| PR_BK_01 |
Basic |
Organic chemistry: drugs as organic molecules: types of intermolecular bonds; interactions between molecules; organic compared with inorganic compounds; bond strength; important atomic constituents: C, N, O, P, S and halides |
| PR_BK_02 |
Basic |
Organic chemistry: ionization of molecules: type of groups that ionize: amides, hydroxyl, carboxyl. Oxidation and reduction. Permanently charged [quaternary ammonium] drugs. |
| PR_BK_03 |
Basic |
Drug chemistry: solubility, partition coefficients and movement of drugs through membranes: Lipid solubility; influence of pKa and pH; partition coefficients. Passive and active transport mechanisms |
| PR_BK_04 |
Basic |
Isomers: structural and stereoisomers: classification systems; clinical relevance |
| PR_BK_05 |
Basic |
Mechanisms of drug action: physicochemical; pharmacodynamic; pharmacokinetic: drug-receptor interactions; dose-response and log[dose]-response curves; agonists, partial agonists, antagonists. Reversible and irreversible antagonism. Potency and efficacy |
| PR_BK_06 |
Basic |
Non-specific drug actions: Physicochemical mechanisms: e.g. adsorption; chelation; neutralization |
| PR_BK_07 |
Basic |
Voltage-gated ion channels; membrane-bound transport pumps. Sodium, potassium and calcium channels as targets for drug action |
| PR_BK_08 |
Basic |
Receptors as proteins; ion channels; transmembrane transduction and intermediate messenger systems; intracellular/nuclear receptors. Receptor regulation and tachyphylaxis |
| PR_BK_09 |
Basic |
Transduction systems as receptors: G-protein coupled receptors [GPCRs] and non-GPCR systems. |
| PR_BK_10 |
Basic |
Nuclear receptors: Intracellular hormone receptors. e.g. cytoplasmic receptors for steroids; corticosteroids vs. mineralocorticoid receptors |
| PR_BK_11 |
Basic |
Enzymes as drug targets: Michaelis-Menten kinetics. Direct and allosteric mechanisms. e.g. acetylcholinesterase; cyclo-oxygenase; phosphodiesterase |
| PR_BK_12 |
Basic |
Anticholinesterases: Classification of drugs that inhibit acetylcholinesterase and plasma cholinesterase including organophosphates |
| PR_BK_13 |
Basic |
Predictable side effects of drugs: non-selective actions of drugs; action at multiple receptors; multiple anatomical locations; predictable enzyme induction-inhibition |
| PR_BK_14 |
Basic |
Idiosyncratic side effects of drugs: e.g. blood and bone-marrow dyscrasias; pulmonary fibrosis; anti-platelet effects. Anaphylactic and anaphylactoid reactions: comparison; treatment; identification of responsible drug; risks with polypharmacy |
| PR_BK_15 |
Basic |
Tachyphylaxis and tolerance: Examples of drugs demonstrating tachyphylaxis; proposed mechanisms. Opioid dependence and tolerance |
| PR_BK_16 |
Basic |
Drug interactions: Types of interaction: synergism, additivity, antagonism; isobolograms. Classification of mechanisms of drug interaction |
| PR_BK_17 |
Basic |
Pharmacokinetics: general principles: absorption, distribution and redistribution; elimination, excretion. Chemical properties of drugs and their pharmacokinetics: blood-brain-barrier and placental barrier. Protein binding: plasma and tissue. Body compartments; adipose and vessel-poor tissue. Bioavailability; clearance |
| PR_BK_18 |
Basic |
Administration and absorption: routes of administration; first-pass metabolism and bioavailability. Selection of appropriate route. Drug delivery systems: e.g. sustained release, enteric coated, transdermal patch and iontophoretic systems |
| PR_BK_19 |
Basic |
Oral administration: Time-course for systemic appearance; factors e.g. pKa, lipid solubility, active transport. Bioavailability of drugs given orally and its measurement |
| PR_BK_20 |
Basic |
Drug elimination from plasma. Mechanisms: distribution; metabolism; excretion: exhalation; renal; biliary; sweat; breast milk. Factors affecting e.g.: pathological state: renal and hepatic failure; age, including extremes of age; gender; drug interactions. Active and inactive metabolites; pro-drugs. Enzyme induction and inhibition |
| PR_BK_21 |
Basic |
Non-enzymatic drug elimination: Hofmann degradation |
| PR_BK_22 |
Basic |
Pharmacokinetic modelling: types of models available: one, two and three-compartment models; non-compartmental; physiological. Pharmacokinetic parameters: volume of distribution, half-life and time constant, clearance |
| PR_BK_23 |
Basic |
Context-sensitive half-time: comparison of drugs e.g. propofol, fentanyl and remifentanil. Target-controlled infusions [TCI] |
| PR_BK_24 |
Basic |
TCI in practice: accuracy, applicability, cost. Variations due to patient differences: predictable and unpredictable |
| PR_BK_25 |
Basic |
Differences in patient response to therapy: gender; pathology; polypharmacy; in particular, changes occurring with increasing age |
| PR_BK_26 |
Basic |
Pharmacogenetics: pharmacokinetic variation e.g. pseudocholinesterase; acetylation; CYP450 variants. Poor and fast metabolizers; racial and geographic distribution of common abnormal genes |
| PR_BK_27 |
Basic |
Volatile and gaseous anaesthetic agents: Structure of available agents. MAC. Clinical effects: CNS [including ICP], CVS, RS. Unwanted effects of individual agents. MH susceptibility; hepatitis risks. Factors affecting onset and offset time. Oil/gas partition coefficient |
| PR_BK_28 |
Basic |
Intravenous anaesthetic agents: Chemical classes. Properties of an ideal induction agent. Adverse effects on CNS [including effects on ICP], CVS, RS; pharmacokinetics including metabolism |
| PR_BK_29 |
Basic |
Mechanisms of general anaesthetic action |
| PR_BK_30 |
Basic |
Benzodiazepines: classification of action. Clinical actions. Synergism with anaesthetic agents. Antidote in overdose |
| PR_BK_31 |
Basic |
Local anaesthetic agents. Additional effects, including anti-arrhythmic effects. Mechanism of action. Clinical factors influencing choice: operative site, patient, available agents. Toxicity syndrome; safe clinical and maximum clinical doses; treatment of overdose |
| PR_BK_32 |
Basic |
Analgesics. Simple analgesics, NSAIDs and opioids. Available routes of administration; peri-operative prescribing; chronic compared with acute pain prescribing |
| PR_BK_33 |
Basic |
Aspirin and paracetamol. Comparison of structures; indications and contraindications; mechanisms of action. Bioavailability; metabolism; toxicity |
| PR_BK_34 |
Basic |
Non-steroidal anti-inflammatory analgesics: Classification. Mechanism of action. Clinical effects and uses; unwanted effects, contraindications |
| PR_BK_35 |
Basic |
Opioid analgesics: Receptor classification. Mechanism of action. Inhibitory effects, sites of action on pain pathways. Unwanted effects. Full and partial agonists and partial agonists. Routes of administration |
| PR_BK_36 |
Basic |
Muscle relaxants. Classification. Sites of action. Properties of an ideal muscle relaxant. Dantrolene and management of MH |
| PR_BK_37 |
Basic |
Depolarizing muscle relaxants: Structure, mechanism of action. Organophosphate poisoning. Adverse effects and contraindications |
| PR_BK_38 |
Basic |
Non-depolarizing muscle relaxants: Structural classification; sub-classification according to onset-time and duration of action. General comparison of aminosteroids and bisbenzyisoquinoliniums. Comparison of individual agents; metabolism and active metabolites. Unwanted effects. |
| PR_BK_39 |
Basic |
Reversal of neuromuscular blockade: Indications for use; mechanisms of action; clinically unwanted effects of reversal of neuromuscular blockade |
| PR_BK_40 |
Basic |
Drugs and the autonomic nervous system: anatomy; myelinated and unmyelinated nerves; ganglia and rami communicantes. Neurotransmitters. Sites at which drugs can interfere with autonomic transmission |
| PR_BK_41 |
Basic |
Drugs and the sympathetic nervous system: adrenergic receptors and molecular mechanisms of action: Indications for pharmacological use of naturally occurring catecholamines and synthetic analogues. Other classes of drugs active in the sympathetic system: e.g. MAOIs: |
| PR_BK_42 |
Basic |
Drugs and the parasympathetic nervous system: nicotinic and muscarinic receptors with subgroups. Mechanism of action. Agonists, antagonists. Comparison of available drugs. Hyoscine and antiemesis |
| PR_BK_43 |
Basic |
Cardiovascular system: general: drug effects on the heart [inotropy and chronotropy] and on the circulation: arterial and venous effects; systemic and pulmonary effects |
| PR_BK_44 |
Basic |
Inotropes and pressors: Classification; site of action. Synthetic inotropes compared with adrenaline |
| PR_BK_45 |
Basic |
Drugs used in ischaemic heart disease: Classification of drugs used. Mechanisms of drug action. Unstable angina |
| PR_BK_46 |
Basic |
Antiarrhythmics: Classification. Indications for use, including use in resuscitation |
| PR_BK_47 |
Basic |
Hypotensive agents: Classes of drugs to produce acute hypotension in theatre. Therapeutic antihypertensive agents: classification according to mechanism of action. Adverse effects of drugs in each class |
| PR_BK_48 |
Basic |
Anticoagulants: oral and parenteral. Sites of action; indications use; monitoring effect. Comparison of heparins: unfractionated and fractionated. Newer anticoagulants |
| PR_BK_49 |
Basic |
Antiplatelet agents. Perioperative management of antiplatelet medication |
| PR_BK_50 |
Basic |
Pro-coagulants: Drugs. Individual factor concentrates; multi-factor preparations including FFP; vitamin K |
| PR_BK_51 |
Basic |
Colloids, including blood and blood products: Composition of preparations; safe use and avoidance of errors |
| PR_BK_52 |
Basic |
Crystalloid fluids: Composition; suitable fluids for maintenance and replacement of losses. Comparison with colloids; unwanted effects |
| PR_BK_53 |
Basic |
Respiratory system: general: Classes of drugs acting on the respiratory tract including bronchodilators; oxygen; surfactant; mucolytics; pulmonary vasodilators. Methods of administration; indications for use; mechanisms of action; adverse effects |
| PR_BK_54 |
Basic |
Respiratory system: drugs used in acute severe asthma and chronic asthma; volatile agents. Mechanisms of action |
| PR_BK_55 |
Basic |
Gastrointestinal system: general: antisialogogues; drugs reducing gastric acidity; drug effects on the GI tract including gastric and bowel motility |
| PR_BK_56 |
Basic |
Antiemetics: Anatomical sites for antiemetic action; central and peripheral inputs to vomiting centre; use of dexamethasone |
| PR_BK_57 |
Basic |
Renal system: diuretics: Classification of diuretics. Unwanted effects; indications for use |
| PR_BK_58 |
Basic |
CNS: antiepileptic agents: Mechanisms of action; unwanted side effects |
| PR_BK_59 |
Basic |
CNS: antidepressants: Classes of drug: anaesthetic relevance |
| PR_BK_60 |
Basic |
Therapy for diabetes mellitus: Drugs used in type 1 and type 2 diabetes: Insulins: classification of types available; routes of administration; perioperative management. Unwanted effects and risks and therapy of hypo- or hyperglyaemia |
| PR_BK_61 |
Basic |
Hormones: corticosteroids: Indications for use; clinical effects; long-term complications of glucocorticoid use |
| PR_BK_63 |
Basic |
Hormones: treatment of thyroid disorders: Synthesis and release of thyroid hormones. Preparations used in hyper- and hypo-thyroidism |
| PR_BK_64 |
Basic |
CNS stimulants; classes, mechanisms of action, uses in anaesthesia |
| PR_BK_65 |
Basic |
RS stimulants including theophyllines, doxapram |
| PR_BK_66 |
Basic |
Antimicrobial agents: general classification: Types of antimicrobial agents: antiviral; antibacterial; antifungal; bacteriostatic and bacteriocidal. Mechanism of action. Indications for use of different classes of antibiotics. Bacterial resistance |
| PR_BK_67 |
Basic |
Effects of drugs on the eye and vision; includes intra-ocular pressure |
| PR_BK_68 |
Basic |
Social drugs including tobacco, alcohol and non-legal drugs: anaesthetic relevance |
| PR_IK_01 |
Intermediate |
Analgesia: principles of analgesia including infusions, patient controlled analgesia; medications for chronic pain including antidepressants, anticonvulsants, antiarrhythmics; routes of administration including oral; sublingual; subcutaneous, IM; IV; inhalational analgesia, patient controlled analgesia, epidural; agents used for regional techniques and local blocks |
| PR_IK_02 |
Intermediate |
Management of acute poisoning: including aspirin; paracetamol; opioids; aminophylline; digoxin; ecstasy and other social drugs; antidepressants; alcohol |
| PR_IK_03 |
Intermediate |
Drug toxicity, causes and avoidance. Management of malignant hyperthermia. Potential risks of drug additives |
| PR_IK_04 |
Intermediate |
Pharmacokinetics. Including target controlled infusions and effects of renal and/or hepatic impairment on drug disposition and elimination of; influence of renal replacement therapies of commonly used drugs |
| PR_IK_05 |
Intermediate |
Cardiovascular System: principles and use of inotropes and vasodilators, including pulmonary vasodilators; pharmacological problems in cardiopulmonary bypass, cardioplegia; Management of arrhythmias |
| PR_IK_06 |
Intermediate |
Use of drugs in the management of cardiogenic shock and cardiac failure |
| PR_IK_07 |
Intermediate |
Management of hypertension before anaesthesia, including acute management and phaeochromocytoma. Manipulation of blood pressure to assist surgery |
| PR_IK_08 |
Intermediate |
Antibiotics: principles of action; choice of drug. Antibiotic prophylaxis against surgical infection including subacute bacterial endocarditis. Therapy of bacterial, fungal and viral infections |
| PR_IK_09 |
Intermediate |
Anticoagulant and thrombolytic prophylaxis and therapy, including management of pulmonary embolus |
| PR_IK_10 |
Intermediate |
The Respiratory System: management of severe asthma; use of gases: helium and nitric oxide |
| PR_IK_11 |
Intermediate |
The Gastrointestinal System: acid aspiration prophylaxis; anti-emetics |
| PR_IK_12 |
Intermediate |
CNS: general vs regional anaesthesia in all areas of anaesthesia; action of drugs on the eye; control of convulsions |
| PR_IK_13 |
Intermediate |
The Musculoskeletal System: muscle relaxants and reversal agents; anaesthetic implications of myasthenia gravis and other neuromuscular disorders |
| PR_IK_14 |
Intermediate |
Resuscitation: including management of allergy and anaphylaxis |
| PR_IK_15 |
Intermediate |
Principles of parenteral and enteral nutritional formulas in intensive care |
| PR_IK_16 |
Intermediate |
Therapeutics in pathologic states: problems associated with organ transplantation; anaesthetic relevance of drugs used in malignancy; therapy in acute and chronic respiratory diseases |
| PR_IK_17 |
Intermediate |
Problems of drug dependency and addiction |
| PR_IK_18 |
Intermediate |
Environmental effects of anaesthetic agents |
| PR_IK_19 |
Intermediate |
Influence of age on drug pharmacokinetics and pharmacodynamics |
| PR_IK_20 |
Intermediate |
Assessment of cognitive dysfunction issues such as delirium, POCD and dementia, and implications |