Promoting Metabolic and Endocrine Health in Children and Adolescents Treated with Antipsychotics
Faculty: Christoph U. Correll, MD | Robert L. Findling, MD | Linmarie Sikich, MD
CE credit hour: 1.0
Clinicians need to carefully consider the overall impact of weight gain, associated metabolic issues, and endocrine abnormalities associated with antipsychotic treatment.  Several recent epidemiological studies have documented a sharp increase in the prescription of second-generation antipsychotics for children and adolescents with psychotic and non-psychotic conditions. A thorough understanding of the different adverse effect profiles of second-generation antipsychotic agents is required to effectively manage the mental and physical health of this vulnerable patient population.

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.

The Practical and Regulatory Perspective of Bioequivalence
Faculty: Sandra L. Kane-Gill, PharmD, MSC | Joseph F. Dasta, MS, FCCM, FCCP | Nicholas M. Fleischer, RPh, PhD. | Mary Lea Gora-Harper, PharmD, FASHP
CE Credit hour: 1.0
Bioequivalence needs to be determined before an automatic substitution of products or product dosage forms can be made.  When automatic substitutions between brand and generic, generic and generic or between dosage forms are made, clinicians need to be aware of the potential clinical and regulatory issues associated with these substitutions. While product interchange between brand and generic medications, generic and generic medications or different forms of the same product is not typically a problem, this activity will highlight some examples of clinical concerns and related regulation considerations.  It will also provide some direction on obtaining relevant information of bioequivalence.

The Role of Imaging in the Management of Rheumatoid Arthritis Patients: What Does this Mean for My Patients?
Faculty: Orrin M. Troum, M.D. | John V. Crues, III, MD | Sergio Schwartzman, MD
CE credit hour: 1.0
RA management requires frequent monitoring and adjustment of therapy. Therefore, imaging data is an important component of assessing RA severity. New research into the use of ultrasound, MRI, and x-ray show that these imaging techniques have the potential for greater clinical benefits than traditional radiography. This activity aims to provide physicians with the tools necessary to interpret and score imaging data and ultimately, better utilize this information for improving patient outcomes.

Translating Evidence to Practice: A Case-Based Approach to VTE Prevention, Diagnosis & Management
Faculty: Samuel Goldhaber, MD, | Ruth B. Morrison, RN, BSN, CVN | James B. Groce, III, PharmD, CACP | Sylvia McKean, MD
CME credit hour: 2.0
This case-based educational program will help you to identify and discuss pertinent clinical data for the treatment and prevention of VTE, as well as demonstrate how these data can be interpreted and applied into clinical practice. This would include discussion of current issues and controversies surrounding management of VTE, identifying risk factors for VTE, the treatment and secondary prophylaxis in VTE, treatment options for the management of acute PE, as well a special consideration for the medically ill or patients with comorbidities. By reviewing specific patient cases, our esteemed faculty will provide concise and contemporary insight addressing concerns practitioners have regarding the management of patients with VTE.

Common Misconceptions With Bioequivalence & Interchangeability
Faculty: Andrew J. Pultz, Jr, PharmD, RPh | Joseph F. Dasta, MSc, FCCM, FCCP | Sandra L. Kane-Gill, PharmD, MSc
CE credit hour: 1.0
Bioequivalence is a comparison of two or more products with respect to their bioavailabilities. Bioequivalence of trade and generic products or different dosage forms of the same product needs to be determined before the products can be legally interchanged. Numerous factors can affect bioavailability (and bioequivalence) determinations. Thus, there is a great potential for wide variability among the pharmacokinetic profiles among patient populations and bioequivalence determinations. As pharmacists and Nurses, we are in an optimal position to prevent or intervene when a patient is experiencing drug-drug and drug-food interaction resulting in bioavailability alterations with outcomes including sub-therapeutic responses or adverse events. While product interchange between trade and generic medications or between dosage forms of the same product is typically not a problem this activity is going to highlight some examples of when it is a concern.

A Review of Cold-Induced Urticaria Disorders (Accreditation Expired)
Faculty: Hal M. Hoffman, MD
CME credit hour: 1.0
This program reviews cold-induced urticaria disorders and the characteristics that distinguish acquired from hereditary disorders. Each of these cold-induced urticaria disorders may have multifactorial etiologies and an unclear natural history course within the various types of acquired (primary, secondary and atypical), as well as hereditary and familial cold uriticaria. As new clinical data reveal more about these conditions, this program aims to educate healthcare professionals on the pathology, symptoms, distinguishing features and treatment of the condition in order to avoid more severe complications.

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.

Current Therapeutic Trends in the Treatment of Chemotherapy-Induced Anemia
Faculty: Leon E. Cosler, RPh, PhD | John Glaspy, MD, MPH | Gary H. Lyman, MD, MPH, FRCP (Edin) | Christopher R. Friese, RN, PhD, AOCN^®
CME / CE credit hours: 1.5
Anemia is common in cancer patients, but the impact is often poorly appreciated. It is a major cause of tumor hypoxia, a condition that can further tumor survival and malignant progression and also reduces the effectiveness of several anticancer therapies, including radiotherapy and oxygen-dependent cytotoxic agents. Strategies for incorporating clinical guidelines into practice and the safety and pharmacoeconomic issues surrounding treatment of anemia with ESPs will be discussed in this activity.

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 (Accreditation Expired)
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 (Accreditation Expired)
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.

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.

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.

Real World Effectiveness of Antipsychotic Drugs in Patients with Chronic Mental Illness
(Accreditation Expired)
Faculty: John W. Newcomer, MD | John M. Kane, MD | T. Scott Stroup, MD, MPH | Michael F. Green, PhD | Lawrence Blonde, MD, FACP, FACE
CME Credit hour: 1.0
This CME initiative features a panel discussion delving into the overall "illness burden" associated with mental illness. A highly regarded panel of experts in the area of psychiatry and mental illness will discuss the different domains of function and how to put them all together to provide better treatment for their patients.

Chemotherapy-Induced Neutropenia: Impact, Risks & Prevention (Accreditation Expired)
Faculty: David C. Dale, MD | Michael Rader, MD | Robert E. Smith, MD | Christopher R. Friese, RN, PhD
CME Credit hour: 1.0
Three of the nation's leading specialists will discuss the efficacy and appropriate use of myeloid growth factors for the prevention of chemotherapy-induced neutropenia and febrile neutropenia.

Use of Fixed Dose Combination Antihypertensives for Uncontrolled Hypertension Patients Currently on Monotherapy (Accreditation Expired)
Faculty: Elijah Saunders, MD, FACC, FACP
CME Credit hour: 1.0
This activity reviews the role of combination therapy in attaining BP goals and reducing complications in diverse patient populations.

Challenges in Dosing Low Molecular Weight Heparin
(Accreditation Expired)
Faculty: Joseph F. Dasta, MSc., FCCM, FCCP | Steven M. Hollenberg, MD | Sandra L. Kane-Gill, PharmD., MSc. | Arthur P. Wheeler, MD
CME Credit hour: 1.0
This program features a discussion between four experts in critical care medicine. The discussion addresses the challenges in dosing and monitoring patients at the extremes of body weight, patients with renal insufficiency, and critically ill patients with altered plasma volume, as well as the pharmacoeconomics of Low Molecular Weight Heparins.

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.

The Evolving Management of Bone Disease: Changes on the Horizon (Accreditation Expired)
Faculty: Ethel S. Siris, MD | Jacques P. Brown, MD, FRCP | John A. Kanis, BSc, MB ChB, MD, FRCP, FRCPath | R. Graham Russell, MD, PhD
CME Credit hour: 1.0
The goal of this program is to offer healthcare professionals the opportunity to review the latest clinical data and approaches in the management of metabolic bone disease.

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