Available Until 2/14/2023

Ambulatory Care Pharmacy Specialty Review Course, Workbook Chapters, and Practice exam (No Recert Credit (Cert # L229164))

ACPE Numbers: Various – see listing below
Pre-Sale Date: 3/17/2022
Content Release Date: 03/30/2022
Expiration Date: 02/14/2023
Activity Type: Application-based
CE Credits: 24.5 hours (ACPE only)
Activity Fee: $425 (ASHP member); $625 (non-member)

These activities were recorded during a live educational event on March 3-5, 2022, at the ACCP/ASHP’s 2022 Live Review & Recertification Courses, Henderson, Nevada. Learners who claimed credit for the live activities should not claim credit for these home study activities.

Activity Overview

Ambulatory Care Pharmacy Preparatory Review and Recertification Course is designed to help pharmacists who are preparing for the Board of Pharmacy Specialties certification examination in Ambulatory Care Pharmacy as well as those seeking a general review and refresher on disease states and therapeutics. The program goals are as follows:

  • To present a high-quality, up-to-date overview of disease states and therapeutics.
  • To provide a framework to help attendees prepare for the specialty certification examination in ambulatory care pharmacy.
  • To offer participants an effective learning experience using a case-based approach with a strong focus on the thought processes needed to solve patient care problems in each therapeutic area. 

This course is NOT intended for those obtaining recertification credit. To earn recertification credit, please see courses here: http://elearning.ashp.org/catalog/amb-care-recert 

These activities are part of the ACCP and ASHP professional development program.

The American College of Clinical Pharmacy and American Society of Health-System Pharmacists are accredited by the Accreditation Council for Pharmacy Education as providers of continuing pharmacy education. 

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 19 activities (see table below) and provides up to 24.5 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. 

For full program information, please visit: http://elearning.ashp.org/catalog/amb-care-review

Learning Activity

ACPE Number

Contact Hours

Expiration Date

Trial Design and Biostatistics 




Endocrine Disorders 



Genitourinary, Electrolytes, and Nutritional Deficiencies/Supplementation in Older Adults 



Cardiology I 



Cardiology II 



Bone/Joint and Rheumatology 



Diabetes Mellitus 



Obstetrics and Gynecology 



Pulmonary Disorders 



Practices and Processes of Care 



Communication Strategies in Pharmacy  0217-9999-22-059-H04-P 1.0 
Developing and Managing a Clinical Practice  0217-9999-22-060-H04-P 1.5

Psychiatric Disorders 



Neurology  0217-9999-22-062-H01-P 1.0
Gastrointestinal Disorders  0217-9999-22-063-H01-P 1.5 
Infectious Diseases I  0217-9999-22-064-H02-P 1.0
Infectious Diseases II 0217-9999-22-065-H01-P 1.0
Nephrology 0217-9999-22-066-H01-P 1.0
Dermatologic and Eyes, Ears, Nose, and Throat, and Immunologic Disorders 0217-9999-22-067-H01-P 1.0

At the end of the presentations, the pharmacist should be able to: 

Trial Design and Biostatistics
ACPE #:0217-9999-22-050-H04-P

  • Describe hypothesis testing and state the meaning of and distinguish between p values and confidence intervals, and measures of central tendency and data spread.
  • Define, compare, and contrast the concepts of internal and external validity, causation, association, bias, and confounding in trial design. Select strategies to eliminate or control for bias and improve internal and external validity.
  • Compare and contrast the advantages and disadvantages of various study designs (e.g., prospective, retrospective, case-control, cohort, cross-sectional, randomized controlled clinical trials, systematic review, meta-analysis).
  • Determine why a statistical test is appropriate or not appropriate, given the sample distribution, data type, and study design. Interpret statistical and clinical significance for results from commonly used statistical tests.
  • Define and evaluate odds ratio, risk/incidence rate, relative risk, number needed to treat, number needed to harm, and other risk estimates.

Endocrine Disorders 
ACPE #: 0217-9999-22-051-H01-P

  • Identify appropriate thyroid hormone replacement therapy dosing strategies for patients with hypothyroidism and hyperthyroidism.
  • Recommend appropriate patient-specific pharmacotherapy for the treatment of polycystic ovary syndrome.
  • Medically manage a patient with hyperprolactinemia, acromegaly, and growth hormone deficiency.
  • Differentiate between available weight-loss medications and design a patient-specific treatment plan.
  • Recognize the clinical presentation, and design a treatment plan for, a patient with adrenal gland disorders and Cushing disease.
  • Compare available testosterone (T) replacement products and list appropriate monitoring guidelines for hypogonadism 

Genitourinary, Electrolytes, and Nutritional Deficiencies/Supplementation in Older Adults
ACPE #: 0217-9999-22-049-H01-P

  • Identify and assess common genitourinary diseases, electrolyte abnormalities, and nutritional deficiencies in ambulatory older adults.
  • Evaluate and manage drug-induced causes of benign prostatic hyperplasia (BPH), urinary incontinence, erectile dysfunction (ED), electrolyte abnormalities, and nutritional deficiencies in ambulatory older adults.
  • Compare and contrast pharmacologic interventions for BPH, urinary incontinence, ED, electrolyte abnormalities, and nutritional deficiencies.
  • Formulate treatment strategies for BPH, urinary incontinence, ED, electrolyte abnormalities, and nutritional deficiencies using patient-specific information.

Cardiology I 
ACPE #: 0217-9999-22-052-H01-P

  • Evaluate the appropriate use of aspirin for primary prevention of cardiovascular (CV) events according to practice guidelines and clinical trial evidence.
  • Design an evidence-based treatment and monitoring strategy for patients with hypertension (HTN) that considers goals of therapy, comorbid conditions, and compelling indications.
  • Create an evidence-based treatment and monitoring plan for patients receiving lipid-lowering therapies for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and hypertriglyceridemia.
  • Devise an evidence-based treatment plan for secondary prevention of acute coronary syndrome (ACS), stroke and transient ischemic attack (TIA), and peripheral arterial disease (PAD).

Cardiology II
ACPE #: 0217-9999-22-053-H01-P

  • Formulate appropriate oral anticoagulant treatment strategies for patients who develop venous thromboembolism (deep venous thrombosis or pulmonary embolism), nonvalvular atrial fibrillation, or who have mechanical heart valves consistent with available consensus panel guidelines, recent U.S. Food and Drug Administration approvals, and randomized clinical trials.
  • Describe key differences in onset of action, dosing, administration, absorption, effects on common coagulation tests, and drug interactions between dabigatran, rivaroxaban, apixaban, edoxaban, and warfarin.
  • Develop patient-specific, guideline-driven treatment, monitoring, and follow-up plans for patients with heart failure, atrial fibrillation, or ventricular tachycardia.
  • Identify treatment goals, common adverse effects, clinically important drug interactions, monitoring, and risk evaluation and mitigation strategies requirements for oral pharmacotherapy of pulmonary arterial hypertension.

Bone/Joint and Rheumatology
ACPE #: 0217-9999-22-054-H01-P

  • Systematically identify patients to screen for osteoporosis, and use the screening results to guide the decision on how to treat the patient.
  • Use a STEPS-wise approach (safety, tolerability, efficacy, preference [pearls], simplicity) for comparing, recommending, and justifying a drug therapy regimen for osteoporosis, rheumatoid arthritis (RA), psoriatic arthritis (PsA), osteoarthritis (OA), fibromyalgia, gout, and systemic lupus erythematosus (SLE).
  • Choose a drug therapy for OA or fibromyalgia syndrome on the basis of drug efficacy and a patient’s comorbid conditions.
  • Select screenings or laboratory tests at correct intervals for patients with RA, PsA, or SLE treated with disease-modifying antirheumatic drug (DMARD) or biologic DMARD therapies.
  • Formulate a care plan to help patients decrease their uric acid concentrations, gout symptoms, and gouty attacks using nonpharmacologic and pharmacologic interventions.

Diabetes Mellitus
ACPE #: 0217-9999-22-055-H01-P

  • Identify differences between prediabetes, type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM), including differences in diagnostic criteria and clinical presentation.
  • Describe the pathophysiology of T1DM and T2DM.
  • Compare agents used in the treatment of diabetes mellitus (DM), including their mechanisms of action, adverse effects, contraindications, advantages, and disadvantages.
  • Select appropriate insulin regimens for patients on the basis of desired onset, peak, and duration of insulin effects.
  • Individualize a comprehensive glycemic treatment and monitoring plan for a patient with prediabetes, DM, and GDM.
  • Discuss appropriate blood pressure and lipid management for patients with DM.
  • Discuss the acute and chronic complications associated with DM and strategies to prevent them or slow their progression.

Obstetrics and Gynecology
ACPE #: 0217-9999-22-056-H01-P

  • Recommend therapy for contraception, infertility, menstrual disorders, endometriosis, and symptoms of menopause on the basis of patient-specific information.
  • Recommend appropriate treatment for common acute and chronic conditions in pregnancy and lactation.
  • Recommend therapy for menopause on the basis of patient-specific information.
  • Develop provider and patient education regarding medication use during pregnancy and lactation, contraception, infertility, menstrual disorders, endometriosis, and postmenopausal therapy.

Pulmonary Disorders
ACPE #: 0217-9999-22-057-H01-P

  • Compare and contrast between common features of patients with asthma or chronic obstructive pulmonary disease (COPD).
  • Select appropriate evidence-based treatment for patients with asthma, COPD, and/or nicotine dependence based on specific patient factors and comorbidities.
  • Develop a comprehensive education plan with monitoring parameters for patients on therapy for asthma, COPD, and/or smoking cessation.
  • Compare and contrast the different respiratory inhaler devices and holding chambers.
  • Integrate brief behavioral counseling and smoking cessation best practices when assisting a patient with quitting smoking. 

Practices and Processes of Care
ACPE #: 0217-9999-22-058-H04-P

  • Discuss issues with transitions of care, including a pharmacist’s role in achieving quality measures and improving the process.
  • Describe different types of patient care services or practice models provided by a pharmacist within an ambulatory practice, along with any applicable regulatory requirements.
  • Apply tools and resources to detect, classify, report, analyze, and reduce preventable and non-preventable adverse drug events.
  • Use formulary management activities and other resources to improve the prescribing of safe, effective, and affordable treatments in an organization.

Communication Strategies in Pharmacy
ACPE #: 0217-9999-22-059-H04-P

  • Use strategies that develop patient rapport, foster trust, and effectively and efficiently obtain accurate, comprehensive histories, despite potential barriers in communication.
  • Use assessments of patients’ knowledge, health literacy, self-management skills, health beliefs, and attitudes toward medications to tailor educational interventions that will improve adherence and self- efficacy.
  • Communicate patient care activities and medication-related information effectively to other health care professionals verbally and in writing through the medical record.
  • Discuss factors and methods used to assess and select appropriate written educational materials intended for the general public.

Developing and Managing a Clinical Practice
ACPE #: 0217-9999-22-060-H04-P

  • Perform an internal and external environmental scan and needs assessment to determine the need for and organizational value of an ambulatory pharmacist–provided patient care service.
  • Discuss steps to implement an ambulatory service, including identifying key stakeholders and developing essential clinic operational activities.
  • Develop a robust and sustainable quality assessment program using the balanced scorecard concept for your clinical service and identifying quality measures important to your organization and patient population.
  • Develop a credentialing and privileging process to ensure the competency of pharmacists providing direct patient care in your ambulatory service.
  • Identify and implement revenue-generating opportunities for pharmacist-provided patient care services in different ambulatory care settings.

Psychiatric Disorders
ACPE #: 0217-9999-22-061-H01-P

  • Analyze the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria and disease course for anxiety disorders, sleep disorders, major depression, bipolar disorder, attention-deficit/hyperactivity disorder, schizophrenia, and substance use disorders.
  • Apply a working knowledge of common drug and nondrug therapies for psychiatric disorders, including drug, dose, frequency, adverse effects, drug interactions, and monitoring values.
  • Recommend appropriate treatments, including both lifestyle modification and specific drug therapy (medication dose, schedule, and delivery system), on the basis of relevant patient factors (pharmacodynamic, physiologic, pharmacokinetic, and socioeconomic parameters).
  • Monitor for adverse drug effects, drug-drug and drug-disease interactions, and appropriateness of therapy, including polytherapy. 

ACPE #: 0217-9999-22-062-H01-P

  • Given a patient case, select an appropriate antiepileptic drug (AED) regimen for a patient with epilepsy on the basis of seizure type and AED mechanism of action, common adverse effects, and drug interactions.
  • Recommend an appropriate pharmacologic therapy for a patient with episodic or chronic migraine headache.
  • Recommend and manage appropriate disease-modifying therapy for a patient with multiple sclerosis (MS) on the basis of MS subtype and other patient-specific factors.
  • Recommend an appropriate pharmacologic therapy for a patient with Parkinson disease, neuropathic pain, or Alzheimer disease.

Gastrointestinal Disorders
ACPE #: 0217-9999-22-063-H01-P

Gastrointestinal (GI) disorders within the objectives refer to the disorders covered in this chapter and include the following: gastroesophageal reflux disease, peptic ulcer disease, chronic liver disease manifestations, viral hepatitis, malabsorption syndrome, diarrhea, constipation, nausea and vomiting, irritable bowel syndrome, and inflammatory bowel disease.

  • Apply national guideline–based treatment strategies for gastrointestinal (GI) disorders.
  • Assess the benefits and risks of drug therapy for patients with GI disorders.
  • Recommend appropriate nonpharmacologic and pharmacologic interventions for managing GI disorders.
  • Develop and implement a patient-specific comprehensive therapeutic plan for managing GI disorders.
  • Provide drug-related patient education and counseling for pharmacologic therapies used in managing GI disorders. 

Infectious Diseases I
ACPE #: 0217-9999-22-064-H02-P

  • Identify the clinical presentations of sexually transmitted infections, and design appropriate treatment regimens.
  • Describe the mechanisms of action and adverse effects associated with antiretroviral agents, and identify major drug interactions associated with them.
  • Formulate treatment strategies for the management of HIV and commonly encountered opportunistic infections.
  • Design appropriate strategies for treatment and prevention of influenza and other viral infections.
  • Explain the risk factors for superficial and endemic fungal infections, and design corresponding treatment regimens.

Infectious Diseases II
ACPE #: 0217-9999-22-065-H01-P

  • Design appropriate pharmacologic and nonpharmacologic treatment regimens for patients with urinary tract infections, prostatitis, community-acquired pneumonia, sinusitis, pharyngitis, acute otitis media, skin and soft tissue infections, latent tuberculosis infection, conjunctivitis, Lyme disease, antibiotic prophylaxis, infectious diarrhea, and Clostridioides difficile infections.
  • Identify risk factors and clinical circumstances for antimicrobial resistance.
  • Design an antimicrobial therapeutic regimen to treat resistant infections and prevent their future development.
  • Apply evidence-based medicine and patient-specific factors to design antimicrobial regimens that are appropriate and cost-effective for the patient.

ACPE #: 0217-9999-22-066-H01-P

  • Identify a patient at risk of developing, or presenting with, acute kidney injury, drug-induced kidney disease, or chronic kidney disease (CKD), and formulate an appropriate care plan to mitigate risk and slow progression.
  • Using appropriate data, assess kidney function, dialysis regimen information, and pharmacokinetic/pharmacodynamic drug properties in a patient to inform clinical decision-making.
  • Formulate an evidence-based treatment plan for managing the most common medical problems in patients with CKD, including anemia, CKD-related mineral and bone disorder, and hyperkalemia.
  • Describe Medicare Part B and D policies related to end-stage renal disease (ESRD) and dialysis care (i.e., ESRD Prospective Payment System, Quality Incentive Program, Conditions for Coverage, Centers for Medicare & Medicaid Services Comprehensive ESRD Care Model) and their respective effects on medication use.

Dermatologic and Eyes, Ears, Nose, and Throat, and Immunologic Disorders
ACPE #: 0217-9999-22-067-H01-P

  • Formulate an ophthalmologic drug therapy regimen for a patient presenting with macular degeneration, dry eye syndrome, or glaucoma.
  • Construct an individualized pharmacy care plan for a patient with allergic rhinitis.
  • Using a treatment algorithm, initiate, change, and modify topical and oral therapeutic regimens for acne.
  • Recommend single or multiple topical and systemic agents for treating plaque psoriasis given a patient’s disease presentation, severity, and prior therapies.
  • Effectively educate a patient presenting with a skin infestation or minor burn on the purpose, proper use, and potential adverse reactions of the first-line treatment options.

Full Faculty Information

Erica F. Crannage, Pharm.D., FCCP, BCPS, BCACP
Associate Professor
St. Louis College of Pharmacy at The University of Health Sciences & Pharmacy;
Clinical Pharmacist
Mercy Clinic Family Medicine
St. Louis, Missouri

Spencer H. Durham, Pharm.D., BCPS, BCIDP
Associate Clinical Professor
Department of Pharmacy Practice
Auburn University Harrison School of Pharmacy
Auburn, Alabama

Jessica Farrell, Pharm.D.
Clinical Pharmacist
The Center for Rheumatology, LLC
Associate Professor of Pharmacy Practice
Albany College of Pharmacy and Health Sciences
Albany, New York

Alicia B. Forinash, Pharm.D., FCCP, BCPS, BCACP
Clinical Pharmacy Specialist
Maternal Fetal Care Center/WISH Center
SSM Health St. Mary’s
Professor of Pharmacy Practice
St. Louis College of Pharmacy at The University of Health Sciences & Pharmacy
St. Louis, Missouri

Nicole M. Hahn, Pharm.D., BCACP*
Clinical Pharmacy Specialist – Neurology
Kaiser Permanente
Denver, Colorado

Endocrine Clinical Pharmacy Specialist
CGM and Remote Monitoring Program Coordinator
Cleveland Clinic Endocrinology & Metabolism Institute
Cleveland, Ohio

Adam B. Jackson, Pharm.D., BCACP*
Clinical Pharmacy Specialist in Drug Utilization Management
Pharmacy Department
Kaiser Permanente Colorado
Denver, Colorado

Ambulatory Pharmacy Clinical Coordinator
Billings Clinic
Clinical Associate Professor
Department of Pediatrics
University of Colorado School of Medicine
Aurora, Colorado

Michelle T. Martin, Pharm.D., FCCP, BCPS, BCACP
Clinical Pharmacist
University of Illinois Hospital & Health Sciences System
Assistant Professor
University of Illinois at Chicago College of Pharmacy
Chicago, Illinois

Jamie L. McConaha, Pharm.D., BCACP*
Assistant Professor of Pharmacy Practice
Division of Pharmacy Practice
Duquesne University
Pittsburgh, Pennsylvania

Emily K. McCoy, Pharm.D., BCACP
Associate Clinical Professor
Auburn University Harrison School of Pharmacy
Mobile, Alabama

Molly G. Minze, Pharm.D., FCCP, BCACP
Associate Professor of Pharmacy Practice
Regional Director of Student Affairs and Admissions
Abilene Campus
Texas Tech University Health Sciences Center
Jerry H. Hodge School of Pharmacy
Abilene, Texas

Jean Y. Moon, Pharm.D., FCCP, BCACP
Associate Professor
PGY1 Residency Program Director
College of Pharmacy
University of Minnesota
Minneapolis, Minnesota

Melissa C. Palmer, Pharm.D., BCPS, BCPP
Clinical Pharmacy Specialist – Mental Health
Alaska VA Healthcare System
Anchorage, Alaska

Katie J. Suda, Pharm.D., M.S., FCCP
Department of Medicine
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Jessica Tilton, Pharm.D., BCACP
Clinical Assistant Professor
Clinical Pharmacist
Medication Therapy Management Clinic;
Clinical Coordinator
University of Illinois at Chicago College of Pharmacy
Chicago, Illinois

Elizabeth Van Dril, Pharm.D., BCPS, BCACP, CDCES
Clinical Assistant Professor
University of Illinois at Chicago College of Pharmacy
Chicago, Illinois

*Content Matter Experts

Jennifer Banks, Pharm.D, BCPS, BCACP, BCGP, CDCES, BC-ADM, BCMTM, AE-C, CDP, CPh
Craig J. Beavers, Pharm.D., FCCP, FACC, FAHA, BCCP, BCPS-AQ Cardiology, CACP
Wiyanna K. Bruck, Pharm.D., BCIDP
Ashley N. Crowl, Pharm.D., BCACP
Frank A, Fanizza, Pharm.D., BCACP, AAHIVP
Melissa Lipari, Pharm.D., BCACP
Sarah A. McGill, Pharm.D., BCACP
Scott Pearson, Pharm.D., BCACP
Ann M. Philbrick, Pharm.D., FCCP, BCPS, BCACP
Melanie K. Proffitt, Pharm.D, BCACP, BCMTMS, MHA
Shelly L. Rutledge, Pharm.D, BCACP, INHC
Lindsay M. Saum, Pharm.D., BCPS, BCGP
Kyle V. Sheffer, Pharm.D., BCACP
Andrew J. Sowles, Pharm.D., BCPS, BCACP, BC-ADM
Sonal A. Taylor, Pharm.D., BCACP
Kris Denzel T. Tupas, Pharm.D., BCPS, BCACP
Susan R. Winkler, Pharm.D., FCCP, BCPS
Hilary Weismantel, Pharm.D., BCACP

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:

  • Consultant/Member of Advisory Board: Katie E. Cardone (AstraZeneca, Vifor, Otsuka, Wolters Kluwer), Spencer H. Durham (Shionogi Pharmaceuticals, Theratechnologies), Jessica Farrell (Cumberland Pharmaceuticals, Boehringer Ingelheim), Diana Isaacs (Lilly, Sanofi), Michelle T. Martin (AbbVie), Molly G. Minze (Wolters Kluwer)
  • Grant Funding/Research Support: Jessica Farrell (Janssen Pharmaceuticals), Michelle T. Martin (Gilead, Merck), Melissa C. Palmer (Telehealth ECHO)
  • Speaker’s Bureau: Jessica Farrell (Pfizer, AbbVie), Michelle T. Martin (AbbVie), Diana Isaacs (Abbott, Bayer, Dexcom, Dexcom, Insulet, Medtronic, Nova Nordisk, Xeris Pharmaceuticals)
  • Minor Shareholder: Michelle T. Martin (AbbVie, Gilead, and Merck), Jessica Tilton (Pfizer, Moderna, Viatris)
  • Other: Alicia B. Forinash (royalties from Wolters Kluwer)

Reviewer Disclosures:

  • Consultant/Member of Advisory Board: Frank Fanizza (Guidepoint)

All other persons in control of content do not have any relevant financial relationships with an ineligible company.

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.

These activities were developed by ACCP and ASHP.

To maintain its strict, independent standards for certification, BPS does NOT endorse or provide review information, preparatory courses, or study guides for Board Certification Examinations.