Learning objectives
The course is aimed to the knowledge of drug effects, either beneficial or
otherwise, in order to properly conduct drug therapy and patient care.
Prerequisites
Knowledge of foundaments of Biochemistry, Physiology and General
Pathology are required.
Course unit content
The course provides the necessary elements for the knowledge of the
effects of drugs, for a rational use of those in the clinical setting and for
an effective control of adverse responses.
Full programme
GENERAL PHARMACOLOGY. Pharmacology as a medical science. Concept
and definition of active substance and medicinal preparation, definition of
drug and its origins, chemical nature, nomenclature of drugs, equivalent
drugs. Actions and effects of drugs: therapeutic and toxic activity of
molecules.
Principles of pharmacodynamics: mechanism of drugs action and
interaction with the components of the organism. Concept of site of
action and receptor. Receptor-acting drugs: drugs on receptors of the
autonomic nervous system. Agonist and antagonist drugs, active drugs at
the level of ion channels, membrane transporters, enzyme inhibitors.
Tolerance and drug dependence.
General principles of pharmacokinetics: Routes and methods of drug
delivery, Absorption, distribution, metabolism and elimination, concept of
bioavailability, volume of distribution and clearance.
Factors that influence the response to drugs: race, age, sex, patient
pathologies. Drug interactions with food and specific components of the
diet. Interactions between medicaments of clinical relevance.
Pharmacogenetics and idiosyncrasies.
SPECIAL PHARMACOLOGY. Chemotherapy. Basic principles of
antibacterial action and main pharmacological classes. Concept of
bactericidal and bacteriostatic action, spectrum of action and selective
toxicity. Main mechanisms of action of antibacterials. Host toxicity from
antibacterial drugs.
General aspects on antiblastic drugs, their preparation, administration,
side effects. Alkylating drugs; platinum compounds and derivatives;
antimetabolites; Vinca alkaloids, Epipodofillotoxins, taxanes. Generalities
on biological drugs and target therapy, monoclonal antibodies.
Cardiovascular System Drugs and Hematostatics:antithrombotic
prophylaxis and heparin therapy, oral anticoagulant therapy, antiplatelet
therapy. Antihypertensive drugs: diuretics, vasodilators, ACE inhibitors
and beta-blockers.
Central Nervous System Drugs: General information on
neurotransmission; Aspecific depressants: general anesthetics, hypnoticsedative
(benzodiazepines). Local anesthetics.
Analgesic drugs. Pain: types and classification. Nociceptive and
neuropathic pain, WHO assessment scale, clinical application of
assessment scales. Oncologic pain: pathophysiological mechanisms,
systems and receptors involved. Pain pathways, nociceptors, synapses,
neurons.
NSAIDs: Classification, mechanism of action, side effects, drug
interactions, literature analysis. Main chemical classes: salicylates,
propionic acid derivatives, arylacetic acid, oxicami, coxibs,
arylsulfonamides. Specific COX-2 inhibitors. Paracetamol: generality,
peculiarity, side effects.
Opiates: mechanisms of analgesic action, pharmacokinetics,
pharmacodynamics, clinical uses, routes of administration, toxicity,
literature analysis. Main pharmacological classes and prototypes:
morphine, codeine, fentanyl, buprenorphine, hydromorphone, oxycodone,
methadone; associations with NSAIDs. New opiates: tramadol,
tapentadol. Adjuvants.
Nursing management of the patient with pain: control of the state of
consciousness, vital parameters, side effects from drugs, alternative
routes of drug administration.
Neuromuscular blocking drugs. Competitive curarizing agents and
succinylcholine.
Gastrointestinal Tract Drugs: antiulcer and gastroprotectors, purgatives,
spasmolytics, prokinetic drugs.
Antidiabetic drugs. Insulin, insulin analogues, oral hypoglycemic agents.
Bibliography
Clayton – Stock: Fondamenti di farmacologia per infermieri. Third
Ed. (or newer). Ed. Edises.
Assessment methods and criteria
The achievement of the objectives of the course will be performed by an
oral exam. Through general and specific questions relative to the
program of the course, the level of knowledge relative to the properties
of therapeutic drug and their correct use in the clinical setting will be
determined. Moreover, the ability of the student to contribute with
autonomy of judgment and professional approach to an appropriate care
plan will be also assessed.
