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Anticoagulation Management Pearls

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Describe effective anticoagulation management strategies.
  2. Describe components of effective anticoagulation education session.
  3. Identify barriers to learning.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN Code

ACPE #0009-0000-22-026-H04-P

Session Code

22AC26-EXW48

Accreditation Hours

1.0 hours of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. This series consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit 1.0 hours (or 0.1 CEUS) for the online activity ACPE #0009-0000-22-026-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Anuja Rizal, Pharm.D., RPh, CACP
Anticoagulation Clinical Coordinator
UConn Health Center
Farmington, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Rizal has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

This activity may contain discussion of off label/unapproved use of drugs. The content and views presented in this educational program are those of the faculty and do not necessarily represent those of the University of Connecticut School of Pharmacy. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Anticoagulation Management Pearls

1. The Joint Commission revised National Patient Safety Goal is intended to:

  1. Ensure all providers are providing same level of care
  2. Set standards on provider’s level of knowledge of anticoagulant medications
  3. Reduce the likelihood of patient harm associated with the use of anticoagulant therapy
  4. Provide guidance on how to deal with providers who do not adhere to the standards
  5. None of the above

 

2. Which of the following are important Anticoagulation Management Considerations?

  1. Assessing pt’s fall risk
  2. Patient Education and Adherence
  3. Selecting appropriate drug
  4. All of the above
  5. None of the above

 

3. Staff education should consist of:

  1. Professionalism in the workplace
  2. Strategies to manage difficult coworkers
  3. Diversity training
  4. Effective time management strategies
  5. How to delegate

 

4. Which of the strategies is best when managing patients with language barriers?

  1. Ask pt. to bring in family members who can help interpret
  2. Ask pt. to bring in friend who can help interpret
  3. Ask bilingual coworker to help interpret
  4. Use google translate
  5. Use qualified interpreter

 

5. When speaking to deaf patients it is important to:

  1. Make indirect contact to avoid conveying incorrect tone/meaning thru facial expressions
  2. Speak slowly and clearly
  3. Learn ASL
  4. Use Visual Aids
  5. Repeat instructions

 

6. Which of the following statements are false?

  1. Using pamphlets or videos will enhance learning for the Visual learners
  2. A person can only have one learning style
  3. It is important to tailor the education to meet the pt’s learning style
  4. Kinesthetic learners learn best by gaining hands on experience
  5. Asking pt’s to repeat your points back to you by asking questions and calling for audience answers enhances learning for the Auditory learner

 

7. The best strategy to manage the non-compliant patient is to:

  1. Identify and address barriers to adherence
  2. Use motivational interviewing
  3. Minimize polypharmacy
  4. Utilize available family and social support
  5. All of the above

 

8. Select the most appropriate response:

  1. Medicare codes 99495 and 99496 are reimbursable for transitional of care services
  2. Transition of care addresses patients moving from one state to another
  3. Transition of care is handled solely by hospital staff
  4. Provide transition of care assistance to elderly patients who request it
  5. None of the above

 

9. Select the most appropriate response:

  1. Americans have been reported to have high health care literacy
  2. Low health care literacy can be managed by ensuring patients learn how to speak English
  3. Using interpreters can help combat low health care literacy
  4. Low health care literacy indicates cognitive decline
  5. None of the above

 

10. AIDET stands for:

  1. Acknowledge, Introduce, Duration, Explanation, Train
  2. Acknowledge, Inform, Duration, Explanation, Train
  3. Acquaint, Inform, Describe, Extent, Teach
  4. Acknowledge, Introduce, Duration, Explanation, Thank you
  5. Acquaint, Introduce, Describe, Extent, Teach

Challenging Topics in Anticoagulation

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the pharmacist will be able to:

  • Discuss managing techniques for challenging patient types including alcoholism, pregnancy, and patients with Antiphospholipid Antibodies Syndrome
  • Describe the discrepancy between POC testing and laboratory measurement of INR
  • Discuss the evidence for 12 week follow up visits and how to determine which patients are  appropriate
  • Evaluate anticoagulation therapy for selected challenging cases

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN Code

0009-0000-22-038-H01-P

Session Code

22AC38-PFX62

Accreditation Hours

1.0 hours of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ADD ACPE UAN 0009-0000-22-038-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Michael Smith, PharmD, CACP, BCPS
East Region Clinical Manager, Pharmacy
Hartford Healthcare
William W. Backus Hospital
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Challenging Topics in Anticoagulation

  1. Alcohol interacts with warfarin through

A             CYP450 1A2

B             Alcohol dehydrogenase

C             Interaction has not been clearly defined

D            p-Glycoprotein

 

  1. The greatest risk of fetal abnormalities related to warfarin use occurs during

A             The first trimester

B             The second trimester

C             The third trimester

D            stable throughout pregnancy

 

  1. The optimal duration of follow-up for patients receiving warfarin is:

A             Weekly

B             Monthly

C             Every 12 weeks

D            Not clearly defined in the literature

 

  1. When using enoxaparin during pregnancy for the prevention of VTE in patients who have been receiving long term warfarin therapy:

A             Use near therapeutic treatment level doses adjusted for body weight

B             Use standard prophylactic doses

 

  1. Antiphospholipid antibody syndrome:

A             Decreases the levels of Factor II and X

B             is associated with an Increase in the risk of hemorrhagic complications

C             is a viral disease

D            May interfere with the INR measurement of patients receiving warfarin

 

  1. Alcohol

A             Should be avoided at any level in all patients receiving warfarin

B             Can be managed similar to other drug interactions

C             Multiple studies on the interaction between binge drinking and warfarin have been published

D            Alcoholism is a FDA labeled contraindication to the use of warfarin

 

  1. The risk of thrombosis in pregnant women with mechanical heart valves is

A             Lowest in patients being treated with warfarin

B             Lowest in patients being treated with a LMWH

 

  1. No major group of international experts have supported the notion testing the INR in a patient receiving warfarin as little as once every 3 months

A             True

B             False

 

  1. A clinically appropriate way to monitor a patient receiving warfarin with antiphospholipid antibody syndrome is:

A             Factor II activity level

B             Factor X activity level

C             Activated Clotting Time (ACT)

D            Both A and B

 

  1. Binge drinking of alcohol in an anti-coagulated patient increase the risk of

A             Falls

B             Gastrointestinal bleeding

C             Non-compliance

D            All of the above

 

 

Laboratory Monitoring of Anticoagulation

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Explain the role of common laboratory tests used in monitoring of anticoagulation therapy.
  2. Identify an alternative to INR monitoring for warfarin therapy.
  3. Identify the clinical situations requiring Activated whole blood Clotting Time (ACT) and Anti-factor Xa activity monitoring for unfractionated heparin.
  4. Discuss the technical differences between point of care testing and laboratory testing and the influence on patient care.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN

ACPE #0009-0000-22-027-H01-P

Session Code

22AC27-TXJ44

 

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-027-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Michael Smith, Pharm.D., BCPS, CACP,
East Region Clinical Manager
Pharmacy Hartford Healthcare
William W. Backus Hospital
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Laboratory Monitoring of Anticoagulation

1.  The Prothrombin time is prolonged in patients:

  1. Receiving warfarin
  2. With significant liver disease
  3. on a typical dose of enoxaparin
  4. both A and B

 

2.  A patient receiving warfarin may also be monitored by checking the activity level of:

  1. Anti-factor Xa
  2. Factor II
  3. D-dimer
  4. fibrinogen

 

3.  Useful tests to screen for a coagulation disorder in a bleeding patient include

  1. aPTT and PT
  2. TT and PT
  3. D-dimer and aPTT
  4. ACT and aPTT

 

4.  The activity of heparin can be monitored with

  1. aPTT
  2. Anti factor-Xa
  3. ACT
  4. all of the above

 

5.  Anti-factor Xa test is

  1. test of clotting time
  2. functional test of enzymatic activity

 

6.  Very high doses of unfractionated heparin are best measured with

  1. TT
  2. ACT
  3. aPTT
  4. PT

 

7.  This test measures the last step in the coagulation cascade, the conversion from fibrinogen to thrombin:

  1. TT
  2. ACT
  3. aPTT
  4. PT

 

8.  If the patient’s PT is 39, the control PT is 13, and the sensitivity of the reagent is 1, what is the INR

  1. more info is needed
  2. 2.0
  3. 3.0
  4.  1.0

 

9.  Antiphospholipid Antibody Syndrome:

  1. Is a clinical condition predisposing patients to hemorrhagic complications
  2. May interfere with PT/INR testing leading to a false prolongation
  3. Predisposes the patient to a pro-thrombotic state and may falsely shorten the PT test
  4. Can easily be corrected for by the lab through analytical methods.

 

10.  Argatroban use is not expected to significantly affect the monitoring of warfarin.

  1. True
  2. False

Direct Oral Anticoagulants and Factor IIa and Xa Inhibitors

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Discuss the pharmacology of the DOACs/Factor IIa and Xa inhibitors.
  2. Discuss the indications and contraindications for DOACs/Factor IIa and Xa Inhibitors.
  3. Review the kinetic profiles of the DOACs/Factor IIa and Xa inhibitors.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN

ACPE #0009-0000-22-028-H01-P

Session Code

22AC28-VXT88

 

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-19-020-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Jessica N. LeClair, Pharm.D., MBA
John Dempsey Hospital (JDH)
UConn Health Center
Farmington, CT

Anuja Rizal, Pharm.D., R.Ph., CACP
Anticoagulation Clinic Coordinator
UConn Health Center,
Farmington, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Drs. Rizal and LeClaire have no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Direct Oral Anticoagulants: Factor IIa and Xa inhibitors

1.  The newer oral anticoagulants work by:

  1. Indirectly inhibiting factor VIII
  2. Directly inhibiting factor IIa or Xa
  3. Causing the breakdown of fibrin
  4. Decreasing the production of factor II

2. p-Glycoprotein inhibition leads to

  1. Increased substrate serum levels
  2. Decreased substrate serum levels
  3. Increased metabolism of substrate
  4. No effect

3. Which agent was shown to be superior to warfarin in both safety and efficacy in atrial fibrillation

  1. Dabigatran
  2. Rivaroxaban
  3. Apixaban
  4. None of the above

4. There is no evidence to suggest that pharmacists can impact the care of patients receiving the new oral agents.

  1. True
  2. False

5. For the treatment of an acute venous thromboembolism, initial parenteral anticoagulants are not needed for therapy with:

  1. Dabigatran or Rivaroxaban
  2. Rivaroxaban or Apixaban
  3. Apixaban or Edoxaban
  4. A parenteral anticoagulant is always needed for at least the first week.

6. This drug should not be placed in a pill box

  1. Dabigatran
  2. Rivaroxaban
  3. Apixaban
  4. Edoxaban

7. What type of patient would be considered a good candidate to for DOAC therapy?

  1. Documented warfarin allergy
  2. History of poor INR control on warfarin despite good compliance
  3. Considerable barriers to routine monitoring, such as physical or transportation issues
  4. Document and confirmed warfarin failure such as an ischemic stroke while consistently therapeutic on warfarin
  5. All of the above

8. To switch a patient from subcutaneously LMWH to a DOAC, you would recommend to discontinue the LMWH and then…

  1. begin the new agent 3 days later if the patient has normal renal function
  2. begin the new agent when the patient’s PTT and INR are sub-therapeutic
  3. bridge with LMWH and the DOAC for 24 hours
  4. begin the new agent when the next dose of LMWH would be due

9. Which of the following DOACs’ bioavailability substantially increases when it is taken with food (largest meal of the day)?

  1. Edoxaban
  2. Rivaroxaban
  3. Dabigatran
  4. Apixaban

10. Prior to initiating a DOAC, the patient should be evaluated for which the following?

  1. Renal Clearance
  2.  Appropriate and approved indication for the specific DOAC agent
  3. Review of patient medication profile to check for potentially significant drug-drug interactions
  4. Adequate insurance coverage or prescription assistance before starting the DOAC agent
  5. All of the above

Vitamin K Antagonist Pharmacology, Pharmacotherapy and Pharmacogenomics

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Discuss the pharmacology of the vitamin K antagonist.
  2. Discuss the indications and contraindications for the vitamin K antagonists.
  3. Discuss the role genetics plays in the dosing of warfarin.
  4. Discuss the utility of how genetic testing will affect initial dosing of warfarin.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN

ACPE #0009-0000-22-030-H01-P

Session Code

22AC30-WXT36

 

Accreditation Hours

1.0 hours of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-030-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Jenna Lee, PharmD,
Supervisor
Ambulatory Care Clinical Pharmacy Services
Yale New Haven Hospital
New Haven, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Lee has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Vitamin K Antagonist Questions

1. Which of the following is NOT a catalyst for the coagulation cascade?
a. Tissue Factor
b. Collagen
c. Negatively charged phospholipid surfaces
d. Positively charged phospholipid surfaces

2. The following is true regarding VKOR, except:
a. It is an enzyme
b. It is the target of warfarin’s mechanism of action
c. It binds to negatively charged phospholipids in the presence of calcium
d. It recycles vitamin K epoxide to active vitamin KH2

3. Which if the following is not a contraindication for warfarin therapy?
a. Pregnancy
b. Major surgery or trauma
c. Active bleeding
d. Spinal puncture
e. Asymptomatic PE

4. DE is a 60 year old male being referred to your anticoagulation clinic with a diagnosis of new onset atrial fibrillation. DE’s past medical history is significant for hypertension, hypercholesterolemia, rheumatoid arthritis, and type 2 diabetes mellitus. Based on the CHEST guidelines, what duration of warfarin therapy do you recommend for DE? Why?
a. 3 months to indefinite, CHADS score of 2
b. Indefinite, CHADS score of 4
c. Indefinite, CHADS score of 2
d. Aspirin therapy preferred over warfarin in this patient
e. None of the above

5. ML is a 65 year old female being referred to your anticoagulation clinic with a s/w new mechanical heart valve in the mitral position. What duration of warfarin therapy and INR goal do you recommend for ML?
a. 2-3; Indefinite therapy
b. 2-3; 3-6 months
c. 2.5-3.5; Indefinite therapy
d. 2.5-3.5; 3-6 months
e. 1.5-2; Indefinite therapy
f. Warfarin is not recommended

6. AL is a 48 year old female who is on warfarin therapy with an indication of mechanical heart valve in the aortic position. Her INR goal is 2-3. Today AL’s INR returned at 1.6. She reports no pertinent findings. The patient take 7.5 mg on Monday and 5 mg on all other days.
a. What are your next steps for this patient?
b. No Change. Continue current warfarin dosing.
c. Instruct the patient to take warfarin 5 mg daily
d. Instruct the patient to take warfarin 7.5 mg on M/F and 5 mg on all other days
e. Instruct the patient to take warfarin 10 mg daily
f. Contact the clinician. The patient’s INR goal is incorrect

7. When considering warfarin dosage adjustments, which of the following patient specific factors is important to consider?
a. Dietary vitamin K intake
b. Upcoming dental procedure
c. Newly started amiodarone
d. History of patient non-adherence
e. All of the above

Developing an Anticoagulation Clinic

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Discuss the benefits of establishing an anticoagulation clinic.
  2. List the steps required to establish and run and anticoagulation clinic.
  3. Describe the important aspects of operating an anticoagulation clinic.
  4. Describe the financial considerations of running an anticoagulation clinic.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN Code

ACPE #0009-0000-22-031-H04-P

Session Code

22AC31-YXV46

 

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE ACPE #0009-0000-22-031-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Anuja Rizal, Pharm.D., RPh, CACP
Anticoagulation Clinical Coordinator
University of Connecticut Health Center
Farmington, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Rizal has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Developing an Anticoagulation Clinic

1) Which of the following is not an advantage of having an Anticoagulation Clinic?
a) Improved patient communication and follow up
b) Improved TTR ad better clinical outcomes
c) Consistent dosing and monitoring
d) Formalized patient education
e) None of the above

2) What characteristics are essential when selecting an Anticoagulation Clinic Medical Director?
a. Extensive anticoagulation knowledge base
b. Approachable and available
c. Helps achieve goals of the clinic
d. Strong advocate for the clinic
e. All of the above

3) What is an Anticoagulation Clinic’s primary goal?
a. Optimize safety and efficacy
b. Improve efficiency
c. Provide cost effective care
d. Improve pt. satisfaction

4) Which of the following is an advantage of a Pharmacist run Anticoagulation Clinic?
a) Able to draw venous samples
b) Autonomy in both dosing and billing
c) Extensive knowledge of warfarin’s pharmacokinetic and pharmacodynamic properties
d) Able to assess vital signs

5) What are the requirements of having a collaborative practice agreement run Anticoagulation Clinic?
a. Pharmacists are required to submit minimum monthly therapeutic summaries
b. Pharmacists may only enter into collaborative practice agreement with prescribers permissible under state law
c. The physician must have an established relationship with patient
d. The collaborative practice agreement needs to be renewed yearly for each patient
e. All of the above

6) What are ongoing costs of running an Anticoagulation Clinic?
a) Printer
b) Personnel salaries
c) Office furniture
d) Fax
e) Scanner

7) Which of the following clinic tasks MUST be performed by a pharmacist?
a. Schedule patient appointments in the clinic for initial visit, follow up INR visits and education visits
b. Interpret INR results by assessing patient specific factors and adjust warfarin dose as needed
c. Order supplies
d. Retrieve INR results either from an outside laboratory
e. Identify past due INR patients and address as per policies and procedures

8) What are the characteristics of an ideal anticoagulation software program?
a. Data integrity
b. IT support after clinic hours
c. Ability to trend data for individual patient
d. A and C

9) Anticoagulation clinic staff training should:
a. Be documented
b. Be provided in an appropriate learning environment
c. Involve real world situations
d. All of the above

10) What characteristics should you look for when selecting an anticoagulation clinic support staff?
a. Strong interpersonal skills
b. Strong computer and data entry skills
c. Previous anticoagulation knowledge
d. A & B

Pharmacist Reimbursement for Anticoagulation Services

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the learner will be able to:

  1. Identify the reimbursement issues with a pharmacist-run anticoagulation service or clinic.
  2. Describe the process for billing for anticoagulation services.
  3. Identify challenges and obstacles for reimbursement issues for anticoagulation services.
  4. Discuss solutions to the challenges of reimbursement for pharmacist-run anticoagulation services.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$8.50

ACPE UAN Code

ACPE #0009-0000-22-032-H04-P

Session Code

22AC32-XZY77

Accreditation Hours

0.5 hours of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ADD ACPE ACPE #0009-0000-22-032-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Michael Smith, Pharm.D., BCPS, CACP,
East Region Clinical Manager
Pharmacy Hartford Healthcare
William W. Backus Hospital
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Pharmacist Reimbursement for Anticoagulation Services

1. Pharmacist, as recognized providers, can directly bill Medicare for services

  1. True
  2. False

 

2. Medicare can be billed for:

  1. Evaluation and management of an INR level
  2. Performing a finger-stick POC INR test
  3. Calling a patient to report their results
  4. A and B

 

3. The level of service for a clinic visit for HOPPS billing is

  1. Set to the same guidelines for “incident to billing”
  2. Set by institution policy
  3. Arbitrary
  4. Must be code “99211”

 

4. Physician supervision rules:

  1. are the same for both on and off-campus clinic sites
  2. pertain only to “incident to” billing
  3. May be satisfied by having an advanced practice nurse on site
  4. Increase the allowable billing level when they are followed

 

5. A point-of-care INR test:

  1. Can be billed separately as a lab procedure
  2. Must be performed by a lab technician in order to be billed
  3. Are not considered valid by Medicare
  4. Are not covered

Risk Management in Anticoagulation

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Discuss the education and training needs of pharmacists who participate in anticoagulation services.
  2. Discuss the documentation needs of a pharmacists-run anticoagulation service or clinic.
  3. Identify corporate infrastructure needs to support anticoagulation services or clinics.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN

ACPE #0009-0000-22-033-H04-P

Session Code

22AC33-PVX33

 

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-033-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Michael Smith, Pharm.D., BCPS, CACP,
East Region Clinical Manager
Pharmacy Hartford Healthcare
William W. Backus Hospital
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Risk Management in Anticoagulation

1. High quality risk management programs protect…

  1. The patient
  2. The provider
  3. The institution
  4. All of the above

 

2. The three most important ways to reduce risk are:

  1. Education, providing a quality service, and complete documentation
  2. Physician involvement, light workload, and malpractice insurance
  3. Commercial management software, education, and malpractice insurance
  4. Providing a quality service, good customer service, and malpractice insurance

 

3. Application, analysis and synthesis of new knowledge can best be taught through:  

  1. Lecture
  2. Reading
  3. Case presentation and practice-based learning
  4. Observation

 

4. A high quality protocol will include:

  1. Rigid dosing guidelines
  2. Process for medication refill requests
  3. Critical value cut-offs
  4. All of the above
  5. A B and C

 

5. It is important to document all patient interaction:

  1. True
  2. False

6. Documentation must be recorded by using:

  1. Commercial software
  2. A quality home-grown system
  3. A paper record
  4. A or B
  5. Any medium as long as it’s complete and retrievable

 

7. Limiting risk through risk sharing can be accomplished by

  1. Physician oversight
  2. Patient education
  3. Both A and B
  4. Risk cannot be shared between involved parties

 

8. Adhering to institutionally approved clinic policies helps to minimize the risk of the individual practitioner

  1. True
  2. False

 

9. Quality improvement activities:

  1. Increase risk
  2. Decrease risk
  3. Have no effect on risk

 

10. When a pharmacist’s recommendations are reviewed and approved by a physician:

  1. The physician assumes all the risk
  2. The pharmacist still carries risk
  3. The pharmacist does not need to document
  4. The pharmacist can only bill for the lab test

Perioperative Management of Warfarin Interruption

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the learner will be able to:

  1. Review recommendations for when to interrupt warfarin therapy.
  2. Review guidelines for determining thromboembolic risk.
  3. Review recommendations for bridging therapy implementation.
  4. Review cases for appropriate method to manage warfarin interruption based on risk stratification.
  5. Apply case-specific monitoring parameters for anticoagulation bridge therapy.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN

ACPE #0009-0000-22-036-H01-P

Session Code

22AC36-MXT39

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-036-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Victoria Lambert, Pharm.D., CACP
Clinical Coordinator
William W. Backus Hospital
Norwich, CT

Janki S. Shah, PharmD, BCACP
William W. Backus Hospital,
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Drs. Lambert and Shah have no relationships with any ineligible companies and therefore have nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Perioperative Management of Warfarin Interruption

 1. A patient presents to your clinic and informs you that he is having a colonoscopy.  He wants to know what to do with his warfarin for the procedure and seeks out your advice.

  1. Tell the patient to contact his PCP
  2. Review the patients indication for warfarin therapy and provide appropriate recommendations to PCP
  3. Stop warfarin for 5 days and bridge with LMWH
  4. Continue warfarin

 

2. Which is the correct description of CHADS2 scoring?

  1. CHF, hypertension, age >65, DM, prior history of stroke
  2. Cardiomyopathy, hypertension, age >75, DM, prior history of stroke
  3. CHF, hypertension, age > 75, DM, prior history of stroke
  4. CHF, hyperlipidemia, age >75, DM, prior history of stroke

 

3. TL is a 75 year old male on warfarin indefinitely for atrial fibrillation.  His CHADS2 score is 5. TL is scheduled for a biopsy of his bladder. Per coordination with his cardiologist, LMWH bridging is ordered and implemented according to your clinic protocol.  Three days after the procedure, he continues to have hematuria and the urologist advises to hold warfarin but continue LMWH due to his high CHADS2 score.  The urologist seeks your advice on the appropriate dose of LMWH.

  1. Continue full treatment dose and order antiXa levels
  2. Reduce the dose of LMWH to a prophylactic regimen until hematuria resolves, then resume warfarin and continue LMWH bridging until INR is therapeutic
  3. Stop LMWH and continue warfarin as it will take several days for warfarins fullest effects
  4. Defer to cardiology

 

4. Warfarin therapy must be interrupted for the following:

  1. Mole excision
  2. Hip Replacement surgery
  3. Cortisone injection in the knee
  4. Epidural
  5. B and D

 

Case Studies in Drug Interactions with Anticoagulation Therapy

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the learner will be able to:

  1. Identify clinically significant drug interactions with anticoagulation therapy.
  2. Discuss drug interactions that patients may hear about, but are generally not clinically significant.
  3. Analyze cases to determine if a drug interaction is clinically significant.
  4. Formulate plans for the identified drug interactions in simulated cases.
  5. Formulate monitoring parameters for the identified drug interactions in the simulated cases.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN

ACPE #0009-0000-22-037-H01-P

Session Code

22AC37-FWK49

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-037-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Philip M. Hritcko, Pharm.D., CACP
Dean, School of Pharmacy
UConn School of Pharmacy
Storrs, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Hritcko has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Case Studies in Drug Interactions with Anticoagulation Therapy

1. You are not familiar with drug X. How would you determine if a drug interaction is likely between drug X and warfarin?

  1. Check drug X prescribing information
  2. Evaluate metabolic characteristics of drug X
  3. Review case reports through Medline
  4. Request information from the manufacturers of warfarin
  5. All of the above

2.Warfarin is a racemic mixture of both R- and S- warfarin. What is the primary route of elimination for the S-warfarin version of this racemic mixture?

  1. Renal
  2. Hepatic CYP1A2, CYP3A4
  3. Hepatic CYP2C15
  4. Hepatic CYP2C9

3. Acute alcohol use “binge drinking” would have what effect on the INR of a patient who has been stable on warfarin anticoagulation therapy?

  1. INR value would go down
  2. INR value would remain the same
  3. INR value would go up
  4. None of the above

Patient Case:

JM is a 35 YO female with a history of DVT and is on chronic warfarin therapy with an INR goal of 2.0-3.0.  JM is not taking any other meds and has discontinued her birth control tablets several years earlier due to the association with her developing a DVT.  JM decides to self-treat what is believed to be a vaginal yeast infection with miconazole nitrate vaginal cream for 7 days.

4. Based upon the information provided in this patient case should you be concerned about JM self-treating her yeast infection?

  1. Yes
  2. No
  3. Undecided

5. Based upon the information provided in this case what would you expect to happen to JM’s INR level after 3-4 days of her using the miconazole nitrate vaginal cream?

  1. INR would go up
  2. INR would remain the same
  3. INR would go down
  4. None of the above

6. Based upon the information that you have on patient JM when should you schedule her next INR testing time?

  1. Recheck INR in 1 month
  2. Recheck INR in 2 weeks
  3. Recheck INR in 3-4 days
  4. Recheck INR in 90 days

7. Warfarin decreases the production of which of the following vitamin K dependent clotting factors?

  1. II
  2. VII
  3. IX
  4. X
  5. All of the above

8. Which of the following best describes examples of pharmacodynamic mechanisms for drug interactions?

  1. Protein binding
  2. Enzyme induction
  3. Synergism
  4. None of the above

9. Which of the following oral anticoagulant agents currently has an approved reversal agent to reverse their anticoagulant actions?

  1. Fondaparinux
  2. Rivaroxaban
  3. Warfarin
  4. Dabigatran
  5. Both c and d above

10. The best over-the-counter (OTC) self-treatment option for a patient with minor headaches, aches and pains who is also taking warfarin is acetaminophen (APAP). Why would you recommend APAP over aspirin or NSAIDs to a patient on warfarin?

  1. APAP does not inhibit platelet function
  2. APAP does not cause injury to the GI mucosa
  3. APAP is highly protein bound
  4. Both a and b above