1. PHRC 5410. Pharmacotherapy I. Fall 2012. Faculty Coordinator(s): Sandra
Benavides, PharmD. William Wolowich, PharmD. Course Faculty/Instructors.
PHRC 5410 Faculty Coordinator(s):
Pharmacotherapy I Sandra Benavides, PharmD William Wolowich, PharmD
Fall 2012
Course Faculty/Instructors Name
Email
Office Hours
Jaime Riskin, PharmD, BCPS Eglis Tellez-Corrales, PharmD William Wolowich, PharmD
[email protected] [email protected] [email protected]
TBA TBA TBA
Course Facilitator(s) Ft. Lauderdale: TBA International Grad: TBA Ponce, PR: TBA Palm Beach: TBA
Day(s)/Time(s):
Day/Time
Location(s) Ft. Lauderdale: TBA International Grad: TBA Ponce, PR: TBA Palm Beach: TBA
Catalog Description This is the first of four courses in the Pharmacotherapy sequence. The first one-half of the course will lay the groundwork of clinical pharmacokinetics for the remaining course sequence. It will apply the concepts and techniques of biopharmaceutics and pharmacokinetics to rational design of the individualized drug dosage regimens, taking into consideration factors such as hepatic and renal impairment, effects of other diseases, and drug interactions. The course sequence will then cover specific disease states and focus on the therapeutic decision making process. Concepts in the course sequence include physical findings, laboratory values, adverse drug effects, drug interactions, and patient education. Application of previous course materials, including pathophysiology, pharmacodynamics and pharmacokinetics is required. This course will focus on the development of the subjective, objective, assessment, plan, and patient education (SOAPE) note, management of fluid and electrolyte disorders, and nutrition.
Course Prerequisites PHRC 4250 Pharmacokinetics PHRC 4410/4420 Physiology and Pathophysiology I & II PHRC 4210/4220 Pharmacodynamics I & II PHRC 4200 Pharmacy Calculations Course Credit Hours 1
PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD 3 credit hours
Course Objectives Upon successful completion of this course, students will be expected to: A. Apply the interrelationship between biopharmaceutics, pharmacokinetics, and pharmacodynamics to achieve rational drug therapy. B. Identify and apply models and equations developed for predicting drug concentrations after single and multiple doses from different routes of administration. C. Predict the importance of factors such as age, gender, weight, genotype/phenotype, organ function, disease-state and drug-interactions based on the pharmacokinetic drug profile and apply these factors to patient specific data in order to modify dosing regimens. D. Identify which drugs need special dosage adjustments based on the concepts learned during this course, and be able to describe why. E. Describe the pathophysiology of selected disease states and explain the rationale for corresponding drug therapy. F. Describe pharmacodynamic and pharmacokinetic properties of medications prescribed for various disease states. G.Select appropriate initial and maintenance drug regimens for patients with a given disease and disease characteristics. H. Adjust medication regimen utilizing accepted pharmacokinetic principles to individualize therapy. I. Describe potential adverse effects of medications and discuss strategies to prevent and or manage the occurrence of such effects. J. Identify drug/drug, drug/laboratory, and drug/food interactions and select appropriate strategies for the prevention or management of such interactions. K. Interpret relevant diagnostic tests and laboratory values associated with applicable medications. L. Analyze patient specific pharmacotherapy cases utilizing a S.O.A.P.E format that includes: 1. Identifying, prioritizing, and assessing the patient’s medical problem(s) 2. Identifying abnormal physical findings and laboratory values 3. Identifying adverse drug effects as well as drug/drug, drug/laboratory, and drug/food interactions 4. Identifying both actual and potential drug related problems and document rationale 5. Designing and evaluating treatment regimens for optimal outcomes using disease states and previous or current drug therapy 6. Developing backup plans based on what problems are likely to occur from/with the primary plan 7. Developing corresponding monitoring parameters and therapeutic goals for the patient 8. Developing appropriate counseling strategies to promote optimal patient outcomes
College Educational Outcomes The educational outcomes addressed in this course are represented below. A1. Provide patient-centered care A.1.1 Design, implement, monitor, evaluate and adjust pharmacy care plans that are patient specific and evidence-based A1.1.1. Gather comprehensive patient information to identify potential drug problems A1.1.2. Evaluate patient and drug-related data needed to identify actual or potential drug therapy problems (prescription and nonprescription) A1.1.3. Develop a complete medical and drug therapy problem list
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD
A1.1.4. Select and recommend appropriate drug therapy (prescription and nonprescription) as part of a care plan A1.1.5. Select and recommend nondrug therapy as part of a care plan A1.1.6. Devise and implement a patient monitoring plan to ensure achievement of desired therapeutic outcomes A1.2 Educate patients, caregivers, and other involved health care providers to engender a team approach to patient care A1.2.1. Educate patients and/or caregivers about drug therapy A1.2.1.1. Identify sources of patient education information that meet the patient’s needs A2. Provide population based care A2.1. Develop and implement population specific, evidence-based disease management programs and protocols based upon analysis of epidemiologic and pharmacoeconomic data, medication use criteria, medication use review and risk reduction strategies A2.1.1. Assess the health needs of a specific patient population C1. Identify public health problems C1.1. Apply population specific data, quality assurance strategies and research processes to identify public health problems C1.1.1. Identify features of target population C1.1.2. Apply epidemiological methods to define and assess the health status of individuals and populations C1.1.3. Define the role of screening tools in identifying public health problems C2. Solve public health problems C2.1. Develop a plan for provision of informational and preventive efforts and identify potential methods and/or plans to generate physical or financial support from internal and external sources C2.1.1. Design a plan to address public health problems C2.1.2. Promote patient education on wellness, health improvement, and disease prevention and control D3.1. Identify the types and quality of information that are available in primary, secondary and tertiary information sources, including electronic resources and those intended for lay audiences D3.2. Critically analyze relevant literature D3.3. Draw conclusions by integrating evidence from the literature and clinical expertise D4. Apply patient specific data, population specific data, quality assurance strategies and research strategies to make informed, rational and evidence-based decisions D4.1. Apply patient specific data to make informed, rational and evidence-based decisions D4.2. Apply population specific data to make informed, rational and evidenced-based decisions D4.4. Apply research processes to make informed, rational and evidence-based decisions D5. Acquire skills that promote self directed lifelong learning D5.1. Maintain professional competence by identifying and analyzing emerging issues, products and services that may impact pharmacy practice
Course Format and Policies The course is delivered utilizing video conferencing/live classroom/Blackboard to multiple sites. Faculty from multiple sites may be used to deliver the course. 1. Professional Behavior Students must conduct themselves in a professional manner. This includes maintaining the proper dress code set by the College and being courteous to classmates, facilitators and
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD instructors both in class and online. Individuals, who do not conduct themselves professionally, will be subject to disciplinary action. 2. Academic Dishonesty Students should avoid the appearance of impropriety in all activities. Cheating, or the appearance of cheating, will not be tolerated and is subject to disciplinary action. Cheating includes, but is not limited to:
Sharing exam content or answers during an exam or disseminating exam questions after the exam; Looking at a neighbor’s paper; Unauthorized collaboration on projects or homework; Plagiarism (assignments may be processed through Turnitin.com to detect plagiarism); Fabrication of data; Deceptions of any manner.
Academic honesty and integrity are fundamental values expected of all students. Students who are caught of academic dishonesty will receive a failing grade for the assignment, quiz, exam and/or the course. Additionally, students will be referred to the Student Progress Committee for further disciplinary action. 3. Attendance/Tardiness Attendance is mandatory as per NSU College of Pharmacy Handbook. The College of Pharmacy Office of Student Services will be responsible for determining excused absences. Students are responsible for obtaining materials and completing assignments missed when absent. It is the student’s responsibility to maintain a record of absences and excuses. Excused absences must be submitted for approval by Student Services within 48hours of the missed class. Classes begin at 10 minutes after the hour. Students may enter the classroom after that time but in a quiet and organized manner. However, the instructor has the right to ask you to wait outside until the break. Attendance may be taken by randomly calling on students to answer questions during lectures, pop quizzes, Turning Point activities, or failure to be present during case days. If a student is not present to complete the quiz or activity at the time it is given, the student will be considered absent for class that day. Unexcused absences will result in the following deductions from the final grade: Number of Unexcused Absences
Point Reduction From Final Grade
1
5
2
10
3
15
4
Fail Course
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD
4. Make-up Policy Excused absences do not entitle students to have the opportunity to make up in-class quizzes or assignments. Make-up examinations will only be given for approved excused absences and at the discretion and convenience of the faculty coordinator. The make up examination may be essay or short answer and will likely not be a multiple choice examination.
5. Distance Learning All students will be taught, at one time or another, by a faculty member who is teaching from another location. Students are expected to show respect to their fellow students and the classroom facilitator by exhibiting professional behavior during class. Students who fail to exhibit appropriate behavior in class, and are disruptive to other students, will be asked to leave the class. Lectures will be digitally recorded for times when there is a loss of transmission, unless otherwise stated. Access to recorded lectures will be granted at the discretion of the faculty coordinator and/or lecturer. Access to the digital recording can be obtained by following the instructions provided on the College of Pharmacy Office of Student Affairs website under Access to videotaped lectures http://pharmacy.nova.edu/NewWebsite/StudentAffairs/Main.html) 6. Additional Student Responsibilities A. Prepare for each class by completing all reading assignments, reviewing handouts, and completing cases where applicable. Direct observation of students, questioning and pop quizzes will occur randomly in class to assess attendance and/or preparedness for class. B. Students are expected to check Blackboard prior to each class. Prepare for each class by completing all reading assignments, reviewing handouts, and completing cases where applicable. As previously mentioned, random pop quizzes will be used to assess attendance and students will be randomly called upon to assess their preparedness for class. C. Review and understand each faculty members’ learning objectives prior to class. D. Dress code will be enforced at all times. Students not in dress code may be asked to leave class and will receive an unexcused absence for that class period. Please see the NSU College of Pharmacy Student Handbook for dress code policies. E. No food or beverages (excluding bottled water) are permitted in the classrooms. F. All cellular phones, pagers, and personal digital assistants are to be turned off during class and recitation. Any student whose cell phone, pager, and/or personal digital assistant is activated during class may be asked to leave the room and may receive an unexcused absence for that class period. G. Faculty will only recognize student e-mail when it is from their Nova Southeastern University account. Students must include their full name and site in their signature of the email. The content of the e-mail should be written in English or it will not be acknowledged. The student should expect to wait a minimum of 48 hours for the faculty response (not counting weekends).
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD Resources Required Text
DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. th Pharmacotherapy: A Pathophysiologic Approach, 7 ed. New York, NY: McGrawHill, 2008. ISBN is 9780071478991. Bauer LA. Applied Clinical Pharmacokinetics, 2 2008. ISBN is 9780071476287.
nd
ed. New York, NY: McGraw Hill,
Recommended Text Koda-Kimble MA, Young, L Alldredge BK, Corelli RL, Ernst ME, Guglielmo BJ, Jacobson PA, Kradjan WA, Williams BR, eds. Applied Therapeutics: The Clinical Use of Drugs, 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2012. ISBN: 9781609137137 Other Resources: Selected readings from the primary literature or other sources may be provided to supplement or replace the textbook readings. There may be weekly reading assignments. It is the student’s responsibility to read the assigned material prior to attending class. Response Pads are required for every class as quizzes or case assignments may be graded via this method. Failure to have your clicker for a quiz, attendance, or participation will result in a zero/absence for that activity. A nonprogrammable calculator (recommended: TI 30XA) and access to Microsoft Excel is also required.
Delivery Methods (Teaching Methodology) Course content will be delivered using a variety of teaching and learning methods including lectures, in-class and online discussions, assigned readings, self-study modules, demonstration of pharmacokinetic software (WinNonLin), and assignments. Class meetings will consist predominantly of lectures and informal open discussions. Blackboard: http://Blackboard.nova.edu will be utilized to provide and supplement course materials; to conduct online discussions; and to provide links to resources. (Students are encouraged to complete the Blackboard Tutorial and Quiz within the first week of the course). All course handouts and information will be available to students through Blackboard. Handouts will not be provided in class. All course materials will be provided in Adobe Portable Document Format. Adobe Acrobat Reader and Power Point Viewer can be downloaded free at: http://www.adobe.com/products/acrobat/readstep2.html, and http://www.microsoft.com/downloads/details.aspx?familyid=048dc840-14e1-467d-8dca19d2a8fd7485&displaylang=en. Course announcements will be made either in class, on Blackboard bulletin board, or NSU email. Students are responsible for accessing and responding to all information disseminated. Students must have access to a printer, and computer with internet connection, to allow them to access internet and web resources, and download and print course material.
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD Assessment Methods Student learning will be assessed using the following formative and summative assessment methods: 1.
Self-Assessment: (non-graded) The following self-assessment tools will be used throughout the semester and may be used to determine attendance in class. a. b. c. d.
2.
Case Studies or Assignments Discussion Pop Quizzes Auto Response Pads
Summative Assessment: (graded) The following tools will be used throughout the semester and may be used to determine attendance in class. a. Case Assignments b. Quizzes (in class and on Web-CT/Blackboard) c. Examinations
Grading Policies Grading Mode: Numeric Course Grades will be determined as follows: Exam 1 28% Exam 2 28% Exam 3 28% Case 4% Quizzes 12% Total: 100% Grades will be given on a percentage scale. A passing grade for the course is defined as 70% or better.
Exam Policies Failure to follow exam behavior protocol may be considered as evidence of academic dishonesty. 1. Exams will be administered OUTSIDE of class time. It is the responsibility of the student to know the time and location for each exam. Course coordinators will announce the exam date, time, and locations via Blackboard. 2. Students must arrive promptly for the exam (NOTE exam times). No additional time will be given for students who arrive late. 3. Students may not enter the classroom after the first person has left the exam room at any site. 4. A student may not leave the exam room unless accompanied by a faculty member or facilitator. 5. Talking or other disruptive behaviors are not allowed. 6. Cheating, or the appearance of cheating, will not be tolerated. 7. Unnecessary materials (backpacks, cell phones, books, etc.) must be placed in the front of the room. Cell phones must be turned OFF. 8. Failure to completely and accurately fill in your name, site, NSU ID, form #, or exam #, on Scantron or other examination forms will result in a loss of 4 points.
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD 9. No make-up exams will be given for any unexcused absences. Students with an excused absence for an examination will receive a makeup at the discretion and convenience of the faculty coordinator (more likely at the end of the semester, during dead week). 10. Exam keys will not be posted until exams have been received from all sites and graded. 11. Up to 20% of each exam may be from cumulative material covered previously within the course.
Grading Disputes Refer to COP Student Handbook.
Additional Information Americans with Disability Act It is the student’s responsibility to initiate the process for disability services. Students approved for accommodations under the Americans with Disability Act should have completed the required forms and received accommodation approval from the HPD Student Disability Coordinator Ms. Susan Gonzalez at
[email protected]. Information and forms are available at http://www.nova.edu/disabilityservices/studentinfo.html.
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PHRC 5410
Pharmacotherapy I
Fall, 2012
Faculty Coordinator(s): Sandra Benavides, PharmD William Wolowich, PharmD
Date
Topic
Faculty Broadcasting From (Site)
Instructor
MODULE 1—Pharmacokinetics Week 1 Week 2 Week 3 Week 4 Week 5
Introduction to course and syllabus (1) Review of pharmacokinetic concepts (2) Review of pharmacokinetic concepts (2) PK models and equations (1) PK models and equations (3) Hepatic clearance of drugs /well stirred model (3) Hepatic clearance/well stirred model (2) Hepatic clearance (1)
Davie Davie
Benavides Shawaqfeh Shawaqfeh Wolowich
Davie
Wolowich
Davie
Wolowich
Davie
Wolowich
Davie
Wolowich
Hepatic clearance (2) Week 6 Application Exercises (1) MODULE 2—Pharmacokinetics and Introduction to Pharmacotherapy Week 7 Week 8 Week 9 Week 10
Renal drug clearance (3) (MODULE 1 EXAM—scheduled out of class) Renal drug clearance (3) Concepts of PK monitoring (1) Overview of laboratory parameters (1) SOAPE notes and medical abbreviations (1) Fluid and electrolytes (3)
Davie
TellezCorrales
Davie
TellezCorrales
Davie
Wolowich Riskin
Davie
TellezCorrales TellezCorrales
Week 11
Acid-base disorders (3)
Davie
Week 12
Application exercises (1) Module 2 Case-based activity (2) (case/quiz time)
Davie
Riskin/TellezCorrales
Davie
TellezCorrales
MODULE 3—Renal Week 13 Week 14 Week 15
Acute Renal Failure (2) Chronic Kidney Disease (1) (MODULE 2 EXAM—scheduled out of class) Chronic Kidney Disease (2) Anemia (1) Anemia (1) Case-based activity (2) (case/quiz time)
Davie Davie
TellezCorrales TellezCorrales Colon-Pratt
Week 16 9 rev: April 27, 2011
