Osteoporosis: Opportunity for Better Outcomes
Faculty: Felicia Cosman, MD | Nelson B. Watts, MD | Michael R. McClung, MD | Kenneth W. Lyles, MD
CME credit hours: 2.0
Osteoporotic fractures affect millions of postmen-opausal women, and can have a substantial negative effect on daily functioning and quality of life. These fractures are associated with an increased risk of future fracture, clinical complications, and a higher risk of death. However, osteoporosis remains woefully under-diagnosed and undertreated, even among patients who already have fractures. When treatment is provided, adherence and persistence are often suboptimal, reducing the likelihood of a positive outcome.

Congestion in Acute Decompensated Heart Failure: A Case Based Discussion
Faculty: Mihai Gheorghiade, MD, FACC | Clyde W. Yancy, MD, FACC, FAHA, FACP
CME credit hours: 1.5
This program reviews the definition, demographics, and risks of acute decompensated heart failure. Our expert faculty will discuss the strengths, limitations and concerns of standard therapies such as diuretics, vasodilators, inotropes, and natriuretic peptides. The faculty will also discuss emerging therapies including ultrafiltration, adenosine antagonists, and vasopressin receptor antagonists. This activity aims to give cardiologists and other cardiac care givers a good understanding of how to optimize medical therapy for their patients with acute decompensated heart failure, with an emphasis on relieving symptoms.

ACS Patients and Antiplatelet Resistance: Where We Are and Where We're Going.
Faculty: Deepak L. Bhatt, MD | Cindy L. Grines, MD | Peter B. Berger, MD
CME / CE credit hour: 1.5
Myocardial ischemia secondary to acute restrictions in coronary artery blood flow leads to acute coronary syndromes (ACS). Dual antiplatelet therapy with aspirin and clopidogrel is the standard of care for patients with ACS. However, resistance to these agents is associated with adverse clinical events, and is of great concern to clinicians. This educational program will review clinical data pertinent to the current state of antiplatelet therapy for the management of patients with ACS.

Generic Substitution and Therapeutic Equivalence of Antiepileptic Drugs: Clinical and Pharmacoeconomic Issues in Epilepsy Management
A Priority Report
Faculty: John M. Pellock, MD | Andrew J. Pultz, Jr, PharmD, RPh
CME / CE credit hour: 1.0
The issue of generic drug substitution is complex and often poorly understood by physicians and pharmacists. Although the FDA requires that two drugs are similar as demonstrated by bioequivalence data, therapeutic equivalence (or therapeutic effectiveness) and bioequivalence are not necessarily the same. In the case of antiepileptic drugs (AEDs), the therapeutic range over which they are effective may be narrow and, although generic substitution of AEDs may be appropriate for some patients with epilepsy, it may represent suboptimal care for others. This program will give an overview of these and other important issues associated with generic substitution of AEDs.

The Practical and Regulatory Perspective of Bioequivalence
Faculty: Sandra L. Kane-Gill, PharmD, MSC | Joseph F. Dasta, MS, FCCM, FCCP | Nicholas M. Fleischer, RPh, PhD. | Mary Lea Gora-Harper, PharmD, FASHP
CE Credit hour: 1.0
Bioequivalence needs to be determined before an automatic substitution of products or product dosage forms can be made.  When automatic substitutions between brand and generic, generic and generic or between dosage forms are made, clinicians need to be aware of the potential clinical and regulatory issues associated with these substitutions. While product interchange between brand and generic medications, generic and generic medications or different forms of the same product is not typically a problem, this activity will highlight some examples of clinical concerns and related regulation considerations.  It will also provide some direction on obtaining relevant information of bioequivalence.

Common Misconceptions With Bioequivalence & Interchangeability
Faculty: Andrew J. Pultz, Jr, PharmD, RPh | Joseph F. Dasta, MSc, FCCM, FCCP | Sandra L. Kane-Gill, PharmD, MSc
CE credit hour: 1.0
Bioequivalence is a comparison of two or more products with respect to their bioavailabilities. Bioequivalence of trade and generic products or different dosage forms of the same product needs to be determined before the products can be legally interchanged. Numerous factors can affect bioavailability (and bioequivalence) determinations. Thus, there is a great potential for wide variability among the pharmacokinetic profiles among patient populations and bioequivalence determinations. As pharmacists and Nurses, we are in an optimal position to prevent or intervene when a patient is experiencing drug-drug and drug-food interaction resulting in bioavailability alterations with outcomes including sub-therapeutic responses or adverse events. While product interchange between trade and generic medications or between dosage forms of the same product is typically not a problem this activity is going to highlight some examples of when it is a concern.

Contemporary Cardiovascular Ultrasound: A Case Based Approach
Faculty: Bijoy K. Khandheria, MD, FESC, FASE, FACC | Pamela R. Burgess, BS, RDCS, RDMS, RVT | Rick Rigling, BS, RDCS, FASE
CME credit hour: 1.0
An expert panel of faculty discusses the use of cardiovascular ultrasound techniques utilizing real-world case studies. The panel demonstrates the use of established techniques and methods of diagnosis, as well as the investigation of extended applications of existing contrast agents. Additionally, a presentation of case studies demonstrates how development of newer contrast agents and optimization of ultrasound imaging acquisition techniques can ensure a minimally invasive, yet precise method of assessing coronary artery disease. These important new developments establish that echocardiography will play an ever increasing role in the management of cardiac patients.

Generic Substitution and Therapeutic Equivalence of Antiepileptic Drugs: Clinical and Pharmacoeconomic Issues in Epilepsy Management
Faculty: John M. Pellock, MD | Andrew J. Pultz, Jr, PharmD, RPh | Michael C. Smith, MD
CME / CE credit hour: 1.0
The issue of generic drug substitution is complex and often poorly understood by physicians and pharmacists. Although the FDA requires that two drugs are similar as demonstrated by bioequivalence data, therapeutic equivalence (or therapeutic effectiveness) and bioequivalence are not necessarily the same. In the case of antiepileptic drugs (AEDs), the therapeutic range over which they are effective may be narrow and, although generic substitution of AEDs may be appropriate for some patients with epilepsy, it may represent suboptimal care for others. This program will give an overview of these and other important issues associated with generic substitution of AEDs.

Chemotherapy-Induced Neutropenia Prevention: Implications of New Clinical Data and Guidelines
Faculty: Jeffrey C. Crawford, MD | David C. Dale, MD | Gary H. Lyman, MD, MPH, FRCP (Edin) | Christopher R. Friese, RN, PhD, AOCN^®
CME / CE credit hour: 1.0
Chemotherapy-induced neutropenia has very serious and important clinical consequences in terms of medical care, quality of life, and economic factors for cancer treatment. Chemotherapy patients who develop neutropenia are at risk of developing febrile neutropenia, which is a medical emergency that requires immediate medical management. Febrile neutropenia has historically been treated through the use of prophylactic antibiotics, but their usefulness continues to be controversial and the incidence of febrile neutropenia continues to be high. The use of hematopoetic colony stimulating factors (CSFs) has improved the outcomes for patients who experience febrile neutropenia.

Role of PPARs in the Treatment of Insulin Resistance & Cardiovascular Disease
Faculty: Lawrence Blonde, MD, FACP, FACE | James R Gavin III, MD, PhD
CME Credit hour: 1.0
This CME initiative provides primary care providers, endocrinologists and cardiologists, who are the forefront in preventing and treating diabetes and CVD, with up-to-date information on the role of PPARs in the treatment of insulin-resistant diabetes and CVD. Topics of discussion include the interrelationship and impact of diabetes, metabolic syndrome, and CVD; current treatment strategies and unmet needs; safety and efficacy data on PPAR activators; and the potential clinical application of dual alpha-gamma PPAR activators.

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