Presentation Outline ICHP Annual Meeting September 13-15

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Stroke, MI, and Hormonal Contraception • Study cohort – Danish population from 1995 to 2009 Inclusion (and Endpoint Inclusion) Exclusion (and Endpoint Exclusion) Diagnostic code of “transient Women 15 to 49 years y of age g iischemic h i attack” k” Diagnostic codes for “cerebral infarction” and “cerebral apoplexy” Prior diagnosis of venous or arterial thrombotic event Acute myocardial infarction Cancer (prior to study period) Gynecologic surgeries (some censored) Censored –pregnancy and coagulation disorders N Engl J Med. 2012;366(24):2257-2266. Stroke, MI, and Hormonal Contraception • Prescription/Lifestyle Data – Obtained from The Register of Medicinal Product Statistics – Categorized by: estrogen dose, dose progestin type, type route of administration – Duration of use: Rx fill date to last fill date/event – Rxs for DM, arrhythmia, HTN, hyperlipidemia – Smoking habits (from National Registry) N Engl J Med. 2012;366(24):2257-2266. http://laegemiddelstyrelsen.dk/en/topics/statistics,-prices-and-reimbursement/statistics-andanalyses/about-the-register-of-medicinal-product---tatistics-. Stroke, MI, and Hormonal Contraception • Endpoints – First‐ever thrombotic stroke and myocardial infarction N Engl J Med. 2012;366(24):2257-2266. 8/30/2012 14
• Age • Calendar year • Educational level • Type of contraception • Duration of use N Engl J Med. 2012;366(24):2257-2266. Variables • Predisposing risk factors – DM – HTN – Hyperlipidemia – Arrhythmia – Smoking Results: Overall Rates of Events 1,626,158 women with 14,251,063 person‐years of observation Hormonal Contraception Status Thrombotic Stroke Myocardial Infarction Rates higher in nonusers due to older Number/ age and more risk person‐years factors compared to nonusers Crude incidence rates per 100,000 person‐ years Number/ Person‐years Users Nonusers 1051/4.9 million 2260/9.3 million N Engl J Med. 2012;366(24):2257-2266. 21.4 24.2 497/4.9 million 1228/9.3 million Crude incidence rates per p 100,000 person‐ years 10.1 13.2 Does type of hormonal contraception affect rates of MI and stroke (according to this study)? 8/30/2012 15
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ACTIVITY DESCRIPTION Target Audienc
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Current Challenges • Expansion of
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Examples of Medication Consideratio
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Etiology (Dana Point, 2008) 1’. P
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PAH Therapy Targets Schulze-Neick I
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Chronic Adjuvant Therapies in PAH D
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Cummulative suurvival Survival in I
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ACCF/AHA Consensus PAH Treatment Al
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Study Name Drug SUPER-1 Oral silden
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IV Epoprostenol in PAH Due to Scler
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70 60 50 40 30 20 10 Inhaled Ilopro
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Conclusions • PAH therapy improve
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ESC/ERS Guidelines Galie N, et al.
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FUTURE DIRECTIONS WHICH MAY IMPACT
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Rationale for “Front-Loaded” Ap
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Addressing gthe Challenges g in PAH
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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
Page 71 and 72: Discharge Education/Med Rec • New
Page 73 and 74: Media‐Worthy Trials? Making Sense
Page 75 and 76: Prevention of Recurrent VTE • Unp
Page 77 and 78: VTE recurrence during study period
Page 79 and 80: Which patient might be a candidate
Page 81 and 82: Azithromycin and CV Death • Endpo
Page 83 and 84: Azithromycin and CV Death Azithromy
Page 85: Hormonal Contraception and VTE •
Page 89 and 90: ARR=2.20, 2.28 for stroke, MI when
Page 91 and 92: Which of the following combinations
Page 93 and 94: 3 Months of Treatment for Latent TB
Page 95 and 96: 3 Months of Treatment for Latent TB
Page 97 and 98: T/F: Rifapentine in combination wit
Page 99 and 100: 2. Which of the following statement
Page 101 and 102: Fitting the Counseling Piece into M
Page 103 and 104: Current Evidence: Implementing Bund
Page 105 and 106: Teach Back Process • Step 1 Expla
Page 107 and 108: Questions for Consideration and Dis
Page 109 and 110: Why do we care about ADE? • Adver
Page 111 and 112: True or False • Medication errors
Page 113 and 114: Check Point Which of the following
Page 115 and 116: Proactive Screening Process Patient
Page 117 and 118: MTI Pilot at NAH PharmD Students tr
Page 119 and 120: ASHP PPMI Case Study Adding Value:
Page 121 and 122: Interdisciplinary Teamwork: How Phy
Page 123 and 124: Highly Effective Healthcare • Wha
Page 125 and 126: Inter‐Professional Teams ‐ Chan
Page 127 and 128: Meeting the PPMI Goals for Technolo
Page 129 and 130: Drug‐Bug Mismatch Example Con’t
Page 131 and 132: Drug‐Bug Mismatch Build Rules •
Page 133 and 134: Meeting the PPMI Goals for Technolo
Page 135 and 136: Patient Scanning Compliance Sample
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Meeting the PPMI Goals for Technolo
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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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Green Zone • Patient is not havin
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• 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
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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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