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Chemotherapy of Infectious and Neoplastic Diseases

  • Module code: LS6003
  • Year: 2018/9
  • Level: 6
  • Credits: 30
  • Pre-requisites: LS5008 or LS5001 plus LS5003
  • Co-requisites: None

Summary

This is a core module for Pharmacology and an option for other Life Science degree courses, namely Biological Sciences (Medical Biology route) and Biochemistry.

This module provides an opportunity to learn about the various chemotherapeutic agents used in the treatment of both infectious and neoplastic disease. Treatments for infectious diseases will cover drugs that have actions on bacteria, viruses, fungi and parasites, while the neoplastic disease therapy will include a range of different cancers, including both solid and blood cancers. The lectures will focus on the mode of action, side effects and mechanisms of resistance of both antimicrobials and anti-cancer drugs.

Aims

  • To provide a knowledge and understanding of the biochemical basis of chemotherapy.
  • To provide a rationale for the use of chemotherapeutic agents in the treatment of infectious and neoplastic diseases.
  • To raise awareness of the issue around, and mode of resistance to, chemotherapeutic agents.

Learning outcomes

On successful completion of the module, students will be able to:

  • Critically analyse the rationale for the choice of chemotherapeutic agents in the treatment of specific infectious/neoplastic diseases.
  • Describe the side effects associated with the use of chemotherapeutic agents.
  • Discuss the theoretical and practical considerations relating to the use and testing of chemotherapeutic agents.
  • Discuss the mechanisms thought to be responsible for resistance to chemotherapeutic agents in micro-organisms and cancers.
  • Demonstrate the ability to acquire, evaluate and communicate information from a variety of sources.
  • Perform and evaluate appropriate practical microbiological skills.

Curriculum content

  • Basic principles of chemotherapy: Concept of selective toxicity.  Molecular basis of chemotherapy. Types of biochemical reactions that act as potential targets for chemotherapeutic intervention.
  • Antibacterial agents: Beta-lactam antibiotics (penicillin); agents interfering with action of, or synthesis of, folate; agents affecting bacterial protein synthesis; agents affecting nucleic acids; agents affecting topoisomerase II; antimycobacterial agents used in the treatment of tuberculosis and leprosy.
  • Antifungal agents: Antifungal antibiotics (Amphotericin, Nystatin, Griseofulvin).  Synthetic antifungal agents (Azoles, Terbinifines).
  • Antiviral agents:  Types of pathogenic viruses, strategies to invade host cells and evade host responses.  HIV/ AIDS, Transcription inhibitors (DNA polymerase inhibitors and reverse transcription inhibitors), Inhibitors of post-translational events (protease inhibitors), Inhibitors of attachment/penetration of host cells, Immunomodulators.
  • Antiprotozoal agents and antihelminthic agents: Host-parasite interactions, Lifecycle of protozoal infections.  Drugs used to treat malaria, amoebiasis, Leishmaniasis, Trypanosomiasis, Trichomoniasis and Toxoplasmosis. Types of helminth infection and their treatment.
  • Antibiotic resistance:  Mechanisms of antibiotic resistance.  Importance of monitoring antibiotic use and resistance.
  • Introduction to Biology of cancer: Cancer epidemiology, aetiology, the process of carcinogenesis, benign and malignant tumours, classification of cancer and cancer metastasis, various therapeutic strategies against cancer.
  • Chemotherapy of cancer: Point of action of phase-specific drugs, chemotherapy, cytotoxic chemotherapy, mechanisms of genetic resistance to cytotoxic drugs, cytotoxic antibiotics, mitotic inhibitors, mechanism of action of antimetabolites
  • Anti-cancer drugs: Cytotoxic drugs and Targeted therapy of cancers using monoclonal antibodies and small molecule tyrosine kinase inhibitors
  • Conventional chemotherapy for haematological cancers: Conventional chemotherapy (mainly combination chemotherapy) for common blood cancers such as leukaemia, myeloma and lymphoma.
  • Novel therapeutic strategies for haematological cancers: The differentiation and apoptosis induction therapy for acute promyelocytic leukaemia, tyrosine kinase inhibitors for chronic myeloid leukaemia, monoclonal antibodies for chronic lymphocytic leukaemia, antiangiogenic therapy for multiple myeloma, other targeted therapies, etc.
  • Hormone responsive cancers (prostate and breast) and angiogenesis inhibitors.

Teaching and learning strategy

The purpose of lectures in this module is to introduce and explain concepts and define the areas of knowledge required. Additional examinable information will be provided on Canvas, for directed reading, and students are strongly advised to keep abreast of the latest developments in antimicrobial and anti-cancer treatments through reading peer-reviewed articles.

Lectures will introduce topics in a logical progression and will be used to provide a sound theoretical background in contemporary understanding of both anti-microbial and anti-cancer agents. The antibiotic lectures will be augmented by practical sessions utilising methods and techniques routinely used in clinical and research settings. Tutorials will allow students to clarify issues arising, and to gain feed-forward experience, from formative-based assessments. These sessions may also be used for tutor-directed learning to develop skills in independent learning and in abstracting scientific information from articles and texts.

Breakdown of Teaching and Learning Hours

Definitive UNISTATS Category Indicative Description Hours
Scheduled learning and teaching 45 one hour lectures 2 x 3 hour practical sessions 10 x 2 hour workshops/tutorials 71
Guided independent study Student independent study 229
Study abroad / placement
Total (number of credits x 10) 300

Assessment strategy

A three-hour end of module examination worth 50% will require students to answer essay questions which will enable students to demonstrate depth of knowledge and integration of material studied in the course of the module.

There are two summative assessments; the first is linked to the microbiology practical and comprises a written report of results obtained from a laboratory practical class. This practical examines how antimicrobial agents are currently tested within the UK using accredited methods. This assesses students' ability to perform a range of microbiology techniques and their ability in intrepreting data produced in the assays. Secondly, students prepare two abstracts of a current research paper, the first of which is formative and is used to feed forward for the second abstract (summative). The abstract assessment allows student to demonstrate their ability to identify key points within an article and to concisely summarise the findings.

A range of formative assessments are undertaken during workshops, and these provide feed-forward guidance on assessments. The formative assessments include an essay, similar in scope to those in the examination, which are marked and feedback given in a tutorial session. This provides feed-forward guidance for the summative final examination.

Mapping of Learning Outcomes to Assessment Strategy (Indicative)

Learning Outcome Assessment Strategy
1. Critically analyse the rationale for the choice of chemotherapeutic agents in the treatment of specific infectious/neoplastic disease. Abstract coursework (F/S), End of module exam (S)
2. Describe the side effects associated with such use. End of module exam (S)
3. Discuss the theoretical and practical considerations relating to the usage and testing of chemotherapeutic agents. End of module exam (S)
4. Discuss the mechanisms thought to be responsible for resistance to chemotherapeutic agents in micro-organisms and cancers. End of module exam (S)
5. Demonstrate the ability to acquire, evaluate and communicate information from a variety of sources. Practical report (F/S), End of module exam (S)
6. Perform and evaluate appropriate practical microbiological skills. Practical report (F/S)

Elements of Assessment

Description of Assessment Definitive UNISTATS Categories Percentage
End-of-year formal examination Written exam 50%
Practical report Coursework 30%
Abstract report Coursework 20%
Total (to equal 100%) 100%

Achieving a pass

It IS NOT a requirement that any major element of assessment is passed separately in order to achieve an overall pass for the module.

Bibliography core texts

The latest versions of these texts are recommended.

Rang, Dale, Ritter, Flower & Henderson. Rang and Dale's Pharmacology, Churchill Livingston, Oxford.

Chabner & Longo. Cancer Chemotherapy & Biotherapy, Liincott Williams & Wilkins

Bibliography recommended reading

Fischer et al. The Cancer Chemotherapy Handbook, Mosby

Kalant, Grant & Mitchel. Principles of Medical Pharmacology, Saunders

Murray et al. Manual of Clinical Microbiology, ASM press

Baron S. Medical Microbiology. An online textbook.

URL: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=mmed

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