Unit PHARMACOLOGY, ANESTHESIOLOGY AND GENERAL SURGERY. FIRST AID

Course
Midwifery
Study-unit Code
A001456
Curriculum
In all curricula
CFU
7
Course Regulation
Coorte 2020
Offered
2022/23
Type of study-unit
Obbligatorio (Required)
Type of learning activities
Attività formativa integrata

ANESTHESIOLOGY

Code 50002101
CFU 1
Teacher Edoardo De Robertis
Teachers
  • Edoardo De Robertis
Hours
  • 15 ore - Edoardo De Robertis
Learning activities Base
Area Primo soccorso
Academic discipline MED/41
Type of study-unit Obbligatorio (Required)
Language of instruction italian
Contents -
Reference texts -
Educational objectives - To frame anesthesia as "perioperative medicine" aimed at protecting the patient from surgical trauma.
- Run BLS-D.
- Know the strategies to stabilize vital functions and prevent post-anoxic brain damage
- Monitor the patient and manage respiratory support.
- Be able to monitor acute and chronic algic syndromes.
Prerequisites In order to understand the contents of the lessons and the learning objectives, the student must have a solid foundation of physiology, pathophysiology and clinical pharmacology, as well as the ability to integrate information from different disciplinary sectors.
Teaching methods Frontal lessons, exercises on dummy, attendance in the Operating Room, in Intensive Care and in the outpatient clinics of Pain Medicine.
Other information -
Learning verification modality written/oral exam
Extended program Pharmacological basis anesthesia (Clinical pharmacology of intravenous and inhalation anesthetics, opioids, benzodiazepines, NSAIDs, local anesthetics)
Perioperative medicine
Preoperative evaluation and preparation
General and locoregional anesthesia techniques
Anesthesia work station and intraoperative monitoring
Airway management
Management of acute postoperative and first aid pain
Partoanalgesia
Cardiac arrest (BLS-D, ALS)
Respiratory insufficiencies
Oxygen therapy and respiratory support bases
Shock: possible causes and treatment
Obstetric bleeding

GENERAL SURGERY

Code 50111501
CFU 1
Teacher Francesco Barberini
Teachers
  • Francesco Barberini
Hours
  • 15 ore - Francesco Barberini
Learning activities Base
Area Primo soccorso
Academic discipline MED/18
Type of study-unit Obbligatorio (Required)
Language of instruction Italian
Reference texts R. Dionigi: Chirurgia. Basi teoriche e chirurgia generale-Chirurgia specialistica: 1-2 (ed. 2017)
Educational objectives The student will be able to: know the most important nosologie surgery concerning obstetrics. to distinguish the signs and symptoms of different diseases, understand the degree of severity of various diseases.
Prerequisites Anatomical, physiopathological and technological bases
Teaching methods face to face
Learning verification modality oral exam
Extended program Acute appendicitis (historical notes pathophysiology, classification, clinical symptoms and signs, laboratory and instrumental examinations, medical and surgical therapy)

Pathology of the biliary tract: cholelithiasis, acute cholecystitis, obstructive jaundice (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

Acute abdomen: peritonitis, traumatic hemoteritoneum, visceral perforations, intestinal occlusion (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

Surgical pathology of colon, rectum and anus: diverticulosis / diverticulitis, neoplasms, hemorrhoidal disease (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

PHARMACOLOGY

Code 50573402
CFU 2
Teacher Emira Maria Ayroldi
Teachers
  • Giorgia Manni (Codocenza)
  • Emira Maria Ayroldi
Hours
  • 6 ore (Codocenza) - Giorgia Manni
  • 24 ore - Emira Maria Ayroldi
Learning activities Base
Area Primo soccorso
Academic discipline BIO/14
Type of study-unit Obbligatorio (Required)
Language of instruction Italian
Contents GENERAL PHARMACOLOGY
1 Pharmacokinetics: Absorption, Distribution, Metabolism, Excretion:
2 Elements of Pharmacodynamics
3 Elements of Toxicology
SPECIAL PHARMACOLOGY
1 Estrogen, SERMs, progestins and drugs affecting uterine motility
2 General principles of antibiotic therapy
3 Nonsteroidal antiinflammatory drugs (NSAIDs)
4 Glucocorticoids
5 Opioid analgesics and their antagonists
6 Local anesthetics
7 Sedative-hypnotics: benzodiazepines
Reference texts Clementi Francesco, Fumagalli Guido Farmacologia generale e molecolare, casa editrice UTET
- Katzung B.G., - Farmacologia generale e clinica - Piccin, Padova
- Cella, Di Giulio, Gorio, Scaglione, Farmacologia Generale e Speciale per lauree sanitarie, Casa Editrice Piccin
- Rang H.P., Dale M.M., Ritter J.M. – Farmacologia - Casa Editrice Ambrosiana, Milano
- Mario Furlanut Farmacologia Principi e applicazioni, Casa Editrice Piccin
Educational objectives After completing the course, students: 1) should know and understand (To know) the most recent acquisitions in the field of pharmacology, with particular attention to the drugs used in pregnancy. Students must have the exact awareness of how the pregnancy is a peculiar period in terms of pharmacological treatment and must be able to recognize both, drugs allowed and prohibited (toxic or teratogenic), in the light of the most recent acquisition in this discipline; 2) must have the ability (know-how) to supervise drug treatment on pregnant women, having authority and relationship skills (knowing how to be) in the pharmacological control of pregnancy. These capabilities are achieved through a full understanding of the pharmacokinetics and pharmacodynamics of the main drugs.
Prerequisites To fully understand the topics enclosed in the programs, the student must have basic knowledge of biology, reproductive physiology, electrophysiology and pathophysiology of inflammation.
Teaching methods The lessons will be divided in three main headings: 1) General pharmacology, which lays the basis for studying the mechanism of action of drugs; 2) Special pharmacology, which analyzes the mechanism of action, clinical use and side effects of the most common drugs; 3) Obstetric pharmacology that studies mechanism of action, clinical use and side effects of drugs most widely used in obstetrics.
Each new lesson will be preceded by a summary of the previous lesson, with the help of students, who are often encouraged to intervene in the course of the lesson, with the aim to achieve maximum understanding and learning of the topic, directly in classroom.
Other information Frequency is required
Learning verification modality The exam is an oral test consisting in a discussion lasting about 20 minutes, which will be aimed not only to test knowledge of the program, but also to judge the student's ability to critically associate the notions, for example, pharmacological effects with the pathophysiology and side effects. The potential to apply the acquired knowledge and presentation skills and reasoning, will compete for the final judgment of the student.
Extended program GENERAL PHARMACOLOGY
1) Pharmacokinetics:
- Absorption: transfer mechanisms of drug across membranes, water-soluble and lipid-soluble drugs, drug ionization, routes of administration. Blood-brain barrier and placental barrier
- Distribution: factors affecting the distribution of drugs, plasma-proteins binding
- Metabolism: phase I and phase II reactions. Enzyme induction and inhibition. Pharmacokinetic
tolerance
- Excretion: renal and biliary excretion. Other routes of drug excretion. Clearance and half-life. Bioavailability and first pass effect.
2) Pharmacodynamics:
- Mechanism of drug action
- Definition of agonist, antagonist, partial agonist
- Dose-response curves: definition of effectiveness and potency
- Structure and function of the four classes of receptor
3) Elements of Toxicology:
-Toxic effects of drugs, teratogenicity, abuse, tolerance, addiction. Basic knowledge of major drug addictions

SPECIAL PHARMACOLOGY
1) Ovarian cycle:
- Estrogen, SERMs (selective estrogen receptor modulators), progestins and anti-progestins
- Menopause and hormone replacement therapy
- Hormonal contraceptives
2) Drugs affecting uterine motility
3) General principles of antibiotic therapy:
- Penicillin
- Cephalosporin
4) Nonsteroidal anti-inflammatory drugs (NSAIDs):
- Arachidonic acid
- Physiological and pathological role of prostaglandins, prostaglandins and inflammation
- Mechanism of action of NSAIDs
- Aspirin and acetaminophen
- NSAIDs and pregnancy
5) Glucocorticoids
- Mechanism of action and hypothalamic-pituitary-adrenal axis
- Physiological and pharmacological effects
- Side effects and clinical uses
- Glucocorticoids and pregnancy
6) Opioid analgesics and their antagonists
- Opioid receptors and endogenous opioid peptides
- Mechanism of action of opioid analgesics
7) Local anesthetics:
Mechanism of action and clinical uses (surface, infiltration, troncular, epidural and spinal anesthesia,)
8) Sedative-hypnotics: benzodiazepines
- GABAergic transmission
- Mechanism of action of benzodiazepines
- Side effects, dependence and withdrawal syndrome
- Benzodiazepines and pregnancy

GENERAL, CLINICAL AND PAEDIATRIC NURSING SCIENCES

Code 50144401
CFU 1
Teacher Bianca Reitano
Teachers
  • Bianca Reitano
Hours
  • 15 ore - Bianca Reitano
Learning activities Caratterizzante
Area Scienze ostetriche
Academic discipline MED/45
Type of study-unit Obbligatorio (Required)
Language of instruction Italian.
Contents First Aid and emergency management with Basic Life Support in life-threatening conditions.
Reference texts Triage infermieristico, GFT Gruppo Formazione Triage, McGraw-Hill, quarta edizione;
Linee Guida European Resuscitation Council per la Rianimazione (2021);
National Early Warning Score (NEWS), Berni G., Francois C., Tonelli L., SNLG Regioni 24, Linee Guida Regione Toscana (2016);
Decreto n. 7691 del 28/05/2018 – Approvazione del documento di indirizzo operativo per l’identificazione precoce e la gestione della sepsi in ostetricia, Regione Lombardia.
Educational objectives The goal is to rapidly identify potentially life-threatening conditions requiring immediate intervention.
Prerequisites None.
Teaching methods Lecture, Simulation.
Other information None.
Learning verification modality Oral examination.
Extended program 1. First Aid and Emergency Care;
2. The chain of survival;
3. NEWS/MEWS and the respective MEOWS;
4. The choice of priorities: the triage process;
5. Assessment and intervention of Basic Life Support in life-threatening conditions based on the sequence ABCDE;
6. Main scenarios of emergency and urgency: Transient loss of consciousness, Stroke, Not traumatic chest pain, Myocardial infarction, Rhythm disturbances, Arterial hypertension, Diabetes, Dyspnea, Allergic reaction and anaphylaxis, Cardiogenic shock, Hypovolemic shock, Septic shock, Trauma and polytrauma, Head trauma, Musculoskeletal trauma, Burns, Wounds, amputations and subamputations;
7. The crash cart.

MIDWIFERY, NURSING AND GYNAECOLOGICAL SCIENCES

Code 50512902
CFU 2
Teacher Rosamaria Garofoli
Teachers
  • Rosamaria Garofoli
Hours
  • 30 ore - Rosamaria Garofoli
Learning activities Caratterizzante
Area Scienze ostetriche
Academic discipline MED/47
Type of study-unit Obbligatorio (Required)
Language of instruction Italian
Contents THE ROLE OF THE MIDWIFE IN THE OPERATING ROOM
the activities of a midwife in the operating room in all gynecological-obstetric
Emergencies and urgencies in ostetrricia and Gynecology
Reference texts Testi di riferimento:
Pescetto.De Cecco.Pecorari : MANUALE DI GINECOLOGIA E OSTETRICIA.
MARTIN : MANUALE ELENCO FERRI CHIRURGICI-
M. Guana, F. Lucchini : ARTE E SCIENZA DELLA MIDWIFERY L’ostetrica oggi – Ed. Cic Internazionali
M.Cattaneo Milko P. Zanini : IL PROCESSO DI STERILIZZAZIONE
Educational objectives The student must acquire ability to learn and apply the principles underlying diagnostic-therapeutic procedures of urgency and emergency.Must acquire knowledge about techniques for analgesia in labor in childbirth and knowing how to understand and interpret theanesthesia folder.
Prerequisites
Teaching methods face-to-face
Practical training
Other information
Learning verification modality Oral Exam
Extended program Preparing the operating room for surgery. Check list. Forms. Acceptance of the patient in the operating room. Surgical path of pt. Correct access mode in the operating room.Surgicalhand washing.Coroner responsibility of midwife.
THE MIDWIFE AND CESAREAN SECTION.:
Preparing professionals room; TC Elective and urgent, the midwife in Dan operating roomemergency, principals and medicines. Various types of sutureCheck list routine medicationsand emergency
PRE-INTRA-OPERATORY. POST: positioning the patient in the surgical bed.VitaliControllosuturaControllo parameter control drainage.Blood loss control.
BLOOD RECOVERY MACHINE MANAGEMENT
Preparing blood recovery Machine Activation devices.Autologous blood infusion in the operating room
MIDWIFE'S ROLE IN REGIONAL ANESTHESIA CARE
Epidural, Spinal
THE BABY WAS BORN BY CAESAREAN SECTION
Encourage the first link bambinoPrime/mother/child care certifications of Midwife and/or
EDUCATIONAL WORKSHOP:
CAESAREAN INSTRUMENTATION-INSTRUMENTATION LAPAROSCOPY FOR ECTOPIC PREGNANCY.LAPAROISTERECTOMIA INSTRUMENTATION WITH BILATERALANNESSECTOMIA. COLPOISTERECTOMIA – PLASTIC INSTRUMENTATION Procedure.maintenance surgical instruments: Decontamination dell'operatore irons Protection manual washing-mechanical testing-packaging-traceability
Steam sterilization under pressure or Plasma Gas Responsibility and preservation ofdocumentiClassificazione of different procedures in the operating room: Sanitizing, disinfection, sterilization.
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