Standard Pharmacy Course Program : Leeway Marketplace

Standard Pharmacy Course Program

Biomedical Sciences
- Biochemistry
  - Enzymes: Its reactions and Kinetics
  - Carbohydrates: Structures & Functions, Synthesis & Degradation
  - Glycolysis
  - Citric Acid Cycle
  - Glyoxylate Cycle
  - Pentose Phosphate Cycle
  - Lipids: Biosynthesis
  - Insulin and Glucagon: Regulation
  - Steroid Hormones and atherosclerosis
  - Amino acids: Oxidation and Degradation
  - Fatty acids: Oxidation and Formation of Ketone bodies
  - ATP and Bioenergetics: Oxidative Phosphorylation, Electron transport and the effects of Xenobiotics
  - Nucleic acid
  - Protein Synthesis
  - Chromosome: Structure, DNA replication and transcription, effects of antibiotics, Cancer causing viruses
  - Lipids and Membranes
- Molecular Biology and Genomics
  - Proteins and Lipids: Structures and functions
  - Biochemistry and Cellular Organization
  - Essential Amino acids: Degradations of Purines and Uric acid production
  - Cell signaling (Neurotransmitters, hormones)
  - Cellular growth (The cell cycle)
  - Organization of human genome
    - Gene expression and regulation
  - DNA: Structure and functions
  - Instability of the human genome
    - Replication, Mutation and DNA repair
    - Recombination and developmental genetics
  - Relationships between Genes and Proteins
    - Proteins: Its structures and functions
    - Protein folding and conformation
    - Transcription into RNA
    - mRNA translation into proteins
  - Gene engineering and Cloning of genes
    - Cell-based DNA cloning
    - Cloning vectors
  - Molecular pathology: Identifying human disease genes
    - Its Application: Gene therapy and other molecular gene-based therapeutic approach
- Human Physiology
  - Respiration
    - How the body obtains oxygen and eliminates carbon dioxide
    - The balance of respiration and PH level in fluids
    - Changes during exercise and various states
  - Kidney
    - How kidney regulate the volume and composition of fluids
    - How the kidney function during malnutrition and various diseases
    - Hormonal regulation
  - Blood and Immune System
    - Cellular and molecular components of the blood: Their roles in oxygen transport
    - Clothing mechanisms and Body’s defense mechanisms
    - Immunology: Dealing with normal immune reactions
  - Cardiovascular system
    - The structure and contractile properties of the heart
    - Mechanical forces regulating blood pressure
    - Hormonal and neural regulating mechanisms
  - Gastrointestinal system
    - Gastric acid secretion
    - How the body obtains nutrients, water and electrolytes
    - Transfer into plasma and various tissues
    - Hormonal and neural regulatory factors in normal and disease states
    - Elimination of undigested food
  - Neurophysiology
    - Description of biological membranes and ionic channels
    - The basis of bioelectricity
    - Detailed explanation of synaptic transmission
      - The synapse as a primary subject of action of various drugs which act upon the nervous system
      - Major sensory systems such as somatosensory, visual and auditory systems
      - The pain perception
      - Neural control of skeletal musculature
      - Mental illnesses
    - Temperature regulation
      - The homeostatic mechanisms regulating body temperature
        In normal condition
        
        During diseases
        
        During exercise
    - Endocrinology and Reproduction
      - The hypothalamic system controlling hormonal release
      - The pituitary gland
      - The thyroid gland
      - The adrenal gland
      - The reproductive cycle and its hormonal control
  - Functional Anatomy
    - Introduction to Anatomy
      - The Anatomical position: movement
      - Ultrastructure of the cell
      - Examination of basic tissue type of the body and their functions
    - The Integument
      - Histology of skin
    - Musculoskeletal system
      - Types of muscle: Histology of muscle
      - How movement occurs
      - Regional study – Role of calcium in skeletal contraction
      - Diaphram; Upper limb; Lower limb; and their clinical aspects
    - The Cardiovascular system
      - Mediastinum
      - Arteries Vs Veins: Histological approach
      - Blood as a tissue
      - Heart: Adult Vs Fetal structure and their flow of blood
      - Coronary circulation; conducting system and their clinical aspects
      - Regional Supply
    - The respiratory system
      - Histological survey
      - Pleural and pleural cavity: Breathing movement
      - Clinical aspects
      - Development of respiratory system
    - The Digestive system
      - Anterior abdominal wall
      - Palate and Oral cavity; Salivary glands
      - Esophagus
      - Peritoneal cavity
      - Abdominal viscera
      - Histological aspects and function
      - Clinical anatomy: Small intestine, large intestine, liver, pancreas
      - Blood supply including portal venous system and the “first-pass effect”
    - The Nervous System
      - Introduction to terminology
      - Synaptic morphology; neurotransmission
      - Organization of the nervous system
        Organization of the nervous system
        Central Nervous System
        Spinal Cord: anatomy; meninges; major ascending and descending tracts
        
        Brain: gross anatomical features, location and function meninges
        
        Cerebral Hemispheres – sulci, gyri, major sensory and motor regions
        
        Brain Stem: cerebellum; ventricles
        
        CSF: flow, composition, function; blood supply- clinical anatomy
        
        Peripheral Nervous System
        Cranial nerves; spinal nerves; dermatomes; brachial plexus
        
        lumbosacral plexus – pudendal and sciatic nerves
        
        Autonomic Nervous System
        Centres of control; sympathetic and parasympathetic systems
        
        neurotransmitters
    - Organs of Special Sense
      - Eye, Ear, Olfaction, Taste
    - The Urinary System
      - Function; components and relations
      - Kidneys: location, gross anatomy; histology; flow of urine; ureter, bladder, male and female urethra; pelvic diaphragm
    - The Reproductive System
      - Bony pelvis and perineal region; urogenital triangle; anal triangle; male external genitalia; the breast; the placenta; early embryology; susceptibility of the fetus to critical periods of development
    - The Endocrine System
      - Pituitary gland
      - Thyroid gland
      - Pancreas
      - Parathyroid glands and adrenal glands
    - The Lymphatic System
      - Significance
      - Gross anatomy and histology of lymphatic tissue
      - Lymphatic vessels; lymph node
      - Spleen, thymus, appendix
- IMMUNOLOGY
  - Overview of the Immune System
    - Specificity and memory
    - Cells and organs of the immune system
    - Clonal selection theory
  - Humoral Immune Responses
    - Antibodies: structure, classes, and function
  - Cell Mediated Immune Responses
    - T cell subsets and functions
    - T cell receptor
    - MHC (Major Histocompatability Complex) molecules
    - Antigen processing and MHC-restricted presentation
    - T cell recognition of antigens
  - Implications to Vaccine Design
    - Conventional and modern vaccines
  - Hybridoma Technology and Monoclonal Antibodies
    - Clinical applications: as research tools and as diagnostic and therapeutic agents
    - Biotechnology and Pharmacogenetics
- MEDICAL MICROBIOLOGY
  - Introduction to Microbiology
    - Bacterial structure, replication and classification
    - Bacterial pathogenesis and virulence factors
    - Normal microbial flora / Host response to infection
    - Principles of diagnostic microbiology
  - Bacterial Infections
    - Infections of the circulatory system
      - Endocarditis
    - Infections of bones and joints
      - Osteomyelitis, arthritis, prostheses
    - Skin and wound infections
      - Cellulitis, impetigo, wounds
    - Infections of the gastrointestinal tract
      - Food poisoning, gastroenteritis, antibiotic-associated colitis
    - Infections of the eye
      - Conjunctivitis, keratitis
    - Infections of the urogenital tract
      - Urinary tract infections
      - Sexually transmitted infections
    - Infections of the CNS
      - Meningitis
      - Abcesses
    - Infections of the respiratory tract
      - Otitis, pharyngitis, sinusitis
      - Pneumonia, bronchitis, croup
      - Tuberculosis
  - Antimicrobial Agents
    - β-Lactams
    - Quinolones
    - Macrolides, clindamycin, tetracyclines
    - Aminoglycosides, vancomycin
    - Sulfonamides and trimethoprim
    - Metronidazole
  - Viral Infections
    - Properties, structure, replication, and transmission
    - Viral pathogenesis, host response, and principles of diagnostic virology
    - Sites/types of viral infections
      - Respiratory tract
      - CNS
      - Gastrointestinal tract
      - Genitourinary tract
      - HIV and AIDS
      - Hepatitis
      - Measles, mumps, rubella
      - Chickenpox and shingles
      - Infections in the fetus and newborn
    - Antiviral agents
  - Parasitology
    - Protazoal diseases
      - Protazoas and helminths
    - Malaria
    - Ectoparasites
      - Lice, scabies, ticks
  - Mycology
    - Properties, structure, replication, and transmission
    - Systemic mycoses
      - Candidiasis
      - Aspergillosis
      - Histoplasmosis
      - Blastomycosis
      - Coccidiodomycosis
      - Cryptococcosis
    - Superficial mycoses
      - Dermatophytes
    - Antifungal agents
  - Sterilization and Disinfection
    - Infection control methods
  - Immunoprophylaxis and Vaccines
PHARMACEUTICAL SCIENCES
- PHARMACEUTICS AND DRUG DELIVERY SYSTEMS
  - The solid state
    - Bonding: Van der Waal’s, hydrogen, covalent, electrostatic, metallic crystal systems and habits
    - Crystallization: saturated and supersaturated solutions, crystal growth
    - Crystallinity: amorphous solids, degree of crystallinity, crystal defects
    - Polymorphism: effects on formulation, bioavailability
    - Hydrates and solvates: hygroscopicity, deliquescence, phase diagrams, effects on formulation, bioavailability, lyophilization
    - Eutectic mixtures, solid solutions, clathrates and inclusion compounds
  - Solid dosage forms
    - Properties of powders, handling of powders, drying, mixing and milling
    - Particle size analysis: definitions, methods
    - Tableting: excipients and formulation, methods of granulation, tablet compression
    - Tablet coating: methods and types of coating
    - Capsules: hard gelatin, soft gelatin, non-gelatin based capsules, formulation
    - Evaluation tests: uniformity of weight, content, dissolution, disintegration, hardness, friability
    - Sustained/controlled release: formulation, effect on bioavailability
    - Effervescent powders and tablets: formulation, storage
  - Solutions and Solubility
    - Thermodynamics of pharmaceutical solutions
    - 1st law, enthalpy, work
    - 2nd law, entropy
    - Gibbs free energy and chemical potential
    - Phase equilibria
  - Pharmaceutical solvents
    - Waters, alcohols, hydroalcohols, cosolvents
  - Aqueous and non-aqueous solutions
    - Syrups, elixirs, tinctures, collodions, spirits, liniments
  - Solvent/solute interacation
    - Intermolecular bonding, functional groups, prediction of drug solubility in water
  - Liquid-liquid solutions
    - Ideal and non- ideal solutions, Raoult’s law, partial miscibility
  - Solid-liquid solutions
    - Colligative properties, solutions of electrolytes and non-electrolytes, ionic equilibria, buffers, isotonicity
  - Gas-liquid solutions
    - Solubility of gases, Henry’s law.
  - Factors affecting solubility
    - pH, pKa, salts, temperature, esterification, complexation, solubilization, particle size, cosolvency, polarity, solubility parameters
  - Dissolution
    - Theory, methods of measuring dissolution rate, factors affecting dissolution rate
    - Hixon-Crowell Cube-Root Relation, Noyes-Whitney equation
    - Types of dissolution apparatuses
    - USP Dissolution monographs and acceptance criteria
    - In vitro – in vivo correlation
  - Partition
    - Fick’s first and second laws, Nernst distribution law, pH-partition theory,steady state and non-steady state diffusion
  - Surface Chemistry and Dispersed Dosage Forms
    - Interfacial tension, spreading, contact angle, tendency of wetting
    - Nature & properties of surfaces, interfaces-absorption at liquid & solid interfaces
    - Surfactants: classification, properties, pharmaceutical applications (HLB, wetting, solubilization, detergency)
  - Emulsions
    - Emulsion types, applications, emulsifying agents
    - Physical stability: creaming, coalescence, cracking, inversion
    - Formulation, preservation
    - Microemulsions: formulation, physicochemical properties, applications
  - Suspensions
    - Desired characteristics, applications
    - Electrical properties, Zeta potential, Nernst potential
    - Physical stability: flocculation, deflocculation, sedimentation
    - Formulation
    - Rheological properties of vehicles including hydrocolloids, thixotropy, rheopexy,structured vehicles
  - Drug Stability
    - Drug stability
      - Physical, chemical, microbiological stability: definitions, causes of instability
    - Chemical stability
      - Mechanisms of degradation: hydrolysis, oxidation, photolysis
      - Zero and first order degradation: rate equations, half-life, shelf-life
      - Effect of temperature, ionic strength, solvents and pH on reaction kinetics
      - Factors affecting rates of hydrolysis and oxidation, stability programs, stabilitytesting, accelerated stability studies
      - Stabilization of drugs against hydrolysis, oxidation and photolysis
  - Pulmonary Drug Delivery
    - Components of aerosols: propellants, valves, containers
    - Formulation of aerosols: solutions, suspensions, emulsions
    - Design of aerosols: metered dose inhalers, dry powder inhalers, nebulizers, spacer devices
    - Inhalation therapy: deposition of particles in the lungs, metered dose inhalers, powderinhalers, nebulizers
  - Dermal and Transdermal Drug Delivery
    - Skin structure: nature of barrier to percutaneous absorption
    - Percutaneous absorption: diffusion, partitioning, flux
    - Factors affecting percutaneous absorption: skin intactness, age, site, hydration, partitioncoefficient, solubility, penetration enhancers and formulation
    - Types of dermatological vehicles: ointments, creams, gels, liquids, pastes, selection ofappropriate vehicle in topical drug therapy
  - Parenteral Drug Delivery
    - Methods of sterilization, sterility testing, pyrogen testing, tests for particulate matter
    - Routes of administration: advantages, disadvantages
    - Formulation: vehicles, additives, osmolarity, osmolality, particle size
    - Principles of aseptic technique, reconstitution, intravenous admixtures and causes ofincompatibilities
    - Total parenteral nutrition: design of solution, preparation, administration, complications
  - Ophthalmic, Otic, Nasal Drug Delivery
    - Ophthalmic drug delivery
      - Cornea as a barrier to drug absorption
      - Formulation: tonicity, sterility, pH additives
    - Otic drug delivery
      - Site of drug administration
      - Formulation
    - Nasal drug delivery
      - Formulation: pH, additives
    - Rectal and Vaginal Drug Delivery
      - Definition and uses
      - Preparation, excipients, density displacement factors
      - Stability
    - Vaginal tablets, ointments, creams, gels and aerosol foams
  - New Drug Delivery Systems
    - Controlled/targeted delivery
      - Controlled drug release, targeted drug delivery: definitions, rationale, comparison to conventional delivery systems
      - Parenteral polymeric delivery systems: biodegradable, non-degradable, polymers, reservoirs, matrices, mechanisms of drug release, formulation of implants, microspheres, nanospheres
      - Liposomes: formulation, interaction with cells, applications, targeting
      - Transdermal drug delivery: applications, mechanisms of controlled release formulations
      - Immunoconjugates and new innovations
    - Protein drug delivery
      - Protein drug delivery: formulation strategies to stabilize proteins, formulation of protein/peptide drugs using conventional injections, formulation of polymer implants or microspheres
      - Nasal and pulmonary delivery: physiology, use of penetration enhancers
      - Buccal delivery and other potential delivery systems
    - Good Manufacturing Practices (GMP)
    - Batch record
    - International Organization for Standardization (ISO)
    - Lot number
  - Product Quality Control and Risk Management
  - Places
    - Premises and equipment
  - People
    - Personnel and quality assurance
  - Processes
    - Sanitation program and operations
  - Products
    - Specifications, stability, samples, batch records, recall reporting, sterile products
  - Pharmaceutical Analysis
    - Chromatographic separation methods
      - High Pressure Liquid Chromatography (HPLC)
      - Gas Liquid Chromatography (GLC)
    - Other chromatographic detectors
      - Fluorescence
      - Radiometric assays (gamma and beta counting)
    - Spectrophotometry and other analytical methods
      - Ultraviolet-visible
      - Infrared and Nuclear Magnetic Resonance (NMR) spectrometry
      - Atomic absorption
      - Mass spectrometry
      - Gel electrophoresis and Western blot
- PHARMACOKINETICS & BIOPHARMACEUTICS
  - Compartment Concepts
    - One compartment open model
    - Multicompartmental models
    - Model-independent pharmacokinetics
  - Absorption
    - Kinetics of oral drugs (absorption and elimination)
    - Kinetics after one dose
    - Kinetics after multiple doses
    - Zero-order absorption model
    - First-order absorption model
    - Significance of absorption rate constant
    - Physiologic factors related to oral absorption
    - Modified release of drug products
  - Distribution and Protein Binding
    - Physiologic factors
    - Volume of distribution
    - Kinetics of protein binding
  - Elimination and Clearance Concepts
    - Drug clearance
    - Renal clearance
    - Hepatic clearance
    - Biotransformation
  - Kinetics of Intravenous (IV) Drugs
    - IV Bolus
    - IV infusion
    - IV intermittent infusion
    - Multiple daily dosage regimens
  - Kinetics of Doses
    - After constant input
    - After 1st order input
  - Model-Independent Pharmacokinetics
    - Nonlinear pharmacokinetics
  - Bioavailability and Bioequivalence Issues
  - Clinical Application of Pharmacokinetics
    - Dosage regimens
    - Effects of pathophysiologic changes: monitoring and adjustment of doses in renal and hepatic dysfunction
    - Kinetics of drug interactions
    - Special populations
      - Pediatric patients
      - Pregnant and lactating women
      - Geriatric patients
    - Therapeutic drug monitoring
      - Drugs in renal failure: Aminoglycosides, cyclosporine
      - Drugs with saturable kinetics: Phenytoin
      - Drugs with linear kinetics: Digoxin
  - Examples of Pharmacokinetics Calculations
    - Pharmacokinetic rate constants
      - Apparent volume of distribution, elimination rate constant, half-life, clearance
    - Blood drug concentration following IV bolus dose administration
      - One compartment model
      - Two compartment model
    - Drug concentration vs. time curves
      - Determining what model the drug follows
    - Clearance rates
    - Loading doses and time to reach steady state
    - Pharmacokinetic-pharmacodynamic modeling
- MEDICINAL CHEMISTRY
  - Fundamental Aspects of Organic Chemistry
    - Chemical bonding: introductory aspects, such as atomic orbitals, molecular orbitals, localized versus delocalized chemical bonding, specific bond types (e.g.,covalent and ionic), aromaticity, and tautomerism.
    - Stereochemistry
    - Solubility
    - Acidity and basicity
    - Functional groups
      - Aliphatic and aromatic hydrocarbons
      - Alcohols and phenols
      - Ethers
      - Aldehydes and ketones
      - Amines
      - Carboxylic acids
      - Functional derivatives of carboxylic acids
      - Sulfonic acids and sulfonamides
      - Heterocycles
      - Nitrates and nitrites
  - Fundamental Concepts of Medicinal Chemistry:
    - Structure-activity relationships
    - Ionization and pK_avalues: electronic effects in medicinal compounds
    - Metabolism: routes of metabolism, specific isozymes, induction and inhibition ofenzymes giving rise to specific drug interactions, and genetic polymorphism ofclinical relevance.
    - Transporters
    - Chemical and physical properties of related medicinal compounds
  - Drug/Receptor Interactions: Theory and Practice
    - Drug-receptor binding: importance of the equilibrium dissociation constant
    - Fraction of bound receptors and the analogous enzyme-substrate relationships
    - Importance of hydrophilic and hydrophobic interactions
- PHARMACOLOGY
  - General Principles of Pharmacology
    - Drug absorption, disposition, biotransformation, elimination
  - Receptors
    - Receptor theory, macromolecular structure of receptors, signal transductionmechanisms, molecular pharmacology
    - Drug/receptor interactions
      - Evidence of specific receptor-mediated processes
      - Agonists/antagonists
      - Dose-response curves
      - Desensitization and super-sensitivity
  - Autonomic Pharmacology
    - Drugs and catecholamine metabolism
    - Sympathomimetics (adrenergic agents)
    - Sympatholytics (adrenergic blocking agents)
    - Cholinergic drugs
    - Anticholinesterases
    - Anticholinergics
    - Skeletal muscle relaxants
  - Anaesthetics
    - Local anaesthetics
    - General anaesthetics
  - Pharmacology of Inflammation
    - Chemical mediators of inflammation
      - Histamine, prostaglandins, leukotrienes, bradykinin, platelet activating factor,cytokines
    - Anti-inflammatory drugs
      - ASA, NSAIDs, COX-2 inhibitors, 5-ASA
    - Immunosuppressive drugs
    - Drugs used in the treatment of inflammatory diseases
      - Asthma
      - Rheumatoid arthritis
      - Gout
    - Biologic response modifiers
  - Central Nervous System Pharmacology
    - Pain and opioid analgesics
    - Anxiolytic drugs
    - Sedative/hypnotic drugs
    - Antipsychotics
    - Antidepressants
    - Psychostimulants
    - Anti-Parkinson drugs
    - Antiseizure drugs
    - Drugsfor Alzheimer’s disease
    - Drugs for migraine
  - Drugs Affecting the Haematopoietic System
    - Iron, folic acid, vitamin B₁₂ , erythropoietin, filgrastim
  - Cardiovascular Pharmacology
    - Antiarrhythmic drugs
    - Cardiac glycosides and inotropic drugs
    - Vasodilators
    - Calcium channel blockers
    - Beta-blockers
    - ACE inhibitors
    - Angiotensin receptor antagonists
    - Nitrates
    - Antihypertensive agents
  - Hemostasis and Thrombosis
  - Vitamin K
  - Oral anticoagulants
  - Heparins (including low molecular weight heparins)
  - Anti-Xa inhibitors
  - Direct thrombin inhibitors
  - Thrombolytics
  - Drugs for Dyslipidemia
  - Diuretics
  - Cancer Chemotherapy
    - Alkylating agents, antimetabolites, cytotoxic antibiotics, plant alkaloids, hormones,biologic response modifiers
    - Adjunctive agents including antiemetics
  - Gastrointestinal Pharmacology
    - Drugs affecting GI motility
    - Drugs affecting gastric secretion
    - Anti-obesity drugs
  - Endocrine Pharmacology
    - Insulin and oral antihyperglycemics
    - Corticosteroids
    - Thyroid and anti-thyroid drugs
    - Androgens and anabolic steroids
    - Estrogens and anti-estrogens, progestins, hormonal contraception (oral and otherroutes)
    - Gonadotropins
    - Vasopressin
    - Oxytocin
    - Bone mineral homeostasis
  - Anti-Infective Agents
    - Antibacterial drugs
    - Beta-lactam antibiotics, carbapenems, sulphonamides, trimethoprim,tetracyclines, aminoglycosides, macrolides, fluoroquinolones, vancomycin,metronidazole, nitrofurantoin.
    - Antiviral drugs
    - Antifungal drugs
    - Antiprotozoal drugs
    - Anthelmintic drugs
  - Respiratory Drugs
    - Antitussives
    - Anti-inflammatory agents
    - Bronchodilators
  - Ophthalmic Drugs
    - Antiglaucoma agents
    - Mydriatics
  - Drugs of Abuse
    - Ethanol, amphetamines, barbiturates, benzodiazepines, nicotine, cannabis, GHB,cocaine/crack, fentanyl, heroin, ketamine, methadone, nitrites, solvents, hallucinogens, cocaine/crack, fentanyl, heroin, ketamine, methadone, nitrites, solvents, hallucinogens.
- TOXICOLOGY AND CLINICAL TOXICOLOGY
  - Introduction to Toxicology
    - Perspective: subdisciplines, magnitude, monitoring, resources
    - Pharmacological principles: relation of toxic response to frequency, dose and tissueconcentration
    - Discrimination among toxins
  - Mechanisms
    - Receptor-mediated vs. reactive intermediate-mediated toxicity
    - Covalent binding, oxidative stress
    - Elimination, bioactivation, detoxification, cytoprotection and macromolecular repair
  - Modulators of Chemical Toxicity
    - Pharmacological factors
      - Disposition, biotransformation, renal elimination
    - Physiological factors
      - Species, strain, age, sex, genetics, diet, pregnancy, functional reserve capacity,tolerance
    - Pathophysiological factors
      - Diseases of hepatic, renal cardiovascular, pulmonary, gastrointestinal andbiochemical systems
  - Toxicological Evaluation
    - Chemical measurements
      - Biological relevance of measuring active and inactive parent chemical andmetabolites, stereoisomers and reactive intermediary metabolites
      - Biochemical measurements of cellular response
      - Biochemical measurements of cellular response, in vivo andin vitrostudies,exvivohuman assessment
  - Chemical Teratogenesis
  - Carcinogenesis/Mutagenesis
  - Chemicals and Environmental Toxins
    - Alcohols, glycols, aldehydes, nitrates and nitrites, sulfide, hydrocarbons
    - Carbon monoxide, cyanide
    - Pesticides
    - Metals
    - Corrosives
    - Plants
    - Warfare chemical weapons
  - Drug Toxicity
    - Analgesics and anti-inflammatory drugs
    - Opioids
    - CNS stimulants and depressants, antidepressants, hallucinogens
    - Anticholinergics
    - Cardiovascular drugs
    - Vitamins
- BIOTECHNOLOGY AND PHARMACOGENETICS
  - Introduction to Biotechnology
    - Modern biotechnology and its impact on development of drugs and pharmacy practice
    - Pharmacoeconomics of biotechnology drugs
  - Recombinant DNA Technology and Production of Protein Drugs
    - Review of protein biosynthesis in prokaryotic and eukaryotic cells
    - Regulation of gene expression
    - Methods of creating recombinant DNA
    - Isolation of cloned genes
      - cDNA cloning, genomic DNA cloning
    - Expression of recombinant proteins
      - Host cells, expression vectors
      - Strategies in design of recombinant plasmids for pharmaceuticals (e.g., humangrowth hormone)
  - Industrial Production of Protein Drugs
    - Modern fermentation technology
    - Requirements for bacterial, yeast and mammalian cell culture
    - Overview of fermenter design and fermentation processes
    - Large-scale production of protein pharmaceuticals with examples
    - Production of biotechnology drugs
      - Cultivation and downstream processing
      - Issues to consider in production and purification of proteins
      - Formulation of biotechnology drugs
        Sterility, pyrogen removal
        
        Excipients used in biotechnology drugs (parenteral formulations)
        
        Shelf-life of biotechnology drugs
        
        Delivery of biotechnology drugs: route of administration and absorptionenhancement; rate-controlled delivery; site-specific delivery enhancement; rate-controlled delivery; site-specific delivery
      - Pharmacist’s role with biotechnology products
        Dispensing biotechnology drugs: handling and special considerations; storage;preparation; administration; patient assessment and monitoring; outpatient/homecare issues.
        
        Pharmacotherapeutics of approved biotechnology products (clinical and regulatoryaspects)
        Hematopoietic growth factors
        
        Interleukins and interferons
        
        Insulin
        
        Growth hormones
        
        Recombinant tissue-type plasminogen activator
        
        Gonadotropins
        
        Monoclonal antibody-based pharmaceuticals
  - Biotechnology-related Techniques
    - Polymerase chain reaction
    - DNA sequencing
    - DNA hybridization
    - Protein engineering
      - Site-directed mutagenesis
      - Antibody engineering
    - Peptide chemistry/medicinal chemistry
      - Peptidomimetic drugs
      - Rational design of peptide drugs
    - Nucleic acid technologies
      - Antisense oligonucleotides
      - DNA triplex technology
      - Ribozymes
    - Catalytic antibodies (abzymes)
    - In vitroscreening and combinatorial chemistry
  - Transgenic (TG) Animals
    - Production of TG animals by DNA injection (gain-of-function)
    - Production of TG animals by homologous recombination (loss-of-function)
    - Protein production in TG animals
    - TG animal models of disease and application in drug discovery and development
    - TG animal patents
  - Gene Therapy
    - Approaches and targeted diseases
    - Methods forex vivoandin vivodelivery of genes to somatic cells
    - Applications to diseases
      - ADA deficiency, cystic fibrosis, and cancer
    - Case studies of current clinical trials
    - Potential diseases where gene therapy could be applied to or is currently used fortreatment
    - Gene transfer methods
      - Viral vectors (retrovirus vectors, adenovirus vectors, etc.)
  - Pharmacogenomics and genotyped prescribing (future role for pharmacists)
  - Antisense Oligonucleotide Therapy
    - Inhibition of gene expression by oligonucleotides
    - Design of oligonucleotides and approaches to delivery
  - Small interfering RNA (siRNA)
    - Mechanism, potential applications
  - Immunology: Overview of the Immune System
    - Specificity and memory
    - Cells and organs of the immune system
    - Clonal selection theory
    - Humoral immune responses
      - Antibodies: structure, classes, and function
    - Cell mediated immune responses
      - T cell subsets and functions
      - T cell receptor
      - MHC molecules
      - Antigen processing and MHC-restricted presentation
      - T cell recognition of antigens
      - Implications to vaccine design
  - Monoclonal Antibodies
    - Hybridoma technology
    - Applications: as research tools, and as diagnostic and therapeutic agents
  - Vaccines: Biotechnology Approaches
    - Cloned proteins: Hepatitis B
    - Synthetic peptides: AIDS
    - Synthetic carbohydrates: Cancer
    - Attenuated organism with site-specific mutation: Cholera
    - Vaccine delivery systems
      - Live vectors
      - Pharmaceutical formulations
  - Cytokines
    - General characteristics, classification
    - Origin, molecular characteristics and physiological function of each cytokine
    - Therapeutic cytokines
      - Interferons, interleukins and colony stimulating factors
  - Erythropoietin
  - Thrombolytic Agents
  - Formulation of Protein and Peptide Drugs
    - Problems: stability, bioavailability and routes of administration
    - Recent approaches in protein and peptide drug delivery
PHARMACY PRACTICE– Clinical Sciences
- PATHOPHYSIOLOGY
  - Cell Injury and Death
    - Mechanisms of cell injury
      - Ischemia/hypoxia
      - Free radicals
      - Chemical injury
    - Laboratory investigation
      - Morphology – reversible injury, necrosis, apoptosis
      - Biochemical changes
  - Genetics
    - Common chromosomal syndromes
    - Pharmacogenetics
  - Fluid and Electrolyte Disorders
    - Metabolic acid-base disorders
    - Disorders of oxygenation
  - Inflammation
    - Acute inflammation
    - Chronic inflammation
      - Inflammatory events and mediators
    - Edema
  - Immunopathology
    - Hypersensitivity reactions
      - Four major types: immediate (anaphylactic), cytotoxic, immune complex, delayed
    - Autoimmune diseases
  - Obstructive Lung Disease
    - Asthma
    - Chronic obstructive pulmonary disease (COPD)
  - Gastrointestinal Disease
    - Gastroesophageal reflux disease (GERD)
    - Peptic ulcer disease
    - Inflammatory bowel disease
      - Crohn disease
      - Ulcerative colitis
    - Zollinger-Ellison syndrome
  - Liver Disease
    - Cholestasis
    - Hepatitis (A, B, C)
    - Cirrhosis
    - Drug-induced hepatotoxicity
  - Renal Disease
    - Acute renal insufficiency
    - Chronic renal insufficiency
  - Endocrine Disorders
    - Thyroid disorders
      - Hyperthyroidism
      - Hypothyroidism
    - Adrenal disorders
      - Cushing’s Syndrome
      - Addison’s Disease
    - Metabolic bone disorders
      - Osteoporosis
      - Osteomalacia
      - Paget’s Disease
    - Glucose metabolism and disorders
      - Diabetes mellitus (type 1 and type 2)
    - Cardiovascular
      - Dyslipidemia
      - Ischemic heart disease
      - Myocardial Infarction
      - Hypertension
      - Heart failure
      - Dysrhythmias
      - Coagulation and thrombotic disorders
    - Haematology
      - Anemias
        Normocytic (i.e., thalassemias, sickle cell anemia)
        Microcytic (i.e., iron deficiency anemia)
        Macrocytic (i.e., vitamin B₁₂ deficiency and folic acid deficiency)
      - Haemostatic disorders
    - Neurology
      - Neurodegenerative diseases
        Alzheimer’s disease and dementias
        Parkinson’s Disease
      - Pain and headache
        Acute or chronic
        Migraine
      - Seizure disorders
      - Stroke
    - Psychiatry
      - Anorexia, bulimia, and eating disorders
      - Anxiety
      - Attention deficit hyperactivity disorder (ADHD)
      - Bipolar disorder
      - Depression
      - Insomnia
      - Schizophrenia
    - Carcinogenesis and Neoplasia
      - Sites
        Lung neoplasms
        Gastrointestinal neoplasms
        Gynecologic neoplasms
        Urinary tract neoplasms
        Hematology (e.g., leukemia and lymphoma)
        Skin neoplasms (e.g., malignant melanoma and others)
        Cancer of the bone, brain, breast, prostate
- CLINICAL BIOCHEMISTRY / LABORATORY AND DIAGNOSTIC TESTING
  - Routine Hematology
    - Hematocrit and hemoglobin
    - Red blood cell count
    - Red cell indices (MCV, MCH, MCHC)
    - Complete blood count (CBC)
    - WBC differential (components)
    - Platelets
  - Hematologic Diagnostic Tests
    - Anemias (iron, ferritin, TIBC)
    - Coagulation tests (INR, aPTT)
  - Electrolytes and Blood Chemistry
    - Sodium
    - Potassium
    - Chloride
    - Glucose (random or FBG)
    - Uric Acid
    - Arterial blood gases (PaO₂, PaCO₂)
    - pH
    - Anion gap
    - Bicarbonate
  - Liver Biochemistry
    - Bilirubin
    - Alkaline phosphatase (ALP)
    - Transaminases (AST, ALT)
    - Albumin
    - α-Fetoprotein
  - Bone Metabolism
    - Bone mineral density
    - Minerals (calcium, phosphate)
    - Magnesium
    - Vitamin D
  - Renal Function and Disorders
    - Urinalysis
    - Urine electrolytes
    - Blood urea nitrogen (BUN)
    - Serum creatinine
  - Estimation of Glomerular Filtration Rate (GFR) and Renal Blood Flow
    - Methods of calculation and use of nomograms
    - Creatinine clearance
  - Gastrointestinal Tract
    - Schilling’s test
    - Occult blood
    - Endoscopy
  - Pulmonary Function Tests
    - Pulmonary function testing
    - Histamine, methacholine challenge test
  - Neurology
    - Cerebral spinal fluid (CSF)
  - Cardiovascular Diagnostic Tests
    - Cardiac isoenzymes (including creatine kinase)
    - Troponin
    - Lipoprotein profile (LDL, HDL, triglycerides, total cholesterol)
  - Neoplasm Screening
    - Prostate-specific antigen (PSA)
    - Breast self-examination
    - Mammogram
    - Pap smear
  - Endocrinology
    - Hypothalamus-pituitary axis
      - Prolactin
      - Growth hormone (GH)
      - Gonadotropins (LH and FSH)
      - Adrenocorticotropin (ACTH)
    - Adrenal disorders
      - Plasma cortisol
      - Urine and serum osmolality
    - Thyroid function
      - TSH
      - Free T₃
      - Free T₄
    - Sex hormones
      - Pregnancy testing
    - Diabetes and glucose monitoring
      - Glucose tolerance test
      - Fasting blood glucose
      - Urine ketones
      - Glycosylated hemoglobin (A1C)
    - Infectious Disease / Immunologic / Rheumatologic /Other Tests
      - HIV tests
      - Western blot
      - CD4+ T-cell counts
      - Erythrocyte sedimentation rate
    - Laboratory Aspects of Antimicrobial Agents
      - Culture and sensitivity tests
- PHARMACOTHERAPEUTICS (INCLUDING PRESCRIPTION, NONPRESCRIPTION ANDCOMPLEMENTARY THERAPY)
  - Respiratory Diseases
    - Asthma
    - Chronic obstructive pulmonary disease (COPD)
    - Croup
    - Smoking cessation
  - Dermatology
    - Acne
    - Acne rosacea
    - Allergic contact dermatitis
    - Atopic dermatitis
    - Burns
    - Cellulitis
    - Dermatomycosis
    - Diaper rash
    - Dry skin
    - Impetigo
    - Pediculosis and scabies
    - Onychomycosis
    - Sunburn and photosensitivity reactions
    - Viral infections (including chicken pox, herpes and shingles)
  - Eye, Ear, Nose and Throat
    - Acute otitis media
    - Allergic rhinitis
    - Bacterial conjunctivitis
    - Bacterial sinusitis
    - Glaucoma
    - Mucositis
    - Otitis externa
    - Pharyngitis
    - Teething
    - Viral upper respiratory tract infections
  - Gastroenterology
    - Cirrhosis
    - Constipation
    - Diarrhea
    - Dyspepsia and peptic ulcer disease
    - Esophagitis
    - Gastroesophageal reflux disease (GERD)
    - Gastrointestinal bleeding
    - Hepatotoxicity and liver dysfunction
    - Infant feeding problems including colic
    - Inflammatory bowel disease: including Crohn disease and ulcerative colitis
    - Irritable bowel syndrome
    - Nausea and vomiting
    - Pseudomembranous colitis
  - Cardiovascular diseases
    - Angina
    - Cardiac insufficiency (including heart failure)
    - Cerebrovascular accident (including ischemic stroke)
    - Venous thromboembolism (DVT and PE)
    - Dyslipidemia
    - Endocarditis prophylaxis
    - Hypertension
    - Myocardial infarction
    - Rhythm disorders
  - Genitourinary diseases
    - Benign prostate hypertrophy
    - Prostate cancer
    - Urinary incontinence
    - Urinary tract infections (cystitis, pyelonephritis, and prostatitis)
  - Musculoskeletal diseases
    - Chronic pain
    - Multiple sclerosis
    - Osteoarthritis
    - Osteoporosis
    - Rheumatoid arthritis
    - Skeletal pain
    - Post-operative pain
    - Tendonitis and sport injuries
  - Gynecology
    - Bacterial vaginitis
    - Contraception (including emergency contraception)
    - Endometriosis
    - Erectile dysfunction
    - Fertility
    - Menopause
    - Pregnancy
    - Premenstrual syndrome (PMS)
    - Vaginal candidiasis
  - Infectious Diseases
    - Bone and joint infections (osteomyelitis)
    - Central nervous system infections (meningitis)
    - Infections related to travel
    - Endocarditis
    - Fungal infections
    - Gastrointestinal infections (includingC. difficile-associated diarrhea
    - HIV and AIDS (including opportunistic infections)
    - Intra-abdominal infections
    - Malaria
    - Pneumonia (community acquired pneumonia and nosocomial)
    - Respiratory tract infections (lower and upper)
    - Sepsis and septic shock
    - Sexually transmitted infections
    - Skin and soft tissue infections
    - Surgical prophylaxis
    - Tuberculosis
    - Urinary tract infections (UTIs)
  - Neurology
    - Alzheimer’s disease and other dementias
    - Headaches (migraine, tension-type, cluster, medication overuse)
    - Neuropathic pain
    - Parkinson’s disease
    - Seizure disorders (including partial, generalized, status epilepticus and others)
  - Endocrinology
    - Breast cancer
    - Diabetes mellitus (types 1 and 2)
    - Hypothyroidism
    - Hyperthyroidism
  - Psychiatry
    - Aggressive behaviour
    - Anxiety disorders
    - Bipolar disorder
    - Depression
    - Drug withdrawal syndromes
    - Insomnia and sleep disorders
    - Obsessive-compulsive disorder
    - Panic disorder
    - Personality disorders
    - Schizophrenia
  - Nephrology
    - Chronic renal dysfunction
    - Nephrotoxicity
    - Renal transplantation
  - Other
    - Anemias
    - Chemotherapy and related toxicities
    - Dehydration
    - Fluid and electrolyte disorders
    - Obesity
- HEALTH PROMOTION AND DISEASE PREVENTION
  - Development of health promotion strategies
    - Health and wellness of individuals and groups
    - Collaboration with other health care providers
  - Public Health Agency of Canada
    - Travel health
    - Vaccies and immunizations
    - Disease prevention
  - Preventative health services (e.g., immunizations, tobacco cessation counselling)
- PATIENT CARE PROCESS
  - Assessment
    - Meet the patient and establish the therapeutic relationship
    - Elicit relevant information from the patient
    - Determine whether the patient’s drug-related needs are being met and identify drugtherapy problems:
      - The patient requires drug therapy but is not receiving it,
      - The patient is taking or receiving the wrong drug,
      - The patient is taking or receiving too little of the right drug,
      - The patient is taking or receiving too much of the right drug,
      - The patient is not taking or receiving the drug or is taking or receiving the druginappropriately,
      - The patient is experiencing an adverse reaction to the drug,
      - The patient is experiencing a drug interaction (including drug-drug, drug-food, drug-laboratory test, drug-disease, or drug-blood product),
      - The patient is taking or receiving a drug for no medically valid indication or substanceabuse.
  - Care plan
    - Establish goals of therapy
    - Select appropriate interventions for:
      - Resolution of drug therapy problems
      - Achievement of goals of therapy
      - Prevention of drug therapy problems
    - Schedule a follow-up evaluation
  - Follow-up evaluation
    - Elicit clinical and/or lab evidence of actual patient outcomes and compare them to thegoals of therapy to determine the effectiveness of drug therapy
    - Elicit clinical and/or lab evidence of adverse effects to determine the safety of therapy
    - Assess patient for any new drug therapy problems
    - Schedule the next follow-up evaluation
  - Documentation
    - Document clinical status and any changes in pharmacotherapy that are required
    - Application of privacy legislation and ethical considerations
    - Preparation and maintenance of patient records (includes profiles, charts, etc)
- SPECIAL POPULATIONS
  - Unique pharmacotherapeutic considerations for special populations including:
    - Neonates
    - Pediatrics
    - Geriatrics
    - Pregnant women
    - Lactating women
- NUTRITION
  - Digestion
  - Function of nutrients in the body
  - Dietary requirementsand Food Guide
  - Assessment of nutritional status
  - Malnutrition and effects on health
  - Metabolism and transport of nutrients
  - Regulation of blood glucose
  - Weight management and eating disorders
PHARMACY PRACTICE – Professional Practice Skills
- PRESCRIPTION PROCESSING AND PRODUCTPREPARATION
  - Accurate interpretation of prescription orders
  - Application of legislative requirements (federal legislation only) – see Law/Jurisprudencesection also
  - Non-sterile and sterile compounding
  - Handling of hazardous drugs
  - Cold chain management
  - Checking processes for dispensing prescriptions, including:
    - Appropriateness of medication choice
    - Therapeutic duplication
    - Correct dosage, route, dosage form, frequency, and duration of therapy
    - Allergies and contraindications
    - Drug interactions
    - Adherence issues
    - Financial considerations (pricing, third party billing, quantity restrictions, etc)
- PRESCRIPTION CALCULATIONS
  - Systems and units of measure (including metric system, SI)
    - Intersystem conversion
  - Dosage calculations
    - Amount of drug
    - Number of doses
    - Dosing based on body weight, body surface area
    - Dosing based on age or pharmacokinetic parameters
  - Compounding calculations (non-sterile and sterile)
    - Ratio and proportion
    - Percentage
    - Dilution and concentration
    - Stock solutions
    - Alligation
    - Electrolyte solutions (milliequivalents, millimoles, osmolarity)
  - Dosing calculations for parenteral medications
    - Reconstitution
    - Infusion flow rate
    - Total parenteral nutrition (TPN)
  - Prescription processing calculations
    - Dispensing fees
    - Insurance co-payments
- COMMUNICATION / PATIENT COUNSELLING
  - Pharmacist interactions in the workplace
    - Effective dialogue with patients, caregivers, and other health providers
    - Individual consultations
    - Presentations to a group
    - Staff relations
  - Development of effective communication skills
    - Dialogue and interviewing techniques/process
    - Verbal and nonverbal listening
    - Probing and gathering information
    - Empathy, assertive skills
    - Cultural diversity and other patient variables
  - Patient counselling and education on prescription medications, including:
    - Pulmonary delivery
    - Ophthalmic, otic, and nasal delivery
    - Topical products
    - Vaginal and rectal delivery
    - Transdermal delivery
    - Oral, sublingual, and buccal dosage forms
    - Parenteral products
    - Other
  - Patient counselling and education to promote adherence to regimens and therapy
    - Strategies to optimize adherence
    - Identification of under-utilization of medication
    - Identification of over-utilization of medication
  - Patient counselling and education on diagnostic/monitoring tools, including:
    - Home blood glucose monitoring
    - Blood pressure monitors
    - Home pregnancy/ovulation test kits
    - Thermometers
    - Peak flow meters
  - Patient counselling and education on nonprescription medications
    - Self-care topics and issues
  - Patient counselling and education on “no public access” medications
  - Patient counselling and education on herbal and complementary therapies
  - Patient counselling and education on home health care, including:
    - Medical supplies
    - Aids for daily living
    - Foot care
    - Wound care
    - Other
- DRUG INFORMATION
  - Selection of suitable references and information databases
    - Cochrane Collaborative Library
    - Medline
    - Micromedex
    - Lexicomp
    - RxFiles
    - RxTx
    - Primary, secondary, tertiary references
  - Response to drug information requests
- LITERATURE EVALUATION / RESEARCH METHODS /EVIDENCE-BASED DECISION-MAKING(including PHARMACOEPIDEMIOLOGY)
  - Evaluation of drug literature and scientific information (critical appraisal)
    - Clinical Trials
    - Evidence-based medicine
    - Clinical practice guidelines
    - Systematic reviews and meta-analysis
    - Observational studies
    - Conflict of interest, publication bias, research funding source, researchethics, institutional review boards (IRB)
    - Cochrane Collaboration and similar agencies
  - Research Methods
    - Design
    - Placebo-controlled, cross-over, washout, factorial, N of 1, parallel
    - Randomized, cohort, case-control, cross sectional, case reports,population studies
    - Experimental, causal-comparative, correlational, descriptive, historical
  - Measures
    - Frequency
      - Prevalence, incidence, cumulative incidence, risk
    - Association
      - Relative risk reduction or benefit, absolute risk reduction orbenefit, odds ratio, number-needed-to-treat, hazards ratio
    - Validity
      - Internal
        Bias and confounding
      - External
        Generalizability
    - Diagnostic testing
      - Sensitivity, specificity, positive predictive value, negative predictive value,likelihood ratio
- MEDICATION / PATIENT SAFETY PRACTICES
  - Policies and procedures to ensure safety and effectiveness of persons, medical productsand pharmacy services
  - Vigilance Program – adverse drug reaction monitoring
  - Health MedEffect: advisories, warnings and recalls
  - Development of strategies and actions to prevent medication incidents
    - Error-prone abbreviations and dosage designations
    - Look-alike and sound-alike drug names
  - Identification, management, and documentation of medication incidents–NationalSystem for Incident Reporting (NSIR) and Canadian Medication Incident Reports andPrevention System (CMIRPS)
  - Institute for Safe Medication Practices (ISMP)
  - Medication reconciliation
  - Patient Safety Institute (PSI)
- LAW / JURISPRUDENCE
  - Provincial Regulatory Authorities (PRAs)
    - Mandate, Roles, Responsibilities
  - NAPRA
    - Mandate, Roles, Responsibilities
  - Federal legislation
    - Prescriptive authorities and regulatory issues pertaining to the profession ofpharmacy
    - Food and Drugs Act and Regulations
    - Controlled Drugs and Substances Act
      - Precursor Control Regulations
      - Benzodiazepines and other Targeted Substances Regulations
      - Marihuana medical access
    - Narcotic Control Regulations
      - Privacy legislation
      - Personal Information Protection and Electronic Documents Act (PIPEDA)
    - Personal Information Protection and Electronic Documents Act (PIPEDA)
      - Hazardous Products Act
      - WHMIS
- PROFESSIONALISM/ ETHICS
  - Ethical principles
    - Beneficence, nonmaleficence, autonomy, justice, veracity, fidelity
  - Patient consent and decision-making
    - Capacity, encumbrances, competency
    - Patient surrogates: substituted judgement, best interest judgment, advance
    - directives, living wills, children and minors, the place of the family
  - Respecting professional boundaries
  - Pharmacist conscientious objection (right to refuse)
  - Other Issues in pharmacy and health care ethics
    - Clinical drug trials research
    - Health reform and allocation of limited resources
    - Interdisciplinary decision-making
    - Ethics committees
    - Conflict of interest (gifts from patients and the pharmaceutical industry)
  - Professionalism
    - Trust, integrity, competence, respect, altruism, compassion, collegiality
- COLLABORATIVE PATIENT CARE
  - Collaboration with other health care professionals to optimize patient outcomes
  - Referral to other health care providers for specific services
    - Identifying need
    - Most appropriate resource or health care professional
  - Effective working relationships
    - Establishing rapport
    - Decision-making strategies
    - Accountability
    - Conflict resolution
    - Scopes of practice
  - Promotion of health and wellness in the community
BEHAVIOURAL, SOCIAL AND ADMINISTRATIVEPHARMACY SCIENCES
- Basic Responsibilities of Management

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