OSU Medical Center
Tulsa
HIV/AIDS Clinical Rotation
Description of Rotation:
The Internal Medicine Specialty Clinic (IMSS) is a specialty clinic of Oklahoma State University Center for Health Sciences. It is the largest HIV/AIDS clinic in Eastern Oklahoma and serves over 800 patients with HIV. Pharmacy students will be exposed to the various treatment modalities and stages in HIV management from the newly diagnosed patient to the experienced, treatment salvage patient. It allows the student the opportunity to apply advanced skills in the pharmacotherapeutic management of HIV/AIDS patients. The student may be exposed to clinic research or industry-sponsored investigational clinical trials.
Learning Objectives:
Knowledge:
At the conclusion of the HIV/AIDS Clinical rotation, the Pharmacy student will be able to:
- Discuss the etiology, epidemiology, pathophysiology of the human immunodeficiency virus.
- Discuss the antiretroviral mechanism of action, pharmacokinetics, drug class effects, common and unique adverse side effects and drug interactions for:
- Nucleoside/nucleotide reverse transcriptase inhibitors
- Non-nucleoside reverse transcriptase inhibitors
- Protease inhibitors
- Entry/fusion inhibitors
- Understand the various antiretroviral adverse side effects in terms of pathophysiology, and treatment modalities, both common and investigational for:
- GI side effects
- Dermatologic drug reactions
- Lactic acidosis
- Pancreatitis
- Lipoatrophy
- Fat redistribution
- Glucose intolerance
- Hyperlipidemia
- Peripheral neuropathy
- Discuss the various opportunistic infections affecting the HIV patient in terms of the etiology, epidemiology, pathogenesis and treatment for:
- Pneumocystis carinii pneumonia
- Toxoplasmosis
- Candidia
- TB
- Histoplasmosis
- Cryptococcus neoformans
- Cryptosporidium
- HCV and HBV
- Understand the development of antiretroviral regimens for treatment naïve, experienced and salvage patients with the use of patient characteristics, history and laboratory data.
- Discuss the issues surrounding adherence to HAART
- Discuss HIV resistance, its development and ramifications to public health.
- Discuss any other topics encountered during the rotation.
Skills:
At the conclusion of the HIV/AIDS Clinical rotation, the pharmacy student will be able to:
- Effectively communicate relevant information to patients regarding their HAART regimen including:
- Regimen characteristics
- Common ADR and their management
- Importance of adherence and consequences of resistance
- Effectively communicate any issues/ concerns to the multidisciplinary team regarding patient matters.
- Develop and enhance existing organization/prioritization skills.
- Monitor adherence, adverse side effects and laboratory data.
- Develop a therapeutic plan for each patient including therapeutic outcomes,
- Design a regimen utilizing patient characteristics, medication history and laboratory and genotype data for the:
- Treatment naïve patient
- Second or Third regimen patient
- Salvage patient
- Identify potential and actual drug interactions (food, drug, herb, disease) with antiretrovirals.
- Correctly identify drug related side effects and its proper management.
- Use proper resources to provide drug information as requested.
Other Responsibilities:
- Participate in physician clinics and be available for consults.
- Research an assigned topic to be presented in a written format (review article) or as an oral presentation to the multidisciplinary team.
- Participate in the MedWatch reporting system with the FDA when appropriate.
- Participate in clinic research or industry-sponsored clinical trials.
- Conduct chart reviews as necessary.