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Saturday, March 17, 2012

JNTU ADVANCED CLINICAL PHARMACY – LAB


M. PHARMACY (HOSPITAL AND CLINICAL PHARMACY)
COURSE STRUCTURE AND SYLLABUS

I YEAR  I SEMESTER
Code
Group
Subject
L
P
Credits


Modern Pharmaceutical Analytical Techniques
3
0
3


Advanced Biostatistics and Research Methods
3
0
3


Pathophysiology and Applied Pharmacotherapeutics - I 
3
0
3


Advanced Clinical Pharmacy
3
0
3


Community Patient Care/Community Pharmacy
3
0
3

Lab
Pathophysiology and Applied Pharmacotherapeutics – I Lab
0
3
2

Lab
Advanced Clinical Pharmacy- Lab
0
3
2


Seminar
-
-
2


Total Credits 


21




 MODERN PHARMACEUTICAL ANALYTICAL TECHNIQUES
(Common to all Branches)
HCPT-1.1

Unit-I
A detailed study of separations and determination involved in the following chromatographic techniques.
a.      Column chromatography : Theory, preparation, procedures, methods of detection.
b.     This layer chromatography : Theory, preparation, procedures, detection of compounds
c.      Paper  Chromatography : Theory, different techniques employed, filter papers used, quantitative and quantitative detections.
d.     Counter, current extraction , soild phase extraction techniques.

Unit-II
a.      Gas chromatography: fundamentals, Instrumentation, columns preparation and operations, detection, derivitasation, LC-MS, GC-MS.
b.     HPLC : Principles and Instrumentations.

Unit-III
a.      UV-Visible Spectroscopy : Principle, Beer Lambert’s law, study and working principle of instrumentation, applications in pharmaceutical analysis and derivatives spectroscopy.
b.     IR Spectroscopy: Theory, different types of molecular vibrations, sampling techniques, instrumentation and applications in pharmaceutical analysis, FTIR
c.       Flurorimetry :  Theory, fluorescence and chemical structure, factors affecting the fluorescence, study of working principles of the instrument and applications in pharmaceutical analysis.

Unit-IV
a.      NMR : theory, Chemical-shift, spin-spin coupling, shielding, working principle of instrumentations and applications in pharmaceutical analysis, HNMR, and cosy 13CNMR.
b.     Mass: principle, different methods of  production of ions metastable ions, working principle of mass spectrometer and applications in pharmaceutical analysis.

Unit-V
a.      Differential thermal analysis, partial thermal analysis.
b.     Radiometric techniques, Radio immunoassay, Elisha test.
c.      X-ray diffraction, polarimetry.




ADVANCED BIOSTATISTICS & RESEARCH METHODS
HCPT-1.2
Unit-I :
Developing a research question, Resources for research question,
Literature Review: Traditional Qualitative Review
                                    Meta-Analysis—A Quantitative Review
Preparation of Research Proposal

Variables—Definition of Variable, Types of variables—Dependent and Independent variables, Confounded variables, Measurement of variables, Types of measurement scales and their comparison. Reliability and Validity of Measurements.

Unit-II :
Validity, Types of validity—Internal validity, Construct validity, External validity, Threats to validity. 
Control: Subject as own control (Within Subject control), Statistical control.

Unit-III:
Non-experimental Research:
Part 1—Observational, Archival and Case-Study Research: The Hermeneutic Approach. 
Observational Research: Naturalistic Observation, Participant-Observer Research.
Archival Research: Archival Data Collection and Compilation.
Case Studies:  Characteristic of Case Studies.  
Non-experimental Research: Survey Research—Designing of Questionnaire, Methods of Administration, Response Rates.  Types of Samples—Haphazard Samples, Purposive Samples, Convenience Samples and Probability Samples.  

Unit-IV :
True Experiments: Single-Factor Designs, Factors, Levels, Conditions, and Treatments.  Within-Subject Designs. 

True Experiments Part-2—Factorial Designs—Main Effects, Interactions, A Mixed Factorial Design. 

Unit V :
Single-Subject Experiments: Advantages and Disadvantages. 
Quasi Experiments: The differences between Quasi and True Experiments.
Design without Control Groups—Interrupted Time Series Designs and Repeated Treatment Designs. 

Text Books   
 1. Donald H. McBurney -Theresa L. White   “Research Methods” (Cengage learning India Pvt. Ltd)
2. Statistics for business and economics 3rd edition by-Hooda-R.P- MC. Millan Business books
3. Biostatistics & Computer applications by GN Rao and NK Tiwari
Reference Books
1. Remingtons pharmaceutical Sciences
2.. Theory & Practice of  Industrial  Pharmacy by Lachman


PATHOPHYSIOLOGY AND APPLIED PHARMACOTHERAPEUTICS – I
HCPT-1.3

Pathophysiology and applied Pharmacotherapeutics of diseases associated with following system/diseases with of special reference to the drug of choice.

Title of the topic
Unit-I  Cardiology:
·       Acute Coronary Syndrome
·       Hypertension
·       Congestive Cardiac Failure
·       Ischaemic Heart Disease (Angina Pectoris, Myocardial Infarction)
·       Arrythmias
·       Hyperlipidarmia
·       Cardiopulmonary Arrest
·       Shock
Unit-II  Respiratory System
·       Introduction to pulmonary function tests
·       Asthma
·       Chronic Obstructive Pulmonary Disease
·       Drug Induced Pulmonary Diseases
·       Hydrogen Ion Hemostasis & Blood Gases.
Unit-III  Haematological Diseases & Nephrology
·       Anaemia’s
·       Drug Induced Haematological Diseases
·       Venous Thromboembolism

·       Acute Renal Failure / Chronic Renal Failure
·       Renal Dialysis and Transplantation
·       Drug Dosing In Renal Failure / Impairment
·       Drug Induced Renal Diseases
·       End-Stage Renal Disease
·       Diuretic Therapy
·       Potassium Depletion
·       Hyperkaelemia
·       Alakalosis
Unit-IV  Gastroentrology & Rheumatology
·       Gastro – Oesophageal Reflux Disease
·       Peptic Ulcer Disease
·       Inflammatory Bowel Disease
·       Hepatitis, Viral
·       Jaundice & Cirrhosis
·       Diarrhoea & Constipation
·       Drug Induced Liver Disease
·       Gout & Hyperuricemia
·       Rheumatoid Arthritis
·       Osteoarthritis
·       Spondylitis
Unit-V  Endocrinology &Dermatology
·       Adernal Gland Disorders
·       Diabetic Mellitus
·       Thyroid Disorders
·       Osteoporosis
·       Acne Vulgaris
·       Psoriasis
·       Scabies
·       Eczema
·       Drug Induced Skin Disorders
·       Vetiligo
Text Books
1.     Clinical Pharmacy and Therapeutics – Roger and Walker, Churchill Livingstone Publication.
2.     Pharmacotherapy : A Patho-physiology approach - Joseph T. Dipiro et al. Appleton and Lange.
3.     Goodman & Gillman: JG Hardman, LE Limbard, 10th Edn. McGraw Hill Publications,2001.
Reference Books
1.     Principles of Internal Medicine : Harrisons : Braunwald et al, 16th Edn. McGraw Hill Publications, 2005.
2.     Davidsons Principles and Practice of Medicine : Christopher Haslett, et al, 19th Edn. Churchill Living stone Publications, 2002.
3.     American Hospital Formulary Services : GK Mc Evoy, Published by American Society of Hospital Pharmacists, 2004.
4.     Pathologic basis of diseases – Robins SL, W. B. Saunders Publication
5.     Pathology and Therapeutics for pharmacists : a basis for clinical pharmacy practice – Green and Harris, Chapman and Hall Publication
6.     Clinical Pharmacy and Therapeutics – Eric Herfindal, Williams and Wilkins Publication.
7.     Applied Therapeutics : The clinical use of drugs. Lioyd Young and Koda – Kimble MA [ISBN 0-333-65881-7]
8.     Avery’s Drug Treatment, 4th Edn 1997,Adis International Ltd.
9.     Basic skills in interpreting laboratory data – Scott L T.American Society of Health System Pharmacists.
10.  Practice Standards and Definitions – The Society of Hospital Pharmacists – Australia 1997.
11.  Relevant review articles from recent medical and pharmaHCPtical Journals.




ADVANCED CLINICAL PHARMACY

HCPT-1.4

Unit-I  Introduction to clinical pharmacy
·       Definition, Scope, History and Development of clinical pharmacy
Unit-II  Professional Activities of a Clinical Pharmacist
·       Ward Round Participation
·       Medication History Interview
·       Drug Therapy Monitoring (Medication Chart Review, Clinical Review, Therapeutic Drug Monitoring & Pharmacist Interventions)
·       Adverse Drug Reaction Management
·       Drug Information & Poison Information
·       Patient Counseling
·       PharmaHCPtical Care
·       Drug Utilization evaluation (DUE) & Review (DUR)
·       Quality Assurance of Clinical Pharmacy Services
Unit-III  A) Patient Data Analysis
·       The patient’s case history, its structure & use in evaluation of drug therapy, presentation of cases.
·       Communication skills, including patient counseling techniques, medication history interview, teaching skills.
·       Understanding common medical abbreviations & terminologies used in clinical practices.
B) Clinical Laboratory Tests used in the evaluation of diseases states & interpretation of test results.
·       Haemotological, Liver function, Renal function, Thyroid function tests.
·       Tests associated with cardiac disorders
·       Fluid & Electrolyte balance
·       Common tests in urine, sputum, faeces, CSF.
·       Sensitivity screening for common pathogenic microorganisms, its significance, resistance in disease states & selection of appropriate anti-microbial regimens.
·       Pulmonary function tests.
Unit-IV  A) Drug & Poison Information
·       Introduction to Drug information, resources available,
·       Systematic approach in answering drug information serve queries
·       Critical evaluation of drug information and literature
·       Preparation of written and verbal reports
·       Establishing a drug information center
·       Poisons information-organisation and information resources
·       Poisons management in drug dependence and drug abuses (opiates, cocaine, amphetamines, alcohols, benzodiazepines, barbiturates, tobacco). Role of emetics, anti- emetics and respiratory stimulants.
B) Evidence Based Medicine
·       Formulating Clinical Questions
·       Searching for the best evidence
·       Critical Appraisal of the evidence
·       Applying evidence to patients
·       Evaluation
Unit-V  A) Medication Error and Medication Adherence
·       Categories and causes of medication error
·       Performance indicators of the medication use process
·       Categories of medication non-adherence
·       Role of pharmacists at medication error and medication adherence
B)    Pharmacovigilance
·       Scope, Definition and Aims of Pahrmacovigilance
·       Adverse Drug Reactions – Classification, Mechanism, Predisposing Factors, Causality Assessment [different scaled used].
·       Reporting, evaluation, monitoring, preventing & management of ADR’s
·       Role of pharmacist in management of ADR’s
Text books
1.     A text book of clinical pharmacy practice – Essential concepts and skills. G. Parthasarathi et al, 1st Edn. Orient longman Publications,2004.
2.     Comprehensive pharmacy review : Leon Shargel, 5th Edn. Published by Lippincott Williams & Wilkins 2004.
3. Remington Pharmaceutical Sciences
Reference Books
1.     Basic skills in interpreting laboratory data – Scott LT . American Society of Health System Pharmacists Inc.
2. Practice Standards and definitions – The Society of Hospital Pharmacists of Australia.,1997.
3. Clinical Pharmacokinetics – Rowland and Tozer, Williams and Wilkins Publication.
4. Biopharmaceutics and Applied Pharmacokinetics – Leon Shargel, Prentice Hall Publication.
5. Relevant review articles from recent medical and pharmaceutical literature.
6. Evidence Based Medicine: How to pratice and teach EBM. Sharon E Straus E.Sraus III Edn. Churchill Livingtone.







COMMUNITY PATIENT CARE/COMMUNITY PHARMACY
                                                            HCPT-1.5

Unit-I  Introduction to the concept of community pharmacy – its activities and professional responsibilities
a) The role of community pharmacy and its relationships to other local health care providers
b) Prescribed medication order- Interpretation and legal requirements
c) Over the counter (OTC) sales
Unit-II  Health Education and Community Pharmacy: Family planning, first aid, communicable disease prevention, smoking cessation, screening programs.
         Unit-III  a) Services to nursing homes/clinics.
b) Community Pharmacy Management: Financial, material and staff management, infrastructure requirements, drug information resources, computers in community pharmacy.
c) Code of ethics for community pharmacy
d)     Poly pharmacy and its implications
Unit-IV  A)Communication skills – Principles and elements of communication skills, non -verbal communication in pharmacy, barriers in communication, listening skills, questioning skills, explaining Skills. Patient counseling in community pharmacy
B) Education and training staff, training and continuing education for pharmacists, pharmacy students, Medical staff and students, nursing skills , explaining skills and ethics in communication
Unit-V  A) Public Health Policy and Health Care System – National & International
B) Concept of Rational Use of Drugs – Importance of rational drug use, pharmacists role, drug use indication, guidelines for rational prescribing.

Text Books (Latest Edition)
1. Hospital Pharmacy – Hassan WE. Lec and Febiger Publication
2. Textbook of hospital pharmacy – Allwood MC and Blackwell.
Reference books:
1. Avery’s Drug treatment, 4th Edn, 1997, Adis International Ltd.
2. Evidence Based Medicine: How to practice and teach EBM. Sharon E Straus E Sraus III Edn, Churchill Livingstone.
3. Remington PharmaHCPtical Sciences
4. Relevant review articles from recent medical and pharmaHCPtical literature.


PATHOPHYSIOLOGY AND APPLIED PHARMACOTHERAPEUTICS-I LAB
HCPL-1.6

            The students are required to be posted to various clinical wards for their exposure with therapeutic management and other clinical aspects. They are expected to have experience and do a tutorial as well as case presentation in the following clinical conditions. The students have to make at leas 10 case presentations covering most common diseases found in the hospital to which the college is attached. The student should also submit a record of the cases presented. The list of clinical cases presented should include follow-up of the clinical cases mentioned below from the day of admission till discharge and presented in the SOAP (Subjective, Objective, Assessment and Plan) format.
The cases may be selected from the following departments
1.     Cardiology
2.     Respiratory System
3.     Haematological Diseases & Nephrology
4.     Gastroentrology & Rheumatology
5.     Endocrinology & Dermatology
Assignments
            The students are required to submit a minimum of three written assignments (1500 to 2000 words) selected from the topics on different disease conditions given to them. The students are required to discuss both the clinical and therapeutic aspects in the same.






ADVANCED CLINICAL PHARMACY – LAB
HCPL-1.7

Patient medication history interview, answering drug information questions, patient medication counseling, participation in ward rounds. Case studies related to laboratory investigations covering the topics dealt in theory class.
1.     Answering drug information questions (4)
(Queries related to Dosage, administration, contraindications, adverse drug reactions, drug use in pregnancy and lactation, drug profile, efficacy and safety)
2.     Patient medication counseling – (3) Common diseases like Diabetes, Hypertension, Asthma, COPD, Acute Renal Failure, chronic Renal Failure.
3.     Case studies related to laboratory investigations (4) – LFT, Hematology, Thyroid, Renal, Cardiac Enzymes.
4.     Patient medication history interview (2)
5.     Medication order review (2)
6.     Detection and assessment of adverse drug reaction and their documentation (3)
Assignments
Drug information,
Patient medication history interview
Patient medication counseling
Problem solving in clinical Pharmacokinetics
Literature evaluation pertaining to therapeutic range used in therapeutic monitoring of any two drugs frequently subjected for TDM.
Critical appraisal of two recently published articles in the biomedical literature, which deals with a drug or therapeutic issue.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    

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