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Title
Therapeutic Aspects of Cardiovascular Pharmacy and Oncology
Code
PY334/5/6
Level
6
Credit rating
40 credits
Pre-requisites
Therapeutic Aspects of Neuroendocrinology and Pharmacokinetics.
Pharmaceutical Microbiology, Immunology and Biotechnology.
Type
Extensive
Aims
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Learning outcomes
to understand the physiology and pathology of the
cardiovascular system and the processes underlying cellular
replication and differentiation and to gain a sound
understanding of the mechanisms by which different
pharmacological agents can modify these processes and hence
manage disease.
to gain an ability to predict Type 1 adverse drug reactions and an
appreciation of the direction of future drug developments.
to instil in students the concepts of evidence-based therapeutics
and to help students integrate this knowledge with details of the
patients case history, the results of simple diagnostic tests and
the pharmacology and chemistry of cardiovascular and anticancer drugs, to enable them to evaluate drug therapy.
to develop competency in aseptic preparation of anti-cancer
agents and to continue to develop the skills necessary to
communicate health and related matters.
On completion of this module students should be able to:
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demonstrate a systematic and coherent knowledge of the
cardiovascular system and oncology, to associate common
symptoms with relevant pathological conditions, understand the
aetiologies of various cardiovascular diseases and cancers and
discuss the rationales underlying the use of pharmacological
agents in their treatment.
discuss the applicability of various simple diagnostic tests in the
evaluation of physiological and pathological function and
discuss them with reference to evaluating drug therapy.
recognise the potential for drug interactions to occur on the basis
of pharmacological knowledge and discriminate between them
in terms of clinical importance.
critically evaluate data from a variety of sources (case history,
clinical trials data, diagnostic testing) and utilise this knowledge
to exercise judgement to evaluate drug therapy.
accept accountability for achieving personal and/or group
outcomes by demonstrating competence in a variety of
professional skills.
recognise their professional/ethical responsibilities.
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Content
This module normally comprises 64 hours of lectures, 40 hours of
practicals/seminars/laboratory classes, 208 hours of guided study
that will include case-based learning and experiential learning.
Blood: overview of the structure and functions of blood. Principles of
blood grouping and blood transfusions. Physiological control of
plasma clotting, platelet adhesion and aggregation. Indications for
haematology testing and interpretation of results; blood counts,
haemoglobin, serum iron, iron binding capacity, ferritin and
transferrin, platelet function, clotting parameters, anticoagulant
monitoring. Characteristics of malignant tumour development,
classification of cancers biochemical markers and approaches to
treatment. This module will concentrate on the mechanisms of action,
uses and limitations of chemotherapeutic agents in treating leukaemias
and lymphomas, together with the principles underlying the choice of
regimen and adjunctive treatment of side effects. Impact of National
Service Framework (NSF) for cancer on patient care. Genomics of
various cancers and their implications on treatment and alternative
therapies to cancer chemotherapy. (Normally 25 hours)
Cardiovascular physiology and pharmacology: overview of the
functions of the cardiovascular system. Physiological control of the
cardiac cycle, cardiac output, cardiac work, the systemic circulation,
arterial blood pressure, venous pressure, transcapillary exchange
mechanisms, and the integrated control of the whole system.
Definitions, aetiologies, symptoms, diagnosis and introduction to the
rationales of drug treatments of hypertension, coronary heart disease,
chronic congestive heart failure, hyperlipidaemias and cardiac
dysrhythmias. Pharmacological actions and rationales for use of
calcium channel antagonists, potassium channel openers, angiotensin
converting enzyme inhibitors, angiotensin receptor antagonists,
alpha 2 adrenoceptor agonists, nitrates, alpha and beta adrenoceptor
antagonists, inotropes, diuretics, endothelin antagonists and possible
future drug developments. Recent advances in relating
polymorphisms in the cardiovascular system to disease. Alternative
therapies for the treatment of cardiovascular diseases. (Normally 12
hours)
Treatment of the cardiovascular diseases described above will be
discussed in terms of the assessment of risk/benefit ratios and the
choice of drug, dose and route of administration. Pharmacological
incompatibilities, drug interactions and their clinical significance.
Evidence-based medicine including, protocol writing, data
evaluation and outcome measures. Impact of National Service
Framework (NSF) for coronary heart disease on patient care. . The
scientific basis for public health and preventative medicine.
Pharmaco-epidemiology and economics. Clinical audit. (Normally 9
hours)
Clinical pharmacology: pharmacodynamics; the time course of drug
action, volume of distribution, compartment models, biological halflife, rates and simple kinetics of absorption and elimination for
cardiovascular drugs (digoxin, warfarin and amiodarone). Effects of
these on serum levels and dosage regimens. Mathematical
approaches, predictions and clinical applications. Adverse drug
reactions to include the underlying mechanisms of pharmacogenetics,
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idiosyncrasy and allergy, methods of reporting such reactions. Postmarketing surveillance. (Normally 6 hours)
Extended clinical pharmacy skills: pharmaceutical care including
cardiac rehabilitation, criteria for patient selection. Drug utilisation
reviews, economic evaluation of prescribing. Pharmacy contribution
to effective prescribing in primary care. (Normally 4 hours)
Pharmacist/patient interface: patients perspective on disease, general
principles to be applied when responding to patients' requests for
advice and information; structured history taking; symptoms
heralding serious disease; clustering of symptoms; the decision
whether or not to refer for immediate medical attention. Advice to
patients about lifestyle (including nutrition, smoking, alcohol, stress
management) and about monitoring their own therapy or
physiological parameters such as blood pressure and plasma
cholesterol. (Normally 8 hours)
Coursework
A typical coursework programme may include the following:
laboratory practicals, for example the effects of drugs on the isolated
heart, the effects of exercise on cardiovascular function in human
volunteers), seminars, tutorials, case presentations, problem-solving
exercises in therapeutics, simulated exercises in the pharmacy to
include dispensing, aseptic transfer and intravenous administration
of cyclotoxic drugs, counselling, responding to symptoms,
professional interaction, health promotion, prescription reviews. (64
hours)
Experiential learning
This will include consultant/pharmacist-led ward rounds (including
anticoagulation, cardiac rehabilitation and cardiac pre-admission
clinics) , general practitioner surgery visits, simulated patient
training, log book/portfolio, drug history taking and drug
information exercise. (20 hours)
Teaching and learning
strategies
A variety of teaching and learning strategies will be employed
in the delivery of this module, including formal lectures (64 hours),
seminars/practicals (40 hours), guided study (including experiential
learning (20 hours), problem-based learning and resource-based
independent study (208 hours)) and independent study and
assessment time (78 hours). Students will also be directed to attend
those research seminars held within the School which are relevant to
cardiovascular system physiology and pharmacology and oncology.
Learning support
Anatomy and Physiology, 5th Ed, Thibodeau, G A and Patton, K T,
Mosby, 2003.
Pharmacology, 4th Ed, Rang, H P, Dale, M M and Ritter, J M,
Churchill Livingstone, 1999.
Medical Pharmacology at a Glance, Neal, M J, 3rd Ed, Blackwell
Scientific Publications, 1997.
Human Pharmacology - Molecular to Clinical, 3rd Ed, Brody,T M, et
al, Mosby, 1998.
Human Pharmacology, Gard P R, Taylor and Francis, 2000.
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Clinical Pharmacy and Therapeutics, Walker R and Edwards C (Ed),
3rd Edition, Churchill Livingstone, 2002.
Davidson’s Principles and Practice of Medicine, Haslett, C, 19 th
Edition, Churchill Livingstone, 2002.
Clinical Evidence (Issue 8),Barton, S. (Ed), http://www.nelh.nhs.uk/
Drugs in Use: Clinical Case Studies for Pharmacists, Dodds, L, 2nd
Ed, Pharmaceutical Press, 1996.
Clinical Biostatistics: an Introduction to Evidence-Based Medicine,
Dunn, G and Everitt, B, Arnold, 1995.
Minor Illness or Major Disease? Responding to Symptoms in the
Pharmacy, Edwards, C. and Stillman, P., 3rd Edition, Pharmaceutical
Press, 2000.
Pharmaceutical Practice, Winfield A J, and Aulton, M E, 2 nd Edition,
Churchill Livingstone, 1998.
Guided study
Introduction to Cardiovascular Physiology, Levick, J R, 3rd Ed,
Butterworth-Heinemann, 2000.
Do you Understand the Cardiovascular System? Part 1 The Heart,
Sutcliffe, M, Brighton Polytechnic, 1991.
Pathophysiology of Heart Disease, Lilly L S, Lea and Febiger, 3 rd
Edition, 2003.
Videos
The Restless Pump series, Biology, Form and Function, programme
No 12, Open University
Vital Poison (Horizon) - Nitric Oxide, a lethal gas, is involved in the
most basic functions of our bodies
Eye into the Heart (NMR)
Ischaemic Heart Disease (Open University)
CAL packages
Coronary Circulation, Armstrong. D, Spriggs, B, Sutcliffe, M, Clewes
P., Latty, M. 1995
Haemostasis, Armstrong, D., Brazil, M., Hong, A., Clewes, P.,
Armstrong, M., Latty, M., Pharma-CAL-ogy, 1995.
Clinical Trials and Drug Development, Cunningham, M., Foster, R.,
Gibbs, A., George, A., Ogg, G., Padgham, C. Pharma-CAL-ogy, 2002.
Alternative Therapies, Amwar, K. Jim, N., Huckbody, K. and I.
Hughes. Pharma-CAL-ogy, 2002.
CD-ROM
The Dynamic Human, Jacobsen, C, Mosby, 1996
Interactive Pharmacology, Dale, M. M., Cunnane, T C, Purves, R and
Haylett, D G, Blackwell Science, 1995
Assessment
The unit of study will be assessed by means of:
PY334 Coursework (10 credits): composed of the pharmacological,
clinical and professional elements of the coursework.
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PY335 Examination (20 credits): three hours unseen examination
containing MCQ and essay questions.
PY336 OSCE (10 credits): a professional skills examination that will
contribute up to 35% towards the final Professional Competency
assessment.
Brief description of module
This module extends the pathophysiology, pharmacological, clinical
and professional knowledge and understanding acquired in modules
Respiratory and Dermatological Therapies in Pharmacy Practice and
Therapeutic Aspects of Neuroendocrinology and Pharmacokinetics.
Area Examination Board
MPharm Biological Sciences
Module authors
Drs M S Yeoman, M CAllen, J G Davies and A B MacAdam
Semester offered
1 and 2
Site where delivered
Moulsecoomb and the Recognised Clinical Teaching Hospitals of the
University
Date first approved
January 2003
Date of approval of this
version
Version number
1
Course(s) for which module
is acceptable and status in
that field
Compulsory MPharm
School home
School of Pharmacy and Biomolecular Sciences
External examiner
Christine Bond
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Title
Neurological and Psychiatric Pharmacy
Code
PY337
Level
3
Credit rating
20 credits
Pre-requisites
Therapeutic Aspects of Neuroendocrinology and Pharmacokinetics
Type
Extensive
Aims
To provide a sound framework of the physiology of the central
nervous system upon which the students can:
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Learning outcomes
On completion of this module the student should be able to:
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Content
develop knowledge of disease-related pathological and/or
behavioural changes in the functioning of the central nervous
system.
recognise the necessity for pharmacological intervention.
rationalise the mechanisms by which different pharmacological
agents can modify physiological and pathological processes.
further develop understanding of drug dependence and
substance abuse.
rationalise likely future developments in respect of drug
therapies and diagnostic techniques.
acquire knowledge as a necessary prerequisite for applied clinical
studies.
demonstrate a systematic and coherent knowledge of the
physiological functioning of the central nervous system,
recognise the differences between neurological and
psychological diseases of the brain, and critically appraise the
implications of these differences with respect to diagnosis, drug
treatment and future drug development.
recognise the basic pathophysiological processes involved in
nociception and the possible mechanisms involved in drug
dependence and identify treatments for drug and substance
abuse.
critically evaluate data from a range of sources (case history,
clinical trials data and diagnostic testing) and utilise this
knowledge to exercise judgement to evaluate drug therapy for
the conditions described above.
discuss modern techniques available for analyses of structurefunction relationships of the central nervous system.
accept accountability for achieving personal and/or group
outcomes by developing a variety of professional skills.
recognise his/her professional/ethical responsibilities
This double module normally comprises 37 hours of theory and 28
hours of coursework supported by 75 hours of guided study.
Structural and functional organisation of the central nervous system:
the hierarchical and functional organisation of the brain and the
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spinal cord. Non invasive medical imaging for diagnostic
measurements of CNS function. (Normally 3 hours)
Emotions and psychopathology: pharmacology of the
central nervous system: sedative/hypnotic drugs &
sleep disturbances. Principles of anaesthetic
practice. Pathophysiology and treatments of the different types
of epilepsies. Definitions, types, incidences, symptoms and drug
treatments of psychoses and affective disorders. Benefits and adverse
drug reactions of drug therapies; phenothiazines, butyrophenones,
thioxanthenes,‘atypical’ anti-psychotics, first and second generation
anti-depressants and lithium. Consideration of the possible
mechanisms of action of the above drugs in relation to the ‘amine
hypothesis’ of affective disorders and the ‘dopamine- serotonin
hypothesis’ of schizophrenia. Anxiety states and their treatments.
Efficacy and rationale for complementary therapies for affective
disorders. The genetic bases of psychiatric disorders and possible
future drug developments in psychiatry. Clinical aspects of
depression, anxiety and schizophrenia. Aetiologies, symptoms and
treatment strategies related to anorexia nervosa and bulimia. Impact
of National Service Framework (NSF) for mental health on patient
care. (Normally 10 hours)
Higher brain functions and neurodegeneration: degenerative
neurological diseases and their treatments: Parkinson’s disease;
incidence, symptoms, aetiology and consideration of the rationale of
drug treatments. Benefits of treatment and adverse drug reactions.
Dementia states & Alzheimer’s disease; incidence, diagnosis,
symptoms, pathology, aetiology and consideration of the rationale of
drug treatments (including complementary therapies) and socioeconomic consequences. Pharmacogenetics of neurodegenerative
diseases. Ageing and cognition and cognitive decline and their
treatment with nootropic agents. Attention deficit hyperactivity
Disorder (ADHD). (Normally 9 hours)
Sensory systems, pain and analgesia: definition of analgesia and
consideration of the pathophysiological bases of pain. Descriptions of
central nervous system pain pathways. General properties of opioid
agonists and antagonists and the relationship between analgesic
efficacy and clinical usage and adverse drug reactions. Possible
mechanism of opioid analgesia and future drug developments
including pharmacogenetics. WHO pain treatment ladder.
Differences between pharmacological actions of opiate vs. non-opiate
(non-steroidal anti-inflammatory, NSAID) analgesic agents.
Description of common pain states. Migraine: symptomology and
pharmacological treatment. (Normally 4 hours)
Drug dependence and substance abuse: the neurobiology and
neurochemistry of reward. Role of dopaminergic and glutamatergic
pathways. Types and mechanisms of tolerance, sensitisation and
dependence associated with the abuse of therapeutic and nontherapeutic substances. Basic characterisation of the drugs of abuse.
Characteristics and treatments of poisoning and withdrawal.
Pharmacological and clinical aspects of the treatment of substance
misuse. Law: Misuse of drugs act and future changes in drug laws.
Current treatments for heroin dependancy. Methadone maintenance
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therapy and needle exchange schemes. Future treatments for
substance abuse. (Normally 11 hours)
One day seminar examining the issues of substance misuse from a
variety of perspectives. (Normally 8 hours)
Coursework
A typical coursework programme may include the following:
laboratory practicals, for example pre-clinical drug development in
psychiatry, seminars, tutorials, case presentations, problem-solving
exercises in therapeutics, simulated exercises in the pharmacy to
include extemporaneous dispensing of controlled drugs, counselling,
responding to symptoms, professional interaction, health promotion,
herbal and homeopathic remedies, prescription reviews. (20 hours)
Teaching and learning
strategies
A variety of teaching and learning strategies will be employed in the
delivery of this module, including formal lectures (37 hours),
seminars/practicals (28 hours), guided study (including problembased learning and resource-based independent study (75 hours))
and independent study and assessment time (60 hours). Students
will also be directed to attend those research seminars held within
the School which are relevant to CNS disorders, addiction and the
treatment of pain.
Learning support
Texts
Anatomy and Physiology, 5th Ed, Thibodeau, G A and Patton, K T,
Mosby, 2003.
Pharmacology, 4th Ed, Rang, H P, Dale, M M and Ritter, J M,
Churchill Livingstone, 1999.
Medical Pharmacology at a Glance, Neal, M J, 3rd Ed, Blackwell
Scientific Publications, 1997.
Human Pharmacology - Molecular to Clinical, 3rd Ed, Brody,T M, et
al, Mosby, 1998.
Human Pharmacology, Gard P R, Taylor and Francis, 2000.
Clinical Pharmacy and Therapeutics, Walker R and Edwards C (Ed),
3rd Edition, Churchill Livingstone, 2002.
Davidson’s Principles and Practice of Medicine, Haslett, C, 19th
Edition, Churchill Livingstone, 2002.
Clinical Evidence (Issue 8),Barton, S. (Ed), http://www.nelh.nhs.uk/
Case Studies in Psychopharmacology: The use of drugs in
psychiatry"Editors David Taylor and Carol Paton, 2002.
Drugs in Use: Clinical Case Studies for Pharmacists, Dodds, L, 2nd
Ed, Pharmaceutical Press, 1996.
Clinical Biostatistics: an Introduction to Evidence-Based Medicine,
Dunn, G and Everitt, B, Arnold, 1995.
Dale and Appelbe’s Pharmacy Law and Ethics, Appelbe, GE and
Wingfield J, 7th Edition, Pharmaceutical Press, 2001.
Minor Illness or Major Disease? Responding to Symptoms in the
Pharmacy, Edwards, C. and Stillman, P., 3rd Edition, Pharmaceutical
Press, 2000.
Pharmaceutical Practice, Winfield A J, and Aulton, M E, 2 nd Edition,
Churchill Livingstone, 1998.
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Guided study
Psychopharmacology: drugs, the brain and behaviour, Meyer J S,
Sunderland Sinauer Associates, 2005
Brain Biochemistry and Brain Disorders, Strange, P G, Oxford
University Press, 1992
Drug Treatment in Psychiatry, Silverstone, T and Turner, P, 5th Ed,
Routledge, 1995
Neuropharmacology, Stone, T W, Freeman, 1995
Videos
Awakening the Frozen Addicts (Parkinson's Disease), Horizon, 1993
Prisoners of the Brain (drug treatment for manic depression and
schizophrenia), Infinite Voyage, 1994.
CAL packages
Central 5-HT transmission, Dewhurst, D, Collins, G and Bailey, B,
Pharma-CAL-ogy, 1996
Central Dopaminergic Transmission, Dewhurst, D, Collins, G and
Bailey, B, Pharma-CAL-ogy, 1996
Movement Disorders- Parkinsons Disease, Huckbody, K, Kelly, E,
Gent, P and Hughes, I, Pharma-CAL-ogy, 2002
Schizophrenia, Dadabhai, Y, Lyon, E, Clewes, P and George, A,
Pharma-CAL-ogy, 1996
Drug Dependence, Ogg, G, Benwell, M and Balfour, D, Pharma-CALogy, 1996
Central Peptidergic Transmission, Dewhurst, D, Collins, G and
Bailey, B, Pharma-CAL-ogy, 1996
Alternative Therapies, Amwar, K. Jim, N., Huckbody, K. and I.
Hughes. Pharma-CAL-ogy, 2002.
CDRom
The Dynamic Human, Jacobsen, C, Mosby, 1996
Interactive Pharmacology, Dale, M M, Cunnane, T C, Purves, R and
Haylett, D G, Blackwell Science, 1995
Assessment
Two hour end of module examination comprising MCQ and essay
type questions (70%) and coursework (30%), the threshold for each
component is 35%. The coursework assessment will include one
practical dispensing assessment which will contribute 35% to the
overall Professional Competency assessment, the threshold for this
component is 35%.
Brief description of module
This module extends the pathophysiological and pharmacological
knowledge and understanding acquired in modules entitled
Respiratory and dermatological therapies in pharmacy practice,
Therapeutic aspects of neuroendocrinology and pharmacokinetics
and Therapeutics aspects of cardiovascular pharmacy and oncology.
Area Examination Boards
MPharm Biological Sciences
Module team/authors
Dr A Jackson, Dr P R Gard and Dr A MacAdam
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Semester offered
1&2
Site where delivered
Moulsecoomb
Date of first approval
January 2003
Date of approval of
this version
Version number
1
Course(s) for which module
is acceptable and status
in course
MPharm. (Compulsory)
School home
Pharmacy and Biomolecular Sciences
External examiner
Professor K Wilson
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