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Ministerul Sănătăţii al Republicii Moldova IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu” Catedra Farmacologie şi farmacie clinică PA 7.5.1 SILLABUS RED: 02 DATE: 21.12.2013 Pag. 1/8 Approved Discussed and Approved At the meeting of the Committee At the meeting of the Pharmacology of the Faculty of Pharmacy and Clinical Pharmacy Department Minutes Nr.___ as of ____________ Minutes Nr.___ as of ____________ Dean of the Faculty of Pharmacy, Head of Department, Dr, associate professor _____________ N. Ciobanu Dr.Hab, professor, ___________V. Gonciar SILLABUS FOR STUDENTS OF PHARMACEUTICAL FACULTY Name of the course: CLINICAL PHARMACY Code of the course: S.09.O.087, S.10.O.093 Type of course: Compulsory discipline Total number of hours – 100h, Out of which 31h – lectures, 59h – practical works; Number of credits allocated to the course: 9 credits Name of authors that teach the course: Dr., Associate professor C. Scutari CHISINAU, 2014

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Page 1: SILLABUS FOR STUDENTS - farmacieclinica.usmf.md. prog...IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu” Catedra Farmacologie şi farmacie clinică PA

Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 1/8

Approved Discussed and ApprovedAt the meeting of the Committee At the meeting of the Pharmacologyof the Faculty of Pharmacy and Clinical Pharmacy DepartmentMinutes Nr.___ as of ____________ Minutes Nr.___ as of ____________Dean of the Faculty of Pharmacy, Head of Department,Dr, associate professor _____________ N. Ciobanu Dr.Hab, professor, ___________V. Gonciar

SILLABUS FOR STUDENTS

OF PHARMACEUTICAL FACULTY

Name of the course: CLINICAL PHARMACY

Code of the course: S.09.O.087, S.10.O.093

Type of course: Compulsory discipline

Total number of hours – 100h,

Out of which 31h – lectures, 59h – practical works;

Number of credits allocated to the course: 9 credits

Name of authors that teach the course: Dr., Associate professor C. Scutari

CHISINAU, 2014

Page 2: SILLABUS FOR STUDENTS - farmacieclinica.usmf.md. prog...IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu” Catedra Farmacologie şi farmacie clinică PA

Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 2/8

I. The purpose of the subject of Clinical Pharmacy:Currently it is discussed the need and importance of particular functions in medicine and

pharmacy, which largely depends on the quality of medical and pharmaceuticals providedservices that directly influence the strengthening of population health. Today, another problem isthe acceleration of European integration and therefore the need to reassess nationalpharmaceutical strategy.

The necessity for a new field in the profession of pharmacist, such as clinical pharmacy,is argued that, although the drugs are increasingly effective, drug therapy is often compromised.Clinical pharmacy was born from finding that morbidity and mortality related to drug misuse,put problems to patients and society: patients are exposed to avoidable iatrogenic pathology, andthe society is loaded with care financing. The new concept includes all current objectives of thepharmacist: the quality of medicines, prescriptions control, controlling drug interactions, plus thesuccess of of therapeutic care to help patients in treatment success. So, the main goal of clinicalpharmacy is the optimal use of pharmaceutical and biomedical knowledge in order to improveefficiency, security, accuracy and economy of use of medicines by patients and society.

II. Training objectives for the subject of Clinical Pharmacy:At the level of knowledge and understanding:

To know the pathophysiological status of specific pathology, which serves as anindication for prescribing these pharmacological preparations (including those ofvegetable origin);

To argue the selection or substitution of the optimum preparation according topathophysiological variants of disease assessment;

To appreciate the optimum regimen for drug administration and their dosage ; To determine drug compatibility with other ones, which the patient already uses or will

use in the future.

Upon completion of the subject the student will be able to know: Etiopathogenic factors and clinical symptoms of these diseases; Algorithm and conduct of treatment of specific diseases; Offering advisory aid to doctors and patients about the prevention of complications of

pharmacotherapy; Drug compatibility related to their associated use; Supervision of correctness of prescribing recipes by physicians.

At the level of practical use: Advising on prescription medication, after a scientific analysis of the prescription; Guiding self-medication with OTC drugs known and requested by the patient; Written recommendation regarding OTC medications prescribed by pharmacists for 1-2

days at the request of the patient which presents symptoms of acute illness,

Page 3: SILLABUS FOR STUDENTS - farmacieclinica.usmf.md. prog...IP Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu” Catedra Farmacologie şi farmacie clinică PA

Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 3/8

recommendation based on minimum consultation in the area of confidentiality ofpharmacy;

Release without precription of 1-2 doses of the drug that is not a part of OTC inemergency cases;

Solving pharmacotherapeutic problems of the patient based on the creation of patient'sfile with complete data (diagnosis, laboratory tests, pharmacotherapy prescription andself-medication history);

Pharmacotherapeutic assistance at home.

At level of integration:To provide maximum clinical effect of medicinal preparations by using efficient optimal

treatment for each patient category;To reduce the risk of side effects associated with therapy by monitoring the treatment and

patient compatibility with this therapy;To minimize costs for pharmacological treatment, namely to try offering the best

alternative treatment for a maximum number of patients.

III. Preliminary terms and requirements:Clinical pharmacy is a discipline and pharmaceutical specialty that uses optimum

pharmaceutical and biomedical knowledge in order to improve the efficiency and safety ofmedication treatment by patients and society. It combines knowledge from many fields ofmedical and biological disciplines and clinicians’ experience of practical use of drugs, that areconstantly improved by in the light of progress of experimental and clinical pharmacology andpharmaceutical sciences.

Clinical pharmacy is closely related to pharmacology and pharmaco- and phytotherapy.Pharmacy students have a priority in this aspect, as they studied the pharmacokinetics andpharmacodynamics of drugs, their selection in various pathologies, as well pathogenesis,symptoms and, drug and phytotherapeutic treatment of the most common illnesses. This momentmakes more accessible for pharmacists to study clinical pharmacy. From another point of view,students from the faculty of pharmacy have studied the disciplines of clinical profile in reducedvolume, which imposes the need to explain some medical terms, indices of diagnostic andlaboratory tests, effectuation of clinical anamnesis, examination and evaluation of specificdisease cases, especially studying and monitoring treatment records of patients in order to ensurea personalized therapy. These principles were the basis for drawing up the syllabus of clinicalpharmacy for students of the faculty of Pharmacy.

In addition, this university training will give possibility and will become opportune forpharmacist’s participation in providing treatment in clinical conditions. Direct contact with thepatient, doctors and nurses allow pharmacist’s decisions to have a direct impact on the safety andefficiency of medicinal prescriptions.

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Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 4/8

IV. The basic content of the course:Lectures:

Semester IXNr. Subject Hours1. Notion of clinical pharmacy (definition, purpose, content, etc.). The main

problems of clinical pharmacy.1

2. Clinical pharmacy of hypertensive disease (I p). 13. Clinical pharmacy of hypertensive disease (II p). 14. Clinical pharmacy of hypotensive disease. 15. Clinical pharmacy of ischemic heart disease. 16. Clinical pharmacy of heart failure. 17. Clinical pharmacy of atherosclerosis. 18. Clinical pharmacy of acute respiratory infections and bronchitis. 19. Clinical pharmacy of asthma. 1

10. Clinical pharmacy of pneumonia. 111. Clinical pharmacy of gastritis. 112. Clinical pharmacy of peptic ulcer. 113. Clinical pharmacy of hepatitis. 114. Therapeutic supervision of pathological states produced by drugs. 1

Semester XNr. Subject Hours1. Clinical pharmacy of liver cirrhosis. 12. Clinical pharmacy of cholecystitis. 13. Clinical pharmacy of pancreatitis. 14. Clinical pharmacy of constipation. 15. Clinical pharmacy of diarrhea. 16. Clinical pharmacy of pyelonephritis (I p). 17. Clinical pharmacy of pyelonephritis (II p). 18. Clinical pharmacy of glomerulonephritis (I p). 19. Clinical pharmacy of glomerulonephritis (II p). 1

10. Clinical pharmacy of nephrolithiasis. 111. Clinical pharmacy of kidney failure. 112. Clinical pharmacy of emerginses (I p.) 113. Clinical pharmacy of emerginses (II p.) 114. Excessive use of drugs with special statutory (I p.). 115. Excessive use of drugs with special statutory (II p.). 116. General notions about pharmacoepidemiology and pharmacovigilance (I p.). 117. General notions about pharmacoepidemiology and pharmacovigilance (II p.). 1

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Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 5/8

Practical classes:Semester IX

Nr. Subject Hours1. Notion of clinical pharmacy (definition, purpose, content, etc.). The main

problems of clinical pharmacy.3

2. The study of a clinical case (accumulation of anamnesis, laboratory andinstrumental investigations analysis, examining records of treatment)

3

3. Clinical pharmacy of hypertensive disease. 34. Clinical pharmacy of hypotensive disease. 35. Clinical pharmacy of ischemic heart disease (IHD). 36. Clinical pharmacy of heart failure and atherosclerosis. 37. Clinic visit. Summarizing the themes 3-7. 38. Clinical pharmacy of acute respiratory infections and bronchitis. 39. Clinical pharmacy of asthma. 3

10. Clinical pharmacy of pneumonia. 311. Clinic visit. Summarizing the themes 8-10. 312. Clinical pharmacy of gastritis and of peptic ulcer. 313. Clinical pharmacy of hepatitis. 314. Therapeutic supervision of pathological states produced by drugs. 3

Semester XNr. Subject Hours1. Clinical pharmacy of liver cirrhosis. 12. Clinical pharmacy of cholecystitis. 13. Clinical pharmacy of pancreatitis. 14. Clinical pharmacy of constipation. 15. Clinical pharmacy of diarrhea. 16. Clinic visit. 17. Summarizing the themes “Clinical pharmacy of gastrointestinal diseases”. 18. Clinical pharmacy of pyelonephritis (I p). 19. Clinical pharmacy of pyelonephritis (II p). 1

10. Clinical pharmacy of glomerulonephritis (I p). 111. Clinical pharmacy of glomerulonephritis (II p). 112. Clinical pharmacy of nephrolithiasis. 113. Clinical pharmacy of kidney failure. 114. Clinic visit. 115. Summarizing the themes 8-13. 116. Clinical pharmacy of emerginses 117. General notions about pharmacoepidemiology and pharmacovigilance. 1

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Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 6/8

V. Reccommended literature:A. Mandatory:

1. Cristea A. Farmacie clinică. Vol.I: Farmacia clinică în farmacia de comunitate.București. Editura medicală, 2006, 428 p.

2. Cristea A. Farmacie clinică. Vol.II: Farmacia clinică în farmacia de spital. București.Editura medicală, 2012, 1048 p.

3. Herfindal E., Gourley D. Et al. Clinical pharmacy and therapeutics. Fifth edition.USA, Copyright, 2007, 1628 p.

B. Additional:1. Зупанец И.А. и др. Клиническая фармация. (фармацевтическая опека) для

студентов высших медицинских учебных заведений специальностей «Фармация»,«Клиническая фармация». Харьков, «Золотые страницы», 2012, 776 с.

VI. Teaching and learning methods to be used:Test (questions of self-control, testing Editor, problems of situation) written for

highlighting the initial level of knowledge; Practical activities: solving the problems of situation,examination of clinical cases, analysis of medical records, of drug prescriptions, demonstratingthe video. Knowledge verification on questions of methodical guidelines and implementation oftasks for the next theme of practical work (working independently at home).

Final: Differentiated oral examination (Semester X)

VII. Suggestions for individual work:One of the most effective methods to assimilate the material studied in the process of

explaining lectures and effectuating practical lessons at clinical pharmacy is activity at patientbedside, with the accumulation of anamnesis, subjective and objective symptoms examinationand participation in drug therapy team with physician in clinic and community pharmacy.Extensive use of audio-visual media of instruction in the form of figures, movies or videorecordings is also a method for an easier assimilation of the information.

To be successful in learning clinical pharmacy student must be active, to presentinteresting communications, reports, scientific reports, and teachers are indirectly involved,especially their role consists in guiding, correcting and assessing student. The methods of work-in in groups are based on the cooperation of students under the guidance of the teacher. Bothstudents and teachers take an active role in these methods. The students work in groups of threeto four people. They try to solve the teacher’s proposed themes. The professor gets involved byproposing the approached themes and by the fact that he answers students’ questions, clarifiesany doubt, explains, makes additions and systematizations of the studied material. Are developedstudent activism and the ability to speak in front of a group, it’s a good training for shy people.

A major importance in the effective assimilation of subject material is the rationalmanagement of time. According to the requirements in effect for each working hour in directcontact with professor, student must work individually 1-2 hours. Thus, for the sufficient

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Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 7/8

acquisition of discipline of Clinical Pharmacy, the student of faculty of Pharmacy will workindividually at least 8-10 hours per week.

VIII. Evaluation methods:As the model can be applied the following organizational structure of making the

laboratory works (practical lessons) at clinical pharmacy: Motivation (topicality). Determination of the purpose of practical work, answering the

students’ questions. Thesis (testing) written to highlight the initial level of knowledge. Practical activities: solving the problems of situation the questions of methodological

indications for laboratory work in Pharmacology (Faculty of Pharmacy), conductingexperiments on laboratory animals, demonstration of video materials.

Examination of clinical cases, including at patient bedside. The final knowledge testing and assigning the tasks for the next theme of practical work

(independently homework).

On the Clinical Pharmacy subject during the school year, there are 4 Summarizingevaluations, as follows:

Summarizing evaluation " Clinical pharmacy of cardiovascular diseases "; Summarizing evaluation " Clinical pharmacy of bronchopulmonary diseases "; Summarizing evaluation " Clinical pharmacy of gastrointestinal diseases "; Summarizing evaluation " Clinical pharmacy of excretory system diseases ";

Thus the formative evaluation consists of 4 summarizing evaluations. Each summarizingevaluation is marked separately with marks from 0 to 10 and can be supported by 2-3 times. Theannual average is formed by the amount of points accumulated during the study divided by 4.

Summarizing evaluation consists of 3 questions of self-training and 2 cases of diseases.Students with grades for current evaluation lower than “5” are not admitted to the final examination, aswell as students who did not recover absences from lectures and practical works.

Differentiated oral examination at Clinical Pharmacy (summative assessment) is acombined test that consists of the oral exam (oral test).

The oral test (oral exam) is performed by including in tickets 4 questions from clinicalpharmacy discipline and 1 problem of situation. The student has 30 minutes to prepare theanswer. The test is evaluated with marks of 0 to 10.

The exam subjects are approved by the department and presented to the students at leastone month before the session. The final mark consists of 2 components: the annual average mark(coefficient 0.5) the oral test (coefficient 0.5). Knowledge assessment is appreciated with gradesfrom 10 to 1 without decimals as follows:

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Ministerul Sănătăţii al Republicii MoldovaIP Universitatea de Stat de Medicină şi Farmacie “Nicolae

Testemiţanu”Catedra Farmacologie şi farmacie clinică

PA 7.5.1SILLABUS

RED: 02DATE: 21.12.2013

Pag. 8/8

Method of marks rouding

The weighted sum of marks from currentassessments and final examination

The final

mark

5 55,1-5,5 5,55,6-6,0 66,1-6,5 6,56,6-7,0 77,1-7,5 7,57,6-8,0 88,1-8,5 8,58,6-9,0 99,1-9,5 9,59,6-10 10

The absence at the exam without due cause shall be recorded as "absent" and is equivalent tograde 0 (zero). The student has the right to 2 repeated allegations of examination failed.

IX. Language of the course:

Romanian