Improving Outcomes in Patients with Traumatic Brain Injury

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Activity Dates: 04/19/2010 - 04/19/2013

This course is closed. Please look for other available products in CPNP University.

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the comprehensive medication management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Session Summary

Traumatic brain injury (TBI) is a significant health problem in the United States, and a frequent cause of disability in young individuals. The Wars in Iraq and Afghanistan have heightened the public awareness of this condition and resulted in an increasing number of individuals presenting for treatment due to concern of a suspected TBI. In order to best manage the sequelae of TBI, providers must understand important prognostic factors which impact clinical outcome including injury severity and co-morbid conditions.

This presentation will provide a survey of the recent literature on clinical outcomes after TBI, pharmacological interventions for common post-injury sequelae, and the effects of co-occurring psychiatric conditions on post-concussive symptoms. This lecture will emphasis recent literature about individuals sustaining combat-related traumatic brain injuries, as well as clinical practice guidelines for management of TBI in the post-acute phase.

Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

Review the full content of the activity and reflect upon its teachings.
Complete the post-test at the end of the activity no later than the closing activity date. (login first)
Complete the evaluation at the end of the activity. (login first)
Receive a passing grade (60%).
Provide the necessary details in your profile to ensure correct reporting by CPNP to CPE Monitor. (login first)

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

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Faculty Information and Disclosures

Amy Bowles, MD
Douglas Cooper, PhD

View biographical information and disclosures

Amy Bowles, MD
Chief, Traumatic Brain Injury Program
Brooke Army Medical Center
San Antonio, TX

Dr. Bowles grew up in Houston, Texas and graduated from Rice University in 1995. She was a Rice/Baylor Medical Scholar and received her medical degree from Baylor College of Medicine in 1999. She then stayed at Baylor to complete her Internship in Internal Medicine. Dr. Bowles finished Residency in Physical Medicine and Rehabilitation (PM&R) through the Baylor College of Medicine and University of Texas Health Science Center Alliance in 2003. She is Board Certified in PM&R.

After completion of her Residency, Dr. Bowles moved to San Antonio to become the Medical Director of the Brain Injury Program at Reeves Rehabilitation Center, University Health Systems. In August 2007, Dr. Bowles moved to Brooke Army Medical Center where she is the Chief of the Traumatic Brain Injury Program. She has led the clinical and administrative development of the BAMC TBI Program which is widely recognized as a model for military TBI care. Dr. Bowles regularly participates in local, regional, and national forums where military TBI care is discussed.

Douglas Cooper, PhD
Clinical Neuropsychologist
Traumatic Brain Injury Program
Brooke Army Medical Center
San Antonio, TX

Dr. Cooper is a clinical neuropsychologistin the Traumatic Brain Injury Program in the Department of Orthopedics and Rehabilitation at Brooke Army Medical Center (BAMC).

In his current role, he is involved in the evaluation and treatment of service members with brain injuries, particularly in those returning from combat deployments. Dr. Cooper actively participates in teaching, supervision, and research. He has authored and co-authored peer-reviewed articles on a variety of neuropsychological syndromes, including traumatic brain injury, post-traumatic stress disorder, stroke, Alzheimer’s disease, and substance dependence. Dr. Cooper served as a member of the working group for the establishment of the Department of Defense and Veterans Healthcare System’s Clinical Practice Guidelines for mild Traumatic Brain Injury, as well as the Cognitive Rehabilitation Specialty subgroup guidelines.

Faculty Disclosures

Presentation will include discussion of off-label, experimental, and/or investigational use of drugs or devices: None

Learning Objectives

Compare symptoms of TBI for mild, moderate, and severe injury.
Recognize post-TBI medical complications including intracranial hypertension, posttraumatic seizures, coagulopathy and electrolyte disorders.
Describe possible long-term consequences associated with TBIoutcomes including disorders of pain, mood, cognition, movement and sleep.
Identify pharmacotherapeutic options for treatment of patients with TBI, including combination therapy.

Continuing Education Credit and Disclosures

Activity Dates: 04/19/2010 - 04/19/2013
ACPE Contact Hours: 1.0
ACPE Number: 0284-0000-10-011-H04-P (Knowledge)
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPE The College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This self-study course provides 1.0 contact hours (0.10 CEUs) of knowledge-based continuing education credit from CPNP approved programming. The ACPE universal program number assigned to this course is 0284-0000-10-011-L04-P (1.0 contact hours).

ACPE approved contact hours are accepted for ANCC Certification Renewal (see pages 5 and 6): At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:

Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
Continuing medical education (CME) approved for CME hours
Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration

View planning committee disclosures

2009-2010 CPNP Program and Recertification Committees

Name	Disclosures of Interest
Tami R. Argo, PharmD, BCPP Clinical Pharmacy Specialist-Psychiatry Iowa City VA Medical Center Iowa City, IA	Employment: Department of Veterans Affairs External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: CE Program - Iowa Pharmacy Association - January 2011 Educational Grants, Research Grants or Contracts: VA Research, McCabe Mental Health Research Grant, Iowa City, Iowa ($5,000)
Denise L. Beale, PharmD, BCPP Clinical Coordinator/Investigational RPh. St. Louis Clinical Trials LC St. Louis, MO	No Relevant Financial Relationships to Disclose
Nancy C. Brahm, PharmD, MS, BCPP, CGP Clinical Associate Professor University of Oklahoma Tulsa, OK	No Relevant Financial Relationships to Disclose
Ben Chavez, PharmD, BCPP Assistant Professor University of Hawaii at Hilo, College of Pharmacy Hilo, HI	No Relevant Financial Relationships to Disclose
Elizabeth Eichel, PharmD, BCPP, BCPS Clinical Pharmacist SHANDS Jacksonville Medical Center Jacksonville, FL	No Relevant Financial Relationships to Disclose
Martha P. Fankhauser, RPh, BCPP, FASHP Private Consulting Clinical Professor University of Arizona College of Pharmacy Tucson, AZ	Employment: Arizona Smokers' Helpline, The University of Arizona, Pharmacotherapy Specialist, Reed's Compounding Pharmacy, Neuropsychiatric Consulting Non-Financial Interests: Arizona Chapter of Tourette Syndrome Association - Board Member
Joshana K. Goga, PharmD, BCPP Program Committee Past Chair (2010) Clinical Specialist Sheppard Pratt Health System Towson, MD	Employment: Sheppard Pratt Hospital External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Stanley Foundation Non-Financial Interests: Maryland Governor's Council
James J. Gugger, PharmD, BCPP Assistant Clinical Professor St. John's University Jamaica, NY	No Relevant Financial Relationships to Disclose
Sally K. Guthrie, PharmD, BCPP Associate Professor University of Michigan Ann Arbor, MI	No Relevant Financial Relationships to Disclose
Beth M. Hall, PharmD, BCPP Clinical Pharmacist Fulton State Hospital Fulton, MO	Employment: Clinical Manager for Pharmacy Systems, Inc. placed at Fulton State Hospital External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: CPNP Review Course author/speaker
Cynthia K. Kirkwood, PharmD, BCPP 2011 BCPP Program Director Associate Professor Virginia Commonwealth University Richmond, VA	Employment: Virginia Commonwealth University, Associate Professor of Pharmacy
Phillip Lai, PharmD, BCPP Clinical Pharmacist CommUnity Care Austin, TX	No Relevant Financial Relationships to Disclose
Susan Lakey, PharmD, BCPP Clinical Assistant Professor University of Washington Seattle, WA	No Relevant Financial Relationships to Disclose
Kelly Lee, PharmD, BCPP, FCCP Assistant Professor of Clinical Pharmacy University of California La Jolla, CA	External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: MedImpact, California Department of Corrections and Rehabilitation, Otsuka America Pharmaceutical, Inc.
Rex S. Lott, PharmD, BCPP Professor of Pharmacy Practice Idaho State University - College of Pharmacy Boise, ID	External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Eisai Pharmaceuticals: Consultant
Jodie V. Malhotra, PharmD Clinical Pharmacy Specialist, Behavioral Health Denver Health Medical Center Denver, CO	No Relevant Financial Relationships to Disclose
Jehan Marino, PharmD, BCPP Assistant Professor of Pharmacy Practice Nova Southeastern University Fort Lauderdale, FL	Employment: Nova Southeastern University, Assistant Professor of Pharmacy Practice
Sarah T. Melton, PharmD, BCPP, CGP Associate Professor, Director of Addiction Outreach Appalachian College of Pharmacy Lebanon, VA	Employment: Appalachian College of Pharmacy, Director of Addiction Outreach, Associate Professor of Pharmacy Practice
Troy Moore, PharmD, MS, BCPP Clinical Pharmacy Specialist/Assistant Professor STVHCS/University of Texas HSC San Antonio San Antonio, TX	Employment: South Texas Veterans Health Care System, Clinical Pharmacy Specialist- Psychiatry, University of Texas Health Science Center at San Antonio, Assistant Professor External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Planning committee for the University of Texas College of Pharmacy Psychopharmacology Update
Andrew Muzyk, PharmD Assistant Professor/Clinical Pharmacist Duke University Hospital Durham, NC	No Relevant Financial Relationships to Disclose
Sudha Narayanaswamy, PharmD, BCPP Senior Clinical Pharmacy Specialist GNYHA New York, NY	Employment: GNYHA Services, Inc., Senior Clinical Pharmacy Specialist External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Pharmacy Consultant for Hemodialysis at a hospital in NJ, General Advisory Board, My Gateway to Overcoming Autism in Life, MyGoal, Inc
Leigh Anne Nelson, PharmD, BCPP Associate Professor University of Missouri-Kansas City Kansas City, MO	Educational Grants, Research Grants or Contracts: Otsuka, Eli Lilly
Gerald P. Overman, PharmD, BCPP* Board Liaison for 2011 Program Committee Clinical Pharmacy Specialist, NIMH National Institutes of Health Washington, DC *Dr. Overman is serving in his own personal capacity	No Relevant Financial Relationships to Disclose
Tawny L. Smith, PharmD, BCPP 2012 Program Committee Chair Clinical Pharmacy Specialist-Psychiatry Seton Family of Hospitals Austin, TX	Employment: Seton Family of Hospitals, Clinical Pharmacy Specialist - Psychiatry
Steve Stoner, PharmD, BCPP Clinical Professor and Chair University of Missouri at Kansas City School of Pharmacy Kansas City, MO	Employment: UMKC School of Pharmacy, Chair, Department of Pharmacy Practice and Administration, Clinical Professor External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Astra-Zeneca Speakers Bureau Educational Grants, Research Grants or Contracts: HRSA supported grant funding
Christopher Thomas, PharmD, BCPP, BCPS, CGP Clinical Pharmacist in Psychiatry Chillicothe VAMC Chillicothe, OH	Employment: Chillicothe VAMC (Clinical Pharmacist and Residency Program Director), Wife: Omnicare (Consultant/Clinical Pharmacist) Financial Interests: Omnicare, Pfizer, Merck, Glaxo, Lilly, Proctor and Gamble Stock
Heidi Wehring, PharmD, BCPP Assistant Professor of Psychiatry Maryland Psychiatric Research Center, University of Maryland School of Medicine Baltimore, MD	No Relevant Financial Relationships to Disclose
Jennifer L. Zacher, PharmD, BCPP 2011 Program Committee Chair Clinical Pharmacy Specialist Captain James A. Lovell Federal Health Care Center North Chicago, IL	No Relevant Financial Relationships to Disclose

View disclaimer and disclosure of off-label use

Off-Label Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA (see faculty information and disclosures). The opinions expressed in the educational activity do not necessarily represent the views of CPNP and any educational partners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Presentation-Specific Disclosure: None

Grant Support

This programming was supported in part by grants from Janssen, Ortho-McNeil Janssen Scientific Affairs, LLC, supported by an educational grant from Janssen, Division of Ortho-McNeil Janssen Pharmaceuticals, Inc. administered by Ortho-McNeil Janssen Scientific Affairs, LLC. and Lilly USA, LLC.

Annual Meeting Grant Supporter

This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit www.lillygrantoffice.com.

Recertification Education Grant Provider

Supported by an educational grant from Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., administered by Ortho-McNeil Janssen Scientific Affairs, LLC

This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit www.lillygrantoffice.com.