The effect of unliganded gating on agonist response in nicotinic receptors.

Understanding the agonist concentration-response curve (CRC) is the cornerstone in pharmacology. While CRC parameters, agonist potency (EC50) and efficacy (maximum response, Imax) are well-studied, the role of unliganded gating (minimum response, Imin) on CRC is often overlooked. This study explores the effect of unliganded gating on agonist response in muscle-type acetylcholine (ACh) receptors, focusing on the underexplored role of Imin in modulating EC50 and Imax. Three Gain-of-Function (GOF) mutations that increase, and two Loss-of-Function (LOF) mutations that decrease the unliganded gating equilibrium constant (L0) were studied using automated patch-clamp electrophysiology. GOF mutations enhanced agonist potency, whereas LOF mutations reduced it. The calculated CRC aligned well with empirical results, indicating that agonist CRC can be estimated from knowledge of L0. Reduction in agonist efficacy due to LOF mutations was calculated and subsequently validated using single-channel patch-clamp electrophysiology, a factor often obscured in normalized CRC. The study also evaluated the combined impact of mutations (L0) on CRC, confirming the predictive model. Further, no significant energetic coupling between distant residues (>15Å) was found, indicating that the mutations' effects are localized and do not alter overall agonist affinity. These findings substantiate the role of unliganded gating in modulating agonist responses and establishes a predictive model for estimating CRC parameters from known changes in L0. The study highlights the importance of intrinsic activity in receptor theory.

Feasibility and evaluation of high-fidelity simulation education for acute clinical toxicology.

To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and lessons learned of this training. Since 2019, each year approximately 180 fifth-year medical students are invited to participate in the SBME training. The training consists of an interactive lecture and two SBME stations. For each station, a team of students had to perform the primary assessment and management of an intoxicated patient. After the training, the students completed a questionnaire about their experiences and confidence in clinical toxicology. Overall, the vast majority of students agreed that the training provided a fun, interactive and stimulating way to teach about clinical toxicology. Additionally, they felt more confident regarding their skills in this area. Our pilot study shows that SBME training was well-evaluated and feasible over a longer period.

The Dutch list of essential drugs for undergraduate medical education: A modified Delphi study.

AIMS: Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate medical curriculum. To support CP&T education, it is important to determine which drugs medical undergraduates should be able to prescribe safely and effectively without direct supervision by the time they graduate. Currently, there is no such list with broad-based consensus. Therefore, the aim was to reach consensus on a list of essential drugs for undergraduate medical education in the Netherlands. METHODS: A two-round modified Delphi study was conducted among pharmacists, medical specialists, junior doctors and pharmacotherapy teachers from all eight Dutch academic hospitals. Participants were asked to indicate whether it was essential that medical graduates could prescribe specific drugs included on a preliminary list. Drugs for which ≥80% of all respondents agreed or strongly agreed were included in the final list. RESULTS: In all, 42 (65%) participants completed the two Delphi rounds. A total of 132 drugs (39%) from the preliminary list and two (3%) newly proposed drugs were included. CONCLUSIONS: This is the first Delphi consensus study to identify the drugs that Dutch junior doctors should be able to prescribe safely and effectively without direct supervision. This list can be used to harmonize and support the teaching and assessment of CP&T. Moreover, this study shows that a Delphi method is suitable to reach consensus on such a list, and could be used for a European list.

Pharmacology teaching in dental education in India: Time for a reappraisal.

India has a unique position with its vast population and rapidly increasing healthcare demand. Dental health is integral to a holistic health care need, and a robust dental education system is necessary. Dental education in India is mainly regulated by the Dental Councilof India, setting broad guidelines. Universities having dental colleges and institutes develop fine curriculum development and evaluation details. General and Dental Pharmacology and Therapeuticsis a crucial subject taught to undergraduate dental students during the second year of a 4-year duration course. A dental graduate should be well trained in general and systemic pharmacology and rational therapeutics principles. This has been set as an objective by the Dental Council of India. Sound knowledge of the drug action mechanisms, indications, adverse drug reactions, drug interactions and contraindications, evidence-based medicine, and rational use of adrug is core to the allopathic system. The practical exercises on human simulation or computer-assisted learning are critical for understanding pharmacology. The subject of pharmacology for dental graduates has been allotted 70 hours of theory and 20 hours of practicals with almost the same syllabus as medical graduates. This article highlights the areas of concern concerning the deficiency of teaching hours and needed improvement in the curriculum to make it competent to achieve its objective. The authors bring this much-needed topic for discussion among academicians and for the attention of regulatory authorities.

The introduction of team-based learning into the clinical pharmacology section of the endodontics clinical course.

Team-based learning (TBL) has been widely applied and evaluated to produce better student outcomes. TBL has been introduced into the clinical pharmacology section of the endodontics clinical course at the School of Stomatology, Wuhan University since 2021. Here, the teaching experience in this course was summarized. The TBL course consisted of a knowledge assignment, intrateam and interteam discussion, practicing, evaluation, cases discussion and examination. The topics of the TBL class included cavity preparation and filling for treatment of dental caries, disinfection, and shaping and filling of root canal for root canal therapy. A total of 64 students participated in the TBL course. The students completed course work and hands-on practice to the satisfaction of the instructor. Furthermore, most participants held positive attitudes toward the TBL course because TBL provided the opportunity for teamwork to enable them to acquire and understand the therapeutic drug and material more quickly and made them more confident in the following practice. Our experience suggested that the application of the TBL contributed to the authentic practice of the endodontics clinical course.

Alternative to animal experimentation in pharmacology teaching: Development and validation of an equivalent digital learning tool.

Regarding animal experiments in pharmacology teaching, ethical considerations led us to examine an alternative approach to the use of living animals. This study aimed to assess whether digital tools could replace live animal experiments in terms of motivation and knowledge acquisition. The study was carried out with students enrolled in the 5th year of the industry/research stream at the Faculty of Pharmacy of the University of Limoges. The participants were randomly assigned to groups of traditional or digital teaching methods, with the common theme of the class being the effect of a diuretic agent (furosemide) in rats. The scenario and learning objectives were identical for the two groups. Before the class and after randomization, the acceptance of the digital educational material was assessed with a scale, which predicts the acceptability of users according to individual dimensions and social representations, followed by the assessment of the motivation by a situational motivation scale (SIMS) for both groups. After the class, the students' motivation was assessed by a questionnaire based on Deci and Ryan's self-determination theory. In the end, the participants were evaluated for homogeneity, based on general knowledge of renal pharmacology, and for knowledge acquisition concerning specific knowledge related to this teaching session. This study revealed a good acceptance of the digital tool and a good motivation toward the digital method among all the students. It found the two teaching methods (digital and traditional) to be equivalent in terms of motivation and knowledge acquisition. In our study, digital pedagogical tools as an alternative to live animals did not affect students' motivation and knowledge acquisition.

Cholinergic Capsules and Academic Admonitions.

Herein, I intend to capture highlights shared with my academic and research colleagues over the 60 years I devoted initially to my graduate and postdoctoral training and then to academic endeavors starting as an assistant professor in a new medical school at the University of California, San Diego (UCSD). During this period, the Department of Pharmacology emerged from a division within the Department of Medicine to become the first basic science department, solely within the School of Medicine at UCSD in 1979. As part of the school's plans to reorganize and to retain me at UCSD, I was appointed as founding chair. Some years later in 2002, faculty, led largely within the Department of Pharmacology and by practicing pharmacists within UCSD Healthcare, started the independent Skaggs School of Pharmacy and Pharmaceutical Sciences with a doctor of pharmacy (PharmD) program, where I served as the founding dean. My career pathway, from working at my family-owned pharmacy to chairing a department in a school of medicine and then becoming the dean of a school of pharmacy at a research-intensive, student-centered institution, involved some risky decisions. But the academic, curricular, and accreditation challenges posed were met by a cadre of creative faculty colleagues. I offer my experiences to individuals confronted with a multiplicity of real or imagined opportunities in academic health sciences, the related pharmaceutical industry, and government oversight agencies.

Exploration on the application of course ideological and political education in Pharmacology teaching for nursing specialty / 中华医学教育探索杂志

The purpose of this study is to dig deep into teaching materials, find ideological and political elements, and integrate ideological and political courses into pharmacology teaching on the premise of improving moral education ability of teachers. A variety of teaching methods are used in learning and teaching, and nursing professionalism is trained while imparting knowledge, so that students can establish correct outlook on world, life and values, cultivate their innovation and entrepreneurship ability, and do a better job of cultivating morality and cultivating people of nursing specialty.

Lower scores in pharmacokinetics than in pharmacodynamics assessment among students in a health and life sciences curriculum.

In pharmacology teaching, pharmacokinetics (PK) and pharmacodynamics (PD) may be defined as part of the 'general pharmacology' domain, whereas effects of drugs on the autonomic nervous system and clinical trial design might be defined as part of the 'medical' and 'clinical' pharmacology domain, respectively. We recently designed a pharmacology course covering these domains for second year Health and Life Sciences students at the Vrije Universiteit Amsterdam (VU). We used a combination of lectures, problem-based learning and practicals to transfer knowledge to students in order for them to acquire sufficient knowledge and insight to solve real-world pharmacological problems. To evaluate whether we 1) successfully aligned our course objectives with both our teaching strategy and assessment, and 2) to identify topics in our course that would benefit from improvement in teaching strategy and/or effort, we determined success rate of the exam questions in above-defined pharmacology domains. We analyzed 3 consecutive second year cohorts (n = 377) of students enrolled in our course, and found a statistically significant reduction in success rate in exam questions of the general pharmacology domain (especially in PK), compared to domains covering 'medical' and 'clinical' pharmacology. In addition, we found lower success rates for 'knows how' questions compared to 'knows' questions in the combined PK/PD domain. Our data show that we overall succeeded in aligning our course objectives with both our teaching strategy and assessment, but that outcomes on the PK domain might benefit from additional attention.

Evaluation of impact of teaching clinical pharmacology and rational therapeutics to medical undergraduates and interns.

OBJECTIVES: To find out the impact of teaching clinical pharmacology and rational therapeutics (CPT) to medical undergraduates (UGs) and interns. MATERIALS AND METHODS: This cross-sectional, prospective study was conducted on three UGs batches and interns using two pretested validated structured questionnaires, modified from the work of Tobaiqy et al. The study was approved by the Institutional Ethics Committee. ANOVA and Chi-square test were used for statistical analysis. The value of P < 0.05 was considered statistically significant. RESULTS: A total of 379 UGs and 96 interns participated in this study. Mean knowledge score of interns was significantly reduced as compared to UGs (P < 0.0001). A significant increase in confidence for unsupervised prescribing of nonsteroidal anti-inflammatory drugs (99%), oral rehydration salt, iron salts was perceived among interns as compared to UGs (P < 0.05). However, 63.5% confessed problems in selection of drugs, drug-drug interactions, prescribing in special patient population. Although they were confident prescribing fixed dose combination for adult patients (89.5%), majority were hesitant to prescribe opioids (77%), steroids (76%), vaccines (75%), and antihypertensives (62%). CONCLUSION: The theoretical CPT teaching transfers knowledge to UGs; however, it is not retained in internship and does not adequately prepare interns to prescribe safe and rational drugs.

Teaching safe prescribing to medical students: perspectives in the UK.

Prescribing is a characteristic role of a medical practitioner. On graduating from medical school, students are presumed to have acquired the necessary pharmacology knowledge underpinning the therapeutics and developed their personal skills and behaviors in order to write a safe and effective prescription (The Four Ps). However, there are reports of errors in medical prescribing and dissatisfied feedback from recent graduates, which evidence potential flaws in the current training in the practice of prescribing. We examine the Four Ps from a systems approach and offer scope for educators and curriculum designers to review and reflect on their current undergraduate teaching, learning, and assessment strategies in a similar manner. We also adopt a national framework of common competencies required of all prescribers to remain effective and safe in their area of practice as a more objective layer to the broader learning outcomes of the General Medical Council Tomorrow's Doctors 2009. This exercise demonstrates where standard, recognized competencies for safe prescribing can be accommodated pedagogically within existing medical curricula.

A review of computer assisted learning in medical undergraduates.

Laboratory based practical classes, have been the corner stone of undergraduate pharmacology learning. Ethical issues with the use of animals and rapid development of information technology has led to newer trends in teaching and learning such as computer assisted learning. Computer assisted learning (CAL) software includes computer based packages, focusing on interactive instruction in a specific subject area, collection of animal experiments that encourage students to understand concepts in pharmacology. CAL offers a number of advantages to both students and teachers; most important being meeting the learning objectives. Few disadvantages and pitfalls to implementation in medical schools are also associated with CAL sessions. This article reviews the trend of CAL in pharmacology, advantages, disadvantages and pitfalls to the implementation of CAL.

Research and practice of permeating the humanity quality education into pharmacology teaching / 中华医学教育探索杂志

Enhancing medical students' humane quality education is an urgent requirement for modem medical mode transformation for medical education.The pharmacology teachers of Chongqing Medical University follow the modem education concepts and fully search the human spirit materials hidden in pharmacology,then actively explore how to integrate the humanity spirit education into the pharmacology teaching to achieve the changes of from exam-oriented education to quality education.

La enseñanza de la farmacología en las escuelas de medicina: situación actual y perspectivas / The teaching of pharmacology in medical schools: current status and future perspectives

La farmacología es una ciencia básica que estudia las interacciones entre los fármacos y la materia viva. En las escuelas de medicina se imparte en el segundo año y su estudio se centra en los fundamentos de la disciplina y en los fármacos útiles en el tratamiento de las enfermedades del hombre. Se asume que este conocimiento farmacológico se repasa y expande en los cursos clínicos y que los estudiantes están preparados para prescribir fármacos apropiadamente cuando se gradúan. Sin embargo, desde hace varios años se sabe que la educación farmacológica es insuficiente y que la prescripción irracional de medicamentos es muy frecuente. La sobrecarga de información y la proliferación de nuevos medicamentos son dos factores que contribuyen a este problema. Para enfrentar esta situación se ha recomendado la elaboración de programas básicos de farmacología y una lista de fármacos prototipo. Con base en nuestra experiencia docente identificamos el contenido de lo que debe constituir un programa básico de farmacología, y publicamos una guía para orientar el estudio de la disciplina. Ambos documentos permiten a los estudiantes apreciar qué necesitan aprender del conocimiento farmacológico y los fármacos que deben manejar; el total de ellos se limita a 168. Nuestro programa representa el primer esfuerzo para medicalizar la enseñanza de la farmacología en las escuelas de medicina; esperamos que la mayoría de ellas lo consideren, ya que se puede aplicar a todas las modalidades curriculares vigentes.

Pharmacology is a core course in all medical school curricula. In most medical schools, pharmacology is taught during the second year and teaching covers both basic aspects and useful drugs for the treatment of human diseases. It is assumed that relevant pharmacologic knowledge is revisited during the clinical clerkships and that students are adequately trained to prescribe drugs upon graduation. However, for many years it has been noted that pharmacological training is sometimes insufficient and that inadequate and irrational prescription of drugs is a very common problem in clinical settings. Information overload and proliferation of new drugs have been recognized as two of the major contributing factors. To address this issue, many authors have recommended the development of a core curricula in pharmacology which all students would have to complete coupled with a restricted list of drugs. Based on our own teaching experience we have identified what should constitute the core content of pharmacology courses in medical schools and have written a study guide for this discipline. Both documents provide an organizational framework to help second year medical students ascertain what part of the vast knowledge in pharmacology they need to learn. The number of drugs that students have to manage is limited to 168. Our program constitutes the first effort to medicalize the teaching of pharmacology in medical schools. We expect that most medical schools will follow our guidelines as our program is applicable to all curricula modalities.

Research into the delightful teaching mode of pharmacology in medical vocational colleges / 中华医学教育探索杂志

This paper intends to explore a method which can arouse the students'interests,improve their study efficiency and develop their creativity by applying the delightful teaching mode during the pharmacology teaching in medical vocational colleges.When applying the de-lightful teaching mode,it is important for us to take advantage of different delightful materials,use various flexible teaching skills and emphasize the attractive education,and only in this way can we obtain good results.

Combination of Theories of Medical Ethics with Pharmacology Teaching / 中国医学伦理学

There are many chances to meet with ethical problems in the use of pharmacology, so it's necessary to combine the education of medical ethics with pharmacology teaching. Several methods can be used. The first is to build up models for students. The teacher's diathesis should be cultivated and strengthened to further the education of medical ethics in pharmacology teaching. At the same time, medical staff with noble morality can be taken for example to guide the students to develop their personality and self-cultivation, which will contribute to the foundation of human culture as well as the appropriate application of professional knowledge. The second is to collect, coordinate and renewal the information of medical ethics from internet, mass medium and historical materials, etc, so as to maintain a fresh feeling of teaching. Meanwhile, the introduction of medical ethics will encourage the students to rethink the value of study and improve the recognition of the meaning in the fields of medicine. The third is to select suitable content and chance to combine both without increasing the periods of pharmacological studies. The last method is to discuss and perfect the efficiency of estimation system. It will be discussed later.