Generic Substitution and Therapeutic Equivalence of Antiepileptic Drugs: Clinical and Pharmacoeconomic Issues in Epilepsy Management A Priority Report Faculty: John M. Pellock, MD | Andrew J. Pultz, Jr, PharmD, RPh CME / CE credit hour: 1.0 The issue of generic drug substitution is complex and often poorly understood by physicians and pharmacists. Although the FDA requires that two drugs are similar as demonstrated by bioequivalence data, therapeutic equivalence (or therapeutic effectiveness) and bioequivalence are not necessarily the same. In the case of antiepileptic drugs (AEDs), the therapeutic range over which they are effective may be narrow and, although generic substitution of AEDs may be appropriate for some patients with epilepsy, it may represent suboptimal care for others. This program will give an overview of these and other important issues associated with generic substitution of AEDs.
Inflammatory Aspects and Detection of Vulnerable Plaque: Clinical Impact of Assessement Faculty: Peter Libby, MD | John Cooke, MD, PhD | Antonius F. W. van der Steen, PhD CME / CE credit hours: 2.0 Rupture-prone (i.e. "vulnerable") plaques are a primary cause of acute coronary syndromes and myocardial infarction. Though the features of rupture-prone atherosclerotic plaques have been described by pathologists, the identification of high-risk plaque in vivo remains a challenge. While coronary angiography is the gold standard for diagnosis of a plaque, alternative detection methods that rely upon physical, optical, and mechanical parameters may help to direct treatment decisions and improve clinical outcomes.
Management of Febrile Neutropenia and Anemia in Chemotherapy Patients: Clinical Practice Guidelines Update Faculty: Dwight Kloth, PharmD, FCCP, BCOP CME / CE credit hour: 1.0 Despite data showing the positive impact of treating febrile neutropenia and anemia in chemotherapy patients, a majority of patients still do not receive proper treatment. The European Cancer Anemia Survey (ECAS) reported that over 60% of the cancer-associated anemia patients did not receive any treatment for their anemia. Moreover, approximately 60,000 cancer patients are hospitalized annually with febrile neutropenia in the United States. This program will address strategies for treating chemotherapy induced anemia and febrile neutropenia, including identifying patients at risk and available treatment agents. Additionally, a review of the updated practice guidelines from ASCO, NCCN and EORTC and their practical applications will be discussed.
Generic Substitution and Therapeutic Equivalence of Antiepileptic Drugs: Clinical and Pharmacoeconomic Issues in Epilepsy Management Faculty: John M. Pellock, MD | Andrew J. Pultz, Jr, PharmD, RPh | Michael C. Smith, MD CME / CE credit hour: 1.0 The issue of generic drug substitution is complex and often poorly understood by physicians and pharmacists. Although the FDA requires that two drugs are similar as demonstrated by bioequivalence data, therapeutic equivalence (or therapeutic effectiveness) and bioequivalence are not necessarily the same. In the case of antiepileptic drugs (AEDs), the therapeutic range over which they are effective may be narrow and, although generic substitution of AEDs may be appropriate for some patients with epilepsy, it may represent suboptimal care for others. This program will give an overview of these and other important issues associated with generic substitution of AEDs.
Novel Therapies in the Treatment of Rheumatoid Arthritis Faculty: Roy Fleischmann, MD | Kathryn Hobbs, MD | Philip Mease, MD | Alan J. Bridges, MD CME credit hours: 1.5
Recent developments in the treatment of rheumatoid arthritis include the approval of two new biologic agents (abatacept and rituximab), earlier initiation of treatment, and a move toward tight control of therapy with consistent monitoring of disease activity. Data from clinical trials of abatacept and rituximab in patients with rheumatoid arthritis suggest these agents are relatively effective and safe. Our panel of rheumatology experts discusses these issues within the context of recent clinical trial results and the implications for treating patients with rheumatoid arthritis. CME Credit hours: 1.5
Addressing Safety Concerns in the Treatment of Atopic Dermatitis Faculty: Jon Hanifin, MD | Mark Boguniewicz, MD | Adelaide Hebert, MD | Jonathan Spergel, MD, PhD CME / CE credit hour: 1.0
In this CME activity, four distinguished members of the medical community review and discuss current clinical trial data focusing on safety issues surrounding the use of topical corticosteroid and TCIs. Panel members review the potential short- and long-term adverse effects of each drug class and then place this information into context by evaluating the risk-benefit ratio associated with each treatment.
Interpreting Important Clinical Trials in Schizophrenia: Evaluating the Effectiveness of Antipsychotic Faculty: Scott Stroup, MD, MPH | Joseph McEvoy, MD | Leslie Citrome, MD, MPH CME credit hour: 1.0
Schizophrenia is a major mental illness, affecting approximately 2.4 million American adults. It is also among the world’s top ten causes of long-term disability. The availability of antipsychotic drugs to treat schizophrenia has greatly expanded with the addition of several newer agents, and it is therefore important for clinicians to be able to compare these agents with regard to long-term efficacy and safety. This program focuses on several recent clinical trials in hopes of providing doctors with information to help guide the selection of anti-psychotic medications for patients with schizophrenia. This educational activity is designed to help interpret the findings of these trials and assist physicians faced with the common and confusing dilemma of choosing an antipsychotic agent that will produce the most positive outcomes for their patients with schizophrenia.
Benefits and Risks of Antipsychotic Medication: A Focus on Sedation (Accreditation Expired) Faculty: John M. Kane, MD | Christoph U. Correll, MD | Del D. Miller, PharmD, MD CME credit hour: 1.0
In the management of psychotic episodes, the implications of sedation differ depending upon the intervention stage. Sedation that is advantageous in acute intervention may interfere with therapy in later stages. Historically, the sedation associated with older antipsychotic agents was considered a sign of efficacy. Recent studies, however, show that newer antipsychotic agents effectively control both psychosis and acute agitation with minimal sedation. Use of these agents may achieve acute control while allowing the patient to participate in therapeutic and normal daily activities. In this program, our experts will review the role of sedation in the management of psychotic episodes, from acute stabilization through maintenance.
A Global Look at Second Generation Anti-Epileptic Drug Treatment Faculty: Blaise F. D. Bourgeois, MD | Edward P. Sloan, MD, MPH | Barry E. Gidal, PharmD, RPh | Andres M. Kanner, MD CME credit hours: 1.5
Physicians face unique diagnostic and treatment challenges when treating patients with seizures. Primary care physicians may not be familiar with current treatment options and clinical trial evidence supporting newer first-line agents. In the emergency setting, the evaluation and treatment of a patient with seizures depends upon whether the patient has a history of epilepsy or is presenting with his or her first seizure. Emergency health physicians must decide what level of treatment. This program features a distinguished panel of experts sharing clinical experiences and suggesting strategies for treating patients with epilepsy with a focus on primary care and emergency treatment.
Current Perspectives in Epilepsy Treatment: Focus on Monotherapy (Accreditation Expired) Faculty: John M. Pellock, MD | Michael D. Privitera, MD CME credit hour: 1.0
Combination therapy with antiepileptic drugs is associated with a variety of complications, including toxicity and the potential for drug interactions. In addition, many patients who do not respond to sequential monotherapy, will not become seizure-free with polytherapy. Monotherapy has several advantages over polytherapy, including a reduced risk of side effects and complications due to drug interactions, lower cost, and better compliance. hts issues relating to the use of newer antiepileptic drugs as monotherapy in the treatment of adults and children with epilepsy.
Chemotherapy-Induced Neutropenia Prevention: Implications of New Clinical Data and Guidelines Faculty: Jeffrey C. Crawford, MD | David C. Dale, MD | Gary H. Lyman, MD, MPH, FRCP (Edin) | Christopher R. Friese, RN, PhD, AOCN® CME / CE credit hour: 1.0
Chemotherapy-induced neutropenia has very serious and important clinical consequences in terms of medical care, quality of life, and economic factors for cancer treatment. Chemotherapy patients who develop neutropenia are at risk of developing febrile neutropenia, which is a medical emergency that requires immediate medical management. Febrile neutropenia has historically been treated through the use of prophylactic antibiotics, but their usefulness continues to be controversial and the incidence of febrile neutropenia continues to be high. The use of hematopoetic colony stimulating factors (CSFs) has improved the outcomes for patients who experience febrile neutropenia.
Applying Evidence to Practice: Recent Advances in the Management of Chemotherapy-Induced Neutropenia Faculty: Christopher R. Friese, RN, PhD, AOCN® | Joan M. Giblin, MSN, APRN-BC, AOCN® | Rebecca B. Donohue, MSN, RNCS, FNP, AOCN®, APNG | Anne Doyle, RN, MSN CE credit hour: 1.0 Neutropenia is the major dose-limiting toxicity associated with cancer chemotherapy and febrile neutropenia is associated with considerable morbidity, mortality, and cost. Colony Stimulating Factors, or CSFs, are used to reduce the severity and duration of chemotherapy-induced neutropenia and diminish the risk of febrile neutropenia and infection for patients receiving chemotherapy. The risk of neutropenia varies depending on the agent used and dose delivered. Predictive factors of febrile neutropenia have been identified for several types of malignancies. Identification of these risk factors when chemotherapy is planned can support the appropriate use of CSFs to reduce the risk of febrile neutropenia for patients.
The Conundrum of Rash in Management of EGFR Inhibitors(Accreditation Expired) Faculty: Roy S. Herbst, MD, PhD | Mario Lacouture, MD | Roman Perez-Soler, MD | Sandy Kurtin, RN, MS, AOCN®, NP CME / CE credit hour: 1.0 New therapies targeting the epidermal growth factor receptor (EGFR) have been used in the treatment of a variety of cancers. Although generally well tolerated, EGFR inhibitors are associated with the development of dermatologic reactions (e.g., papulopustular rash, xerosis, pruritus, periungual inflammation, and alopecia) in most patients. At present, little is known about the etiology of these reactions, and no evidence-based management guidelines have been set forth in the dermatologic literature.
Esophageal Capsule Endoscopy in Evaluating Esophageal Varices in Cirrhosis: Current Perspectives on Screening(Accreditation Expired) Faculty: Fredric D. Gordon, MD | Hugo E. Vargas, MD CME credit hours: 2.0 Portal hypertension and esophageal varices are two of the main complications of liver cirrhosis. Bleeding from esophageal varices causes death in about 20% of cases. Current international guidelines recommend conventional endoscopic screening (esophagogastroduodenoscopy) for patients with cirrhosis every few years to detect esophageal varices. Recent innovations in capsule endoscopy show promise that it can be an accurate diagnostic tool in screening these patients.
Real World Best Practices for DVT Prophylaxis (Accreditation Expired) Faculty:Paul E. Marik, MD, FCCP, FCCM | Arthur P. Wheeler, MD, FCCP | Jamie E. Siegel, MD | Sandra L. Kane-Gill, PharmD, MSc. CME Credit hours: 1.5 Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. There exists a gap in knowledge for the treatment of VTE with secondary prophylaxis, acute PE, as well as a special consideration for the critically ill (e.g. volume overloaded) or patients with comorbidities (e.g. renal insufficiency). Furthermore, the existing clinical data needs to be discussed and interpreted in order to be applied, as well as a discussion surrounding current issues and controversies in VTE treatment and prophylaxis. This program provides concise and contemporary insight addressing concerns practitioners have regarding the management of patients with VTE.
Diagnosing & Treating Atypical Depression(Accreditation Expired) Faculty:Michael E. Thase, MD | Jonathan W. Stewart, MD | John M. Zajecka, MD CME Credit hour: 1.0
Join Dr. Michael Thase, Dr. Jonathan Stewart, and Dr. John Zajecka, as they discuss the biologic profile, diagnosis, and treatment of atypical depression. These three distinguished panelists share their clinical experiences and suggest strategies for diagnosing and treating patients with atypical depression.
Role of PPARs in the Treatment of Insulin Resistance & Cardiovascular Disease Faculty:Lawrence Blonde, MD, FACP, FACE | James R Gavin III, MD, PhD CME Credit hour: 1.0 This CME initiative provides primary care providers, endocrinologists and cardiologists, who are the forefront in preventing and treating diabetes and CVD, with up-to-date information on the role of PPARs in the treatment of insulin-resistant diabetes and CVD. Topics of discussion include the interrelationship and impact of diabetes, metabolic syndrome, and CVD; current treatment strategies and unmet needs; safety and efficacy data on PPAR activators; and the potential clinical application of dual alpha-gamma PPAR activators.
Cardiovascular and Renal Protection In Patients with Diabetes and Metabolic Syndrome(Accreditation Expired) Faculty:George L. Bakris, MD, F.A.S.N. CME Credit hour: 1.0 Micro- and macrovascular complications affecting the heart and kidneys are a major cause of morbidity and mortality in patients with diabetes and the metabolic syndrome. Aggressive blood pressure management, in addition to glycemic and lipid management, can provide significant cardiovascular and renal protection in this high-risk patient population. Controlling blood pressure has been shown to reduce cardiovascular disease and microvascular disease. However, many patients with hypertension receive no or suboptimal treatment, and most of those patients do not reach the recommended blood pressure goals.
This program addresses the challenges faced by clinicians who treat hypertension and provides evidence-based strategies for optimizing blood pressure control to prevent cardiovascular and renal complications in patients with diabetes and the metabolic syndrome.
Applying Innovations in Capsule Endoscopy to Clinical Practice(Accreditation Expired) Faculty:Glenn Eisen, MD, MPH | Prateek Sharma, MD CME Credit hours: 2.0 Every year, millions of Americans undergo esophagogastroduodenoscopies (EGDs) to detect conditions such as GERD, Barrett's Esophagus, chronic heartburn, and esophageal varices. A new technology called capsule endoscopy can aid in the diagnosis of gastrointestinal conditions in a less invasive and more time effective manner. Use of this device for widespread screening may lead to an increase in the number of patients evaluated for gastroesophageal disease. This program will review several gastroesophageal diseases as well as provide an overview of capsule endoscopy in evaluating these diseases as well as Crohn's disease.
Pediatric Epilepsy: Identifying & Treating Different Seizure Types Faculty:John M. Pellock, MD | James W. Wheless, MD | Patricia Dean, ARNP, MSN CME Credit hour: 1.0 Nearly one-third of the population newly diagnosed with epilepsy each year is children. More specifically, 45,000 children under the age of 15 develop epilepsy each year. Classification of seizure disorders has evolved considerably over time and many new treatment options have become available in recent years. For the majority of patients, seizures can be adequately controlled without unendurable side effects. This program will examine issues and considerations related to identifying seizure types and managing epilepsy in pediatric patients.
Special Considerations in the Treatment of Geriatric Epilepsy Faculty: Mark Spitz, MD | James Cloyd, PharmD | Ilo Leppik, MD CME Credit hour: 1.0 Currently, 1.5 million elderly people reside in nursing homes, therefore as many as 150,000 elderly patients in nursing homes may be taking AEDs. The widespread prevalence of epilepsy in this population indicates a need to educate the physicians who treat them. Upon completing t his program, physicians will be able to discuss the epidemiology of epilepsy in the elderly, review the means by which seizures are produced and presented in geriatric patients to better understand which treatment is most appropriate, and discuss the special considerations that must be addressed regarding drug interactions in these patients as well as new data regarding the safety and tolerability of pharmacologic and non-pharmacologic treatments in this population.
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Generic Substitution and Therapeutic Equivalence of Antiepileptic Drugs: Clinical and Pharmacoeconomic Issues in Epilepsy Management
Inflammatory Aspects and Detection of Vulnerable Plaque: Clinical Impact of Assessement
Diagnosing & Treating Atypical Depression
Real World Effectiveness of Antipsychotic Drugs in Patients with Chronic Mental Illness
Chemotherapy-Induced Neutropenia: Impact, Risks & Prevention
Challenges in Dosing Low Molecular Weight Heparin
