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• Undergraduate study:
• Courses
• Order a prospectus
• How to apply
• Information for applicants
• Why choose Kingston University
• Disability and mental health support
• Accommodation
• Undergraduate fees
• Fees, funding and payments
• Access, participation and inclusion

The Cardio-respiratory System 1

• Module code: PY5040
• Year: 2018/9
• Level: 5
• Credits: 30
• Pre-requisites: None
• Co-requisites: None

Summary

This module aims to introduce the underlying mechanisms of cardiovascular and respiratory disease and their treatment.The lectures, tutorials and practicals will set the scene for the teaching of cardiac and respiratory function and dysfunction including angina, dysrhythmias, heart failure, asthma and stroke. The focus will be on the more common cardiac and respiratory, which future pharmacists will need to treat and will cover pathology, diagnosis, treatment and treatment side-effects. There will also be discussion of treatments with respect to drug development and individual variations to treatment as well as dealing patients presenting with minor ailments in the pharmacy. The development, pharmaceutics and design of delivery systems for pulmonary administration of medicines such as inhalers and nebulisers will also be covered.

Aims

• To introduce the cardiorespiratory and renal systems, the pathology, diagnosis, and treatment their related diseases
• To discuss the major disease states associated with the cardiorespiratory & renal systems with reference to altered cellular function and the impact upon the individual.
• To provide an introduction to the design, effects and mechanism of action of selected drugs and formulations on specific organ systems.
• To highlight the possible side effects of agents taken to treat disorders of the cardiorespiratory and renal systems.

Learning outcomes

On successful completion of the module, students will be able to:

• Describe and explain the physiology of the cardiorespiratory system
• Diagnose different diseases and be able to understand differential diagnosis with respect to the systems studied
• Discuss the management and treatment options available within those systems based on current guidelines
• Discuss and evaluate  the chemistry and the pharmacology underpinning selected treatment options
• Explain the rationale for the formulation of dosage forms used for delivery of drugs using in cardiorespiratory diseases
• Describe and discuss basic knowledge and understanding of the potential side effects of treatments available (toxicology)

Curriculum content

Cardiovascular

1. Physiology and pharmacology of the cardiac action potential, regulation of intracellular calcium, regulation of smooth muscle contraction
2. Physiology and pharmacology of cardiac arrhythmias, heart failure, ischaemic heart disease, hypertension, hyperlipidaemia     
3. Evidence based practice and use of guidelines with respect to cardiorespiratory disease.
4. The aetiology, epidemiology and pathology of the cardiovascular system: heart failure, hypertension, oedema, arrhythmias, angina pectoris, peripheral vascular disease, hyperlipidaemia, myocardial infarction, deep vein thrombosis
5. Health promotion related to the CVS
6. Treatment of angina, organic nitrates, b-adrenoceptor blockers and calcium channel blockers.       
7. Treatment of arrhythmias including sodium channel blockers, β-adrenoceptor blockers, potassium channel blockers, calcium channel blockers and other antiarrhythmic agents 
8. Treatment of congestive heart failure including vasodilators, diuretics and inotropic agents in the treatment with an emphasis on new therapies for heart failure eg., b-adrenoceptor blockers, ACE inhibitors, neutral endopeptidase inhibitors, angiotensin II type I receptor blockers, vasopeptidase inhibitors, endothelin receptor antagonists, aldosterone receptor antagonists).
9. Maintaining electrolyte homeostasis and blood pressure: antihypertensive drugs, diuretics, ACE inhibitors, angiotensin II type I receptor blockers and, b-adrenoceptor blockers.
10. Renal and urogenital pharmacology: Description of agents which cause natriuresis and diuresis. Drugs to be studied include loop diuretics, thiazide diuretics, potassium sparing diuretics, osmotic diuretics and carbonic anhydrase inhibitors. Drugs acting on urogenital smooth muscle which are used in the treatment of benign prostatic hypertrophy ( α1 adrenocepter antagonists and finasteride) and impotency (sifenadil, papaverine) 
11. The pharmacy management of thrombolytics, lipid lowering agents and anti-coagulants and the chemistry of statin biosynthesis.       
12. The pathology of stroke

Pulmonary

13. Respiratory Pharmacology: Drugs which act as bronchodilators - muscarinic receptor antagonists, β-adrenergic agonists and xanthines and their usage in the treatment of chronic obstructive pulmonary diseases such as asthma and bronchitis.      

14. Anti-inflammatory drug action on the respiratory system; corticosteroids, H1 receptor antagonists, mast cell stabilisers such as cromoglicate. Anti-tussive drugs

15. Introduction to the factors affecting drug deposition in the lungs and airways

16. Physiology, pharmacology  and management of  respiratory disease including; asthma, COPD, interstitial lung disease, lung cancer

Teaching and learning strategy

Core concepts are discussed in keynote lectures by the module team.

Lectures will introduce topics in accordance with the aims above.  Workshops will involve discussion of the subjects covered in the lectures and lead students to their own private reading. Small group teaching sessions allow certain key employability skills to be developed (eg. interpersonal skills, oral communication). Other employability skills are inherently tested and developed in practicals (eg. numeracy, written communication, teamwork). Practical sessions will set experiments in the laboratory with a report to be submitted afterwards.

Directed private study includes consolidation of lecture notes with additional reading, and the production of experimental reports. Self-directed learning includes preparation for tests and the end-of-module examination and associated work. Students will be directed to further reading to support their learning. An extensive range of formative question banks on Canvas enables students to test their understanding of theoretical and practical key concepts and encourages revision for summative assessments. The blended learning approach taken in this module facilitates the development of independent learning key skills.

Breakdown of Teaching and Learning Hours

Assessment strategy

Assessment will be through a mixture of coursework and examination.  The examination will test basic understanding, knowledge and application.  Coursework will consist of an essay which will develop critical appraisal skills as well as written communication and report writing skills. A portfolio of four mini quizzes (each worth 5%) associated with workshops and tutorials will be used to both encourage student engagement but also to provide feedback on progress and permit the student to identify how they are developing and any additional learning they require.

Formative assessment will include a practical investigating the use of inhalers and a workshop reflecting case based learning assessed through a group presentation. There is also a formatively assessed cardiac anatomy laboratory session which addresses a number of learning outcomes and underpins much of the theoretical content of the module.

Independent learning skills will be developed through directed reading, to supplement formal teaching

Level 5 MPharm students are required to pass a synoptic OSCE style assessment and a synoptic calculations test before they can progress to Level 6. These are to assure that even at this Level the student is demonstrating the appropriate skills, knowledge, understanding and attributes to become a future pharmacist. Learning in this module feeds forward into these synoptic assessments. In particular the scientific and clinical background to patient management will be developed in practicals, workshops and tutorials where they will be formatively and summatively assessed, feeding forward into the synoptic OSCE assessment.

Mapping of Learning Outcomes to Assessment Strategy (Indicative)

Elements of Assessment

Achieving a pass

It is a requirement that the elements of assessment are passed separately in order to achieve an overall pass for the module.

Bibliography core texts

• Rang, Dale, Ritter and Moore. Pharmacology 5th edition. Churchill Livingstone, ISBN: 0443071454.
• Levick. R. Introduction to cardiovascular physiology. 4th edition. Blackwell. ISBN: 0340809213.
• Pulmonary Physiology, Seventh Edition (Lange Physiology Series) by Michael G. Levitzky (1 Feb 2007)
• An Introduction to Medicinal Chemistry by Graham L. Patrick (22 Jan 2009)
• Drugs in Use: Clinical case studies for pharmacists (4th Ed), Dodds. Pharmaceutical Press (2009). ISBN 0853697914
• Clinical Pharmacy & Therapeutics (4th Ed), Walker and Whittlesea. Churchill Livingstone (2007). ISBN 0443102856
• Pathology and therapeutics for pharmacists: A basis for clinical practice (3^rd Ed), Greene and Harris. Pharmaceutical Press, (2008). ISBN 978 0 85369 6902
• Clinical Medicine (7th ed). Kumar and Clark. Elsevier Health Sciences (2009). ISBN 0702029939
• Oxford Textbook of Clinical Pharmacology and Drug Therapy (3^rd ed). Grahame-Smith and Aronson. OUP Oxford (2002). ISBN 0192632345
• Adverse Drug Reactions (2^nd revised Ed), Lee. Pharmaceutical Press, (2006). ISBN 0853696012
• British National Formulary, Latest Edition, edited by the Joint Formulary Committee. Pharmaceutical Press. ISBN 0853697760
• Clinical Biochemistry (4^th Ed), Gaw, Murphy et al. Churchill Livingstone (2008). ISBN 0443069328
• Saunders' Pocket Essentials of Clinical Medicine (3^rd ed), Ballinger and Patchett. Saunders (W.B.) Co Ltd (2003). ISBN 070202645X

Bibliography recommended reading

• Berne & Levy: Principles of Physiology: With STUDENT CONSULT Online
• Access, 4e by Matthew N. Levy MD, Bruce M. Koeppen MD PhD and Bruce A. Stanton PhD (Paperback -9 Sep 2005)
• Pulmonary Pathophysiology (Lange Physiology Series) by Juzar Ali, Warren G. Summer and Michael G. Levitzky (1 Jan 2005)
• Greenspan (2003) Basic and Clinical Endocrinology, 7th Edition, Appleton and Lange. ISBN: 0071402977
• Nussey SS & Whitehead SA (2001) Endocrinology: an integrated approach, London: Taylor & Francis. Available on PubMed for download.
• Applied Therapeutics: The Clinical Use of Drugs (8th revised Ed) Koda-Kimble, Young. Lippincott Williams and Wilkins, (2004). ISBN 0781748453
• Clinical Pharmacy Survival Guide, Barber and Willson. Churchill Livingstone (1999). ISBN 085369754X
• Stockley's Drug Interactions (8th ed) Stockley. Pharmaceutical Press (2007). ISBN 0853695040
• Meyler's Side Effects of Drugs (15th ed): The International Encyclopaedia of Adverse Reactions and interactions (Meyler's Side Effects of Drugs), Aronson (2006). ISBN 0444509984
• Clinical pharmacokinetics: concepts and applications (3rd ed) Rowland. Williams & Wilkins (1995). ISBN 0683074040
• ABC of monitoring drug therapy, Aronson, et al. BMJ books (1993). ISBN 0727907913
• Clinical pharmacy pocket companion, Wright et al, Pharmaceutical Press (2006). ISBN:9780853696490,
• Concise clinical pharmacology, Greenstein, et al. Pharmaceutical Press (2006). ISBN:9780853695769
• MCQ in Clinical Pharmacy, L. M. Azzopardi. Pharmaceutical Press (2007). ISBN:9780853696667