immunoglobulin preparations o Individuals with isolated immunoglobulin A (IgA) deficiency (individuals could have an anaphylactic reaction to subsequent administration of blood products that contain IgA) • The antisera o Patients with hypersensitivity to horse serum or any other component of the serum PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 290 STEP 4: Dose, Dosage and Course of Sera and Immunoglobulin (40 minutes) • Gamma – Globulins Injection o Available as Gamma – Globulins Injection I.V 500mg, 2.5g and 5g o Hereditary haemolytic anaemia  Immunoglobulin IgG 400mg/kg (IV) daily for 5 days o Idiopathic thrombocytopenic Purpura (ITP) for the emergence of acute bleeding caused by severe thrombocytopenia  IV immunoglobulin may be given as a single dose infusion of 0.4-1.0g/kg followed immediately platelets transfusion Splenectomy • Anti-D(Rho) Immunoglobulin Injection o Available as Anti-D(Rho) Immunoglobulin Injection 0.25 mg/ml in set of 5ml o Dose by deep intramuscular injection, to rhesus-negative woman for prevention of Rho(D) sensitisation;  Following birth of rhesus-positive infant: 500 units immediately or within 72 hours  For transplacental bleed of over 4mL fetal red cells: Extra 100–125units per mL fetal red cells  Following any potentially sensitising episode (e.g. stillbirth, abortion, amniocentesis) up to 20 weeks‘ gestation . 250 units per episode (after 20 weeks, 500units) immediately or within 72 hours  Antenatal prophylaxis 500 units given at weeks 28 and 34 of pregnancy; if infant rhesus-positive, a further dose is still needed immediately or within 72 hours of delivery  Following Rho(D) incompatible blood transfusion 100–125 units per mL transfused rhesus-positive red cells • Anti-rabies Immunoglobulin Injection o Available as Anti-rabies Immunoglobulin Injection 1000 IU/5ml ampoule o Passive immunization of rabies  Anti-rabies human immunoglobulin 20 IU/kg half the dose given parenterally and the other half injected into and around the wound o Active immunization of rabies  Rabies immunoglobulin with the first dose (day 0) Tetanus toxoid vaccine Refer students to Handout 31.1: Management of rabies for exposed individuals for further reading • Activated Prothrombin o Treatment of bleeding episodes o Activated Prothrombin Complex Concentrate (APCC) 50-100IU/kg every12-24hrs • Factor VII PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

NTA Level 4 • Semester 2 • PST04211 Description of Vaccines for Immunization ………………………………….297 Basic Pharmacology • Source Session/Topic 46 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 46: Description of Vaccines for Immunization ………………………………….297 PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide iii Background There is currently an ever increasing demand for pharmaceutical personnel in Tanzania. This is due to expanding investment in public and private pharmaceutical sector. Shortage of trained pharmaceutical human resource contributes to poor quality of pharmaceutical services and low access to medicines in the country (GIZ, 2012). Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with Development Partners (DPs) in Germany and Pharmaceutical Training Institutions (PTIs) worked together to address the shortage of human resource for pharmacy by designing a project named “Supporting Training Institutions for Improved Pharmaceutical Services in Tanzania‖ in order to improve quality and capacity of PTIs in training, particularly of lower cadre pharmaceutical personnel. The Pharmacy Council formed a Steering committee that conducted a stakeholders workshop from 18th – 22ndAugust 2014 in Morogoro to initiate the implementation of the project. Key activities in the implementation of this project included carrying out situational analysis, curriculum review and harmonization, development of training manual/facilitators guide, development of assessment plan, training of trainers and supportive supervision. After the curricula were reviwed and harmonized, the process of developing standardised training materials was started in August 2015 through Writer‘s Workshop approach. The approach included two workshops (of two weeks each) for developing draft documents and a one-week workshop for reviewing, editing and formatting the sessions of the modules. The goals of writers workshops were to build capacity of tutors in the development of training materials and to develop high-quality, standardized teaching materials. The training package for pharmacy cadres includes a facilitator guide, assessment plan and practicum. There are 12 modules for NTA level 4 making 12 facilitator guides and one practicum guide. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide iv Acknowledgment The development of standardized training materials of a competence-based curriculum for pharmaceutical sciences has been accomplished through involvement of different stakeholders. Special thanks go to the Pharmacy Council for spearheading the harmonization of training materials in the pharmacy after noticing that training institutions in Tanzania were using different curricula and train their students differently. I would also like to extend my gratitude to St. Luke Foundation (SLF)/Kilimanjaro School of Pharmacy –Moshi for their tireless efforts to mobilize funds from development partners. Special thanks to John Snow Inc (JSI), Deutsche GesellschaftFür Internationale Zusammenarbeit (GIZ), Merck Kgaa, BoehringerIngelheimGmbhand Bayer Pharma Ag and action medeor.V for the financial and technical support. Particular thanks are due to those who led this important process to its completion, Mrs Stella M. Mpanda Director, Childbirth Survival Intenational, and Members from the secretariat of National Council for Technical Education (NACTE) for facilitating the process. Finally, I very much appreciate the contributions of the tutors and content experts representing PTIs, hospitals, and other health training institutions. Their participation in meetings and workshops, and their input in the development of this training manual/facilitators guide have been invaluable. These participants are listed with our gratitude below: Mr.Wilson Mlaki DSt. Luke Foundation/Kilimanjaro School of Pharmacy Mr.Samwel M. Zakayo- Pharmacy Council Ms. Ester A. Tuarira MUHAS Ms. Tumaini H. Lyombe MUHAS PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide v Ms. Dilisi J. Makawia KSP Ms. Julieth Koimerek KSP Rev. Baraka A.M. Kabudi MEMS Mr. Kelvin E. Mtanililwa Royal Pharmaceutical Training Institute Ms. Rose Bulilo CEDHA Ms. Diana H. Gamuya CEDHA Dr.Melkiory Masatu CEDHA Mr. Habel A. Habel City College of Health and Allied Sciences Ms. Zaina Msami Meru District Council Director of Human Resources Development Ministry of Health, Community Development, Gender, Elderly and Children PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide vi Introduction Module Overview This module content is a guide for tutors of Pharmaceutical schools for training of students. The session contents are based on sub-enabling outcomes and their related tasks of the curriculum for Basic Technician Course in Pharmaceutical Sciences. The module sub- enabling outcomes and their related tasks are as indicated in the in the Basic Technician Certificate in Pharmaceutical Sciences (NTA Level 4) Curriculum Target Audience This module is intended for use primarily by tutors of pharmaceutical schools. The module‘s sessions give guidance on the time, activities and provide information on how to teach the session. The sessions include different activities which focus on increasing students‘ knowledge, skills and attitudes. Organization of the Module The module consists of forty six (46) sessions; each session is divided into several parts as indicated below: • Session Title: The name of the session • Total Session Time: The estimated time for teaching the session, indicated in minutes • Pre-requisites: A module or session which needs to be covered before teaching the session. • Learning Tasks: Statements which indicate what the student is expected to learn by the end of the session • Resources Needed: All resources needed for the session are listed including handouts and worksheets • Session Overview: The session overview box lists the steps, time for each step, the activity or method used in each step and the step title • Session Content: All the session contents are divided into steps. Each step has a heading and an estimated time to teach that step as shown in the overview box. Also, this section includes instructions for the tutor and activities with their instructions to be done during teaching of the contents • Key Points: Key messages for concluding the session contents at the end of a session This step summarizes the main points and ideas from the session, based on the learning tasks of the sssion • Evaluation: The last section of the session consists of short questions based on the learning tasks to check the understanding of students. •

NTA Level 4 • Semester 2 • PST04211 Description of Antifungal Drugs Basic Pharmacology • Source Session/Topic 13 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 13: Description of Antifungal Drugs Total Session Time: 120 minutes Prerequisites module • None Learning Tasks By the end of this session students are expected to be able to: • List indications of systemic and mucosal antifungal drugs • List contraindications of systemic and mucosal antifungal drugs • Describe dose, dosage and course of systemic and mucosal antifungal drugs • List side effects and adverse effects of systemic and mucosal antifungal drugs • Describe interactions and precautions of systemic and mucosal antifungal drugs Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Overhead projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ Indications of Systemic and Mucosal 2 20 minutes Buzzing Antifungal Drugs Presentation/ Contraindications of Systemic and Mucosal 3 20 minutes Brainstorming Antifungal Drugs Dose, Dosage and Course of Systemic and 4 30 minutes Presentation Mucosal Antifungal Drugs Presentation/ Side Effects and Adverse Effects of Systemic 5 20 minutes Brainstorming and Mucosal Antifungal Drugs Interactions and Precautions of Systemic and 6 15 minutes Presentation Mucosal Antifungal Drugs 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 75 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Antifungal Drugs (20 Minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What are the indications of antifungal drugs? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Amphotericin B o Is useful agent for nearly all life-threatening mycotic infections o It is often used as the initial induction regimen for serious fungal infections and is then replaced by one of the newer fluconazole o Is s especially important for immunosuppressed patients and those with severe fungal pneumonia, cryptococcal meningitis with altered mental status, or sepsis syndrome due to fungal infections • Clotrimazole, Miconazole and Fluconazole o Are useful agents in management of candida species, Cryptococcus neoformans, the endemic mycoses (blastomycosis, coccidioidomycosis and histoplasmosis) • Griseofulvin is only use is in the systemic treatment of dermatophytosis example infections of the skin, scalp, hair and nails where topical therapy has failed or is inappropriate • Nystatin used in treatment of oral candidiasis; and skin infection PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 76 STEP 3: Contraindications of Antifungal Drugs (20 Minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are contraindications of antifungal drugs? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Amphotericin B is not contraindicated to specific group of individual • Clotrimazole, Miconazole and Fluconazole are contraindicated in acute porphyria, hepatic impairment and breast-feeding • Griseofulvin is contraindicated to people with severe liver disease; systemic lupus erythematosus acute, porphyria, pregnancy (avoid pregnancy during and for 1 month after treatment men should not father children within 6 months of treatment) and breast- feeding • Nystatin is not contraindicated to specific group of individual STEP 4: Dose, Dosage and Course of Systemic and Mucosal Antifungal Drugs (30minutes) • Amphotericin B lozenges taken 4 times daily. Allowed to dissolve slowly in the mouth for 10–15 days (continued for 48 hours after lesions have resolved); increased to 8 daily in severe infection • Clotrimazole o 2% cream for vaginal candidiasis. Applied twice a day for 7 days • Miconazole o Topical: 2% cream, is used for vaginal candidiasis, vulvovaginal candidiasis and candidal balanitis o 200 mg vaginal suppositories is used for vaginal candidiasis o The drug is applied twice daily for 5 to 7 days • Fluconazole o Vaginal candidiasis, Vulvovaginal Candidiasis, and candidal balanitis, ADULT and children over 16 years, by mouth, a single dose of 150 mg. o Mucosal candidiasis (except genital), by mouth, 50 mg daily (100 mg daily in unusually difficult infections) given for 7–14 days in oropharyngeal candidiasis PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 77 • Griseofulvin o Dermatophyte infections, 500 mg once daily or in divided doses o In severe infection dose may be doubled, the dose need to be reduced when response occurs children under 50 kg, 10 mg/kg once daily or in divided doses o Tinea capitis caused by Trichophyton tonsurans, 1g once daily or in divided doses children under 50 kg, 15– 20 mg/kg once daily or in divided doses o Treatment should continue for not less than 21 days • Nystatin o Treatment for adult and children suffering from oral pharyngeal candidiasis 100 000 units 4 times daily after food, usually for 7 days (continued for 48 hours after lesions have resolved) STEP 5: Side Effects and Adverse Effects of Antifungal Drugs (20 Minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the side effects and adverse effects of antifungal drugs? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Amphotericin B o When given parenterally it causes anorexia, nausea and vomiting, diarrhoea, epigastric pain, febrile reactions, headache, muscle and joint pain, anaemia disturbances in renal function and renal toxicity • Clotrimazole o The most common adverse reaction is relatively minor gastrointestinal upset and, very rarely, clinical hepatitis • Miconazole o Causes nausea, vomiting; rash; with buccal tablets o

NTA Level 4 • Semester 2 • PST04211 General Classification of Medicines Basic Pharmacology • Source Session/Topic 2 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 2: General Classification of Medicines Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define pharmacological classes of essential medicines • Describe pharmacological classes of essential medicines Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and overhead projector where necessary SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Learning Tasks Definition of Pharmacological Classes of 2 40 minutes Presentation/buzzing Essential Medicines Presentation/small Description Pharmacological Classes of 3 65 minutes group discussion Essential Medicines 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 8 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Definitions of pharmacological classes of essential medicine (40 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question • What are the pharmacological classes of medicines? ALLOW few pairs to respond and let other pairs add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • There are several pharmacological classes of medicines which are listed in the National essential drug lists. The classes include: o Anaethetics which are used in surgery and intubation o Muscle relaxants which are used in surgery o Analgesics which are used in management of pain and fever o Anti allergies which are used in management of allergic reactions o Antidotes which are used in counteracting the effects of a particular poison o Anti epileptic which are used in management of epilepsy o Anti infective which are used in management of various types of infections o Anti-neoplastic/immunosuppressive drugs which are used in immunosuppression especially during organ transplant and management of some cancers o Ant parkinsonism which are used in management of Parkinson‘s disease o Blood boaster which are used in management of anemia o Anti coagulants which are used as blood thinner and management of thrombosis o Cardiovascular medicines which are used in management of heart and problems associated with blood vessels o Dermatological medicines which are used in management of skin diseases o Gastro intestinal medicines which are used in management of problems in gastrointestinal tracts o Hormone and antidiabetic medicines which are used in management of diabetes and other hormonal diseases o Vaccines which are used in prevention of diseases PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 9 o Ophthalmological preparations which are used in management of eye diseases o Medicine used in ear and nose which are used in management of ear and nose problems o Oxytocics which are used in management of delayed labour o Psychotherapeutics which are used in management of psychiatric conditions o Medicines acting on the respiratory tracts which are used in management of diseases associated with respiratory system o Solution correcting water and electrolyte which are used in management of fluid and electrolyte imbalances o Vitamins and minerals which are used in management of vitamin and mineral deficiency STEP 3: Description Of Pharmacological Classes of Essential Medicines (65 Minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • How do we describe pharmacological classes of essential medicines? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Pharmacological classes of medicines include drugs which have similar functions. Examples of drugs with similar functions are: o Anaethetics include general anaesthetic (halothane, ketamine, isoflurane and thiopental) and local anaesthetics ( lignocaine and bupivacaine) o Muscle relaxants include gallamine, neostigmine, pancuronium, suxamethonium o Analgesics is for pain relief and include aspirin, paracetamol, diclofenac, ibuprofen, indomethazine, piroxicam, mefenamic acid, naproxen, they also have antpyretic and antinflammatory effects, narcotics such as tromadol are pain relief and they act in the central nervous system o Anti allergies such as chlorpheniramine, loratadine, cetirizine, adrenaline, dopamine hydrocortisone, promethazine, dexamethasone are used in management of allergic reactions o Antidotes such as ipecacuanha, activated charcoal, magnesium salt and antivenom used in counteracting the effects of poisons o Anti epileptics (carbamazepine, diazepam, Phenobarbital, phenytoin and magnesium sulphate) are used in management of epilepsy PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 10 o Anti-neoplastic/immunosuppressive ( cyclophosphamide, rituximub and prednisolone) are used in immunosuppression especially during organ transplant and management of some cancers o Antiparkinsonism such as benzhexol, biperidine, bromocriptine and carbidopa are used in management of Parkinson‘s disease o Blood boaster such as ferrous sulphate, folic acid and vitamin B12 are used in management of anemia o Anti coagulants such as aspirin, activated prothrombin, enoxaparin sodium, heparin, vitamin K, protamin sulphate, streptokinase, alteplase, frozen plasma, factor viii and factor ix are used as blood thinner and management of thrombosis o Cardiovascular medicine; drugs used in management of heart disease and problems associated with blood vessels, they include:  Anti anginal drugs ( glyceryl trinitrate, isosorbide mono/dinitrate, nifedipine, clopidegral and propranolol), used in management of angina  Anti arrythimic drugs, (amiodarone, verapamil, adenosine and lidocaine) are used in management of cardiac arrhythmias  Anti-hypertensivesuch as methyldopa, captopril, nifedipine, atenolol, propranolol, labetalol, bumetanide, peridopril, carvediol, metoprolol, amlodipine, hydralazine and bisoprolol are used in management of hypertension  Cardiac Glycosides such as digoxine is used in management of congestive heart failure  Diurects such as frusemide, bendrofluazide, spironolactone, mannitol and glycerol syrup are used in management of hypertension and extracellular edema  Lipid Lowering such as simvastatin and atovastatin are used in lowering cholesterol level in

NTA Level 4 • Semester 2 • PST04211 Description of Anti-infective Medicines Basic Pharmacology • Source Session/Topic 3 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 3: Description of Anti-infective Medicines Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define anti-infective medicine • Describe pharmacological classes of anti-infective medicine Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and overhead projector where necessary SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ 2 40 minutes Definition of Anti Infective Medicine Buzzing Presentation/ Description of Pharmacological Classes of 3 65 minutes small group Anti Infective Medicine discussion 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 15 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Definitions of Pharmacological Classes of Essential Medicine (40 Minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What is anti-infective medicine? ALLOW few pairs to respond and let other pairs add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Ant –infective medicines are those medicines used to fight against organisms that cause infections • Drug, anti-infective: Something capable of acting against infection, by inhibiting the spread of an infectious agent or by killing the infectious agent outright • . Anti-infective is a general term that encompasses antibacterials, antibiotics, antifungals, antiprotozoans and antivirals. STEP 3: Description of Pharmacological Classes of Anti Infective Medicine (65 Minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • List the pharmacological classes of anti-infective medicines? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 16 • There are several pharmacological classes of anti-infective medicine which are listed in the National essential drug lists. The classes include: o Antibacterial : used in treatment of various bacterial infection groups of antbacterials include aminoglycosides, antitubaculosis and leprosy, fluoroquinolones, peniciliins and cephalosporins, macrolides, chloramphenical, tetracyclines, o Antiprotozoans: used to treat protozoans infections such as mamoebiasis, filariasis, leishmaniasis, malaria, and schistosomiasis and trypanosomiasis o Ant helminthes: used in treatment of various worm infestation o Fungicides (Systemic and Mucosal): used in management of systemic and mucosal fungal infection o Antiviral: used to treat viral infection STEP 7: Key Points (5 Minutes) • In pharmacological classification, anti-infective drugs are grouped according to similarity indication • The definition of anti-infective drugs are based on their pharmacological action STEP 7: Evaluation (5 Minutes) • What is ant-infective medicine? • What are the main groups of ant-infective medicines? PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 17 References Ministry of Health and Social Welfare. (2013). Standard Treatment Guidelines & National Essential Medicines List Tanzania Mainland (4th ed.). Dar es salaam, Tanzania government printers. Robert, L., Talbert, Gary C. Yee, Gary R., Matzke, Barbara, G., Wells, L. Michael. (2014). Pharmacotherapy: A Pathophysiologic Approach (9th ed.). New York, McGraw-Hill Education. Sally S.R, Jeanne C.S. (2000). Introductory Clinical Pharmacology (6th ed) New York, Lippincott Williams and Wilkins. School of Pharmaceutical sciences. (2011).Tanzania Pharmaceutical Handbook (2nd ed.). Dar es Salaam, ARDHI University press. The Royal Pharmaceutical Society of Great Britain. (2007). Martindale, the Extra Pharmacopoeia (5TH ed). London, pharmaceutical press. The Royal Pharmaceutical Society of Great Britain. (2009). British National Formulary (59th ed). London, BMJ Group and RPS Publishing. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 18 PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 19 ← Previous TopicNext Topic →View all Basic Pharmacology topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 4 • Semester 2 • PST04211 Description of Penicillin and Cephalosporins Basic Pharmacology • Source Session/Topic 4 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 4: Description of Penicillin and Cephalosporins Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of penicillins and cephalosporins • List contraindications of penicillin and cephalosporins • Describe dose, dosage and course of penicillins and cephalosporins • List side effects and adverse effects of penicillins and cephalosporins • Describe interactions and precautions of penicillins and cephalosporins Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Overhead projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning tasks Presentation/ 2 20 minutes Indications of Penicillins and Cephalosporins Buzzing Presentation/ Contraindications of Penicillins and 3 20 minutes Brainstorming Cephalosporins Dose, Dosage and Course of Penicillins and 4 30 minutes Presentation Cephalosporins Presentation/ Listing side effects and adverse effects of 5 20 minutes Brainstorming Penicillins and Cephalosporins Drugs Description of interactions and precautions of 6 15 minutes Presentation Penicillins and Cephalosporin Drugs 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 20 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Penicillins and Cephalosporins (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following questions for 2 minutes • Mention commonly used penicillins and cephalosporins • What are indications for cephalosporins and penicillins? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below The remarkably powerful and specific activity of antimicrobial drugs is due to their selectivity for targets that are either unique to microorganisms or much more important in them than in humans • Penicillins: o Have greatest activity against gram-positive organisms, gram-negative cocci, and non-lactamase-producing anaerobes. o However, they have little activity against gram-negative rods, o They are active against staphylococci and streptococci but not against enterococci, anaerobic bacteria, and gram-negative cocci and rods. o Extended-spectrum penicillins (ampicillin and the antipseudomonal penicillins) retain the antibacterial spectrum of penicillin and have improved activity against gram-negative organisms o Commonly used Penicillins include:  Amoxicillin  Flucloxacillin  Benzyl penicillin  Procaine penicillin  Ampicillin PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 21 • Cephalosporins: o similar to penicillins o But more stable to many bacterial lactamases o Therefore have a broader spectrum of activity o However, strains of E coli and Klebsiella species expressing extended-spectrum lactamases that can hydrolyze most cephalosporins are becoming a problem o Cephalosporins are not active against enterococci and L monocytogenes o Commonly used Cephalosporins include:  Cefuroxime  Cefotaxime  Ceftriaxone  Cefalexin  Cefradoxil STEP 3: Contraindications of Penicillins and Cephalosporins (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: What are contraindications of penicillins and cephalosporins? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Penicillins are contraindicated: o In patients with renal failure o In patients with penicillin hypersensitivity • Cephalosporins are contraindicated: o In patients with cephalosporin hypersensitivity o In patients with a history of anaphylaxis to penicillins STEP 4: Dose, Dosage and Course of Penicillins and Cephalosporins (30 minutes) • Penicillins o Amoxicillin 250-500mg every 6hourly for 5-7 days o Ampicillin 250-500mg every 6hourly for 5-7 days o Penicillin G up to 2.4mU/dose I.M • Cephalosporins o Orally PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 22  Cephalexin is given orally in dosages of 0.25-0.5 g four times daily (15-30 mg/kg/d)  Cefadroxil in dosages of 0.5-1 g twice daily. o Parenterally  The usual intravenous dosage for adults is 0.5-2 g intravenously every 8 hours.  can also be administered intramuscularly STEP 4: Side Effects and Adverse Effects of Penicillins and Cephalosporins (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are side effects and adverse effects of penicillins and cephalosporins? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Penicillin o Adverse effects and side effects:  The penicillins are remarkably nontoxic  Most of the serious adverse effects are due to hypersensitivity.  All penicillins are cross-sensitizing and cross-reacting  Allergic reactions include anaphylactic shock (serum sickness-type reactions, urticaria, fever, joint swelling, angioneurotic edema, intense pruritus, and respiratory embarrassment variety of skin rashes  Oral lesions, fever, interstitial nephritis vasculitis may also occur  Most patients allergic to penicillins can be treated with alternative drugs • Cephalosporins o Adverse effects and side effects:  Cephalosporins are sensitizing and may elicit a variety of hypersensitivity reactions that are identical to those of penicillins  These include anaphylaxis, fever, skin rashes, nephritis, granulocytopenia, and hemolytic anemia  Local irritation can produce severe pain after intramuscular injection and thrombophlebitis after intravenous injection  Renal toxicity, including interstitial nephritis and even tubular necrosis. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 23 STEP 5: Interactions and Precautions of Penicillins and Cephalosporins (15 minutes) • Penicillins o Interactions  Reduce excretion of cytotoxic like methotrexate  Allopurinol increases risk of rash when used with amoxicillin or ampicillin  Effects of anticoagulants are altered by penicillin o Precautions  History of allergy  Most patients allergic to penicillins can be treated with alternative drugs. • Cephalosporins o Interaction and precaution 

NTA Level 4 • Semester 2 • PST04211 Description of Macrolide Drugs Basic Pharmacology • Source Session/Topic 5 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 5: Description of Macrolide Drugs Total Session Time: 60 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of Macrolide Drugs • List Contraindications of Macrolide Drugs • Describe dose, dosage and course of Macrolidede Drugs • List side effects and adverse effects of Macrolide Drugs • Describe interactions and precautions of Macrolide Drugs Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ 2 10 minutes Indications of Macrolide Drugs Buzzing Presentation/ 3 10 minutes Contraindications of MacrolideDrugs brainstorming The dose, Dosage and Course of Macrolide 4 10minutes Presentation Macrolide Drugs Presentation/ The Side Effects and Adverse Effects of 5 10 minutes brainstorming Macrolide Drugs Interactions and Precautions of Macrolide 6 05minutes Presentation Drugs 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 26 SESSION CONTENTS STEP1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Macrolide Drugs (10minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What are macrolide antibiotics? • What are the indications of Macrolide drugs? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZEby using the content below • Macrolide antibiotics includes: o Erythromycin o Clarithromycin o Azithromycin • The indication of the macrolides: o Are effective against gram-positive organisms, especially pneumococci, streptococci, staphylococci, and corynebacteria o Also effective to Mycoplasma, legionella, Chlamydia trachomatis, Chlamydia psittaci, Chlamydia pneumoniae, helicobacter, listeria, and certain mycobacteria (Mycobacterium kansasii, M scrofulaceum) o Gram-negative organisms such as Neisseria sp, Bordetella pertussis, Bartonella henselae, and B quintana (etiologic agents of cat-scratch disease and bacillary angiomatosis) some rickettsia sp, Treponema pallidum, and campylobacter sp are susceptible. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 27 STEP 3: Contraindication of Macrolide Drugs (10minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the contraindications of Macrolide drugs? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Erythromycin is contraindicated in: o In patient with hepatic impairment o In patient with Renal impairment • Clarithromycin is contraindicated in: o Pregnancy o Hepatic dysfunction o Renal impairment • Azithromycin are contraindicated in: o Breastfeeding o Pregnancy o Hepatic dysfunction o Renal impairment STEP 4: Dose, Dosage and Course of Macrolide drugs (10minutes) • Erythromycin o The oral dosage of erythromycin base is250-500mg every 6 hours (for children, 40 mg/kg/d) o Over 8 years 250-500mg every six hoursOr 4000mg daily in divided doses in severe infection o The dosage of erythromycin ethylsuccinate is 400-600mg every 6 hours o Oral erythromycin base (1 g) is sometimes combined with oral neomycin or kanamycin for preoperative preparation of the colon o The intravenous dosage of erythromycin gluceptate or lactobionate is 500-1000 mg every 6 hours for adults and 20-40 mg/kg/d for children PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 28 • Azithromycin o 500mg once daily for 3three days o 500mg on the firstday then250mg once daily for 4 days o Child over 6 month 10mg/kg once daily for 3 days • Clarithromycin o 250mg every 12 hours for seven days o In severe infections 500mg 12hourly for 14 days o Intravenously infusion 500mg twice daily STEP 5:Side Effects and Adverse Effects of Macrolide Drugs(10 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the side effects and adverse effects of macrolide drugs? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below The following are the side effects/adverse effects of macrolides drugs: • Anorexia, nausea, vomiting, and Diarrhoea occasionally accompany oral administration • Gastrointestinal intolerance, which is due to a direct stimulation of gut motility, • Can produce acute cholestatic hepatitis (fever, jaundice, impaired liver function) • Other allergic reactions include fever, eosinophilia, and rashes STEP 6: Interaction and Precaution of Essential Macrolide drugs(5min) • Interaction and precaution: o Erythromycin metabolites can inhibit cytochrome P450 enzymes thus increase the serum concentrations of theophylline, oral anticoagulants, cyclosporine, and methylprednisolone o Erythromycin increases serum concentrations of oral digoxin by increasing its bioavailability PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 29 Step 7: Key Points (5 minutes) • Macrolide drugs includes erythromycin,Clarithromycin and azithromycin • Macrolides are effective against gram-positive organisms, especially pneumococci, streptococci, staphylococci, and corynebacteria • Macrolides are contraindicated in: Pregnancy, Hepatic dysfunction Renal impairment • Macrolides can be given orally or by injection • Common side effects of Macrolides are Anorexia, nausea, vomiting, and Diarrhoeadiarrhoea • Macrolides increases effects of many drugs like digoxin and theophylline STEP 8: Evaluation (5 minutes) • What are the indications of Macrolide drug? • What are the Contraindications of Macrolide drugs? • What are the dose, dosage and course of Macrolide drugs? • What are side effects and adverse effects of Macrolide drugs? • What are the interactions and precautions of Macrolide drugs? PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 30 References Robert, L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells& L. Michael. (2014). Pharmacotherapy: a pathophysiologic approach (9thed.). New York, McGraw-Hill Education. Ministry Of Health and Social Welfare. ( 2013). Standard

NTA Level 4 • Semester 2 • PST04211 Description of Aminoglycoside Drugs Basic Pharmacology • Source Session/Topic 6 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 6: Description of Aminoglycoside Drugs Total Session Time: 120 minutes Prerequisites • Session 3: General Classification of Essential Medicine Learning Tasks By the end of this session students are expected to be able to: • List indications of aminoglycosides • List contraindications of aminoglycosides • Describe dose, dosage and course of aminoglycosides • List side effects and adverse effects of aminoglycosides • Describe interactions and precautions of aminoglycosides Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning tasks Presentation/ 2 20 minutes Indications of Aminoglycosides Buzzing Presentation/ 3 20 minutes Contraindications of Aminoglycosides Brainstorming 4 30 minutes Presentation Dose, Dosage and Course of Aminoglycosides Presentation/ Side Effects and Adverse Effects of 5 20 minutes Brainstorming Aminoglycosides Interactions and Precautions of 6 15 minutes Presentation Aminoglycosides 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 32 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Aminoglycosides (20minutes) Activity: Buzzing (5minutes) ASK students to pair up and buzz on the following questions for 2 minutes • What are the types of aminoglycosides? • What are the indications of aminoglycosides? ALLOW few pairs to respond and let other pairs add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • The aminoglycosides include streptomycin, neomycin, kanamycin, amikacin, gentamicin, tobramycin • All aminoglycosides are bactericidal and active against some Gram-positive and many Gram-negative organisms • Amikacin, gentamicin, and tobramycin are also active against Pseudomonas aeruginosa • Streptomycin is active against Mycobacterium tuberculosis and is now almost entirely reserved for tuberculosis STEP 3: Contraindications of Aminoglycosides (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are contraindications of aminoglycosides? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 33 • The aminoglycosides are contraindicated in: o Myasthenia gravis o In patients with renal failure o Hearing impairment o Pregnancy STEP 4: Dose, Dosage and Course of Aminoglycoside (30 minutes) The following are the commonly dose, dosage and courses of common aminoglycosides o Gentamycin Multiple daily dose regimen, by intramuscular or by slow intravenous injection over at least 3 minutes or by intravenous infusion, 3–5 mg/kg daily (in divided doses every 8 hours) o Neomycin Given by mouth, pre-operative bowel sterilisation, 1 g every hour for 4 hours, then 1 g every 4 hours for 2–3 days, for Hepatic coma, up to 4 g daily in divided doses usually for 5–7 days o Amikacin Given by intramuscular or by slow intravenous injection or by infusion, 15 mg/kg daily in 2 divided doses, can be increased to 22.5 mg/kg daily in 3 divided doses in severe infections; max. 1.5 g daily for up to 10 days (max. cumulative dose 15 g) STEP 4: Side Effects and Adverse Effects of Aminoglycosides (20minutes) Activity: Brainstorming (5 minutes) ASK students to brainstorm on the following question: • What are the common side effects/ adverse effects of aminoglycosides?‖ ALLOW few learners to respond WRITE their responses on the flipchart SUMMARIZE the discussion by the following information All aminoglycosides are ototoxic and nephrotoxic • This is more likely to be encountered when therapy is continued for more than 5 days, at higher doses, in the elderly, and in the setting of renal insufficiency) • Neomycin, kanamycin, and amikacin are the most ototoxic agents • Streptomycin and gentamicin are the most vestibulotoxic • Neomycin, tobramycin, and gentamicin are the most nephrotoxic PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 34 STEP 5: Interactions and Precautions of Aminoglycosides (15minutes) Interaction and precaution of the aminoglycosides • Concurrent use with: loop diuretics eg, furosemide, ethacrynic acid • Other nephrotoxic antimicrobial agents eg, vancomycin or amphotericin) potentiates nephrotoxicity • The above drugs should be avoided if possible when using aminoglycosides Step 6: Key Points (5minutes) • Commonly used Aminoglycosides are: streptomycin, neomycin, kanamycin, amikacin, gentamicin, tobramycin • Aminoglycosides are active against gram-negative enteric bacteria • Aminoglycosides are contraindicated in myasthenia gravis, renal and hearing problems • Aminoglycosides are mainly given by injection STEP 7: Evaluation (5minutes) • What are the indications of aminoglycoside drugs? • What are the contraindications of aminoglycoside drugs? • What are the common side effects of aminoglycoside drugs? PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 35 References Ministry Of Health and Social Welfare. (2013). Standard Treatment Guidelines & National Essential Medicines List Tanzania Mainland (4th ed.). Dar es salaam, Tanzania government printers. Robert, L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael. (2014). Pharmacotherapy: A Pathophysiologic Approach (9th ed.). New York, McGraw-Hill Education. Sally, S.R, Jeanne C.S. (2000). Introductory Clinical Pharmacology (6th ed) New York, Lippincott Williams and Wilkins. School of Pharmaceutical sciences. (2011). Tanzania Pharmaceutical Handbook (2nd ed.). Dar es Salaam, ARDHI University press. The Royal Pharmaceutical Society of Great Britain. (2007). Martindale, the Extra Pharmacopoeia (5TH ed). London, pharmaceutical press. The Royal Pharmaceutical Society of Great Britain. (2009). British National Formulary (59th ed). London, BMJ Group and RPS Publishing. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 36 PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 37 ← Previous TopicNext Topic →View all Basic Pharmacology topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa

NTA Level 4 • Semester 2 • PST04211 Description of Fluoroquinolone Drugs Basic Pharmacology • Source Session/Topic 7 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 7: Description of Fluoroquinolone Drugs Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of Fluoroquinolone Drugs • List Contraindication of Fluoroquinolone Drugs • Describe dose, dosage and course of Fluoroquinolone Drugs • List side effects and adverse effects of Fluoroquinolone Drugs • Describe interaction and precaution of Fluoroquinolone Drugs Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and projector SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning tasks Presentation/ Indications of Fluoroquinolone 2 20 minutes Buzzing Drugs Presentation/ Contraindication of Fluoroquinolone 3 20 minutes brainstorming Drugs 4 30 minutes Presentation Dose, Dosage and Course of Fluoroquinolone Drugs Presentation/ Side Effects and Adverse Effects of 5 20 minutes brainstorming Fluoroquinolone Drugs Interaction and Precaution of Fluoroquinolone 6 15 minutes Presentation Drugs 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 38 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Fluoroquinolone Drugs (20minutes) Activity: Buzzing (5 minutes) Ask students to pair up and buzz on the following questions: • What are the Fluoroquinolone drugs? • What are the indications of Fluoroquinolone drugs? ALLOW few pairs to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Fluoroquinolones include Nalidixic acid, norfloxacin, ciprofloxacin, oxfloxacin and levofloxacin • The remarkably powerful and specific activity of antimicrobial drugs is due to their selectivity for targets that are either unique to microorganisms or much more important in them than in humans • Fluoroquinolones are active against a variety of gram-positive and gram-negative bacteria • Nalidixic acid and norfloxacin are effective in uncomplicated urinary-tract infections. • Ciprofloxacin is active against both Gram-positive and Gram-negative bacteria. It is particularly active against Gram-negative bacteria, including salmonella, shigella,campylobacter, neisseria, and pseudomonas • Ciprofloxacin has only moderate activity against Gram-positivebacteria such as Streptococcus pneumoniae and Enterococcusfaecalis; it should not be used for pneumococcal pneumonia.It is active against chlamydia and some Mycobacteria • Ofloxacin is used for urinary-tract infections, lowerrespiratory-tract infections, gonorrhoea, and non-gonococcalurethritis and cervicitis • Levofloxacin is active against Gram-positive and Gramnegativeorganisms. o It has greater activity against pneumococci than ciprofloxacin. o Levofloxacin is licensed for community-acquired pneumonia but it is considered to be second-line treatment for this indication PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 39 STEP 3: Contraindication of Fluoroquinolones Drugs (20 minutes) Activity: brainstorming (5 minutes) ASK learners to brainstorm on the following question • What is contraindication of Fluoroquinolone drugs? ALLOW few students to respond WRITE their responses on the flipchart CLARIFY and SUMMARISE by using the content below Fluoroquinolones are contraindicated in: • Pregnancy • Patients with a history of tendon disorders related to quinolone use • Severe hepatic impairment • Bradycardia • History of symptomatic arrhythmias • Heart failure • Electrolyte disturbances STEP 4: Dose, Dosage and Course of Fluoroquinolone drugs (30 minutes) • Ciprofloxacilin o By mouth, respiratory-tract infections, 500–750 mg twice daily (750 mg twice daily( in pseudomonal lower respiratory-tract infection in cystic fibrosis) o Urinary-tract infections, 250–750 mg twice daily (250 mg twice daily for 3 days usually adequate for acute uncomplicated cystitis in women) o Acute or chronic prostatitis, 500 mg twice daily for 28 days o Gonorrhoea, 500 mg as a single dose o Most other infections, 500 mg twice daily (increased to 750 mg twice daily in severe or deep-seated infection o Surgical prophylaxis [unlicensed], 750 mg 60 minute before procedure o Prophylaxis of meningococcal meningitis by intravenous infusion over 60 minutes, 400 mg o Anthrax (treatment and post-exposure prophylaxis, every 8–12 hours o by mouth, 500 mg twice daily o By intravenous infusion over 60 minutes, 400 mg every 12 hours • Levofloxacilin o By mouth, acute sinusitis, 500 mg daily for 10–14 days o Exacerbation of chronic bronchitis, 250–500 mg daily for 7–10 days o Community-acquired pneumonia, 500 mg once or twice daily for 7–14 days o Urinary-tract infections, 250 mg daily for 7–10 days(for 3 days in uncomplicated infection) PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 40 o Chronic prostatitis, 500 mg once daily for 28 days o Skin and soft tissue infections, 250 mg daily STEP 4: Side Effects and Adverse Effects of Fluoroquinolone Drugs (20minutes) ACTIVITY: brainstorming (5 minutes) ASK students to brainstorm on the following question • What are the side effects and adverse effects of Fluoroquinolone drugs? ALLOW few students to respond WRITE their responses on the flipchart CLARIFY and SUMMARISE by using the content below Adverse effects and side effects of Fluoroquinolones • Fluoroquinolones are extremely well tolerated • The most common effects are nausea, vomiting, and diarrhea • Occasionally, headache, dizziness, insomnia, skin rash, or abnormal liver function tests develop • Photosensitivity has been reported with lomefloxacin and pefloxacin may damage growing cartilage and cause an arthropathy • Tendinitis, a rare complication that has been reported in adults STEP 5: Interactions and Precautions of Essential Fluoroquinolone Drugs (15 minutes) • Interaction of Fluoroquinolones o Also should avoided in those receiving quinidin procainamide sotalol, ibutilide, amiodarone) o Patients receiving other agent like erythromycin, tricyclic antidepressants should be given fluoroquinolones with caution • Precaution Quinolones should be used with caution in: o Patients with a history of epilepsy or conditions that o Renal impairment o Pregnancy o During breast-feeding o Quinolones may induce convulsions in patients with without a history of convulsions o