UNIVERSITY OF FLORIDA
COLLEGE OF NURSING
Course Syllabus

Fall 2012

COURSE NUMBERNGR 6172 (sect 1165)

COURSE TITLEPharmacotherapeutics for Advanced Practice Nursing

CREDITS4

PLACEMENTVariable

PREREQUISITES NGR 6002CAdvanced Health Assessment and Diagnostic Reasoning

NGR 6140Physiology and Pathophysiology for

Advanced Nursing Practice

FACULTY OFFICEPHONE OFFICE HOURS

Denise Schentrup, DNP, ARNP, BC HPNP 2205273-6345 Fri 11-1pm

Clinical Assistant ProfessorC 278-0132

DEPARTMENT CHAIR

Susan Schaffer HPNP2229273-6366by appt.

PhD, ARNP, FNP-BCHPNP

Clinical Associate Professor

JACKSONVILLE CAMPUS DIRECTOR

Andrea Gregg, DSN, RNJax LRC904-244-5172by appt

Associate Professor3rd floor

COURSE DESCRIPTION This course provides the knowledge and skills to assess, diagnose, and pharmacologically manage a client's common health problems in a safe, high quality, cost-effective manner. Emphasis is on the development of therapeutic decision-making in drug selection for the client based on health problems, individual variations, and economic considerations. Focus is on prescriptive practice, client education and monitoring therapeutic response to pharmacological agents in diverse clients across the lifespan.

COURSE OBJECTIVES Upon completion of this course, the student will be able to:

  1. Apply the principles of pharmacokinetics and pharmacodynamics in selecting drugs.

2.Analyze the relationship between pharmacologic agents and physiologic/pathologic responses.

3.Compare and contrast pharmacological agents with respect to treatment of individuals with specific acute and chronic health problems across the lifespan.

4.Select pharmacologic agents for the management of client health problems based on client variations, the problem being managed and cost effectiveness.

5.Identify actual and potential adverse drug reactions and significant drug interactions.

6.Develop relevant client education strategies to facilitate client collaboration in treatment and to maximize therapeutic response.

7.Evaluate the effects of single and multiple drug regimens on client health status and functioning.

  1. Evaluate the interactions of nonprescription therapies with prescription therapies.

COURSE SCHEDULE

E-Learning Sakai is the course management system that you will use for this course. E-Learning is accessed by using your Gatorlink account name and password at There are several tutorials and student help links on the E-Learning login site. If you have technical questions call the UF Computer Help Desk at 352-392-HELP or send email to .

It is important that you regularly check your Gatorlink account email for College and University wide information and the course E-Learning site for announcements and notifications.

Weekly lectures and exams will be accessed via E-learning Sakai.

Optional interactive pre exam review sessionswill be presented live via web-if you cannot attend, they will be recorded and put on the course website - more information regarding this will be posted on the website.

This course will use one of UF’s web hosted collaborative software applications (Adobe

Connect and or Voice Thread) for lecture presentation and or assignments. These collaborative applications have the functionality of recording your text, audio and or video comments.If you do not want to be recorded please notify assigned faculty member prior to the first class. You do not need to provide a photo or use the video comment option, this is your choice. The recordings are accessed through web links provided by your faculty member and should not be share with anyone not enrolled in the course. The recordings are available to the class during the semester. The recordings will not be used in another course.

ATTENDANCE

There is no attendance for this course. Students are expected to listen to lectures and complete required assignments as listed in the course syllabus and on the course web-site. Timeframes for the posting and receiving of materials are listed in the course materials on the course web-site.

ACCOMMODATIONS DUE TO DISABILITY

Each semester, students are responsible for requesting a memorandum from the Disability Resource Center to notify faculty of their requested individual accommodations. This should be done at the start of the semester.

COUNSELING AND STUDENT HEALTH

Students may occasionally have personal issues that arise on the course of pursuing higher education or that may interfere with their academic performance. If you find yourself facing problems affecting your coursework, you are encouraged to talk with an instructor and to seek confidential assistance at the University of Florida Counseling Center, 352-392-1575, or Student Mental Health Services, 352-392-1171. Visit their web sites for more information: or

STUDENT HANDBOOK

Students are to refer to the College of Nursing Student Handbook for information about College of Nursing policies, honor code, and professional behavior.

TOPICAL OUTLINE

  1. Clinical pharmacokinetics and individualization of drug therapy including absorption, distribution, metabolism and excretion for various client populations
  2. Principles of half-life, effective concentration, peak plasma levels, therapeutic blood levels, and minimal and maximum effective levels
  3. Pharmacodynamics including alterations of cell environment and functions and drug receptor activity
  4. Pharmacotherapeutic decision-making for common acute and chronic health problems across the lifespan including drug selection, intervention, and monitoring for
  1. Immunological Alterations
  2. Tissue Defense Alterations
  3. Endocrine Alterations
  4. Neurological Alterations
  5. Hematological Alterations
  6. Dermatological Alterations
  7. Cardiovascular Alterations
  8. Respiratory Alterations
  9. Gastrointestinal Alterations
  10. Musculoskeletal Alterations
  11. Genitourinary Alterations
  12. Affective and Cognitive Alterations

5.Therapeutic response to pharmacological agents

6.Adverse drug reactions and appropriate interventions

7.Drug interactions based on selected drug categories including drug-drug interactions, drug-food interactions, drug-ethanol/tobacco interactions and drug-environmental interactions

8.Prescriptive practice and dispensing limitations for advanced practice nurses including writing prescriptions, legal authority and restrictions, ethics, and clinical standards

9.Alternative therapies

10.Client education and adherence

11.Economic implications of drug selection and management on client’s lifestyle

12.Implications of client's cultural health beliefs and practices on drug selection and monitoring

13.Resource utilization

TEACHING METHODS:

The course will be strictly online. Lectures will be posted each week throughout the semester. Students are required to listen to the lectures weekly. Students are required to complete online assignments as per the course outline.

LEARNING ACTIVITIES:

  • AssignmentStudents will be required to complete one assignment during the first week of class. This assignment is an exercise in prescription writing and pharmacokinetics. The assignment will be posted on Sakai, E-learning. Students will need to review the first week’s lectures before attempting this assignment. Remember to include all of the requirements for the prescriptions as discussed in the Introduction lectures.
  • Case studiesStudents will do 5 case study assignments throughout the semester. The cases will be posted at least 1 week prior to the due date. Please review the outline regarding the schedule of due dates for the case studies. Criteria for the case studies is posted on the website. You are encouraged to work in groups for the case studies. If you have trouble with participation in your groups, please address this as soon as possible. It is very important for EVERYONE to participate in the case studies to enhance the understanding of the application of the information. Case studies will be sent to me at by e-mail attachment using Word or WordPerfect OR can be handed in via E-learning. The case studies are due by 5pm on the due dates listed in the syllabus. Two points will be deducted from the case study each 24 hours that it is late. Please scan all work for viruses prior to submission.
  • Assignment and cases will be graded and returned no later than 2 weeks after the due date unless there are extenuating circumstances. In that case, the students will be notified of the delay in returning grades.

EVALUATION METHODS:

Examinations/breakdownThere will be 4exams. They are not cumulative exams; however, students will be responsible for knowing possible drug interactions with medications despite where they are discussed throughout the semester. The exams will be given online via E-learning. You will be proctored by the website Proctor U.

ProctorUInformation:

  • Major course examinations will be administered via ProctorU, a live proctoring service, to ensure a secure testing environment.
  • Each student computer must be in compliance with Policy S1.04, Student Computer Policy and must contain a web cam, microphone, and speakers.
  • Each examination will cost $22.50 per exam.
  • Students go to the website and click on “How To Get Started”. This will permit students to create an account and test out their system.
  • Once the exam is available, students go online to ProctorU to schedule and pay for the exam session. Students must provide a valid email address and phone number where they can be reached during an exam.
  • There will be no makeup exams. If you have extenuating circumstances please inform faculty as soon as possible. Students will be evaluated by examinations and scheduled case studies/assignments.

EVAUATION BREAKDOWN

Exams 60%

Case studies30%

Assignment 10%

GRADING SCALE

Letter Grade / Grading Scale / Quality Points
A / 95-100 / 4.0
A- / 93-94 / 3.67
B+ / 91-92 / 3.33
B / 84-90 / 3.0
B- / 82-83 / 2.67
C+ / 80-81 / 2.33
C / 74-79 / 2.0
* 74 is the minimal passing grade
C- / 72-73 / 1.67
D+ / 70-71 / 1.33
D / 64-69 / 1.0
D- / 62-63 / .67
E / 61 or below / 0.0

REQUIRED TEXTBOOK/WEBSITE

Woo, T.M. and Wynne, A.L. (2011). Pharmacotherapeutics for Nurse Practitioner Prescribers(3nd ed.). Philadelphia: F.A.Davis

Required electronic source: Clinical Pharmacology online, accessed via the Health Science Center Website.

WEEKLY CLASS SCHEDULE

Reading assignments will also consist of Internet sites. Please review the links in each lecture for pertinent information related to the weekly topics.

Date / Topic / Readings
Week 1 Wednesday Aug 22nd
Assignment #1 due Wednesday Aug 29thby 5pm / Introduction to pharmacology & Prescription writing
Pharmacokinetics & Pharmacodynamics
Pharmacogenetics and Special Populations / Unit 1
Chapters 1-8
Unit IV
Chapters 50-51
Week 2 August 29th
Case #1 Due Wednesday Sept 5th by 5pm / Respiratory Agents / Unit I
Chapter 13 p 153-154
Unit II
Chapter 17
Ch 25 p. 886876-
Unit III
Chapter 30
Week 3 September 5th
Case #2ABXdue Wednesday Sept 12th by 5pm / Antibiotics / Unit II Ch 24
Unit III Ch 42, 44, 46, 47
Week 4 September 12th / GI / Unit I Ch 13 p 156-159
Unit II Ch 20
Unit III Ch 34
Week 5 September 19th / Exam #1 Week 2-4 / Available Wed Sept 19th from9am-5pm
Week 6 September 26th / Lipid medications
Anticoagulants/Anemia / Unit II Ch 16 p. 359-368
Ch 18
Unit III Ch 27, 39
Week 7 October 3rd
Case#3 DueWednesday October 10th by 5pm / Cardiovascular/Diuretics/CHF / Unit II Ch 14 168-199
Ch 16 303-359, 369-378
Unit III Ch 28, 36, 40
Week 8 October 10th / Endocrine / Unit II Ch 587-642
Unit III Ch 33, 41
Week 9 October 17th / Exam #2 Weeks 6-8 / Available Wednesday October 17th9am-5pm.
Week 10 October 24th / Dermatology/topical agents / Unit 1 Ch 13 p 160
Unit II Ch 23
Unit III Ch 32
Week 11October 31stCase #4 Due Wednesday November 7thby 5pm. / HRT/Contraception/androgens
Osteoporosis / Unit 1 Ch 13 161
Unit II Ch 21 572-578
Ch 22
Unit III Ch 31, 38
Week 12November 7th / Mental Health/
ADD/Insomnia / Unit II Ch 15 254-274, 277-292, 297-302.
Unit III Ch 29
Week 13November 14th / Exam #3 Week 10-12 / Available Wednesday November 14th from 9am-5pm.
Week 14November 21st
Case #5Due Wednesday November 28th by 5pm. / Musculoskeletal/gout
Pain management / Unit 1 Ch 13 p 152
Unit II Ch 15 p. 292-297
Ch 25 p869-877, 886-907
Unit III Ch 35
Week 15November 28th / Anticonvulsants/Antiparkinson agents/Alzheimer’s- / Unit II Ch 14 p.202-214, 219-230
Ch 15 p236-253, 274-277
Week 16December 5th / Genitourinary/Vaccines / Unit II Ch 14 219-230
Ch 19
Week 17December 12th /

Final Exam #4 Weeks 14-16

/ Available Wednesday December 12th from 9am-5pm.

Case study Format:Case study Information:

For each case study students will be given the patient situation which includes a complete SOAP note including diagnosis and any pertinent diagnostic tests. For each situation, you will provide the necessary information including a prescription using the case study template found on the course website. If in doubt about how to do any of these case studies, please e-mail me. If there seems to be a common theme in the e-mails I will post to the Main Bulletin Board.

Please review your Advanced Health Assessment text if necessary. You must list all references used, they do not need to be in APA format. You will need to review current literature and use sources other than your text and Clinical Pharmacology online when doing the case studies. Throughout the lectures national treatment guidelines will be provided when available for that particular disease. You are required to use these national guidelines and other research references in your case study. If you do not, points will be deducted.

Be concise but thorough in your responses to the questions. The length of the case study should be no more than 2 pages plus the prescription.Do not include a discussion of the pathophysiological processes involved in the patient's disease process. Focus on the pharmacological intervention that you have chosen.

It is strongly encouraged that students work in groups of 2-3 for the case studies. E-mail one copy of the case study with each student’s name on it. If you are having problems with group members not participating please address this early on in the semester and contact me immediately. The case studies are meant for FULL participation from ALL group members. Case studies are to be e-mailed to me at my UF e-mail address or handed in via E-learning Sakai. These case studies are designed to assist you in understanding all the complex nature of prescribing medications. Explain to me the thought processes involved in your choice of one drug or another. Moreover, remember, this is a pharmacology course. Therefore, opting not to prescribe a medication is NOT an option. Each case study will usually have more than one therapeutic option. However, you must choose the correct drug/class of drugs. Above all (as in real life), do not, by action or omission of action, cause harm to your patient. Be careful of your drug choices and consider rationale for using that specific medication.