Nursing (NURS) 521

Introduction

Nursing 521 Pharmacotherapeutics for Nurse Prescribers is a course in a program of study leading to the Master of Nursing degree or the Post Master's Diploma: Advanced Nursing Practice. NURS 521 is a prerequisite course for NURS 520, NURS 522, NURS 524, NURS 526 and NURS 528. NURS 521 can be taken as an elective course by other Master of Nursing or Master of Health Studies students and by non-program students.

Building on basic knowledge of pharmacology, this course focuses on principles of drug action, pharmacokinetics and pharmacotherapeutics in the context of advanced nursing practice. Common drug classes, indications, and evaluations of outcomes of therapy are presented. The legal and professional issues of prescribing as well as the significance of keeping up-to-date using evidence-based practice are addressed.

Course Goals

After completing this course, students should be able to:

1. describe the basic principles of pharmacokinetics and pharmacodynamics, and how these principles may affect prescribing decisions;
2. demonstrate an understanding of the selection and use of drugs in the management and treatment of disease, including the application of pharmacokinetics and pharmacodynamics to client clinical context and the integration of client social context (age, health status, gender, concomitant therapies, cultural beliefs, financial status, etc) to the selection of drugs of choice;
3. identify and incorporate special considerations when prescribing for specific populations: pregnancy, breastfeeding, older adults, children and infants, and genetic factors;
4. evaluate and then apply research findings to the development of evidence-based, comprehensive client pharmaceutical plans of care;
5. evaluate prescribed drug regimens for safety, clinical efficacy and outcomes, in partnership with the client;
6. identify and incorporate strategies to address potential barriers to regimen adherence into client assessment and education;
7. communicate effectively in order to support, educate, coach and counsel clients in regards to their optimal treatment regimen;
8. appropriately access antimicrobial guidelines to include community therapies;
9. describe and analyze the impact of health system resource allocation on drug selection and utilization (pharmacoeconomics);
10. demonstrate safe evidence-based prescriptive practices and implements ways to reduce potential medication mishaps into personal prescribing practices;
11. integrate knowledge of adverse drug reactions and interactions in safe prescribing and appropriately report adverse drug reactions;
12. understand professional, ethical and legal considerations and responsibilities when prescribing;
13. describe the current status of prescriptive authority for nurse practitioners in your province/territory;
14. recognize polypharmacy and takes appropriate interventions to optimize therapy; and
15. summarize the role of interdisciplinary consultation in optimizing drug therapy.

Course Materials

Online Materials

• Introduction: Provides essential information about the course design and materials.
• Schedule: Outlines the timing of course activities.
• Units: There are eight units in this course.
• Assessment: Outlines the assignments/evaluation procedure of the course.
• Reference: Listing of required readings and websites included in the course.

Textbook

Course Structure

The course includes Internet access to health-related websites around the world, participation in email, and computer conferencing with students from across the country. Students are expected to connect to an Internet Service Provider at their own expense.

Technical Requirements

Computer System

In order to successfully complete this course, you must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the Centre for Nursing and Health Studies technical site.

Course Outline

Unit 1: Pharmacotherapeutics in Nurse Practitioner Practice
Unit 1 explores the art of prescription writing to include ethical, legal and professional responsibilities. Prescribing considerations incorporating regulation of nursing practice, rational drug selection and client education are discussed. Learning activities are included to assist you with the best action to take in real life situations. It is important to stay current in your practice. Suggested resources are provided with a focus on the development of a personal formulary to assist you with frequently used medications.

Unit 2: Principles of Pharmacotherapeutics
This unit will include study of pharmacodynamics and pharmacokinetics, adverse drug reactions and drug interactions, pharmaceutics with special populations, and polypharmacy, a common problem in the older population.

Unit 3: Drugs: Infections, Cardiovascular and Renal Systems, and Blood Disorders
This unit focuses on the general treatment principles applicable to most infections. A brief pathophysiology overview is included. Decision making for infectious disease coverage should include drugs referenced from the latest infections disease guidelines. The most common first line primary care drugs in the treatment of cardiovascular and renal system diseases are discussed. Blood disorder drugs to include the newer class of erythropoiesis­stimulating agents (ESAs) are addressed.

Unit 4: Drugs: Respiratory, Endocrine, and Integumentary Systems
The management of respiratory conditions is a common occurrence in the primary care setting ranging from upper respiratory tract infections to pneumonia, as well as exacerbations of chronic illnesses. Endocrine disorders can be complex; however, those commonly encountered relate to diabetes and thyroid disease. Drugs affecting the reproductive system discussed in this unit relate to hormone replacement therapy with a brief synopsis of less frequently used treatments. The integumentary system (derived from the Latin word "integumentum" meaning “covering”) encompasses skin, hair or nail tissue, of which treatment of associated diseases are a common occurrence in the primary care setting.

Unit 5: Drugs: Pain and Inflammation, Eye and Ear Disorders, and Neuropsychiatric Disorders
This unit introduces drugs used for conditions commonly seen in the primary care setting. These include pain and inflammation (for example, migraine and gout) as well as drug therapy for eyes and ears. Antipsychotic drugs are addressed; the nurse practitioner will most frequently prescribe antidepressants from this class.

Unit 6: Drugs: Gastrointestinal, Genitourinary, and Reproductive Systems
This unit focuses on the development of your knowledge of medication classifications used to treat common health problems of the gastrointestinal, genitourinary, and reproductive systems.

Unit 7: Drugs: Substance Abuse, Vaccines, and Nutritional and Alternative Therapies
This unit provides an approach to the medication used for substance abuse. Immunizations are common practice for the nurse practitioner. Electrolyte and nutritional replacements (vitamins and minerals) as well as appetite stimulants are also discussed. The word medicine refers to all those drugs ordered by a prescriber as well as over-the-counter (OTC) drugs bought for self-medication. Consider the use of herbals as well as alcohol and caffeine (also thought of as drugs) when taking a medication history. Adverse drug reactions or interactions may occur with medications you prescribe.

Unit 8: Issues in Pharmacotherapeutics
Unit 8 encourages you to discuss current issues related to pharmacotherapeutics, including your professional obligations as a nurse practitioner. Clinical investigational drug research is addressed. The issue of drug-seeking behaviour commonly occurs in the primary care setting and it is important for you to recognize the characteristics of the drug-seeking client.