Ateneo - UPO

This course provides the fundamental knowledge of pharmacology required to understand the mechanisms of action, clinical use, efficacy and safety of the main drugs used in nursing practice. The general principles of pharmacology will be addressed, including drug development, pharmacokinetics, pharmacodynamics, drug-drug interactions, toxicity and pharmacovigilance. The main classes of drugs used in the treatment of pain and of cardiovascular, neurological, metabolic, respiratory and gastrointestinal disorders will also be covered, together with the principal antimicrobial, antiviral and antifungal agents. The course will further address the pharmacological aspects relevant to the management of emergencies, anaemia and shock, also through supplementary teaching materials available on the DIR platform.

- Farmacologia generale e speciale per lauree sanitarie (Cella, Di Giulio, Gorio, Scaglione), Piccin.
- Compendio di farmacologia Generale e Speciale (Roxas Amico M., Caputi A.P., Del Tacca M), EDRA.

The Clinical Pharmacology module is delivered within the Integrated Course in Clinical Nursing in the Medical Area and is worth 2 CFU credits, corresponding to 24 hours of lecture-based teaching.The course aims to provide students with the essential pharmacological knowledge required to understand the principles governing drug action and their application in clinical and nursing practice. By the end of the course, students will be able to:
- understand the processes of drug development and clinical trials;
describe the principles of pharmacokinetics and pharmacodynamics and the major drug-drug interactions;
- recognize the mechanisms underlying adverse drug reactions, toxicity and pharmacovigilance;
acquire knowledge of the main drugs used in the conditions of greatest relevance to nursing practice;
- apply pharmacological knowledge to the therapeutic management of the patient, with particular attention to the efficacy, safety and appropriateness of drug use;
- identify and monitor both the therapeutic and adverse effects of pharmacological treatments.

To achieve the expected learning outcomes, the student must have acquired the essential knowledge of Anatomy, Physiology, Biochemistry, General Pathology and Pathophysiology.

All lessons will be delivered in the classroom with PowerPoint presentations, and the active participation of students is encouraged where their prior knowledge allows. The materials used during the lessons will be uploaded to the course DIR page.

The teacher receives students by appointment, to be arranged via email.
Students with physical disabilities, Learning Disabilities or Special Education Needs can request specific services and tools via the Staff Sviluppo e Coordinamento Carriere e Servizi alle Studentesse e agli Studenti, consulting the University webpage: https://www.uniupo.it/en/services/services- students-physical-or-learning-disabilities Students with disabilities, learning disabilities or special education needs, once they have contacted the University Staff, can refer to the tutor in charge of the course to define the examination modalities, concerning academic aspects.

The Clinical Pharmacology component contributes 10 single-answer multiple-choice questions (MCQs) to the written exam of Clinical Nursing in the Medical Area, of which Clinical Pharmacology is a part. A comprehensive description of the assessment methods for the examination of the Integrated Course in Clinical Nursing in the Medical Area is provided in the syllabus of the Integrated Course

General Principles of Pharmacology
1. Introduction and drug development. Definition of drug, active ingredient and excipient. Stages of drug development (preclinical testing and phase I–IV clinical trials), concept of post-marketing pharmacovigilance.
2. ADME and pharmacokinetic interactions. Absorption, distribution, metabolism and excretion. Bioavailability, plasma protein binding, drug metabolism reactions (overview of cytochrome P450 and phase I and II reactions), main routes of drug elimination. Reference pharmacokinetic parameters (half-life, steady-state plasma concentration, etc.) and their significance for drug dosing regimens. Pharmacokinetic interactions (enzyme induction and inhibition, competition) and clinical situations at risk: elderly patient, hepatic and renal impairment.
3. Pharmacodynamics and pharmacodynamic interactions. Molecular targets (receptors, enzymes, ion channels), concepts of agonism and antagonism, dose–response relationships, potency and efficacy, therapeutic index. Pharmacodynamic interactions (synergism and competitive and non-competitive antagonism, inverse agonists) and their relevance in polytherapy.
4. Toxicity, teratogenicity, adverse drug reactions and pharmacovigilance. Classification of adverse drug reactions (type A and type B ADRs), dose-dependent toxicity, allergic and idiosyncratic reactions. Risk in pregnancy and breastfeeding. The pharmacovigilance system and the nurse's role in reporting adverse drug reactions.

Pharmacology of Pain
NSAIDs and paracetamol, glucocorticoids, opioids (mechanism, titration, management of side effects and of respiratory depression), drugs for neuropathic pain. Principles of pain management and nursing monitoring.

Cardiovascular and Haematological Pharmacology
Antihypertensive drugs and diuretics, pharmacological treatment of heart failure, drugs affecting haemostasis (anticoagulants, antiplatelet agents, overview of fibrinolytic drugs, agents for the reversal of anticoagulant action) with particular attention to monitoring and bleeding risk. Overview of the pharmacological treatment of myocardial ischaemia. Antiarrhythmic drugs. Treatment of acute and chronic anaemia: iron supplementation and erythropoietin.

Pharmacology of the Central Nervous System
Anxiolytics and hypnotics. Antiepileptic drugs: selection criteria, clinical indications, adverse effects and drug interactions. Antipsychotics: clinical use, adverse effects and drug interactions. Antidepressants: mechanisms of action, indications, adverse effects and drug interactions. Overview of antiparkinsonian pharmacology, with particular attention to adverse effects. Local and general anaesthetics.

Drugs Acting on Metabolism
Treatment of dyslipidaemias. Treatment of diabetes mellitus (oral hypoglycaemic agents and insulins), with attention to patient education and recognition of hypoglycaemia. Drugs for the treatment of gout.

Pharmacology of the Respiratory System
Treatment of chronic obstructive pulmonary disease (COPD), with an overview of bronchial asthma therapy. Antitussive and mucolytic drugs.

Pharmacology of the Gastrointestinal System
Antiemetics. Antidiarrhoeal drugs. Laxatives. Antacids and antisecretory drugs.

Antimicrobial Drugs
Main classes of antibiotics and their spectrum of action, principles of antibiotic therapy and resistance; antiviral and antifungal drugs.

Emergency Pharmacology
Pharmacological management of hypovolaemic and normovolaemic shock. Fluid therapy. Blood transfusions.

By the end of the Clinical Pharmacology course, in line with the educational objectives of the Degree Programme in Nursing and with the Tuning Matrix, students will have achieved the following learning outcomes, defined according to the Dublin Descriptors.

D1 – Knowledge and understanding
The student knows and understands the basic concepts of general pharmacology and the pharmaco-toxicological characteristics of the different drug classes. In particular, they will be able to:
- describe the fundamental principles of pharmacokinetics (ADME) and pharmacodynamics;
- illustrate the main mechanisms of action, therapeutic indications and adverse effects of the pharmacological classes covered;
- explain the mechanisms underlying drug interactions, adverse reactions and the pharmacovigilance system;
- outline the principles of pharmacological therapy in the main conditions of nursing interest.

D2 – Applying knowledge and understanding
The student is able to use theoretical knowledge to reason critically about drug administration, with a professional approach. They will be able to:
- interpret the therapeutic and adverse effects of the main drugs in the clinical and nursing care context;
- recognize the main drug interactions and the risk factors associated with treatments;
- apply pharmacological knowledge to the nursing care of the patient, in accordance with nursing competences and responsibilities;
- contribute to monitoring the efficacy and safety of pharmacological therapies.

D3 – Making judgements
The student is able to critically examine the knowledge acquired and to discuss independently the issues arising from its practical application. They will be able to:
- critically evaluate the benefits and risks of pharmacological treatments;
- recognize the clinical situations that require particular attention during drug administration and monitoring;
- integrate pharmacological knowledge with information on the individual patient.

D4 – Communication skills
The student is able to convey the knowledge acquired using appropriate terminology, so as to engage in a professional manner. They will be able to:
- correctly use pharmacological terminology;
- communicate clearly and unambiguously the essential information regarding drugs and therapies to specialist and non-specialist interlocutors, including the patient;
- interact with other healthcare professionals in the context of the patient's therapeutic management.

D5 – Learning skills
The student has developed the learning skills required for continuous updating in the pharmacological field. They will be able to:
- independently update their own pharmacological knowledge;
- critically consult reliable scientific sources and institutional documents (drug databases, summaries of product characteristics, guidelines, pharmacovigilance communications).