ACPE Numbers: Various – see listing below
Release Date: 4/17/2019
Expiration Dates: 10/15/2019
Activity Type: Application-based
CE Credits: 15 hours
Accreditation for Pharmacists
The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
These Literature Studies are designed to help board-certified pharmacy practitioners who are seeking recertification credit hours to maintain their Board of Pharmacy Specialties (BPS) Board Certification.
The Literature Study Module is intended for board certified pharmacists in need of recertification credit and is designed based on the content outline developed by the Board of Pharmacy Specialties (BPS). This module consists of 3 online home study activities (see table below). Each activity is designed to assess the learners’ ability to analyze and apply peer-selected contemporary articles to practice.
Module 1A – Neurology: This module focuses on the management of stroke. Topics include the guidelines for acute ischemic stroke, the use of tenecteplase before thrombectomy and clopidogrel and aspirin use in acute ischemic stroke.
Module 1B – Critical Care Update: This module focuses on updates in the management of critically ill patients. Topics include fluid management, the use of procalcitonin guidance and angiotensin II use in patients with shock.
Module 1C – Infectious Diseases/Gastroenterology: This module focuses on infectious disease and gastroenterology. Topics include guidelines for Clostridium difficile infection, Crohn's Disease and the prophylaxis against upper GI bleeding in hospitalized patients.
Learners will be required to review the content and complete the associated online assessments. The learner must be able to correctly answer the questions based upon their interpretation of the content, as well as “baseline specialty specific knowledge and/or easily retrievable information.” For purposes of this Literature Study, “baseline specialty specific knowledge and/or easily retrievable information” is defined as product labeling and well-established standards of practice in the specialty practice.
These activities are part of the ASHP and professional development program for BCPS recertification approved by the BPS.
Board certified pharmacists are eligible to receive up to 15 hours of recertification credit for completing this module. To earn recertification credit, learners must review the activity content and successfully complete the online assessments by the deadline. Only completed assessments will be eligible for credit; no partial or incomplete assessments will be processed. You are allowed only one attempt to successfully complete this assessment.
*Assessment Pass Point
Pharmacotherapy and Critical Care Pharmacy Literature Study Module 1A: Neurology
Pharmacotherapy Literature Study Module 1B: Critical Care Update
Pharmacotherapy Literature Study Module 1C: Infectious Diseases/Gastroenterology
Articles and Learning Objectives
Module 1A - Neurology
This module focuses on the management of stroke. Topics include the guidelines for acute ischemic stroke, the use of tenecteplase before thrombectomy for ischemic stroke and clopidogrel and aspirin use in acute ischemic stroke.
Campbell BCV, Mitchell PJ, Churilov L et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med. 2018; 378:1573-82.
- Explain the rationale, methodology, findings, limitations, and implications of the Tenecteplase versus Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) study
- Make recommendations for the use of thrombolytic therapy before endovascular thrombectomy in patients with ischemic stroke
Johnston SC, Easton JD, Farrant M et al. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. N Engl J Med. 2018; 379:215-25.
- Explain the rationale, methodology, findings, limitations, and implications of the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) study
- Make recommendations for antiplatelet therapy in patients with a minor acute ischemic stroke or high-risk transient ischemic attack (TIA)
Powers WJ, Rabinstein AA, Ackerson T et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018; 49:e46-e110.
- Describe the 2018 American Heart Association (AHA)/American Stroke Association (ASA) guidelines for early management of patients with acute ischemic stroke pertaining to prehospital care, emergency evaluation and treatment, and in-hospital care
- Make recommendations for prehospital care, general supportive care, and emergency treatment of adults with acute ischemic stroke
- Make recommendations for in-hospital general supportive care, treatment of acute complications, and secondary prevention measures for adults with acute ischemic stroke
Module 1B - Critical Care Update
This module focuses on updates in the management of critically ill patients. Topics include fluid management, the use of procalcitonin guidance and angiotensin II use in patients with shock.
Monnet X, Marik PE, Teboul JL. Prediction of fluid responsiveness: an update. Ann Intensive Care. 2016; 6:111
- Describe the advantages and disadvantages of various tests used to predict preload (i.e., fluid) responsiveness in critically ill patients with acute circulatory failure
- Recommend methods for testing preload responsiveness to guide fluid management in critically ill patients with acute circulatory failure
Semler MW, Self WH, Wanderer JP et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018; 378:829-3
- Explain the rationale, methodology, and limitations of the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) comparing balanced crystalloids with saline for intravenous fluid administration in critically ill adults in intensive care units
- Discuss the findings and implications of the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) for fluid resuscitation therapy in critically ill adults in intensive care units
Lam SW, Bauer SR, Fowler R, Duggal A. Systematic review and meta-analysis of procalcitonin-guidance versus usual care for antimicrobial management in critically ill patients: focus on subgroups based on antibiotic initiation, cessation, or mixed strategies. Crit Care Med. 2018; 46:684-90
- Explain the rationale, methodology, findings, limitations, and implications of the systematic review and meta-analysis of studies of procalcitonin use to guide antibiotic therapy in critically ill adults
- Make recommendations for the use of procalcitonin levels to guide antibiotic therapy in critically ill adults
Bissell BD, Browder K, McKenzie M, Flannery AH. A blast from the past: revival of angiotensin II for vasodilatory shock. Ann Pharmacother. 2018; 52:920-7
- Explain the rationale, methodology, findings, limitations, and implications of studies of angiotensin II for the treatment of vasodilatory shock
- Make recommendations for the use of angiotensin II in patients with vasodilatory shock
Khanna A, English SW, Wang XS et al. Angiotensin II for the treatment of vasodilatory shock. N Engl J Med. 2017; 377:419-30
- Explain the rationale, methodology, findings, limitations, and implications of the phase 3 Angiotensin II for the Treatment of High-Output Shock (ATHOS-3) study
- Make recommendations for the use of angiotensin II in patients with catecholamine-resistant vasodilatory shock
Module 1C – Infectious Diseases/Gastroenterology
This module focuses on infectious disease and gastroenterology. Topics include guidelines for Clostridium difficile infection, Crohn's Disease and the prophylaxis against upper GI bleeding in hospitalized patients.
Cook D, Guyatt G. Prophylaxis against upper gastrointestinal bleeding in hospitalized patients. N Engl J Med. 2018; 378:2506-16
- Evaluate the incidence, pathophysiologic features, risk factors and consequences of using prophylaxis of upper gastrointestinal (GI) bleeding in hospitalized patients
- Design and evaluate the success of an evidence-based regimen for the prevention of upper GI bleeding in a hospitalized patient
Lichtenstein GR, Loftus EV, Isaacs KL et al. ACG clinical guideline: management of Crohn's disease in adults. Am J Gastroenterol. 2018; 113:481-517
- Describe the clinical features, natural history, diagnosis, and treatment of Crohn’s disease (CD) in adults
- Design and evaluate efficacy and safety outcomes from evidence-based regimen for the management of CD in adults
McDonald LC, Gerding DN, Johnson S et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018; 66:e1-e48.
- Describe the updated (2017) Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) clinical practice guidelines for Clostridium difficile infection in adults and children
- Make recommendations for the management of Clostridium difficile infection in adults and children
Monique Bidell, Pharm.D., BCPS
Assistant Professor of Pharmacy Practice
Albany College of Pharmacy and Health Sciences
Jennifer Clements, Pharm.D., FCCP, BCPS, CDE, BCACP
Professor and Director of Postgraduate Education
Presbyterian College School of Pharmacy
Salia Farrokh, Pharm.D., BCPS, BCCCP
Neuro ICU Clinical Pharmacist Specialist
Johns Hopkins Hospital
Lauren Igneri, Pharm.D., BCPS, BCCCP
Clinical Pharmacy Specialist
Cooper University Health Care
Brianne Ritchie, Pharm.D., M.B.A., BCCCP, BCPS
Amy Sipe, R.Ph.
Kansas City VA Medical Center
Kansas City, MO
Heather Torbic, Pharm.D., BCPS, BCCCP
Clinical Pharmacy Specialist
Sarah Welch, Pharm.D., BCCCP
Clinical Pharmacy Specialist
Content Matter Experts
Snehal Bhatt, Pharm.D., AACC, BCPS-AQ Cardiology, FASHP
Associate Professor of Pharmacy Practice
MCPHS University School of Pharmacy Boston
Beth Israel Deaconess Medical Center
Christopher Betz, Pharm.D., BCPS, FASHP, FKSHP
Professor, Sullivan University College of Pharmacy
Cardiovascular Clinical Pharmacy Specialist
Jewish Hospital Rudd Heart & Lung Center - KentuckyOne Health
Angela L. Bingham, Pharm.D., BCCCP, BCNSP, BCPS
Associate Professor of Clinical Pharmacy
Philadelphia College of Pharmacy - University of the Sciences
Mary M. Hess, Pharm.D., BCCCP, FASHP, FCCM, FCCP
Associate Dean, Student Affairs
Jefferson School of Pharmacy
Douglas Slain, Pharm.D., BCPS (AQ-ID), FCCP, FASHP
Associate Professor and Infectious Diseases Clinical Specialist
West Virginia University School of Pharmacy
Morgantown, West Virginia
Paul Szumita, Pharm.D., BCCCP, BCPS, FASHP, FCCM
Clinical Pharmacy Practice Manager
Brigham & Women's Hospital
Susan R. Dombrowski, M.S., R.Ph.
Tony Martin, Pharm.D., MBA
Anna M. Wodlinger-Jackson, Pharm.D., BCPS
Maha Abdelrhman, Pharm.D., BCPS
Nada Alkhani, Pharm.D., BCPS, BCCCP
Nancy Balch, Pharm.D., BCCCP
Dominique Brewster, Pharm.D., BCPS, BCGP, AAHHIVP
Dorian Brown, Pharm.D., BCPS
Linda Chickering, R.Ph., BCPS
Briana Coyne, Pharm.D., BCPS
Danhe Cui, Pharm.D.,BCPS
Adamma Davis, Pharm.D., BCPS, BCNSP
Fady Faltas, Pharm.D., BCPS
Michelle Fraley, Pharm.D., BCPS
Teresa Grund, R.Ph., BCPS
Rachel Jankowski, Pharm.D., BCPS
SHIAO HUI LIM, R.Ph., BCCCP
Ana Miladinovic, Pharm.D. BCPS
Cody Null, Pharm.D., BCCCP, BCPS
Nathan Pingle, Pharm.D., BCCCP
Megan Smetana, Pharm.D., BCPS
Julie Stephens, Pharm.D., BCCCP, BCPS
Sara Swearingen, Pharm.D., BCPS
JENNIFER TING-CHAN, Pharm.D., BCCCP BCPS
Barbara Wiggins, Pharm.D., BCPS, BCCCP, BCCP
Paul Wong, Pharm.D., BCCCP
Madona Yahia, Pharm.D., BCPS
In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support and the Accreditation Council for Pharmacy Education’s Standards for Commercial Support, ASHP requires that all individuals involved in the development of activity content disclose their relevant financial relationships. A person has a relevant financial relationship if the individual of his or her spouse/partner has a financial relationship (e.g. employee, consultant, research grant recipient, speakers bureau, or stockholder) in any amount occurring the in the last 12 months with a commercial interest whose products or series may be discussed in the educational activity content over which the individual has control. The existence of these relationships is provided for the information of participants and should not be assumed to have an adverse impact on the content.
All faculty and planners for ASHP education activities are qualified and selected by ASHP and required to disclose any relevant financial relationships with commercial interests. ASHP identifies and resolves conflicts of interest prior to an individual’s participation in development of content for an educational activity. Anyone who refuses to disclose relevant financial relationships must be disqualified from any involvement with a continuing pharmacy education activity.
- Snehal Bhatt: Advisor, Portola Pharmaceuticals; Speaker Bureau, Janssen Pharmaceuticals, Inc.
- All other planners, presenters, and reviewers of this session report no financial relationships relevant to this activity.
Methods and CE Requirements
Activity consists of audio/ video/PDF files, an attestation statement, assessment, and activity evaluation. In order to receive continuing pharmacy education credit, learners must:
- Complete the attestation statement
- Review all content
- Complete and pass the assessment
- Complete the evaluation
- Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity.
Note: Learner must complete and pass the assessment in order to claim continuing pharmacy education credit.
System Technical Requirements
Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating web sites.
View the minimum technical and system requirements for learning activities.
These activities were developed by ASHP.