NUTR7405-Egan, 2007U.doc - UM Drive - University of Memphis

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Dec 3, 2012 (4 years and 6 months ago)

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Semester, The University of Memphis

-
1
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Course,
Instructor




College of Education

The University of Memphis

HSS

NUTR7405

Pharmacology for Nutrition Professionals

Spring 2007

Instructor: Beth M. Egan, MS, RD, LDN

College of Education Norms

I take 100% responsibility.

I seek equity of voice.

I am willing to tal
k about sensitive issues.

I listen for understanding.

I appreciate the strengths and contributions of others.

I bring positive energy and encouragement to the team.

I
commit to the

mission of the college.


7405: Pharmacology for Nutrition Professionals


Co
urse Description:

Introduction to pharmaceutical sciences including general
principles and phases of drug action, drug and nutrient interactions, pharmaceutical issues
in nutrition support, supplemental/herbal issues, and highlights of commonly prescribed
medications that are used in medical conditions which have a nutrition component.


Prerequisites:
Enrollment in the Dietetic Internship and Residency Program or
completion of an ADA approved dietetic internship.




Text(s):





Adams MP, Josephson DL, Hollan
d LN. Pharmacology for Nurses: A
Pathophysiologic Approach.


2005. Pearson/Prentice Hall. Upper Saddle River, New
Jersey.


ISBN: 0
-
13
-
028148
-
4



Gould BE.


Pathophysiology for the Heath Professions, 3
rd

edition.


2006. Elsevier.


Philadelphis, PA. ISBN:1
-
416
0
-
0210
-
3



Nutrition Diagnosis: A Critical Step in the Nutrition Care Process


Adjunct Materials:



Several web
-
based assignments call for membership.

In all cases, membership is free.

Intern will have to join before completing the assignment


Support of Con
ceptual Framework: Pharmacology for Nutrition Professionals

will
enable graduates to apply the science of pharmacology and pharmacotherapy as it relates
to drug actions and interactions on nutrients and on the nutritional status in the care for
individuals

and groups within the scope of nutrition practice. This will be achieved in a
variety of settings among diverse populations by offering an educational experience that
Semester, The University of Memphis

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2
-

Course,
Instructor

provides the knowledge and skills to: (this last sentence doesn’t seem right as it is no
t in a
variety of settings [classroom]


I took this directly from NCP I/II syllabus)



practice as an entry level RD



develop an effective practice



incorporate scientific advances



take a leadership role



pursue lifelong professional learning


Methods of Ins
truction:

Lecture, written assignments, web
-
based exercises, self
-
study, case studies


Key Assessments:
Students in the Dietetic Internship are expected to meet a number of
accreditation competencies (from the Commission on Accreditation of Dietetic
Educa
tion).


The competencies that relate to this course are listed below and the
assessments for each are listed.


Competency I:


Graduates will demonstrate the ability effectively communicate and
educate.

Student Learning Outcomes

Assessment Activity

CD6
. U
se current technologies for
information and communication activities
(perform)



Use computer to perform activities related to nutrition
and food service duties.



Use PowerPoint or other technology, such as computer
-
based learning to complete assignments.



Res
earch clinical or food
-
service related questions
utilizing list
-
serves or other internet resources.

CD8.

Provide dietetics education in
supervised practice settings



Successful presentation of issues related to popular
dietary supplements.



Successful prese
ntation of ADA Position and Practice
Papers related to drugs and/or dietary supplements.

CD11
.


Develop and review educational
materials for target populations



Successful completion of low
-
literacy handout on a
drug
-
nutrition related issue.

Competency

II:


Graduates will demonstrate the ability to effectively apply the
principles of the nutrition care process.

CD13.


Interpret and incorporate new
scientific knowledge into practice




Successful completion of web
-
based exercises related to
new issues/
discoveries/ of nutrition
-
related drugs and/or
dietary supplements.

CD32.


Assess nutritional status of
individual patients/clients with complex
medical conditions, e.g., renal disease, multi
-
system disease, organ failure, and trauma



Successful completi
on of web
-
based case studies of
nutrient
-
drug/supplement related issues



Successful completion of exams

CD42
. Provide nutrition care for


people of
diverse cultures and religions across the
lifespan, i.e., infants through geriatrics



Successful completion
of web
-
based case studies and
activities.

Competency IV: Graduates will demonstrate an understanding of how public policy,
professional engagement, and professional learning impact the practice of dietetics
and the RD’s individual practice.
=
=
=
CD1
. Perfor
m in accordance with the Code
of Ethics for the Profession of Dietetics



Intern will be able to discuss

Position and/or Practice
Papers related to medications and dietary supplements.

Semester, The University of Memphis

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3
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Course,
Instructor




Successful completion of a case
-
based ethics activity.

CD5.


CD 5
. Participate in legislative and public
policy processes as they affect food, food
security, nutrition, and health care



Successful completion of web
-
based activities.



Successful completion of exams


Course Objectives:

1.

Increase awareness of clinical dietit
ian’s role in professional practice especially as
it relates to pharmacotherapy.

2.

Develop an understanding of general principles of pharmaceutical sciences
including definition and nature of drugs and pharmacological concepts and terms.

3.

Learn the processe
s involved in the pharmaceutic, pharmacokinetic, and
pharmacodynamic phases of drug action.

4.

Learn significant drug
-
nutrient interactions; review effects of food on drug
therapy and effects of drug therapy on nutrients and nutritional status.

5.

Discuss issu
es related to supplements and herbals.


Review supplements clients
commonly use in prevention and treatment of medical disorders.

6.

Review major classes of drugs and highlight drugs commonly used to prevent or
treat medical conditions in which nutritional t
herapy is a cornerstone of treatment.

7.

Develop critical thinking and problem solving skills.

8.

Meet the competencies for dietary supplements as outlined in Figure 4
(Complementary and alternative medicine: Competencies for dietetics
professionals.


Tougher
-
Decker, R and Thomson CA.


JADA.


2003.


103;11:1465
-
1469)







Semester, The University of Memphis

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4
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Course,
Instructor

Assignments, Exams, and Grading Criteria:

Assignments



Assignments will be evaluated based on completeness of cont
ent, degree of
organization and integration of lectures, readings, objectives and class discussions.





A varying number and type of assignments will be assigned and be worth a varying
number of points based on the assignment criteria, completeness and qual
ity.


Enough advance notice will be provided in order to complete assignments.


Complete instructions will be provided at that time.



Assignments should be turned in on the date due.


Late assignments will not be
accepted.



Exams



An exam will be given eac
h week.


Exams may be in multiple formats including
multiple choice, true/false, matching, short answer, discussion, or essay type
questions.


Exams are worth 100 points.


Grading Criteria



In most cases grading rubrics will be used to evaluate assignments
and will be based
on the guidelines for that assignment; copies of rubrics will be provided for
assignments.


Weighted Value of
Exams, Assignments,
and


Projects

%Weight

Exams

25

Alternative and
Complementary Therapy
Presentations

15

Other Assignments

60



Total

100


Grading Scale:

A+


97
-
100


B+


87
-
89

A


93
-

96


B


83
-
86

A
-


90
-
92


B
-


80
-
82


C+


77
-
79




C


73
-
76

C
-


70
-
72


Course Requirements:
Acceptance into Dietetic Internship and Residency Program or
Registered Dietitian status.

Make
-
Up Policy:


Classes and/or exams can not be made up.

Cell
-
phone Policy
:


Cell phones must be turned o
ff and out of sight.


Do not use cell
phones in the classroom.


Do not use cell
-
phones for calculators.



Semester, The University of Memphis

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5
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Course,
Instructor

Late Policy:


Be ready to start at the beginning of class or after break.


Late arrivals will
not be tolerated.

Americans with Disabilities Act
: The
University of Memphis does not discriminate on
the basis of disability in the recruitment and admission of students, the recruitment and
employment of faculty and staff, and the operation of any of its programs and activities,
as specified by federal laws
and regulations.
The student has the responsibility of
informing the course instructor (at the beginning of the course) of any disabling
condition, which will require modification to avoid discrimination
. Faculty are required
by law to provide "reasonable
accommodation" to students with disabilities, so as not to
discriminate on the basis of that disability. Student responsibility primarily rests with
informing faculty at the beginning of the semester and in providing authorized
documentation through design
ated administrative channels.

Written Assignments and Academic Misconduct
:
All written work submitted must be
the student’s original work; plagiarism will not be tolerated.


Students are expected to
conduct themselves in a professional manner.



HSS Posi
tion Statements:

Promoting a Positive Learning Environment

The Department of Health and Sport Sciences

recognizes its responsibility to promote a
safe and diversity
-
sensitive learni
ng environment that respects the rights, dignity, and
well being of students, faculty, and staff. Diversity means the fair representation of all
groups of individuals, the inclusion of contrasting perspectives and voices, together with
the appreciation and

valuing of different cultural and socioeconomic group practices.
Moreover, we aspire to foster a climate of mutual respect and empathy, among and
between students, faculty, and staff, by nurturing an atmosphere that is free from
discrimination, harassment
, exploitation, or intimidation. Departmental courses will strive
to provide an opportunity for all students to openly discuss issues of diversity including,
but not limited to, age, disability, ethnicity, gender, race, religious beliefs, and sexual
orient
ation.

Special Needs

Any student who has special needs for assistance and/or accommodation, and who is
registered with the Office of Student Disability Services should meet with the instructor
during the first week of classes.

Plagiarism


Plagiarism includ
es, but is not limited to, the use, by paraphrase or direct quotation, of
the published or unpublished work of another person without full or clear
acknowledgment.
This means that any substantive ideas, phrases, sentences, and/or any
Semester, The University of Memphis

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Course,
Instructor

published ideas must b
e properly referenced to avoid even the appearance of plagiarism.
.
It also includes the unacknowledged use of materials prepared by another person or
agency in the selling of term papers of other academic materials.
It is the student’s
responsibility to kn
ow all relevant university policies concerning plagiarism. Any
documented cases of plagiarism can and will result in dismissal from the course with a
failing grade, and may result in other more serious sanctions by the College of Education.

Your written wo
rk may be submitted to
Turnitin.com
, or a similar electronic detection
method, for an evaluation of the originality of your ideas and proper use and attribution
of sources. As part
of this process, you may be required to submit electronic as well as
hard copies of your written work, or be given other instructions to follow. By taking this
course, you agree that all assignments may undergo this review process and that the
assignment m
ay be included as a source document in
Turnitin.com
's restricted access
database solely for the purpose of detecting plagiarism in such documents. Any
assignment not submitted according to the
procedures given by the instructor may be
penalized or may not be accepted at all. Please refer to the University’s
Code of Stud
ent
Conduct

for actions that may result from student academic misconduct.

Awarding an Incomplete Grade

A grade of “I” (Incomplete) may be assigned by the Instructor of any course in which the
student is unable to complete the work due to EXTRAORDINARY eve
nts beyond the
individual's control. The “I” may not be used to extend the term for students who
complete the course with an unsatisfactory grade. Unless the student completes the
requirements for removal of the “I” within 45 days (for undergraduate course
s, or 90 days
for graduate courses) from the end of the semester or Summer term in which it was
received, the “I” will be changed to an “F,” regardless of whether or not the student is
enrolled.

Dealing with Harassment

The Department of Health and Sport Sciences

believes it is important to respond to
insensitive and inappropriate behavior in a spirit of collegiality, mutual respect, and
professionalism. If you believe that you have b
een the target of discrimination by another
student, faculty member, or staff member, due to age, disability, ethnicity, gender, race,
religious beliefs, sexual orientation, or cultural group membership, you can choose to
pursue one or more of the followin
g avenues

The most direct approach, if you feel comfortable doing so, is to speak directly to the
person whose behavior you consider to be inappropriate.

You may speak to the instructor, and HSS faculty member, the Department Chair (678
-
4165), or the Unive
rsity's Affirmative Action Officer (678
-
2713).

You may contact the Assistant Dean of Students (678
-
2298), in the
Office of Student
Judicial Affairs
.

Semester, The University of Memphis

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7
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Course,
Instructor

It

is important that you speak immediately to someone, with whom you feel comfortable,
in order that your concerns can be handled promptly and fairly. In all complaints of
discrimination, including sexual harassment, the
Office of Affirmative Action

will be
notified.

COE Norms

1.

I

take 100% responsibility

I neither make excuses or cast blame


2.

I

seek equity of voice

I participate, I support, I listen and I pe
rform and

contribute in a manner that encourages other to do the same.


3.

I

am willing to talk about sensitive issues.

I encourage dialogue and am prepared to discuss sensitive issues.


4.

I

listen for understanding.

I neither interrupt nor participate in secon
dary conversations.

I will go directly to the source for information and problem resolution.


5.

I

appreciate the strengths and contributions of others.

I need, I want and I value the strengths and contributions of others.


6.

I

bring positive energy and encoura
gement to the team.

I contribute positively; I have high expectations of others and I contribute synergy
to the team.


7.

I

implement the mission of the college.

I commit, I support and I actively encourage others to implement the mission


The HSS iWebfolio P
osition Statement

This course satisfies one or more of the performance outcomes and curriculum standards
required for program approval and/or accreditation, and some assignments may be
identified for posting on an electronic portfolio (iWebfolio). Standard
s and outcomes for
your area of study are presented at
http://www.iwebfolio.com.

If you are required to
register for iWebfolio during this semester, more information and instructions

will be
provided. If iWebfolio is not used in this course this semester, you should save all
projects, presentations, and assignments for uploading at a later time.


Date


Plan


Note: “Text” = Pharmacology Test

Items highlighted in plum color are assignme
nts that must be turned in to
instructor.


All “answers” that must be turned in “today” should be typed in a
Word document with the question preceding the answer.

All of the “today’s
answers” should be on one Word Document.

Please use name instead of la
st
4.


In
-
class assignments are to be turned in the day of the assignment.

M
-
14

Orientation for Methodist Hospital Systems: all interns must attend.



READING
:


Food
-
Drug Interactions Which Ones Really Matter?

Semester, The University of Memphis

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8
-

Course,
Instructor

http://www.uspharmacist.com/index.asp?show=article&page=8_1983.htm
.


Please make notes regarding these issues: How do the various foods affect the

drug or drug class?

What is the MOA of this interaction?
Please turn answers
tomorrow, Tuesday, the 15th.


T
-

15

TOPICS:


Intro, Selected JCAHO Standards, Drug Resources, Drug
Development/Evaluation, Drug Regulations/Legal Issues, Drug Safety, Drug
Fo
rms, Routes of Administration, Drug Classes, Drug Nomenclature, Nutrition
Diagnoses Related to Drugs, Branches of Pharmacology, Basic Principles of
Pharmacology


READING:

Text:

1, 2, 4, 5, 6, 9.4
-
9.7.


Pathophysiology

book:


p 254
-
263.

Online:

Interactions

Between Herbs and Conventional Drugs: Introductory
Considerations
.


http://www.herbalgram.com/herbalgram/articlevie
w.asp?a=2262
.


Be able to meet these
Objectives
: be able to name important literature sources for
data on herb
-
drug interactions.



IN
-
CLASS ASSIGNMENTS :



FDA Exploration

Go to the
Food and Drugs Administration

homepage at
www.fda.gov
.


Explore
the entire website.


Don’t go too deeply into CDER section.




USP Exploration

Go to the
United States Pharmacopeia

website at
http://www.usp.org
/
.


Read
the overview “About the USP”.


Watch the Interactive Video.


Be able to answer
these
Objectives
: Who are they and what do they do? Look at the USP
-
NF
section.


What is it?


View a sample monograph
-

what is a monograph?


Look at
USP Verified.


Wha
t does USP Verified mean?


What is verified? Print the list of
verified brands. Read the Verified Dietary Supplement Ingredients section, then
scroll down and click on Patient and Education Resources.


Check out the
Professional and Consumer Education Mate
rials and some of the other activities
on this webpage.


Read about the USP Verified Mark.


How is it different from a
USP Verified Pharmaceutical Ingredient mark?


Read: The USP Dietary
Supplement Verification Program: Helping Pharmacists and Consumers Se
lect
Dietary Supplements on the USP Verified page
.


Answer any questions and turn in
today.



W
-

16

TOPICS:

Adverse Drug Reactions, Effects of Food & Nutrients on Drug Therapy,
Effects of Drug Therapy on Nutrients, Effects of Herbal and Dietary Supplemen
ts
on Drug Therapy, EN & PN and Drug
-
Nutrient Interactions, Ethics and Legalities
of Botanicals


READING:

Text
: 11.


Journal:

Practice Applications: Avoiding Medical Errors: JCAHO

Documentation Requirements.

JADA
. 2004; 104:171
-
173. Be able to fullfil th
e
objectives listed after the Online reading assignment.


Online
:


http://www.ismp.org/ Tools/errorproneabbreviations.pdf
.


Print for your records
Semester, The University of Memphis

-
9
-

Course,
Instructor

and be able to fulfill these
Objectives
: Be able to write the “preferred term” or
“intended meaning” for the medical abbreviation and the correct way (intended
meaning) to write numbers if given on an exam.



IN
-
CLASS ASSIGNMENT
S




ISMP (Institute for Safe Medication Practices) Exploration

Go to
http://www.ismp.org/Default.asp
.


Explore the website.


Check out the
Medication Tools and print the li
sts of high
-
alert meds, confused drug names list,
error
-
prone list, Do Not Crush list, and any other list that looks important to be
aware of/know about.


Check out the report errors and look at the mechanisms for
reporting drug errors.


You should know ab
out MedWatch.


Go look at the:
ISMP
-
FDA

A
BBREVIATIONS
T
OOLKIT

and check out the Power Point slides


i.e. read it slowly.


Check ou
t the BlackBox Warnings section and the JCAHO
Sentinel Events section.


What is a black box warning?


What is a sentinel event?


Turn in answers to these questions today.




CDER Exploration

Go to the
Center for Drug Evaluation and Research

at

www.fda.gov/cder
.
Review the top tabs (CDER Home, About CDR, Drug Information, Regulatory
Guidance, CDER Calendar, Specific Audiences, CDER Archives) to see type of
information on this web
-
site.


Explo
re the website. Also view the nonprescription
products section http://www.fda.gov/cder/Offices/OTC/default.htm.




Recently Approved Drugs Search

Go to
www.fda.gov

Go to “Product Approvals.”


Then
go to “Latest drug
approvals (listed by date).”


Choose a non
-
OTC drug approved in the last month.


Identify the brand name, generic name, and therapeutic class.


Find the therapeutic
equivalent, find the approval history and note why this drug was
approve
d/reapproved.


Go to the manufacturer’s website to get specific
information regarding therapeutic use, adverse effects, and any other interesting
info.


You may copy and paste information to a word document.


Print a copy to
turn

in; don’t forget to identi
fy with your name.


Go to
http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm
.


Click on
Drugs@
FDA Demo and do the demo (takes approximately 10 minutes).

Then
click on What’s New in Drugs at FDA and look around in there.


(see picture of
web
-
page below)

From
http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm
, click on
“Advanced Search.”


Scroll down to option “C.”


Enter a date range for the last 3
months.


Choose a different non
-
OTC drug a
pproved in the last 3 months.


Follow
instructions.


Identify the brand name, generic name, and therapeutic class.


Find
the therapeutic equivalent, find the approval history, and note why this drug was
recently approved/reapproved.


Go to the manufacturer
’s website to get specific
information regarding therapeutic use, adverse effects, and any other interesting
info.


You may copy and paste information to a word document.


Print copy to turn
in today.

Semester, The University of Memphis

-
10
-

Course,
Instructor


WHAT IS DUE
:
Fraudulent Pharmaceuticals
.


Go to
www.quackwatch.org
.


Find a drug/herbal/botanical/vitamin/mineral topic of interest to you.


Read.


Type
a short paragraph stating why this topic was of interest to you and what you
learn
ed from the article.


What did you think about this article


did you believe
it?


Why or why not.


Have you ever visited this site before?



Th
-

17

TOPICS
: Vitamins, Minerals, and Drugs; ANS drugs; Urinary System Drugs


READING:

Text
: 13, 28.5
-
Nursing P
rocess focus, 38, 46.1
-
3, 43, 46.7


IN
-
CLASS ASSIGNMENT
: Website Exploration:



NCCAM Exploration

Go to the
National Center for Complementary and Alternative Medicine

at:
http://nccam.nih.gov/
.


Click on “continuing education series” under Training.
Click on: Herbs and Other Dietary Supplements at:

http://nccam.nih.gov/videolectures/herb
s.htm
.


Click on “Take Course”.


You will
then have to register.


When you get to the correct webpage
(http://videolectures.nccam.nih.gov/main.php), take the “Test”.


Turn in copy of
printed certificate of completion along with percentage correct and your

name.

You can go through the entire video program on this chapter if you wish, but you
should have enough info at this point to pass this test.






CFSAN Dietary Supplements Exploration

Go to the Dietary Supplements section of the
Center for Food Safety a
nd
Nutrition

http://www.cfsan.fda.gov/~dms/supplmnt.html.


Explore the website




Rx
-
to OTC Switch List

Go to:
http://www.fda.gov/cder/Of
fices/OTC/rx
-
to
-
otc.htm
.


Look at those
medications that have had their status changed from prescription to OTC from Jan
2001 until now.


Choose the one that is most related to nutrition.


Go to the website
for that drug.


Look at the drug monograph.


Wha
t is the MOA for that drug?


You
do not have to turn this in; call me over and show me.

F
-

18

TOPICS:

continuation of previous topics


READING:


Go to:
http//www.uspharmacist.com/index.asp?page=ce/novelmechanisms/default.htm.

Please read in relation to
providing a thorough nutrition assessment and in relation
to physical exam, testing, and medications that could be ordered to treat.

Be able
to recognize names and types of drugs and their MOA.



IN
-
CLASS ASSIGNMENT:





ODS Exploration

Go to the
Office of

Dietary Supplements

at:
http://ods.od.nih.gov/index.aspx.
Briefly

explore the site; be sure to look at the International Bibliographic
Information

on Dietary Supplements at:
Semester, The University of Memphis

-
11
-

Course,
Instructor

http://ods.od.nih.gov/Health_Information/IBIDS.aspx


WHAT IS DUE:

Each team will present their
Position

Paper
; Katie will present
Practice Paper

M
-

21

TOPICS
: GI Medications, Endocrine Agents, Cardiovascular Disease Drugs


READING
:

Text: 36, 37, 39, 40, 41, 42, 21, 22, 23, 24, 25, 26, 27


IN
-
CLASS ASSIGNMENT:



Postoperative Ileus

CE and


post
-
test & answe
rs to objectives.


Go to:


www.uspharmacist.com/print.asp?page
-
ce/10193/default.htm
.


Answer the
objectives
, take the post
-
test and program evaluation; copy and paste to Word
document and turn in (all one document).

Objectives:


Be able to answer the 4
objectives listed on the first page of the CE lesson.


In addition, for the 3
rd

objective, in addition to “ide
ntify” current options for treatment of POI, briefly
describe their MOA and whether the evidence demonstrate the effectiveness of
these methods.


Type the question and the answer on a Word document and turn
in hard copy.




Using Insulin Analogs and Premixe
d Analogs in Patients with Type 2
Diabetes: A Practical Guide for Pharmacists

CE and post test.


Answer the
objectives, take the post
-
test and program evaluation, copy and paste to Word
document (along with answers to objectives) and turn in.

Objectives:

B
e able
to answer the 4 educational objectives listed at the beginning of the CE.


Type
your answers and add to your Word document.

T
-

22

TOPICS:


Cardiovascular Disease Drugs, Pulmonary Disorders, Appetite
Stimulants, Anorexiants, Nutritional Supplements


READING: Text:


29, 37.8, 38.10.


Journal Articles
:

Ca
lcium Supplements:
Benefits and Risks
.


http://www.medscape.com/viewarticle/497826
.


Objecti
ves:

be able to describe the epidemiology of those with osteoporosis, associated
morbidity, risk factors, factors that impair calcium absorption, daily requirements,
food sources, recommendations for taking calcium supplements, risk of too much
calcium, de
fine milk
-
alkali syndrome, know recommendations for vitamin D,
toxicity issues of vitamin D, and lead issues related to calcium supplements.


You
do not have to turn in answers to the objectives.




IN
-
CLASS ASSIGNMENT
:

Go to: http.uspharmacist.com/print/a
sp?page=ce/105422/default.htm and complete
tutorial and post test.

Copy and paste your post
-
test with percentage correct and
your name and turn in today.



WHAT IS DUE:

GERD case studies “Extinguishing the Burn
.”


Go to:


www.gicme.com
.
Click
Pediatric Hot Spot
.

Click
Extinguishing the Burn
: Case
Studies in Pediatric Reflux Disease.


Read all three case studies.


Take the post
-
test
Semester, The University of Memphis

-
12
-

Course,
Instructor

and print cert as per instructions.


Copy and paste answer
s to Word document,
answer Objectives on same Word document and turn in hard copy.
Objectives

for
Extinguishing the Burn: Type the answers and turn in.



1)

Be able to distinguish between GER and GERD.

2)

Be able to state lifestyle modifications (i.e. diet/posit
ioning) for an infant

3)

Be able to state the drug classes, their MOA, and some common generic
and trade names (Table 1 of Extinguishing the Burn).

W
-

23

TOPICS:
Antibiotics, Antivirals, Neoplastic Drugs


READING:
Text: 32, 34, 35


WHAT IS DUE:

Alternative
and Complementary Medicine

presentations
.

See
instructions below.

Th
-

24

TOPICS
: Fluids, Electrolytes, and Volume Expanders, osteoporosis drugs


READING
:
Text:
44, 26.4, 46.4


ACTIVITES AND IN
-
CLASS ASSIGNMENTS TBA

F
-

25

ACTIVITIES
:


Exam.




WHAT IS D
UE:


E
-
mailed copy

of
Other Commonly Prescribed Drugs

assignment.


Please title your file: Other Commonly Prescribed Drugs


“your
name”.



In
-
Class Assignments



These websites will be explored during class.


If a question is asked (in the
inst
ructions for the assignment), be able to answer the question.



Some of the websites are tutorials and have a post
-
test.


You should copy and
paste your post
-
test answers to a Word document before submitting the post
-
test for
grading.


Once you h
ave submitted the post
-
test, you will receive a certificate.


Print that,
staple all together and turn in as soon as completed.



In most cases, these instructions are listed in the class calendar.


FDA Exploration



Go to the Food and
Drugs Administration Homepage at
www.fda.gov
.


Explore
the entire website.


Don’t go too deeply into CDER


CDER Exploration

Go to the
Center for Drug Evaluation and Research at

www.fda.gov/cder
.
Review
the top tabs (CDER Home, About CDR, Drug Information, Regulatory Guidance, CDER
Calendar, Specific Audiences, CDER Archives) to see type of information on this web
-
site.


Go to
Wha
t’s New
:
http://www.fda.gov/cder/whatsnew.htm

and sign up for the
newsletter.


Explore the website. Also view the nonprescription products section
http://www.fda.gov/cder/Offices/OTC/default.htm


Semester, The University of Memphis

-
13
-

Course,
Instructor

USP Exploration



Go to the United States Pharmacopeia website at
http://www.usp.org/
.


Read the
overview “About the USP”.


Watch the Interactive Video.


Who are they and what do
they do? Look at the USP
-
NF section.


What is it?


View a sample monograph
-

what is a
monograph.


Look at USP
Verified.


What does USP Verified mean?


What is verified?
Print the list of verified brands. Read the Verified Dietary Supplement Ingredients
section, then scroll down and click on Patient and Education Resources.


Check out the
Professional and Consumer
Education Materials and some of the other activities on this
webpage.


Read about the USP Verified Mark.


How is it different from a USP Verified
Pharmaceutical Ingredient mark?


Read: The USP Dietary Supplement Verification
Program: Helping Pharmacists an
d Consumers Select Dietary Supplements on the USP
Verified page.


CFSAN Dietary Supplements Exploration

Go to the Dietary Supplements section of the Center for Center for Food Safety
and Nutrition http://www.cfsan.fda.gov/~dms/supplmnt.html.


Explore the w
ebsite


Institute for Safe Medication Practices



Go to
http://www.ismp.org/Default.asp
.


Explore the website.


Check out the
Medication Tools and print the list
s of high
-
alert meds, confused drug names list, error
-
prone list, Do Not Crush list, and any other list that looks important to be aware of/know
about.


Check out the report errors and look at the mechanisms for reporting drug errors.


You should know abou
t MedWatch.


Go look at the:
ISMP
-
FDA

A
BBREVIATIONS
T
OOLKIT

and check out the Power Point slides


i.e. read it slowly.


Check out
the
BlackBox Warnings section and the JCAHO Sentinel Events section.


What is a black
box warn?


What is a sentinel event?




Rx
-
to OTC Switch List

Go to:
http://www.fda.gov/cder/Offices/OTC/rx
-
to
-
otc.htm
.

Look at those
medications that have had their status changed from prescription to OTC from Jan 2001
until now.


For any of those which you think may have a nutritional implication, lo
ok up
that drug and list any possible nutrition related implications.


Recently Approved Drugs Search

Go to
www.fda.gov

Go to “Product Approvals.”


Then go to “Latest drug
approvals (listed by da
te).”


Choose a non
-
OTC drug approved in the last month.


Identify the brand name, generic name, and therapeutic class.


Find the therapeutic
equivalent, find the approval history and note why this drug was approved/reapproved.


Go to the manufacturer’s we
bsite to get specific information regarding therapeutic use,
adverse effects, and any other interesting info.


You may copy and paste information to a
word document.


Print a copy to turn in.


Go to
http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm
.


Click on Drugs@FDA
Demo and do the demo (takes approximately 10 minutes).

Then click on
What’s Ne
w

in
Drugs at FDA and look around in there.



Semester, The University of Memphis

-
14
-

Course,
Instructor










FAQ


|


Instructions

|

Glossary

|

Contact Us

|

CDER Home



Drugs@FDA Demo

|

What's New in Drugs@FDA




From
http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm
, click on
“Advanced Search.”


Scrol
l down to option “C.”


Enter a date range for the last 3
months.


Choose a different non
-
OTC drug approved in the last 3 months.


Follow
instructions.


Identify the brand name, generic name, and therapeutic class.


Find the
therapeutic equivalent, find the

approval history, and note why this drug was recently
approved/reapproved.


Go to the manufacturer’s website to get specific information
regarding therapeutic use, adverse effects, and any other interesting info.


You may copy
and paste information to a w
ord document.


Print copy to turn in


Postoperative ileus

www.uspharmacist.com/print.asp?page
-
ce/10193/defau
lt.htm
.


Take the post
-
test; copy
and paste to Word document and turn in.


Pediatric GERD (both are for the same program)

http://www.uspharmacist.com/index.asp?page=ce/pediatricr/default.htm


OR
www.gicme.com
. Click Pediatric Hot Spot.

Click Extinguishing the Burn: Case Studies
in Pedi
atric Reflux Disease.


Read all three case studies.


Take the post
-
test and print cert
as per instructions.


In addition, answer the questions listed on the class calendar.


Constipation



Go to: http//www.uspharmacist.com/index.asp?page=ce/novelmechanisms
/default.htm.


Osteoporosis

Log onto CEMedicus; click on Resource Centers then click on “visit resource
center” in Bone Health Resource Center.


Then, go the featured activity:
The Vitamin D and
Calcium Crisis:
Strategies to Improve Bone Health.


Click on
AAFP under choose your
professional accreditation.


Scroll all way down and
select profession to continue
(other)
.


Reenter your username and log
-
in.


Then click to view the
Activity
.


This
program runs about an hour and a half but is very comprehensive.


It has over 300 slides


some is a review for you & has interesting historical bits.


After you view, take the post
test (and copy and paste your answers to a word document to turn in).


There will also be
a place to evaluate the speakers


so try to pay a
ttention as each new speaker is
introduced.


Keep track of the amount of time it took you to complete the CEU. These
Semester, The University of Memphis

-
15
-

Course,
Instructor

questions will be asked right after the post test.


Then submit your info.


Your CEU
certificate will pop up.


Print and turn into me along

with your Word Document of the
test. It will be helpful to view the other info (short)


esp. the list of calcium supplements.

There are also “Additional Featured Activities”:


Osteoporosis: Current Strategies
in Diagnosis and Treatment
,
The Face of Osteo
porosis: The Complete Physician's Guide
to Bone Health,

and
New Approaches and Patient Counseling in the Treatment of
Osteoporosis
.


I did the first one, glanced through the second, and looked at the section
“Compliance Iss
ues in Osteoporosis: Integrating Treatment Options . . .”.


I thought all of
them were good.





ASSIGNMENTS


Fraudulent Pharmaceuticals

(10 points) due Wednesday, May 16
th
.





Go to
www.quackwatch.org
.


Find a drug/herbal/botanical/vitamin/mineral topic
of interest to you.


Read.


Type a short paragraph stating why this topic was of interest to
you and what you learned from the article.

What did you think about this arti
cle


did
you believe it?


Why or why not.


Have you ever visited this site before?




Team Presentation of ADA Position Papers (20 points) due Thursday, May 17
th
.



Position Papers are statements regarding a particular stance that the American
D
ietetic Association takes on an issue.


There are over 30 positions.


Four of them are
related to medications if medication is defined in the broadest sense.


In this class,
medication will be used in the broadest sense and include dietary supplements


wh
ether
taken as OTC dietary supplements, used in “functional foods” or used in biologically
engineered foods.


There are four positions that fit this:


Agricultural and Food Biotechnology ,
Fortification and Nutritional Supplements

,
Functional Foods

,
Integration of Medical Nutrition
Therapy and Pharmacotherapy

.





Work in four teams of two and each group take one position (Katie, you have
another assignment).

You can decide your “group”.

You will thoroughly read your
assigned positio
n then present a summary of that position to the rest of the group.

You
should plan on speaking 10
-
20 minutes.



Instead of using Power Point or overhead
transparencies, you will have to use a flip chart and write on it as you are presenting your
topic


i.e. it needs to be brief and to the point.


As part of your summary (when
applicable):

1)

Briefly describe some of the main points used to support the position.

2)

Describe some actions, you, as an individual can take to help implement this
position on a hospi
tal
-
wide, citywide, statewide, and or nationwide level?

3)

What is the role of the RD in relation to this position?

4)

Do you agree with the position?


Why?


(You do not both have to agree, but each
one should speak about this then)

5)

Are there points you don’t a
gree with?


Why?

6)

How will knowledge of this position guide you in your future as an RD?

7)

Which facts/data/statements/points/conclusions, etc. surprised or disturbed you
the most?


Semester, The University of Memphis

-
16
-

Course,
Instructor

Katie, you will read the Practice Paper on Dietary Supplements (March 2005 JA
DA).


http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_509_ENU_HTML.htm

Briefly

summarize the article the above questions probably do not apply in this case.


Regarding role of RD


summarize (don’t list point by point).


What you should
concentrate on is Figure 2: Evaluating Dietary Supplement Use


you are to “in
-
service”
the dieti
tians on how to incorporate evaluation into their patient assessment.


Using the
Nutrition Diagnosis and Intervention: Standardized Language for the Nutrition Care
Process


book, find those classes and sub
-
classes within each domain that are related to
med
ications or supplements (in their broadest sense) and point them out to class and
include title & number of domain/class E.g. Inadequate bioactive substance intake (NI
-
4.1).


You can do that part as a handout vs. writing it down on the flip chart.


Then, w
hen
discussing provide a definition of the “problem” and discuss possible etiologies and signs
and symptoms.


Alternative and Complementary Medicine Power Point Presentation (100 points)
due Wednesday, the 23
th
.

1.


Prepare a 10
-
15 minute Power Point pres
entation on the botanical assigned.

2.


All references on the last slide except that references (URL) should be on the slide

itself; reputable references should be used (no Wikipedia
-

unless it is a picture).



3.


Make PP handouts for your classmates (th
is is your presentations WITHOUT your

notes).


E
-
mail the file to me by midnight, Monday the 21
st
.



4.


E
-
mail the entire file of your presentation (the one with your notes) by midnight,

Monday the 21
st
.



Print and bring hard
-
copy to class

5.


You will

be graded on the completeness and thoroughness in addressing the points and

on your presentation skills using the rubric found at:
umdrive.memphis.edu/

bethegan/

public/

7405 Pharmacology 2007/ Presentation rubric for UM DI.doc.



The top ten herbals in order of dollar sales* are: St. John’s
Wort, Echinacea, Saw
palmetto, Feverfew, Garlic, Ginger, Ginseng, Valerian.


Other important herbals are
Black Cohash, Ginkgo, Melatonin and Milk Thistle.


Other nutrients of recent interest are
borage oil, cinnamon, licorice, and turmeric.


Assignments:




Rebekah


St. John’s wort


Alaina
-

Echinacea



Georgia


Saw Palmetto


Laura
-

Feverfew



Jill
-
Garlic




Courtney


Milk Thistle



Ta
ra
-

Cinnamon


Megan
-

Ginkgo



Katie


Black Cohash





These points should be addressed:


Name and synonyms, botanical name, picture
of plant or substance, part of plant with therapeutic value.


Common
formulations
containing substance (if applicable


e.g. glucosamine combined with chondroitin or
sulfate or other substances).


How it is marketed (what is on the label


what will it do for
those who take it?), what functional foods is this supplement in?

(if any), do they have
any legal right to make health claims? What are its therapeutic uses (indications; what
publications say it is for).


If it were a drug, what would be its therapeutic class?


What is
Semester, The University of Memphis

-
17
-

Course,
Instructor

the MOA, contraindications, adverse effects, herb
al
-
nutrient interactions, herbal
-
drug
interactions (Rx’d, OTC, and illegal).


What is the recommended dosage for adults,
pediatric, and pregnancy (and what pregnancy category).


Cost to treat the condition per
month assuming consumer takes recommended dosa
ge (you may have to go to the
pharmacy to figure this out


do it with several brands


make sure you compare
equivalent doses). Also, include studies that support or do not support
efficacy/effectiveness. Cover the pharmacokinetics (routes, onset, peak).


Find locally
available brands that contain a standardized amount (USP, Consumer Labs certified).


Include at the end a “mini
-
case study” and challenge us to write nutritional diagnosis or
diagnoses based your case study (you should also generate your own
diagnoses


but do
not let audience know until you go over it with them).


* info from Drug Information Center, Memphis, TN from:
www.postgradmed.com/

issues/2003/
08_03/garg_tabl
e1.htm



Other Commonly Prescribed Drugs

The drugs these instructions are referring to follow the instructions. Look up the
drugs in your Pharmacology book and for each drug, answer the following questions
(type).


Please separate by chapter.


E
-
mail a Wor
d copy of completed assignment by the
last day of class.



Please title your file: Other Commonly Prescribed Drugs


“your
name”.

1)

Know the trade and generic names of these drugs and their use (what do they
treat?).



If the generic name is composed of two
words like ". .
X

. . bitratrate”, or
“. .
X
. . hydrochloride”


don’t worry about that second part of it


just the first
word in the generic names [like epogen alfa.


Epogen is enough].


If the trade
name is bolded, you
do not need

to know the generic nam
e.



2)

Briefly describe their mechanism of action.

3)

For the prototype drug, be sure and note any d
-
n, n
-
d factors, and dietary
implications.


Prototype drugs are covered in the tables in each chapter entitled:
PROTOTYPE DRUG and NURSING PROCESS FOCUS.

4)

Answer

any questions in the table below.



Trade and Generics to Know



Chapter


Use


Trade name

14

Anxiety

Xanax,
Librium
, Valium, Ativan.


What is a
benzodiazepine?


What is a barbiturate?

14

Insomnia

Restoril, Halcion
, BuSpar,
Ambien

15

Seizures

Luminal,
Valium, Ativan, Dilantin (what special
considerations with phenytoin on EN patients?)

16

Depression

Know the 4 classes on anti
-
depressants (TCA’s, MAOI’s,
etc). Read the section on MAOI’s (p. 179
J
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Semester, The University of Memphis

-
18
-

Course,
Instructor

foods containing tyramine.


Know foods with tyrosine.
What is serotonin syndrome?

16

Bi
-
Polar

Lithium
.


What mineral has an interaction with lithium?


What are recommendations for use of this mineral in the
diet?

16

ADHD

Ritalin


17

antipsychoti
c

Thorazine, Haldol, Risperdal. What are extrapyramidal side
effects? And what are some symptoms? Define neuroleptics.

18

Parkinsonism

(define)

L
-
Dopa,
Cogentin

What are nutrients of concern for those on levodopa?

18

Alzheimers

Aricept

19

Pain

What is n
ociceptor pain? Neuropathic pain? What are
Opioids? Vicodin, Percocet, Percodan, Darvocet, Any anti
-
inflammatory with a codeine No.2.


Also codeine,
OxyContin,
Darvon, Dilaudid
, Demerol,
Stadol, Nubain,
Talwin
.


What is an opioid antagonist?



19

31
-
31.4

Pain

What does NSAIDS stand for? Selective COX
-
2 inhibitiors,
ibuprofen, and salicylates are examples of?


Celebrex
,
Advil/Motrin, indomethacin (generic)
Toradol, Relafen
,
Naprosyn, Aleve/Anaprox.


What is acetylsalicylic acid?


What is ASA?


What other co
nditions besides pain is ASA
used for.


What is the most dangerous side effect of ASA?


Why might aspirin be enteric
-
coated or buffered?


What are
signs/symptoms of this side effect?


Which lab test is used
to detect blood in the stool?


What minerals do i
buprofen
and naproxen have a drug
-
nutrient interaction?


What
organs can be damaged from use of NSAIDS?

20

Anaesthesias

Contrast local and general anaesthesia. Be able to
differentiate which drugs are in which category.


Novacain
,
Xylocaine, Diprivan, Pen
tothal, Versed, ketamine.


Note
that some of the benzodiazinepines when given IV are used
as anesthetic agents vs. when given p.o.


What consideration
should you take in mind when an NS patient is receiving
propofol?

28

Hematopoietic
Disorders

Please read

28.1
-
28.3:


Epogen, Aranesp,
Neupogen.
What
is Procrit?










READING




Text and adjunct material: see calendar

Semester, The University of Memphis

-
19
-

Course,
Instructor



ADA Reports.


Position of the American Dietetic Association: Integration of medical
nutrition therapy and pharmacotherapy.

JADA.

2003; 103:
1363
-
1370.



ADA Reports.


Position of the American Dietetic Association: Fortification and
Nutritional Supplements.
JADA.

2005; 105:1300
-
1311.



ADA Reports.


Position of the American Dietetic Association: Agricultural and Food
Biotechnology



ADA Reports.


Pos
ition of the American Dietetic Association: Functional Foods



ADA Reports.


Practice Paper of the American Dietetic Association: Dietary
Supplements. JADA. 2005; 105: 460
-
470.



Beckwith MC, Barton RG, Graves C.


A Guide to Drug Therapy in Patients with
Ente
ral Feeding Tubes: Dosage Form Selection and Administration Methods.


Hospital
Pharmacy.


1997, 32 (1): 57
-
64.




RESOURCES and ARTICLES (FYI only)


Drugs that sound alike; do not use abbreviation list:
http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/

http://www.usp.org/pdf/EN/patientSafety/ismpAbbreviations.pdf


2006 Dialysis of Drugs (the 2007 issue is not out).



http://www.nephrologypharmacy.com/


Information for professionals for new prescribing information on drugs.

http://www.fda.gov/cder/regulatory/physLabel/default.htm


Overview of Dietary Supplements

http://www.cfsan.fd
a.gov/~dms/ds
-
oview.html#regulate


Blumenthal M.
Interactions Between Herbs and Conventional Drugs: Introductory
Considerations
. HerbalGram.


2000;49:52
-
63.


Available at
http://www.herbalgram.com/herbalgram/articleview.asp?a=2262


Table of Herbal
-
Drug In
teractions:

http://www.vitaminherbuniversity.com/summary_chart.asp


Pharmacokinetics tutorial
: http://www.rxkinetics.com/pktutorial/1_1.html


Dead
ly Mix: Herbs, Supplements and Drug Interactions

at

http://www.freece.com/freece/Article.asp?dbArticleID=113


Lead Content of Calcium Supplements.


Go to: http://jama.ama
-
assn.org/cgi/content/full/284/11/1425


Dietary Supplement Verification Programs

Semester, The University of Memphis

-
20
-

Course,
Instructor

http:
//www.uspverified.org

http://www.nsf.com/business/dietary_supplements


Medicare Issues

Go to the Center for Medicare. http://www.cms.hhs.gov/MLNProducts/

http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=1


http://www.uspharmacist.com/index.asp?page=ce/105073/default.htm