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Stephen F. Austin State University DeWitt School of Nursing PHARMACOLOGY ACROSS THE LIFESPAN SYLLABUS Course Number: NUR 308 Section Number: 001 Spring 2015 Course Instructor Gina Haidinyak, M.Ed., MSN, JD, RN ALL INFORMATION IN THIS SYLLABUS IS SUBJECT TO THE WRITTEN POLICIES AND PROCEDURES OF THE SCHOOL OF NURSING, STEPHEN F. AUSTIN STATE UNIVERSITY, NACOGDOCHES, TEXAS. IN THE CASE OF COMMISSION, OMISSION, AMBIGUITY, VAGUENESS, OR CONFLICT, THE POLICIES AND PROCEDURES OF THE SCHOOL OF NURSING SHALL CONTROL. EACH STUDENT SHALL BE RESPONSIBLE FOR ACTUAL AND/OR CONSTRUCTIVE KNOWLEDGE OF THE POLICIES AND PROCEDURES OF THE SCHOOL OF NURSING AND FOR COMPLIANCE THEREWITH. EACH STUDENT IS RESPONSIBLE FOR ALL INFORMATION IN THIS SYLLABUS. This syllabus is provided for informational purposes only. 1 Name: Department: Email: Phone: Office: Office Hours: Greta Eugenia (Gina) Haidinyak, M.Ed., MSN, JD, RN Nursing [email protected] 936-468-7735 Room 170 Mondays: 0830 – 0900 and 1200 - 1500 Tuesdays: 0830 – 0900; 1030 – 1200 Wednesdays: 0830 – 0900 and 1200 - 1500 Thursdays: 0830 – 0900 and 1030 - 1100 Fridays: By appointment Class Meeting Time and Place: 1200 – 1500 on Tuesdays in Assigned Classroom Textbooks and Materials: Karch, Amy M. (2013) Focus on Nursing Pharmacology (6th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Gray Morris, Deborah (2010) Calculating with Confidence (6th ed.). St Louis, Missouri: Elsevier Mosby Course Description Three semester didactic hours. Establishes a foundation for the pharmacological aspects of nursing. Examines student readiness for clinical practicum with qualifying exam. Unabridged Course Description This course establishes a foundation for the pharmacological aspects of nursing and builds on concepts from core curriculum, previous, and concurrent nursing courses. The course will encompass basic principles of pharmacology, medication administration, and classification of drugs. Number of Credit Hours 3 credit hours (3 lecture) Course Prerequisites and Co-requisites Pre-requisites: NUR 304, Admission to Nursing Program Co-requisites: NUR 305, NURS 306, NURS 307 Program Learning Outcomes 1. Apply knowledge of the physical, social, and behavioral sciences in the provision of nursing care based on theory and evidence based practice. 2. Deliver nursing care within established legal and ethical parameters in collaboration with clients and members of the interdisciplinary health care team. 3. Provide holistic nursing care to clients while respecting individual and cultural diversity. 4. Demonstrate effective leadership that fosters independent thinking, use of informatics, and collaborative communication in the management of nursing care. 2 5. Assure responsibility and accountability for quality improvement and delivery of safe and effective nursing care. 6. Serve as an advocate for clients and for the profession of nursing. 7. Demonstrate continuing competence, growth, and development in the profession of nursing. General Education Core Curriculum Objectives/Outcomes None Student Learning Outcomes 1. Identify concepts and principles of the arts, sciences, humanities, and nursing as foundational content for the science of pharmacological nursing. 2. Identify the nursing responsibility and accountability related to pharmacology and medication administration. 3. Identify the interdisciplinary collaboration involved with pharmacology. 4. Describe the moral, ethical, economic, political, and legal issues involved in nursing and pharmacology. 5. Explain how holistic, socio-economic, spiritual, and ethno-cultural characteristics of clients affect nursing and pharmacology. 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes. 8. Describe processes utilized in medication administration. 9. Demonstrate medication calculations through successful completion of calculation exam prior to administering medications in the clinical setting. Differentiated Essential Competencies (DEC’s) The Richard and Lucille DeWitt School of Nursing prepares graduates to demonstrate the Differentiated Essential Competencies of Graduates of Texas Nursing Programs Evidenced by Knowledge, Clinical Judgments, and Behaviors (DECs). The competencies are based upon the preparation in the program of study. In nursing education, the DEC’s serve as a guideline and tool for curriculum development and revision, a tool for benchmarking and evaluation of the program, and statewide standard to ensure graduates will enter practice as safe and competent nurses. The DECs are incorporated into every course in the SON to ensure uniformity and continuity of standards. Please refer to the Texas BON website for additional information http://www.bon.texas.gov/about/pdfs/delc-2010.pdf Course Requirements: Homework #1, #2 and #3 Presentation Test I Test II Test III Final Exam Total 30 points 70 points 100 points 100 points 100 points 100 points 500 points 3 TENTATIVE SCHEDULE ALL ASSIGNMENTS ARE IN KARCH UNLESS OTHERWISE INDICATED. Jan. 20 Introduction to Course Calculations I (Chapter 5) Review Chapters 1 – 9 in Gray Morris Jan. 27 Introduction to Drugs (Chapters 1 & 2) Drug Therapy (Chapters 3 & 6) Calculations II Review Chapters 10 – 14, 17 & 18 in Gray Morris Calculation Homework #1 Due Feb. 3 Endocrine Agents (Chapters 34 – 37) Diabetic Agents (Chapter 38) Calculations III Review Chapters 19 – 23 in Gray Morris Calculation Homework #2 Due Feb. 10 CALCULATION TEST Calculation Homework #3 Due Make-up Exams TBA Feb. 17 Anti-Infectives I (Chapters 10 – 13) Anti-Infectives II (Chapters 10 – 13) Chemotherapy (Chapter 14) Feb. 24 TEST I March 3 ANS Agents (Chapters 29 – 33) Respiratory Agents (Chapters 53 – 55) Presentations #1 and #2 March 10 CV Agents I (Chapters 42 – 43) CV Agents II (Chapters 44 – 45) PRESENTATIONS #3, #4 and #5 March 17 SPRING BREAK March 24 CV Agents III (Chapters 46 – 47) CV Agents IV (Chapters 48 – 49) PRESENTATIONS #6 and #7 March 31 TEST II 4 April 7 NSAIDs and Related Agents (Chapters 15 – 17) Neurological Agents I (Chapters 19 – 21) PRESENTATIONS #8, #9 and #10 April 14 Neurological Agents II (Chapters 22 – 24) Neurological Agents III (Chapters 25 – 28) PRESENTATIONS #11 and #12 April 21 GI Agents (Chapters 56 – 59) Renal Agents (Chapters 50 – 52) PRESENTATIONS #13, #14 and #15 April 28 TEST III May 5 Optional Review (Dead Week) May 12 COMPREHENSIVE FINAL EXAMINATION (1200 - 1400) Grading Policy: A = 90 - 100 % (450 – 500 points) B = 80 - 89 % (400 – 449 points) C = 75 - 79 % (375 – 399 points) F = 74 % and below (below 375 points) Attendance Policy: Class attendance and participation are important. Students are expected to attend class. Academic Integrity (A -9.1) Academic integrity is a responsibility of all university faculty and students. Faculty members promote academic integrity in multiple ways including instruction on the components of academic honesty, as well as abiding by university policy on penalties for cheating and plagiarism. Definition of Academic Dishonesty Academic dishonesty includes both cheating and plagiarism. Cheating includes but is not limited to (1) using or attempting to use unauthorized materials to aid in achieving a better grade on a component of a class; (2) the falsification or invention of any information, including citations, on an assigned exercise; and/or (3) helping or attempting to help another in an act of cheating or plagiarism. Plagiarism is presenting the words or ideas of another person as if they were your own. Examples of plagiarism are (1) submitting an assignment as if it were one’s own work when, in fact, it is at least partly the work of another; (2) submitting a work that has been 5 purchased or otherwise obtained from an Internet source or another source; and (3) incorporating the words or ideas of an author into one’s paper without giving the author due credit. Please read the complete policy at http://www.sfasu.edu/policies/academic_integrity.asp Withheld Grades (Semester Grades Policy A – 54) Ordinarily, at the discretion of the instructor of record and with the approval of the academic chair/director, a grade of WH will be assigned only if the student cannot complete the course work because of unavoidable circumstances. Students must complete the work within one calendar year from the end of the semester in which they receive a WH, or the grade automatically becomes an F. If students register for the same course in future terms the WH will automatically become an F and will be counted as a repeated course for the purpose of computing the grade point average. The circumstances precipitating the request must have occurred after the last day in which a student could withdraw from a course. Students requesting a WH must be passing the course with a minimum projected grade of C. Students with Disabilities To obtain disability related accommodations, alternate formats and/or auxiliary aids, students with disabilities must contact the Office of Disability Services (ODS), Human Services Building, and Room 325, 468-3004/ 468-1004 (TDD) as early as possible in the semester. Once verified, ODS will notify the course instructor and outline the accommodation and/or auxiliary aides to be provided. Failure to request services in a timely manner may delay your accommodations. For additional information, go to http://www.sfasu.edu/disabilityservices/. Acceptable Student Behavior Classroom behavior should not interfere with the instructor’s ability to conduct the class or the ability of other students to learn from the instructional program (see Student Conduct Code, policy D – 34.1). Unacceptable or disruptive behavior will not be tolerated. Students who disrupt the learning environment may be asked to leave class and may be subject to judicial, academic or other penalties. The prohibition applies to all instructional forums, including electronic, classroom, labs, discussion groups, field trips, etc. The instructor shall have full discretion over what behavior is appropriate/inappropriate in the classroom. Students who do not attend class regularly or who perform poorly on class projects/exams may be referred to the Early Alert Program. This program provides students with recommendations for resources or other assistance that is available to help SFA students succeed. Late to Class If you are late to class, please wait until the break to enter the classroom. Cell Phones Cell phones should be turned off and out of sight during this class. Their use is forbidden. 6 Electronics No computers, notebooks, or electronic tablets are allowed in class. WEIGHTED MEAN AVERAGE A student must have a weighted mean average of at least seventy-five percent (75%) on Tests I, II, III and the Comprehensive Final Examination to pass the course. This does NOT include the calculation exam(s). The weighted mean average will be calculated by taking each test score and multiplying it by the percentage it is worth. Those results will be added and the total divided by the total percentage of the tests. If the weighted mean average of the tests is less than 75%, the student will earn an “F” in the course. A STUDENT WHO FAILS THE COURSE WILL NOT BE ALLOWED TO PROGRESS IN THE NURSING PROGRAM. CALCULATION TEST A student must pass the Calculation Test before being allowed to administer medications in the clinical area. A student who does not pass the Calculation Test will earn an “F” in the course. The calculation test is pass/fail. A passing percentage is 90%. This grade is not included in the weighted mean average. MAKE-UP EXAMS For good cause shown, Make-up Exams will be individually arranged. HOMEWORK #1, #2, AND #3 Homework #1 is due Jan. 27, homework #2 is due Feb. 3, and homework #3 is due Feb. 10. This homework is on D2L (Desire to Learn) and each will be worth 10 points for a total of 30 points. PRESENTATIONS Each student will be randomly assigned to a group and each group will do a presentation upon an assigned critical thinking exercise in the text. This assignment is worth 70 points. Students should be CREATIVE in the presentation. Skits, power point slides, videos and other creative aides may be used. Each group will prepare a brochure on the medication in the critical thinking exercise and present it to the instructor and to each student in the class. The only written material will be a reference page. 7 TOTAL POINTS = 70 CONTENT 35 points The presentation should include: Brief summary of the critical thinking exercise Basic facts about the medication or medication type Important assessment data related to medication Choose ONE (1) nursing diagnosis Implementation Evaluation Relevant patient teaching WRITTEN MATERIAL 5% 5% 5% 5% 5% 5% 5% 5 points References At least three (3) in addition to text Do not use Wikipedia Due on single piece of paper to instructor before the actual presentation PRESENTATION 10 points The presentation should last between 10 and 15 minutes Use of appropriate and creative audiovisual aides Appropriate dress and actions BROCHURE 20 points The brochure should be creative The information should be directed toward patient teaching Part of a group project is learning to work together and every student will receive the same grade. Because of this, please make sure all the work has been done to your satisfaction even if it was not part of your specific assignment by the group. 8 INTRODUCTION TO COURSE Reading: Syllabus DOSAGE CALCULATIONS I Reading: Chapter 5 in Karch Review Chapters 1 – 9 in Gray Morris Review handouts Student Learning Outcomes 8. Describe processes utilized in medication administration. 9. Demonstrate medication calculations through successful completion of calculation exam prior to administering medications in the clinical setting. Unit Objectives 1. Describe the measuring systems that can be used in drug therapy. 2. Convert between different measuring systems when given drug orders and available forms of the drugs. 3. Calculate the correct dose of a drug when given examples of drug orders and available forms of the drugs ordered. 4. Discuss why children require different dosages of drugs than adults. 9 INTRODUCTION TO DRUGS Reading: Chapters 1 & 2 in Karch Review Chapters 10 – 14, 17 & 18 in Gray Morris Student Learning Outcomes 1. 2. 3. 4. 5. Identify concepts and principles of the arts, sciences, humanities, and nursing as foundational content for the science of pharmacological nursing. Identify the nursing responsibility and accountability related to pharmacology and medication administration. Identify the interdisciplinary collaboration involved with pharmacology. Describe the moral, ethical, economic, political, and legal issues involved in nursing and pharmacology. Explain how holistic, socio-economic, spiritual, and ethno-cultural characteristics of clients affect nursing and pharmacology. Unit Objectives 1. 2. 3. 4. 5. 6. Define pharmacology. Describe federal and state controlled substances. Differentiate between generic and brand-name drugs, OTC and prescription drugs. Define drug interactions. Explain the meaning of half-life, therapeutic index, and first-pass effect. Describe how body cells respond to the presence of drugs that are capable of altering their function. 7. Outline the process of dynamic equilibrium that determines the actual concentration of a drug in the body. 10 DRUG THERAPY Reading: Chapters 3 and 6 in Karch Student Learning Outcomes 1. Identify concepts and principles of the arts, sciences, humanities, and nursing as foundational content for the science of pharmacological nursing. 2. Identify the nursing responsibility and accountability related to pharmacology and medication administration. 3. Identify the interdisciplinary collaboration involved with pharmacology. 4. Describe the moral, ethical, economic, political, and legal issues involved in nursing and pharmacology. 5. Explain how holistic, socio-economic, spiritual, and ethno-cultural characteristics of clients affect nursing and pharmacology. Unit Objectives 1. 2. 3. 4. 5. 6. 7. 8. 9. Define the term adverse drug reaction and explain the clinical significance. List types of allergic responses to drug therapy. Discuss drug induced tissue damage. Define the term poison. Discuss the impact of the media, the internet, and direct-to-consumer advertising on drug sales and prescriptions. Explthe growing use of OTC drugs and the impact is has on safe medical care. Discuss the lack of controls on herbal or alternative therapies and the impact this has on safe drug therapy. Define off-label use. Describe measures being taken to protect the public in cases of bioterrism. 11 CALCULATIONS II Reading: Chapters 10 – 14, 17 & 18 in Gray Morris Student Learning Outcomes 8. Describe processes utilized in medication administration. 9. Demonstrate medication calculations through successful completion of calculation exam prior to administering medications in the clinical setting. Unit Objectives 1. State the consequences of medication errors. 2. Identify the causes of medication errors. 3. Identify the role of the nurse in preventing medication errors. 4. State the “rights” of medication administration 5. Define critical thinking. 6. Explain the importance of critical thinking in medication administration. 7. Discuss the impact of client teaching. 8. Identify error-prone abbreviations, symbols and dose designations 9. Read and write correct medical notations. 10. State a ratio and proportion to solve a given dosage calculation problem. 11. Solve simple calculation problems using the ratio and proportion method. 12. Identify the forms of oral medication. 13. Identify the terms on the medication label to be used in calculation of dosages. 14. Calculate dosages for oral and liquid medications using ration and proportion. 15. Read medication labels on parenteral medications. 16. Calculate dosages of parenteral medications already in solution. 17. Identify appropriate syringes with which to administer dosages calculated. 12 ENDOCRINE AGENTS Reading: Chapters 34 – 37 in Karch Student Learning Outcomes 1. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 2. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Name the glands of the traditional endocrine system and list the hormones produced by each. 2. Discuss the theories of hormone action. 3. Outline the negative feedback system. 4. Describe the relationships between the hypothalamus and the pituitary gland. 5. Describe the mechanisms of action, indications for use, and pertinent educational needs for clients taking hypothalamic and pituitary agents. 6. Explain the control of the synthesis and secretion and physiological effects of the adrenocortical agents. 7. Describe therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions and important drug-drug interactions associated with the adrenocortical agents. 8. Describe the mechanisms of action, indications for use, and pertinent educational needs for clients taking adrenocortical agents. 9. Explain the control of the synthesis and secretion of thyroid and parathyroid hormones. 10. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs for clients taking thyroid and parathyroid agents. 11. Evaluate the effects of endocrine agents on physiologic and psychological processes. 13 DIABETIC AGENTS Reading: Chapter 38 in Karch Review Handout on Insulin Student Learning Outcomes 1. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 2. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Describe the pathophysiology of diabetes mellitus, including changes to basement 2. Identify select drug classifications, mechanisms of action, indications for use and pertinent client educational needs for clients taking diabetic agents. 3. Identify effects of diabetic agents on physiologic and psychological processes. 4. List signs and symptoms of hyperglycemia and hypoglycemia and the treatment for each. 14 CALCULATIONS III Reading: Chapters 19 – 23 in Karch Student Learning Objectives 8. Describe processes utilized in medication administration. 9. Demonstrate medication calculations through successful completion of calculation exam prior to administering medications in the clinical setting. Unit Objectives 1. Identify the varying directions for reconstitution and select the correct directions to prepare the dosage ordered. 2. Calculate dosages from reconstituted medications. 3. Identify important information on insulijn labels. 4. Measure insulin in single dosages. 5. Measure combined insulin dosages. 6. Identify common intravenous (IV) solutions and abbreviations. 7. Calculate milliliters per hour (mL/hr). 8. Calculate IV flow rate in drops per minute (gtt/min) using a formula method 9. Calculate the flow rate for medications ordered IV over a specified time period. 10. Calculate infusion times and completion times. 11. State the importance of calculating heparin dosages accurately. 12. Calculate heparin dosages being administered intravenously. 13. Calculate subcutaneous dosages of heparin. 15 ANTI-INFECTIVES I Reading: Chapters 7, 8 and 9 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. 2. 3. 4. Explain selective toxicity and discuss its importance in anti-infective therapies. Differentiate between board-spectrum and narrow-spectrum drugs. Define bacterial resistance to antibiotics and discuss the emergence of resistant strains. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs for clients taking antibiotics. 5. Evaluate effects of antibiotics on physiologic and psychological processes. 6. Describe three common adverse reactions associated with the use of antibiotics. 7. Explain how an antibiotic is selected for use in a particular clinical situation. 8. Discuss use of antibiotics as they are used across the lifespan. 9. Compare and contrast prototype drugs for each class of antibiotics with other drugs in that class. 10. Outline nursing considerations for patients receiving each class of antibiotic. 16 ANTI-INFECTIVES II Reading: Chapters 10, 11, 12 and 13 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs for clients taking antivirals, antifungals, antiprotozoals, and anthelmintic agents. 2. Evaluate the effects of antivirals, antifungals, antiprotozals, and anthelmintic agents on physiologic and psychological processes. 17 CHEMOTHERAPY Reading: Chapter 14 in Karch Student Learning Outcomes 5. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 6. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Describe the nature of cancer and the changes the body undergoes when cancer occurs. 2. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions, and important drug-drug interactions associated with each class of chemotherapeutic agents. 3. Discuss the use of antineoplasstic drugs across the lifespan. 4. Compare and contrast the prototype drugs for each class of antineoplastic agents with the other drugs in that class. 5. Outline the nursing considerations and teaching needs for patients receiving each class of antineoplastic agents. . 18 ANS AGENTS Reading: Chapters 29 – 33 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. 2. 3. 4. 5. 6. 7. 8. Describe the autonomic nervous system. Outline a sympathetic response and the clinical manifestations of that response Describe alpha and beta receptors. Outline the actions of the parasympathetic nervous system. Identify two ways the sympathetic drugs act of produce their effects. Describe how adrenergic blocking agents produce their effects. Describe how cholinergic agonists and antagonists produce their effects. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions, and important drug-drug interactions associated with adrenergic agonists, adrenergic antagonists, cholinergic agonists, and anticholinergics. 9. Outline the nursing considerations, including important teaching points, for patients receiving an adrenergic agent, an adrenergic blocking agent, a cholinergic agent, or an anticholinergic agent. 19 RESPIRATORY AGENTS Reading: Chapters 53 – 55 in Karch Student Learning Outcomes 8. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 9. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Describe the major structures of the respiratory system. 2. Differentiate between the common conditions that affect the upper respiratory system. 3. Identify three conditions involving the lower respiratory tract, including the clinical presentations of these conditions. 4. Describe the underlying pathophysiology involved in obstructive pulmonary disease and correlate this information with the presenting signs and symptoms. 5. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions, and important drug-drug interactions associated with drugs acting on the respiratory tract. 6. Discuss the use of drugs that act on the respiratory tract across the lifespan. 7. Compare and contrast the prototype drugs with other agents in their class and with other classes of drugs that act on the respiratory tract. 8. Outline the nursing considerations, including important teaching points, for patients receiving drugs acting on the respiratory tract. 20 CARDIOVASCULAR AGENTS PARTS I, II, III, AND IV Reading: Chapters 42 – 49 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Describe the flow of blood during the cardiac cycle, including flow to the cardiac muscle. 2. Describe the conduction system of the heart, correlating the normal ECG pattern with the underlying electrical activity in the heart. 3. Discuss four normal controls for blood pressure 4. Describe the capillary fluid shift, including factors that influence the movement of fluid in clinical situation. 5. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions, and important drug-drug interactions associated with drugs affecting blood pressure. 6. Discuss the use of drugs that affect blood pressure across the lifespan. 7. Describe the pathophysiologic process of heart failure and the resultant clinical signs. 8. Explain the body’s compensatory mechanisms that occur in response to heart failure. 9. Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most common adverse reactions, and important drug-drug interactions associated with the cardiotonic agents. 10. Discuss the use of cardiotonic agents across the lifespan. 11. Compare and contrast the prototype drugs digoxin and inamrinone, and digoxin immune Fab. 12. Outline the nursing considerations, including important teaching points, for patients receiving cardiotonic agents. 13. Describe the cardiac action potential and its phases. 14. Discuss the use of arniarrhythmic agents across the lifespan. Compare and contrast the prototype antiarrhythmic drugs lidocaine, propranolol, sotalol, and diltiazem with other agents in their class and with other classes of antiarrhythmics. 15. Outline the nursing considerations, including important teaching points, for patients receiving antiarrhythmic agents. 16. Describe coronary artery disease, including identified risk factors and clinical presentation. 17. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, and cautions, most common adverse reactions, and important drug-drug interactions associated with the nitrates, beta-blockers, and calcium channel blockers used to treat angina. 18. Discuss the use of antianginal agents across the lifespan. 21 19. Compare and contrast the prototype drugs nitroglycerin, metoprolol, and diltiazem with other agents used to treat angina. 20. Outline the nursing considerations, including important teaching points, for patients receiving drugs used to treat angina. 21. Outline the mechanisms of fat metabolism in the body and discuss the role of hyperlipidemia as a risk factor for coronary artery disease. 22. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, and cautions, most common adverse reactions, and important drug-drug interactions associated with the bile acid sequestrants, HMG-CoA inhibitors, cholesterol absorption inhibitors, and other agents used to lower lipid levels. 23. Discuss the use of drugs that lower lipid levels across the lifespan. 24. Compare and contrast the various drugs used to lower lipid levels. 25. Outline blood coagulation in the body and compare with the actions of drugs used to affect clotting. 26. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions, and important drug-drug interactions associated with drugs affecting blood coagulation. 27. Discuss the use of drugs that affect blood coagulation across the lifespan. 28. Compare and contrast the ptototype drugs aspirin, heparin, urokinase, antihemophilic factor, and aminocaproic acid with other agents used to affect blood coagulation. 29. Outline the nursing considerations, inclinding important teaching points, for patients receiving drugs used to affect blood coagulation. 30. Explain erythropoiesis. 31. Discuss the use of drugs used to treat anemias across the lifespan. 32. Compare and contrast the ptototype drugs epoetin alfa, ferrous sulfate, folic aicd, and hydroxocobalamin with other agents in their class. 33. Outline the nursing considerations, including important teaching points, for patients receiving drugs used to treat anemias. 22 IMMUNE AGENTS Reading: Chapters 15 - 17 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes Unit Objectives 1. List four natural body defenses against infection. 2. Describe the cells associated with the body’s fight against infection and their basic functions. 3. Outline the sequence of events in the inflammatory response. 4. Correlate the events in the inflammatory response with the clinical picture of inflammation. 5. Outline the sequence of events in an antibody-related immune reaction and correlate these events with the clinical presentation of such a reaction. 6. Describe the sites of action of the various anti-inflammatory agents. 7. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions and important drug-drug interactions associated with each class of anti-inflammatory agents and immune modulators. 8. Discuss the use of anti-inflammatory agents across the lifespan. Compare and contrast the prototype drugs for each class of anti-inflammatory drugs and immune modulators with the other drugs in that class. 9. Outline the nursing considerations and teaching needs for patients receiving each class of anti-inflammatory agents and immune modulators. 23 NEUROLOGICAL AGENTS Reading: Chapters 19 -26 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes Unit Objectives 1. Explain what a neurotransmitter is, including its origins and functions at the synapse. 2. Describe the function of the cerebral cortex, cerebellum, hypothalamus, thalamus, midbrain, pituitary gland, medulla, spinal cord, and reticular activating system. 3. Define the states that are affected by anxiolytic or hypnotic agents. 4. Discuss the use of neurological agents across the lifespan. 5. Compare and contrast the prototype drugs for each class of anxiolytic or hypnotic drugs with the other drugs in that class. 6. Outline the nursing considerations and teaching needs for patients receiving each class of anxiolytic or hypnotic agent. 7. Describe the biogenic theory of depression 8. Compare and contrast protypical drugs in each class of antidepressant. 9. Outline the nursing considerations and teaching needs for patients receiving antidepressants. 10. Define the term psychotherapeutic agent and list conditions that the psychotherapeutic agents are used to treat. 11. Define the terms generalized seizure, tonic-clonic seizure, absence seizure, partial seizure, and status epilepticus. 12. Describe the current theory of the cause of Parkinson disease and correlate this with the clinical presentation of the disease. 13. Describe a spinal reflex and disucss the pathophysiology of muscle spasm and muscle spasticity. 14. Outline the gate theory of pain and explain therapeutic ways to block pain using the gate theory. 15. Discuss the use of different classes of narcotics, narcotic antagonists, and antimigraine agents across the lifespan. 16. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, mmost common adverse reactions, and important drug-drug interactions associated with neurological agents. 17. Outline the nursing considerations, including important teaching points, for patients neurological agents. 18. Compare and contrast the prototype drugs for each class of neurologic agent with other drugs in that class and other neurological drugs. 24 GI AGENTS Reading: Chapters 56 – 59 in Karch Student Learning Outcomes 8. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 9. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Identify the parts of the gastrointestinal (GI) tract, describing secretions, absorption, digestion, and type of motility that occurs in each part. 2. Discuss the nervous system control of the GI tract. 3. List three of the local GI reflexes and describe clinical application of each. 4. Describe the steps involved in swallowing. 5. Discuss the vomiting reflex, addressing three factors that can stimulate the reflex. 6. Describe the current theories on the pathophysiological process responsible for the signs and symptoms of peptic ulcer disease. 7. Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most common adverse reactions, and important drug-drug interactions associated with drugs used to affect the GI tract. 8. Discuss the drugs used to affect the GU tract across the lifespan. 9. Compare and contrast prototypical drugs which affect the GI tract. 10. Outline nursing considerations, including important teaching points, for patients receiving drugs used to affect the GI tract. 25 RENAL AGENTS Reading: Chapters 50 – 53 in Karch Student Learning Outcomes 6. Identify selected drug classifications, mechanisms of action, indications for use, and pertinent client educational needs. 7. Evaluate drug effects on physiologic and psychological processes. Unit Objectives 1. Review the anatomy and physiology of the kidney, including the structure of the nephron. 2. Explain the basic processes of the kidney and where these processes occur. 3. Describe the renin-angiotensin-aldosterone system, including controls and clinical situations where the system is active. 4. Discuss the roles of the kidney in acid-base balance, calcium, regulation, and RBC production, integrating this information to explain the clinical manifestations of renal failure. 5. Define the term diuretic and list the five classes. 6. Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most common adverse reactions, and important drug-drug interactions associated with the various classes of diuretic drugs, those drugs use to treat BPH, antiinfectives, analgesics, and bladder protectants. 7. Discuss the prototype drugs in each class of diuretic and compare with other agents in their class. 8. Outline nursing considerations, including important teaching points, for patients receiving renal agents. 26 27