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VSHP May Newsletter 
VSHP Elections Results

The following members have been elected to serve on the VSHP Board.

President-elect

Craig Kirkwood

 

Secretary

Natalie Nguyen

 

Board member at large

Scott Lang

 

Technician Rep

Leah West

 

Region 1 President-elect

Donna Shuler Truoccolo

 

Region 2- President-elect

Caitlin Prather

 

Region 3 President-elect

Jonathan Dubyk

 

Region 4 President-elect

Erin Hickey

 

Region 5 President

Sarah Ladd

 

Region 7 President

Amber Weisner

 

Region 8 President

June Javier

 

Region 8 President-elect

Anna Donnis

 

VSHP CONDUCTING MEMBER SURVEY-INPUT REQUESTED

VSHP is a member-driven organization and as such our success is dependent on meeting the diverse needs of our colleagues practicing in various settings across the state. The VSHP Board of Directors would like to solicit your ideas and opinions on current programming offered by VSHP as well as identify new opportunities to enhance the organization's value to our membership.   

Below is a link to a member survey which is designed to help us better understand your needs.  Please visit the link below.


Please take a few minutes of your time to provide us with this important input.  
We kindly request your response by  June 5, 2020.   The first 50 members to complete the survey will be entered into a drawing for a $25 Amazon gift card.
Thank you for your participation and your support of VSHP
Virginia Board of Pharmacy Update

The Virginia Board of Pharmacy convened a virtual meeting on May 18, 2020 (virtual meetings of government bodies during the COVID-19 public health emergency have been allowed by the Governor and General Assembly). The agenda packet can be found here.

Public Hearings and Adoption of Minutes
All Board members were present. There was no public comment for the Public Hearing on Placement of Chemicals into Schedule I and Conforming Drug Schedules to Actions Taken by DEA.
All minutes from the previous Board of Pharmacy meetings listed on the agenda were approved.
Christina Barille, VPhA, stated that pharmacists are prepared to offer COVID-19 testing and vaccinations. She mentioned HB 1506 (Sickles) from the 2020 General Assembly Session regarding pharmacist scope of practice as a positive initial step (more on HB 1506 below).
Three representatives spoke on behalf of Covetrus Maine, an internet and mail delivery pharmacy that provides pharmacy services to veterinarians and is licensed in Virginia as a non-resident pharmacy. See p. 150 in the agenda packet and the New Business section below for more information.

Department of Health Professions (DHP) Director's Report
Dr. David Brown mentioned that the Board of Pharmacy has issued various waivers to address COVID-19. DHP's various other regulatory boards have also issued waivers to address licensure and continuing education, and the Governor issued an executive order to increase the healthcare workforce during the COVID-19 public health emergency.
DHP is working on electronic participation for regulatory board members and members of the public when in-person meetings resume, provided that an in-person quorum of the Board will be required.
Some teleworking among DHP staff will likely continue after the public health emergency.
Legislative/Regulatory/Guidance
Elaine Yeatts, DHP Senior Policy Analyst, reviewed the list of General Assembly Post Session Studies/Reports on p. 43 of the agenda packet, particularly the extensive "rewrite of pharmacist scope" required by HB 1506. Board member Kristofer Ratcliffe stated that he wants to make sure frontline pharmacists are involved in the pharmacist scope study. VSHP is sending a letter to the Board regarding the various stakeholder groups we will engage in.
At the Reconvened Session on April 22, 2020, the General Assembly accepted the Governor's amendments to SB 976 (Marsden) pertaining to pharmaceutical processors and cannabis dispensing facilities. The major change was to replace the two definitions of CBD and THC-A oils with a single definition of cannabis oil.
As a result of COVID-19, study reporting deadlines may be extended if requested by DHP. No activity has been conducted on the various studies, and staff will likely ask for an extension on the 2020 deadlines.
The Virginia Joint Commission on Health Care request on statewide standing protocols is similar to the stakeholder group created by HB 1506. Staff will determine if both studies can be addressed in the same work group, which is expected to begin this summer.

Chart of Regulatory Actions (p. 60). Ms. Yeatts stated that the adopted fee increase was approved by the Secretary of Health and Human Resources and is now awaiting action at the Governor's office. The fee increase needs to go into effect by this fall in order to avoid a possible budget deficit at the Board of Pharmacy.
Adoption of Exempt Regulation to Schedule Certain Chemicals into Schedule I (pp. 61-70) - Adopted.
Adoption of Exempt Regulation to Conform Drug Schedules to Actions Taken by DEA (pp. 71-83) - Adopted.
Adoption of Final Regulations for Delivery of Prescription Devices (pp. 84-88) - Adopted.
Adoption of Final Regulations for Delivery of Dispensed Prescriptions, Labeling (pp. 89-93).Chair Cynthia Warriner stated that she remains concerned about the lack of certain contact information on the label for the pharmacy where the prescription is picked up that could lead to confusion, especially for senior citizens. She also stated that the public comment period for the proposed regulations was during the height of the COVID-19 emergency, which may have deterred public input.
Ms. Juran stated that she received a message from a lobbyist requesting that the public comment period be extended. Ms. Yeatts stated that the Board can vote to extend the public comment period, and that notice is required. The public hearing for this matter was canceled as part of the March Board meeting that was canceled due to the public health emergency.
The Board voted to extend the public comment period to, and schedule a public hearing at, the June Board meeting for this item.
Adoption of Proposed Regulations for Pharmaceutical Processors (pp. 94-125) - Adopted.
Adoption of Final Regulations for White Bagging and Brown Bagging (pp. 126-135) - Adopted.
Adoption of Regulatory Amendments for Handling Fee for Returned Check (pp. 137-149) - Adopted. Raises the fee to $50 from $35 consistent with other regulatory boards.
New Business
Consideration of certification from a substantially similar program approved by the Board for nonresident pharmacies (§ 54.1-3434.1(A)(4)) (pp. 150-156) - The Board voted to waive the VIPPS certification but require an approved credential. Staff will draft a Guidance Document on acceptable credentials for consideration at the June Board meeting.
Chairman's Report
Chairman Warriner stated that the 2 years of experience requirement for PIC eligibility went into effect on December 11, 2019 and has created some confusion and questions to the Board. The Board can grant an exemption for good cause shown. Staff will draft guidance for the June meeting formalizing the process for exemption requests, including for when a PIC moves to a new store vs. staying at the same store when the PIC has less than 2 years of experience.
Board of Health Professions Report
Board member Ryan Logan reported that there were 50% more bills related to healthcare this General Assembly session. He highlighted the pharmaceutical processor program and licensing of dispensaries, Art Therapists which will now be licensed under the Board of Counseling, and Music Therapists which will now be licensed under the Board of Social Work.
Other items
There were no presentations on the remaining agenda items. Please refer to the agenda packet for any written documentation provided.
Caroline Juran has been elected President-Elect of the National Association of Board of Pharmacy (NABP). Please congratulate her in this exciting accomplishment!   https://nabp.pharmacy/newsroom/news/nabp-2020-2021-executive-committee-inaugurated-at-associations-116th-annual-meeting
NOTE: This virtual Board of Pharmacy meeting was not eligible for live CE credit.
 
The next Board meeting is scheduled for June 16, 2020 at 9:00 AM.

FREE CE for VSHP Members! 

Webinar-Wednesday, June 3, 2020 - 7:00pm- 8:00 pm
One hour of live CE
Sponsored by VSHP Region 2

Title:  Optimizing Medication Safety Among Culturally Diverse Patients
 
Presenter:
Nkem Nonyel, Pharm.D., MPH, BCPS
Assistant Professor of Pharmacy Practice
UMES School of Pharmacy
 
Learning Objectives:
  • Explain at least two medication safety issues among culturally diverse patient populations.
  • Describe at least two strategies for promoting medication safety among patients form diverse cultural backgrounds.
  • Given a case scenario with patient-related cultural variables, provide patient education to optimize medication safety.-Characterize postpartum depression and its impact
Virginia Society of Health-System Pharmacists is accredited by the Acc reditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Participants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 1.0 contact hours (0.10 CEU) submitted to CPE Monitor as early as 1 days after the event and no later than 60 days after the event. The participant is accountable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.

UAN # 0108-0000-20-030-L05-P; 0108-0000-20-030-L05-T
This is a member service of VSHP.  There is no charge for members to attend.   Dues must be current to receive CE credit.
Non-members will be charged $20.
 



FREE LIVE CE for VSHP Members! 
Webinar-VSHP Virtual Residents Presentations

Thursday, June 4, 2020 - 1:00pm- 5:15 pm and Friday, June 5, 2020 -9:30am- 2:00pm

CE will be available for each hour of participation. You do not have to attend the entire program. You can attend hour long sessions as you are able.

There are 3 different registration links.
 
Schedule
Thursday
1p-2p
Evaluating the impact of a pharmacy led transitions of care bundle on high risk patients
Effect of Pharmacist-driven Efforts to Reduce Alert Fatigue Associated with Drug-drug and Drug-disease Interactions
Analyzing the new implementation of a sedation protocol for critically ill patients receiving mechanical ventilation in the intensive care unit
2p-3p
            The impact of a pharmacist within a heart failure transitions clinic
Hospital Readmission Rates for Patients with Venous Thromboembolism who Use a Meds to Beds Service at Discharge
Impact of a pharmacist-initiated allergy screening tool in patients with a self-reported penicillin allergy
3:15-4:30p
Effect of Scheduling Gabapentin as a Controlled Substance on Discharge Prescribing Patterns
Comparison of IV Push versus IV Piggyback on Timely Administration in ED Sepsis Patients
Antimicrobial Stewardship in Transitions of Care
Evaluating the Impact of a Chronic Obstructive Pulmonary Disease Transitions of Care Program in a Managed Care Setting
 
Friday
8:30a-9:30a
Assessment of scheduling cyclobenzaprine as an opiate-sparing method through pharmacist-led education for multimodal muscle pain regimens
Impact of pharmacist intervention on the safety of fentanyl infusions in mechanically ventilated adults.
Limiting the Use of Sulfonylureas at a Community Hospital
 
9:30a-10:30a
Association Between Utilization of an Order Set and Discharge on Guideline Directed Medical Therapy in Heart Failure with Reduced Ejection Fraction Patients.
Impact of pharmacist intervention on the safety of bridging anticoagulation in a community hospital
Optimization of antibiotic duration for community-acquired pneumonia patients in a community hospital
10:45-11:45a
Comparison of safety with traditional dosing vs. BMI-based dosing of IV acyclovir
Evaluation of outcomes in hospitalized patients treated for asymptomatic bacteriuria in a community hospital setting 
Improving Direct Pharmacist Counseling Rates for Oral Oncolytic Medications at an Outpatient Oncology Clinic
 
1p-2p
Assessing pembrolizumab and nivolumab in the development of immune-related adverse events (irAEs)
The Impact of a Pharmacist-led Protocol on Optimizing Heart Failure Medications
Evaluation of Provider Interpretation and Implementation of the 2019 American College of Cardiology and American Heart Association Aspirin for Primary Prevention guideline recommendations for older adults

Virginia Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Participants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for up 7.25 contact hours (0.725 CEU) submitted to CPE Monitor as early as 14 days after the event and no later than 60 days after the event. Please know that if accurate e-Profile information is not provided within 50 days of the event, credit cannot be claimed after that time. The participant is accountable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.

This is a member service of VSHP.  There is no charge for members to attend.   Dues must be current to receive CE credit.
Non-members will be charged $20.

After registering, you will receive a confirmation email containing information about joining each webinar.
FREE CE for VSHP Members! 

Webinar-Thursday, June 18, 2020 - 12:00pm- 1:00 pm
One hour live CE

Title:  A Tale of Two Antivenins

Presenter:
Lorrie LeClair, PharmD, BCPS
Clinical Pharmacy Specialist, Emergency Medicine
Inova Fairfax Medical Campus

Learning Objectives-Pharmacists and Pharmacy Technicians:
1. Identify basic first-aid and wound management principles that should be applied to all patients with snakebites.
2. Compare and contrast characteristics and venom profiles of common venomous snakes found in the United States.
3. Describe differences between the two antivenins currently available in the United States.

Virginia Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Participants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 1.0 contact hours (0.10 CEU) submitted to CPE Monitor as early as 1 day after the event and no later than 60 days after the event. The participant is accountable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.
UAN # 0108-0000-20-029-L01-P; 0108-0000-20-029-L01-T

This is a member service of VSHP.  There is no charge for members to attend.   Dues must be current to receive CE credit.
Non-members will be charged $20.

 
 
After registering, you will receive a confirmation email containing information about joining the webinar.

VSHP Leadership Profile
Matthew Morrisette
 
What is your current leadership position in VSHP?
President elect of Region 1
 
What benefits do you see in being active in a professional association such as VSHP?  
 
I believe I have benefited most from learning directly from the leaders in our profession. Having the opportunity to work with such a motivated and dedicated group of people has influenced my work ethic and professional growth in a positive way.
 
What initially motivated you to get involved in VSHP?
 
I became involved in VSHP as a PGY-2 resident when I was recruited by the current Region 1 president to attend a meeting. I appreciated the idea of getting to interact with my pharmacy colleagues outside of the hospital setting, working towards bigger, career changing goals.
 
Where did you go to pharmacy school?
 
I attended the Medical University of South Carolina College of Pharmacy from 2010-2014.
 
Where have you trained or worked?  
I completed PGY-1 training at Carolinas Medical Center in Charlotte, NC and PGY-2 training in Critical Care at the University of Virginia Health System (UVHS). I accepted a clinical position at UVHS following residency and remain in that position today.
 
Describe your current area of practice and practice setting:
 
I am a critical care clinical pharmacist working primarily in a thoracic and cardiovascular surgical ICU.
 
What advice would you give to student pharmacists?
 
Take advantage of every opportunity you can while in a dedicated learning environment. The more exposure to different practice settings you can obtain will only influence your perspectives in a positive way. Discovering and maintaining a high level of intellectual curiosity will set you up for success in whichever path your career leads.  
 
What pharmacy related issues keep you up at night?
 
Inappropriate angiotensin II usage.
 
Do you have any special interests or hobbies outside of work?
 
Sailing, snowboarding, and hanging outside with my family.
 
What is your favorite place to vacation?
 
BVI's
 
What 3 adjectives would people use to best describe you?
 
Easy-going
Curious
Motivated

Dueling with Antiplatelet Therapy:
Which Medication Should We Choose and For How Long?
 
Lana Lyon, PharmD, PGY1 Sentara Healthcare Hampton Roads Resident
 
Dual antiplatelet therapy (DAPT) has a variety of indications for patients in the hospital setting including stable ischemic heart disease (SIHD), acute coronary syndrome (ACS), and stroke. 1 For the purposes of this article the focus will be on coronary artery disease (CAD) and DAPT, as this subject has the most emerging evidence available.
 
DAPT consists of low dose aspirin, usually less than 100 mg daily, and a P2Y12 inhibitor. 1 Aspirin inhibits platelet activation by irreversibly binding to cycloxygenase-1 (COX-1). 2 P2Y12 inhibitors consist of reversible and irreversible inhibitors that block adenosine diphosphate (ADP) from binding to the P2Y12 receptor which stops the activation of platelets. 3 A further look into the differences between P2Y12 inhibitors can be found in Table 1.
 
DAPT Drug Comparisons
 
When placing a patient on DAPT, practitioners often inquire which P2Y12 inhibitor is best for each particular patient. Multiple factors need to be considered when selecting a P2Y12 inhibitor. For example, clopidogrel is a prodrug that must be activated by the cytochrome P450 (CYP) CYP2C19 enzyme. If the patient happens to be a poor metabolizer of CYP2C19, then clopidogrel may seldom reach the active form and, therefore, will not work effectively in those patients. Prasugrel is also a prodrug, but a patients' genetic differences will not affect this medication like clopidogrel. 3 However, prasugrel should not be used in patients who have had a stroke or transient ischemic attack (TIA) in the past, whereas clopidogrel does not carry the same warning. 1,3 Cangrelor is the only P2Y12 inhibitor available in intravenous (IV) form and has a fast onset of action with steady state being reached within 30 minutes. 3
 
There have been multiple major trials comparing P2Y12 inhibitors in patients experiencing ACS, including the TRITON-TIMI 38 Trial, the TRILOGY ACS Trial and the PLATO trial. 4,5,6 In the TRITON-TIMI 38 Trial, the authors wanted to compare prasugrel against clopidogrel in patients undergoing percutaneous coronary intervention (PCI). Prior to this trial, it was expected that prasugrel would be superior to clopidogrel in this population because prasugrel has been shown to inhibit platelet aggregation on a more consistent basis than clopidogrel. In this trial prasugrel was found to have a statistically significant lower incidence of the primary composite endpoint of cardiovascular causes, nonfatal myocardial infarction (MI), or nonfatal stroke, when compared to clopidogrel. However, prasugrel was found to have a statistically significant higher incidence of non-coronary artery bypass graft (CABG) related thrombolysis in myocardial infarction (TIMI) major bleeding when compared to clopidogrel. 4
 
In the TRILOGY ACS Trial, prasugrel was compared to clopidogrel in patients who did not undergo PCI but were medically managed only for ACS. In this trial prasugrel was not found to be any better than clopidogrel for the primary outcome of cardiovascular death, MI, or stroke. There was also no difference between clopidogrel or prasugrel for severe or life-threatening bleeding. 5 In general, the evidence has shown mixed results whether prasugrel or clopidogrel is superior to one another.
 
However, there has been evidence that suggests ticagrelor is superior to clopidogrel in the PLATO trial. 6 In the PLATO trial, ticagrelor was compared to clopidogrel for patients with ACS. In this study ticagrelor was found to have a statistically significant decrease in the primary outcome of death from vascular causes, MI or stroke. There was no difference in major bleeding between the two medications, but ticagrelor was found to have a statistically significant higher rate of fatal intracranial bleeding and dyspnea. 6 The choice of the most appropriate P2Y12 inhibitor for a particular patient still remains unclear and must be based on individual patient risk factors and history.
 
Duration of DAPT
 
Practitioners are also faced with how long to keep a patient on DAPT. Current literature suggests that shorter durations of DAPT therapy are equally effective as longer duration therapy, and also have less incidents of bleeding side effects. 7,8 For example, in the SMART-CHOICE Trial, patients who had undergone PCI were randomized to either 3 months of DAPT followed by 9 months of monotherapy with a P2Y12 inhibitor or 12 months of DAPT. This study found the 3 months of DAPT followed by 9 months of monotherapy with a P2Y12 inhibitor was non-inferior to 12 months of DAPT for the primary outcome of a composite of all-cause mortality, MI, or stroke. Adverse bleeding events were found to be statistically lower in the group treated with 3 months of DAPT followed by P2Y12 inhibitor monotherapy when compared to the group treated with 12 months of DAPT. 7
 
The STOPDAPT-2 Trial also focused on duration of therapy of DAPT after an ACS. This trial similarly focused on patients who had undergone PCI and were either randomized to 1 month of DAPT followed by monotherapy with clopidogrel, or 12 months solely of DAPT. This trial found that one month of DAPT followed by monotherapy with clopidogrel had less incidence of the primary end point of composite of cardiovascular death, MI, definite stent thrombosis, ischemic or hemorrhagic stroke, or TIMI major or minor bleeding compared to 12 months of DAPT. Bleeding adverse events were also less likely to occur in the 1 month DAPT group followed by clopidogrel therapy compared to the group exposed to 12 months of DAPT. 8
 
Although the data suggests there is no difference in shorter duration of DAPT, the 2016 ACC/AHA guidelines still recommend 12 months of DAPT after PCI in ACS. 1 However, these guidelines do not address the concern for patients who are at high ischemic risk and low bleeding risk after ACS that may require longer duration of DAPT. 8 Conversely, recent data is promising for high bleed risk patients who may need only a short duration of DAPT. 7,8
 
Scores have been developed to help practitioners determine whether their patient is at high bleeding risk or high ischemia risk. The DAPT score, outlined in the 2016 ACC/AHA guideline, is a scoring tool to help decide whether a patient is a high bleeding risk or high ischemia risk. A score greater than or equal to 2 suggests that the patient is at a high thrombosis risk, and longer DAPT would be beneficial. Scores less than 2 suggests that the patient is at a high bleeding risk and a short duration of DAPT is more favorable for the patient. 1 Another scoring tool called the PRECISE-DAPT score was created to determine risk of out-of-hospital bleeding while on DAPT. This score accounts for the patients' age, creatinine clearance, hemoglobin, white blood cell count, and previous spontaneous bleeding. The PRECISE-DAPT score suggests that high bleeding risk is a score greater than or equal to 25, and a low bleeding risk score is less than 25. If the patient is at a high risk of bleeding, then it has been shown that less than 12 months of DAPT may be beneficial in this group of patients. Patients who are not a high risk for bleeding according to their PRECISE-DAPT score are able to receive the standard length of therapy of DAPT. 9
 
As healthcare practitioners, we should always look at a patient as a whole when deciding medical therapy and making recommendations. For DAPT, this principle is especially important when deciding which P2Y12 inhibitor to initiate for a patient and for determining the length of therapy. Genetics, cost, and past medical history should all be taken into account when deciding the right P2Y12 inhibitor for a patient. Ischemic risk as well as bleeding risk should be weighed when determining the length of therapy for DAPT. Not every patient fits exactly into the guidelines that are written, and this is why we develop our clinical judgement to determine the best course of action for our patient.
 
Table 1:
P2Y12 Inhibitors3,10,11,12,13,14
Medication
Type
Dose
Other
Clopidogrel
  • Irreversible
  • Thienopyridine
  • 300 mg oral loading dose followed by 75 mg once daily
  • Prodrug

Prasugrel
  • Irreversible
  • Thienopyridine
  • 60 mg oral loading dose followed by 10 mg daily
  • 5 mg daily if < 60 kg

  • Prodrug
  • Do not use in hx of stroke or TIA

Ticagrelor
  • Reversible
  • Cyclopentyl triazolopyrimidine
  • 180 mg oral loading dose followed by 90 mg twice daily for first year
  • After 1 year 60 mg twice daily

  • Active moiety

Cangrelor
  • Reversible
  • Stabilized ATP analog
  • 30 µg/kg IV bolus prior to PCI followed by 4 µg/kg/min IV infusion for at least 2 hours or duration of procedure (whichever is longer)

  • Only IV form
  • Active moiety

*hx: history, TIA: transient ischemic attack, IV: intravenous
   
Resources
  1. Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease. JACC. 2016;68(10):1082-115
  2. Espinosa EP, Murad JP, and Khasawneh FT. Aspirin: Pharmacology and Clinical Applications. Thrombosis. 2012;2012:1-15
  3. Damman P, Woudstra P, Kuijt WJ, et al. P2Y12 Platelet Inhibition in Clinical Practice. J Thromb Thrombolysis. 2012;33:143-153
  4. Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndromes. NEJM. 2007;357(20):2001-2015
  5. Roe MT, Armstrong PW, Fox KAA, et al. Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization. NEJM. 2012;367(14):1297-1309
  6. Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes. NEJM. 2009;361(11):1045-1057
  7. Hahn J, Song YB, Oh J, et al. Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial. JAMA. 2019;321(24):2428-2437
  8. Watanabe H, Domei T, Morimoto T, et al. Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial. JAMA. 2019;321(24):2414-2427
  9. Costa F, van Klaveren D, James S, et al. Derivation and Validation of the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) Score: A Pooled Analysis of Individual-Patient Datasets from Clinical Trials. Lancet. 2017;389:1025-34
  10. Plavix (clopidogrel bisulfate) FDA Package Insert. 1997
  11. Effient (prasugrel) FDA Package Insert. 2009
  12. Brillinta (ticagrelor) FDA Package Insert. 2011
  13. Kengreal (cangrelor) FDA Package Insert. 2015
  14. Acute Coronary Syndromes. In: Wells BG, DiPiro JT, Schwinghammer TL, DiPiro CV. Wells B.G., DiPiro J.T., Schwinghammer T.L., DiPiro C.V. Eds. Barbara G. Wells, et al.eds. Pharmacotherapy Quick GuideNew York, NY: McGraw-Hill; http://accesspharmacy.mhmedical.com.proxy.library.vcu.edu/content.aspx?bookid=2177§ionid=165471451. Accessed March 05, 2020.
Members in Spotlight

Please help us highlight members by emailing contact@vshp.org

Did You Know...

If you were unable to attend our live webinars, you can view them at http://vshp.org/Webinars
 
There are 2 options for viewing-one with one hour of pharmacist or pharmacy technician CE credit ($10 CE processing fee) and one without CE.

Clinical Writing Opportunities for APPE Students

As a new year of APPE rotations begin, writing a clinical article for the VSHP newsletter is a great way for students to get publication experience. As preceptors we can co-author these articles with our students, engage them in the writing process, and enhance their rotation experiences. Topics can be anything related to hospital-system pharmacy. Examples include (but are not limited to): new drug updates, national policy updates for hospital pharmacy, guideline updates, therapeutics reviews, and clinical controversies. Articles are generally 1-3 pages in length, and can include tables and figures. Interested member and students should email Steve Glass, contact@vshp.org for more details.

 
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