Clinical Pharmacy I - GAF345
|
|
|
|
|
||
|
The subject Clinical Pharmacy I (CP I) focuses on basic knowledge of clinical pharmacy, essential for the follow-up subject of the specialized undergraduate branch of clinical pharmacy called Clinical Pharmacy II (CP II) and for the utilization of knowledge in pharmacy/pharmaceutical care in the subject Pharmaceutical Care II (PC II).
The main content of Clinical Pharmacy I subject is to focus on ethiopathogenesis and epidemiology of basic diseases in clinical practice, risk factors including drug causes, diseases manifestations (symptoms, basic diagnostic tests/assessments), complications of untreated diseases, goals of therapy, treatment strategies in various clinical situations (non-pharmacological, pharmacotherapeutic strategies - major indications, contraindications of drug groups/drugs), and repetitive knowledge of class and individual properties of medicines, and new knowledge on drugs risk/benefit in the main clinical situations and absolute and relative contraindications of medications in clinical practice. The subject trains the ability of students to assess at the basic level appropriateness of the indicated drugs/drug regimens and to evaluate the basic rationality of pharmacotherapy (from the point of view of appropriate indications and contraindications of frequently used medications) by taking into account patients´ comorbidities and standard clinical recommendations of evidence based medicine.
The subject Clinical Pharmacy I (CPI.) is followed in undergraduate specialized branch of clinical pharmacy by the subject Clinical Pharmacy II (CP II), which deepens knowledge on the principles of individualization of drug schemes in specific groups of patients (eg. in patients suffering from renal and hepatic failure, in geriatric and peadiatric patients etc.), with an emphasis on the use of knowledge from both subjects CP I and CP II in the individualization of drug schemes in clinical practice.
Teacher of CPI interactive lectures and seminars is:
Prof. Dr. J. Vlček, CSc. (vlcek@faf.cuni.cz), Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, new campus, e-mail: vlcek@faf.cuni.cz; phone: 00420 739 488 202
Lectures and seminars are held according to actual schedule of the subject Clinical Pharmacy I.-ENGL sent by teacher (prof. Vlček) to students by email. Study materials are sent to students by teacher as well. Updates of instructions, materials or changes in the teaching hours are sent to students before lectures and seminars.
Last update: Fialová Daniela, doc. PharmDr., Ph.D. (27.09.2024)
|
|
||
|
I/ Credit - conditions - 70% presents in the lectures and seminars. If not, it will be necessary to prepare one case from particular topic = 3hour - Successful credit test (70%)
a/ Written credit test content Basic principles of rational pharmacotherapy + arterial hypertension Dyslipidemia, atherosclerosis Ischemic heart disease, heart failure Diabetes mellitus + thyreopathy Pain management Respiratory and urinary diseases GIT disease (peptic ulcer, GERD, diarrhea, constipation) Rational pharmacotherapy of infectious diseases Asthma bronchiale, COPD Anemia, depressive disease Explain: Goal of the treament, Diagnostic methods/interpretations, Strategy of the treatment of acute and chronic forms of disease b/Discussion on your prepared patient clinical case - mechanisms of the effects and side effects of medicines and their indication and contraindication, what is the goal, if it can be reached or was reached, analysis of the patient case..... This case will be prepared by the student and discussed during seminars and also during the oral examination
II/ Oral examination Oral examination consists of 3 sections 1/ Section No 1: Knowledge regarding selected nosological unit
1/ Arterial hypertension 2/ Diabetes mellitus type I 3/ Diabetes mellitus type II 4/ Hypothyroidism 5/ Coronary heart disease 6/ Heart failure 7/ Peptic ulcer 8/ Asthma bronchiale 9/ Chronic obstructive pulmonary disease 10/ Respiratory infection 11/ Urinary tract infection 12/ Viral infections – overview and differences against bacterial diseases from point of view of symptoms, complications, strategy and analysis of one (self-selected) viral disease according to the structure of the nosological unit 13/ Cardiac arrhythmias 14/ Atherosclerosis 15/ Dyslipidaemia 16/ Deep venous thromboembolism 17/ Peripheral artery disease 18/ Constipation 19/ Diarrhoea 20/ Benign prostatic hyperplasia 21/ Sleep disorders 22/ Depression 23/ Pain - generally principles of pain management 24/ Neuropathic pain, back pain 25//Headache 26/ Hyperthyroidisms 27/ Principles of rational use of anti-infective drugs 28/ Gastro-oesophageal reflux disease 29/ Mycotic and fungal diseases– overview and differences against bacterial disease from the point of view of symptoms, complications, and treatment strategies and analysis of one of viral disease according to the structure of the nosological unit 30/ Epilepsy 31/ Parkinson disease and dementia 32/ Anaemia 33/ Emesis and GIT motion sickness 34/ Stroke
Answer is requested in this order: Short characteristic of the disease) Etiopathogenesis Causes and triggers of disease Complication of non-treated or wrongly treated disease Epidemiology and risk factors of disease Symptomatology Diagnosis (5 question of diagnostics- a diagnostic method what allows health care workers to answer 5 questions: 1/ does patient suffer from disease; 2/ what is the severity of disease? 3/ are there present risk factors and triggers of a particular disease? 4/ are there present complications of disoder and risk factors of complications? 5/ does the treatment reach the aim?) Aim of the treatment Strategy of treatment of acute form and chronic form of disease (with focus mainly on pharmacotherapy) Medicines used in pharmacotherapeutic strategies (therapeutical properties (pharmacology, evidence based medicine, and population based clinical experience); For Erasmus students without credit from pharmacology exam this examination will be enlarged in part where prof. Vlček will examine pharmacological knowledge of the student. Erasmus students without prerequisites have to self-study pharmacology properties of medicines used in lectured nosological units or to ask for consultation at the Department of Pharmacology.
2/ Section No 2: Main indications and contraindications of selected groups of drugs, incl. theoretical explanation of mechanism of effect and adverse drug reactions or their class effect 1/ Beta blockers 2/ Calcium channel blockers 3/ ACE-I 4/ Sartanes 5/ Nitrates, salt of magnesium and calcium 6/ Inhibitors of renin, central sympatholytics 7/ Drugs for benign prostate hyperplasia 8/ Thyroidal hormones 9/ Diuretics 10/ Alfa-sympatholytic agents 11/ Beta-sympathomimetics 12/ Non-steroidal anti-inflammatory drugs 13/ Proton pump inhibitors and antacids 14/ Prokinetics, alginates, antacids 15/ Laxative agents 16/ Antihistamines 17/ Anticoagulant agents 18/ Corticosteroids 19/ Paracetamol and weak opioids 20/ Hormonal contraception, hormonal replacing therapy 21/ Penicillines, macrolides 22/ Fluoroquinolones, sulphonamides 23/ Antidepressants 24/ Antimycotics 25/ Antivirotic agents 26/ Antidiabetics 27/ Antiplatelet agents 28/ Agents with anticholinergic activity 29/ Amiodarone, propafenon, digoxin 30/ Hypnotics 31/ Thyreostatics 32/ Hypolipidemics 33/ Medication for the treatment of diarrhoea 34/ Agents with dopaminergic activity
3/ Section No 3: Preparation of one patient case – IT IS NECESSARY TO SEND THE PATIENT CASE ONE WEAK BEFORE EXAMINATION FOR APPROVAL Structure of a patient case (usually a close person): Characteristics of the patient – age, gender, family history, symptoms and diagnosis Personal history (diagnoses and symptoms) The goal of the treatment of disease Clinical investigation and lab data, if available (blood pressure, glycaemia) – here you can train 5 questions of diagnostics! List of used medicines (trade names, INNs, dosage schemes, indication/reason of the use) Opinion of the patient: how he/she evaluates the therapy, how he/she administers a particular drug
Discussion: Does any medicine reach an aim? Does the medicine cause harm (state mainly contraindication; it´s voluntary to analyze some adverse drug reactions (ADR), drug-drug interactions) and is it possible to measure any theoretical future harm? Is any particular medicine missed in the drug scheme? Why? Would you recommend to stop some medicines? Why? How to improve drug non – adherence?
Always explain why do you think so? !!! Not all topics are lectured. You must be able to use main algorithms of patient case solution and to self-study some topics from different sources (used during previous study years)
Consultation before exam is scheduled in any time during lectures and on January 7th and 8th as stated in study plan of lectures and seminars. If student needs additional consultation, prof. Vlček offers them according to the need to all students, but without payment only for students participating at least at 70% of lectures.
Last update: Fialová Daniela, doc. PharmDr., Ph.D. (27.09.2024)
|
|
||
|
Obligatory:
Recommended:
Last update: Fialová Daniela, doc. PharmDr., Ph.D. (27.09.2024)
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Methods of education: - lectures followed by interactive seminars - individual student work on patient case reports that undergo teacher´s review Active preparation of students: It is necessary to refresh your knowledge regarding pharmacological properties of particular medicines and knowledge regarding particular nosologic unit, which will be lectured
Guarant of the subject: Assoc. prof. Fialová Daniela, PharmD, Ph.D. (daniela.fialova@faf.cuni.cz)
Lecturer: Prof. RNDr. Jiří Vlček, CSc. (vlcek@faf.cuni.cz); phone contact: 00420 739 488 202 Lectures and seminars are held once weekly according to schedule sent by prof. Vlček. Lectures and seminars 2024/2025
Clinical pharmacy I._ List of lectures (1,5hours, room A203. start 7:45)
Comments: 1,5hours for each topic is not enough! I require from students to refresh main knowledge regarding diseases and medicines what they learned in the past years
Clinical pharmacy I._ seminars (room A203, 120 minutes) Content: repetition what you learned in lectures, discussion of unclear points regarding disease (diagnostic method, aim, strategy….) and discussion of your homework from the preliminary week) Time: 1.10. 13:10 – 15:10 p.m. (proposal 12:40 – 14:40) 8.10. cancelled 15.9. 12:40 – 16:40 p.m. 22.10 - 29.10. 13:10 – 15:10 p.m. (proposal 12:40 – 14:40) 6.11. - 8.1. 8:00 – 10:35
Topics: 1.10. Basic principles of rational pharmacotherapy + arterial hypertension 15.10. Dyslipidemia, atherosclerosis; ischemic heart disease, congestive heart disease 22.10. Diabetes mellitus + thyreopathy 29.10. Pain management 6.11. Rational pharmacotherapy of infective diseases 13.11. Asthma bronchiale, COPD, respiratory and urinary infections + 1 case 20.11. GIT diseases (peptic ulcer, GERD, diarrhea, constipation) + 1 case 27.11. Algorithm SAFE to assess risk and benefit of pharmacotherapy (3 hours) + 2 cases. 4.12. Deep venous thrombosis, diseases based on thrombophilia + 1 case 11.12. Anemia, depressive disorders + 1 case 18.12 Credit test + consultation 8.1. Credit test + consultation
Last update: Fialová Daniela, doc. PharmDr., Ph.D. (27.09.2024)
|
|
||
|
Credit - conditions - 70% of seminars absolved. If not fulfilled, it will be necessary to prepare one case from topic - Successful credit test Exam Condition to register for exam: 1/ credit from clinical pharmacy 1 2/ presented patient case 3/ record from SIS with information that you passed exam from pharmacology (for erasmus students not having this examination it will be part of this exam) Oral examination consists of 3 sections 1/ Section No 1: Knowledge regarding selected nosological unit
1/ Arterial hypertension 2/ Diabetes mellitus type I 3/ Diabetes mellitus type II 4/ Hypothyroidism 5/ Coronary heart disease 6/ Heart failure 7/ Peptic ulcer 8/ Asthma bronchiale 9/ Chronic obstructive pulmonary disease 10/ Respiratory infection 11/ Urinary tract infection 12/ Viral infections – overview and differences against bacterial diseases from point of view of symptoms, complications, strategy and analysis of one (self-selected) viral disease according to the structure of the nosological unit 13/ Cardiac arrhythmias 14/ Atherosclerosis 15/ Dyslipidaemia 16/ Deep venous thromboembolism 17/ Peripheral artery disease 18/ Constipation 19/ Diarrhoea 20/ Benign prostatic hyperplasia 21/ Sleep disorders 22/ Depression 23/ Pain - generally principles of pain management 24/ Neuropathic pain, back pain 25//Headache 26/ Hyperthyroidisms 27/ Principles of rational use of anti-infective drugs 28/ Gastro-oesophageal reflux disease 29/ Mycotic and fungal diseases– overview and differences against bacterial disease from the point of view of symptoms, complications, and treatment strategies and analysis of one of viral disease according to the structure of the nosological unit 30/ Epilepsy 31/ Parkinson disease and dementia 32/ Anaemia 33/ Emesis and motion sickness 34/ Stroke
Answer is requested in this order: Short characteristic of the disease (approx. 10 sentences) Etiopathogenesis Causes and triggers of disease Complication of non-treated or wrongly treated disease Epidemiology and risk factors of disease Symptomatology Diagnosis (5 question of diagnostics (a diagnostic method what allows health care workers to answer 5 questions: 1/ does patient suffer from disease; 2/ what is the severity of disease and are there present complications of disease? 3/ are there present risk factors and triggers of a particular disease? 4/ are there present complications of disoders risk factors of complications? 5/ does treatment reach the aim?) Aim of the treatment Strategy of treatment of acute form and chronic form of disease (with focus mainly on pharmacotherapy) Medicines used in pharmacotherapeutic strategies (therapeutical properties (pharmacology, evidence based medicine, and population based clinical experience); For Erasmus students without credit from pharmacology exam the examination will be enlarged in part where will be examined pharmacological knowledge. Erasmus students without prerequisites have to self-study pharmacology properties of medicines used in a particular nosological unit or to ask for consultation at the Department of Pharmacology
2/ Section No 2: Main indications and contraindications of selected groups of drugs, incl. theoretical explanation of mechanism of effect and adverse drug reactions or their class effect 1/ Beta blockers 2/ Calcium channel blockers 3/ ACE-I 4/ Sartanes 5/ Nitrates, salt of magnesium and calcium 6/ Inhibitors of renin, central sympatholytics 7/ Drugs for benign prostate hyperplasia 8/ Thyroidal hormones 9/ Diuretics 10/ Alfa-sympatholytic agents 11/ Beta-sympathomimetics 12/ Non-steroidal anti-inflammatory drugs 13/ Proton pump inhibitors and antacids 14/ Prokinetics, alginates, antacids 15/ Laxative agents 16/ Antihistamines 17/ Anticoagulant agents 18/ Corticosteroids 19/ Paracetamol and weak opioids 20/ Hormonal contraception, hormonal replacing therapy 21/ Penicillines, macrolides 22/ Fluoroquinolones, sulphonamides 23/ Antidepressants 24/ Antimycotics 25/ Antivirotic agents 26/ Antidiabetics 27/ Antiplatelet agents 28/ Agents with anticholinergic activity 29/ Amiodarone, propafenon, digoxin 30/ Hypnotics 31/ Thyreostatics 32/ Hypolipidemics 33/ Medication for the treatment of diarrhoea 34/ Agents with dopaminergic activity
3/ Section No 3: Preparation of one patient case – IT IS NECESSARY TO SEND THE PATIENT CASE ONE WEAK BEFORE EXAMINATION FOR APPROVAL Structure of a patient case (usually a close person): Characteristics of the patient – age, gender, family history, symptoms and diagnosis Personal history (diagnosis and symptoms) The goal of the treatment of disease Clinical investigation and lab data, if available (blood pressure, glycaemia) – here train 5 questions of diagnostics! List of used medicines (trade names, INNs, dosage schemes, indication/reason of the use) Opinion of the patient: how he/she evaluates the therapy, how he/she administers a particular drug
Discussion: Does any medicine reach an aim? Does the medicine cause harm (state mainly contraindication; it´s voluntary to analyze some adverse drug reactions (ADR), drug-drug interactions) and is it possible to measure any theoretical future harm? Is any particular medicine missed in the drug scheme? Why? Would you recommend to stop some medicines? Why? How to improve drug non – adherence?
Always explain why do you think so? !!! Not all topics are lectured. You must be able to use main algorithms of patient case solution and to self-study some topics from different sources (used during previous study years)
Consultation before exam is scheduled in any time during lectures and at January 7th and 8th as stated in study plan of lectures and seminars. If student needs additional consultation, I offer them according to the need to all students, but without payment for students participating on at least 70% of lectures.
Credit test: Cardiovascular disease, atherosclerosis, DM, thyreopathy, peptic ulcer, gastro-esophageal reflux disease, asthma bronchial, chronic obstructive pulmonary disease, pain, rational use of antibiotics:
Goal Diagnostic methods Strategy of treatment of acute and chronic forms of disease Last update: Fialová Daniela, doc. PharmDr., Ph.D. (24.09.2024)
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Study program: Pharmacy Course title: Clinical Pharmacy I. Code of the course: GAF345 Department: Department of Social and Clinical Pharmacy Garant of the course: Assoc. prof. Daniela Fialová, PharmD., Ph.D. Teacher of the course: prof. Dr. Jiří Vlček, CSc. (vlcek@faf.cuni.cz); phone contact: 00420 739 488 202 State of the course: compulsory ECTS: 8 Lectures (hours/semester): 70 hours/winter, Seminars/practice (hours/semester): 36 hours/winter Credit: written exam and discussion on patient case Examination: oral exam + discussion on clinical case of ill relative - preparing word and PowerPoint presentation Syllabus Subject aims The subject of Clinical Pharmacy I. (CP I.) is aimed at gaining basic knowledge and skills in clinical pharmacy, necessary for continuing studies in Clinical Pharmacy II (CP II), the core subject within the pregraduate branch of Clinical pharmacy. This subject (CP I.) creates also an important base for clinically oriented pharmaceutical care in pharmacies, lectured and trained in the subject Pharmaceutical Care II (CP II.). The content of the subject Clinical pharmacy I. (CP I.) is oriented (for selected nosologic units) to ethiopathogenesis and epidemiology of disorders, risk factors (including drug-related risk factors), complications (when disease is untreated or inappropriately treated/managed), to clinical manifestation of disorders (symptomatology and basic diagnostic tests), diagnosis – 5 questions of diagnostics –(1/does a patient suffer with disease; 2/ what is the severity of disease, 3/ risk factors of disease are present?; 4/risk factors of complications of disease are present?; 5/ is there a probability to reach the goal?), aims of therapy (with the emphasis on aims of pharmacotherapy), main treatment strategies (including both pharmacological and nonpharmacological strategies of acute and chronic stage of disease), frequently indicated drug schemes and other treatment modalities. Knowledge about class effect of drugs, their main mechanism of action, efficacy, clinical indications and contraindications are also lectured and trained. Clinical pharmacy I. educates students in main principles of the evaluation of appropriate drug indications, contraindications and in the basic rationality of drug regimen. Knowledge in CP I. are focused mainly on appropriateness of clinical indications and contraindications of frequently used drugs in patients with selected comorbidities and other clinical characteristics and on standard clinical recommendations. CP I. is a prerecvisity for the subject Clinical Pharmacy II (CP II) which further broaden students´ knowledge in principles of individualization of drug schemes for specific patient populations/groups and in individualization of drug regimens in concrete patient cases.
Clinical pharmacy I._ List of lectures (1,5hours, room A203)
Comments: 1,5hours for each topic is not enough! I require from students to refresh main knowledge regarding diseases and medicines what they learned in the past years
Clinical pharmacy I._ seminars (room A203, 120 minites) Content: repetition what you learned in lectures, discussion of unclear points regarding disease (diagnostic method, aim, strategy….) and discussion of your homework from the preliminary week) Time: 1.10. 13:10 – 15:10 p.m. (proposal 12:40 – 14:40) 8.10. cancelled 15.9. 12:40 – 16:40 p.m. 22.10 - 29.10. 13:10 – 15:10 p.m. (proposal 12:40 – 14:40) 6.11. - 8.1. 8:00 – 10:35
Topics: 1.10. Basic principles of rational pharmacotherapy + arterial hypertension 15.10. Dyslipidemia, atherosclerosis; ischemic heart disease, congestive heart disease 22.10. Diabetes mellitus + thyreopathy 29.10. Pain management 6.11. Rational pharmacotherapy of infective diseases 13.11. Asthma bronchiale, COPD, respiratory and urinary infections + 1 case 20.11. GIT diseases (peptic ulcer, GERD, diarrhea, constipation) + 1 case 27.11. Algorithm SAFE to assess risk and benefit of pharmacotherapy (3 hours) + 2 cases. 4.12. Deep venous thrombosis, diseases based on thrombophilia + 1 case 11.12. Anemia, depressive disorders + 1 case 18.12 Credit test + consultation 8.1. Credit test + consultation
Credit - conditions - 70% of absolved seminars. If not fulfilled, it will be necessary to prepare one case from particular topic = 3hour Successful credit test a/ credit test content aims, risk factors of disease, risk factors of complication, basic diagnostic method + strategy of disease treatment discussed during seminars Content: Basic principles of rational pharmacotherapy + arterial hypertension Dyslipidemia, atherosclerosis Ischemic heart disease, congestive heart disease Diabetes mellitus + thyreopathy Pain management Respiratory and urinary disease GIT disease (peptic ulcer, GERD, diarrhea, constipation) Rational pharmacotherapy of infectious diseases Asthma bronchiale, COPD Anemia, depressive disease Diabetes mellitus b/ Discussion on your own patient case (an ill relative or close person), mechanisms of the effects and side effects of medicines and their indication and contraindication, what is the goal, if it can be reachable or was reached, analyses of the patient case. This case prepared by the student will be discussed also during the oral examination Oral examination Condition to register for exam: 1/ credit from clinical pharmacy 1 2/ accepted prepared patient case_must be sended 2 weeks before exam on e-mail: vlcek@faf.cuni.cz) …type in title of patient case report “case_23_name of the student” (eg: “case_23_Vlcek Jiri”) 3/ record in SIS with information that student passed exam from pharmacology. Consultation (another as planned for January 10th) before examination without payment for students participating on 80 % of lectures)
Sections of oral exam 1/ Section No 1: Knowledge regarding selected nosological unit. Answer is requested in this order: Short characteristic of the disease (approx. 10 sentences) Etiopathogenesis Causes and triggers of disease Complication of non-treated or wrongly treated disease Epidemiology and risk factors of disease Symptomatology Diagnosis (5 question of diagnostics (a diagnostic method what allows health care workers to answer 5 questions: 1/ does patient suffer from disease; 2/ what is the severity of disease and are there present complications of disease? 3/ are there present risk factors and triggers of a particular disease? 4/ are there present risk factors of complications? 5/ does treatment reach an aim?) Aim of the treatment Strategy of treatment of acute form and chronic form of disease (with focus mainly on pharmacotherapy) Medicines used in pharmacotherapeutic strategies (therapeutical properties (pharmacology, evidence based medicine, and population based clinical experience); For Erasmus students without credit from pharmacology exam the examination will be enlarged for examinatio of pharmacological knowledge. Erasmus students without prerequisites have to self-study pharmacology properties of medicines used in a particular nosological unit before lecture or to ask for consultation at the Department of Pharmacology 2/ Section No 2: Main indications and contraindications of selected groups of drugs, incl. theoretical explanation of mechanism of effect and adverse drug reactions or their class effect. Not all topics are lectured. You must be able to use main algorithms of patient case solution and to self-study some topics from different sources (used during previous study years)
3/ Section No 3: Discussion of the prepared patient case
Last update: Fialová Daniela, doc. PharmDr., Ph.D. (24.09.2024)
|
|
||
|
For English branch, documents are sent by teacher prof. Vlček via email to registered students before lectures and seminars. Last update: Fialová Daniela, doc. PharmDr., Ph.D. (27.09.2024)
|
