PHAR 2204 Pharmaceutical Care Laboratory - Texas Tech ...

Pharmaceutical Care Laboratory
PHAR 2203 Course Syllabus
Team Leader:
Jill Frost, Pharm.D. jill.frost@ttuhsc.edu SOP Office #324
806-356-4000 Ext.240 Emergency: 806-420-0990
Abilene Campus Leader:
Stephen Wise, Pharm.D. stephen.wise@ttuhsc.edu SOP Office #2602
325-676-7948 Ext. 265 Emergency: 325-725-0109
Abilene Team:
Saagar Akundi, Pharm.D. Saagar.akundi@ttuhsc.edu SOP Office #2600F
Nicole (Franklin) Brock, Pharm.D.
Nicole.franklin@ttuhsc.edu SOP Office # 2613
Sherry Laguardia, Pharm.D. sherry.laguardia@ttuhsc.edu SOP Office #2604
325-676-7948 Ext. 266
Amarillo Team:
Joel Epps, MBA joel.epps@ttuhsc.edu SOP Office #319
806-356-4000 Ext. 226
Les Covington les.covington@ttuhsc.edu SOP Office #203
Butch Habeger, R.Ph., MBA,
FASHP
Shanna James, Pharm.D.
butch.habeger@ttuhsc.edu SOP Office #B31
806-356-4000 Ext. 249
shanna.james@ttushc.edu SOP Office #321
806-356-4000 Ext.304
Anna Karamyan, Ph.D. anna.karamyan@ttuhsc.edu
806-356-4015 Ext.265
SOP Office #444
Kenna Payne, Pharm.D., BCPS kenna.payne@ttuhsc.edu SOP Office #323
806-356-4000 Ext. 246
Kayley Will, Pharm.D. kayley.will@ttuhsc.edu SOP Office #203
Aaron York, Pharm.D. Aaron.york@ttuhsc.edu SOP Office #203
OFFICE HOURS: By Appointment
Prerequisites or Concurrent Enrollment
PHAR 2202 - PHARMACEUTICAL CARE II
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Course Catalog Description
Laboratory exercises focused in community and ambulatory pharmacy practice, including: pharmacy based technology;
counseling and communication; drug knowledge and prospective drug use reviews; prescription dispensing; interviewing
and documentation. One hour lecture and one 3-hour laboratory each week. Levels: Pharmacy-Doctoral Schedule Types:
Lecture, No Credit Laboratory, All Sections for this Course Pharmacy Department
Course Mission
Through a series of lectures and laboratory exercises, PHAR 2203 will provide the doctoral candidates with
basic skills required to effectively communicate with patients and healthcare practitioners both verbally and in
writing. Basic drug knowledge gained throughout this course is the foundation for candidates to accurately
dispense medications, review medication profiles, and counsel patients according to federal and state laws. This
course will also emphasize critical thinking to solve, document, and communicate common problems
encountered in a community pharmacy or ambulatory care setting.
Course Delivery
Facilities
Campus Activity Schedule Location
Amarillo Lecture Monday 11A-11:50A AMA PAC 1120
Abilene ABI SOP 2300
Amarillo Lab M-Th 2:30P-5:10P; Fri 1:30P-5:10P AMA SOP 209
Abilene M, W 2:30 – 5:10 PM ABI SOP 1120
Textbook/Course Materials
Required (purchase one of the two following options):
1. Sigler’s Prescription Drug Cards 27 th Edition
2. Sigler’s Prescription Drug Cards Update cards (for earlier editions 27 th )
3. Sigler’s Prescription Drug Cards iPhone App
Required Course Materials and Technology:
Mobile Phone
Laptop with RX30 software
Required (free): TTUHSC Libraries Website Access
Micromedex® Healthcare Online Series
Lexi-comp Online® Database
Recommended (free):
Micromedex iPhone App
Teaching Methods
Course sessions are designed to illustrate the course objectives. Laboratory sessions will utilize 77% and
didactic lectures account for 23% of time. Students are expected to come prepared for lab and complete the
necessary worksheet/rubrics prior to lecture or laboratory sessions.
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Pre-Laboratory Didactic Lecture will include lecture, slides, videos, demonstrations and discussions of
material and activities directly related to laboratory activity content.
Laboratory Teaching Methods will include, and are not limited to, hands-on activities with various
medications and drug delivery devices, student presentations, deliberate practice of counseling skills, writing
SOAP notes with direct feedback from faculty and peers, required readings, videotaped communication skills,
interviewing mock patients, performing simulated written and verbal pharmacist interventions with confederate
practitioners, practice of various documentation methods including annotations on prescriptions, drug therapy
problem identification (manually and electronically), basic drug therapy monitoring, basic pharmaceutical
calculations, database management, use of various drug information sources, and medication administration
techniques.
“TOP 200” Drug Knowledge (Sigler’s Prescription Drug Cards or iPhone App) will primarily focus on
drug knowledge of brand/generic, indication, and basic mechanism of action. Cumulative closed book quizzes
will accumulate approximately ~20 additional drugs each week. These cumulative quizzes, self-study with the
cards/app and laboratory activities will help prepare the student for the final closed book cumulative
examination on this basic drug knowledge.
RX30 & Mirixa Databases may be used to create patient medication profiles (PMR), perform drug utilization
reviews (DUR), fill prescriptions, and practicing medication therapy management (MTM). Candidates are
required to use a PC (Windows) computer in the laboratory; computers with operating systems other than
Windows (e.g., Macintosh, Linux, etc.) are not permitted as they do not support RX30 software.
Simulation & Standardized Patients will be utilized within this course. Simple simulation activities may
occur within the laboratory and may include faculty acting as a confederate practitioner to hone a candidate’s
verbal intervention skills. The Amarillo and Abilene Centers for Simulation and Assessment (CSA) will be
utilized. Students may perform interviews with other professions or standardized patients. These interviews may
serve as the basis for a clinical documentation activity in the form of partial or complete SOAP notes.
Mobile Devices (Phones) and Interprofessional Teams (TeamSTEPPS) Students may interact via phone
with each other or with a student of another professional discipline (e.g. nursing or medicine). TeamSTEPPS
“Check-Back” and “SBAR” may be employed and peer-rated during these communications.
Course Objectives
At the end of the course, the Doctor of Pharmacy Candidate is expected to:
1. Recall, comprehend, interpret, apply, analyze, synthesize, and evaluate drug knowledge specific to
community care and ambulatory care pharmacy practices. (A01, A06, A07, A12, A13, A14, A22, A39,
A45)
2. Demonstrate how to implement best practices when utilizing and interpreting federal and state
regulations while dispensing and counseling patients on prescription medications. (A08, A10, A12, A13,
A14, A15, A16, A18, A21, A22, A23, A39, A40, A41, A42, A43, A44, A45, A46, A47, A51)
3. Obtain and effectively document relevant patient specific information within various community
pharmacy or ambulatory pharmacy practice interview scenarios. (A01, A02, A15, A16, A23, A40, A41,
A44, A46, A47)
4. Effectively formulate a written patient care plan in the SOAP note format based on an ambulatory
pharmacy practice scenario. (A07, A08, A09, A10, A13, A14, A16, A18, A39, A40, A41, A44, A45, A46,
A47)
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5. Posture effective and professional communication with patients, peers, colleagues, caregivers, and
healthcare practitioners within all written, verbal and non-verbal interactions. (A39, A40, A41, A42,
A44, A45, A46, A48, A49, A50, A52)
Drug Classes Covered in this Course
• Top 200 Medication List will cover BRAND NAME, GENERIC NAME, INDICATION & MOA
(mechanism of action – basic).
o Adverse drug reaction, disease contraindications for the drug, clinical laboratory monitoring,
pharmacokinetics and pharmacodynamics, drug-drug/or drug/food interactions, and counseling
points will be integrated into the context of specific lab activities, but not assessed in drug
knowledge quizzes or midterm and final exams.
Antitussives Upper Respiratory
Agents
Cardiovascular
Agents
Antihypertentives
Antianginals
Sigler’s Drug Class Categories
Antiasthmatics Gastointestinal
Agents
Antiarrythmics Anti-Infectives Penicillins
Cephalosporins
Antiulcer Agents GI Anticholinergics
Macrolides
Tetracyclines
Flouroquinolones
Hormone and
Electrolyte Agents
CNS Agents Antidepressants Antipsychotics Antidiabetics Estrogens
Oral Contraceptives
Analgesic Narcotic Analgesics Nonsteroidal Topical Agents Anti-anxiety Agents Miscellaneous Agents
Antiinflamatory
Antiinflammatory
Agents
Agents
• Counseling Drugs covered in this course will focus on medications with alternate routes of administration or
with specific drug delivery systems (e.g. patches ophthalmics, inhalers, suppositories, injectable, etc.) The
following drug list will be assessed for counseling as per the TTUHSC standardized counseling rubric.
Actonel
Weekly Tablet
Advair Diskus
Amoxicillin
Suspension
Lantus Solostar
Course Expectations
Lidoderm
Patches
Nasacort AQ
Pre-Laboratory Preparation
Counseling Drugs
Lovenox
Injectable
Nuvaring
NTG
Sublingual Tablet
Ortho Evra Patch
Pataday
Ophthalmic Gtts
Spiriva
Handihaler
Promethazine
Suppository
Xopenex MDI
Attendance to pre-laboratory lecture is required so the student will be adequately prepared for laboratory session activities
for the week. Rubrics and worksheets may be reviewed where answers and demonstrations may be provided and
discussed in detail. Designated portions of the worksheet and rubrics are required to be completed in order to be admitted
to the laboratory session for the week. Students with incomplete rubrics or worksheets will not be admitted to the
laboratory and will incur a tardy (1% deduction) from the final course grade for each occurrence.
Missed Laboratory Policy
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Attendance to laboratory sessions is required. Candidates are required to attend the laboratory session for which
they have enrolled. Students are required to be on time, professional and engaged in the laboratory activities
and complete coursework in order to receive full credit for the session. Laboratories will not be made up.
Per the TTUHSC-SOP Student Handbook: Code of Professional and Academic Misconduct, a student who
fails to attend any class (for any reason) is responsible for the material presented in class, assignments,
examinations, announcements, etc. to the same extent as though the student had attended the class.
Legitimate reasons for missing a laboratory may include death in the family, family emergency (TTUHSC OP
70.01), catastrophic accident, or acute illness. Documentation will be required, and the candidate must attend an
alternate lab during that week. If the absence occurs on the last day of the laboratory week for that campus the
lab assignment may be completed within the timeframe as defined by the team. Circumstances affecting the
acute attendance of an entire lab session (e.g. school closure, campus closure, etc.) will be dealt with based on
the most current TTUHSC policies and procedures and logistics as identified by the course team.
Unexcused laboratories will result in a 5 point deduction from the final course grade. A missed laboratory
deduction may occur if a candidate is ≥ 30 minutes late to the session for two occasions with no documentation,
refusal to participate in any part of the laboratory session, leaving the classroom prior to dismissal, or being
excused for professional or academic misconduct.
Alternate lab day requests must be submitted to the team leader or campus leader prior to the first day of the
laboratory week; documentation will be required. In general, one lab switch may be permitted per candidate per
semester. In the event that another lab session is full, it is the responsibility of the student seeking the lab
change to identify a student who is willing to switch lab days. Professional leave request should be submitted
according to the TTUHSC-SOP professional leave policy. Work, travel, examinations or other coursework are
not valid excuses for requesting an alternate lab day. The team reserves the right to approve or deny requests.
Appropriate Laboratory Attire
Guidelines for appropriate professional attire are defined for the candidate within the TTUHSC-SOP
Professional Conduct Code .
Candidates are required to don: 1) professional attire; 2) a clean-pressed Texas Tech School of Pharmacy
laboratory coat; and 3) Texas Tech nametag to all laboratory sessions, standardized patient interviews, and
counseling assessments. Scrubs are not appropriate attire for this laboratory. A 2.5 point deduction from the final
course grade will result for each occurrence in the laboratory. A 5 point deduction from the final course grade will result if
during an SP interview or counseling assessment.
Professional & Ethical Standards in the Laboratory
Candidates are expected to respect the learning environment and exhibit ethical academic and professional
behavior at all times.
Appropriate Use of Technology: The use of the internet, databases (RX30 and Mirixa), personal mobile devices, and
earphones must be consistent with course activities. Texting, calling, streaming audio or video files, surfing the internet,
or abusing the database profiles for non-course related activities during laboratory sessions is prohibited.
Eating and drinking in the laboratory is prohibited. Candidates are not permitted to eat or drink food within the
laboratory.
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Students must follow the guidelines within the TTUHSC-SOP Professional Conduct Code , TTUHSC-SOP
Student Handbook: Code of Professional and Academic Misconduct , TTUHSC-SOP (PHAR 2203)
Instructions for (Written/WebCT) Major Assessments (page 11) or TTUHSC-SOP (PHAR 2203) Instructions
for (Laboratory) Major Assessments (page 12).
Failure to follow these standards may be considered professional and/or academic misconduct, and may result
in dismissal from the classroom, laboratory, or assessment with the corresponding point deduction (5 points)
and up to a zero (0) in the course for academic misconduct. Misconduct will be documented with the Office of
Student Services.
Course Grading
Assessment Methods
Laboratory Counseling Exams: Students will be scheduled for 15 minute blocks for counseling and should
arrive at least 10 minutes prior to scheduled time.
Standardized Patient (SP) Interview: Students will be scheduled for ~15 minute block to interview an SP and
collect information on a provided data sheet. Students should arrive at least 10 minutes prior to scheduled time.
The interview and corresponding SOAP note are individual assignments.
Sigler’s Cumulative Prescription Drug Quizzes: Occur approximately every week with approximately 20 new drugs
added each week.
WebCT Midterm and Final Examination: 120 questions, closed book based on Sigler’s drug list. Midterm will be
cumulative to that point of material covered in the course. Final will be cumulative.
ASSESSMENT SCHEDULE
Exam Other Date
Mon 10/1 2:30 –TBA
Location
Mid-term
Tues 10/2 2:30 –TBA AMA CSA
Laboratory
Counseling Exam
Wed 10/3 2:30 – TBA
Thu 10/4 2:30 – TBA
Fri 10/5 2:30 – TBA
ABI CSA
WebCT Midterm
Exam (Cumulative)
EXAM BLOCK Wed 10/17 @ 8:30-10:00AM
AMA 1120
ABI 2300
SP Interview & Standardized Patient Interview
Mon 11/12 2:30 -TBA AMA CSA
SOAP
***
DATA sheets returned to students ABI CSA
Students Turn In Data Sheets
Wednesday 11/14
Immediately after Interview SOAP DUE Wed 11/21 @ 11:59PM
Mon 12/3 2:30 –TBA
Final Laboratory
Tues 12/4 2:30 –TBA
Counseling Exam
(15 Minutes per 2 students)
Wed 12/5 12:30 – TBA
Thu 12/6 2:30 –TBA
Fri 12/7 2:30 –TBA
AMA CSA
ABI CSA
WebCT Final
Exam (Cumulative)
EXAM BLOCK Thurs 12/13 @ 8:30-10:00AM
AMA 1120
ABI 2300
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GRADING SCHEME
% of Total Grade Item
10% 14 Sigler’s Drug Knowledge Cumulative Quizzes
15% Midterm (Cumulative) WebCT Exam
20%* Counseling Mid-term Practical Lab
20%* Counseling Final Practical Lab
15%* Interview & SOAP Note
20%* Final (Cumulative) WebCT Exam
*Laboratories are worth 5% per session. Laboratory preparation is worth 1% per session.
Course Examination Policies
Excused Absences
*Major Assessments.
Pertaining to TTUHSC OP 77.11, it is the responsibility of the student to exhaust all possible means of contact
as soon as possible if an absence from an examination might occur. Regardless of the method(s) of
communication employed, a student must obtain a response from faculty on the course team before assuming
that their absence is acknowledged and therefore excused. Documentation is required for any absence and all
documentation should be provided as soon as possible after the student’s return. If documentation is not
feasible, the student will sign an affidavit stating the reasoning for his/her absence. If a student makes a claim
for an excused absence that is determined to be untrue, then it becomes an issue of academic misconduct which
may result in a zero (0) for the course. No points can be awarded for an assessment that was not performed. A
grade of 0 for the assessment will be assessed for all unexcused absences.
Late to WebCT (Written) Assessment
It is at the discretion of the course team as to whether a penalty is assigned as a consequence for late arrival to a
WebCT (written) assessment. No time extensions will be provided for an assessment for a student who arrives
late. Candidates arriving after the first student has left the classroom must meet the criteria for excused absence
or will otherwise not be admitted into the assessment and incur a zero (0) for the assessment.
Accommodations for Excused Absences:
An examination can only be made up with the approval of the course team. Make-up examinations may differ
from the original activity. The faculty team will make accommodations within a reasonable timeframe to
provide an alternate or make up assessment for excused absences. No point deduction or penalty will be
assessed for excused absences. Make-up assessments are not required to be the same format as the scheduled
assessment and the make-up format will be at the discretion of the course team. The time of the make-up
assessment will also be at the discretion of the course team.
Late to Laboratory Assessment
Arriving to a laboratory counseling practicum or SP interview after the scheduled time block for the candidate
has ended and will be considered a missed practicum which will result in a zero (0) for the activity.
A candidate will be considered late if arriving after his/her scheduled time block begins and before it ends.
Candidates may be fit-into the laboratory assessment schedule at the discretion of the faculty proctoring the
assessment. For counseling practicums, the full time will be allowed for a late candidate and partner. The
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maximum attainable score for the late candidate will be 70% for all remaining attempts. Candidates arriving late
to a standardized patient (SP) interview will only receive the remaining time in their scheduled block to perform
the interview. Cases may be reviewed using the same guidelines outlined by the missed examination policy
(page 6).
Candidate Inquiries
Emergency contact numbers for Drs. Frost and Wise are provided to students as the preferred method of
communication with the team in the event of an urgent or emergency situation. Please reserve the use of
emergency contact numbers for these circumstances.
For general inquiries, email is the preferred method of communication. The teaching team welcomes questions
from students, and responses are typically given within 2 business days. If there are questions or concepts that
require further explanation, candidates may schedule an appointment with the instructor who taught the
material.
Reasonable Accommodations for Candidate Disability
Candidates seeking reasonable accommodations must follow the TTUHSC-SOP OP 77.P.21.
It is the responsibility of the candidate to meet with either Dr. Frost (Amarillo) or Dr. Wise (Abilene) during the
first week of class (or as soon as possible for later diagnosis) to present and review the candidate’s “Letter of
Accommodation” (LOA) and contract. After obtaining the LOA, the course team faculty will notify the Office
of the Regional Dean, Logan Larue (Amarillo) or Melissa Edwards (Abilene) of the LOA, contract, and testing
schedule by the end of the first week of classes or as soon as possible. Once the Office of the Regional Dean has
the proper documentation, they will begin making reasonable accommodations applicable to the candidate and
course.
No requirement exists that accommodations be made prior to completion of this approved university process.
Second Chance Policy
The Second Chance Policy applies to all courses except case studies and clerkships. A doctor of pharmacy
student, if eligible, may take a single comprehensive examination to demonstrate competency in that course
providing that:
• The student has passed 50% or more of the major assessments in that course
• The student has earned a final grade of 66-69% in the course, and
• The student has not exceeded the number of second chance attempts as outlined below.
A student may invoke the Second Chance Policy in a maximum of two courses per semester, and no more than
four times total in his/her career at the School. No student may invoke the second chance exam for the same
course twice. The second chance assessment shall occur in a timely fashion, the timing at the discretion of the
course team.
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Week Topic Pre-­‐Lab
Top 200 to Cover Counseling
Lecture
Drug Rubrics
1
8/13 Course Introduction
Syllabus, RX30, RX
Entry, PMR, DUR
Frost/James Antiarrythmics/ Antihypertensive
DRUG KNOWLEDGE
RUBRIC for LAB:
Lidoderm Patches
Actonel
2
8/20 Communication
3
8/27 Counseling
4
9/3
5
9/10
6
9/17
7
9/24
8
10/1
9
10/8
10
10/15
Labor Day
Counseling & ISMP
Med Safety
Interviewing
Med History
Documentation
Intro / Midterm
Prep
8 Weeks Exam Block
No Class
Documentation
MTM/Targeted
Notes
Documentation
SOAP
10/17 Written Midterm
@8:30 AM
11 Documentation
10/22 MTM/Targeted
Notes
12
10/29
13
11/5
Documentation
S & O
Documentation
A & P
COURSE LECTURE SCHEDULE WITH DESCRIPTION
Epps/Frost Antianginals/Misc. Cardiovascular
Agents
DRUG KNOWLEDGE
RUBRIC for LAB:
Lovenox Injectable
NTG Sublingual
Lab
Lab Intro; RX30;RX Entry;
PMR;DUR
Dispensing & Law Label
Requirements
Epps/Frost Estrogens/ Contraceptives DRUG KNOWLEDGE
RUBRIC for LAB:
Ortho Evra
Nuvaring
Counseling; Law
No Lecture No Lab
James Antiulcer/Ulcer/GI Anticholinergics
& Antispasmodics/Misc. GI Agents
James Macrolides, Tetracyclines;
Fluoroquinolones; Misc. Anti-­‐
Infectives; Penicillins,
Cephalosporins
DRUG KNOWLEDGE
RUBRIC for LAB:
(Phenergan) Rectal
ID (Suspension
tastes lab?)
DRUG KNOWLEDGE
RUBRIC for LAB:
(Amoxicillin
Suspension)
James Antianxiety/ Antidepressant DRUG KNOWLEDGE
RUBRIC for LAB:
(Pataday)
Ophthalmic
(Nasacort AQ) Nasal
Recorded Counseling;
Dispensing; ISMP Med
Safety; Dispensing & Law
Counseling; Dispensing;
Documentation
Interviewing; Counseling;
Dispensing
Frost Antitussives/Misc. Upper Resp Counseling Midterm
No Lecture Take Home Lab –
Mirixa/Wise
Payne Asthma Respiratory
DRUG KNOWLEDGE
RUBRIC for LAB:
Advair, Xopenex
HFA, Spiriva,
Respiratory:
Inhalers, Nebulizers
Grade a SOAP
Counseling; Dispensing;
Drug Knowledge
Wise Topicals MTM
Laguardia Antipsychotics/ Misc. CNS Write S & O
Counseling; Dispensing;
Drug Knowledge
Payne Misc. Analgesics and Anti-­‐
Inflammatory; Narcotic Analgesics;
NSAIDS
Write A & P
Chart Review Exercise
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Week Topic Pre-­‐Lab
Top 200 to Cover Counseling
Lab
Lecture
Drug Rubrics
14 SOAP Review Payne Misc. Hormones/ Electrolytes SP Counseling
11/12 SP Prep
15 Counseling Review Epps Misc. Agents No Lab
11/19 & Special
Populations
Thanksgiving Week
16
Frost Anti-­‐Diabetic Agents Endocrine Insulin Lab & Drug
11/26
Drug Knowledge
DRUG KNOWLEDGE
RUBRIC for LAB:
Delivery Devices
Insulin & Injection
(Lantus Solostar)
Injectable Insulin
Mixing
17 Drug Knowledge Frost Counseling Lab Practical
12/3 Review Games
12/13 Written Final
Thursday @8:30
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