Pharm D 4th Year Syllabus Pdf Download

Pharm D 4th Year Syllabus Pdf

Pharm D 4th Year Syllabus Exam Pattern

Sr No	Name of Subjects	I<–	Maximum Marks for Theory	–>I	I<–	Maximum Marks for Practicals	–>I
–	–	Examination	Sessional	Total	Examination	Sessional	Total
1.1	Pharmacotherapeutics – III	70	30	100	70	30	100
1.2	Hospital Pharmacy	70	30	100	70	30	100
1.3	Clinical Pharmacy	70	30	100	70	30	100
1.4	Biostatistics and Research Methodology	70	30	100	–	–	–
1.5	Biopharmaceutics and Pharmacokinetics	70	30	100	70	30	100
1.6	Clinical Toxicology	70	30	100	–	–	–
–	–	–	–	600	–	–	400=1000

Pharmacotherapeutics – III

Theory (Topic-wise Lecture)

I. Gastrointestinal System

1. Peptic ulcer disease
2. Gastro Esophageal Reflux Disease
3. Inflammatory bowel disease
4. Liver disorders
   • Alcoholic liver disease
   • Viral hepatitis including jaundice
   • Drug-induced liver disorders

II. Haematological System
1. Anaemias
2. Venous thromboembolism
3. Drug-induced blood disorders

III. Nervous System
1. Epilepsy
2. Parkinsonism
3. Stroke
4. Alzheimer’s disease

IV. Psychiatry Disorders
1. Schizophrenia
2. Affective disorders
3. Anxiety disorders
4. Sleep disorders
5. Obsessive Compulsive disorders

V. Pain Management

• Pain pathways, neuralgias, headaches

VI. Evidence-Based Medicine

Practicals (Experiments List)

Hospital postings for a period of at least 50 hours are required to understand the principles
and practice involved in ward round participation and clinical discussion on the selection of
drug therapy.

Students are required to maintain a record of 15 cases observed in the ward
and the same should be submitted at the end of the course for evaluation. Each student
should present at least two medical cases they have observed and followed in the wards.

Practical Examination Scheme

Topic	Sessionals	Annual
Synopsis	05	15
Major Experiments	10	25
Minor Experiments	03	15
Viva-voce	02	15
Maximum Marks	20	70
Duration	03hrs	04hrs

Reference Text Books

1. Clinical Pharmacy and Therapeutics – Roger and Walker, Churchill Livingstone publication
2. Pharmacotherapy: A Pathophysiologic Approach – Joseph T. Dipiro et al., Appleton & Lange
3. Pathologic Basis of Disease – Robins SL, W.B. Saunders publication
4. Pathology and Therapeutics for Pharmacists: A Basis for Clinical Pharmacy Practice – Green and Harris, Chapman and Hall publication
5. Clinical Pharmacy and Therapeutics – Eric T. Herfindal, Williams and Wilkins Publication
6. Applied Therapeutics: The Clinical Use of Drugs – Lloyd Young and Koda-Kimble MA

Hospital Pharmacy

Theory (Topic-wise Lecture)

I. Hospital – its Organisation and Functions
II. Hospital Pharmacy – Organisation and Management
1. Organizational structure – Staff, Infrastructure & workload statistics
2. Management of materials and finance
3. Roles & responsibilities of hospital pharmacist
III. The Budget – Preparation and Implementation
IV. Hospital Drug Policy
1. Pharmacy and Therapeutic Committee (PTC)
2. Hospital formulary
3. Hospital committees
– Infection committee
– Research and ethical committee
4. Developing therapeutic guidelines
5. Hospital pharmacy communication – Newsletter

V. Hospital Pharmacy Services
1. Procurement & warehousing of drugs and Pharmaceuticals
2. Inventory control
– Definition, various methods of Inventory Control
– ABC, VED, EOQ, Lead time, safety stock
3. Drug distribution in the hospital
– Individual prescription method
– Floor stock method
– Unit dose drug distribution method
4. Distribution of Narcotic and other controlled substances
5. Central sterile supply services – Role of pharmacist
VI. Manufacture of Pharmaceutical Preparations
1. Sterile formulations – large and small volume parenteral
2. Manufacture of Ointments, Liquids, and creams
3. Manufacturing of Tablets, granules, capsules, and powders
4. Total parenteral nutrition
VII. Continuing Professional Development Programs
– Education and training
VIII. Radio Pharmaceuticals – Handling and Packaging
IX. Professional Relations and Practices of Hospital Pharmacists

Practicals (Experiments List)

1. Assessment of drug interactions in the given prescriptions
2. Manufacture of parenteral formulations, and powders.
3. Drug information queries.
4. Inventory control

Practical Examination Scheme

Topic	Sessionals	Annual
Synopsis	05	15
Major Experiments	10	25
Minor Experiments	03	15
Viva-voce	02	15
Maximum Marks	20	70
Duration	03hrs	04hrs

Reference Text Books

1. Hospital Pharmacy by William E. Hassan
2. A Textbook of Hospital Pharmacy by S.H. Merchant & Dr. J.S. Qadry. Revised by R.K. Goyal & R.K. Parikh
3. WHO Consultative Group Report
4. R.P.S. Vol. 2. Part – B; Pharmacy Practice section
5. Handbook of Pharmacy – Health Care edited by Robin J. Harman, The Pharmaceutical Press

Clinical Pharmacy

Theory (Topic-wise Lecture)

I. Definitions, Development, and Scope of Clinical Pharmacy
II. Introduction to Daily Activities of a Clinical Pharmacist
a. Drug Therapy Monitoring
b. Ward Round Participation
c. Adverse Drug Reaction Management
d. Drug Information and Poisons Information
e. Medication History
f. Patient Counseling
g. Drug Utilization Evaluation (DUE) and Review (DUR)
h. Quality Assurance of Clinical Pharmacy Services

III. Patient Data Analysis
– The patient’s case history, its structure and use in the evaluation of drug therapy
– Understanding common medical abbreviations and terminologies used in clinical practices.
IV. Clinical Laboratory Tests Used in the Evaluation of Disease States and Interpretation of Test Results
a. Haematological, Liver Function, Renal Function, Thyroid Function Tests
b. Tests Associated with Cardiac Disorders
c. Fluid and Electrolyte Balance
d. Microbiological Culture Sensitivity Tests
e. Pulmonary Function Tests

V. Drug & Poison Information
a. Introduction to Drug Information Resources Available
b. Systematic Approach in Answering DI Queries
c. Critical Evaluation of Drug Information and Literature
d. Preparation of Written and Verbal Reports
e. Establishing a Drug Information Centre
f. Poisons Information – Organization & Information Resources
VI. Pharmacovigilance
a. Scope, Definition, and Aims of Pharmacovigilance
b. Adverse Drug Reactions – Classification, Mechanism, Predisposing Factors, Causality Assessment [Different Scales Used]
c. Reporting, Evaluation, Monitoring, Preventing & Management of ADRs
d. Role of Pharmacist in Management of ADR.
VII. Communication Skills, Including Patient Counseling Techniques, Medication History Interview, Presentation of Cases.
VIII. Pharmaceutical Care Concepts
IX. Critical Evaluation of Biomedical Literature
X. Medication Errors

Practicals (Experiments List)

Students are expected to perform 15 practicals in the following areas covering the topics
dealt in theory class.
a. Answering drug information questions (4 Nos)
b. Patient medication counselling (4 Nos)
c. Case studies related to laboratory investigations (4 Nos)
d. Patient medication history interview (3 Nos)

Reference Text Books

1. Practice Standards and Definitions – The Society of Hospital Pharmacists of Australia
2. Basic Skills in Interpreting Laboratory Data – Scott LT, American Society of Health System Pharmacists Inc.
3. Biopharmaceutics and Applied Pharmacokinetics – Leon Shargel, Prentice Hall publication
4. Australian Drug Information – Procedure Manual, The Society of Hospital Pharmacists of Australia
5. Clinical Pharmacokinetics – Rowland and Tozer, Williams and Wilkins Publication
6. Pharmaceutical Statistics: Practical and Clinical Applications – Sanford Bolton, Marcel Dekker, Inc.

Biostatistics and Research Methodology

Theory (Topic-wise Lecture)

I. Research Methodology

1. Types of clinical study designs:
   • Case studies
   • Observational studies
   • Interventional studies
2. Designing the methodology
3. Sample size determination and Power of a study
   • Determination of sample size for simple comparative experiments
   • Determination of sample size to obtain a confidence interval of specified width
   • Power of a study
4. Report writing and presentation of data

II. Biostatistics
1. Introduction
2. Types of data distribution
3. Measures describing the central tendency distributions
– Average, median, mode
4. Measurement of the spread of data
– Range, variation of mean, standard deviation, variance, coefficient of variation, standard error of mean
5. Data graphics
– Construction and labeling of graphs, histograms, pie charts, scatter plots, semilogarithmic plots
6. Basics of testing hypothesis
– Null hypothesis, level of significance, power of test, P value, statistical estimation of confidence intervals

7. Level of significance (Parametric data)
– Students t-test (paired and unpaired), chi-square test, Analysis of Variance (one-way and two-way)
8. Level of significance (Non-parametric data)
– Sign test, Wilcoxan’s signed-rank test, Wilcoxon rank sum test, Mann Whitney U test, Kruskal-Wallis test (one-way ANOVA)
9. Linear regression and correlation
– Introduction, Pearson’s and Spearman’s correlation and correlation coefficient
10. Introduction to statistical software: SPSS, Epi Info, SAS
11. Statistical methods in epidemiology
– Incidence and prevalence, relative risk, attributable risk

III. Computer Applications in Pharmacy
1. Computer System in Hospital Pharmacy: Patterns of Computer use in Hospital Pharmacy – Patient record database management, Medication order entry – Drug labels and list – Intravenous solution and admixture, patient medication profiles, Inventory control, Management Report & Statistics
2. Computer in Community Pharmacy
3. Computerizing the Prescription Dispensing process
4. Use of Computers for Pharmaceutical Care in community pharmacy
5. Accounting and General ledger system
6. Drug Information Retrieval & Storage: Introduction – Advantages of Computerized Literature Retrieval Use of Computerized Retrieval

Reference Text Books

1. “Pharmaceutical Statistics: Practical and Clinical Applications” by Sanford Bolton, 3rd edition, published by Marcel Dekker Inc., New York.
2. “Drug Information: A Guide for Pharmacists” by Patrick M. Malone, Karen L. Kier, John E. Stanovich, 3rd edition, McGraw Hill Publications 2006.

Biopharmaceutics and Pharmacokinetics

Theory (Topic-wise Lecture)

I. Biopharmaceutics
1. Introduction to Biopharmaceutics
a. Absorption of Drugs from Gastrointestinal Tract
b. Drug Distribution
c. Drug Elimination
II. Pharmacokinetics
1. Introduction to Pharmacokinetics
a. Mathematical Model
b. Drug Levels in Blood
c. Pharmacokinetic Model
d. Compartment Models
e. Pharmacokinetic Study
2. One Compartment Open Model
a. Intravenous Injection (Bolus)
b. Intravenous Infusion
3. Multicompartment Models
a. Two Compartment Open Model
b. IV Bolus, IV Infusion, and Oral Administration
4. Multiple Dosage Regimens
a. Repetitive Intravenous Injections – One Compartment Open Model
b. Repetitive Extravascular Dosing – One Compartment Open Model
c. Multiple Dose Regimen – Two Compartment Open Model

5. Nonlinear Pharmacokinetics
a. Introduction
b. Factors Causing Non-linearity
c. Michaelis-Menton Method of Estimating Parameters
6. Noncompartmental Pharmacokinetics
a. Statistical Moment Theory
b. Mean Residence Time (MRT) for Various Compartment Models
c. Physiological Pharmacokinetic Model
7. Bioavailability and Bioequivalence
a. Introduction
b. Bioavailability Study Protocol
c. Methods of Assessment of Bioavailability

Practicals (Experiments List)

I. Improvement of Dissolution Characteristics of Slightly Soluble Drugs by Some Methods
II. Comparison of Dissolution Studies of Two Different Marketed Products of the Same Drug
III. Influence of Polymorphism on Solubility and Dissolution
IV. Protein Binding Studies of a Highly Protein-Bound Drug and Poorly Protein-Bound Drug
V. Extent of Plasma-Protein Binding Studies on the Same Drug (i.e., Highly and Poorly Protein Bound Drug) at Different Concentrations in Respect of Constant Time

VI. Bioavailability Studies of Some Commonly Used Drugs on Animal/Human Model
VII. Calculation of Ka, Ke, t1/2, Cmax, AUC, AUMC, MRT, etc. from Blood Profile Data
VIII. Calculation of Bioavailability from Urinary Excretion Data for Two Drugs
IX. Calculation of AUC and Bioequivalence from the Given Data for Two Drugs
X. In Vitro Absorption Studies

XI. Bioequivalency Studies on Different Drugs Marketed (e.g., Tetracycline, Sulphamethoxazole, Trimethoprim, Aspirin, etc.) on Animals and Human Volunteers
XII. Absorption Studies in Animal Inverted Intestine Using Various Drugs
XIII. Effect on Contact Time on the Plasma Protein Binding of Drugs
XIV. Studying Metabolic Pathways for Different Drugs Based on Elimination Kinetics Data
XV. Calculation of Elimination Half-Life for Different Drugs by Using Urinary Elimination Data and Blood Level Data
XVI. Determination of Renal Clearance

Reference Text Books

1. Biopharmaceutics and Clinical Pharmacokinetics by Milo Gibaldi
2. Remington’s Pharmaceutical Sciences by Mack Publishing Company, Pennsylvania
3. Pharmacokinetics” by Milo Gibaldi and Donald R. Mercel, Dekker Inc.
4. Handbook of Clinical Pharmacokinetics by Milo Gibaldi and Laurie Prescott, ADIS Health Science Press
5. Biopharmaceutics and Pharmacokinetics by Robert F. Notari
6. Biopharmaceutics by Swarbrick

Clinical Toxicology

Theory (Topic-wise Lecture)

I. General Principles Involved in the Management of Poisoning
II. Antidotes and Their Clinical Applications
III. Supportive Care in Clinical Toxicology
IV. Gut Decontamination
V. Elimination Enhancement
VI. Toxicokinetics
VII. Clinical Symptoms and Management of Acute Poisoning with the Following Agents:
a) Pesticide Poisoning: Organophosphorous Compounds, Carbamates, Organochlorines, Pyrethroids
b) Opiates Overdose
c) Antidepressants
d) Barbiturates and Benzodiazepines
e) Alcohol: Ethanol, Methanol
f) Paracetamol and Salicylates
g) Non-steroidal Anti-inflammatory Drugs
h) Hydrocarbons: Petroleum Products and PEG
i) Caustics: Inorganic Acids and Alkali
j) Radiation Poisoning

VIII. Clinical Symptoms and Management of Chronic Poisoning with the Following Agents:
– Heavy Metals: Arsenic, Lead, Mercury, Iron, Copper
IX. Venomous Snake Bites:
– Families of Venomous Snakes
– Clinical Effects of Venoms
– General Management as First Aid
– Early Manifestations
– Complications and Snake Bite Injuries
X. Plants Poisoning:
– Mushrooms
– Mycotoxins
XI. Food Poisoning
XII. Envenomations – Arthropod Bites and Stings

Reference Text Books

1. “Ellen horn’s Medical Toxicology – Diagnosis and Treatment of Poisoning” by Matthew J. Ellenhorn, Second Edition, Williams and Wilkins publication, London
2. “Handbook of Forensic Medicine and Toxicology” by V.V. Pillay, Thirteenth Edition 2003, Paras Publication, Hyderabad