2012-2013 Psychiatric Pharmacy Review Course Course Components (ACPE Only)

# 0284-0000-12-040-H04-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the Pharmacy & Therapeutics Committee, formulary management, Medication Use Evaluation (MUE), and the MUE process from identification of drug to development and implementation of protocols or guidelines.
2. Outline a plan to start a new service or evaluate a current service using the performance improvement cycle.
3. Outline a program to monitor medication misadventures and develop strategies to prevent their occurrence.
4. Recognize The Joint Commission standards related to pharmacy practice in psychiatric settings (e.g., Medication Management, National Patient Safety Goals).
5. Describe the use of State Operations Manual F-tags in the pharmacological management of psychiatric disorders in long term care facilities.
6. Explain the basic ethical principles of the Belmont Report and its relationship to human subject research and clinical practice.
7. Describe the roles of the Institutional Review Board, U.S. Department of Health and Human Services, and Office for Human Research Protections in research that impact patients with psychiatric illness.
8. Describe the role of Centers for Medicare and Medicaid Services in the reimbursement process for healthcare, including pharmacy.
9. Explain the ASHP Residency program standards for the PGY2 pharmacy residency in psychiatry.
10. Identify organizations that provide support and advocacy for patients with mental illness and their families.

Pharmacy Director-San Antonio State Hospital
Pharmacy Services Director-
Texas Department of State Health Services, Hospital Section
Clinical Assistant Professor-
College of Pharmacy
The University of Texas at Austin
San Antonio, TX

# 0284-0000-12-032-H04-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the differences between internal and external validity.
2. Explain various study designs, including strengths and weakness, and types of bias present in each type.
3. Describe appropriateness of the study design for research questions and hypotheses.
4. Explain key epidemiologic concepts: incidence, prevalence, relative risk, odds ratio, relative and absolute risk reduction, and number needed to treat.
5. Differentiate between descriptive and inferential statistics.
6. Describe different types of data, which statistical tests can be used for each type, groups being used, and the relationship between groups.
7. Explain the process of calculating a sample size.
8. Explain the different types of error and how to reduce each.
9. Describe different ways to report and interpret statistical significance of a study using p-values and confidence intervals.
10. Describe the different types of survival analyses.
11. Outline the differences between noninferiority and traditional hypothesis testing trials.
12. Discuss the differences between clinical and statistical significance.

Assistant Professor, College of Pharmacy, University of New England Portland, ME

# 0284-0000-12-035-H04-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Explain the difference between efficacy and effectiveness studies.
2. Identify the different types of pharmacoeconomic studies.
3. Discuss the different outcomes that can be evaluated in a study.
4. Describe the features of decision analysis and sensitivity analysis.
5. Outline key features of meta-analysis and how the data are analyzed.
6. Discuss common statistical analyses included in a meta-analysis such as effect size, funnel plot and tests for heterogeneity.

Professor

The University of Texas Austin, TX

# 0284-0000-12-021-H33-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for bipolar disorder.
2. Explain the use of common rating scales for research, diagnosis and management of bipolar disorder.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of bipolar disorder.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used in biploar disorder.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for bipolar disorder.
6. Select an evidenced-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects.
8. Discuss the role of drug therapy in the management of bipolar disorder in special populations (e.g., pregnancy/lactation, children, and elderly).
9. Identify essential information to discuss during patient counseling about the drug therapy of bipolar disorder.

Psychiatric Clinical Pharmacy Specialist

# 0284-0000-12-034-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for major depressive disorder, seasonal affective disorder, and substance-induced mood disorder.
2. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for major depressive disorder, seasonal affective disorder, and substance-induced mood disorder.
3. Explain the use of common rating scales for research, diagnosis and management of depressive disorders.
4. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of depressive disorders.
5. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for antidepressants.
6. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for major depressive disorder.
7. Select an evidence-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
8. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects.
9. Discuss the role of drug therapy in the management of antidepressants in special populations (e.g., pregnancy/lactation, children, and elderly).
10. Identify essential information to discuss during patient counseling about antidepressants.

Director of Pharmacy

# 0284-0000-12-030-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, and pathophysiology for delirium, aggression, and agitation, and the DSM-IV-TR criteria for delirium.
2. Explain the use of common rating scales for research, diagnosis and management of aggression, agitation and delirium.
3. Discuss the efficacy of pharmacological and nonpharmacologic treatment options in the acute and long-term management of aggression, agitation and delirium.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used in aggression, agitation and delirium.
5. Describe treatment guideline and clinical trials, including study design, strengths and weaknesses, and significance of findings for aggression, agitation and delirium.
6. Select an evidence-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy.
8. Identify essential information to discuss during patient counseling about the drug therapy of aggression, agitation and delirium.

Clinical Pharmacy Specialist,
Psychiatry

Louis Stokes Cleveland Department of Veterans Affairs Medical Center Cleveland, OH

# 0284-0000-12-036-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, diagnostic criteria, and pathophysiology for seizure disorders, Parkinson's disease, primary headache disorders, neuropathic pain, fibromyalgia, and traumatic brain injury.
2. Explain the use of common rating scales for research, diagnosis and management of neurologic disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of neurologic disorders.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used in neurologic disorders.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for neurologic disorders.
6. Select an evidence-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects.
8. Discuss the role of drug therapy in the management of the disorder in special populations (e.g., pregnancy/lactation, children, and elderly).
9. Identify essential information to discuss during patient counseling about the drug therapy of neurologic disorders.

Associate Professor

University of Maryland School of Pharmacy Baltimore, MD

# 0284-0000-12-031-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for anxiety disorders.
2. Explain the use of common rating scales for research, diagnosis and management of anxiety disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of anxiety disorders.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used in anxiety disorders.
5. Describe treatment guidelines and clinical trials including study design, strengths and weaknesses, and significance of findings for anxiety disorders.
6. Select an evidence-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects, if appropriate.
8. Discuss the role of drug therapy in the management of anxiety disorders in special populations (e.g., pregnancy/lactation, children, and elderly).
9. Identify essential information to discuss during patient counseling about the drug therapy of anxiety disorders.

Director of Addiction Outreach,
Associate Professor of Pharmacy Practice

Appalachian College of Pharmacy Oakwood, VA

# 0284-0000-12-038-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for personality and eating disorders.
2. Explain the use of common rating scales for research, diagnosis and management of personality and eating disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of personality and eating disorders.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for medications used to treat personality and eating disorders.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for borderline personality disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder.
6. Select an evidenced-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects for medications used to treat personality and eating disorders.
8. Discuss the role of drug therapy in the management of personality and eating disorders in special populations (e.g., pregnancy/lactation, children, and elderly).
9. Identify essential information to discuss during patient counseling about treatment for personality and eating disorders.

Assistant Professor

Southern Illinois University of Edwardsville Edwardsville, IL

# 0284-0000-12-039-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for Alzheimer’s disease, vascular dementia, Lewy Body dementia, late-life depression, and late-life anxiety disorders.
2. Explain the use of common rating scales for research, diagnosis and management of dementia, late-life depression, and late-life anxiety disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of dementias, late-life depression, and late-life anxiety disorders.
4. Outline the mechanisms of action, pharmacokinetic, pharmacodynamic, and pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used in dementias, late-life anxiety depression, and late-life anxiety disorders.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for Alzheimer’s disease, vascular dementia, Lewy Body dementia, late-life depression, and late-life anxiety.
6. Select an evidenced-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy ( including laboratory tests and managing adverse effects, if appropriate).
8. Identify essential information to discuss during patient counseling about the drug therapy of dementias, late-life depression, and late-life anxiety disorder.
9. Discuss the Center for Medicare and Medicaid Services State Operations Manual standards in the management of the patients in long-term care facilities who are receiving psychotropic drug therapy.

Clinical Pharmacy Specialist in Psychiatry

# 0284-0000-12-037-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for attention deficit hyperactivity disorder (ADHD), Tourette’s and tic disorders, conduct and oppositional-defiant disorders, and separation anxiety disorder.
2. Explain the use of common rating scales for research, diagnosis and management of the above disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of psychiatric disorders in children.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used for the above disorders.
5. Describe treatment guidelines (DIII) and clinical trials, including study design, strengths and weaknesses, and significance of findings (DII) for ADHD.
6. Design an evidenced-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse using given the clinical presentation of a specific patient with the above disorders.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects.
8. Identify essential information to discuss during patient counseling about the drug therapy of psychiatric disorders in children. (DII)
9. Recognize the behavioral phenotypes and the major medical complications of the following syndromes:
   1. Autistic Disorder
   2. Asperger’s Disorder
   3. Down Syndrome
   4. Prader-Willi Syndrome
   5. Fragile X Syndrome
   6. Klinefelter’s Syndrome
   7. Rett’s Disorder
10. Discuss risk factors, pathogenesis, clinical course, and appropriate drug treatment options of the above syndromes.
11. Identify special considerations for treating the following problems in an individual with various genetic disorders:
    1. Self-Injurious Behavior / Disruptive Disorders
    2. Mood Disorders
    3. Anxiety Disorders
    4. ADHD Symptoms

Assistant Professor

# 0284-0000-12-041-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for schizophrenia, schizoaffective disorder, schizophreniform, brief reactive psychosis, and substance-induced psychotic disorder.
2. Explain the use of common rating scales for research, diagnosis and management of psychotic disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of psychotic disorders.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for antipsychotics.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for schizophrenia.
6. Select an evidence-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects, for antipsychotics.
8. Discuss the role of drug therapy in the management of antipsychotics in special populations (e.g., pregnancy/lactation, children, and elderly).
9. Identify essential information to discuss during patient counseling about antipsychotics.

Instructor, Department of Psychiatry

University of Maryland School of Medicine Maryland Psychiatric Research Center Baltimore, MD

# 0284-0000-12-042-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the clinical presentation, signs and symptoms, DSM-IV-TR criteria, and pathophysiology for insomnia, narcolepsy, sleep apnea, and movement disorders of sleep.
2. Explain the use of common rating scales for research, diagnosis and management of sleep disorders.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of sleep disorders.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used in sleep disorders.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for sleep disorders.
6. Evaluate landmark clinical trials, including study design, strengths and weaknesses, and significance of findings, and treatment guidelines for sleep disorders.
7. Select an evidenced-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
8. Outline a plan for monitoring the safety and efficacy of drug therapy (including laboratory tests and managing adverse effects, if appropriate).
9. Discuss the role of drug therapy in the management of sleep disorders in special populations (e.g., pregnancy/lactation, children, and elderly).
10. Identify essential information to discuss during patient counseling about the drugs prescribed for sleep disorders.

Clinical Pharmacy Specialist - Psychiatry,

Clinical Associate Professor-Pharmacy and Psychiatry Virginia Commonwealth University Health System, Richmond, VA

# 0284-0000-12-043-H01-P (Knowledge)

Learning Objectives
At the end of this program, the participant should be able to:

1. Describe the signs and symptoms based on the DSM-IV-TR criteria, the pathophysiology, the presentation, the clinical course of acute intoxication, acute withdrawal, and chronic dependency associated with the use of the following drugs of abuse: alcohol, opiates, nicotine, cocaine and stimulants, inhalants, marijuana.
2. Explain the use of common rating scales for research, diagnosis and management of substance abuse and dependence.
3. Discuss the efficacy of pharmacologic and nonpharmacologic treatment options in the acute and long-term management of substance abuse and dependence.
4. Outline the mechanisms of action, pharmacokinetic and pharmacodynamic, pharmacogenetic properties, adverse events, drug interactions, and warnings/precautions for drugs used to treat alcohol, nicotine, and opiate dependence.
5. Describe treatment guidelines and clinical trials, including study design, strengths and weaknesses, and significance of findings for substance abuse and dependence.
6. Select an evidenced-based drug therapy regimen (drug, dose, schedule and duration of therapy) for stabilizing symptoms and preventing relapse given the clinical presentation of a specific patient.
7. Outline a plan for monitoring the safety and efficacy of drug therapy, including laboratory tests and managing adverse effects.
8. Discuss the role of drug therapy in the management of substance abuse in special populations (e.g., pregnancy/lactation, children, and elderly).
9. Identify essential information to discuss during patient counseling about the drug therapy of alcohol, nicotine, and opiate dependence.

Assistant Professor, Psychopharmacology College of Pharmacy University of New England Portland, ME