Pediatric Pharmacy Review Course and Practice Exam Package (Cert # L249095) (No Recert Credit)

These activities are intended for pharmacists who are seeking to update their knowledge and skills commensurate with a board certification examination in the areas listed below.

This course consists of 5 groups of activities, containing a total of 20 topics (see table below) and provides up to 25 contact hours of continuing pharmacy education credit The Review Course includes case-based presentations for application to real-life scenarios, a practice exam along with correct answers, and links to the reference sources, and domains, tasks, and knowledge statements. To help you further prepare, this package includes a compilation of practice questions in the same format and rigor to help you prepare for the BPS Specialty Examination.  

After participating in this CPE activity, learners should be able to: 

Group 1
ACPE #: 0204-9999-24-924-H01-P

Deep Vein Thrombosis and Metabolic Syndrome

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions, including deep vein thrombosis, type 2 diabetes mellitus, dyslipidemia, and hypertension.
• Identify resources and treatment options for sexually transmitted infections.
• Select appropriate monitoring considerations of anticoagulation medications.
• Recognize the impact of pharmacogenomic differences on warfarin therapy. 

Cardiovascular Disease

• Interpret signs, symptoms and diagnostic tests in a pediatric patient with congenital heart disease (specifically VSD, ASD, TOF, coarctation of aorta, and hypoplastic left heart) or Kawasaki disease.
• Identify drug-related problems, including drug interactions.
• Develop the most appropriate therapy and monitoring plans based on patient-specific information and the most current guidelines.
• Use PALS to determine appropriate therapy for bradycardia and tachycardia. 

Neonatal Sepsis

• Develop appropriate treatment and monitoring plans for a complex neonatal patient with multiple conditions, including patent ductus arteriosus, apnea of prematurity, early and late onset sepsis, and necrotizing enterocolitis.
• Evaluate the clinical and therapeutic implications of placental transfer of medications.
• Identify age-specific pharmacokinetic differences among neonates, infants, children, and adolescents.
• Apply FDA alerts for adverse drug events and drug-drug interactions into clinical practice.
• Identify characteristics that facilitate transfer of medications into the breast milk. 

Pediatric Nutrition

• Evaluate if nutrition needs of a pediatric patient are being met based on assessment of appropriate growth and development.
• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with parenteral and enteral nutrition needs.
• Evaluate patients for weight (overweight or obese) based on current guidelines. 

Group 2
ACPE #: 0204-9999-24-925-H01-P

Sickle Cell Disease with Vaso-Occlusive Crisis

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions, including a vaso-occlusive crisis, cellulitis, constipation, and need for immunizations.
• Select most appropriate patient controlled analgesia regimen based on vaso-occlusive crisis severity.
• Apply pharmacodynamic principles when selecting appropriate antibiotic regimens.
• Identify required immunizations for adolescents, including patients with risk factors for vaccine-preventable diseases. 

Acute Lymphoblastic Leukemia with Tumor Lysis Syndrome

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions, including acute lymphoblastic leukemia (ALL), tumor lysis syndrome, febrile neutropenia, invasive aspergillosis infection, and Clostridium difficile infection.
• Select appropriate medication dose modifications related to hepatic impairment. 

Pediatric Hematology and Oncology

• Interpret signs, symptoms and diagnostic tests for chemotherapy-induced nausea and vomiting, mucositis, immune thrombocytopenia, infantile hemangioma, and palliative care in pediatric cancer patients.
• Evaluate patient information to identify drug-related problems and response to therapy.
• Identify appropriate modifications and supportive care plans based on patient-specific follow up assessment. 

Medication Error & Practice Management

• Incorporate position statements, white papers, national guidelines from recognized regulatory organizations into institutional policies and procedures related to:
  • Medication reconciliation
  • Appropriate drug preparation and delivery (e.g., extemporaneous compounding and standardized concentrations)
  • Selection of appropriate equipment/technology and decision support
  • Adverse drug event monitoring and reporting
  • Metrics for evaluating quality of pediatric pharmacy services 

Group 3
ACPE #: 0204-9999-24-926-H01-P

Acute Asthma

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions, including acute and chronic asthma, ADHD, acne, and GERD.
• Evaluate essential components of social history, including smoke exposure and home environment.
• Formulate a plan to address barriers to patient education and adherence, including age, language, cultural considerations, and inhaler technique.
• Describe the impact of age on classification and management of asthma.
• Assess available resources to improve access to medications, including patient assistance programs. 

Pediatric Pulmonary Disease

• For the following specific pulmonary topics:  cystic fibrosis (exacerbation management) and chronic asthma management
  • Interpret relevant clinical and laboratory data and results of diagnostic procedures in a pediatric patient with an exacerbation of cystic fibrosis or chronic asthma.
  • Identify relevant differences in laboratory sampling for pediatric patients (e.g., blood volume; method, frequency and timing of sampling).
  • Develop the most appropriate therapy and monitoring plans based on patient-specific information and the most current guidelines. 

Status Epilepticus and Cardiopulmonary Resuscitation

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions and needs, including status epilepticus, cardiopulmonary resuscitation, and sedation/analgesia.
• Differentiate treatment options in cardiopulmonary arrest based upon patient presentation.
• Select the appropriate dose and route of administration for medications.
• Assess the need and processes for reporting adverse drug events.
• Identify cultural considerations related to treatment and counseling of the pediatric population.
• Distinguish between the four preceptor roles. 

Pediatric Critical and Emergency Care

• Interpret diagnostic and/or laboratory tests, vital signs, and clinical presentation of a pediatric patient with traumatic brain injury or select toxicological emergencies (e.g., acetaminophen, ethylene glycol).
• Develop the most appropriate therapy and monitoring plans based on patient-specific information and the most current guidelines.
• Develop appropriate medication dosing plans for a pediatric patient on ECMO.
• Develop plans to manage underlying disorders. 

Group 4
ACPE #: 0204-9999-24-927-H01-P

Pediatric Neurology and Psychiatry

• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with migraines, autism, cerebral palsy, depression or anxiety.
• Evaluate patients for drug-related problems and response to therapy.
• Identify appropriate modifications of patient-specific treatment plans based on follow up assessment. 

Pediatric Neurology - Focus on Seizures

• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with febrile seizures, neonatal seizures, infantile spasms, absence seizures, and Lennox-Gastaut syndrome.
• Evaluate patients for drug-related problems.
• Identify appropriate modifications of patient-specific treatment plans based on follow up assessment. 

Diabetic Ketoacidosis

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions, including diabetic ketoacidosis, type 1 diabetes mellitus, and urinary tract infection.
• Calculate maintenance and replacement fluid requirements and urine output.
• Identify factors affecting medication adherence.
• Recommend appropriate dosing of insulin based on patient age and weight.
• Select an effective method of delivery for insulin. 

Statistics, Evidence-Based Medicine and Research Design

• Evaluate quality and appropriateness, with specific attention to study design, statistical analysis, internal/external validity, source of bias/confounders, and quality of conclusions and interpretation of graphs.
• Explain why a statistical test is appropriate or not appropriate, based on the sample distribution, data type, and study design.
• Interpret clinical and statistical significance for results from commonly used statistical tests.
• Explain the strengths and limitations of different types of measures of central tendency (mean, median, and mode) and data spread (standard deviation, standard error of the mean, range, and interquartile range).
• Evaluate odds ratio, risk/incidence rate, relative risk, number needed to treat, number needed to harm, and other risk estimates.
• Assess whether the study applies to a specified patient population. 

Group 5
ACPE #: 0204-9999-24-928-H01-P

Pneumonia and Septic Shock

• Develop appropriate treatment and monitoring plans for a complex pediatric patient with multiple conditions, including pneumonia, septic shock, and acute kidney injury.
• Calculate creatinine clearance, fluid requirements, and urine output in pediatric patients.
• Apply scoring systems to assess pediatric patients.
• Select appropriate dosing for medications based on renal dysfunction and/or replacement modalities.
• Differentiate vital signs between stable and critically-ill pediatric patients. 

Pediatric Infectious Diseases - Part 1

• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a well-appearing febrile infant.
• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with otitis media.
• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with bronchiolitis.
• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with tuberculosis.
• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with meningitis.
• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with pneumonia. 

Pediatric Infectious Diseases - Part 2

• Develop treatment and monitoring plans based on patient-specific information and the most current guidelines for a pediatric patient with HIV, Herpes Simplex Virus Types 1 and 2, or systemic fungal infections. 

Regulatory and IRB Considerations

• Identify appropriate off-label use of medications in the pediatric population.
• Recognize IRB requirements for documentation of clinical studies.
• List characteristics of patients who require informed assent/consent.
• Recognize federal legislation relevant to the use of medications in pediatric patients.

The Core Therapeutic Modules Review Package consists of 10 activities in which faculty review clinical topics and practice skills using a case-based approach. The activities are designed to assist the learner in identifying knowledge gaps in preparation for a pharmacy specialty board examination. In addition to a recorded presentation, each activity includes links to resources for further self-study and a practice test developed in the same format and rigor as the specialty exam.

After participating in these CPE activities, learners should be able to:

Select Topics in Acid-Base Disorders
ACPE #: 0204-0000-21-610-H01-P

For the following specific acid/base disorders - respiratory, metabolic acid base disorders including anion gap/non-anion gap acidosis, renal tubular acidosis, as well as delta gap equation:

•  Interpret laboratory and diagnostic tests.
• Recommend the most appropriate treatment and monitoring plans based on patient-specific information and current guidelines

Select Topics in Infectious Diseases in Critical Care Patients
ACPE #: 0204-0000-22-643-H01-P

For the following specific infectious disease topics: urinary tract infections, meningitis, catheter related infections, bacteremia, and infective endocarditis:

• Interpret laboratory and diagnostic tests.
• Recommend the most appropriate treatment and monitoring plans based on patient-specific information and current guidelines.

Select Neurology Topics in Critical Care Patients
ACPE #: 0204-0000-20-990-H01-P

• For the following specific critical care topics: status epilepticus, traumatic brain injury, ischemic stroke, subarachnoid hemorrhage:
  • Interpret laboratory and diagnostic tests.
  • Evaluate benefits and risks of drug therapy considering other medication, and other patient-specific factors.
  • Recommend the most appropriate treatment and monitoring plans based on patient-specific information and current guidelines.

Alterations in Pharmacokinetics and Pharmacodynamics in Critical Care
ACPE #: 0204-0000-21-611-H01-P

• Identify pharmacokinetic and pharmacodynamic (PK/PD) changes that occur in critical illness, and the impact on commonly administered medications in this setting.
• Apply knowledge of general PK/PD changes in critical illness to the following patient-specific factors that further complicate drug dosing:
  • Burns
  • Obesity
  • Pregnancy
  • Continuous renal replacement therapy (CRRT)
  • Extracorporeal membrane oxygenation (ECMO)

• Develop a therapeutic strategy to optimize PK/PK for commonly used medications in the intensive care unit. "

Select Topics in Prevention and Supportive Care in Critical Care Patients
ACPE #: 0204-0000-20-991-H01-P

For the following specific critical care topics─stress ulcer prophylaxis (SUP), venous thromboembolism (VTE) prophylaxis, bowel regimens, and ventilator associated pneumonia (VAP) prevention:

• Interpret laboratory and diagnostic tests.
• Recommend the most appropriate treatment and monitoring plans based on patient-specific information and current guidelines.

Select Topics in Toxicology
ACPE #: 0204-0000-21-612-H01-P

For the following specific toxicology topics: acetaminophen, toxic alcohols, calcium channel blockers, beta blockers, opioids, and ecstasy:

• Interpret laboratory and diagnostic tests
• Recommend the most appropriate treatment and monitoring plans based on patient-specific information and current guidelines.

Select Topics in Pulmonary Disorders
ACPE #: 0204-0000-22-644-H01-P

For the following specific pulmonary disease topics: asthma exacerbation, acute exacerbation of chronic obstructive pulmonary disease, pulmonary embolism, and pulmonary arterial hypertension:

• Interpret laboratory and diagnostic tests.
• Recommend the most appropriate treatment and monitoring plans based on patient-specific information and current guidelines.

Cardiac Arrhythmias and Advanced Cardiac Life Support
ACPE #: 0204-0000-20-992-H01-P

• Interpret signs, symptoms and diagnostic tests for cardiac arrhythmias.
• Identify drug-related problems, including drug interactions and adverse effects, associated with pharmacotherapy of cardiac arrhythmias.
• Identify strategies to prevent drug-induced arrhythmias.
• Recommend therapy and monitoring for cardiac arrhythmias based on patient-specific information, current guidelines and Advanced Cardiac Life Support guided therapies.

Pharmacotherapy Considerations in the Management of Shock
ACPE #: 0204-0000-20-993-H01-P

• Interpret diagnostic and/or laboratory tests, vital signs, and clinical presentation in order to differentiate types of shock (hypovolemic, distributive, cardiogenic)
• Compare and contrast the pharmacologic agents utilized in shock
• Recommend therapy and monitoring based on patient-specific information and current guidelines for the treatment of shock

Fluid, Electrolytes, and Nutrition
ACPE #: 0204-0000-22-617-H01-P

• Interpret laboratory and diagnostic tests for fluid, electrolyte, and nutrition status.
• Recommend the most appropriate therapy and monitoring in patients with fluid, electrolyte, and nutritional disorders based on patient-specific information and current guidelines.
• Apply strategies to manage drug-related electrolyte interactions and nutrient interactions.

Faculty Bios

Teia Brandenburg, PharmD, BCPPS
Clinical Pharmacist – Child Neurology
University of Kentucky HealthCare
Lexington, Kentucky 

Christine Bryant, PharmD, BCPPS
Team Lead, Pediatrics
University of Virginia Health Children’s
Charlottesville, Virginia 

Dana Cerminara, PharmD, BCPPS
Clinical Pharmacy Specialist, Liver Transplant/GI/Hepatology/Nutrition
Texas Children’s Hospital
Houston, Texas 

Jennifer Dannelley, PharmD
Clinical Pharmacist, Cystic Fibrosis Program Coordinator
University of Oklahoma College of Medicine
Oklahoma City, Oklahoma 

Kaitlin “Katie” Hughes, PharmD, BCPPS
Clinical Pharmacy Specialist Pediatric Critical Care
Riley Hospital for Children
Indianapolis, Indiana 

Peter N. Johnson, PharmD, BCPPS, FPPA, FCCM, FASHP*
Professor and President’s Associate Presidential Professor
University of Oklahoma College of Pharmacy
Clinical Pharmacy Specialist—CICU
Oklahoma Children’s Hospital at OU Health
Oklahoma City, Oklahoma 

Lauren Leiby, PharmD, BCPPS, FPPA, FCCM, FASHP
Behavioral Health Patient Care Pharmacist
Nationwide Children’s Hospital
Columbus, Ohio 

Rachel S. Meyers, PharmD, BCPS, BCPPS, FPPA
Clinical Professor
Ernest Mario School of Pharmacy, Rutgers University
Piscataway, New Jersey
Pediatric Clinical Pharmacist
Cooperman Barnabas Medical Center
Livingston, New Jersey 

Jamie L. Miller, PharmD, BCPPS, FPPA *
Professor
University of Oklahoma College of Pharmacy
Clinical Pharmacist
Oklahoma Children’s Hospital at OU Health
Oklahoma City, Oklahoma 

Misty Miller, PharmD, BCPS, AAHIVP
Associate Professor
University of Oklahoma College of Pharmacy
Oklahoma City, Oklahoma 

Ashley Nebbia, PharmD, BCPPS
Clinical Pharmacist, Residency Program Director
Physicians Regional
Naples, Florida 

Long “Lane” Nguyen, PharmD, BCPPS
Clinical Pharmacist Specialist, Pediatric Critical Care Medicine
Memorial Sloan Kettering Cancer Center
New York, New York 

Katherine “Katie” Olney, BCIDP
Pediatric Infectious Diseases Clinical Pharmacist
University of Kentucky Healthcare
Adjunct Assistant Professor
University of Kentucky College of Pharmacy
Lexington, Kentucky 

Nicole Omecene, PharmD, BCPPS
Assistant Professor
Virginia Commonwealth University School of Pharmacy
Clinical Pharmacy Specialist
Children’s Hospital of Richmond
Richmond, Virginia 

Kate Reichert Gasparini, PharmD, BCOP, BCPPS
Pediatric Oncology Clinical Pharmacy Specialist III
Memorial Sloan Kettering Cancer Center
New York, New York 

Ashley Sabus, PharmD, BCOP
Clinical Pharmacist, Ambulatory Neuro-Oncology, Hematology and Ancillary Services
Children's Hospital Colorado
Clinical Assistant Professor
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Services
Aurora, Colorado 

Jennifer Thackray, PharmD, BCPS, BCPPS*
Manager, Pediatric Clinical Pharmacy Services and Director, PGY2 Pediatric Oncology Residency Program
Memorial Sloan Ketting Cancer Center
New York, New York 

Lisa Thames, PharmD, BCPS
Assistant Director, Inpatient Pharmacy Services
University of Florida Health Shands
Gainesville, Florida

*Content Matter Experts

Michelle Abalos, PharmD
Susan R. Dombrowski, MS, RPh
Kristi Hofer, PharmD

In accordance with our accreditor’s Standards of Integrity and Independence in Accredited Continuing Education, ASHP requires that all individuals in control of content disclose all financial relationships with ineligible companies. An individual has a relevant financial relationship if they have had a financial relationship with an ineligible company in any dollar amount in the past 24 months and the educational content that the individual controls is related to the business lines or products of the ineligible company. 

An ineligible company is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The presence or absence of relevant financial relationships will be disclosed to the activity audience. 

The following persons in control of this activity’s content have relevant financial relationships: 

Kate Reichert: Jazz Pharmaceuticals (consultant)
Rachel Meyers: Takeda - stockholder; CMP Pharma - consultant 

As required by the Standards of Integrity and Independence in Accredited Continuing Education, all relevant financial relationships have been mitigated prior to the CPE activity.

Activities can be completed in any order. Each activity consists of audio, video, and/or PDFs and evaluations. Learners must review all content and complete the evaluations to receive continuing pharmacy education credit for each activity. 

Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity.