Clinical Pharmacology (Clinical Pharmacology Laboratory -VTH)

Program Description
The defining characteristics of the specialty of veterinary clinical pharmacology reside in an advanced knowledge of the many complex factors that constitute rational drug therapy in animal patients. The Residency Program in Veterinary Clinical Pharmacology at North Carolina State University is designed to provide training and practice experience for a candidate to fulfill eligibility requirements for board certification as a Diplomate by the American College of Veterinary Clinical Pharmacology (ACVCP). Residents in clinical pharmacology also will have the option of working towards an advanced academic degree in veterinary pharmacology.

Program Supervisor
Mark G. Papich, DVM, MS, Professor, Department of Molecular Biomedical Sciences. Dr. Papich is the current president of the American College of Veterinary Clinical Pharmacology. He also is a member of the Council of the American Academy of Veterinary Pharmacology and Therapeutics and was elected to the Council of Experts for United States Pharmacopeia (USP) and chairs the USP Expert Committee on Veterinary Drugs. His interests and expertise: pharmacokinetics, antimicrobial therapy, analgesic drugs, and analytical methodology.

Training Components
The Residency Program is a three (3) year program. The first year of the training program is designed to establish the resident's knowledge base of the comparative pharmacology of principal drug groups employed in veterinary therapeutics. In the second year, the resident is expected to learn the basic mechanisms and pathophysiologic features of a wide variety of diseases occurring in the various classes of domesticated animals and to understand the role of drugs in modifying the disease process. The resident will be involved with the College's Clinical Pharmacology Laboratory during this portion of the training period. The resident also is expected to take part in clinical teaching rounds, and take an active role consulting with clinical staff. The resident may be expected to keep a logbook of cases in which he/she played an active role. The third year of the training program is intended to develop the resident's knowledge and skills in specific areas that are critical to the practice of clinical pharmacology. The primary focus during the third year will be a research project designed to provide the resident with skills necessary to be a successful investigator in veterinary clinical pharmacology.

Contacts
Candidates for residency/graduate program in Clinical Pharmacology should contact Dr. Mark G. Papich (mark_papich@ncsu.edu) for further information.

For application materials to the College's graduate program, candidates should contact the administrator of the graduate office:

Phone: (919) 513-6203
Fax: (919) 513-6452
E-mail:

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Specific Objectives of Training Program

A. Knowledge of pharmacology:
A diplomate of the ACVCP is expected to possess advanced knowledge of the comparative pharmacology of principal drug groups employed in veterinary therapeutics, including knowledge in the following special areas as they pertain to these drugs.
1. Physiochemical drug characteristics.
2. Mechanisms of drug action.
3. Drug effects in various animal species, and interspecies differences.
4. Pharmacokinetics and drug disposition.
5. Therapeutic indications.
6. Drug toxicology and recognition of adverse drug effects.
7. Pathophysiology of adverse drug reactions, drug interactions, and drug allergy.
8. Causes of therapeutic failure.
9. The influence of patient factors such as disease, habitus, age, and pregnancy on drug disposition and effects.

B. Diplomates of the ACVCP are expected to have advanced knowledge of the following principal drug groups:
1. Drugs affecting the autonomic and somatic nervous system.
2. Autacoids and drugs affecting inflammation.
3. Drugs affecting the blood and blood-forming organs and the immune system.
4. Drug affecting water, salts, and ion balance.
5. Hormones and hormone antagonists.
6. Drugs affecting renal function.
7. Cardiovascular drugs.
8. Drugs affecting the gastrointestinal system (including the liver and pancreas).
9. Drugs affecting the central nervous system.
10. Antibacterial drugs.
11. Antiparasitic drugs.

C. Drug groups in other specialties:
Diplomates of the ACVCP are expected to have a general knowledge of the other drug groups, which are within the realm of special expertise of other clinical specialists. These drug groups are as follows:
1. General and local anesthetics (anesthesiology)
2. Oxytocic and tocolytic drugs (theriogenology)
3. Antineoplastic drugs (oncology)
4. Drugs that affect the eye (ophthalmology)
5. Locally-acting drugs (dermatology)
6. Vitamins and minerals (nutrition)
7. Toxic gases, plants, vapors, heavy metals, pesticides (toxicology)
8. Disinfectants (preventative medicine and surgery)

D. Management of Disease:
Among the many diseases, a Diplomate of the ACVCP is expected to be able to diagnose and treat complex therapeutic problems such as:
1. Management of pain in any species.
2. Management of inflammation in any species.
3. Management of infections in any major organ system and the use of antibiotics to treat infections.
4. The effect of diseases (for example, renal and hepatic failure) on drug disposition.
5. Management of medical emergencies requiring potent and often, multiple drugs (for example, circulatory shock, heart failure, cardiac arrhythmias, pulmonary edema, thromboembolism, diabetic ketoacidosis, seizures, bronchoconstriction, hypoglycemia, hypocalcemia, gastrointestinal hemorrhage, etc.)
6. The effect of physiologic state (for example, neonate or pregnancy) on drug disposition and therapy.
7. Recognition and management of drug and chemical intoxications of either an acute or chronic nature.
8. Recognition and management of drug reactions including those caused by radiologic contrast media, anesthetics, or allergies.
9. Management of diseases associated with specific organ failures.

E. Skills:
The resident is expected to develop the skills necessary to be an active clinical pharmacologist. These skills include:
1. Interpretation of experimental and statistical data obtained from drug studies performed in laboratory and domesticated animals.
2. Planing and interpretation of results of clinical trials for the evaluation of safety and efficacy of drugs belonging to the principal drug groups.
3. The use of statistical methods to evaluate studies on drugs in animals.
4. A general knowledge of the analytical methods used to measure drug concentrations in animals (for example, HPLC, RIA, FPIA). The resident should have a practical understanding of assay validation and quality control.
5. Planning and interpreting pharmacokinetic studies in animals.
6. Evaluation of drug therapy in patients through the application of therapeutic drug monitoring, pharmacokinetic, and pharmacodynamic methods.
7. Calculation of the dose of drugs from knowledge of the minimum effective drug concentration, bioavailability, effective plasma drug concentrations, route of elimination, and other pharmacokinetic data. Similarly, the resident should be able to modify dosage regimens to accommodate for pharmacokinetic alterations caused by disease.
8. Understand the important species differences in response to pharmacologic approaches to therapy.
9. The resident should have a practical understanding of the process of drug development and approval.
10. The resident should understand the legal and regulatory considerations pertinent to extra-label drug use, drug compounding, avoidance of violative drug residues in food animals, prescription writing, and responsibilities for using and dispensing controlled substances.

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