College of Nursing UNIVERSITY OF CENTRAL FLORIDA COLLEGE OF NURSING Spring 2013 Course Number: NGR 6172 Course Title: Pharmacology for Advanced Nursing Practice Credit Hours: 3 (3, 0) Prerequisites or Co-requisites: NGR 5141 (Pathophysiological Bases for Advanced Nursing Practice) Students concurrently enrolled in a clinical practice course and NGR 6192 who choose to withdraw from NGR 6172 MUST also withdraw from the clinical practice course. Catalog Description: Comprehensive study of medications used in the promotion and maintenance of health across the lifespan. Examination of the implications for advanced nursing practice. May be used in the degree program a maximum of 2 times. Purpose: Introduce graduate nursing students to advanced pharmacological concepts employed by advanced practice nurses across the lifespan. Instructors: Christopher W. Blackwell, Ph.D., ARNP, ANP-BC, CNE Associate Professor and Coordinator of Nurse Practitioner Programs College of Nursing (407) 823-2517 (office); (407) 823-5675 (fax) (407) 375-4334 (personal cell) Office: UT: 453 (by appt.) E-Mail: christopher.blackwell@ucf.edu Sally Ayash, Pharm.D., RPh, CPH Instructor College of Nursing (407) 823-2744 (main CON number); (407) 823-5675 (fax) Office Hours: By appt. E-Mail: sally.ayash@ucf.edu Meeting Time and Location: UT, Room 650A; Select R: 1330-1620 P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 1 Course Objectives: 1. Integrate the concept of pharmacotherapeutics in the prevention and treatment of illness in clients across the lifespan; 2. Apply nursing and related research in the use of pharmacologic agents; 3. Apply concepts of pharmacokinetics and pharmacodynamics in the selection and monitoring of pharmacologic agents; 4. Discuss the ethical, legal, and professional aspects of advanced nursing practice roles in relation to prescriptive authority and the roles of other health care team members; 5. Use knowledge of drug actions to predict possible adverse reactions, toxic effects, and drug interactions associated with drugs used in the management of common health problems; 6. Relate age, gender, pregnancy status, socioeconomic, psychosocial and cultural considerations to the pharmacologic management of common health problem; 7. Incorporate use of a drug history and client knowledge of drug therapy in developing interventions related to drug therapy. Teaching/Learning Strategies: Lecture Class and Web based discussion Reading Written/ Group Assignments Case Studies Review and use of library and electronic resources Examination EVALUATION METHODS: Live Comprehensive Final Examination 7 Module Discussion Case Study Postings 1 Written Pharmacology Case Study Report Attendance and Participation Units of Instruction: (Note order of content in lecture will vary slightly. See course schedule)* I. Prescribing Practices, Patient Adherence, and Rational Drug Selection: 1. Florida NP Prescription Laws and Regulations 2. Patient Adherence and Compliance 3. Counterfeit Drug Laws 4. Information Technology and Pharmacotherapeutics; Safety in Pregnancy and Lactation; and additional resources 5. Writing Prescriptions: How, What, and Legally Mandated Components P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 2 II. Pharmacokinetics and Pharmacodynamics 1. Basic Principles of Pharmacology 2. Adverse Drug Reactions & Interactions 3. Factors that Foster Positive Outcomes 4. Rational Drug Selection III. Pharmocogenetics, Pharmacoeconomics, OTCs, Herbals, and Supplements: 1. Cultural and Ethnic Influences in Pharmacotherapeutics 2. Pharmacogenomics 3. Nutrition and Nutraceuticals 4. Pharmacoeconmics 5. OTC Medications 6. Herbal and Complimentary Therapies IV. Drugs Affecting the Hematapoietic System: 1. Anemias 2. Anticoagulants 3. Nutritional Fe+ supplements 3. Growth-Colonization Stimulating Factors (GCSF) V. Drugs Affecting the Endocrine System: 1. Diabetes Mellitus 2. HRT and Osteoporosis 3. Hyperthyroidism and Hypothyroidism 4. Hyperparathyroidism VI. Drugs Affecting the Integumentary System: 1. Dermatological Conditions VII. Drugs Affecting the Neurological System and Drugs Used to Treat Psychiatric Disturbances: 1. Anxiety and Depression 2. Mood Disorders 3. Dementia 4. Psychosis 5. Pain Management: Acute and Chronic 6. Headaches 7. Smoking Cessation 8. ETOH Cessation VIII. Drugs Affecting the Gastrointestinal System: 1. Inflammatory Bowel Diseases 2. Gastric Esophageal Reflux Disease (GERD) 3. Peptic Ulcer Disease (PUD) IX. Drugs Affecting the Respiratory System: 1. Asthma and COPD 2. Pneumonia 3. Tuberculosis P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 3 4. Upper Respiratory Infections X. Anti-Infectives and Resistance: 1. Drugs Used to Treat Infectious Diseases 2. Basic Principles of Antibiotics 3. Drug Resistance 4. Methicillin-Resistant Staph. aureus 5. Carbapenam resistant Klebsiella XI. Drugs Affecting the Cardiovascular and Renal Systems: 1. Chronic and Acute Stable/ Low-Risk Angina 2. Heart Failure 3. Hyperlipidemia 4. Hypertension XII. Drugs Affecting the Musculoskeletal System: 1. Muscle Relaxants and Anti-Inflammatories 2. Drugs used to treat OA 3. Drugs used to treat RA XIII. Drugs Affecting the Immune System: 1. Corticosteroids 2. Immunomodulators 3. Biologicals 4. HIV/ AIDS XIV. Drugs Affecting the Reproductive System: 1. Contraception and Pregnancy Prevention 2. Sexually-Transmitted Infections 3. Vulvo-Vaginitis 3. Urinary Tract Infections 4. Prostate, Testicular, and Penile Conditions *- Note, this course does not cover the diagnostic process or management of any disease process. Drugs and other medicinal interventions used to treat diseases will be covered and will include classes of drugs and other specific pharmacological interventions used as part of the management of acute and chronic illnesses. Required Text Woo, T. M. & Wynne, A.L. (2011). Pharmacotherapeutics for nurse practitioner prescribers (3rd ed.) Philadelphia, PA: F.A. Davis. Textbook ISBN: 97808362235 P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 4 Recommended Textbooks: Gilbert, et al. (2012). The Sanford guide to antimicrobial therapy 2012 (42nd Ed.). Sperryville, VA: Antimicrobial Therapy, Inc. Textbook ISBN: 978-1930808706 [also available for mobile devices] Recommended Technology: Apple iPhone, iTouch, or Android device with the following Apps downloaded: Monthly Prescriber’s Reference, MedScape, WebMD, Epocrates (all are free) Course Schedule: Date January 10, 2013 (Live) January 17, 2013 (Live) January 24, 2013 (WWW) January 31, 2013 (Live) Content I. Prescribing Practices, Patient Adherence, and Rational Drug Selection: 1. Florida NP Prescription Laws and Regulation 2. Patient Adherence and Compliance 3. Counterfeit Drug Laws 4. Information Technology and Pharmacotherapeutics 5. Writing Prescriptions: How, What, and Legally Mandated Components Assignment Woo & Wynne (2011): II. Pharmacokinetics and Pharmacodynamics 1. Basic Principles of Pharmacology 2. Adverse Drug Reactions 3. Factors that Foster Positive Outcomes 4. Rational Drug Selection II. Pharmacokinetics and Pharmacodynamics 1. Basic Principles of Pharmacology 2. Adverse Drug Reactions 3. Factors that Foster Positive Outcomes 4. Rational Drug Selection Woo & Wynne (2011): Chapters: 1, 4, 11 Chapters: 2, 3, 5, 6 Woo & Wynne (2011): Chapters: 2, 3, 5, 6 P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 5 January 31, 2013 (Live) February 7, 2013 (WWW) February 14, 2013 (Live) February 21, 2013 (WWW) II. Pharmacokinetics and Pharmacodynamics 1. Basic Principles of Pharmacology 2. Adverse Drug Reactions 3. Factors that Foster Positive Outcomes 4. Rational Drug Selection III. Pharmocogenetics, Pharmacoeconomics, OTCs, Herbals, and Supplements: 1. Cultural and Ethnic Influences in Pharmacotherapeutics 2. Pharmacogenomics 3. Nutrition and Nutraceuticals 4. Pharmacoeconmics 5. OTC Medications 6. Herbal and Complimentary Therapies IV. Drugs Affecting the Hematapoietic System: 1. Anemias 2. Anticoagulants 3. Nutritional Fe+ supplements 4. Growth-Colonization Stimulating Factors (GCSF) Woo & Wynne (2011): Chapters: 2, 3, 5, 6 Woo & Wynne (2011): Chapters: 7, 8, 9, 10, 12, 13 Woo & Wynne (2011): Chapters: 18, 27 Woo & Wynne (2011): Chapters: 21, 33, 38, 41 V. Drugs Affecting the Endocrine System: 1. Diabetes Mellitus 2. HRT and Osteoporosis 3. Hyperthyroidism and Hypothyroidism VI. Drugs Affecting the Integumentary System: 1. Dermatological Conditions Woo & Wynne (2011): Chapters: 23, 32 P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 6 February 28, 2013 (Live) March 4-9, 2013 March 14, 2013 (Live) March 21, 2013 (WWW) VII. Drugs Affecting the Woo & Wynne (2011): Neurological System and Drugs Used to Treat Chapters: 14, 15, 29, 35, 43 Psychiatric Disturbances: 1. Anxiety and Depression 2. Dementia 3. Psychosis 2. Pain Management: Acute and Chronic 3. Mood Disorders 4. Headaches 5. Smoking Cessation 6. ETOH Cessation VIII. Drugs Affecting the Gastrointestinal System: 1. Inflammatory Bowel Diseases 2. Gastroesophageal Reflux Disease (GERD) 3. Peptic Ulcer Disease Spring Break IX. Drugs Affecting the Respiratory System: 1. Asthma and COPD 2. Pneumonia 3. Tuberculosis 4. Upper Respiratory Infections Woo & Wynne (2011): Chapters: 20, 34 No Classes Woo & Wynne (2011): Chapters: 17, 30, 42, 45, 46 (Dr. Christopher W. Blackwell, ARNP, ANP-BC, CNE) X. Anti-Infectives and Resistance: 1. Drugs Used to Treat Infectious Diseases 2. Basic Principles of Antibiotics 3. Drug Resistance 4. Methicillin-Resistant Staph. Aureus 5. Carbapenan resistant Klebsiella Woo & Wynne (2011): Chapters: 24, 42, 45, 46 P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 7 March, 28 2013 (Live) April 4, 2013 (Live) April 11, 2013 (WWW) April 18, 2013 (Live) April 25, 2013 (Live) XI. Drugs Affecting the Cardiovascular and Renal Systems: 1. Chronic and Acute Stable/ Low-Risk Angina 2. Heart Failure 3. Hyperlipidemia 4. Hypertension Woo & Wynne (2011): XII. Drugs Affecting the Musculoskeletal System: 1. Muscle Relaxants and Anti-Inflammatories 2. Drugs Used to Treat OA and RA XIII. Drugs Affecting the Immune System: 1. Corticosteroids and Immunomodulators 2. HIV/ AIDS Woo & Wynne (2011): XIV. Drugs Affecting the Reproductive System: 1. Contraception and Pregnancy Prevention 2. Sexually-Transmitted Infections and Vaginitis 3. Urinary Tract Infections 4. Prostate, Testicular and Penile Conditions Comprehensive Final Examination Woo & Wynne (2011): Chapters: 16, 28, 36, 39, 40 Chapters: 25 Woo & Wynne (2011): Chapters: 25, 37 Chapters: 31, 44, 47, 49 This Comprehensive Final Examination covers all content for the course and is administered live in University Tower. This is a closed-book, closed-note, closed-WWW examination. EVALUATION METHODS Live Comprehensive Final Examination 5 Module Discussion Case Study Postings (10 points each x 5) 50 points 50 points P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 8 1 Written Pharmacology Case Study Report 50 points Attendance and Participation 40 points ______________________________________________________________________________ Total 190 points Grading System: 96-100 92-95 87-91 83-86 79-82 75-78 70-74 69 or below A AB+ B C+* C* D* F* Points 181 - 190 174 - 180 164 - 173 157 - 163 149 - 156 142 - 148 132 - 141 0 - 131 * - Not acceptable for progression in the Doctor of Nursing Practice Program. Academic Progression, Description of Course Assignments, and Course Policies: Academic Progression: An average of 75% must be earned on the final examination to successfully pass this course. Any student with a final exam average less than 75% will not have any other course assignments (including extra credit, when available) calculated in the final grade and cannot progress in the Doctor of Nursing Practice program in the College of Nursing. Comprehensive Final Examination (50 points): Students will complete a comprehensive final examination that will cover all of the content for the course. This examination is administered during the University’s Final Examination Week (see course schedule, above) and is closedbook, closed-note, and closed-WWW. Nothing besides the student’s own knowledge can be used to complete the examination. This examination is administered live and consists of 50 multiple choice/matching/true or false questions. Students will have 2 hours to complete the Comprehensive Final Examination. Module Discussion Case Study Postings (10 points each x 5; 50 points): Students will actively participate in an on-line discussion regarding relevant cases from the modules being covered in the course. Each student group member will be assigned a question from the case and will have to comprehensively answer the item. In addition, the student must uniquely respond to at least one group member’s post using evidenced-based rationales. References must be in APA format and correctly cited. See the grading rubric (below) for more information regarding the requirements of this assignment. Written Pharmacology Case Study Report (50 points): A comprehensive case study regarding an aspect of pharmacology will be assigned to each student in the class. Students will have to address each item in the case study from an evidence-based perspective and prepare a formal written report on the case. See the grading rubric (below) for more information regarding the requirements of this assignment. P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 9 Attendance/ Participation (40 points): Students are expected to arrive promptly to class on the 10 days the course is scheduled to meet live (see course schedule, above). In addition, students are expected to remain in class for the entire meeting session (3 hours) and are required to participate in any on-line initiated discussions. Attendance at each session is worth approximately 4 points. Students are also expected to arrive to the live class sessions prepared for discussion and are expected to complete any assigned reading assignments before the class meeting. In addition, any additional readings and/or resources posted to the WebCourses site should be read and reviewed prior to the class meetings. Students who are enrolled in a Webbased program (Nurse Educator, CNL) can complete the course in an on-line distant WWW-based format. Missed Examinations: It is not advisable to miss an examination. The makeup examination and/or assignment may be different than the original exam and could consist of multiple choice, matching, and/or essay style questioning. The instructor(s) can also require additional work such as research assignments, essays, or other work in addition to the examination substitution. Students who do not notify the instructor of a missed assessment within 2 hours of the exam closure time will forfeit makeup and receive a 0 score. All makeup assessments are taken at the instructor’s discretion and are administered live on the Orlando campus. Canvas On-Line Learning System How do I access Webcourses@UCF? 1. Go to https://webcourses2c.instructure.com/. You will be forwarded to the Shibboleth login page pictured below. P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 10 2. Note: Please DO NOT bookmark the Shibboleth login page shown above. All traffic into Webcourses@UCF must go through https://webcourses2c.instructure.com/. 3. Enter your PID and PID password. 4. Click Continue. ◦ Note: You can bookmark the Webcourses@UCF homepage shown above once you have successfully logged in. 5. Hover over Courses or Courses & Groups at the top of the page. 6. Select the course or group you wish to access. Update Your Profile When you first log in, we recommend you update your profile information and your notification preferences. P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 11 To update your profile settings, take the following steps: 1. Click on your name (or Settings) at the top of the page. 2. Click Edit Settings to make modifications. The default email address associated with your profile is your Knightsmail address. You can add additional email addresses by taking the following steps: 1. Click “Add Email Address” under Ways to Contact. 2. Enter the desired email address. 3. Click Register Email. A window will pop up notifying you that a verification email will be sent to the email address you entered. 4. Click Ok, Thanks. 5. Click the link in that email to finish registering your new email address. Additional Resources • Canvas Tutorial – Review Canvas Student Tutorial at: http://onlinesupport.cdl.ucf.edu/webcourses/instructure-canvas-student-tour/ • Canvas Browser Support – Supported web browser information for Canvas can be found here: http://guides.instructure.com/m/4214/l/41056 • Canvas System Specifications – System recommendations for running Canvas can be found here: http://guides.instructure.com/s/2204/m/4214/l/82542-what-are-the-basic-computerspecifications-for-canvas • Online@UCF Support – Our student helpdesk is prepared to assist you with technical issues encountered in your courses. 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Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 12 College of Nursing NGR 6172: Pharmacology for Advanced Nursing Practice Grading Rubric: Module Discussion Case Study Postings: Criteria Possible Points 3 Adequately addresses each item of the case question. 3 Uses evidencebased data to support any clinical claims; all sources of data are correctly cited in the discussion posting. 2 Uses correct APA formatting according to the 6th edition of the APA Manual. 2 Responds to at least one student’s posting and provides unique feedback and perspective into the case discussion. Actively participates in the group discussion. Total Points Points Earned Instructor Feedback P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 13 College of Nursing NGR 6172: Pharmacology for Advanced Nursing Practice Grading Rubric: Written Pharmacology Case Study Report: Criteria Adequately addresses each item of the case. Uses evidencebased data to support any clinical claims; all sources of data are correctly cited in the written report. Uses correct APA formatting according to the 6th edition of the APA Manual. Total Points Possible Points 20 Points Earned Instructor Feedback 20 10 Overall Feedback to the Student about Case: P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 14 American Nurses Association The Code of Ethics for Nurses 2001 Voted on and accepted by the ANA House of Delegates on June 30, 2001 1. The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. 2. The nurse's primary commitment is to the patient, whether an individual, family, group, or community. 3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 4. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care. 5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. 6. The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action. 7. The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development. 8. The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs. 9. The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. The Code of Ethics for Nurses is available for sale from American Nurses Publishing at 1-800-637-0323 or www.nursesbooks.org P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 15 Office of Student Rights and Responsibilities University of Central Florida YOUR ENROLLMENT STATUS MAY BE AT RISK! Academic Dishonesty in any form will not be tolerated!!! The University of Central Florida has recently started an account with turnitin.com., an automated system which instructors can use to quickly and easily compare each student's report to billions of web sites, as well as an enormous database of student papers that grows with each submission. After submission of the paper, instructors receive a report that states if and how another author's work was used. Violations of student academic behavior standards are outlined in The Golden Rule, the University of Central Florida's Student Handbook. See http://www.ucf.edu/goldenrule/ for further details. 1. Cheating whereby non-permissible written, visual or oral assistance including that obtained from another student is utilized on examinations, course assignments or projects. The unauthorized possession or use of examination or course related material shall also constitute cheating. 2. Plagiarism whereby another's work is deliberately used or appropriated without any indication of the source. Thereby attempting to convey the impression that such work is the student's own. Any student failing to properly credit ideas or materials taken from another has plagiarized. 3. A student who has assisted another in any of the aforementioned breach of standards shall be considered equally culpable. ACADEMIC ACTION * Taken by Instructor, Chair, or Dean of College* 1. Counseling 2. Loss of credit for specific assignment, examination or project. 3. Removal from course with a grade of "F" and/or CONDUCT REVIEW ACTION *Taken by the Office of Student Conduct* 1. Warning 2. Probation 3. Suspension 4. Expulsion 5. Permanent conduct record with UCF accessible by other institutions by request. For more information, please contact the Office of Student Conduct at 823-2851. P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 16 Persons With Disabilities: The University of Central Florida is committed to providing reasonable accommodations for all persons with disabilities. Students who need accommodations must be registered with Student Disability Services (SDS), Student Resource Center Room 132, phone (407) 823-2371, TTY/TDD only phone (407) 823-2116, before requesting accommodations from the professor. Students who are registered with SDS and need accommodations in this course must contact the professor at the beginning of the semester to discuss needed accommodations. No accommodations will be provided until the student has met with the professor to request accommodations. This syllabus is available in alternate formats upon request. P.O. Box 162210 Orlando, FL 32816-2210 407-823-2744 FAX 407-823-5675 An Equal Opportunity and Affirmative Action Institution 17