School of Nursing - UT Health Science Center San Antonio

Fall 2008

NURS 6302-01 Pharmacotherapeutics for Advanced Practice Nurses

This course resides in the Department of Acute Nursing Care

Required Course Packet will be available first class day August 28, 2008, and is located on the home page of course, click on  Blackbord logo.  Familiarize yourself with this process before the first day of class.

This course is Web Enhanced with WebCT
Please be sure to check the Current Computer Requirements

FACULTY
Cheryl Lehman, PhD, RN, CRRN-A, BC

E-mail:  LehmanC@uthscsa.edu
Phone: (210) 567-5870
Pager: (210) 235-0021
Office: 2.212
Office Hours: Wednesday 9:00 a.m. - 12:00 p.m.

Acute Nursing Care Department

 

COURSE DESCRIPTION
This course provides advanced practice nursing students the opportunity to acquire knowledge and skills in the therapeutic use of pharmacologic agents in the practice of primary health care.  Principles of pharmacokinetics and pharmacodynamics will be examined.  The history of disease, pathophysiology, symptomatology and pharmacologic treatment of major health problems that affect South Texas will be explored.  Potential reactions of various cultural groups to prescribed agents will be emphasized, including adherence, cost of drug, cultural values and beliefs, and individual responses to therapy.  The roles of the physician and the nurse, relative to prescriptive authority, will be fully addressed.

CREDIT AND TIME ALLOCATION
3 semester hours, 3 clock hours class

PREREQUISITES
OR CONCURRENT:    NURS 5338  Pathophysiology for Advanced Practice Nurses

COURSE OBJECTIVES
  1. Apply the principles of pharmacology, including pharmacokinetics and pharmacodynamics in the treatment of major health problems across the lifespan.
  2. Identify unexpected and potential adverse reactions to pharmacological agents such as allergic reactions, drug interactions, idiosyncratic reactions, altered metabolism and/or excretion and age/ethnic differences.
  3. Identify appropriate methods of monitoring effectiveness of specific pharmacologic therapy.
  4. Provide rationale for ensuring client adherence to therapeutic regimes through activities of communicating effectively, demonstrating cultural sensitivity, counseling to improve adherence and recognize client's right to refuse treatment.
  5. Explain state and federal laws that regulate the dispensing of various classes of drugs.
  6. Select appropriate drug therapy including over-the-counter medications for specific health problems.
  7. Calculate correct dosages of medications based on relevant individual client characteristics/illness.
  8. Under the appropriate physician authority and protocol: write a prescription for the pharmacologic therapy correctly.

CLINICAL OBJECTIVES
N/A

CRITERIA FOR EVALUATION / GRADES

30 % - Final Exam
20 % - Case Study Paper

15%  - Quizzes
10% - Class Presentations

25%  - Homework Assignments
100% - Total

A = 90-100%
B = 80-89%
C = 70-79%
D = 60-69%
F = Below 60%

Course Policies:

  1. It is required that all students come prepared for class, having read assigned readings.  Attendance is expected.
  2. Written assignments must be submitted by the designated time on the date due in the Assignment Drop Box in  Blackbord logo, unless other instructions are given
  3. Late assignments will not be accepted.  Students may request an extension of due dates from course faculty.  Extensions of due dates will be granted at the discretion of the faculty. 
  4. Routine homework assignments are to be neatly typed.  APA format is not required, except for cited references.
  5. The Case Study paper is to be in APA format.
  6. Quizzes are non-supervised and may be taken on your home computer.  They will be each open for 48 hours.
  7. A large portion of the class is housed in Blackbord logo.  This includes learning modules consisting of weekly objectives, assigned readings and weblinks, and written assignments.  Students are expected to monitor the site closely for updates.  Class communications on email will be within Blackbord logo.  Slides and handouts for each class will be filed in the appropriate learning modules in  Blackbord logo.
  8. If a student's absence is foreseeable, notify the insturctor prior to class date.  If the absence occurs on an examination day, an alternate exam may be provided at the instructor's discretion.  The student is responsible for any content presented in class.

Examinations: Exams will be completed in the computer lab during scheduled times to be announced.  The final exam covers material from the entire course. The final exam is multiple choice and includes content from textbook, lecture and assigned readings.
 

SCHOLASTIC DISHONESTY
Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.

American with Disabilities Act (ADA) Accommodations
Any student seeking ADA Accommodations under the American with Disabilities Act should contact the Associate Dean for Students within the first week of the semester so that appropriate accommodations may be arranged. A Request for Accommodations (Form 100) must be completed. These forms are available in the Office for Students Room: 1.118-16

REQUIRED TEXT / REFERENCE

Wynne, A.L., Woo, T.M. & Olyaei, A.J. (2007),  Pharmacotherapeutics for Nurse Practitioner Prescribers (2nd ed.)                Philadelphia:F.A.Davis

Turkoski, B.B., Lance, B.R., Bonfiglio, M.F.(2009).  Drug Information Handbook for Advanced Practice Nursing
        ( 9th ed.)  Hudson, Ohio:  LexiComp.

Schwinghammer, T.(2005). Pharmacotherapy Casebook:  A Patient-Focused Approach. New York:  McGraw - Hill


RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Tarrascon. Pocket  Pharmacopoeia (2008),  Loma Linda, CA:  Tarrascon Publishing

Buppert, Carolyn (2006). Prescribing: Preventing Legal Pitfalls for Nurse Practitioners. Annapolis: Buppert.


CONTENT OUTLINE

A.    Pharmacokinetic principles

B.    Pharmacodynamic principles

C.    Concept of drug interaction/polypharmacy

D.    Expected side effects vs. idiosyncratic reactions

E.     Allergic reactions to pharmacological agents

F.     Altered metabolism/excretion affects on drug action

G.    Indications for pharmacological therapy

H.    Selection of appropriate drug for various conditions

I.     Over-the-counter drugs

J.    Cultural variation in attitudes towards and use of medications

K.    Ethnic variations in drug effects

L.    Special populations:  children & elderly

M.    Education of client as to need for drug, desired effect, possible side effects, method of taking

N.    Calculation of correct dosages based on individual

O.    Monitoring drugs through physiologic parameters

P.    Monitoring client's understanding and adherence to drug regime

Q.    Legal, ethical aspects of pharmacologic prescribing        

R.    Work in conjunction with physician in pharmacological management

S.    Federal and state laws and regulations for dispensing various classes of drugs

T.    Writing a prescription correctly

U.    Texas Nurse Practice Act

V.    Cost of medication to client, 3rd party payer

W.    Identification of non-compliance

X.    Improving adherence through client counseling

Y.    Drug topics:

  1. Antihypertensives
  2. Diuretics
  3. Cardiovascular pharmacology
  4. Calcium channel blockers
  5. Nitrates
  6. Antilipidemics
  7. Neuroleptics
  8. Hypnotics
  9. Sedatives
  10. Anxiolytics
  11. Anticonvulsants
  12. Opioids
  13. Nonnarcotic analgesics
  14. NSAIDS
  15. Skeletal muscle relaxants
  16. Arthritis medications
  17. Gastrointestinal drugs
  18. Autocoids
  19. Medications used in pregnancy
  20. Anticoagulants
  21. Diabetic medications
  22. Antineoplastics
  23. Immunosuppressants
  24. Endocrine pharmacology
  25. Hormone contraceptives/hormone replacement

CALENDAR - First Week Only
Please check the Fall 2008 Schedules for recent updates on Class Dates & Room.
Date Topic / Assignment Due

Thursday, August 28, 2008

1:00 PM - 4:00 PM

Rm. 1.463

Topics: Class intro T.B O.N. & T.M.B. rules.  Role of the APN.  Ethical issues.  Sources of drug information. Writing a prescription.

Assigned Readings:

1. Texas B. O. N. rule 222 (link on Blackbord logo)

2. Texas Medical Board- Board Rules, Chapter 193 (link on Blackbord logo)

3. Wynne & Woo, Chapters 1, 7, 12

4. Blackbord logoNURS.6302-01 Required Readings

----------"Prescription Writing to Maximize Patient Safety"

----------"How To Avoid Errors When Writing"

----------"Prescribing Under The Influence"