İLERİ KLİNİK ECZACILIK
- Ders
- PSCI636 - İLERİ KLİNİK ECZACILIK
- Bölüm
- Eczacılık Fakültesi
- Ders Tipi
- Ders
- Durum
- Zorunlu
- Dil
- İngilizce
- Kredi
- 3
- AKTS
- 8
- T+P+L
- 3 + 0 + 0
- Ders Koordinatörleri
- -
- Ön Koşul
- -
- Anahtar Sözcükler
Ders Açıklaması
Klinik eczacılık, hastaların tedaviye cevaplarını optimize etmek amacı ile ilaç içeren tedavi protokolleri kullanılarak hasta bakımını hedefleyen bir eczacılık disiplinidir. Kursun içeriği, serbest eczanelerde ve hastane eczanelerinde klinik eczacılık uygulamaları, kardiyoloji, geriatri, pediatri, onkoloji, iç hastalıkları ve bulaşıcı hastalıklar gibi kliniklerde profesyonel klinik eczacılık hizmetlerinin gerçekleştirilmesi, multidisipliner hasta yaklaşımında eczacının rolü ve hasta merkezli ilaç danışmanlığıdır. İlaç Danışma Merkezleri, Merkezi Antineoplastik İlaç Hazırlama ve Tatal Parenteral Beslenme Ünitelerinin faaliyetleri kurs kapsamına dahildir. Dersler vaka bazlı tartışma formatında yürütülür.
İLERİ KLİNİK ECZACILIK
Değerlendirme Araçları (Aktif Dönem)
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Ders çıktıları
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Ders Müfredatı
| Hafta | Konu |
|---|---|
| Hafta 1 | Differential Diagnosis |
| Hafta 2 | Clinical Reasoning |
| Hafta 3 | HYPERTENSION-I. Mr FH, a 48-year-old van driver, was identified by his general practitioner (GP) as having a resting blood pressure of 162/92 mmHg. He was in reasonably good health and purchased over-the-counter (OTC) ibuprofen 400 mg, which he took up to three times daily for arthritis-type pain when necessary. He weighed 95 kg, was 170 cm tall, and had a resting pulse rate of 82 beats per minute (bpm). He smoked 15 cigarettes per day and drank at least 6 units on 4 nights each week. His total cholesterol (TC) had been measured as 5.9 mmol/L and his high-density lipoprotein (HDL) as 1.5 mmol/L (TC:HDL ratio 4.5). |
| Hafta 4 | HYPERTENSION-II. Month 3 Mr FH had had his blood pressure recorded twice more and the values had been recorded as 160/91 mmHg and 164/92 mmHg. His GP decided to start Mr FH on ramipril |
| Hafta 5 | HYPERTENSION-III. Mr FH continued to visit his medical centre at 2-monthly intervals, but his blood pressure remained raised, despite the prescribed ramipril. Nine months later, Mr FH was admitted to the Acute Medical Assessment Unit of the local hospital, having collapsed at work with chest pains, which resolved rapidly after sublingual glyceryl trinitrate. He admitted that he had been getting chest pains on exertion for ‘a couple of months’. His blood pressure was measured as 165/99 mmHg. His haematology and biochemistry results were as follows: • Sodium 140 mmol/L (135–145) • Potassium 4.9 mmol/L (3.5–5) • Creatinine 130 micro mol/L (<110) • Haemoglobin 11.2 g/dL (12–18) • TC 7.1 mmol/L • Blood glucose 4.1 mmol/L • Glycated haemoglobin (HbA1c) 6.7% His current therapy was: I. Ramipril 5 mg daily II. Paracetamol 1 g four times daily when required III. Simvastatin 10 mg daily IV. Aspirin 75 mg daily He admitted to continuing to buy OTC ibuprofen and not being terribly compliant with his statin therapy. |
| Hafta 6 | ARTICLE PRESENTATION & GROUP DISCUSSION |
| Hafta 7 | JOURNAL SELECTION & GROUP DISCUSSION |
| Hafta 8 | TYPE-2-DIABETES MELLITUS-I. Mr KB, a 61-year-old builder, made an appointment with his GP because he had felt increasingly tired over the last few weeks and it was starting to affect his work. He also complained of feeling thirsty and of going to the toilet frequently to urinate, especially during the night, which was unusual for him. His late mother had a history of type 2 diabetes. The GP dipped his urine, which was positive for glucose but not ketones and a trace of protein. His random blood sugar was 11.5 mmol/L and his blood pressure (BP) 156/90 mmHg. He rarely came to see the GP. His previous medical history was osteoarthritis of the knee, for which he was taking the following medications: ▸ Diclofenac 50 mg orally three ▸ Omeprazole 20 mg orally daily times daily after food for gastroprotection. |
| Hafta 9 | TYPE-2-DIABETES MELLITUS-II. The GP asked Mr KB to come back for a fasting blood glucose test the next morning. Day 4 His fasting blood glucose was reported as 8.1 mmol/L (reference range 6.0–7.0). An appointment was made for Mr KB to see the clinical pharmacist (a non-medical prescriber) to discuss the result. Day 7 The clinical pharmacist explained to Mr KB that his reported symp- toms plus one fasting plasma glucose ≥ 7 mmol/L confirmed a diagnosis of type 2 diabetes (as per World Health Organization criteria). A thorough explanation of the cause of diabetes and how it can be managed was given. Mr KB was shocked and upset by the diagnosis, but was keen to understand what he could do to help himself feel better. The clinical pharmacist discussed his diet and lifestyle and what impact this would have on his condition. Mr KB admitted to smoking 20–30 cigarettes per day, drinking 40 units of alcohol a week, eating lots of sugary and fatty foods and doing little physical activity. He was obese, with a weight of 105 kg (body mass index (BMI) 32) and a waist circum- ference of 124 cm. His BP was 152/96 mmHg. |
| Hafta 10 | TYPE-2-DIABETES MELLITUS-III. Mr KB was advised to start modifying his diet and to increase his physical activity, building up to at least 30 minutes five times per week. He was also given a file of written information and leaflets about type 2 diabetes, diet, exercise and diabetes-related complications to reinforce the discussions. He consented to being referred to the primary care dietitian, for which he was asked to complete a food diary. He was also referred to the Structured Education Programme and for retinopathy screening, as well as being advised to make an appointment with an optician for a visual acuity test, and to notify his car insurance company of the diagnosis. A follow-up appointment was arranged for 1 month later. |
| Hafta 11 | - |
| Hafta 12 | - |
| Hafta 13 | - |
| Hafta 14 | - |
| Hafta 15 | - |
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Ders Çıktıları
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