Ateneo - UPO

The study of the main classes of drugs will be conducted by system and by pathology, highlighting the peculiar characteristics and methods of clinical use of each class.

- Farmacologia generale e speciale per lauree sanitarie (Cella, Di Giulio, Gorio, Scaglione), Piccin.
- Fondamenti di Farmacologia per Infermieri (Clayton, Stock; a cura di Preziosi). EdiSes,.
- Farmacologia: principi di base e applicazioni terapeutiche, a cura di F. Rossi, V. Cuomo, C. Riccardi, Edizioni Minerva Medica

The main objective of the course is the knowledge and understanding and the ability to apply the relevant basic knowledge of the main groups of drugs, with particular reference to the methods of their administration in the most common pathologies. The student must acquire adequate knowledge of the mechanisms of action and kinetics of the main groups of drugs, as well as the relationship between desired and undesirable effects and must be able to recognize any The Clinical Pharmacology module, included in the Integrated Course of Clinical Nursing in the medical area, it has harmful effects (acute and chronic) of drugs. The student will also have to acquire the belief that correct drug therapy is subject to constant critical review, both for the introduction of new drugs into therapy and for the highlighting of any new undesirable effects.
The general objective is to enable the student to develop independent judgement, communication skills and learning ability for this subject.

The student must possess the indispensable notions of Anatomy, Physiology, Biochemistry, General Pathology and Physiopathology.

Presentations in Power Point format by the teacher, educational Internet sites.
The presentations are available to students on the website from the beginning of the course.
Students will be actively involved in the learning process and in the development of a critical spirit through clinical examples and computer simulations in the classroom.
Particular attention will be paid to the adoption of gender language and information for students with disabilities, with Specific Learning Disorders (DSA), with Special Educational Needs (BES).

The teacher usually receives on Tuesdays from 2 to 6 pm. Appointments by email are welcome.
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 learning evaluation will include both a written and an oral test.

The written exam consists of 50 multiple-choice questions (MCQ) (just one right answer choice). 40 questions will investigate knowledge, applied understanding and independent judgment through the administration of integrated clinical cases. 10 questions will investigate the knowledge and ability to understand the discipline of pharmacology and in-depth analysis of the same. Time available: 60 minutes. Passing threshold of 60%, equivalent to 30 correct answers from the entire course. Passing the written test grants access to the oral exam, which analyzes a clinical case. The oral exam is scored out of 30 and evaluates the student's ability to investigate the ability to understand applied, independent judgement, communication skills and the ability to learn. A score of 18/30 is considered passed, and if not passed, the whole exam must be repeated (written plus oral). Time available: 15 minutes.

The final certification evaluation is determined by the average of the written and oral evaluations.

Evaluation criteria:
- 25-30 points if exhaustive response, recognizes assistance needs/problems and knows how to handle them correctly
- 18-24 points partially comprehensive, partially recognizes care needs/problems and manages them not completely correctly
- < 18 points if not exhaustive, does not recognize assistance needs/problems and does not know how to manage them correctly

The courses of "Clinical Pharmacology" and that of "Insights into Clinical Pharmacology" are integrated and are held by the same teacher. The two courses are integrated into the course of "Clinical Nursing in the Medical Area" with Internal Medicine and Endocrinology.
The drugs of each single class will be evaluated comparatively, with particular attention to the pharmacokinetic characteristics of each one.

• Drugs: what they are and how they are studied, how they are characterized, how they are developed. Elements of clinical pharmacological experimentation and bioethics. Prescriptive tables.
• Adrenergic and cholinergic agonists and antagonists.
Drugs that interfere with cholinergic neurotransmission:
Short and medium-acting and irreversible anticholinesterases – clinical uses, risks and pralidoxime (antidote)
Depolarizing muscle relaxants (nicotinic muscle receptor agonists) and nondepolarizing muscle relaxants (curarics)
Ganglion blockers (trimetaphan)
Muscarinic receptors:
Agonists (pilocarpine, carbachol, bethanechol and methacholine) – Clinical use (glaucoma, urinary retention, peripheral vascular disease, salivation)
Antagonists (atropine, scopolamine, tropicamide, ipratropium bromide, biperiden) – Therapeutic applications (sinus bradycardias, anti-kinetics, Parkinson's disease, anti-asthmatics)
Botulinum toxin and its therapeutic uses (spsmodic torticollis, facial hemispasm, blepharospasm, dynamic clubfoot deformation)
Drugs that interfere with catecholaminergic neurotransmission: Anatomical locations of alpha, beta, and dopaminergic receptors.
Pharmacology of alpha1 receptors: agonists (ephedrine, adrenaline and noradrenaline) and their uses (nasal and ocular decongestants, shock drugs) and antagonists (prazosin, doxazosin, tamsulosin, terazosin) and their uses (antihypertensives, bladder sphincter relaxants)
Pharmacology of alpha2 receptors: agonists (clonidine) and their uses (antihypertensives, treatment of opioid withdrawal crises, opioid detoxification)
Beta receptor pharmacology: agonists (adrenaline and noradrenaline, dobutamine, dopamine) and their uses and antagonists (selective and non-selective beta-blockers, propanolol, atenolol, carvedilol) and their uses (hypertension, angina pectoris, antiarrhythmics, heart failure, glaucoma, migraine , anxiolysis, benign essential tremor, asthma, shock)
Cocaine
Amphetamine and its derivatives (ecstasy and methamphetamine)
• Respiratory system drugs:
Bronchodilators (short and long-acting beta-2 agonists, anticholinetic drugs, theophylline), Asthmatic disease modifiers (Corticosteroids budesonide, fluticasone, betclomethasone, mometasone; Leukotriene modifiers montelukast, zafirlukast; Cromons; Anti-IgE (omalizumab) Antitussive drugs (codeine, dextromethorphan, levodropropizine)
Mucolytics and expectorants: acetylcysteine, carbocysteine, mesna, bromhexine, ambroxol, dornase alfa
• Anti-inflammatory drugs (costeroids, NSAIDs, selective COX-2 inhibitors)
• Antiallergic drugs: antihistamines (promethazine, hydroxyzine, cetirizine, loratadine, fexofenadine), cromogligate and cortisones (betclomethasone, budesonide, mometasone, triamcinolone)
• Drugs for autoimmune diseases and Organ and bone marrow transplant immunosuppressive drugs (HvGD and GvHD: cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, basiliximab, muromonab, daclizumab, prednisone, methylprednisolone)
• Main groups of antibacterial chemotherapy: role of the nurse in the prevention of resistance, elements of therapy and antibiotic prophylaxis
• CNS drugs:
anxiolytics – benzodiazepines (alprazolam, diazepam, triazolam, chlordiazepoxide), Z-drugs (zolpidem, zaleplon), Buspirone, Hydroxyzine. Flumazenil (antidote for benzodiazepine intoxication)
hypnotics – Temazepam, flurazepam, Z-drugs
antiepileptics: decreased sodium channel activity (phenytoin, carbamazepine, lamotrigine and felbamate), potentiated GABAergic transmission (benzodiazepines: lorazepam, clonazepam, diazepam, vigabatrin, gabapentin, tiagabine; barbiturates: phenobarbital, primidone), decreased channel activity of calcium (ethosuximide, valproate), reduction of glutamatergic transmission (topiramate, felbamate)
drugs for the treatment of Parkinson's disease
drugs for the treatment of Alzheimer's disease
• Antiplatelet agents, Anticoagulants, Fibrinolytics, Antihemorrhagic and Antianemic
• Local anesthetics and general anesthetics
• Osmotic diuretics (mannitol), thiazide hydrochlorothiazide), loop diuretics (furosemide), potassium sparing (spironolactone, amiloride, triamterene) and carbonic anhydrase inhibitors (acetazolamide)
• Opioid drugs and principles of pain management: full agonists (morphine, methadone, fentanyl), partial agonists (pentazocine, buprenorphine) and antagonists (naloxone and naltrexone). Nursing precautions in the management of this class of drugs.
• Elements of pharmacokinetics
Pharmaceutical forms and routes of administration. Nursing instructions for administration
Absorption, Distribution, Elimination, Bioavailability and Half-life of drugs
Drug metabolism
• Elements of pharmacodynamics: Agonists and Antagonists
The course program includes addressing issues relating to the integration of the gender dimension, in particular with reference to the therapeutic management of patients and the behavior of healthcare personnel in this area.

At the end of the course the student will be able to: acquire the knowledge to identify and describe the signs and symptoms of internal disease (Knowledge and comprehension skills). At the end of the course, the student will be able to: i) critically support the patient during drug treatments to reduce the risks, ii) appreciate the importance of pharmacology for improving health. Knowledge and Understanding: Students are expected to have demonstrated knowledge and understanding in their field of study, including some cutting-edge topics. Furthermore, they are expected to have demonstrated knowledge and understanding that extend and strengthen those typically possessed at this level of education, and that may enable them to develop and/or apply original ideas, often in a research context. Ability to Apply Knowledge and Understanding: Students are expected to be able to apply their knowledge and understanding in a manner that demonstrates a professional approach to their work and possess adequate skills to both develop and sustain arguments and solve problems in their field of study. Furthermore, they are expected to be able to apply their knowledge, understanding, and problem-solving skills to new or unfamiliar topics within broader (or interdisciplinary) contexts related to their field of study. Independent judgment: Students are expected to have the ability to collect and interpret data (usually within their field of study) deemed useful for making independent judgments, including reflection on related social, scientific, or ethical issues. They are also expected to have the ability to integrate knowledge and manage complexity, as well as formulate judgments based on limited or incomplete information, including reflection on the social and ethical responsibilities associated with the application of their knowledge and judgments. Students must be capable of critical analysis, evaluation, and synthesis of new and complex ideas. Communication skills: Students are expected to communicate information, ideas, problems, and solutions to both specialist and non-specialist audiences, and to communicate their conclusions, as well as the knowledge and rationale behind them, clearly and unambiguously. Furthermore, students must be able to communicate with their peers, the broader scholarly community, and society at large in their fields of expertise. Learning skills: Students are expected to have developed the learning skills necessary to undertake further studies with a high degree of autonomy, to have developed the learning skills that allow them to continue studying largely self-directed or autonomously, and to be capable of promoting, in academic and professional contexts, technological, social, or cultural advancement in the knowledge-based society.