4 ECTS credits
115 h study time
Offer 1 with catalog number 6017047FNR for all students in the 1st semester at a (F) Master - specialised level.
1. Interpretation of laboratory parameters
Theory + casuistry: 4 hours
Haematology, infection parameters, kidney function, liver function, coagulation
Related to drugs
Ideally by doctors and clinical pharmacists
Including calculating kidney function (MDRD vs C&G) and dose adjustments
2. Applied pharmacokinetics/therapeutic drug monitoring
Theory + exercises + casuistry: 4 hours
Which PK parameters are used by clinical pharmacists in practice?
Including PK/PD of antibiotics and anti-mycotics
Including EUCAST breakpoints – role of PK/PD
Knowledge of TDM in clinical practice
3. Peri-operative drug policy
Theory + casuistry: 4 hours
Overview of classic drug list, knowledge of dangers of quitting/continuing (based on a number of articles from the Pharmaceutical Journal)
Including anticoagulation (bridging of oral coumarins, new thrombine-inhibitors)
Including oral antidiabetics, insulin specimen
4.Drug interactions
Theory + casuistry: 2 hours
Pharmacodynamics
Pharmacokinetics (ADME/ CYP, UGT, PGP and transporters)to Clinical Pharmacy (B-KUL-K05E6a)
5. Informing about home medication
Theory and practice: 2 hours
Standard informing about home medication, including roleplay
6. Safely administering drugs
Theory: 2 hours
Stability
Sterility
Incompatibilities
Flattening – interactions drip-feeding
Influence light/pH
Administering systems
7. Casuistry
Seminars in small groups: 4 hours
Guidelines by way in preparation in advance
Free choice of subjects (about 2-3)
Pain policy (WHO ladder)
Poly-pharmacy (various score systems)
Coagulation (ACCP guidelines)
Pediatrics (article NEJM)
Anti-biotherapy (IDSA)
Nourishment policy (Aspen)
8. Source material and ‘value’ in relation to practice
Theory: 2 hours
Various books, magazines and electronic databases are discussed
9. Evidence-based medicine
Theory: 4 hours
10. Documentation of interventions
Theory: 2 hours
Methods to register interventions and keep track of specific information
11. Clinical pharmaceutical evaluation of patients
Casuistry: 4 hours
Closing part of the entire course applying all elements of clinical pharmacy concerning individual patients.
Application of standard method for clinical pharmaceutical evaluation of individual patients
Case studies
Exercises
Extra during the internships
During year 1 & 2
- 2 x attending meeting on antibiotics policy
- 2x attending meeting of the Medical Pharmaceutical Committee (MFC)
- preparing 1 subcommittee of the MFC
- writing 1 abstract and poster
To provide the student with a sufficient basic knowledge of the principles and different aspects of clinical pharmacy to allow him to practise clinical pharmacy in the
different clinical departments during his 3-year practical formation in hospital pharmacy.
The final grade is composed based on the following categories:
Written Exam determines 100% of the final mark.
Within the Written Exam category, the following assignments need to be completed:
Type : Exam during the examination period
Description of evaluation : Written (partially closed book and partially open book)
Type of questions : Open questions
This offer is part of the following study plans:
Master of Hospital Pharmacy: Standaard traject (only offered in Dutch)