Teaching code

4S000090

Credits

9

Coordinatore

Claudio Sorio

Moodle Seminars

The teaching is organized as follows:

Learning outcomes

The course introduces the student to the basic concepts of major diseases and the fundamental pathogenetic processes, allowing them to correlate cellular homeostatic mechanisms to alterations of the organ functions and clinical manifestations of disease. Students will understand the basic principles of pharmacology, especially in pharmacokinetic and pharmacodynamic mechanisms, and the benefit and risk profile of the drugs. The course will helps students to develop an approach oriented to prevention, assessment and management of respiratory, urinary and intestinal function alteration and the multidimensional assessment of pain. PHARMACOLOGY: The course aims to provide general knowledge about the functions and the use of drug therapy, in the fields of pharmacodynamics, pharmacokinetics, pharmacoepidemiology and pharmacovigilance. Concepts of pharmacology are essential to the development of the nurse's own skills in management and control of drug therapies, as well in patient education. This course is preparatory to the study of the individual classes of drugs, which starts with anti-inflammatory and antibacterial drugs and will be completed in the clinical pharmacology module. SEMEIOTICS AND PHYSIOPATHOLOGY: The course introduces the student to the fundamental concepts of pathophysiology and semiotics, implicated in the activation of organ damage and in the development of the main diseases. The information necessary for understanding the set of events leading to the disease will be selected using a practical approach. Any further details will be reserved for the lessons that specifically deal with the organ and the apparatus. Every fundamental alteration will be explored within a specific organ and the different peculiar manifestations of the organ itself will be clarified. The lessons will also include the semeiotic part, describing the objective signs that characterize diseases. The treatment of semeiotics will be performed after treating the pathophysiology of the various organs. At the end of the course, students must be able to know the general mechanisms that lead to the disease and to identify their characteristics. CLINICAL NURSING I and II: The course offers the contents and the assistance methodology related to person's needs and to "fundamental" nursing care. The course will helps students to develop an approach oriented to prevention, assessment and management of respiratory, urinary and intestinal function alteration and the multidimensional assessment of pain. During teaching, frontal teaching methods will be privileged associated with sessions of application of the contents treated in care situations (guided exercises, video projections, clinical case analysis, testimony readings will be used to analyze and reflect on the perceptions and needs of the patients and family members). GENERAL PATHOLOGY: The course develops the preparatory contents for understanding the basic mechanisms of diseases. The following contents will be covered: the general principles and disorders of homeodynamics of complex systems, the main pathogenic esogenous and endogenous factors, biological damage, responses to damage, with particular reference to inflammation, the processes of healing and chronicity, immunity , haemostasis and thrombosis, vascular pathology and notions of general oncology. The course aims to help the student to understand the essential links between clinical analysis and fundamental mechanisms, facilitating the reading of the conceptual basis of the disease.

Program

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MM: FARMACOLOGIA GENERALE
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GENERAL PRINCIPLES OF PHARMACOLOGY Definition of drug, medicinal product, generic drug, biosimilar, galenic and magistral preparations. Origin of drugs and the process of drug development. The market of drugs in Italy. Leaflet of drugs. Off-label use. International Classification System of drugs. Defined Daily Dose (DDD). Symptomatic, curative, preventive and substitutive drugs. Different actions of drugs: systemic or local, direct or indirect, primary or secondary, collateral, early or late onset. Pharmacokinetics: absorption (mechanisms, routes of administration, formulations), distribution (plasma protein binding, tissue vascularization, blood-brain barrier and placental transfer of drugs), biotransformation reactions and excretion of drugs. Pharmacokinetic parameters: bioavailability, volume of distribution, elimination half-life, clearance. Pharmacodynamics: general mechanisms of action, receptor definition, drug-receptor interaction, agonism and antagonism, affinity and intrinsic activity of drugs. ADVERSE DRUG REACTIONS AND TOXICOLOGY Clinical risks related to drug use: therapeutic errors and classification of adverse drug reactions. Pharmacovigilance: spontaneous reporting and the role of nurse. Drug dependence. Embryo-fetal toxicity. PHARMACOTHERAPY The concepts of risk/benefit and cost/benefit applied to drug treatments. “Placebo” and “Compliance” definitions. Dosage, maximum dose, effective dose, posology, therapeutic index. Therapeutic plasma levels of drugs, peak concentrations, therapeutic range, accumulation, toxic concentrations. Therapeutic drug monitoring. Drug interactions. Variability in drug response: therapeutic problems in neonates and children, elderly, patients with renal or hepatic insufficiency. Antimicrobial therapy: selective toxicity, spectrum of action, bacteriostatic and bactericidal activity, microbial resistance. Pharmacological characteristics and adverse effects of the most important groups of antibiotics, antifungals and antivirals. Non-steroidal antiinflammatory drugs and paracetamol.
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MM: SEMEIOTICA E FISIOPATOLOGIA
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MM: INFERMIERISTICA CLINICA
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MM: PATOLOGIA GENERALE
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Introduction to pathology • Cell homeostasis and alterations at the cell and organism levels • The concept of biochemical lesion and subcellular localization • Alteration of cell homeostasis: adaptation, necrosis, apoptosis, restoration of cell damage • Examples of cell adaptation: alterations of cells status and differentiation Causes of disease and mechanisms of cell damage • General classification of the causes of disease: genetic (example: cystic fibrosis), environmental, multifactorial (example: atherosclerosis), chemical (example: alcohol), radiation, free radicals • Mechanisms of healing Oedema: pathogenesis and classification Introduction to immunology and immunological damage • Innate and acquired immunity: description of leukocytes involved and general mechanisms • General features: antigen presentation, lymphocyte subclasses, complement • MHC ad transplants • Blood groups • Mechanisms of immuological damage: anafilaxis, complement activation, role of antibodies and Fc receptor, cell-dependent cytotoxicity Inflammation • Role of blood vessels in inflammation • Cells involved in inflammation • Classification of inflammatory response based on prevalent features: erithematous, serous, fibrinous, purulent, necrotic-haemorragic • Differences among acute and chronic inflammation • Cytokines and their role in the regulation of the inflammatory response Neoplasia • Differences among benign and malign neoplasms • Properties of neoplastic cells: growth, invasion and differentiation • General classification: epithelial, mesenchimal, neuroectodermal and germinal, hemopoietc cells neoplasms • Natural history of neoplasia: precancerous lesions, carcinoma in situ, metastasis. Preferential localization. TNM score. • Molecular basis of neoplastic transformation: oncogenes and tumor suppressor genes. Mechanisms of activation/inhibition. • Cancer etiology: physical, chemical and biological • Mechanism of damage: compression, paraneoplastic syndromes, cachexia • Cancer biomarkers and their clinical relevance

Bibliography

Examination Methods

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MM: FARMACOLOGIA GENERALE
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Learning evaluation of General Pharmacology is made inside the written exam "Pathophysiology applied at Nursing": 15 questions are provided through multiple-choice (2 correct between 5) or semi-structured answers.
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MM: SEMEIOTICA E FISIOPATOLOGIA
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Quiz: multiple choices. Oral exam at request or if deemed appropriate by the commission .
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MM: INFERMIERISTICA CLINICA
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Oral exam after positive evaluation of a written test
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MM: PATOLOGIA GENERALE
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Quiz: multiple choices. Oral exam at request or if deemed appropriate by the commission .