Presentation Outline ICHP Annual Meeting September 13-15

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On-therapy Favorable Prognostic Indicators • Functional class I or II • 6MWD >380 m • Hemodynamics – normal cardiac index (>2 2 L/min/m2 – normal cardiac index (>2.2 L/min/m ) – normal RA pressure • Positive response to CCB • BNP
70 60 50 40 30 20 10 Inhaled Iloprost Added to Bosentan (STEP) 0 Mean 6MWD Change from Baseline (m) Bosentan + Iloprost (n=32) p=0.051 0 051 Bosentan + Placebo (n=33) 1.00 0.75 0.50 0.25 *log-rank test. McLaughlin VV, et al. Am J Respir Crit Care Med. 2006;174:1257-1263. Proportion Free of Clinical Worsening Iloprost Placebo p=0.02* 0.00 0 28 56 84 Time (d) Inhaled Treprostinil Added to Bosentan or Sildenafil (TRIUMPH) Meters 30 25 20 <strong>15</strong> 10 5 Change in Peak 6MWD by Specific Combination: 6 Background sildenafil Background bosentan Entire population 22 7 6 11 25 0 Day 1 Week 6 Time Week 12 McLaughlin VV, et al. J Am Coll Cardiol. 2010;55:19<strong>15</strong>-1922. 19 9 20 Change from baselinee > defined value (meterss) % Achieving Specific 6MWD Improvements Placebo Inhaled treprostinil 50 12 31 45 14 35 40 17 37 35 22 39 30 28 43 25 32 48 20 32 52 0 20 40 60 Percentage of patients Combination Therapy Caveats • Experience evolving • Most data from ‘add-on’ - ? De novo? Order? • More drugs available – more options – more ways to get it wrong • More questions than answers • Costs/expenditures; third-party hurdles Taichman DB. Ann Intern Med. 2008;149:583-585. 21
Page 1 and 2: ACTIVITY DESCRIPTION Target Audienc
Page 3 and 4: Current Challenges • Expansion of
Page 5 and 6: Examples of Medication Consideratio
Page 7 and 8: Etiology (Dana Point, 2008) 1’. P
Page 9 and 10: PAH Therapy Targets Schulze-Neick I
Page 11 and 12: Chronic Adjuvant Therapies in PAH D
Page 13 and 14: Cummulative suurvival Survival in I
Page 15 and 16: ACCF/AHA Consensus PAH Treatment Al
Page 17 and 18: Study Name Drug SUPER-1 Oral silden
Page 19: IV Epoprostenol in PAH Due to Scler
Page 23 and 24: Conclusions • PAH therapy improve
Page 25 and 26: ESC/ERS Guidelines Galie N, et al.
Page 27 and 28: FUTURE DIRECTIONS WHICH MAY IMPACT
Page 29 and 30: Rationale for “Front-Loaded” Ap
Page 31 and 32: Addressing gthe Challenges g in PAH
Page 33 and 34: Considerations • Central vs. peri
Page 35 and 36: Pulmonary Hypertension • Approxim
Page 37 and 38: Example Cassette Calculations • V
Page 39 and 40: Assessment Question 1 Which of the
Page 41 and 42: Illinois Council of Health‐System
Page 43 and 44: Patient Activity ‐ 1 Patients in
Page 45 and 46: Hospitalists National Trends • Ja
Page 47 and 48: Pharmacy Landscape • PGY‐2: So
Page 49 and 50: Primary Care Physicians by Field, F
Page 51 and 52: Health Systems Pharmacy and TATAI
Page 53 and 54: Readings The 21 Irrefutable Laws of
Page 55 and 56: What is a “Practice Model”? •
Page 57 and 58: Completing the Self Assessment •
Page 59 and 60: Residency trained (B23p) Illinois N
Page 61 and 62: Solving the PPMI Puzzle ‐ Here Ar
Page 63 and 64: Overview of Value Based Purchasing
Page 65 and 66: Implementation of Medication‐ rel
Page 67 and 68: Question #1 Within which programs a
Page 69 and 70: Solving the PPMI Puzzle‐ Here are
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Discharge Education/Med Rec • New
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Media‐Worthy Trials? Making Sense
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Prevention of Recurrent VTE • Unp
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VTE recurrence during study period
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Which patient might be a candidate
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Azithromycin and CV Death • Endpo
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Azithromycin and CV Death Azithromy
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Hormonal Contraception and VTE •
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• Age • Calendar year • Educa
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ARR=2.20, 2.28 for stroke, MI when
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Which of the following combinations
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3 Months of Treatment for Latent TB
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3 Months of Treatment for Latent TB
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T/F: Rifapentine in combination wit
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2. Which of the following statement
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Fitting the Counseling Piece into M
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Current Evidence: Implementing Bund
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Teach Back Process • Step 1 Expla
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Questions for Consideration and Dis
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Why do we care about ADE? • Adver
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True or False • Medication errors
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Check Point Which of the following
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Proactive Screening Process Patient
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MTI Pilot at NAH PharmD Students tr
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ASHP PPMI Case Study Adding Value:
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Interdisciplinary Teamwork: How Phy
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Highly Effective Healthcare • Wha
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Inter‐Professional Teams ‐ Chan
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Meeting the PPMI Goals for Technolo
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Drug‐Bug Mismatch Example Con’t
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Drug‐Bug Mismatch Build Rules •
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Patient Scanning Compliance Sample
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Global Immunizations 3 • Jan 2012
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Mobile Devices: Beyond Angry Birds
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Google Play • Google Play - Inter
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Other Useful Productivity Apps •
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Mobile Devices: Beyond Angry Birds
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Net Activations by Industry Source:
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News Readers/Aggregators Features S
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Contact Information • E‐mail: -
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Early‐Onset Sepsis • Sign and s
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• BR is on day 2 of cefotaxime wi
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Immunizations: The Superheroes to P
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Current ACIP Recommendations Influe
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Herpes Zoster Vaccine Recommendatio
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Assessment Questions 1. What are th
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HIV Linkage and Retention in Care T
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DHHS Guidelines, March 2012: When t
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Protease Inhibitors • Require “
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Mean Change (mg/ /dL) STARTMRK: Lip
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RAL Drug Interactions • Does not
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Instructions for Credit In order to
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Staging Stage Criteria (Durie‐Sal
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Salvage Therapy Partial List Regime
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Bortezomib-Thalidomide-Dexamethason
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Case 2 ST is a 76 y/o African Ameri
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Thalidomide and Lenalidomide • Ad
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Fixed Low-Dose Warfarin Study Thera
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New Drugs 2012 Anna Nowobilski‐Va
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Pulmonology » Cystic Fibrosis •
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Oncology » MTX Toxicity • MTX 1o
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NEW DRUGS AND BIOLOGICALS 2012 RESO
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Disease State Reviews for Pharmacy
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Chronic Obstructive Pulmonary Disea
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Page 205 and 206:
Green Zone • Patient is not havin
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Page 209 and 210:
• A hormone produced by the pancr
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Unraveling Unraveling The The Puzzl
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The Reward Center In time, serious
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So what makes addicted pharmacists
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How to find a treatment center Onli
Page 219 and 220:
Internet Drug Abuse Study conducted
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NIAAA = best resource for alcohol d
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Impact of Postoperative Pain • Pi
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Safety Profile • Amar et al confi
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References 1. Rømsing J, Møiniche
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Society of Regional Anesthesia Meet
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A New Approach IV Acetaminophen •
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References • Schechter, Leslie N.
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Bupivacaine liposome injectable sus
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Error Potential • Inadvertent IV
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Decolonization Methods • Anti-sep
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Evidence: Inpatient ICU MRSA Coloni
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Residency Project Pearls Adherence
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650 subjects id identified tifi d R
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Overtreatment versus Appropriate Tr
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Adherence to and Outcomes Associate
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Background • Lack of comprehensiv
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Results Results‐User User Audits
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Special thanks to: • Carol Heunis
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Antibiotic Prophylaxis American Hea
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Study Limitations • Dependent on
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Study Background • Observation of
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A patient has a CrCl of 25 mL/min.
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• Cysteine hydrochloride: antioxi
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Sample Preparation • Intravenous
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Questions? Residency Project Pearls
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The Interview: Your Preparation •
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PGY1 Residency Options Carol Heunis
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RESIDENCY PROGRAM BASICS • Progra
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CV: The key to a top curriculum vit
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Tips for a Top Notch CV • Focus o
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What is PhORCAS? • PhORCAS is the
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Piecing together the new CHEST guid
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Initiating therapy CHEST 2012 2.1.8
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What is “Consistently Stable?”
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Puzzle # 2A: patient has just compl
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What would you do for JJ? • A. Ho
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Considerations for SB • Bleeding
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Presentation Outline ICHP Annual Meeting September 13-15

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