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.
General principles of pharmacology will be addressed, including drug development, pharmacokinetics, pharmacodynamics, drug interactions, toxicity, and pharmacovigilance.
Additionally, the main classes of drugs used in the treatment of pain, cardiovascular, neurological, metabolic, respiratory, and gastrointestinal diseases will be covered, as well as the principal antimicrobial, antiviral, and antifungal agents.
The course will also explore relevant pharmacological aspects in the management of emergency situations, anemia, and shock, including 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, Caputi, Del Tacca), EDRA.

The Clinical Pharmacology module is part of the Integrated Course in Clinical Nursing in the Medical Area and provides 2 CFU, corresponding to 24 hours of direct 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 nursing practice.
By the end of the course, students will be able to:
• understand the processes of drug development and clinical trials;
• know the principles of pharmacokinetics and pharmacodynamics, as well as major drug interactions;
• recognize the mechanisms underlying adverse reactions, toxicity, and pharmacovigilance;
• acquire knowledge about the main drugs used in conditions of major nursing interest;
• apply pharmacological knowledge to the patient's therapeutic management, paying particular attention to drug efficacy, safety, and appropriateness of use;
• develop the ability to identify and monitor the therapeutic and adverse effects of pharmacological treatments.

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

Classes will all be held in the classroom using PowerPoint presentations, and active student participation is welcome whenever their knowledge permits. The materials used during lectures will be uploaded to the course's DIR page.

The professor receives students by appointment via email.
Students with disabilities, Specific Learning Disorders (SLD/DSA), or Special Educational Needs (SEN/BES) can request dedicated services and accommodations by visiting the specific page on the University website: https://uniupo.it/it/servizi/servizi-studentesse-e-studenti-condizione-di-fragilità-disabilità-dsa-bes. Once students with disabilities, SLD, or SEN have contacted the University Staff, they may contact the professor in charge of the course regarding any necessary adaptations for exam formats and teaching methods.

Assessment consists of a written exam with 7 multiple-choice questions (MCQ), each having only one correct answer. These 7 questions contribute to the written exam for Clinical Nursing in Medical Area, of which the Clinical Pharmacology course is a part.

Introduction and Drug Development
• Definitions: Drug (pharmacological agent), active pharmaceutical ingredient (API), and excipient.
• Drug Development Stages: Preclinical research and clinical trial phases (Phases I–IV).
• Pharmacovigilance: Concept of post-marketing surveillance.
2. Pharmacokinetics (ADME) and Pharmacokinetic Interactions
• ADME Process: Absorption, distribution, metabolism, and excretion.
• Key Pharmacokinetic Concepts: Bioavailability, plasma protein binding, phase I and phase II metabolic reactions (brief overview of Cytochrome P450), and major routes of elimination.
• Pharmacokinetic Parameters: Half-life ($t_{1/2}$), steady-state plasma concentration ($C_{ss}$), and their clinical relevance for dosing regimens.
• Pharmacokinetic Interactions: Enzyme induction and inhibition, competition for binding/excretion sites.
• High-Risk Clinical Scenarios: Elderly patients, hepatic impairment, and renal failure.
3. Pharmacodynamics and Pharmacodynamic Interactions
• Molecular Targets: Receptors, enzymes, ion channels, and transporters.
• Core Concepts: Agonism vs. antagonism, dose-response relationships, potency vs. efficacy, and therapeutic index.
• Pharmacodynamic Interactions: Synergism, competitive vs. non-competitive antagonism, inverse agonists, and their relevance in polypharmacy.
4. Toxicity, Teratogenesis, Adverse Reactions, and Pharmacovigilance
• Classification of Adverse Drug Reactions (ADRs): Type A (augmented) and Type B (bizarre) reactions.
• Toxicity Types: Dose-dependent toxicity, allergic reactions, and idiosyncratic responses.
• Special Populations: Risks during pregnancy and lactation (teratogenesis).
• Pharmacovigilance System: The nurse’s role in adverse drug reaction reporting.
Pharmacology of Pain Management
• Analgesics & Anti-inflammatories: NSAIDs and paracetamol (acetaminophen), corticosteroids.
• Opioids: Mechanisms of action, dose titration, management of adverse effects, and handling respiratory depression.
• Neuropathic Pain: Adjuvant drugs for neuropathic pain.
• Nursing Care: Principles of pain management, pain assessment, and nursing monitoring.
Cardiovascular and Hematologic Pharmacology
• Cardiovascular Agents: Antihypertensives, diuretics, heart failure therapeutics, antiarrhythmics, and brief overview of ischemic heart disease treatment.
• Hemostasis Pharmacology: Anticoagulants, antiplatelet agents, overview of fibrinolytics, and anticoagulant reversal agents (with a focus on bleeding risk and clinical monitoring).
• Anemia Therapeutics: Management of acute and chronic anemia through iron supplementation and erythropoietin (EPO).
Central Nervous System Pharmacology
• Anxiolytics & Hypnotics: Benzodiazepines and related agents.
• Antiseizure Medications (ASM): Selection criteria, clinical indications, adverse effects, and drug interactions.
• Antipsychotics: Clinical indications, side effects (e.g., extrapyramidal symptoms), and interactions.
• Antidepressants: Mechanisms of action, indications, side effects, and interactions.
• Antiparkinsonian Agents: Overview of therapy with emphasis on adverse effect profiles.
• Anesthetics: Local and general anesthetics.
Metabolic & Endocrine Pharmacology
• Dyslipidemia Therapy: Statins, fibrates, and other lipid-lowering agents.
• Diabetes Mellitus Management: Oral hypoglycemic agents and insulin regimens, focusing on patient education and recognition/treatment of hypoglycemia.
• Gout Treatment: Medications for acute flare-ups and chronic uric acid management.
Respiratory System Pharmacology
• Obstructive Airway Diseases: Therapy for Chronic Obstructive Pulmonary Disease (COPD) with an overview of bronchial asthma management.
• Symptomatic Relief: Antitussives (cough suppressants) and mucolytics.
Gastrointestinal Pharmacology
• Gastrointestinal Agents: Antiemetics, antidiarrheals, laxatives, antacids, and antisecretory medications.
Farmaci antimicrobici
Principali classi di antibiotici e loro spettro d'azione, principi di terapia antibiotica e resistenze; antivirali e antimicotici.
Farmacologia dell’emergenza.
Gestione farmacologica dello shock ipovolemico e normovolemico. Fluidoterapia. Emotrasfusioni.

Upon completion of the Clinical Pharmacology course, in alignment with the educational objectives of the Bachelor's Degree in Nursing and the Tuning Matrix, students will have achieved the following learning outcomes, detailed according to the Dublin Descriptors:

D1 - Knowledge and Understanding

Students will know and understand the core concepts of general pharmacology and the pharmaco-toxicological characteristics of various drug classes. Specifically, 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 drug classes covered;

Explain the mechanisms underlying drug interactions, adverse reactions, and the pharmacovigilance system;

Present the principles of pharmacological therapy for the primary medical conditions relevant to nursing care.

D2 - Applying Knowledge and Understanding

Students will be able to apply theoretical knowledge to reason critically about drug administration through a professional approach. They will be able to:

Interpret the therapeutic and adverse effects of major drugs within the clinical nursing care context;

Identify key drug interactions and risk factors associated with treatments;

Apply pharmacological knowledge to patient care management, respecting nursing competencies and responsibilities;

Contribute to monitoring the efficacy and safety of pharmacological therapies.

D3 - Making Judgements

Students will be able to critically examine the acquired concepts and independently analyze issues arising from their practical application. They will be able to:

Critically evaluate the benefits and risks of pharmacological treatments;

Identify clinical situations requiring special attention during drug administration and monitoring;

Integrate pharmacological knowledge with individual patient information.

D4 - Communication Skills

Students will be able to convey acquired knowledge using appropriate terminology to engage in professional discourse. They will be able to:

Correctly use pharmacological terminology;

Communicate essential information regarding drugs and therapies clearly and unambiguously to both specialist and non-specialist audiences, including patients;

Interrelate with other healthcare professionals in patient therapy 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 documentation (drug databases, Summary of Product Characteristics [SmPC], guidelines, and pharmacovigilance communications).