This graduate-level course provides MSN students with an in-depth understanding of pharmacologic principles and the clinical application of drug therapy across the lifespan. Building on basic pharmacology knowledge, the course emphasizes pharmacokinetics, pharmacodynamics, pharmacogenomics, and the physiologic basis for drug action and interaction. Students will analyze major drug classifications, therapeutic uses, adverse effects, contraindications, monitoring parameters, and prescribing considerations for common acute and chronic conditions.
Emphasis is placed on evidence-based prescribing, rational polypharmacy management, patient safety, cultural and ethical considerations, and the integration of pharmacology with pathophysiology to support advanced practice roles (Nurse Practitioner, Clinical Nurse Specialist, Nurse Educator). Special attention is given to special populations (pediatrics, geriatrics, pregnancy), health disparities, and emerging trends in pharmacotherapy.
Credit Hours: 3
Prerequisites: MSN5100 Advanced Pathophysiology (or equivalent) and admission to the MSN program.
Required Textbook (example):
Burchum, J. R., & Rosenthal, L. D. (Latest edition). Lehne’s Pharmacology for Nursing Care. Elsevier.
(or equivalent comprehensive advanced pharmacology text such as Woo & Robinson’s Pharmacotherapeutics for Advanced Practice).
Course Learning Outcomes:
Apply pharmacokinetic and pharmacodynamic principles to predict drug behavior and individualize therapy.
Evaluate major drug classes, mechanisms of action, indications, adverse effects, and interactions.
Integrate pharmacologic knowledge with pathophysiology for safe and effective prescribing.
Analyze factors influencing drug response (age, genetics, ethnicity, comorbidities, environment).
Develop patient-centered pharmacologic management plans while addressing safety, adherence, and cost-effectiveness.
Critically appraise current evidence and guidelines for pharmacologic management of disease.
Course Structure
15-week format. Students engage with weekly recorded lectures, textbook readings, supplemental articles/guidelines, and clinical case applications.
Weekly Breakdown:
Week 1: Introduction to Advanced Pharmacology & Core Principles
Notes: Course overview, safe prescribing practices, federal regulations (DEA, FDA), controlled substances, and medication errors. Review of pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics (receptors, dose-response, agonists/antagonists).
Discussion Questions:
How do alterations in pharmacokinetics in older adults affect prescribing decisions?
Discuss the clinical significance of the therapeutic index and narrow therapeutic range drugs.
Assignments: Introductory post and baseline pharmacology quiz; read Chapters 1–4 (or equivalent).
Week 2: Pharmacogenomics, Drug Interactions & Adverse Drug Reactions
Notes: Genetic variations affecting drug response (e.g., CYP450, TPMT, VKORC1), drug-drug, drug-food, and drug-herb interactions, idiosyncratic reactions, and black box warnings.
Discussion Questions:
How should pharmacogenomic testing influence prescribing of warfarin or clopidogrel?
Analyze a complex drug interaction case.
Assignments: Pharmacogenomics reflection paper or case analysis.
Week 3: Autonomic Nervous System Pharmacology
Notes: Cholinergic and adrenergic receptors, parasympathomimetics/sympathomimetics, blockers, and clinical applications (e.g., myasthenia gravis, glaucoma, shock).
Discussion Questions:
Compare and contrast the effects of alpha vs. beta adrenergic agonists.
Discuss the use of autonomic drugs in emergency situations.
Assignments: Autonomic drug classification worksheet.
Week 4: Cardiovascular Pharmacology I (Hypertension & Heart Failure)
Notes: Diuretics, ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, aldosterone antagonists, and newer agents (SGLT2 inhibitors, ARNI).
Discussion Questions:
Develop a stepwise pharmacologic plan for resistant hypertension.
How do RAAS inhibitors provide organ protection beyond blood pressure control?
Assignments: Hypertension case study with rationale for drug selection.
Week 5: Cardiovascular Pharmacology II (Dyslipidemia, Angina, Arrhythmias, Anticoagulation)
Notes: Statins, fibrates, PCSK9 inhibitors, antianginals, antiarrhythmics, anticoagulants, antiplatelets.
Discussion Questions:
Discuss statin-associated muscle symptoms and management.
Compare direct oral anticoagulants (DOACs) vs. warfarin.
Assignments: Cardiovascular drug quiz and anticoagulation monitoring plan.
Week 6: Respiratory & Allergy Pharmacology
Notes: Bronchodilators, inhaled corticosteroids, leukotriene modifiers, monoclonal antibodies, antihistamines, decongestants, and drugs for allergic rhinitis/asthma/COPD.
Discussion Questions:
Differentiate short-acting vs. long-acting beta-agonists in asthma management.
When are biologic agents appropriate in respiratory disease?
Assignments: Asthma/COPD stepwise management case.
Week 7: Endocrine & Diabetes Pharmacology
Notes: Insulin and non-insulin antidiabetic agents, thyroid hormones, antithyroid drugs, corticosteroids, osteoporosis treatments.
Discussion Questions:
Compare mechanisms and side effects of GLP-1 receptor agonists vs. SGLT2 inhibitors.
Discuss pharmacologic management of thyroid storm.
Assignments: Diabetes pharmacotherapy plan (midterm coverage Weeks 1–7).
Week 8: Infectious Disease Pharmacology I (Antibacterials)
Notes: Cell wall inhibitors (penicillins, cephalosporins), protein synthesis inhibitors, fluoroquinolones, macrolides, and principles of antimicrobial stewardship.
Discussion Questions:
How does bacterial resistance develop and how can it be minimized?
Select empiric therapy for common infections with rationale.
Assignments: Antibiotic selection case studies.
Week 9: Infectious Disease Pharmacology II (Antifungals, Antivirals, Antituberculars)
Notes: Antifungals, antiretrovirals (HIV), hepatitis agents, antivirals for influenza/HSV, and TB regimens.
Discussion Questions:
Discuss HAART principles and adherence challenges.
Analyze drug-resistant TB management.
Assignments: Infectious disease management plan.
Week 10: Central Nervous System Pharmacology I (Pain, Anesthesia, Migraine)
Notes: Opioids, NSAIDs, acetaminophen, adjuvant analgesics, migraine therapies, local/general anesthetics.
Discussion Questions:
Weigh risks vs. benefits of long-term opioid therapy in chronic pain.
Discuss multimodal pain management strategies.
Assignments: Pain management case with controlled substance considerations.
Week 11: Central Nervous System Pharmacology II (Psychopharmacology & Neurodegenerative)
Notes: Antidepressants, antipsychotics, anxiolytics, mood stabilizers, ADHD agents, drugs for Alzheimer’s and Parkinson’s.
Discussion Questions:
Compare SSRI vs. SNRI mechanisms and clinical uses.
Discuss black box warnings in pediatric and geriatric psychopharmacology.
Assignments: Psychopharmacology case study.
Week 12: Gastrointestinal, Renal & Genitourinary Pharmacology
Notes: Antiemetics, PPIs, laxatives, drugs for IBD, diuretics (review), BPH agents, erectile dysfunction drugs.
Discussion Questions:
Explain the role of PPIs in GERD and associated long-term risks.
Discuss pharmacologic management of acute kidney injury.
Assignments: GI/Renal drug therapy worksheet.
Week 13: Reproductive & Gender-Specific Pharmacology
Notes: Hormonal contraceptives, hormone replacement therapy, drugs for infertility, PCOS, endometriosis, erectile dysfunction, and prostate cancer therapies.
Discussion Questions:
Compare risks and benefits of combined oral contraceptives vs. progestin-only options.
Discuss pharmacotherapy in transgender care.
Assignments: Reproductive health prescribing scenario.
Week 14: Oncology & Immunopharmacology
Notes: Principles of chemotherapy, targeted therapies, immunotherapies, monoclonal antibodies, and supportive care (antiemetics, growth factors).
Discussion Questions:
Explain the mechanisms and unique toxicities of immune checkpoint inhibitors.
Discuss the role of pharmacogenomics in oncology.
Assignments: Oncology supportive care plan.
Week 15: Special Populations, Toxicology & Emerging Topics
Notes: Pediatric and geriatric prescribing, pregnancy/lactation considerations (FDA categories, LactMed), drug toxicity/overdose management, and future directions (biologics, gene therapy, precision medicine).
Discussion Questions:
Analyze prescribing challenges in a pregnant patient with chronic illness.
How will precision medicine change advanced pharmacology practice?
Assignments: Comprehensive final exam or capstone prescribing portfolio; course reflection paper.
Additional Course Elements
Assessments: Weekly discussions (20–25%), quizzes/case studies (30–35%), exams (25–30%), final project/portfolio (10–15%).
Teaching Methods: Recorded lectures, case-based learning, guideline analysis (e.g., JNC8, ADA, GOLD, IDSA), and virtual prescribing simulations where available.
Policies: Adherence to state prescribing regulations, academic integrity, and university late-work/accommodation policies.