Law: Identifying Imposters: Counterfeit Drugs in the Pharmacy Distribution Chain -RECORDED WEBINAR

Upon completion of this knowledge based CE Activity, a pharmacist will be able to:

Define the terms “counterfeit” and "spurious" drugs

Discuss the prevalence of counterfeiting globally and in the United States

List factors that contribute to drug counterfeiting

Discuss the Drug Supply Chain Security Act (DSCSA) and its implications for the drug supply distribution chain’s integrity

Identify steps that reduce the risk of suspect product being delivered to the pharmacy and to patients

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this knowledge-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-25-062-H03-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

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.

1. What is the difference between “counterfeit” and “spurious” drugs and adulterated drugs?

Counterfeit or spurious drugs are usually contaminated but adulterated drugs are not
Adulterated drugs are usually contaminated but counterfeit or spurious drugs are often not
Counterfeit or spurious drugs and adulterated drugs are the same thing for all practical purposes

2. Approximately how many “online pharmacies” exist globally?

300 to 400
30,000 to 40,000
300,000 to 400,000

3. Which of the following medications is MOST LIKELY to be counterfeited and why?

Erectile dysfunction medications because of the quantity restrictions imposed by drug manufacturers
Any class of medication used frequently by the elderly because of the large volume sold across the country
Monoclonal antibodies and designer oncology drugs because of their high cost and large eligible patient pool

4. A 22-year-old college student attends a weekend rave. Near the dance floor, there’s a large bucket of mixed pills in different colors and shapes. Friends tell him, “Just grab a few—everyone does it.” Which of the following is the MOST APPROPRIATE harm-reduction step for him to take?

Nibble a very small piece of one pill first and wait an hour; if he feels okay, he can assume the pills are safe and take more
Use a reputable test kit (e.g., reagent test, fentanyl test strip) and avoid taking any pills that he hasn’t checked
Choose only pills that are a familiar color and logo (e.g., something he’s seen online) because these are more likely to be genuine

5. What is the difference between a 1D and a 2D barcode?

A 1D barcode stores data in one direction while a 2D barcode stores data in two directions
A 1D barcode is flat on the surface of the packaging, while a 2D barcode has texture
A 1D barcode stores much more information than the typical 2D barcode

6. During an internal audit, a technician asks, “When we receive prescription drugs from a wholesaler, what information are we required to get and keep so we can verify where each product came from if there’s a recall or a counterfeiting investigation?” Which answer best reflects the Drug Supply Chain Security Act (DSCSA) requirements?

A complete pedigree including product identifier and transaction information, history, and statements from trading partners
Only the manufacturer’s lot number/expiration date and the product’s NDC
An invoice showing the purchase price and quantity, the lot number/expiration date, and the package insert

7. Anna is a procurement manager for a large healthcare system. They recently found counterfeit Ozempic in their inventory. Which of the following steps is the MOST IMPORTANT to prevent this from happening again?

Purchase medications from reputable sources approved by regulatory agencies
Check all shipments of prescription drugs to ensure they’ve been shipped in the U.S.
Check all inventory on the online BeSafeRx web site immediately when it arrives

Patient Safety: Gabapentin and Trazadone: Off-label Use is Out of Control-Recorded Webinar

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this knowledge-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-044-H05-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Patient Safety: Gabapentin and Trazodone, Off-label Use is Out of Control
LEARNING OBJECTIVES
At the end of this continuing education activity, pharmacists will be able to
1. LIST the numerous off label uses of gabapentin and trazodone
2. DESCRIBE which of those uses are supported by actual evidence
3. INDICATE the potential adverse effects and medication related problems that patients who take these drugs may experience
4. ARTICULATE ways to approach prescribers with alternative suggestions

1. Which of the following is an off-label use for gabapentin?
A. Postherpetic neuralgia
B. Adjunctive therapy in partial seizures
C. Migraine prophylaxis

2. Which of the following is an off-label use for trazodone?
A. Chronic insomnia
B. Major depressive disorder
C. Pruritis

3. Which of gabapentin’s off-label uses has the strongest evidence to support it?
A. Bipolar disorder
B. Alcohol withdrawal syndrome
C. Pain syndromes

4. Which of trazodone’s off-label uses has the strongest evidence to support it?
A. Little evidence is available to support the use of trazodone in any of its purported off-label uses.
B. The best evidence supports its use in chronic insomnia, with more than 15 RCTs indicating it is effective.
C. A surprise finding has been that it is effective for behavioral issues in kids who have ADHD; it may help adults, too.

5. Which if the following links gabapentin and trazodone to a most common adverse effect?
A. Gabapentin = dose-dependent CNS and respiratory depression; trazodone = nausea/vomiting, xerostomia, dizziness, drowsiness
B. Gabapentin = dose-dependent CNS priapism and suicidal ideation; trazodone = hypersensitivity reactions and peripheral edema
C. Gabapentin = cardiac arrythmias and QT prolongation; trazodone = cumulative depressant effects when given with SSRIs

LAW: Off-Label Drug Use and The Pharmacists Role-RECORDED WEBINAR

Upon completion of this application based CE Activity, a pharmacist will be able to:

1. Define the term "off-label" in terms of drug promotion, prescribing, and use.
2. Distinguish between the use of unapproved drugs and unapproved uses of approved drugs.
3. List at least two reasons why off-label drug promotion could be harmful to patients.
4. Explain whether a pharmacist has an obligation to dispense (or not dispense) a drug prescribed for an off label
use.
5. Identify potential liabilities for pharmacists who recommend off-label use of a drug.

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-037-H03-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Post Test
2023 CE Finale – LAW: Off-Label Drug Use and the Pharmacist’s Role

1. Which of the following statements about off-label drug use is TRUE?
a. Connecticut’s Pharmacy Practice Act prohibits a pharmacist from dispensing a drug for a use other than its FDA-approved indication.
b. Drug companies have a First Amendment (“free speech”) right to promote FDA-approved drugs for unapproved indications.
c. Pharmacists who have declined to fill a prescription for an unapproved use have been found liable for interfering with the prescriber-patient relationship.

2. According to the FDA, which of the following statements about unapproved drugs and unapproved uses of approved drugs is FALSE?
a. Unapproved drugs have not been cleared as safe and effective by the FDA.
b. All drugs compounded pursuant to a prescription are unapproved drugs.
c. The importation and use of an unapproved drug is prohibited in all circumstances.

3. According to the Agency for Healthcare Research and Quality (AHRQ), off-label prescribing accounts for approximately what percentage of all prescriptions in the United States?
a. 3%
b. 20%
c. 40%

4. A patient asks the pharmacist to mix up some “Magic Mouthwash” consisting of two FDA-approved OTC medications (such as Benadryl liquid and Mylanta) to treat mouth sores. What should the pharmacist tell the patient?
a. The pharmacist needs to do some research; if research indicates this product is effective, he can make it.
b. A prescription is needed because the pharmacist is compounding two FDA-approved drugs for an unapproved use.
c. The pharmacist can make Magic Mouthwash because both medications are OTC (not prescription-only).

5. Which of the following statements about pharmacist responsibilities when dispensing FDA-approved drugs for an unapproved use is TRUE?
a. Unless it’s a prescription for a compounded drug, a pharmacist is obligated to verify the intended use of each drug that is dispensed pursuant to a prescription.
b. When a pharmacist recognizes that a prescription is for an off-label use, the pharmacist is obligated to inform the patient that the use is not approved by the FDA.
c. If a pharmacist recommends an off-label use of a drug to a prescriber, the pharmacist should be aware of evidence-based support for the use.

The ABCD of Off-Label Medications for Weight Management-RECORDED WEBINAR

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-038-H01-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

The ABCD of Off-Label Medications for Weight Management
Post Test
1. When working with a patient to manage ABCD, what is the first goal?

A. prevent weight regain
B. stop further weight gain
C. achieve weight reduction

2. Which of the following is the correct order of weight reduction efficacy (highest to lowest)?

A. tirzepatide > semaglutide > phentermine
B. semaglutide > SGLT2 inhibitors > phentermine
C. metformin = semaglutide > topiramate

3. What did the SELECT RCT report about patients 45 years and older with ABCD and existing cardiovascular disease who did not have diabetes?

A. The placebo-subtracted weight reduction for weekly semaglutide 2.4 mg was 15% of baseline body weight.
B. Subcutaneous semaglutide 2.4 mg once weekly reduced major adverse cardiovascular events in ABCD.
C. Subcutaneous semaglutide 2.4 mg once weekly significantly reduced weight but did not prevent cardiovascular events.

4. What is the most common adverse reaction for GLP-1 receptor agonist-based medications?

A. nausea and other gastrointestinal adverse effects
B. hypoglycemia
C. sleep disturbance

5. With which drug class can tirzepatide interact ?

A. beta blockers
B. ACE inhibitors
C. oral hormonal contraceptives

TOP 10 Cardiovascular Drugs Used Off Label!!!-RECORDED WEBINAR

Upon completion of this application based CE Activity, a pharmacist will be able to:

Identify how an FDA approved and off label indication differ and the implications of that differential designation

Identify which 10 FDA approved cardiovascular drugs have the most promising off label uses for treating other cardiac or noncardiac disorders

Describe the mechanisms of action for the purported off label uses of these drugs

Identify which national guidelines or consensus statements recommend the off-label use of drugs

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-039-H01-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Post Test “TOP 10 Cardiovascular Drugs Used Off Label!!!”

1. Which of the following drugs has been used to enhance the chances of delivering a baby in patients with Factor 5 Leiden and what is the mechanism of benefit?
a) Thiazide diuretics; reduced placental calcium that stops crystalline umbilical cord blockage
b) LMWH; preventing placental thrombosis in patients who are hypercoagulable
c) Disopyramide – decreasing the inotropic effect in hypertrophic cardiomyopathy that leads to placental detachment

2. Which of the following drugs is effective for treating anal fissures and what is the mechanism of action?
a) IV iron; iron deficiency anemia promotes fissure formation so treating it reverses fissure
b) Amiodarone; overactive potassium channels in the anus lead to apoptosis of anal mucosal cells
c) CCBs; Blood vessel dilation enhancing blood flow to targeted areas in the body

3. Which of the following drugs is properly linked to the off-label indication it is commonly used for?
a) Beta-blockers – Raynaud’s phenomenon
b) Prazosin – Nightmares in PTSD patients
c) Clonidine – Stage fright

4. Which of the following drugs is used off label for the treatment of abnormal face and body hair growth in patients and what is the mechanism of action?
a) Spironolactone – blocking the effects of testosterone in several ways
b) Beta-blockers – blocking epinephrine induced follicular stimulation
c) Clonidine – central outflow of norepinephrine causes abnormal hair growth

5. Sally Sue has had atrial fibrillation for several months. Her cardiologist has prescribed several therapies that have been ineffective, and one that is on the drug shortage list and hard to find. Which of the following might the cardiologist use off-label according to the AHA/ACC Guideline?

a) Calcium channel blockers
b) Prazocin
c) Amiodarone

Antipsychotic Utilization in a Pediatric Population-RECORDED WEBINAR

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-043-H01-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Antipsychotic Utilization in a Pediatric Population

Megan Ehret, PharmD

1. Which medication is a first-line treatment option for a 14-year-old patient with newly diagnosed schizophrenia?
a. Divalproex Sodium
b. Haloperidol
C. Risperidone

2. Which medication is a first-line treatment option for a 16-year-old patient with bipolar disorder, most recent episode depressed?
A. Aripiprazole
B. Divalproex Sodium
C. Lurasidone

3. Which medication can cause the most substantial weight gain?
A. Cariprazine
B. Lumateperone
C. Olanzapine

4. Which rating scale should be used to screen patients for tardive dyskinesia?

A. Extrapyramidal Symptom Rating Scale
B. Barnes Akathisia Rating Scale
C. Abnormal Involuntary Movement Scale

5. In which disease state would it be appropriate to initiate an antipsychotic medication in a pediatric patient?
A. Autism
B. Conduct Disorder
C. Intellectual Disability

Immunization: It is Now Time to Make it Unclear: Reconciling Differences between Public Health Vaccine Recommendations and FDA Product Labeling-RECORDED WEBINAR

Upon completion of this application based CE Activity, a pharmacist will be able to:

1. Compare and contrast the roles & activities of the Center for Biologics Evaluations and Research (CBER), US Food & Drug Administration (FDA), Centers for Disease Control & Prevention (CDC), and the Advisory Committee on Immunization Practices (ACIP) during the development and clinical use of vaccines in the United States.

2. Describe one specific example where the routine clinical use of a vaccine may differ from FDA-approved product prescribing information due to the following:

(a) costs, (b) disease epidemiology, (c) public acceptance, (d) vaccine supplies.

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-042-H06-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Immunizations (Aeschlimann) – Post-Test Questions

If asked, which of the following activities would the Food and Drug Administration decline to do and send to another agency?

Verify appropriate vaccine manufacturing processes
Approve advertising for vaccine products Reporting System (VAERS)
Determine the strategy for public use of vaccines in the U.S.

2.) Which of the following items would you expect to always/very-commonly see in the FDA-Approved product labeling for a vaccine product?

Instructions for preparation of the product and route of administration
Comparative effectiveness data for people taking chronic steroid therapy
Recommendations for use of lower doses in case of product shortages

3.) Which of the following is a correct example of a vaccination situation for which ACIP has issued “Shared Clinical Decision-making” (SCDM) guidance?

Intranasal influenza vaccine administration in immunocompromised persons
Respiratory syncytial virus vaccination for adults aged 60 years and older
Human papillomavirus vaccination for persons aged 16-21 years

4.) Which entity ultimately approves the content for FDA vaccine product labeling?

The Vaccines and Related Biological Products Advisory Committee
The Center for Biologic Evaluation & Research
The Center for Drug Evaluation and Research

5.) Which of the following people would be allowed to sit in the CDC’s Advisory Committee on Immunization Practices (ACIP)?

A member of a vaccine manufacturer’s current Board of Directors
A college professor whose expertise is mechanical engineering
A practicing physician who is an expert in virology and vaccine safety

6.) What does ACIP recommend after healthcare providers receive a full series of hepatitis B immunizations?

Serologic testing for all healthcare providers at high risk for occupational percutaneous or mucosal exposure to blood or body fluids.
Serologic testing for immunocomproised healthcare providers at high risk for occupational percutaneous of any type.
Molecular testing for all healthcare providers at high risk for occupational percutaneous or mucosal exposure to blood or body fluids.

Indication Deviation in Women’s Health: Off-Label Drug Use from Conception to Menopause-RECORDED WEBINAR

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-23-040-H01-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Pharmacist Post-test

Learning Objectives
After completing this continuing education activity, pharmacists will be able to
• RECOGNIZE diverse instances of off-label drug use in women's health, spanning pre-conception to menopause
• DISCUSS risks and advantages associated with off-label drug utilization during various reproductive stages
• IDENTIFY the pharmacist's role in advocating for safe and informed off-label drug use for women’s health

1. Which of the following can be treated through off-label use of metformin?
A. Hirsutism of PCOS
B. PCOS with BMI ≥ 25 kg/m2
C. Endometriosis

2. Which of the following medications is used off-label to induce ovulation in women experiencing infertility and trying to conceive?
A. Letrozole
B. Clomiphene citrate
C. Cetrorelix

3. Which of the following drugs is used off-label to treat menopausal hot flashes?
A. Clonidine
B. Paroxetine
C. Fezolinetant

4. Which of the following is TRUE about off-label medication use during pregnancy?
A. All drugs have sufficient efficacy and safety data to support their use during pregnancy
B. Providers should use the letter-based FDA rating system to aid in shared clinical decision-making
C. About three-quarters of pregnant women use medications for off-label uses during pregnancy

5. A patient comes to your pharmacy experiencing frequent hot flashes. She states that a friend suggested she try taking black cohosh. She takes lisinopril for hypertension and metformin for prediabetes, and she is otherwise healthy. Which of the following is the BEST response?
A. Black cohosh will interact with your blood pressure medication, so you should not take it. Ask your doctor about clonidine instead.
B. Black cohosh shows some benefit, but clinical trials are inconsistent and available data is insufficient. You can try taking 20 mg daily for a few weeks to see if your symptoms improve.
C. Black cohosh shows no benefit whatsoever for VMS of menopause. Ask your doctor about letrozole instead.

6. Which of the following is TRUE about Pregnancy Exposure Registries?
A. They steal data about women’s babies and sell it on the black market
B. They are FDA-sponsored registries that collect health information
C. Pregnant women volunteer to share their experiences with off-label drug use

PATIENT SAFETY: Biosimilar Doppelgangers-RECORDED WEBINAR

Upon completion of this application based CE Activity, a pharmacist will be able to:

Compare and contrast a small molecule drug from a biological drug

Compare and contrast how a reference biologic drug compares with its biosimilar

Describe where a pharmacist would identify a biosimilar product and the legal implications of a biosimilar achieving interchangeable status with a reference product

Describe the nocebo effect and how to prevent it from occurring

Apply the knowledge from the objectives above to specific patient care scenarios in the self-assessment questions

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-25-066-H05-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

Patient Safety: Biosimilar Doppelgangers
25-066 Posttest

1. When a rituximab-arrx biosimilar is prescribed, how can you preempt the patient from falling victim to the nocebo effect?
a) Reinforce that biosimilars are inexpensive but equally effective and safe versions of the biologic they were taking
b) Go into the deep science and talk about tertiary protein folding difference but that they are not in the critical molecular areas
c) Tell them about how the deep state is out to get them and that taking a biosimilar leads to brainwashing impelled prescribing of 5G linked vaccines that makes people “Libtards”

2. You made the substitution to rituximab-arrx and three years go by with no issues. Then the efficacy starts to wane, and some flair ups occurs. What is the best course of action for the patient?
a) Switch back to the reference biologic rituximab
b) Switch to another biosimilar rituximab-pvvr
c) Switch to a biologic drug in another class

3. A patient has been successfully taking adalimumab-ryvk for a year now but, due to a supply chain issue, you do not have it in stock. Can you automatically substitute it for adalimumab-adbm?
a) You would look at the Purple Book and if one of them is an interchangeable biosimilar, the answer is yes
b) You can always automatically substitute a biosimilar to another biosimilar regardless if one is interchangeable or not
c) You are not allowed to automatically swap out one biosimilar for another even if they are both interchangeable with a reference (you need to call the prescriber and get a new prescription)

4. How is a biosimilar different from a generic drug?
a) A biosimilar is a small molecule product while generic drugs are large molecule
b) A biosimilar requires both immunogenicity assessments and pharmacodynamic assessments while generic drugs do not
c) A generic drug requires both immunogenicity assessments and pharmacodynamic assessments while biosimilars do not

5. Which of the following would not promote defining something as a biologic?
a) Expensive price
b) Monoclonal antibody
c) Made from living cells

6. Which of the following is true of an interchangeable biologic product vs. a biosimilar?
a) In all states, pharmacists can automatically substitute an interchangeable biologic product for an innovator product but would need a new prescription to dispense a biosimilar without interchangeable status.
b) Interchangeable biologic products are likely to have the same efficacy and safety as biosimilar products without interchangeable status.
c) The FDA is considering making interchangeable status harder to obtain by strengthening the evidence standards.

Hormone Therapy’s Twin Faces: Sorting Science from Misconception-RECORDED WEBINAR

Upon completion of this application based CE Activity, a pharmacist will be able to:

Discuss the clinical evidence on safety, efficacy, and patient outcomes for hormone replacement therapy (HRT), highlighting areas of misconception or confusion

Compare HRT options and bioidenticals, including mechanisms of action, formulations, and regulatory pathways

Apply guidelines and evidence-based recommendations to individualize patient counseling and therapeutic decision-making when managing HRT

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs) for completing the activity ACPE UAN 0009-0000-25-067-H01-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

1. Which statement BEST reflects current evidence regarding the safety of hormone replacement therapy (HRT)?
A. HRT is associated with increased cardiovascular and cancer risk regardless of age or timing
B. HRT’s benefit-risk profile is favorable when started before age 60 or within 10 years of menopause
C. HRT should generally be avoided due to persistent risks identified in early WHI trial reports

2. Which menopausal symptom is MOST effectively treated with systemic estrogen therapy?
A. Vasomotor symptoms, such as hot flashes and night sweats
B. Isolated vaginal dryness without other menopausal complaints
C. Mild urinary symptoms without associated vasomotor complaints

3. Which statement accurately compares FDA-approved bioidentical hormones with compounded bioidentical hormone products?
A. Both FDA-approved and compounded bioidentical hormones undergo the same regulatory review
B. Compounded bioidentical hormones are preferred because they are more natural and tailored to patient needs
C. Only FDA-approved bioidentical hormones have standardized dosing and known safety profiles

4. Which statement BEST describes the FDA’s November 2025 updates to boxed warning language for HRT?
A. All boxed warnings were removed after evidence showed WHI studies reflected inaccurate data regarding HRT risks
B. Boxed warnings were expanded to emphasize cardiovascular and dementia risks in newly menopausal women
C. Boxed warnings were revised to better reflect age- and timing-specific risk while retaining key safety information

5. A 52-year-old woman who is 2 years postmenopausal presents with bothersome hot flashes and night sweats that are disrupting sleep and daily functioning. She has an intact uterus, no history of cardiovascular disease or venous thromboembolism, and is concerned about cancer risk after reading older media reports about hormone therapy. Which counseling and treatment approach is MOST appropriate?
A. Recommend low-dose transdermal estrogen combined with a progestin and discuss individualized benefits and risks
B. Advise against hormone therapy due to patient age and persistent safety concerns and recommend nonhormonal options only
C. Suggest compounded bioidentical estrogen therapy to minimize systemic exposure and long-term cardiovascular and cancer risks

About this Course

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Accreditation Statement

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CONTENT

Posttest

Handouts

About this Course

Learning Objectives

Additional Information

Accreditation Statement

Grant Funding

Faculty

Faculty Disclosure

Disclaimer

CONTENT

Handouts

About this Course

Learning Objectives

Additional Information

Accreditation Statement

Grant Funding

Faculty

Faculty Disclosure

Disclaimer

Content

Post Test (for viewing only)

Handouts

About this Course

Learning Objectives

Additional Information

Accreditation Statement

Grant Funding

Faculty

Faculty Disclosure

Disclaimer

Content

Post Test

Post Test

Handouts

About this Course

Learning Objectives

Additional Information

Accreditation Statement

Grant Funding

Faculty

Faculty Disclosure

Disclaimer

Content

Handouts

About this Course

Learning Objectives

Additional Information

Accreditation Statement

Grant Funding

Faculty

Faculty Disclosure

Disclaimer

Content

Post Test

Post Test

Handouts

About this Course

Learning Objectives

Additional Information

Accreditation Statement

Grant Funding

Faculty

Faculty Disclosure

Disclaimer

Content

Handouts

Post Test

About this Course

Learning Objectives

Additional Information