SFKKIL109U Pharmacotherapy Practice

Volume 2018/2019
Education

MSc Programme in Pharmacy or Pharmaceutical Sciences (Danish programmes cand.pharm and cand.scient.pharm) - elective

MSc Programme in Medicinal Chemistry - elective

MSc Programme in Pharmaceutical Sciences (English programme)- elective 

 

 

Content

The course will mainly address clinical pharmacy at ward level and will include the impact of drug characteristics and drug formulation upon pharmacokinetic fate and effect.

The course will consist of:

Lectures

2 Introduction lectures covering info on the course,  the internship, and the project work.

15 Interactive double-lectures on the following topics (all dealt with from a practical perspective): 

  • Impact of physicochemical drug properties on the pharmacokinetics
  • Impact of the dosage form and administration route upon compliance and effects 
  • Considerations in drug development from molecule to product; with focus on the patient's needs
  • The interaction between release from different depot principles intended for oral administration and normal gastro-intestinal (GI) physiology
  • Challenges with depot formulations intended for oral administration in patients with pathophysiological changes in the GI-tract
  • Therapeutic drug monitoring; how to use pharmacokinetic to individualise therapy 
  • Intravenous compatibility in intensive care and in the perioperative setting
  • Challenges in practical dispensing and administration issues (tablet crushing, dissolving powders for injection etc.)
  • Pharmacological and safety challenges with generic substitution
  • Challenges with high-risk drugs
  • Dosing in patients with different degrees of organ failure
  • Challenges with off-label use
  • Medication reconciliation and review 
  • How to find and use information from the patient record 
  • Ward specific clinical pharmacy; the pharmacist's role in the multidisciplinary health care team

 

Internship - 1 day at a hospital ward + 1 day of case work

The internship will focus on:
1. the procedures for prescribing, dispensing and administration of medicine 
2. medicine reconciliation/review and assessment of current therapy

The student will follow the procedures during prescribing, dispensing and administration to one or more patients.  

Follow up case work: The student will perform a medication reconciliation and review for one patient; including working out suggestions for improvements and discussing the clinical relevance of the suggestions with the prescribing doctor. 

Project work in groups (problem based learning)

Students will work in groups on predefined projects. The main aim of the projects is to provide the students with an insight in the complex interactions between drug properties, dosage form, administration route, effects (including side-effects), patient condition and -compliance. 

An example: Suggest a dosage form containing Alfentanil for the treatment of break-through pains in patients with cancer in the esophagus and discuss the rationale behind the choice using a SWOT analysis. 

Learning Outcome

The aim is to prepare the students to be able to interact and engage with the work in a multidisciplinary health care team and to be able to provide professional advice to other health care professionals regarding patient's medical treatment and to discuss how to optimize the treatment.

At the end of the course, students are expected to be able to:

Knowledge:

  • use information on pathology, physiology, pharmacology and pharmacy in connection with the practical use of medicines.
     

Skills: 

  • participate in discussions and decisions regarding patients' drug therapies; including the administration route, dosage form and -regiment.

 

Competencies: 

Have gained sufficient insight of collaboration between clinical specialities (eg intensive care therapy and clinical microbiology) and collaboration between the different health professions to interact and engage with a multidisciplinary health care team.

  • discuss how 1) the physicochemical properties of a drug, 2) the dosage form, 3) the administration route and 4) the physiological/​pathophysiological condition of the patient influences the pharmacokinetic fate and hence the pharmacodynamic profile of the drug.
  • discuss the principles of the formulation of a drug in relation to its clinical use.
Literature

National and regional recommendations, circulars, treatment guidelines and scientific papers.

Maybe part of the text book Physiological Pharmaceutics by Clive Wilson and Neena and Clive Washington

Teaching is based on the assumption that the students have acquired knowledge, skills and competences corresponding to those obtained by completion of the first five semesters of the BSc Programme in Pharmacy.
Interactive lectures, group work, internship 1 day at a hospital ward.
  • Category
  • Hours
  • Exam
  • 2
  • Exam Preparation
  • 10
  • Lectures
  • 32
  • Practical Training
  • 20
  • Preparation
  • 64
  • Project work
  • 78
  • Total
  • 206
Oral
Individual
Collective
Continuous feedback during the course of the semester
Peer feedback (Students give each other feedback)
Credit
2,5 ECTS
Type of assessment
Other
Internship
Each student hands in a report containing a medication review, assessment of the medical treatment and a discussion/reflexion of the roles of the different healthcare professionals in the medication process (from prescription to administration).
The students prepare a PowerPoint presentation (PPP) group wise. The PPP is presented at the oral assessment and commented by members of the other groups.
The students obtain a course certificate on the basis of the individual report from the internship and the group wise PPP, the oral presentation, discussion, and critique of other groups PPPs and presentations.
Aid
All aids allowed
Marking scale
completed/not completed
Censorship form
No external censorship
Re-exam

Internship

If the report does not meet the requirement, there is a possibility for correting the report and handing it in again. 

Project work

There is a possibility for a repeated oral presentation and / or critique (by the course manager or his/her representative) depending on which part of the requirement has not been met by the group/student.

Criteria for exam assesment

To pass the internship the student must be able to:

Skills:

  • evaluate a patient's drug treatment  and propose a secure modification the treatment based on the current patient diagnosis, clinical condition and para-clinical data.
  • describe the most essential mechanisms of action, interactions, side effects, and contraindications of the drugs.

 

Competencies:

  • demonstrate insight of collaboration between clinical specialties and the collaboration between the different health professions to interact and engage in a multidisciplinary health care team.
  • demonstrate the ability to extract and discuss the relevant issues concerning the rationale behind the choice of the proposed drug treatment, and why a seemingly proper evidence-based treatment in some cases is not effective.

 

To pass the project work the student must be able to:

Skills:

  • describe the most essential mechanisms of action, interactions, side effects, contraindications for chosen drug.
  • describe the main barriers to optimal drug therapy in the chosen patient group and chose an optimal dosage form. 
  • systematically collect the most essential and correct information regarding the chosen patient group and the chosen drug.

 

Competencies:

  • demonstrate the ability to extract, present and discuss the relevant issues (eg. barriers, side effects, interactions, patient acceptance and - compliance) focusing on the actual patient group and the chosen dosage form.
  • demonstrate the ability to cooperate and ability to utilize competencies across individuals in the project group.
  • demonstrate the ability to provide critical and constructive feedback to fellow students.
Credit
5 ECTS
Type of assessment
Written examination, 2 hours under invigilation
The exam consists of 2 essays focusing on:
1) performing a medication review, assessing a current treatment and discussing the roles of the different health care professionals
2) the interaction between drug properties, dosage form, effect, patient conditions and compliance
Aid
All aids allowed

There is access to the following at the exam on Peter Bangs Vej:

  • Office (Word, Excel, Onenote and Powerpoint)
  • IO2 – the digital pen
  • Panoramic Viewer
  • Paint
  • Calculator – Windows' own
  • R – Statistical programme
  • ITX MC – multiple choice programme
  • MathType formel programme
  • Maple
  • Adobe reader
  • USB access – for usb stick with notes etc.
Marking scale
7-point grading scale
Censorship form
No external censorship
Criteria for exam assesment

To achieve the grade 12 the student must be able to:

Knowledge:

  • master the use of information on pathology, physiology, pharmacology and pharmacy in connection with the practical use of medicines.

 

Skills: 

  • demonstrate ability to discuss and make decisions regarding patients' drug therapy; including the administration route, dosage form and -regiment.

 

Competencies: 

  • demonstrate the ability to extract, present and discuss the relevant issues concerning the rationale behind the choice of the proposed drug treatment, and why a seemingly proper evidence-based treatment, in some cases is not effective.
  • discuss the physico-chemical properties of a drug, the dosage form and the physiological/​patophysiological conditions influences upon the pharmacokinetic fate and hence the pharmcodynamic profile of the drug.
  • discuss the principles of the formulation of a drug in relation to the clinical use.