The Role of Tenecteplase vs. Alteplase, Neurological Focus
Role of Volatile Anesthetics in Critically Ill Patients, Perioperative Focus
Anticoagulant Monitoring for Patients in the Critically Ill Setting & Perioperative Management of the Bleeding Patient

• Series Overview
• Program Content
• Faculty
• Financial Relationship Disclosures
• Target Audience and Learning Objectives
• Continuing Pharmacy Education Credit
• BCCCP Specialty Recertification Credit
• Technical Requirements
• Commercial Support
• Fees

Clinical Reasoning Series in Critical Care Pharmacy has been approved by the Board of Pharmacy Specialties (BPS) as one component of the professional development programs developed by ACCP for recertification of the Board Certified Critical Care Pharmacist (BCCCP) and Board Certified Pharmacotherapy Specialists (BCPS).

This educational series explores cutting-edge, contemporary therapeutic topics, and demonstrates scientifically sound clinical reasoning and decision-making. It employs learning activities designed to advance the participants' skills and abilities to critically evaluate the scientific evidence and effectively incorporate significant findings into daily practice that lead to effective and safe patient care.

The program will consist of several educational activities and is presented in three parts with each part containing:

• streaming audio/slide synchronized presentations
• downloadable mp3 audio files
• downloadable mp4 video files
• downloadable/printable PDFs of presentation slides
• Continuing Pharmacy Education (CPE) credit
• Recertification Credit - Available with Specialty Recertification package

Release date: December 12, 2023
BCCCP and/or BCPS credit expiration date: December 12, 2024
ACPE credit expiration date: November 13, 2026

The Role of Tenecteplase vs. Alteplase, Neurological Focus

This session is designed to provide the audience with an evidence-based approach to the use of tenecteplase in patients suffering from acute ischemic stroke. Program attendees of both BCCCP and BCPS specialties will benefit from the knowledge of the current literature addressed, which covers the use of thrombolytic therapy, overall treatment goals, and alternative agents.

This program will explore the following topics:

• The pathophysiology of acute ischemic stroke (AIS)
• Thrombolytic therapy for treatment of AIS
• A comprehensive clinical comparison of tenecteplase vs. alteplase in the treatment of AIS
• The role of tenecteplase in other indications

Role of Volatile Anesthetics in Critically Ill Patients, Perioperative Focus

Clinical pharmacists should understand the role of volatile anesthetics in critically ill patients outside of the operative setting. Pharmacists must be aware of how these drugs work, how they can be effectively delivered, and the risks and benefits of these agents compared with intravenous sedative agents. As the role of these agents expands, pharmacists involved with sedation management must gain a proper understanding of this novel approach for their professional growth and development.

This program will explore the following topics:

• Mechanisms of general anesthesia
• Influences on volatile anesthetic delivery
• Volatile anesthetic devices
• Volatile anesthetics vs. intravenous sedatives in critically ill patients

Anticoagulant Monitoring for Patients in the Critically Ill Setting & Perioperative Management of the Bleeding Patient

As pharmacists play a vital role in managing anticoagulation and factor stewardship at many institutions, the pharmacotherapeutic management strategies used to prevent and treat a bleeding patient have evolved to include implementing viscoelastic testing. This learning activity will focus on the role of a pharmacist in guiding hemostasis and monitoring of anticoagulants in the intensive care unit and within the perioperative period. In addition, many patients with bleeding disorders may require alternative anticoagulant monitoring due to discordant laboratory markers, and these presentations will address such.

This program will explore the following topics:

• Anticoagulant monitoring
• Barriers to implementing alternative anticoagulant assays
• Assessing pharmacotherapeutic management strategies in the perioperative setting
• Interpreting viscoelastic testing for treatment plans
• Blood factor stewardship

Clinical Reasoning Series in Critical Care Pharmacy - Program Chair

	Audrey J. Jones, Pharm.D., MBA, BCCCP Pharmacy Manager, Inpatient Operations Cleveland Clinic Foundation Cleveland Heights, Ohio

The Role of Tenecteplase vs. Alteplase, Neurological Focus

	Lina Saliba, Pharm.D., BCCCP, BCPS Critical Care Clinical Pharmacy Specialist Inova Fairfax Medical Campus McLean, Virginia
	Sheshadri Hoque, Pharm.D. Critical Care Clinical Pharmacy Specialist Inova Alexandria Hospital Alexandria, Virginia

Role of Volatile Anesthetics in Critically Ill Patients, Perioperative Focus

	Sarah Blackwell, Pharm.D., BCCCP, BCPS Clinical Pharmacy Specialist Princeton Baptist Medical Center Birmingham, Alabama

Anticoagulant Monitoring for Patients in the Critically Ill Setting & Perioperative Management of the Bleeding Patient

	Gianna Lauren H. Casal, Pharm.D., BCCCP Clinical Pharmacist - Surgical/Trauma/Burn Critical Care Massachusetts General Hospital Cambridge, Massachusetts
	Corey J. Witenko, Pharm.D., FCCM, BCCCP, BCPS Medical Science / Clinical Trial Liaison Theravance Biopharma New York, New York

We thank the following peer reviewers for lending their time and expertise to this Clinical Reasoning Series in Critical Care Pharmacy.

Disclosures 

TARGET AUDIENCE
The target audience for Clinical Reasoning Series in Critical Care Pharmacy is the pharmacist practicing in a clinical setting as a Board Certified Critical Care Pharmacist (BCCCP) or Board Certified Pharmacotherapy Specialist (BCPS) looking to earn rectification credit, and those clinicians seeking additional information on the topics covered.

LEARNING OBJECTIVES
The Role of Tenecteplase vs. Alteplase, Neurological Focus:

1. Describe the pathophysiology of acute ischemic stroke (AIS).
2. Differentiate AIS patients who are candidates for thrombolytic therapy.
3. Evaluate the current literature regarding use of tenecteplase in AIS.
4. Compare and contrast key pharmacokinetic, administration, and dosing parameters for tenecteplase and alteplase in AIS.
5. Analyze the role of tenecteplase in other indications, such as myocardial infarction and pulmonary embolism.

Role of Volatile Anesthetics in Critically Ill Patients, Perioperative Focus:

1. Analyze the proposed mechanisms through which sevoflurane, isoflurane, desflurane, halothane, and nitrous oxide induce general anesthesia.
2. Describe the partition coefficients and other properties which influence the delivery of volatile anesthetics to patients being anesthetized.
3. Examine the devices which allow for the delivery of volatile anesthetics in the intensive care unit setting.
4. Compare and contrast the risks and benefits of volatile anesthetics with those of intravenous sedatives in critically ill patients.

Anticoagulant Monitoring for Patients in the Critically Ill Setting & Perioperative Management of the Bleeding Patient:

1. Analyze standard anticoagulation monitoring to identify patients that may warrant alternative assessments.
2. Distinguish between discordant laboratory markers to ensure appropriate anticoagulant monitoring.
3. Propose an individualized anticoagulation monitoring plan based on interacting disease states.
4. Identify barriers to implementing alternative anticoagulant assays.
5. Assess pharmacotherapeutic management strategies to prevent and treat bleeding in perioperative patients with a history of antithrombotic use or an inherited bleeding disorder.
6. Interpret viscoelastic testing to formulate a treatment plan for a bleeding patient.
7. Appraise the current literature surrounding blood factor stewardship and its impact on patient outcomes and the pharmacy department.

The American College of Clinical Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

The Role of Tenecteplase vs. Alteplase, Neurological Focus
Universal Activity Number: 0217-0000-23-097-H01-P
Contact Hours: 1.50
Activity Type: Application-Based Activity

Role of Volatile Anesthetics in Critically Ill Patients, Perioperative Focus
Universal Activity Number: 0217-0000-23-096-H01-P
Contact Hours: 1.50
Activity Type: Application-Based Activity

Anticoagulant Monitoring for Patients in the Critically Ill Setting & Perioperative Management of the Bleeding Patient
Universal Activity Number: 0217-0000-23-098-H01-P
Contact Hours: 3.00
Activity Type: Application-Based Activity

Methods and CE Requirements

Continuing Pharmacy Education Credit

Activities consist of audio/video/PDF files, attestation statements, and activity evaluations. Learners must purchase the product, review all content, complete the attestation statements and course evaluations to receive continuing pharmacy education credit for each activity. You must submit the attestation statements and course evaluations associated with each activity within the course by November 13, 2026.

National Association of Boards of Pharmacy - CPE Monitor Service

Provided through the collaborative efforts of the National Association of Boards of Pharmacy (NABP), the Accreditation Council for Pharmacy Education (ACPE), and ACPE-accredited providers, the CPE Monitor Service allows you to electronically keep track of continuing pharmacy education (CPE) credits from ACPE-accredited providers. ACPE-accredited providers, like ACCP, are responsible for transmitting this information to NABP to be stored in the CPE Monitor system. Statements of credit will be available at CPE Monitor, nabp.pharmacy/cpe-monitor-service/, within 2–3 business days after completion of this activity. For more information on CPE Monitor please visit nabp.pharmacy/cpe-monitor-service/.

To transfer these credits to CPE Monitor on your behalf your NABP e-Profile ID Number and date of birth must be listed on your ACCP account. To verify or update this information in your ACCP account, visit Licensure/Certification. Be sure to save your changes at the bottom of the page.

Some international pharmacists do not use the CPE Monitor service. To verify or update this information in your ACCP account, visit Licensure/Certification. Check the box “I am an international pharmacist or I am not licensed to practice in the United States, and do not have an NABP e-Profile ID.” Be sure to save your changes at the bottom of the page.

   

To be eligible to earn BCCCP and/or BCPS recertification credit, learners must purchase the recertification version of this course, review all content, successfully complete, submit and pass the web-based posttests associated with each activity within the course by December 12, 2024. You are allowed only one attempt to successfully complete this assessment.

The passing point to earn BCCCP and/or BCPS recertification credit is based on an expert analysis of the assessment items in each posttest activity. Any posttest submitted before the recertification posttest deadline that meets this passing point will earn BCCCP and/or BCPS recertification credits (as elected by the learner). These credits will be assigned as of the date of test submission.

All participants must have a Board of Pharmacy Specialties (BPS) board certification credential number, BPS ID Number, and a BPS expiration date on file with ACCP for reporting purposes. To verify or update this information in your ACCP account, visit Licensure/Certification. Be sure to save your changes at the bottom of the page.

For statements of recertification credit, visit www.bpsweb.org. Questions regarding the number of hours required for BCCCP and/or BCPS recertification should be directed to BPS at (202) 946-5026 or www.bpsweb.org.

The ACCP Recertification Dashboard is a free online tool that can track recertification credits as they are earned through ACCP and schedule new opportunities for credits from upcoming ACCP professional development programs.

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The American College of Clinical Pharmacy does not solicit or accept external commercial/financial support for its continuing pharmacy education activities. No commercial/financial support has been solicited or accepted for this activity.