Ateneo - UPO

The course provides the fundamental knowledge of pharmacology required to understand the mechanisms of action, clinical use, efficacy, and safety of the main medicines used in nursing practice. General principles of pharmacology will be covered, including drug development, pharmacokinetics, pharmacodynamics, drug interactions, toxicity, and pharmacovigilance. The course will also address the main classes of medicines used to treat pain and cardiovascular, neurological, metabolic, respiratory, and gastrointestinal disorders, as well as the principal antimicrobial, antiviral, and antifungal agents. It will additionally explore pharmacological aspects relevant to the management of emergencies, anaemia, and shock, also through supplementary teaching material 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, Caputi, Del Tacca), EDRA.

The Clinical Pharmacology module is part of the Integrated Course in Clinical Nursing in Medical Care and is worth 2 CFU credits, corresponding to 24 hours of classroom teaching. The course aims to provide students with the pharmacological knowledge essential for understanding the principles governing drug action and the use of medicines in clinical and nursing practice.
By the end of the course, students will be able to:
- understand drug development and testing processes;
- understand the principles of pharmacokinetics and pharmacodynamics and the main drug interactions;
- recognise the mechanisms underlying adverse reactions, toxicity, and pharmacovigilance;
- acquire knowledge of the principal medicines used in diseases of greatest relevance to nursing practice;
- apply pharmacological knowledge to the therapeutic management of patients, with particular attention to the efficacy, safety, and appropriate use of medicines;
- develop the ability to identify and monitor the therapeutic and undesirable effects of pharmacological treatments.

To achieve the expected learning outcomes, students must possess the essential knowledge of Anatomy, Physiology, Biochemistry, General Pathology, and Pathophysiology.

All classes will be held in person using PowerPoint presentations. Active student participation will be encouraged whenever their level of knowledge allows. The material used in class will be uploaded to the course page on the DIR platform.

The teacher is available to meet students by prior appointment via email.
Students with disabilities, Specific Learning Disorders (SLDs), or Special Educational Needs (SEN) may request dedicated services and specific support tools by consulting the relevant page of the University website:
https://uniupo.it/it/servizi/servizi-studentesse-e-studenti-condizione-di-fragilità-disabilità-dsa-bes.
After contacting the relevant University staff, students with disabilities, SLDs, or SEN may contact the course lecturer to discuss how the examination arrangements may be adapted and any related teaching matters.

Learning will be assessed through a written examination consisting of 7 multiple-choice questions (MCQs), each with only one correct answer. These 7 questions contribute to the written examination for Clinical Nursing in Medical Care, of which the Clinical Pharmacology course is a component.

General principles of pharmacology
1. Introduction and drug development
Definition of a medicine, active ingredient, and excipient. Stages of drug development (preclinical studies and phase I-IV clinical trials); the 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), and the main routes of drug elimination. Key pharmacokinetic parameters (half-life, steady-state plasma concentration, etc.) and their significance for dosage regimens. Pharmacokinetic interactions (enzyme induction and
inhibition, competition) and clinical situations involving increased risk: older adults and patients with hepatic or 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, competitive and non-competitive antagonism, inverse agonists) and their relevance in polypharmacy.
4. Toxicity, teratogenesis, adverse reactions, and pharmacovigilance
Classification of adverse drug reactions (type A and type B ADRs), dose-dependent toxicity, allergic and idiosyncratic reactions. Risks during pregnancy and breastfeeding. The pharmacovigilance system and the nurse's role in reporting adverse reactions.

Pain pharmacology
NSAIDs and paracetamol, corticosteroids, opioids (mechanism of action, dose titration, management of adverse effects and respiratory depression), and medicines for neuropathic pain. Principles of pain management and nursing monitoring.

Cardiovascular and haematological pharmacology
Antihypertensive agents and diuretics; treatment of heart failure; medicines affecting haemostasis (anticoagulants, antiplatelet agents, an overview of fibrinolytics, and agents used to reverse anticoagulant effects), with particular attention to monitoring and bleeding risk. Overview of the treatment of myocardial ischaemia. Antiarrhythmic agents. Treatment of acute and chronic anaemia: iron supplementation and erythropoietin.

Central nervous system pharmacology
Anxiolytics and hypnotics. Antiseizure medicines: selection criteria, clinical indications, adverse effects, and interactions. Antipsychotics: clinical use, adverse effects, and interactions. Antidepressants: mechanisms of action, indications, adverse effects, and interactions. Overview of antiparkinsonian pharmacology, with particular attention to adverse effects. Local and general anaesthetics.

Medicines affecting metabolism
Treatment of dyslipidaemia. Treatment of diabetes mellitus (oral glucose-lowering agents and insulins), with attention to patient education and recognition of hypoglycaemia. Medicines used to treat gout.

Respiratory pharmacology
Treatment of chronic obstructive pulmonary disease (COPD), with an overview of the treatment of bronchial asthma. Antitussives and mucolytics.

Gastrointestinal pharmacology
Antiemetics. Antidiarrhoeal agents. Laxatives. Antacids and antisecretory medicines.

Antimicrobial medicines
Main classes of antibiotics and their spectrum of activity; principles of antibiotic therapy and antimicrobial resistance; antiviral and antifungal agents.

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 learning objectives of the Bachelor's Degree Programme in Nursing and the Tuning Matrix, students will have achieved the following learning outcomes, structured according to the Dublin Descriptors.

D1 - Knowledge and understanding
Students will know and understand the fundamentals of general pharmacology and the pharmacological and toxicological characteristics of the different classes of medicines. In particular, they will be able to:
- describe the fundamental principles of pharmacokinetics (ADME) and pharmacodynamics;
- explain 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 treatment in the main diseases of relevance to nursing practice.

D2 - Applying knowledge and understanding
Students will be able to use theoretical knowledge to reason critically about medicine administration, adopting a professional approach.
They will be able to:
- interpret the therapeutic and undesirable effects of the principal medicines in the clinical and nursing care context;
- recognise the main drug interactions and risk factors associated with treatments;
- apply pharmacological knowledge to patient care management, within the scope of nursing competencies and responsibilities;
- contribute to monitoring the efficacy and safety of pharmacological treatments.

D3 - Making judgements
Students will be able to critically examine the knowledge acquired and independently discuss issues arising from its practical application.
They will be able to:
- critically assess the benefits and risks of pharmacological treatments;
- recognise clinical situations requiring particular attention in medicine administration and monitoring;
- integrate pharmacological knowledge with information relating to the individual patient.

D4 - Communication skills
Students will be able to communicate the knowledge acquired using appropriate terminology and interact professionally. They will be able to:
- use pharmacological terminology correctly;
- communicate essential information about medicines and treatments clearly and unambiguously to specialist and non-specialist audiences, including patients;
- interact with other healthcare professionals in the context of the patient's therapeutic management.

D5 - Learning skills
Students will have developed the learning skills required for continuous professional updating in pharmacology. They will be able to:
- independently update their pharmacological knowledge;
- critically consult reliable scientific sources and institutional documents (medicines databases, summaries of product characteristics, guidelines, and pharmacovigilance communications).