Prescribing Controlled Substances has increased dramatically over the past two decades. Along with it, there has been an increase in patient mortality and medical malpractice claims. Prescribing controlled substances presents a conundrum for physicians and practitioners: adequately treating patients for pain and other problems while avoiding the hazards to practitioner and patient alike from inappropriate prescribing. This Internet presentation presents the risks and the means to reduce risk...

For Pharmacists -- At the completion of this activity, the participant will be able to: To review the evidence for adjunctive use of Rifampin in select Methicillin-resistant Staphyloccus aureus (MRSA) infections; To compare the use of a loading dose of Vancomycin to achieve adequate exposures in select patient populations; Discuss and contrast Colistin dosing recommendations from standard references and recent clinical studies; Compare and contrast the use of Fidaxomicin in the treatmen...

In part 1 of a 3 part series, Dr. Jeffrey Gudin discusses controlled substance prescribing and proper patient selection in opioid therapy. Opioids can be a successful treatment option for chronic, nonmalignant pain, but may not be well tolerated by some patients. Treatment failures occur for various reasons, including opioid-related adverse events, analgesic tolerance, hyperalgesia, comorbid mental disorders, opioid misuse to seek reward, and addiction. Assessing a patient’s suitability ...

Objectives 1. Review the definition of acute kidney injury and the RIFLE classification. 2. Determine the indications for renal replacement therapy (RRT) in the ICU. 3. Understand the basic differences between hemodialysis and hemofiltration. 4. Review the current knowledge concerning RRT modalities, dose, timing, and anticoagulation strategies. 5. Describe the impact of RRT on prescribing practices in the ICU. 6. List the complications of RRT.

Dr. Fishman leads a discussion with Dr. Sitzman who discusses the key clinical challenges which clinicians face when managing chronic pain with long-term opioids.

A renowned ophthalmic surgeon highlights the rationale for the appropriate off-label use of ophthalmic medications and explores the adverse impact of government ‘off-label’ policies as it relates to the traditional practice of dispensing professional drug samples.

1. Differentiate the multiple definitions of polypharmacy in order to be able to recognize it in your patient population. 2. Discuss the current data available in evaluating polypharmacy specifically in older adults with cancer and incorporate the data in your evaluation of older patients. 3. Summarize the agents or drug classes that may be deemed inappropriate in older adults to avoid prescribing medications for older patients that may lead to adverse drug events.

After completing this couse participants should be able to: 1. Identify causes of medication errors. 2. Describe safety systems that may help prevent common medication errors. 3. Recognize strategies to correct error-prone aspects of prescribing. 4. Provide examples of drug packaging problems. 5. Explain ways patients can help protect themselves from medication errors.

At the completion of this activity, the participant will be able to: - Identify contributing factors to urinary symptoms, including polypharmacy and co-morbidities. - Detect the safety risk presented by falls as a result of urinary incontinence and nocturia. - Diagnose urinary symptoms in older patients and communicate effectively regarding choice of therapy. - Address urinary issues by identifying the patient’s therapy preferences, discontinuing or modifying medications that cause bladd...

Although physicians are responsible for directing and prescribing care for patients with acute coronary syndrome (ACS), nurses play a vital role in promoting adherence to practice guidelines. This course begins with an overview of the scope of the problem and its economic impact on health care in the United States. An overview of the pathophysiology of ACS and its underlying disease process, coronary artery disease (CAD), will be presented to provide background for understanding specific pract...

Patients, and in some cases healthcare providers as well, are not fully aware of the health risks incurred by ingestion of herbal medications, either due to their potential adverse effects or pharmacological interactions with other medications. This situation is further compounded by the fact that at least 60% of the patients taking herbal medications do not disclose this fact to their healthcare provider. This course provides the knowledge and tools required for clinicians to discuss natural ...

After completing this program participants will be able to: - Utilize the 5 steps of smoking cessation intervention (the 5 A's) and determine each patient's stage in the tobacco cessation cycle to develop individualized tobacco interventions. - Evaluate personal characteristics or needs of individual patients who smoke (e.g., concerns about weight gain, amount smoked, history of failed attempts at quitting smoking, etc.) and use the information to guide interventions. - Implement the curr...

The following topics will be presented: Natural History of Alcoholism Alcohol Neurobiology Cannabis Pharmacology Adolescents Pregnancy Motivational Interviewing / Stages of Change Benzodiazepines Opioids: receptors and physiology Medical Co-Morbidities Pain and Safe Prescribing Opioids: Maintenance therapy with methadone and buprenorphine Nicotine 12-Step Programs Evidence-based Addiction Treatment Drug Testing Stimulants Co-morbid Addiction and Psychiatric Disorders Eth...

This activity is designed for nurses and nurse practitioners who have an interest in enhancing their clinical skills in treating cancer patients who may be at risk for breakthrough pain (BTP). BTP is very common in cancer patients, with a prevalence of 70%-90%. A number of barriers hinder diagnosis and management, including lack of knowledge about pain and appropriate treatment. In this program, the pathophysiology and characteristics of BTP will be reviewed as well as ways to assess and ident...

At the conclusion of Infectious Disease Cases, attendees should understand: 1. Understand the similarities and differences between Lyme disease and an emerging and dangerous tick borne illness. 2. Identify, assess and treat patients with harsh and unremitting cough. 3. Identify the important causes of food-borne illness and the emergence of a toxic bacteria in Europe, with important implications for patients in the U.S. 4. Assess patients with acute flu like symptoms and understand the use...

This course provides the non-psychiatric physician with an up to date approach to the assessment and treatment of major depression in the primary care office setting. The program defines the key features and sub-classificant of depressive disorders and relates the subclassification to concrete treatment planning and medication prescribing issues. A longitudinal perspective on longterm management issues and relapse prevention is provided. Critical issues in the assessment of suicide risk are de...

Opioids can be a successful treatment option for chronic, nonmalignant pain, but may not be well tolerated by some patients. Treatment failures occur for various reasons, including opioid-related adverse events, analgesic tolerance, hyperalgesia, comorbid mental disorders, opioid misuse to seek reward, and addiction. Assessing a patient’s suitability for opioid therapy can increase chances for successful outcomes and alert clinicians to the need to modify a therapeutic course if opioid thera...

This program is part of is part of the 2011 Fall Conference: Clinical Masterclass Bundle, please click “Access Activity” to view the entire program listing. At the conclusion of Infectious Disease Cases, attendees should understand: 1. Understand the similarities and differences between Lyme disease and an emerging and dangerous tick borne illness. 2. Identify, assess and treat patients with harsh and unremitting cough. 3. Identify the important causes of food-borne illness and the e...

Clinical411 is a dynamic, online educational platform that provides easy and immediate access to evidence-based answers from experts to current clinical questions you may be facing in your practice. Upon review of this Clinical411 answer, you should be able to select an appropriate epinephrine autoinjector (or vial/syringe) dose for children. Unlike lengthy traditional programs, Clinical411 has been created with your busy schedule in mind, providing expert answers that are practical an...

Advanced practice clinicians now have the ability to apply for prescriptive authority in all states*. With the advent of health reform and the spotlight on primary care, APCs will play a significant role in handling the increased number of patients accessing the health care system. It is essential to be up-to-date on the latest pharmaceuticals available for a variety of acute and chronic conditions, including therapeutic effects, monitoring patient response, and managing side effects. Achievin...

Limitations of clopidogrel therapy for acute coronary syndromes (ACS) have led to the conduct and completion of clinical outcome trials investigating different approaches to reduce ischemic risk. These different approaches include alternative dosing strategies with clopidogrel, as well as more potent oral antiplatelet agents. Clinical trials of these more potent agents versus clopidogrel are resulting in significant changes to the landscape of oral antiplatelet therapy. With the completion of ...

Marciarose Winston, MSN, CPNP, AE-C is a pediatric nurse practitioner and asthma educator with The Asthma Center at Children's Hospital of Philadelphia. She received her baccalaureate degree in nursing from Boston University in Boston Massachusetts and her Master's degree as a Pediatric Primary Nurse Practitioner. Ms. Winston is a member of the Association of Asthma Educators and has served as a faculty member in the recertification program. Peter P. Pace, MD, is a physician in the Pulmonary M...

Advanced practice clinicians now have the ability to apply for prescriptive authority in all states*. With the advent of health reform and the spotlight on primary care, APCs will play a significant role in handling the increased number of patients accessing the health care system. It is essential to be up-to-date on the latest pharmaceuticals available for a variety of acute and chronic conditions, including therapeutic effects, monitoring patient response, and managing side effects. Achievin...

PROGRAM DESCRIPTION/IDENTIFICATION OF NEED Since publication of the initial Women's Health Initiative findings, use of hormone treatment after menopause for prevention of disease has decreased greatly. Conflicting opinions in the scientific and lay press are confusing to both clinicians and the public. In addition, there has been a rise in purported alternative therapies not supported by reliable evidence. Physicians need guidance in prescribing menopausal hormone therapy and interpreting t...

Overview Advanced practice clinicians now have the ability to apply for prescriptive authority in all states*. With the advent of health reform and the spotlight on primary care, APCs will play a significant role in handling the increased number of patients accessing the health care system. It is essential to be up-to-date on the latest pharmaceuticals available for a variety of acute and chronic conditions, including therapeutic effects, monitoring patient response, and managing side effects...

Target Audience - Medical Directors and Pharmacy Directors from health plans, HMOs, integrated health systems, employers, quality organizations, and other managed care organizations - Managed care-affiliated care team members involved with patient evaluation, education, and follow-up for growth/growth disorders including: physicians, pharmacists, nurses, and case managers Purpose Statement The purpose of this knowledge-based activity is to improve managed care stakeholders' knowledge o...

Target Audience - Medical directors, pharmacy directors, clinical pharmacists, quality directors, as well as network physicians affiliated with various managed care organizations. - Other managed care health professionals including case managers, policy administrators, utilization managers, IT professionals, etc. Purpose Statement The Food and Drug Administration Amendments Act of 2007 (FDAAA) authorizes the Food and Drug Administration (FDA) to require pharmaceutical manufacturers...

Sponsored by: ACTIVITY TITLE: SURGICAL DECISION MAKING (COMPLETION OF ACTIVITY SATISFIES ONE YEAR OF ABS MAINTENANCE OF CERTIFICATION PART II WITH SELF-ASSESSMENT) ACTIVITY RELEASE DATE: APRIL 7, 2011 ACTIVITY EXPIRATION DATE: APRIL 7, 2013 ACTIVITY LAST REVIEW DATE: APRIL 7, 2011 AMOUNT OF CME CREDIT: Up to a maximum of 5 AMA PRA Category 1 Credits™ Fee: Free Format: Web-based survey PROGRAM OVERVIEW This activity has been designed for practicing ge...

Target Audience This activity has been designed to meet the educational needs of primary care physicians responsible for routine care and follow up of celiac patients. Statement of Need/Program Overview Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. Roughly one out of every 133 Americans has celiac disease, but 95% remain undiagnosed. This means that almost three million Americans have ...

Target Audience This activity has been designed to meet the educational needs of primary care physicians responsible for routine care and follow up of celiac patients. Statement of Need/Program Overview Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. Roughly one out of every 133 Americans has celiac disease, but 95% remain undiagnosed. This means that almost three million Americans have ...